Stage III and Stage IV diagnoses of prostate cancer represent the advanced stages of disease progress, categorised by the spread of secondary tumour(s) to surrounding or distant tissues or organs. While prostate cancer can metastasise (spread) anywhere in the body, the most common secondary location is bone (the skeleton); specifically the pelvis or spine, and can grow at a rapid pace. Secondary prostate cancer tumours are often discovered through various imaging techniques, and depending upon the location and size of these tumours, can require a variety of treatment options which can have dramatic side-effects.
Common treatments for men with metastatic (advanced) prostate cancer can include androgen-deprivation therapy (ADT), radiotherapy and chemotherapy. Surgical removal of organ(s) or tissue(s) invaded by secondary tumours may also be an option in very few cases; however, bone metastases (~80% of metastatic cases) is presently inoperable and incurable. In these cases, therapies act to slow the progression of cancer through various mechanisms in order to increase life expectancy. Other drugs might be administered, such as bisphosphonates, to address side-effects of these treatments. Ultimately, this will depend on whether your specific cancer is responsive or resistant to hormone manipulation.
It is important to understand that exercise, even at this stage of disease progression, remains very relevant to your health. Rather exciting and emerging evidence is beginning to provide an insight into the safety and efficacy of exercise towards slowing tumour invasion, growth and spread by interfering with tumour formation processes. Similarly, exercise in these advanced stages can help prevent muscle and bone loss, maintain good body composition, and ultimately assist you with improving physical function, independence and psychosocial wellbeing. Exercise can also help you with reducing symptoms resulting from the various treatments provided to you.
Men with advanced prostate cancer may encounter many barriers to exercise. There are many possible side-effects resulting from treatments administered to you. Further, bone metastases can increase skeletal fragility which has historically led to clinicians and patients abstaining from exercise participation. However, given the many benefits to your health and wellbeing, we strongly recommend you engage in exercise. You will require modified exercise programs, and should read through our Special Program section, prior to seeking approval from your consulting physician. It is important that you discuss your medical limitations with your physician prior to meeting with your accredited exercise physiologist who specialises in cancer management. Exercise can be safely performed with appropriately written and supervised programs.