Exercise and ADT: 6 ways to reduce the side effects in prostate cancer

Exercise and ADT: 6 ways to reduce the side effects in prostate cancer

Have you heard about how exercise and ADT should go together like sausages and bread? Research has shown exercise can help to reduce side effects of this treatment (without influencing the effectiveness of the drug). Prostate cancer, unfortunately, needs male hormones (androgens such as testosterone) to thrive, so one of the main types of drug therapy for this disease is androgen deprivation therapy (ADT). These medications aim to reduce or block the effect these hormones have. Whilst it can be an effective treatment, reducing the amount of testosterone in a man’s body does have a significant impact in the form of confronting side effects such as weight gain, loss of muscle mass and menopause-like symptoms. Here is a look at 6 different ways exercise can help you deal with treatment side effects:

 

1. Exercise and ADT: Improving body composition whilst on ADT

As a typical side of effect of ADT, men may notice an increase in abdominal fat and reduction of your muscle mass. However, did you know that exercise can lessen the change in your body composition? Research shows that if men complete 2-3 sessions of progressive resistance training per week, they will minimise the loss in muscle mass and strength. If men were taking ADT for a short time (3 months), a combination of moderate to high intensity aerobic and resistance training will help prevent changes in fat mass. However, if men are using ADT over a long period of time, they will have to also make changes with their diet to see changes in your fat mass.

 

2. ADT can impact your strength and endurance: Exercise can help!

ADT and the lack of testosterone can impact their day-to-day capacity/endurance and as such can affect their ability to do the fun things in life (playing with grandchildren, working in the shed, catching up with friends etc). The great news is exercise can help! Whilst it is not new that exercise can help keep everyone feeling fit and capable, the interesting thing is that the sooner men start/continue once ADT is commenced, the less ADT related capacity you stand to lose.

 

3. ADT can lead to excessive fatigue, but did you know exercise is one of the best treatments?

Due to the decline in androgen production (ie: testosterone) and other cancer-related issues, men may notice an increase in their fatigue levels. This may mean they do not feel as able or motivated to live life as they used to. Whilst it may be counterintuitive, research shows that progressive exercise (building up to 150mins per week) is arguably the BEST medical management strategy to reduce fatigue. That being said, it is important to learn how to regulate how much they do depending on how they feel. One day they may find the walk to the letterbox is moderately hard, whereas another day they may be able to complete a full 30 min moderate intensity brisk walk. Interestingly, the higher the fatigue levels, the greater the benefits from exercising.

 

4. Keeping the bones strong is really important when on ADT

Another side effect of ADT is a possible reduction in bone mineral density (and may even lead to osteoporosis and bone fractures). Preliminary research shows that at least 2 sessions of resistance training per week can mitigate losses in bone density. However, this exercise needs to be reasonably heavy and “impact” the bone – we want to challenge the bone enough to increase its density. We recommend that exercise is slowly progressed to this impact exercise so as not to increase the risk of injury.

 

5. Exercise can reduce your risk of other diseases whilst on ADT

Men are already dealing with a lot thanks to a prostate cancer diagnosis. SO it is important to note that due to the changes in hormone levels and a combination of other factors, there is an increased risk of developing other metabolic conditions such as type 2 diabetes, cardiovascular disease and high blood pressure in men on ADT. There is preliminary research showing positive changes in blood sugar, cholesterol and triglyceride levels. In other cancer populations, they have shown that exercise can provide a protective effect against the cardiometabolic diseases. So to reduce the burden, get on your bike!

Beliefs and Health Outcomes

 

6. Other side effects from ADT can be impacted by exercise

There are a few other benefits, which are fantastic for men on ADT! Did you know that new evidence suggests that exercise may help to preserve sexual activity and libido and lessen declines in sexual function? It may improve mood and reduce psychological distress, anxiety and depression. Finally, observational data suggests that is may even reduce the risk of dying from prostate cancer and even improve overall lifespan. If we could put all these benefits into a pill, would you take it?

 

The when, where and how of exercise for men undergoing ADT?

For many men, they are not exactly sure where to start, so here are a few ways:

  • You can visit an accredited exercise physiologist who specialises in treating those with cancer who can set you up with an individualized program. This will help give you the tools and knowledge to exercise and get the benefits from it.
  • There are a few online programs that can guide you if you do not want to or do not have the resources to visit an exercise specialist. Check out online!
  • If you are comfortable exercising on your own, you can get straight into it. Much of the literature prescribes 2-3 resistance training exercise sessions per week plus building up to 150 minutes of moderate intensity aerobic exercise per week (but remember that you do not want to go to hard to quickly – building up is the best way!)
22 benefits of an iNform session

22 benefits of an iNform session

What makes YOU exercise? (Other than your trainer)

We all know that exercise is good for us. Some of us exercise for particular reasons and to get certain benefits over others. Whilst some of us exercise with goals in mind like running a half marathon or just being able to pick up our grandkids. Or it might just be that this our time for ourselves each week. Whatever the reason you exercise, and whatever form of exercise you do, for whatever amount of time you do it for; I pat you on the back for the fact that you do it!

