Exercise and Genitourinary Cancer Survivorship (#10)
Cancers of the genitourinary system include those of the prostate, bladder and kidneys, as well as less common cancers such as those of the urethra and ureters. However, exercise oncology research in genitourinary cancer has been primarily limited to prostate cancer. Prostate cancer represents the major cause of genitourinary malignancy (25%) and approximately 91% of new cases are expected to be diagnosed at local or regional stages. Treatments for prostate cancer are increasingly effective with high 5- and 10-year survival rates; however, adverse treatment effects in particular for androgen deprivation therapy (ADT) impact on quality of life and increase co-morbidities. Men with prostate cancer undergoing ADT gain fat mass, lose muscle and bone mass, and are subject to an array of adverse effects from therapy. These risks are especially important for men with long life expectancies such as those undertaking ADT as neoadjuvant/adjuvant programs with curative radiation. Exercise has been demonstrated to be a very effective countermeasure for a number of these treatment toxicities as well as improving mental health, sexual and physical function and quality of life. Moreover, exercise has been demonstrated to be safe and well tolerated by prostate cancer survivors with localized disease and more recently in survivors with bone metastatic disease with clinical trials in progress to confirm and expand these novel findings. Current recommendation from exercise oncology guidelines is to complete at least 150 min of aerobic exercise and two or more sessions of resistance training per week. More specific exercise prescription is required to address particular treatment toxicities such as bone loss or obesity. Finally, additional studies are needed in genitourinary cancers other than prostate to establish specific exercise training requirements and implementation strategies.