My interest in this, as an aging lifelong endurance athlete with PC, is the question of how much cardiovascular exercise is optimal (not just minimal) to maintain my fundamental fitness? Is there an upper limit at which it becomes detrimental?
I am using longevity studies to be a proxy for indicating the best level of fitness conferred by increasing volumes and intensities of exercise. "Cardiovascular fitness" is a measure of how much energy (Calories/Kg/min) we are able to sustain in exercise. Or alternatively, how much Oxygen we can utilize (VO2max) at our maximal intensity of exercise.
This measure gives a very good estimation of our efficiency and fitness at lower intensities of exercise. It is formally measured in a maximal exercise test on a treadmill or exercise bike. (Sometimes supplemented with blood lactate and exhaled respiratory gas measurements.)
We can do one of several simple tests that can give a rough estimate of VO2 max to assess our current CV fitness status. Perhaps the easiest of these is the Rockport Walking test. It simply requires walking a level measured mile at your fast but sustainable pace and noting the time it takes, and your heart rate immediately at the end. Here is a link and calculator:
Exercise "intensity" is often expressed in terms of "Mets", Metabolic equivalents. One Met is the amount of energy spent per kilogram of body weight per minute at rest. (Or entirely equivalent to Oxygen burned per kilogram per minute), when we are essentially at rest.
"Moderately" intensity exercise is a term applied to activities in the vicinity of 3.5 Mets. This is like somewhat brisk walking on level ground. Heart rate may go above 100, but we hardly notice it and breathing may be only mildly increased. No lactate buildup so it is enjoyable and we can talk easily. The American Heart Association and many other organizations recommend 150 minutes per week at this level as a desirable minimum.
"Vigorous" intensity exercises are those in the vicinity of 6.5 Mets or higher. The AHA and others suggest 75 min/week as an alternative minimum. These feel strenuous but not unsustainable. Breathing is much deeper and rapid. Heart rates may be 75 to 85 % of our maximum. Talking comes in short phrases. Here are links to an overview, with a link to a comprehensive listing, of activities and sports and estimates of their Mets.
So now that we can measure our own current fitness level and our distribution of moderate and vigorous exercise habits. What is optimal for fitness and longevity? The following prospective cohort study looked at over 200,000 Australians, ages 45-70. Followed for exercise habits (volume in minutes per week). Plus the proportion of that exercise that was "vigorous". These were compared with mortality rates.
Rates of mortality continued to decline with increasing volumes of exercise, up to and beyond 300 minutes per week. And additionally, mortality rates were further lowered when a higher percentages the exercise was done at "vigorous" levels, up to 30% of the total volume.
Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians
Results: During 1,444,927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71; crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57; crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49; crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98; crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93; crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus."Conclusions and relevance: Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity."Another study that was a meta-analysis of prospective cohort studies to estimate a "dose-response" relationship between volume of exercise and mortality. It included 661,137 men and women (116,686 deaths); median age 62 (range 21–98) years.It showed further reductions in mortality occurred at increased levels of exercise up to 3 to 5 times the recommended minimum. That would be 450 to 750 minutes per week (7.5 to 12.5 hours)! This is reassuring for me as that corresponds to my own usual minimum of 1.5 -2 hours most days. Furthermore they found no detriment (though also no additional mortality benefit) of up to 10 times the minimum of 150 minutes. 25 hours per week!
That’s an exhaustive and exhausting treatise on grip strength. Easy to measure and compare to norms. But so is walking speed and 6 second get up repeats from chair. The frail are obvious by any measure. And just as obvious is: that is not good. We know what to do!
Interesting and disappointing was that when I had a recent DEXA scan at local radiology center, and asked for values of axial skeletal muscle mass and muscle mass index, I was told they didn’t buy the software modules to calculate those. What?
And when I went to my Physical Therapy practice and asked for grip strength measurement and also knee extension and flexion strength on dynamometer, they said they didn’t have equipment for either. WTF?? And this is a very sports and fitness oriented community. 🤔
yes, and a recent study re balance control and longevity....hmm, I've never had great balance , going back to good ole days ???? yikes?? simple test, stand on one leg for x seconds , and so many seconds predicts good or poor longevity?? Just as accurate as BMI per the authors......but are these markers reaally useful for anything but academic interest/publication??????
