Abstract
Prostate cancer is a leading cause of cancer morbidity and mortality in men. In addition to improved treatments, strategies to reduce disease risk are urgently required. This review summarises the literature that examines the association between exercise and prostate cancer risk. Between 1989 and 2001, 13 cohort studies were conducted in the US and internationally. Of these, nine showed an association between exercise and decreased prostate cancer risk. Five of 11 case-control studies conducted between 1988 and 2002 reported an association between decreased risk of prostate cancer and high activity levels. Considering all studies performed between 1976 and 2002, 16 out of 27 studies reported reduced risk in men who were most active; in nine out of 16 studies the reduction in risk was statistically significant. Average risk reduction ranged from 10–30%. In aggregate, this evidence suggests a probable link between increased physical exercise and decreased prostate cancer risk. The ability of exercise to modulate hormone levels, prevent obesity, enhance immune function and reduce oxidative stress have all been postulated as mechanisms that may underlie the protective effect of exercise. Exercise may also be of benefit in men undergoing treatment for prostate cancer. Overall, study design and control of potential confounding factors varied greatly among studies, possibly contributing to the variation in results. Epidemiological studies that are better controlled, larger in scale and more carefully designed may help to more fully clarify the relationship between exercise and prostate cancer. In addition, intervention trials that test whether exercise programmes can reduce prostate cancer risk are currently underway to rigorously test the ability of exercise to reduce prostate cancer incidence.
Similar content being viewed by others
References
Greenlee RT, Hill-Harmon MB, Murray T, et al. Cancer statistics, 2001. CA Cancer J Clin 2001; 51: 15–36
Friedenreich CM, Thune I. A review of physical activity and prostate cancer risk. Cancer Cases Control 2001; 12: 461–75
Brawley OW, Parnes H. Prostate cancer prevention trials in the USA. Eur J Cancer 2000; 36: 1312–5
Erikssen G. Physical fitness and changes in mortality: the survival of the fittest. Sports Med 2001; 31: 571–6
Exercise and the prostate: can you run away from trouble? Harvard Men’s Health Watch 2001 May; 5(10): 1–3
Friedenreich CM. Physical activity and cancer prevention: from observational to intervention research. Cancer Epidemiol Biomarkers Prev 2001; 10: 287–301
Polednak AP. College athletics, body size, and cancer mortality. Cancer 1976; 38: 382–7
Paffenbarger RS, Hyde RT, Wing AL. Physical activity and incidence of cancer in diverse populations: a preliminary report. Am J Clin Nutr 1987; 45: 312–7
Severson RK, Nomura AMY, Grove JS, et al. A prospective analysis of physical activity and cancer. Am J Epidemiol 1989; 130: 522–9
Lee I-M, Paffenbarger RS. Physical activity and its relation to cancer risk: a prospective study of college alumni. Med Sci Sports Exerc 1994; 26: 831–7
Thune I, Lund E. Physical activity and the risk of prostate and testicular cancer: a cohort study of 53,000 Norwegian men. Cancer Causes Control 1994; 5: 549–56
Hsing AW, McLaughlin JK, Zheng W, et al. Occupation, physical activity, and risk of prostate cancer in Shanghai, People’s Republic of China. Cancer Causes Control 1994; 5: 136–40
Steenland K, Nowlin S, Palu S. Cancer incidence in the National Health and Nutrition Survey I, follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarker Prev 1995; 4: 807–11
Oliveria SA, Kohl HW, Trichopoulos D, et al. The association between cardiorespiratory fitness and prostate cancer. Med Sci Sports Exerc 1996; 28: 97–104
Cerhan JR, Torner JC, Lynch CF, et al. Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes Control 1997; 8: 229–38
Hartman TJ, Albanes D, Tautalahti M, et al. Physical activity and prostate cancer in the Alpha-Tocopherol, Beta-Carotene (ATBC) Cancer Prevention Study (Finland). Cancer Causes Control 1998; 9: 11–8
Giovannucci E, Leitzmann M, Spiegelman D, et al. A prospective study of physical activity and prostate cancer in male health professionals. Cancer Res 1998; 58: 5117–22
Liu S, Lee I-M, Linson P, et al. A prospective study of physical activity and risk of prostate cancer in US physicians. Int J Epidemiol 2000; 29: 29–35
Lund Nilsen TI, Johnsen R, Vatten LJ. Socio-economic and lifestyle factors associated with risk of prostate cancer. Br J Cancer 2000; 82: 1358–63
