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                                December 2009
                 Prostate Cancer Now Includes
                         A Fitness Plan
According to the Australian Institute of Health and Welfare, prostate cancer is the most common cancer
diagnosed in Australia (excluding non-melanoma skin cancers). In 2006, it is estimated that 18,700 new
cases of prostate cancer were diagnosed in Australia. Tragically, in 2005 more than 2,900 Australian
men died from prostate cancer. i

While we may still not know exactly how genes and diet affect our chances of being diagnosed with
cancer – or even how we might recover afterwards – there’s growing agreement that exercise may not
only be preventative, but also help to keep us healthy long after treatment has ended.

Certainly its ability to protect us from some cancers is getting a lot more recognition.

‘The positive link between cancer and exercise looks a little like what happened with heart disease in the
1980’s,’ said Andrew Giles, CEO of the Prostate Cancer Foundation of Australia (PCFA).

‘The population health studies back then began to show the benefits of regular exercise for rehabilitation
following heart problems and that in turn sparked a whole new way to look at prevention and survival.’

‘I think we’re seeing the same changes in cancer care and especially for prostate cancer,’ Andrew said.
‘This is why PCFA has a great interest in funding research to shed more light on how exercise and
healthy living can impact on the development of prostate cancer, and how it can aid with the
rehabilitation for its various treatments.’

The weight of evidence

A major study over 17 years of 2560 Finnish men published in the British Journal of Sports Medicine ii in
July this year showed that the most physically active men were the least likely to develop cancers. In fact
men who did the most vigorous exercise-like jogging for around 30 minutes a day-reduced their risk of
dying prematurely by about half.

It could be a similar story for prostate cancer according to a new US study just published in the Journal
of Urology iii . According to researchers from Duke University Prostate Centre, men in a small study group
who exercised moderately-the equivalent of three to six hours of walking per week-were much less likely
to be diagnosed with the disease or to have an aggressive form of the cancer when they were.
 


If there’s still debate about just why exercise is so valuable for recovery, most now agree on the list of
potential benefits, including maintenance of the muscle and bone strength, physical performance,
emotional and psychological wellbeing, blood flow and quality of life.

No wonder that exercise is increasingly being seen as an integral part of cancer care and no where more
emphatically than with prostate cancer.

No Bones About It
The body’s bones are particularly vulnerable when it comes to prostate cancer.

Prostate cancer can spread to other parts of the body and when it does, it’s most generally to the bones.
Studies have also shown that Vitamin D deficiency - an important factor in maintaining our body’s
immune system, healthy bones and ability to fight cancers - often accompanies prostate cancer and
may, researchers say, be a silent accomplice in the development of the disease.

The situation is further complicated during treatment. Hormone treatment is often used to slow the
growth of prostate cancer, but it comes with a whole range of side-effects like loss of muscle and
strength, increased fat around the waist, higher risk of heart disease and diabetes, and reduced physical
abilities.

Here in Australia PCFA has recently helped to fund new research being conducted at the Prince of
Wales Clinical School, University of New South Wales, into what drives the growth of secondary prostate
cancer cells in the bone. It’s hoped the research will provide more understanding of the occurrence of
prostate cancer bony metastasis and lead to new treatments in future.

The link between exercise, especially weight-bearing exercise, and bone health has long been
recognised and is generally recommended to protect bones from osteoporosis. Now more work on
exercise and prostate cancer is also being done in an effort to understand just how it may benefit men by
protecting them from the disease or minimising its effects.

Some of the most important research has been underway at the Edith Cowan University in Western
Australia since 2003 under the direction of Dr Robert Newton and PCFA Young Investigator grant
recipient Dr Daniel Galvão. Their research has demonstrated that appropriate exercise therapy can
significantly reduce muscle and bone loss in men undergoing hormone therapy for prostate cancer-and
following more funding from the PCFA in 2007 they hope to show a similar impact on the risks of
cardiovascular disease and diabetes.

The exercise message was also in the spotlight at the PCFA’s recent National Conference in
Queensland. Speakers like Dr Stephen Strum from the US and Associate Professor Pauline Chiarelli
from the University of Newcastle in NSW raised the importance of daily exercise in any recovery regime.

Dr Chiarelli’s work has focused on the importance of pelvic floor exercises in helping men overcome
issues like incontinence following surgery, while Dr Strum believes men need to think more broadly
about their health status including bone loss over time.

“The issue of bone health has become a huge focus in breast, prostate and lung cancers,” Dr Strum said
at the PCFA’s National Conference. “But bone loss doesn’t just happen overnight and must have been
going on for years.”
 


Fit For Life
Bone loss may not be the only health issue men - and women – should watch. Studies have also shown
that carrying extra pounds, especially fat around the middle of your body, is associated with an increased
risk of many diseases, including prostate cancer-particularly aggressive prostate cancer.

