Feasibility of Presurgical Exercise in Men With Prostate Cancer Undergoing Prostatectomy: Beyond the Abstract

Prostate cancer (PCa) is one of the most common diagnosed cancer in men. For those with localized disease, radical prostatectomy is a primary curative treatment; however, it is associated with an array of side effects impacting on quality of life and includes incontinence, and reduced physical function.

The decline in physical function in the post-surgical period may be particularly detrimental given the age of the men and potentially low physical reserve capacity. Exercise with rehabilitative intent has been shown to be beneficial in reducing multiple adverse effects, such as fatigue, muscle mass and strength and physical function, cardiorespiratory fitness, as well as sexual function, in men following various PCa treatments but primarily radiation and androgen deprivation therapy. However, a more opportune time to intervene with physical exercise may be the pre-operative period to negate or attenuate the treatment-related adverse effects thereby aiding the tolerance to and recovery from surgery, and enhancing short- and long-term patient outcomes. This study evaluated the feasibility of a combined progressive resistance and aerobic exercise program undertaken before surgery and found that exercising does enhance muscle strength, physical function, and body composition. This study provides initial evidence for altering patient management so that men who are to undergo surgical treatment are prescribed physical exercise in order to get fit for surgery and beyond. This would then allow newly diagnosed PCa patients undergoing surgical treatment to be prescribed individualized exercise programs to get fitter and stronger for surgery.

Current recommended rehabilitation management strategies are relatively poor and if left unmanaged, these adverse effects can cause a negative spiral of physical and mental function. Translation of the findings that places a greater emphasis on pre-surgical fitness could result in lifelong benefits improving not only surgical recovery and accelerating the return to normal daily activities, but also providing the tools for leading a healthy lifestyle. Improving the post-surgical recovery period has the potential to reduce the dependence on pharmaceutical interventions, hospitalization time, and reduced overall costs.

Written by: Favil Singh

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