title: Enhancing active surveillance of prostate cancer: the potential of exercise medicine.
abstract: Active surveillance (AS) is a strategy for the management of patients with low-risk, localized prostate cancer, in which men undergo regular monitoring of serum PSA levels and tumour characteristics, using multiparametric MRI and repeat biopsy sampling, to identify signs of disease progression. This strategy reduces overtreatment of clinically insignificant disease while also preserving opportunities for curative therapy in patients whose disease progresses. Preliminary studies of lifestyle interventions involving basic exercise advice have indicated that exercise reduces the numbers of patients undergoing active treatment, as well as modulating the biological processes involved in tumour progression. Therefore, preliminary evidence suggests that lifestyle and/or exercise interventions might have therapeutic potential in this growing population of men with prostate cancer. However, several important issues remain unclear: the exact value of different types of lifestyle and exercise medicine interventions during AS; the biological mechanisms of exercise in delaying disease progression; and the influence of the anxieties and distress created by having a diagnosis of cancer without then receiving active treatment. Future studies are required to confirm and expand these findings and determine the relative contributions of each lifestyle component to specific end points and patient outcomes during AS.
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Galvão
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|School of Medicine, University of Wollongong, Wollongong, New South Wales 2522, Australia.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Taaffe
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Spry
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|University of Queensland Medical School, 288 Herston Road, Herston, Brisbane, Queensland 4006, Australia.|Department of Urology, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland 4029, Australia.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gardiner
authors.affiliation: Cancer Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria 3800, Australia.
authors.forename: Renea
authors.initials: R
authors.lastname: Taylor
authors.affiliation: Cancer Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria 3800, Australia.
authors.forename: Gail P
authors.initials: GP
authors.lastname: Risbridger
authors.affiliation: Department of Surgery, Monash University, Melbourne, Victoria 3800, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.affiliation: The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Queensland 4072, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hill
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|Menzies Health Institute of Queensland, Griffith University, Brisbane, Queensland 4222, Australia.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Chambers
authors.affiliation: Suite 1001, St Vincent's Prostate Cancer Centre, 438 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Stricker
authors.affiliation: Suite 32, Hollywood Specialist Centre, 95 Monash Avenue, Nedlands Western Australia 6009, Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Shannon
authors.affiliation: Department of Surgery, University of Western Australia (M704), 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
authors.forename: Dickon
authors.initials: D
authors.lastname: Hayne
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|Institute of Cardiovascular Research and Sport Medicine, German Sport University, Graditzer Strasse 87D, Köln 50735, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Zopf
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.|University of Queensland Medical School, 288 Herston Road, Herston, Brisbane, Queensland 4006, Australia.
authors.forename: Robert U
authors.initials: RU
authors.lastname: Newton
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods; D005081:Exercise Therapy / Q000379:methods* / Q000639:trends; D006801:Humans; D008297:Male; D060787:Neoplasm Grading / Q000379:methods / Q000639:trends; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D057832:Watchful Waiting / Q000379:methods* / Q000639:trends
chemical_list: D017430:Prostate-Specific Antigen