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PCF Scientific Retreat 2021: Top Stories For Patients
Part 1: Survivorship and Lifestyle

The PCF 28th Annual Scientific Retreat was held virtually over 4 days in October and November. Once again, researchers, industry partners, clinicians, patient advocates, and others were able to join from anywhere in the world to discuss the latest findings in prostate cancer research, treatment, and survivorship. PCF’s Dr. Andrea Miyahira has identified the top stories for patients.

PCF funds research to help men not only survive through prostate cancer, but to thrive. Three key presentations focused on lifestyle changes that can help men live better, and even reduce the chance of fatal prostate cancer in men at high genetic risk.

 

For Prostate Cancer Survivors, Exercise is Medicine

Christina Dieli-Conwright, PhD, MPH

Harvard: Dana-Farber Cancer Institute

What this means for patients: Dr. Dieli-Conwright has shown that exercise significantly benefits patients with prostate cancer, including improving fitness and quality of life, reducing obesity and other metabolic problems, and reducing muscle wasting. Exercise is a key “prescription” for better outcomes.

The use of exercise to enhance the lives of people diagnosed with cancer dates back 100 years, when doctors noticed an inverse relationship between cancer mortality and “muscular work.” The field of exercise oncology has gained ground, especially in the last 10 years, as studies verified the many health benefits linked to consistent exercise. Much like diet, exercise is known to improve physical and mental quality of life for everyone, with very probable additional benefits to patients with prostate cancer. Today, exercise guidelines have been established for cancer survivorship, and include both aerobic and resistance exercise.

Dr. Dieli-Conwright reported on several clinical trials of exercise in patients with prostate cancer, especially among those undergoing ADT. Exercise interventions had multiple health benefits, including  reduced waist circumference, greater lean mass, and improved fitness. Patients on active surveillance participating in high-intensity interval training had lower PSA levels and slower rise in PSA. Obese men saw improvements, such as a lower chance of developing type 2 diabetes. Overall, exercise should be considered paramount for patients seeking to optimize their health and quality of life during and after treatment. Future studies will help identify the most effective exercise “prescriptions” for prostate cancer survivors.

 

Wake Up! It’s Time to Address Sleep Issues in Prostate Cancer

Stacy Loeb, MD, MSc, PhD (Hon)

New York University; Manhattan Veterans Affairs Hospital

What this means to patients: Sleep is important to physical and mental health. Sleep disturbances are experienced by the large majority of prostate cancer patients and caregivers. More studies into the links between sleep and prostate cancer, as well as interventional studies to improve sleep in patients are needed to improve patient outcomes and quality of life.

Sleep disturbances—such as insomnia and obstructive sleep apnea—are common and are known to have both mental and physical health consequences. Several studies have investigated the relationship between sleep or circadian rhythm disturbances with prostate cancer risk, and many, but not all, suggest an association.

Dr. Loeb and team used a number of methods to study the links between sleep/circadian disruptions and prostate cancer. These include “social listening,” a method that evaluates posts on online prostate cancer communities, surveys of patients and caregivers, and reviewing scientific studies.

Social listening studies found that sleep was a common concern among prostate cancer patients. Surveys found that sleep disturbances are very common among patients and caregivers, with 67% of patients and 88% of caregivers meeting cutoffs for poor sleep quality. However, a survey of urologists found that sleep is rarely discussed with patients and sleep quality is rarely measured.

The team recently initiated a trial that will test a 3-month digital sleep intervention in prostate cancer patients. Dr. Loeb’s practical suggestions for improving sleep hygiene include:

Sleep

 

Healthy Lifestyle Can Offset a High Genetic Risk of Prostate Cancer

Anna Plym, PhD

Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health

What this means for patients: People can’t change their genes, but they can change their lifestyle by increasing exercise, maintaining a healthy weight, quitting smoking (or not starting), and choosing healthy foods such as tomatoes and fatty fish. This study shows that for men at high genetic risk of prostate cancer, lifestyle changes may be key to lowering their risk of dying from the disease.

Prostate cancer is highly heritable, with over 50% of cases being linked to inherited factors. The recently developed Smith test can identify men at highest genetic risk for prostate cancer. Studies by Dr. Plym and colleagues have validated the Smith test and now show that having a healthy lifestyle can reduce the chance of lethal prostate cancer by about 45% in men with highest genetic risk. This suggests that exercise, not smoking, and a healthy diet are essential tools to offset prostate cancer risk in this population.

Read more about this study here, and more information for men at high genetic risk of prostate cancer here.

 

Part 2 – Promising Treatments, New Methods, and Overcoming Prostate Cancer Disparities

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