Why Exercise Is Important When You Have Prostate Cancer, and the Best Workouts to Do

If you've been diagnosed with prostate cancer, you might be wondering whether you can exercise during — and after — your treatment. The answer, in both cases, is yes. Physical activity can help you live longer, improve your quality of life and help alleviate some of the side effects of prostate cancer therapies.

In general, "it's always good for people with prostate cancer to have an exercise regimen," says Mohamad Allaf, MD, the executive vice chairman of the department of urology at Johns Hopkins Medicine in Baltimore. "And for the vast majority of men, they're physically able to participate."

The key, of course, is not to overdo it. Here are some of the benefits of exercising if you have prostate cancer, and how you can start up a routine of your own.

More than 3 million people are currently living with prostate cancer, a cancer that develops in the small, walnut-sized gland located below the bladder and in front of the rectum. It's one of the most common types of cancer in America; about 1 in 9 people with prostates will develop the disease at some point in their lives, according to prostate cancer statistics from the American Cancer Society (ACS).

Sometimes, prostate cancer grows so slowly that treating it won't necessarily cause the person to live longer. In this case, some people take a "watchful waiting" approach, choosing to monitor the cancer over time (in partnership with their doctor) rather than treating it more aggressively.

For those with faster-spreading cancers, or who want to treat the disease more directly, common treatments include surgery, hormone therapy (also called androgen deprivation therapy) or radiation therapy, or some combination of the three.

"Exercise in all its forms is generally good in all phases of prostate cancer."

Research shows that, in people who have prostate cancer, exercise can reduce the risk of dying from any cause. That research, published February 2011 in the ​Journal of Clinical Oncology,​ also found that vigorous exercise can lower the risk of dying from prostate cancer itself — those who did at least three hours of vigorous activity a week were 61 percent less likely to die of prostate cancer than people who did less than one hour a week.

More recently, a January 2016 ​European Urology​ study followed people with prostate cancer for up to 17 years and found that, among those who survived at least two years, the people who were more physically active after diagnosis lived longer.

Exercise also helps protect against heart disease, which can occur in people who have prostate cancer or have had it in the past, according to the American College of Cardiology. In particular, androgen deprivation therapy, one of the main treatments for prostate cancer, works by lowering testosterone levels, which can then increase the risk of heart disease.

Exercise is also recommended for people with prostate cancer who are doing "active surveillance," i.e., monitoring their cancer closely with regular blood tests, rectal exams and biopsies. This is mostly because exercise has been shown to be helpful for prostate cancer in general, says Dr. Allaf, who explains that, at this time, it's unclear whether exercise can help keep prostate cancer from progressing. Although it may aid in preventing recurrence if it leads to weight loss for people who have overweight or obesity, per Johns Hopkins Medicine.

Research also shows that people who have prostate cancer can reap other benefits from exercise, both during and after their treatments. These include:

Prostate cancer surgery is done laparoscopically, by making a small cut in the abdomen.

"If someone has a weaker core, those incisions are a little weaker when we close them, and there's a higher risk of a hernia forming," says Dr. Allaf. "Plus, when you're healing from surgery, you're going to use your core to get out of bed, and the stronger it is, the more mobile you'll be after surgery."

Exercise can help strengthen the pelvic floor area, which can become weakened after radiation therapy and surgery, says Dr. Allaf.

Doing pelvic floor muscle training can also help treat urinary incontinence after surgery for prostate cancer, according to a November 2019 review in ​Clinical Interventions in Aging​.

High-intensity resistance exercise may improve bone mass in people receiving hormone therapy, according to a 2006 study in ​Medicine & Science in Sports & Exercise​.

Exercise might help ease some of the feelings of depression that can be associated with cancers such as prostate cancer, according to a January 2012 review and meta-analysis in ​Cancer Epidemiology, Biomarkers & Prevention​.

As long as you're exercising safely — and not overdoing it — there's no reason to avoid exercise when you have prostate cancer, Dr. Allaf says. "Exercise in all its forms is generally good in all phases of prostate cancer," he notes.

What's more, most people who have prostate cancer can do some kind of activity, although some may need to take it slower than others, he says.

"You have to be reasonable, of course," Dr. Allaf says.

For example, men who've just had prostate cancer surgery shouldn't ride a bike for about six to eight weeks, he says. This is because the perineum, the area between the anus and the scrotum, tends to be sore.

"Exercise promotes a general resiliency that keeps you moving forward."

They may also need a few weeks to recover from the surgery before they can jump back into their normal exercise routine — but that doesn't mean they have to avoid activity altogether. "We get them up to walk the night of surgery now, because we know that helps their recovery," Dr. Allaf says.

For both people undergoing prostate cancer treatment and those in remission, it's important to set up an exercise plan that doesn't exceed what they're currently able to do, says Cris Dobrosielski, CSCS, CPT, a consultant for the American Council on Exercise, owner of Monumental Results in San Diego and the author of ​Going the Distance​.

"If people overdo it, they open themselves up to a number of physiological setbacks, like orthopedic injuries," Dobrosielski says. "We have to have a reasonable plan to increase the volume and intensity of their exercise over a prescribed period of time."

It's a good idea to work with a physical therapist or other certified personal trainer — who can also coordinate your exercise plan with your doctor — before jumping into a new routine.

In general, the ACS suggests getting about 150 to 300 minutes of moderate-intensity exercise or 75 to 150 minutes of vigorous exercise a week.

Experts encourage people who've recently undergone prostate cancer treatment to start walking right away, Dr. Allaf says. After that, they can gradually ramp up their physical activity to include other forms of aerobic, resistance and stretching exercises.

Exercises for people with prostate cancer can include:

• Walking
• Running or jogging
• Biking
• Elliptical training
• Swimming

• Weight training
• Resistance exercises
• Bodyweight exercises

• Yoga
• Tai chi
• Pilates
• Stretching

Stretching exercises can be particularly good for people who are having cancer treatments, says Dobrosielski.

"There's a lot of muscular tension that goes along with being a patient and being in a chair, on a couch or lying down," he says. "There's a tightening or shortening of muscles, so taking online [stretching] classes or going to yoga, Tai chi or Pilates, if you're able, can help lengthen the muscles, open up the joints and improve comfort levels."

Dobrosielski also encourages people who've been diagnosed with cancer to exercise outdoors (as long as your doctor gives it the green light).

"We know that interacting with nature has an impact on the human spirit," he says. "There's something about the healing effect of nature."

And when you don't have enough energy for a workout? "Aim for 'better, not perfect,'" he says.

There may be days where you can't go for a run — or even a short walk — and that's OK, he says. On those days, try to just get outside — or at least away from your TV or cellphone.

People who are still undergoing treatment for prostate cancer — such as hormone therapy or chemotherapy — may want to enlist the help of a physical therapist, personal trainer or even a family member or friend while they're working out.

"If someone is in treatment, there's a possibility for weakness and dizziness," Dobrosielski says.

Another reason to recruit a workout partner: Talking to other people helps you process the past, and gets you focused on your dreams and goals for the future, he says.

The bottom line: Physical activity can provide more than physical benefits — it can also give you a mental and spiritual boost.

"Exercise promotes a general resiliency that keeps you moving forward," Dobrosielski says.