Exercise and Prostate Cancer
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REVIEW ARTICLE
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Exercise and Prostate Cancer Dorothea C. Torti1 and Gordon O. Matheson2 1 2
Program in Human Biology, School of Humanities and Sciences, Stanford University, Stanford, California, USA Division of Sports Medicine, Department of Orthopedic Surgery, School of Medicine, Stanford University, Stanford, California, USA
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363 1. Cohort Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364 2. Case-Control Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365 3. Mechanistic Models: How Might Exercise Affect Prostate Cancer Risk? . . . . . . . . . . . . . . . . . . . . . . . . 366 3.1 Alterations in Hormones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366 3.2 Enhancement of the Immune System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366 3.3 Prevention of Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366 3.4 Generation of Reactive Oxygen Species . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366 4. Methodological Issues: Obstacles and Problems in Study Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367 5. Exercise and Prostate Cancer Therapy: Role in Preventing Bone Mineral Loss . . . . . . . . . . . . . . . . . . . 367 6. Conclusion and Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Abstract
Prostate cancer is a leading cause of cancer morbidity and mortality in men. In addition to improved treatments, strategies to reduce disease risk are urgently required. This review summarises the literature that examines the association between exercise and prostate cancer risk. Between 1989 and 2001, 13 cohort studies were conducted in the US and internationally. Of these, nine showed an association between exercise and decreased prostate cancer risk. Five of 11 case-control studies conducted between 1988 and 2002 reported an association between decreased risk of prostate cancer and high activity levels. Considering all studies performed between 1976 and 2002, 16 out of 27 studies reported reduced risk in men who were most active; in nine out of 16 studies the reduction in risk was statistically significant. Average risk reduction ranged from 10–30%. In aggregate, this evidence suggests a probable link between increased physical exercise and decreased prostate cancer risk. The ability of exercise to modu
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