There are so many studies with different results. Therefore the quantity and intensity of my trainings is based on my lifelong experience and inner voice, too. I do three types of trainings: weight lifting, gymnastics and running. All in all around 2-3 hours a day, sometimes I take a day off, normally one day a week. I trust that it’s beneficial to strengthen our muscles, especially the ones how are on ADT. And I think it’s good to keep our body flexible and balanced to prevent from falling. The running is for CV reasons and flooding the cells with oxygen. Sometimes I run longer, around 1 1/2 hours, sometimes only one hour. Sometimes I run faster, around 6:30 min / kilometer, sometimes slow around 7:30 min / km. Or anything in between, depends how I feel. One last comment: I decided to do what I can to fight prostate cancer but I also do what I can to make sure not to die to early from other diseases. I think too many are only focusing on PC. Statistics say, that more and more people with PC die because of other disease, mainly CVD.
I think you should do moderate cardio, and resistance training. Three times for each a week Have you thought about denying the cancer of glucose? Oncologists never tell us about that. Only drugs. Go on low carb diet, or keto. Both work on lowering glucose, and weight.
I wish I could recall the cite for something I just read recently from a genaerally reliable source...to the effect that glucose deprivation for some other type of cancer can be somewhat /quite beneficial...but not true for PCa .
More of more tips the seesaw negatively. Moderation is salvation. Thanks for your response. I'm 79, and am assiduous in exercising. Have been exercising for 50 plus years. Mainly running. Now, it's necessary to counteract the drugs. My diet is low carb, after diagnosis of prediabetes. I'm well aware of what the body needs. If you follow the recent scientific evidence you will find the advice on recommendations for food charts are topsy turvy. See Dr Ben Bikman On why We Get Sick.
Whenever there are posts about the benefits of exercise, most replies come with detail about workouts etc. We exchange our info which is great, but we might as well be in a secret society.
I say this because statistically less than 15% of Pca patients exercise. A sad reality. Perhaps they can get inspired by reading about us. Stop looking through the glass and come in is what I’d tell them.
Great material, we keep on walking uphill I do the McGill 3 every morning, it has rid me of lower back pain, do 55 situps carefully watching the form squatting below 90 degrees, do ten pushups with a lot of explosion. I play tennis twice a week, both exercise and friends powerful cocktail play , and I walk fast three times a week. I have trouble bringing myself to the gym, which I do every now and then, and actually after I started the McGill 3 I can move so much better that most of my exercise is of a reasonably high intensity. Strugling with my weight I am 220 pounder when I should be a 200 pounder but nobody is perfect. Anyway the material you posted is very valuable as always
Maybe 15% exercise because those numbers translate to even those that are healthy. Add in the "age" factor where exercise becomes less and I think that'll find you at the numbers.
I was never a gym guy. And more a "if I like it, I'll do it" person. So martial arts was my thing. 5x per weeks with 2-3 hours of Gi (uniform) soaking workouts, with stretching, body strength exercises, isometric exercises, grip strength, bone strength exercises, punching, kicking and weapons! Never felt better... And I still developed PCa being diagnosed @53 yrs of age. I also worked in an industry where I walked an average of 12-15 miles per day! Even before I retired and having a desk job, still walked 8-12 per day! And still developed PCa.
Point is, with all that and still getting PCa, I'm not sure how much of keeping that pace would exercise the dastardly disease from my body post diagnosis, lolz... I'm not discounting or dismissing the studies at all, just making light of it all! I'm not afraid to workout, I'm just a little lost right now.
I had issues that prevented me from jumping back in so to say, for the last 2 years, but lately feeling normal and increasing my physical exercising! Couldn't walk a mile+ but now can for miles. Got back on a bike recently and been pedaling away. I want to increase exercise as my body will allow, just looking for some motivation. I've retired (57yrs old) mainly due to StageIV and I'm worried about melting away, so exercise is high on my list. Again, I'm not a gym guy... Put back up the pull-up bar, have a treadmill too and resistance bands for now. I'd appreciate maybe some suggestions in the form of a regimen to get things going and build up strength, etc. Any and all suggestions accepted or PM if necessary.
I did a 5k at 17:20/mile in Tehachapi (4000ft up) last night after my 13th Cabazitaxel that pm.
My, maybe crazy theory, is that I want to increase my heart rate to have the chemo perfuse my entire body with the chemo, and to circulate thru more, thus maybe increasing the exposure of the chemo to the PCa, resulting in ore PCa death.
Plus, exercise increases BDNF (brain-derived neurotrophic factor) which may slow cognitive issues esp those on ADT and chemo (Chemo brain)
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Cardiovascular side effects of Lupron?
Cardiovascular Complications of Prostate Cancer Treatment
Tips for minimizing cardiovascular risk of lifelong hormone therapy
Food, fitness, and fatigue 
Fit or unfit for chemo (Docetaxel)?
