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| Can Walking Prevent Bone Loss in Prostate Cancer Treatment? |
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“Prostate cancer patients are not routinely advised to exercise. Walking is one tool that prostate cancer patients can use to improve their health and minimize the side effects of cancer and cancer treatments,” says Paula Chiplis, a registered nurse at Baltimore’s Johns Hopkins Hospital, who led a study on the effects of exercise on men with the disease. “Walking has no harmful side effects, if done moderately, but it can dramatically improve life for men suffering from side effects from some prostate cancer treatments.” “Localized” prostate cancer, which means the tumor is confined to the gland, allows men to chose surgery, external or internal radiation, or hormone therapy as treatment options. Those men who receive radiation therapy often undergo months of hormone therapy to decreases testosterone and estrogen that feed the cancer cells, thereby keeping the tumor from growing. Losing bone density However, men on hormone therapy generally lose four to 13 percent of their bone density annually, compared to healthy men who lose between .5 to 1 percent per year, beginning in middle age. Men are typically not thought to be at risk for osteoporosis and bone fractures, but their rate of bone loss is greater than that of post-menopausal women. The Johns Hopkins study shows that prostate cancer patients undergoing hormone therapy who walked moderately about five times a week for 30 minutes maintained or gained bone density, while those who didn’t exercise lost more than two percent of their bone density in eight to nine weeks. The study involving 70 sedentary men with prostate cancer gave researchers a glimpse at the effects of of a nurse-directed, home-based walking program in maintaining physical function and managing cancer- and treatment-related symptoms. Chiplis presented her findings Oct. 28 at the American Society for Therapeutic Radiology and Oncology’s 49th annual meeting in Los Angeles. Aiming radiation beams Speaking of radiation therapy, another team of researchers says highly targeted radiation for prostate cancer can ensure that the majority of persons with this tumor will not have any long-term rectal damage. Because the prostate is located on the other side of the rectal wall, one of the major side effects of radiation therapy is damage to the rectum, such as bleeding or bowel incontinence. But researchers at Oregon Health & Sciences University say that nearly 98 percent of men who underwent “intensity-modulated radiation” and “seed marker-based image-guided radiation therapies” had no rectal damage after 1.4 years. The two procedures are high-tech ways of aiming the intense radiation beams square on the tumor and missing as much of the healthy tissues as possible, thus reducing side effects. "If these outcomes hold over time and the results can be reproduced by others, then this combination of radiation therapies for prostate cancer will yield some of the lowest toxicity rates of any definitive treatments for prostate cancer,” says Dr. Todd Scarbrough, a radiation medicine specialist at the university’s medical school. “This would be the treatment for prostate cancer. A patient could cruise through treatment with no side effects.” Note that Scarbrough says more study is needed before men run to their radiation oncologists for treatment. The study also measured the side effects after only 1.4 years, which begs the question, "Does any rectal damage occur in two years?" Besides, the standard thinking among prostate cancer patients when researching which treatment option to pick is that urologists generally recommend their specialty—surgery—and radiation oncologists will recommend their specialty—radiation. Other side effects down? Meanwhile, Scarbrough explains that a major consideration of radiation oncologists treating prostate cancer is to reduce rectal damage. Up to 50 percent of men treated for prostate cancer had some level of rectal pain or complaints after radiation. The image-guided radiation method used placed tiny gold pellets in the subject's prostate prior to treatment and then imaged these markers immediately prior to treatment. Placing of the markers is fast and relatively painless. The heightened accuracy allows for a more precise radiation dose and a more targeted area for treatment of the tumor, Scarbrough says. In addition, 72 percent of the men in the study, whose average age was 74, said they maintained sexual activity. The highly targeted radiation therapy also caused no long-term urinary side effects, according to the results. Impotency and incontinence are two standard side effects of any prostate-cancer treatment. Yarbrough also presented his findings at the radiology and oncology meeting. If you’re curious, I chose surgery as my treatment option. First, if I had chosen radiation, I probably couldn’t have lived with the fact that I left the organ that went cancerous in my body. Second, how would I have known that the radiation beams nuked every cancer cell? Like I said in a previous post on my blog, the treatment decision is solely up to you. Just do your homework thoroughly.
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Exercise may reduce, and even reverse, bone loss caused by hormone and radiation therapies used to treat localized prostate cancer, thereby decreasing the potential risk of bone fractures and improving men’s quality of life, researchers say.
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