Which is one reason that the exercise mantra is not just being promoted for people with prostate cancer
of course, but for older people in general.

Groups like the World Health Organisation (WHO), or the Council On The Aging (COTA) here in
Australia, are recommending that older people build up their level of activity, preferably with some sort of
exercise every day.

In fact the World Health Organisation says that at least 60 percent of the world’s population doesn’t get
the recommended amount of physical activity they should. Figures for Australia suggest that physical
inactivity is responsible for 7 percent of the total burden of disease and injury here, and that roughly 60
percent of men and women over 55 years of age are not doing enough. iv

One reason that exercise is looking so good for older people is that it may be one of the best ways to
boost natural antioxidants in our bodies and that can help to eliminate inflammatory molecules that drive
cancer according to the health experts. While all heart raising activity is good of course, it’s the
endurance type of exercise-walking, running, cycling and swimming-that is generally seen as being the
most effective.

But there’s good news for people who may not really like the full on exercise regime that running or
cycling would seem to demand.

A group of articles just published in a special section of Medicine & Science In Sports & Exercise, the
Journal of the American College of Sports Medicine, v suggests that while we may still be some distance
from really understanding the link between exercise and bones, brisk walking-and strange as it may
seem-jumping up and down on the spot, could be two of the most effective activities to undertake.

Look Before You Leap
Of course not everyone can or should exercise when being treated for cancer and it’s always
recommended that people consult with their doctor first.

There are lots of issues that can block someone from upping their activity level and these include lung
problems or medication that affects them, people with low white or red blood cell counts, pain, nausea or
fatigue-and once again if any symptom is of concern then patients need to consult their doctor or
specialist.

Even healthy people have trouble getting motivated to exercise regularly. A few things can help though –
first and foremost making sure that the exercise is enjoyable; that it is part of a daily routine; that people
start slow, warm up, build in rest periods; and that they think about which parts of the body they want, or
need, to exercise.

‘People tend to find many reasons not to exercise – no time, it’s boring, it’s too hot, it’s too cold – but
what they should focus on is that even a small amount of exercise each day can have a dramatic and
positive effect on their overall wellbeing,’ said Andrew Giles.
 




Prostate Cancer and PCFA

Facts and figures
•    A man has a 1 in 5 risk of developing prostate cancer by the age of 85-years. vi
•    If a first-degree relative (brother or father) has had a diagnosis of prostate cancer, the risk is
     increased three fold.
•    If two first-degree relatives have had prostate cancer, the risk increases eight fold.
•    Men in rural and regional Australia have a 21% higher prostate cancer mortality rate than men in
     capital cities. vii

In the early stages, there are few symptoms of prostate cancer – but if detected at this point, prostate
cancer is often treatable and curable. Men aged 50 and over should not wait for symptoms - they should
talk to their GP annually about prostate cancer. If there is a family history of prostate cancer, men should
talk to their doctor annually from the age of 40 and, if necessary, be tested. It’s a simple step that could
save their lives.

Prostate cancer is an abnormal growth of prostate cells that form a tumour in the prostate. In time, it will
spread to other organs, particularly the bones and lymph nodes, which can be life threatening. Unlike
other common prostate disorders, there are generally no obvious symptoms at this early and potentially
curable stage.

As prostate cancer develops, symptoms become more obvious and can include:
•    The need to urinate frequently, particularly at night;
•    Sudden urges to urinate;
•    Difficulty in starting urine flow;
•    A slow, interrupted flow and dribbling afterwards, or;
•    Blood in the urine or semen and pain during urination.

Men who experience these symptoms should see their doctor immediately to determine the cause –
these can also be symptoms of other common and non-life threatening prostate disorders - and best
treatment.

There are two simple tests that can be done by a GP:
•    The Digital Rectal Examination (DRE). The doctor inserts a gloved finger into the rectum to feel the
     prostate gland. This may detect hard lumps in the prostate before symptoms occur. PCFA
     research indicates that most men who have had the DRE test said it was simple and painless
•    The Prostate Specific Antigen (PSA) blood test. This test measures the amount of PSA in the
     blood. Around 1/3 of men with an elevated PSA reading will have prostate cancer. Other harmless
     prostate conditions account for the rest.

The Prostate Cancer Foundation of Australia is the peak national body for prostate cancer in
Australia. It is dedicated to providing support, raising awareness and funding research.

PCFA activities include:
•   More than 90 Prostate Cancer Support Groups around Australia where men and their partners are
    made welcome, share peer support and create community awareness. Links to each group can be
    found at www.prostate.org.au.
•   Prostate cancer information brochures available through GP surgeries, pharmacies and other
    health professionals;
•   Toll free information number (1800 22 00 99);
 


•         www.prostate.org.au - the PCFA website, offering detailed information on many issues related to
          prostate cancer;
•         Working with community partners such as Movember and beyond blue the national depression
          initiative to promote awareness;
•         Providing the latest information for GPs and other health professionals about prostate cancer;
•         Funding research projects nationally to encourage new researchers and established researchers to
          focus much-needed attention on issues relating to prostate cancer.

