Healthy Living FOR Prostate Cancer PATIENTS AND Survivors PHYSICAL ACTIVITY AND EXERCISE NORDIC WALKING CYCLING RUNNING RESISTANCE BAND GYM SWIMMING WALKING FOOTBALL PILATES YOGA Healthy Living – 01 – November 2020 Living – 01 November Healthy TAI CHI DANCING Healthy Living FOR Prostate Cancer PATIENTS AND Survivors Physical Activity and Exercise ‘Healthy Living for Survivors of Prostate Cancer’ is being developed by PCaSO as an information guide to help persons impacted by prostate cancer. In future it will include other sections such as health of prostate cancer survivors, the immune system, diet and nutrition. It commences here with the section on ‘Physical Activity and Exercise’. Note: This is written for ‘normal times’, however due to the pandemic some activities will be constrained by whatever Covid-19 restrictions and advice are current, so you will need to interpret the information accordingly. Contents: The Benefits of Exercise ‘Leisure Activities and Sports’ Physical Activity – developing an active lifestyle Leisure centres Choosing exercise activities Swimming Setting Goals Walking Football ‘Pace’ of exercise Gym sessions Types of exercise / sport Pilates The ‘Green Gym’ Yoga Walking / Hiking Tai Chi and Qi Gong Nordic walking Dancing Cycling Enjoy a fitness lifestyle. Running The ‘Home Gym’ Summary and Links Gardening Principal Contributors Resistance band exercises If you have pre-existing conditions or have had recent Resistance training – suspension systems surgery, check with your GP before commencing Other ‘Home’ activities vigorous exercise. Exercise your Pelvic Floor muscles 2 Physical Activity AND Exercise This section is targeted at prostate cancer patients/survivors, who will typically be middle-aged or elderly. It is primarily for those who are not very fit, as well as those fitter persons wanting to improve their health through physical activity and exercise. It is never too late to make a difference! If, however you are already very fit it may still be helpful, as to reap full benefit your body needs various types of fitness, so you might wish to broaden the mix and type of your Being fitter is beneficial for men before treatment, as well exercise activities. as for ‘survivors’ of prostate cancer. The fitter you are before treatment the better the recovery time/outcome, especially You should take a sensible and gradual approach to exercise, for chemotherapy or surgery, but also other treatments such appropriate to your age, health and existing fitness level. as brachytherapy, radiotherapy or hormone therapy. A fit For anything new, start gently and recognise that you are healthy body and immune system can help overcome any trying to make a beneficial lifestyle change that may take trauma to the body caused by cancer treatment. On 27th time to build up to moderate levels, and accept that trying December 2019 ‘The Times’ newspaper reported that the to achieve ‘vigorous’ levels of exercise might be unsuitable if ‘NHS will offer fitness bootcamps to boost treatment’ to you are elderly, under treatment or have pre-existing health newly diagnosed cancer patients before they start treatment conditions. It would be wise to first consult your GP before to boost survival rates, by introducing a ‘prehab’ exercise embarking on any unaccustomed exercise activities. When regime of high-intensity cardiovascular workouts and you do exercise, if you get chest pain or extreme shortness of strength-based training. breath, stop the exercise and consult your GP. If you really wish to help your body combat prostate cancer, The Benefits of Exercise exercise is probably the number one thing you should do to Many trials evaluating exercise programmes have concluded help extend your life and lifestyle. that moderate activity can reduce fatigue, improve mood, psychological well-being and benefit body composition. The World Health Organisation (WHO) recommends at Other trials have linked exercise, especially if combined with least 150 minutes of moderate intensity physical activity other lifestyle changes, with a reduced rate of PSA (Prostate throughout the week (or 75 minutes of vigorous intensity) Specific Antigen) progression in men on Active Surveillance, see https://www.who.int/news-room/fact-sheets/detail/ and a reduced risk of relapse after radical treatments. physical-activity The NHS recommend a similar amount, see https://www.nhs.uk/live-well/exercise/. If you do, say, Regular exercise over the long term changes your energy 30 minutes exercise per day 5 days per week, this aerobic metabolism, lowers inflammation and oxidative stress (excess exercise works your lungs and heart, but be aware that of free radicals in the bloodstream), and improves immune muscle strength is also very important to our health. As we response. The associated ‘movement’ of one’s body also age our muscles get weaker, especially if we are ageing