Article

Physical Activity after Diagnosis and Risk of Prostate Cancer Progression: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor

Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
Cancer Research (Impact Factor: 9.33). 06/2011; 71(11):3889-95. DOI: 10.1158/0008-5472.CAN-10-3932
Source: PubMed

ABSTRACT

Vigorous activity after diagnosis was recently reported to be inversely associated with prostate cancer-specific mortality. However, men with metastatic disease may decrease their activity due to their disease; thus, a causal interpretation is uncertain. We therefore prospectively examined vigorous activity and brisk walking after diagnosis in relation to risk of prostate cancer progression, an outcome less susceptible to reverse causation, among 1,455 men diagnosed with clinically localized prostate cancer. Cox proportional hazards regression was used to examine vigorous activity, nonvigorous activity, walking duration, and walking pace after diagnosis and risk of prostate cancer progression. We observed 117 events (45 biochemical recurrences, 66 secondary treatments, 3 bone metastases, 3 prostate cancer deaths) during 2,750 person-years. Walking accounted for nearly half of all activity. Men who walked briskly for 3 h/wk or more had a 57% lower rate of progression than men who walked at an easy pace for less than 3 h/wk (HR = 0.43; 95% CI: 0.21-0.91; P = 0.03). Walking pace was associated with decreased risk of progression independent of duration (HR brisk vs. easy pace = 0.52; 95% CI: 0.29-0.91; P(trend) = 0.01). Few men engaged in vigorous activity, but there was a suggestive inverse association (HR ≥3 h/wk vs. none = 0.63; 95% CI: 0.32-1.23; P(trend) = 0.17). Walking duration and total nonvigorous activity were not associated with risk of progression independent of pace or vigorous activity, respectively. Brisk walking after diagnosis may inhibit or delay prostate cancer progression among men diagnosed with clinically localized prostate cancer.

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    • "In a dataset of 1,455 men diagnosed with clinically localized prostate cancer, those who walked at a pace of over 3 miles per hour had a 57% lower rate of progression than those who walked at a slower pace for under three hours per week. This benefit was also independent of duration [41]. The authors went as far to suggest that, " Brisk walking after diagnosis may inhibit or delay prostate cancer progression among men diagnosed with clinically localized prostate cancer. "
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    • "Yet the inverse association we observed between PCa survival and vigorous activity did not reach statistical significance, perhaps because few men reported vigorous activity. In previous studies, significant inverse trends were found between risk of progression and walking pace[4], and risk of PCa death and vigorous recreational activity[3]. In the latter study[3], a significant 58% risk reduction for PCa deaths was observed with !48 versus <3 MET-hours/week leisure-time activity (37% of MET-hours were vigorous). "
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