The Prostate Cancer Foundation of Australia receives limited funding from government and relies on the
generosity of individuals and the community and its important partnerships with corporate Australia to
carry out its essential work.

Contact PCFA toll free on 1800 22 00 99 or visit www.prostate.org.au


                                                        
i
   AIHW (Australian Institute of Health and Welfare) and AACR (Australasian Association of Cancer Registries) 2007. Cancer in Australia:
an overview, 2006. Cancer series no 37. Cat No CAN 32.
ii
    Laukkanen JA et al, July 2009, Intensity of leisure-time physical activity and Cancer mortality in men, British Journal of Sports Medicine.
iii
    Antonelli J et al, November 2009, Exercise and Prostate Cancer Risk in a Cohort of Veterans Undergoing Prostate Needle Biopsy, The
Journal of Urology, Volume 182, Issue 5, Pages 2226-2231
iv
    Physical Activity For Older Adults, Active Inform, June 2009
v
    Series of articles reviewing exercise and bone health, Medicine & Science In Sports & Exercise, the Journal of the American College of
Sports Medicine, November 2009, Vo 41, Issue 11.
vi
    Ibid.
vii
     Michael D Coory and Peter D Baade. Medical Journal of Australia 2005; 182 (3): 112-115. Urban-rural differences in prostate cancer
mortality, radical prostatectomy and prostate-specific antigen testing in Australia.




Men’s health education kit: valuable resource for health conscious
communities
 
Andrology Australia has developed a comprehensive Men’s Health Education Kit to provide community
members across Australia with the resources and information needed to run a successful men’s health
event. The kit includes a manual on how to run an event, a template for a promotional poster and a flyer, a
media release, follow-up article, evaluation form and a CD-ROM with information and interactive
presentations including comprehensive speaker notes. The development of the kit was supported by the
Rural Health Branch of the Australian Government Department of Health and Ageing. The Men’s Health
Education Kit was developed by Andrology Australia in collaboration with Mensline Australia, Bendigo
Community Health Services, beyondblue, cbus and Lilydale Medical Centre. If you would like to order a free
men’s health education kit, call 1300 303 878, email info@andrologyaustralia.org or visit
www.andrologyaustralia.org.
 
 


                                                                                                                                                                                                   




Resources (click on the heading to access)
Men’s Wellbeing Matters
This website provides the tools and resources for men focusing on becoming healthy. The Mornington
Peninsula is the target area, events are held, education is provided and men’s health and wellbeing
groups occur.

The M5 Project
The M5 Project is being managed by The Royal Australian College of General Practitioners as their GPs
are at the forefront of dealing with men’s health issues every day. This initiative has drawn together a
diverse group of health organisations all focused on ensuring men live long and rich lives. Is a bold new
movement that will use the number ‘five’ to break down the barriers that prevent Australian men from
going to a GP, and ultimately, save men’s lives.

Men's Health Australia
Men's Health Australia is Australia's primary source of information about the psychological and social
wellbeing of men and boys. It has been developed in partnership with the Men's Health Information &
Resource Centre (MHIRC) at the University of Western Sydney and the Australasian Men's Health
Forum (AMHF). A variety of education and resource Development is located on the website focusing on
a National Need.

Mens’ Health Survey Respondent Report, December 2008
The report was developed by Foundation 49. Some of the main results focused on family history, the
main reasons men do and don’t have health check ups, and what would make men have a health check.
Key things that would encourage men to have a regular health check are having a good doctor, staying
healthy for their partner and children and being able to have checks on weekends

Men’s Health Information & Resource Centre
MHIRC designs, develops and supports research and projects which contribute to the enhancement of
the health & well-being of men and boys in a variety of contexts:
•the workplace
•family relationships
•access to health and social support services. 

National Men’s Health Ambassador Speaker Program
This program is managed by Prostate Cancer Foundation of Australia and funded by the Australian
Government Department of Health and Ageing under the National Continence Management Strategy –
National Men’s Continence Awareness Project. Trained Ambassador Speakers are available in every
state and territory and are available anywhere in Australia any day, any time at no cost to present on
Prostate Health and Continence Health. ambassador@prostate.org.au 1800 206 700
www.prostate.org.au

Foundation 49
A Cabrini Health Initiative for men’s health information covering all aspects of physical and emotional
health in each decade of life. www.49.com.au 03 9508 1567or email admin@49.com.au
 


                                                                                                                                                                                                   
MensLine Australia
Run by Crisis Support Services offers professional telephone support and information service for men,
specialising in relationship and family concerns. Available nationally, for 24hours, 7 days a week for the
cost of a local call. www.menslineaus.org.au 1300 78 99 78

				
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