Getting the Lead Out

A study I came across in the 2021 online JAMA Oncology issue noted that high-intensity exercise just might be associated with improvements in prostate cancer progression, especially for those men who find themselves on active surveillance.

The study was done on some 52 men on active surveillance for low-risk to favorable intermediate prostate cancer risk. This study supervised high intensity interval training for one group of men. The second group was more casual when it came to exercise.1

Where it gets interesting

Here is where it gets interesting. The average prostate specific androgen level in the highly active group fell rather nicely from 6.1 nanograms to 5.7. At the same time, the PSA levels for the more casual exercise group saw an increase in PSA levels. The more intense exercise group also experienced reductions in overall PSA velocity (the measurement of PSA rise over a period of time) and in prostate cancer cell growth, compared to the casual exercise group.1

While the study recommends larger trials to evaluate if there is any connection, it suggests to me that a commitment to exercise might play an important role in my prostate cancer progression and in slowing it down.

How much exercise?

The next question that arises is how much exercise I should be doing, and how I measure the intensity of a workout. For those around the age of 70, the average heartbeat is around 150 beats a minute. If a doctor is recommending doing a workout at approximately 60% of that maximum heart rate, the heart rate during exercise would ideally be between 70 and 90 beats a minute.2

It is very important to speak with your doctor before starting any exercise program. Why you ask? So your MD can take into consideration any medications or beta blockers you might be taking that could impact heart rate levels.

A simple measure to determine if you are at the right exercise level is to see if you can talk or sing while doing exercise. If you can do either during a workout, it's possible you are not working out vigorously enough. Conversely, if you cannot carry on a conversation, or in my case sing (God forbid), you may be working too hard. As with all things in life, the sing/talk test is a rough guide, but it can work.

Measuring heart rate

Again, please remember to check with your MD. My neighbor was shocked to learn after a recent physical that he had suffered a silent heart attack a year earlier. Today he has just 30% of his heart muscle remaining. Any type of intense exercise program would not have the best outcome for him. He now plays 9 holes of golf vs 18, and as his MD suggested, he now takes a cart.

How do you measure heart rate? I use a fitness tracker. You can also check your own pulse by placing your index and middle finger on either side of your throat. Then using a stopwatch, you count the number of beats in a minute or double that number if you only count for 30 seconds. A typical heart rate during moderate intensity exercise should be about 50 to 70% of your maximum heart rate. Candidly, I much prefer to use a fitness tracker; it is a lot easier for me.3

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