Prostate Cancer Coverage from Every Angle

Does Exercise Reduce PSA Levels and Growth of Localized Prostate Cancer?

By: Julia Fiederlein
Posted: Monday, September 27, 2021

According to Kerry S. Courneya, PhD, of the University of Alberta, Canada, and colleagues, higher levels of physical fitness and functioning during active surveillance of localized prostate cancer may ease adverse effects and lead to better cancer-related outcomes; however, data are limited in this clinical setting. Based on the single-center phase II ERASE trial results, which was published in JAMA Oncology, high-intensity interval training seemed to increase cardiorespiratory fitness levels and decrease prostate-specific antigen (PSA) levels, PSA velocity, and prostate cancer cell growth.

Patients with localized very low–risk to favorable intermediate–risk prostate cancer who were undergoing active surveillance were randomly assigned to undergo high-intensity interval training or usual care (n = 26 for both). The high-intensity interval training group was instructed to complete 12 weeks of thrice-weekly, supervised aerobic sessions on a treadmill at 85% to 95% of peak oxygen consumption. The usual care group maintained their normal exercise routine.

The rate of adherence to high-intensity interval training was 96%. The peak oxygen consumption increased by 0.9 mL/kg/min in the high-intensity interval training group and decreased by 0.5 mL/kg/min in the usual care group (P = .01). Patients in the high-intensity interval training group experienced decreased PSA levels (P = .04), PSA velocity (P = .04), and growth of the prostate cancer cell line LNCaP (P = .02) compared with those in the usual care group. The difference in testosterone levels or PSA doubling time between the groups did not appear to be statistically significant.

“To our knowledge, the ERASE trial was the first to demonstrate that high-intensity interval training increases cardiorespiratory fitness and inhibits the biochemical progression of prostate cancer in men on active surveillance,” the investigators remarked. “To support the findings of this trial and to determine whether the improvements can translate into better long-term clinical outcomes, larger randomized clinical trials are warranted.”

Disclosure: The study authors reported no conflicts of interest.

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