The World Health Organisation has released some fresh data last week showing almost one third (30.4%) of Australians aren’t getting enough exercise. Out of 168 countries, we ranked 97th for the % of population being sufficiently active. Which is scary considering physical inactivity is so highly associated with chronic health problems.

Just one type of exercise we do: Resistance Training (aka strength training or weight training)

This is what most clients at iNform typically spend the majority of their session doing. It can look like anything from body weighted strength, focusing on alignment and control, to lifting very heavy weights only a handful of times. The person that hasn’t broken a sweat all session, and the person that is drenched in sweat at the end of the session – have both engaged in strength training. It looks completely different for everyone. That’s the beautiful thing about strength training, it can be adapted and individualised just for you and your body’s specific needs.

For those who are reading this that are regulars at iNform, you will know better than anyone the effects that training with us has. Hopefully from brightening your mood and giving you a giggle, to helping increase your body awareness, getting you stronger and facilitating better movement throughout life’s activities. But for those who maybe don’t know all of the amazing benefits that strength training alone can have on your body; I have made a nerdy little list below. Please feel free to share this with your friends and family members who maybe aren’t quite convinced on exercise, there’s something in here for everyone!

Your 30 minute session at iNform…

Mentally

  • Improve focus
  • Improve cognitive function
  • Decrease anxiety
  • Decrease depressive symptoms
  • Improve feelings of well-being
  • Increases self-esteem
  • Decreases risk of dementia

Metabolically

  • Decrease markers of inflammation (particularly in people who are overweight)
  • Decrease cholesterol
  • Decrease blood pressure
  • Improve insulin-swings for those with type 2 diabetes
  • Improves insulin-sensitivity
  • Boosts metabolic rate
  • Reverse ageing factors in mitochondria and muscles

Musculoskeletally

  • Increases bone mineral density (and prevents bone loss)
  • Increases muscle mass
  • Improves movement control
  • Reduces chronic lower back pain
  • Reduces arthritic pain
  • Reduces pain from fibromyalgia

Functionally

And I guarantee I have left some benefits out.

How can you get all these benefits, plus more? (we didn’t even look at the benefits of aerobic exercise!)

If you would like to start getting more out of your resistance training sessions, or if you’re wanting to start resistance training but you have some niggles that bother you, I recommend getting in touch with one of our amazing movement specialists who can help find the right exercises for you!

If you would like more information on particular benefits and which study I sourced it from, feel free to email me at: [email protected]

About the Author

Happiness: What is science telling us?

Happiness: What is science telling us?

9-not-need-happyIt’s surely coincidental that I have been given the task to write about the “science” (I’m a nerd) and “happiness” (I like hugging people).

For some time scientist were unable to measure happiness. And you can hypothesis all you want, but if you can’t lay down the hard evidence then science or in this case psychology will debunk you. Dr. Sue Johnson a counselling psychologist debunked the critics that love could never be measured. With functional MRI showing us nerds the nitty gritty of the brain. Dr. Johnson could indeed show us with a little bit of oxytocin that love can be measured, and we all know that love/bonding is ever so important for the survival of human kind (for more references for Dr. Johnson, read her book “Love sense”) 

So you have gathered I like science and hugging people….BUT! this blog is to celebrate International day of happiness. And how to measure your own happiness.

On the 28th of June 2012  Jayme Illien a United Nations adviser proposed  happiness as a human right and a “fundamental human goal.” Jayme himself was a rescued orphan by Mother Theresa’s International Mission of Hope charities (for more on Jayme, http://www.happinessday.org/).  And what a noble idea it was. And so on the 20th of March every year, International day of happiness is a day to promote, well….happiness!

So there is your sneaky background check. Now to the “science” behind happiness.

There is really one psychologist that has put positive psychology on the map, and there might be a confirmation bias here as I have read all of his books. Quickly,  Positive psychology investigates what brings satisfaction to ones life. Without treating the pathology of mental illness. Professor Martin Seligman is the father of positive psychology and is famous for his previous investigation into learned helplessness. Professor Seligman defied and even challenged the likes of Sigmund Freud with his investigation and methodology. Prof Seligman hypothesised that you can measure happiness and well being. And along with his books Learned optimism and Flourish came about a measuring stick for happiness and well being. Prof Seligman developed a measuring questionnaire called PERMA through the university of Pennsylvania. Which scientifically measures your optimism and well being in life. A pessimistic outlook in life has been linked to poorer immunity, inability to bounce back from setbacks and even presidential speeches that were pessimistic, were less likely to get voted for (true story).

Prof Seligman has done wonderful work here at SAHMRI with the Wellbeing and resilience centre. Setting up PERMA programs through schools, workplaces and within the community with huge success. If you don’t feel inclined to follow up on the links, here is a a TED talk done by the man himself.

https://www.ted.com/talks/martin_seligman_on_the_state_of_psychology?language=en 

PERMA stands for….

Clicking on the above headlines will direct you through to PERMA in more depth along with http://www.pursuit-of-happiness.org/? .