with helps ‘pump’ the lymph fluid through the lymphatic system high cancer risk, or are on hormone therapy. Muscle strength around all internal cells and organs - thus reducing the risk increases rapidly into early adulthood then declines naturally of ‘stagnation’ (akin to areas of still/sluggish water) and so from our 30’s at about 5% every ten years and declines keeping everything healthily flowing. Studies have shown that even more from our 60’s and 70’s. We need therefore to also faster-paced walking or vigorous exercise significantly reduced include resistance exercises at least two days a week, for the risk of prostate cancer recurrence or prostate cancer upper-body, lower-body and core muscle strength. Strength, death, compared with less intense or slower-paced exercise. endurance and balance training, even into our 70’s, 80’s and 3 90’s, can counteract some of the loss of muscle mass as we movement into your daily life will help keep your muscles age, helping to keep older persons on the move and providing engaged. Work on developing an active lifestyle outside of some protection against falls and frailty, especially with your exercise programme itself. Physical activity improves activities such as running and sports. the flow of blood supply, even gardening or cleaning the house can be beneficial. Try to spend less time sitting Some studies have also shown that strength training may down and limit it to 20-30 minutes before getting up for provide some protection against cardio-vascular disease, a break. You could move about while you watch TV, or type 2 diabetes and even cancer. choose active video games. And don’t forget to stand up regularly if you sit down to work. If you can do it safely, a total of three to five hours each week of exercise, moderate and vigorous aerobic, with If you are feeling weary, move and get active. It can make resistance training for strength on two days per week, plus you feel better. Get fitter by moving more. flexibility and balance training, can be most beneficial for your health. (The WHO advises that doing 300 minutes Choosing exercise activities a week, rather than the recommended minimum of 150 Find a sport or activity you enjoy, or do several different minutes, can bring additional health benefits). ones so you don’t get bored. You may get more benefit from a mix of activities than just one. Do not try too much Exercise is also a great way to relieve stress and hence at first, build up gradually. You might find it more fun improve mental wellbeing. to exercise with other people. Ask a friend or your wife/ partner to come with you, or join a sports team, a walking, Physical Activity - cycling or a running group. developing an active lifestyle Physical activity is something we evolved to do from Choose activities and activity levels you can manage our ancestors: being sedentary is not our natural state. If safely. Individuals with pre-existing health issues or you are elderly, but do not do some physical activity, you injuries should check with their GP before starting any might experience a ‘spiral of decline’ leading to frailty. new exercise. If you are on hormone therapy or have If you cannot stand up for long there are exercises you cancer that has spread to your bones, check with your can do whilst seated. Finding ways to incorporate more doctor before doing high impact exercises such as running or contact sports, as you are more likely to break a bone if you fall. If you cannot do some activities or sports Physical activity and because of your prostate cancer treatments or other impact on health conditions you might be able to do another one Prostate Cancer instead, e.g. swimming or cycling. If you have recently had surgery to remove your prostate For adults, at least 150 minutes (2.5 hours) of • take the advice of your doctor as to when and what moderate intensity activity (in bouts of 1 0 minutes or more) a week… or 75 minutes of activities you can safely do. Any exercise following surgery vigorous intensity activity spread across the week should be light and gentle so that your body can heal properly. You will probably be advised by your doctor to • or combinations of moderate and vigorous intensity activity avoid any heavy physical activity for several weeks. • Adults should also undertake physical activity to improve muscle strength on at least After prostate cancer treatment you could ask your GP 2 days a week. for a referral to a local municipal gym on the National Exercise Referral Scheme for a 12-week supervised Aerobic Strengthening and programme, see also the later sub-section on Leisure Exercise toning exercises Centres. There are also charities such as Macmillan Cancer Support who can assist your rehabilitation after prostate cancer treatment. Cancer survivors in West Sussex are Exercise highly fortunate in having the UK’s first ‘Anti-Cancer’ Program exercise Gym.