Clarke G, Whittemore AS. Prostate cancer risk in relation to anthropometry and physical activity: the national health and nutrition examination survey I, epidemiological follow-up study. Cancer Epidemiol Biomarkers Prev 2000; 9: 875–81
Wannamethee SG, Shaper AG, Walker M. Physical activity and risk of cancer in middle-aged men. Br J Cancer 2001; 85: 1311–6
Yu H, Harris RE, Wynder EL. Case-control study of prostate cancer and socioeconomic factors. Prostate 1988; 13: 317–25
Brownson RC, Chang JC, Davis JR, et al. Physical activity on the job and cancer in Missouri. Am J Public Health 1991; 81: 639–42
Le Marchand L, Kolonel LN, Yoshizawa CN. Lifetime occupational physical activity and prostate cancer risk. Am J Epidemiol 1991; 133: 103–11
West DW, Slattery ML, Robison LM, et al. Adult dietary intake and prostate cancer risk in Utah: a case-control study with special emphasis on aggressive tumors. Cancer Causes Control 1991; 2: 85–94
Dosemeci M, Hayes RB, Vetter R, et al. Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control 1993; 4: 313–21
Anderson S-O, Anderson S-O, Baron J, Wolk A, et al. Early life risk factors for prostate cancer: a population-based case-control study in Sweden. Cancer Epidemiol Biomarkers Prev 1995; 4: 187–92
Whittemore AS, Kolonel LN, Wu AH, et al. Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. J Natl Cancer Inst 1995; 87: 652–61
Sung JFC, Lin RS, Pu Y-S, et al. Risk factors for prostate carcinoma in Taiwan: a case-control study in a Chinese population. Cancer 1999; 86: 484–91
Villeneuve PJ, Johnson KC, Kreiger N, et al. Risk factors for prostate cancer: results from the Canadian National Enhanced Cancer Surveillance System. Cancer Causes Control 1999; 10: 355–67
Bairati I, Larouche R, Meyer F, et al. Lifetime occupational physical activity and incidental prostate cancer. Cancer Causes Control 2000; 11: 759–64
Lacey JV, Deng J, Dosemeci M, et al. Prostate cancer, benign prostatic hyperplasia and physical activity in Shanghai China. Int J Epidemiol 2001; 30: 341–9
Vena JE, Graham S, Zielezny M, et al. Occupational exercise and risk of cancer. Am J Clin Nutr 1987; 45: 318–27
Albanes D, Blair A, Taylor PR. Physical activity and risk of cancer in the NHANES 1 population. Am J Public Health 1989; 79: 744–50
Lee I-M, Paffenbarger RS, Hsieh C-C. Physical activity and risk of prostatic cancer among college alumni. Am J Epidemiol 1992; 135: 169–79
Paffenbarger Jr RS, Lee I-M, Wong AL. The influence of physical activity on the incidence of site-specific cancers in college alumni. In: Jacobs MM, editor. Exercise, fat, and cancer. New York: Plenum Press, 1992: 7–15
Ilic M, Vlajinac H, Marinkovic J. Case-control study of risk factors for prostate cancer. Br J Cancer 1996; 74: 1682–6
Whittemore AS, Paffenbarger RS, Anderson K, et al. Early precursors of site-specific cancers in college men and women. J Natl Cancer Inst 1985; 74: 43–51
Wynder EL, Laakso K, Sotarauta M, et al. Metabolic epidemiology of prostatic cancer. Prostate 1984; 5: 47–53
Wheeler GD, Wall SR, Beicastro AN, et al. Reduced serum testosterone and prolactin levels in male distance runners. JAMA 1984; 252: 514–6
Hackney AC, Sinning WE, Bruot BC. Reproductive hormonal profiles of endurance-trained and untrained males. Med Sci Sports Exerc 1988; 20: 60–5
Neiman DC, Pedersen BK. Exercise and immune function: recent developments. Sports Med 1999; 27: 73–80
Daniell HW, Dunn SR, Ferguson DW, et al. Progressive osteoporosis during androgen deprivation therapy for prostate cancer. J Urol 2000; 163: 181–6
Daniell HW. Osteoporosis due to androgen deprivation therapy in men with prostate cancer. Urology 2001; 58Suppl. 2A: 101–7
Ross RW, Small EJ. Osteoporosis in men treated with androgen deprivation therapy for prostate cancer. J Urol 2002; 167: 1952–6
Hamalainen EK, Aldercreutz H, Puska P, et al. Decrease of serum total and free testosterone during a low-fat high-fibre diet. J Steroid Biochem 1983; 18: 369–70
McTiernan A, Ulrich CM, Yancey D, et al. The Physical Activity for Total Health (PATH) study: rationale and design. Med Sci Sports Exerc 1999; 31: 1307–12
McTiernan A. Intervention studies in exercise and cancer prevention. Med Sci Sports Exerc 2003; 35: 1841–5
Ornish DM, Lee KL, Fair WR, et al. Dietary trial in prostate cancer: early experience and implications for clinical trial design. Urology 2001; 57Suppl. 4A: 200–1
Acknowledgements
No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Torti, D.C., Matheson, G.O. Exercise and Prostate Cancer. Sports Med 34, 363–369 (2004). https://doi.org/10.2165/00007256-200434060-00003
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-200434060-00003