I’m known to ramble on, so I will leave the links above and below for you wonderful people to investigate in your time. But as you can see (if you read the links) a splash of positive emotion (being optimistic) and a little sprinkle of engagement (nourishing activities) and you are well on your way to a “flourishing” meaningful life.

Happy international day

Being a coffee snob is good for your health

Being a coffee snob is good for your health

I was in Perth for work last weekend. I don’t know Perth very well at all, yet alone South Perth, where I was staying. This means that I did not know where I could find a good coffee on Monday morning, which is a problem as I am quite the coffee snob.

Fortunately I had recently been told about a phone app called ‘Beanhunter’, which can direct you from your current location to the closest good coffee vendor. Having a personal tracking device permanently on oneself has never been so useful. (more…)

When you can’t breathe, nothing else matters

November is lung awareness month, a chance for everyone to stop and listen to their breathing. Many of us don’t even think about our breathing until we experience challenges. Alarmingly, one in seven Australian’s die because of lung disease every year! With such a high prevalence it is clear we need to pay greater attention to our lungs. On average we take approximately 23,000 breaths a day or one breath every three to five seconds.

What could you do with just one breath?

The Lung Foundation of Australia have developed a set of questions to assess your lung health and determine whether you may need further investigation. As you read through the following questions think about yourself but also your friends and family. Have they mentioned any of the following?

  • Have a new, persistent or changed cough?lungs
  • Cough up mucus, phlegm or blood?
  • Get out of breath more easily than others your age?
  • Experience chest tightness or wheeze?
  • Have frequent chest infections?
  • Experience chest pain, fatigue sudden weight loss?
  • Are a smoker or ex-smoker?
  • Have you ever worked in a job that exposed you to dust, gas or fumes?

If you answered yes to any of the above questions a follow up with your GP is advised.

There are many practices we can adopt on a daily basis to help keep our lungs healthy and give us the best chance of avoiding lung disease. If you have a diagnosed lung condition these should also be adopted to best enhance the lungs potential and prevent worsening of symptoms.

Tips for healthy lungs:

  • Aim for smoke free! This includes passive smoking.
  • Enjoy fresh air daily
  • Protect yourself at work from dust particles, chemicals and fumes
  • Stick to safe products in the home
  • Partake in regular exercise
  • Be aware of the symptoms and risk factors as listed above

It’s important to know that becoming breathless during exercise is normal. Regular exercise, however, can increase the strength and function of your muscles, making them more efficient. Your muscles will then require less oxygen to move and will produce less carbon dioxide. This leads to a reduction in the amount of air you need to breathe in and out for a given exercise or daily task. Aim to accumulate 30 minutes of cardiovascular exercise on most if not all days of the week, and 2 sessions of resistance training per week. Help keep your breathing go un-noticed.

Remember to take a moment every day to stop, relax, listen and breathe…

 

Karla Newman

Do your kids see you sweat??

Do your kids see you sweat??

overweight teenagerLast week I saw a report on the ABC about the growing prevalence of overweight or obese kids in Australia, and it sparked a lot of angry thoughts! As one my areas of passion is seeing healthy active kids!

The stats, as you can imagine, are scary: Back in 2000, approximately 20% of teenagers were overweight or obese, now its 25% and a study conducted by the Victorian Dept of Hman Services predicts that this number will increase to 33% by 2025 (Future prevalence of overweight and obesity in Australian children and adolescents, 2005-2025 Department of Human Services, March 2008)

The consequences are sad and cruel: greater prevalence of cardiovascular disease, Type 2 Diabetes, a whole range of cancers, and mental health issues.

The reasons are both staggering, yet unsurprising:

The study reported on by the ABC was conducted by the Cancer Council and National Heart Foundation, and it revealed teens were spending too much time in front of the television with 58 per cent of students having at least three televisions in their home and 40 per cent with video games in their bedrooms. 75% of teenagers were spending more than two hours in front of screens (for school work or entertainment). A huge 82% are not engaging in more than 60 minutes of physical activity per day.

So what are we going to do about this sad state of affairs? All this takes me back to a paper I was privileged enough to co-author a few years ago. It showed that not only are both adults and children under active, but that the association between parents and their kids’ physical activity is decreasing. So the behaviour modelling strength of parents’ activity is influencing kids less! While the reason why is unclear; my guess is that its due to our changing behaviour patterns. We just don’t see as many families going for walks or bike rides together. You don’t see as many dads kicking the footy with their kids. Now we go to the gym or social sport on the way to or from work, and we are ‘done’ by the time we get home. So while we may be active, our kids don’t see us being active, so they don’t learn from our exercise behaviours!

So lets get out with our kids more. Even when I’m being active on my own, I try to make a point of telling my kids how much I enjoyed my run or bike ride around Adelaide’s beautiful trails!

Martin M, Dollman J, Norton K, Robertson, I. (2005) A decrease in the association between the physical activity patterns of Australian parents and their children; 1985-1997, Journal of Science and Medicine in Sport, 8(1): 71-76.