Football Practice Aids Prostate Cancer Patients’ Weak Bones

Football Practice Aids Prostate Cancer Patients’ Weak Bones

Men with prostate cancer run the risk of brittle bones as a side effect of their cancer treatment, but one hour of football or soccer training a few times a week can effectively counter that risk, according to articles published in Osteoporosis International and the Scandinavian Journal of Medicine and Science in Sports. The two articles were from a PhD thesis by Jacob Uth, a physiotherapist at the University Hospitals Centre for Health Research (UCSF) at Copenhagen University.

The studies, titled “Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy”and “Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy: 32-week follow-up of the FC prostate randomised controlled trial,” revealed that even older men receiving treatment for prostate cancer can strengthen their bones by playing football (known as soccer in the U.S.), and benefit the muscles of the body and the heart in the process. The findings are notable because prostate cancer patients have weaker bones as a result of the disease and, especially, because of Androgen deprivation therapy (ADT)  given to lower testosterone levels and known to impair musculoskeletal health.

The bones in men undergoing ADT become decalcified, putting them at an increased risk of osteoporosis.

“Football training counters many side-effects of the treatment. It is impressive to see such big improvements in both muscular strength and bone density, despite the anti-androgen treatment,” Peter Krustrup, Uth’s supervisor and a Professor of Team Sport and Health in the Department of Nutrition, Exercise and Sports at Copenhagen University, said in a recent news release.

Acceleration and braking make football effective

Uth tracked training activities with the use of a GPS. The measurements showed that players’ average speed was relatively low, but every hour included hundreds of accelerations, decelerations and sudden brakes. This is thought to be the reason why football training was an ideal exercise.

“The changes in bone mass in the legs of the football group show a significant correlation with the number of times they accelerate and brake. This gives an indication that the effect is linked to the specific activity that we see in football, where there is interval running with a lot of accelerating and braking which place great stress on the bone tissue, and that is what makes them stronger,” Uth said. “The more the bones are affected from different angles during exercise, the more complete the stimulation. When you change direction, kick and block the ball, and when you are challenged by an opponent as you are in football, there is a wide range of powerful stimuli to the bone tissue.”

About the FC Prostate study

For the study, 57 men receiving ADT for more than six months were randomly allocated to a football training group (n = 29) practicing 2-3 times per week for 45-60 minutes, or to a standard care control group (n = 28) for 32 weeks.

The study outcomes were total hip, femoral shaft, femoral neck and lumbar spine (L2-L4), bone mineral density (BMD) and systemic bone turnover markers (BTMs), like pro collagen type 1 amino-terminal propeptide, osteocalcin, and C-terminal telopeptide of type 1 collagen. In addition, researchers also evaluated physical functioning (postural balance, jump height, repeated chair rise, stair climbing).

The results revealed that compared to standard care, 32 weeks of football training improved BMD at clinically important femoral sites and in other parameters of physical functioning.

“Our so-called FC Prostate study showed that just 12 weeks of football training increased leg bone mass and elevated the blood-borne bone formation markers osteocalcin and P1NP by 35 and 50%, respectively. After 32 weeks of training, we observed a systematic 1-2% increase in bone mineral density at the hip and upper part of the thigh bone in the football players compared to the control group, equivalent to bones 2-4 years younger,” Professor Krustrup said.

Equally important, two years after the FC Prostate trial ended, many of the men are still playing football.