Special Programs

Overview

Men diagnosed with advanced stage prostate cancer can often have potential contraindications (health-specific restrictions) that can influence the type of exercises that can be performed. While our beginner and advanced programs are suitable for the majority of men with prostate cancer, modifications are required for men in the advanced stages of prostate cancer, especially if it has metastasised to bone!

In recent clinical trials by the ECU Health and Wellness Institute, exercise therapy for men with advanced prostate cancer and bone metastases has been demonstrably beneficial for this high-risk population. In particular, aerobic and resistance exercise is safe and effective for men with bone metastases when supervised and individually tailored to avoid direct loading of bones with secondary tumours.

If you are in the advanced stages of prostate cancer, and have known bone metastasis as identified by your physician and examinations from usual care; you can safely participate in exercise. It is essential that you consult with an accredited exercise physiologist who specialises in cancer management so that a special program can be developed for your unique condition and personal circumstance.

Exercise

Generally, exercises will be modified for you based on the location and severity of any bone lesions, as outlined in the table below:-

   Upper Trunk Lower WB NWB Static
 Pelvis
✓**
 
 Axial Skeleton (lumbar)

    ✓***
 Axial Skeleton (thoracic/ribs)
✓*   ✓***
 Proximal Femur

✓**  
 All Regions
✓*   ✓**   ✓***
✓ = target exercise region;
* = exclusion of shoulder flexion/extension/abduction/adduction – inclusion of elbow flexion/extension;
** = exclusion of hip extension/flexion – inclusion of knee extension/flexion;
*** = exclusion of spine/flexion/extension/rotation;
WB = weight bearing (e.g. walking);
NWB = non-weight bearing (e.g. cycling).

Your consulting physician, in collaboration with your accredited exercise physiologist, will determine your exercise selection based on the location and severity of bone lesions. This will be modified where appropriate through-out your program in response to your feedback and ongoing consultations with these professionals.

To assist your understanding, as an example, if you have a lesion in your Pelvis (which is very common in men with advanced prostate cancer which has metastasised); you are able to perform any resistance exercises involving the upper-body and trunk, with modified resistance exercises involving the lower-body to only allow knee movements while avoiding hip movements. Similarly, you would not perform weight-bearing aerobic exercise, but could perform any non-weight-bearing aerobic exercise and any flexibility exercises. To read the table, you find the location of the lesion (in this case Pelvis), and trace along the row to determine what is permissible and what is to be avoided. In all cases you must seek confirmation and approval from your team of physicians and physiologists so that they can modify your program(s) acquired from the Beginner or Advanced levels to include appropriate exercises for your situation!