Aerobic Recovery after Radical Prostatectomy: A Case Study

This case study examined the recovery after radical prostatectomy (RP) of an endurance-trained 65-yr-old man.

A maximal incremental exercise test and a 1-h steady-state test were performed just before and 3 months after robotic RP to determine maximal oxygen consumption (V˙O2max) and other cardiorespiratory variables. The patient recorded his training as he prepared for an endurance event that was to occur 3 months after RP, the Norwegian Foot March, a 30-km road march carrying 11.4 kg.

In the month before RP, the patient performed 2 to 3 h of vigorous-intensity aerobic exercise per week, fast walking carrying an 11.4-kg pack, with the longest individual session being a 16-km road march. Just before surgery, V˙O2max was 36.7 mL·min·kg, HR during 30 min at 7.2 km·h and 0% grade was 77% of HR reserve (HRR), and during 30 min at 5.3 km·h and 10% grade was 92% HRR. On postsurgery day 44, he did a 19-km road march carrying 11.4 kg, exceeding the training level of the month presurgery. Three months postsurgery, V˙O2max was 42.7 mL·min·kg, and HR during the flat and uphill 30-min sessions at the same absolute intensity as presurgery were 70% and 83% HRR, respectively. He completed the Norwegian Foot March 93 d postsurgery in 4:24:37, with an average HR of 72% HRR.

This case study demonstrates that an aerobically trained prostate cancer patient can return to high-level aerobic training in as little as 7 wk post-RP, and even exceed presurgery fitness. This finding has implications for prognosis given the beneficial effect of vigorous-intensity exercise on prostate cancer progression.