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Platinum Priority – Prostate Cancer
Editorial by XXX on pp. x–y of this issue

Physical Activity and Survival After Prostate Cancer

By: Christine M. Friedenreicha b c , Qinggang Wanga, Heather K. Neilsona, Karen A. Kopciuka b d, S. Elizabeth McGregorb c e and Kerry S. Courneyaf

European Urology, Volume 70 Issue 4, October 2016, Pages 576-585

Published online: 01 October 2016

Keywords: Physical activity, Prospective cohort, Prostate cancer, Sedentary behaviour, Survival analysis

Abstract Full Text Full Text PDF (1,1 MB) Patient Summary

Abstract

Background

Despite the high global prevalence of prostate cancer (PCa), few epidemiologic studies have assessed physical activity in relation to PCa survival.

Objective

To evaluate different types, intensities, and timing of physical activity relative to PCa survival.

Design, setting, and participants

A prospective study was conducted in Alberta, Canada, in a cohort of 830 stage II–IV incident PCa cases diagnosed between 1997 and 2000 with follow-up to 2014 (up to 17 yr). Prediagnosis lifetime activity was self-reported at diagnosis. Postdiagnosis activity was self-reported up to three times during follow-up.

Outcome measurements and statistical analysis

Cox proportional hazards models related physical activity to all-cause and PCa-specific deaths and to first recurrence/progression of PCa.

Results and limitations

A total of 458 deaths, 170 PCa-specific deaths, and, after first follow-up, 239 first recurrences/progressions occurred. Postdiagnosis total activity (>119 vs ≤42 metabolic equivalent [MET]-hours/week per year) was associated with a significantly lower all-cause mortality risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI], 0.42–0.79; p value for trend <0.01). Postdiagnosis recreational activity (>26 vs ≤4 MET-hours/week per year) was associated with a significantly lower PCa-specific mortality risk (HR: 0.56; 95% CI, 0.35–0.90; p value for trend = 0.01). Sustained recreational activity before and after diagnosis (>18–20 vs <7–8 MET-hours/week per year) was associated with a lower risk of all-cause mortality (HR: 0.66; 95% CI, 0.49–0.88). Limitations included generalisability to healthier cases and an observational study design.

Conclusions

These findings support emerging recommendations to increase physical activity after the diagnosis of PCa and would inform a future exercise intervention trial examining PCa outcomes.

Patient summary

In a 17-yr prostate cancer (PCa) survival study, men who survived at least 2 yr who were more physically active postdiagnosis or performed more recreational physical activity before and after diagnosis survived longer. Recreational physical activity after diagnosis was associated with a lower risk of PCa death.

Take Home Message

In men who survived at least 2 yr after diagnosis of prostate cancer (PCa), higher physical activity after diagnosis or recreational activity before and after diagnosis was associated with longer overall survival. Recreational activity after diagnosis was associated with a lower risk of PCa death.

Keywords: Physical activity, Prospective cohort, Prostate cancer, Sedentary behaviour, Survival analysis.

Footnotes

a Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada

b Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

c Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

d Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, Alberta, Canada

e Division of Population, Public and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada

f Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada

Corresponding author. Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Centre, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada. Tel. +1 403 698 8009; Fax: +1 403 264 2654.

Please visit www.eu-acme.org/europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically.

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