Carol Michaels is the founder of Recovery Fitness^®, a nationally recognized exercise program designed to help people diagnosed with cancer recover from surgery and other treatments. She is an award-winning exercise specialist, author, presenter, and consultant. She received her degree from the Wharton School of the University of Pennsylvania. Carol has produced DVDs and created the Cancer Specialist Recovery course in partnership with the National Federation of Professional Trainers. Her book, Exercises for Cancer Survivors, is designed to help anyone undergoing cancer surgery or other treatments.

Did you know that exercise can provide health benefits for men with prostate cancer? Exercise improves heart health and bone density, as well as decreases the risk of diabetes and obesity. In addition, exercise can decrease blood sugar levels, which lowers insulin levels and inflammation. That’s important because there appears to be an association between insulin levels, inflammation, and prostate cancer risk.

The other big benefit of exercise is that it can reduce the side effects of common prostate cancer treatments, such as androgen deprivation therapy (ADT). The side effects of ADT can include muscle loss, an increase in fat mass, and the bone disease of osteoporosis. Risk for diabetes and heart disease also increases with ADT. In addition, exercise can reduce the stress, anxiety, and depression often experienced by men with prostate cancer.

Below is some basic information on starting an exercise program during and after prostate cancer treatment. Be sure to talk with your doctor before you get moving.

What kind of exercise should I do after prostate cancer treatment?

The Department of Health and Human Services recommends that adults get at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity each week. Aerobic exercise, such as walking, jogging, or swimming, is important because it burns calories to keep weight under control. However, men with prostate cancer should avoid prolonged bicycling because of the pressure the seat puts on the perineal area, which is between the scrotum and the anus.

A good fitness routine should also emphasize strength training, which will help increase muscle mass and bone density and decrease body fat. This is especially important because your treatments may cause sarcopenia, which is a change in your fat-to-muscle ratio. Strength training can be performed with weights, bands, machines, or your own body weight. Balance exercises that help with coordination may also be helpful.

How can I strengthen my muscles?

The muscle that surrounds the prostate may be weakened from cancer surgery or other treatments. This can cause urinary incontinence, which is a loss of bladder control. There are different types of incontinence, ranging from mild to severe. For example, stress incontinence can cause a person to leak urine during activities such as coughing, laughing, sneezing, or exercising. Urge incontinence is loss of urine with a sudden, urgent need to urinate, while continuous incontinence is not being able to control the bladder at all.

Kegel exercises can strengthen your pelvic floor muscles. These muscles support the bladder and bowel and are used to stop the flow of urine. Kegels are great for men with prostate cancer because they can help control incontinence without medication or surgery, as well as may improve erectile issues.

It’s smart to start Kegel exercises before surgery and other treatments. To perform a Kegel, tighten and release your pelvic floor muscles. To activate them, pretend you’re stopping and starting a flow of urine. Perform 10 Kegels, holding the stopping contraction tight for 5 seconds each time. Take a 5-second break between each repetition. Try to do 4 sets per day. It may take several weeks or months to work up to these recommendations.

What exercise precautions do I need to take?

Always consult your doctor before you begin an exercise program. Prostate cancer and its treatments can cause specific side effects that may require you to modify your exercise program. If you’re experiencing any of the side effects below, stop exercising and talk to a member of the health care team.

• Fatigue. Physical fatigue can make it harder to exercise vigorously. Monitor your energy levels and adapt your exercises accordingly.

• Osteoporosis. If you’ve been diagnosed with osteoporosis, ask your doctor which weight-bearing exercises you can do safely to strengthen your bones.

• Bone metastases. When cancer cells spread, or metastasize, to the bone, there’s a higher risk of a fracture occurring. Perform balance exercises and other exercises that have a low risk of falling.

• Cardiopulmonary issues. If you have weakened heart muscles or an irregular heartbeat, be sure to begin your exercise program under medical supervision.

• Lymphedema. This common side effect can occur after the removal of lymph nodes and is identified by swelling of a part of the body, such as a leg or trunk. Maintaining range of motion and avoiding infection is important when you have lymphedema. You need to progress slowly and may need to modify some exercises. Always contact your doctor if you have any kind of swelling.

• Peripheral neuropathy. This common side effect of cancer treatment affects the nervous system, causing numbness, loss of sensation, tingling, and pain in different areas of the body. If neuropathy is affecting your hands, it may be hard to safely hold hand weights. Using tubing or bands with handles is safer. Balance training is also important.

• Neutropenia. Cancer treatment can cause neutropenia, a decrease in white blood cells. This may increase your risk of infection. Avoid places that are crowded and not cleaned regularly, like gyms. Ask your doctor about an exercise program you can do at home.

• Myelosuppression. When you have myelosuppression, your bone marrow slows its production of blood cells and platelets, making you more likely to bruise and bleed. This means you should use caution with exercise machines and equipment. If white blood cells are decreased, there may be a higher risk for infection (see Neutropenia, above.)

Read more exercise content on the Cancer.Net Blog.