Cardiovascular health and physical activity in prostate cancer survivors compared to non-cancer age matched controls

Abstract

Background: In New Zealand, prostate cancer is the most commonly diagnosed cancer in men and the third most common cause of male cancer deaths. Better detection, diagnosis, and treatment have improved the five-year prostate cancer survival rate. Although the survival rate is improved, many men do not survive well, with the development of other chronic health conditions being a major concern. Many men with prostate cancer will die of a non-cancer related cause. Cardiovascular disease (CVD) is responsible for 27% of all prostate cancer survivor deaths. It is therefore becoming an imperative research area to establish preventative strategies that will help protect men with prostate cancer from developing comorbidities. Aim: To assess the status of cardiovascular health of prostate cancer survivors (PCa) on a range of treatments and compare them to non-cancer age matched controls (CON). In addition, the association between cardiovascular health variables and physical activity, cardiorespiratory fitness, body composition, and physical function was investigated. Methods: This case control, cross-sectional study recruited 99 participants (PCa: n = 52; CON: n = 47). Men with prostate cancer had either completed (except hormonal therapy) or not started treatment, while the controls were cancer-free. During a single one-hour appointment, participants had their cardiovascular health assessed using the SphygmoCor XCEL, overall physical fitness tested by handgrip strength and the single stage walk test, body composition using bioelectrical impedance analysis, and physical activity examined via International Physical Activity Questionnaire Long Form. Results: The control group demonstrated a higher peripheral and central systolic blood pressure (p < 0.05), while all other cardiovascular measures did not differ between groups. Skeletal muscle mass (p < 0.05) was found to be greater in the control group, as was handgrip strength (p < 0.05). Both groups had similar physical activity habits and cardiorespiratory fitness levels. Only age (PCa: r = 0.625, p < 0.01, CON: r = 0.460, p < 0.01) and VO2max (PCa: r = -0.391, p < 0.05, CON: r = -0.362, p < 0.05) were significantly correlated with pulse wave velocity. Other group-specific relationships were found with strength, fitness, and body composition with various central cardiovascular measures. Conclusions: Examining only cardiovascular variables, there was no difference in CVD risk between men with prostate cancer and non-cancer controls. However, looking at the spectrum of CVD risk factors and cardiovascular health moderators, the prostate cancer survivors may be at a greater risk when compared to non-cancer controls.