Physical activity can improve your physical and emotional health. It is important for managing weight, maintaining muscle, reducing your risk of heart disease, and keeping bones strong. Staying active can help with balance, improve your sleep, and reduce fatigue and anxiety. Exercise can also help with potential side effects of prostate cancer treatment.

The link between exercise, prostate cancer and treatment

Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a greater effect, especially on the risk of advanced prostate cancer. Also, in men with prostate cancer, physical activity is associated with better survival, and a modest amount of vigorous activity, about three hours a week, may substantially improve prostate cancer survival.

Many treatments for prostate cancer can have detrimental effects on your body. Hormone therapy can lead to osteoporosis and loss of muscle mass, both of which can be improved through exercise and strength training. Other treatments, such as surgery, can cause urinary incontinence (inability to control urine flow). Kegel exercises before and after prostate cancer treatment strengthen the pelvic-floor muscles, which can improve incontinence.

Any plan for physical activity should fit your personal situation and fitness level. Talk with your medical team before starting any exercise regimen.

Kegel exercises (Strengthening the pelvic-floor muscles)

The pelvic-floor muscles run from your pubic bone at the front of your groin to your tailbone in the back. They sit just under the prostate. Along with serving as a valve to the bladder, they support your bladder, prostate, and rectum in your pelvis. With prostate surgery, some muscle weakness is inevitable due to the proximity of these muscles to the prostate. By starting to strengthen your pelvic muscles before surgery, you can minimize your muscle weakness and also your risk for incontinence.

Your pelvic floor muscles can be engaged by contracting as if you want to stop your urine stream. To tell whether you’re using the right muscles, you can look for a lifting of your penis during the contraction. Avoid bearing down.

If you leak more when performing Kegels, you may be doing them incorrectly. A physical therapist may be able to help with and optimize your pelvic-floor strengthening program by providing assessment, observation, and biofeedback.

Before surgery

You can do Kegel exercises while lying down or sitting in a chair, depending on your comfort. Contract your pelvic floor for 10 seconds, followed by a 10-second rest. Repeat this five times. Perform this exercise three times a day until your surgery.

After surgery

After your catheter is removed, talk with your nurse or doctor about when to resume doing Kegel exercises (or when to begin them, if you weren’t doing them before surgery).

• Start with a gentle contraction (less that 100 percent effort) while lying down. Hold the contraction for three seconds, and then relax for 15 seconds. Do five repetitions, three times a day. Increase the intensity of the contraction each day. Also, increase the contraction time by one second and reduce the relaxation time by one second per day until you reach a 10-second hold and a 10-second rest. Continue doing five repetitions, three times a day.
• The next step is to perform the exercises while sitting or standing. Repeat the same intervals as above, starting with a five-second hold and 15-second relax and working up to a 10-second hold and 10-second relax.

You should notice a gradual decrease in urine leakage and an increase in your ability to wait longer between times you need to urinate. You should also be able to delay an urge to void for at least 15 minutes and get to the bathroom without leakage. Talk to your doctor if you continue to have difficulty with increased frequency of urination or leakage.

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The Canadian Physiotherapy Association (CPA) represents physiotherapists, physiotherapist assistants and physiotherapist students across Canada. CPA members are rehabilitation professionals dedicated to the health, mobility and fitness of Canadians.

Physiotherapists are primary health care professionals who combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.

More than 20,000 registered physiotherapists work in Canada, in private clinics, general and rehabilitation hospitals, community health centres, residential care and assisted-living facilities, home visit agencies, workplaces, and schools.

The CPA presents its educational references as a public service and for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership.