Exercise guide
Exercise is usually safe for men with prostate cancer, at every stage. If you're starting hormone therapy, NICE (the National Institute for Health and Care Excellence) recommends that you're offered supervised strength and aerobic exercise at least twice a week for 12 weeks: in trials it built muscle, limited fat gain, eased tiredness and improved quality of life. Exercise didn't change PSA (prostate-specific antigen, the blood test used to follow the cancer) in trials, and it works alongside your treatment, not instead of it.
This guide covers how much to do and how to start, looking after your bones and heart on hormone therapy, exercising when the cancer has spread to the bones, and getting back to activity after a prostatectomy, with the pelvic floor exercises NICE recommends for leaking. Timings after surgery differ between hospitals, so your own team's advice comes first.
Prostate Cancer UK says it's usually safe to be active with prostate cancer and during treatment. If you're not active now, start with 10 to 15 minutes and build to 30 minutes of moderate exercise on 3 to 5 days a week, with some muscle-strengthening work.
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NICE recommends that men starting or having hormone therapy are offered supervised strength and aerobic exercise at least twice a week for 12 weeks, to reduce fatigue and improve quality of life. Across 18 trials (1,477 men), supervised exercise improved quality of life and walking.
In trials, 12 weeks of strength and aerobic training increased muscle and strength in men on hormone therapy, and starting when hormone therapy started limited fat gain (about 1.4 kg less fat after 3 months).
Hormone therapy thins bones, mostly in the first year, and makes fractures more likely. Two trials found strength and impact exercise slowed bone loss in the spine, but Prostate Cancer UK says it isn't yet known whether exercise protects bones. Check with your doctor before high-impact exercise or contact sport.
Across 8 trials (594 men), exercise didn't change PSA or testosterone levels. No trial has shown that it slows the cancer or helps men live longer.
Walk from the day after. Prostate Cancer UK says avoid heavy exercise for 4 to 6 weeks and heavy lifting for 8 weeks; East Kent's hospital leaflet says no heavy lifting for 4 weeks. NICE recommends pelvic floor exercises for leaking, kept up for at least 3 months, and Prostate Cancer UK suggests starting them before surgery if you can.
There are about 57,900 new cases of prostate cancer a year in the UK, and about 1 in 8 men get it in their lifetime; 78.9% survive 10 years or more. The risk rises with age, and is higher in Black men and in men with a family history.
Treatment may be monitoring, surgery to remove the prostate (a radical prostatectomy), radiotherapy, often with hormone therapy, or hormone therapy on its own. Monitoring means watchful waiting, with check-ups and blood tests at your general practitioner (GP) surgery, or active surveillance, with regular tests and scans in hospital.
Hormone therapy (androgen deprivation therapy, ADT) lowers or blocks testosterone, which controls muscle strength, erections and other male characteristics. The effects that matter for exercise are tiredness (fatigue), muscle loss, weight gain around the waist, bone thinning (mostly in the first 12 months, and more the longer you're on it), hot flushes, and possibly more heart disease, stroke and type 2 diabetes.
After a prostatectomy, a tube (catheter) drains your bladder for about 1 to 2 weeks. Leaking urine is common once it's out and usually improves with time, and erection problems are common too. In the ProtecT trial, as NICE reports it, 19 in 100 men offered surgery had moderate to severe leaking at 6 months, and 13 in 100 at 6 years.
The pelvic floor muscles run from the pubic bone to the base of the spine. They support the bladder and bowel, help you control when you wee, and help with erections. After surgery, leaks tend to happen when you cough, sneeze, lift or stand up, and more towards the end of the day as the muscles tire.
Doses are starting points; build up to them from where you are.
Be active at least 2 to 3 times a week. Start with 10 to 15 minutes if you need to, and work up to 30 minutes of moderate exercise on 3 to 5 days: your heart beats faster but you can still talk, as in a brisk walk, and 3 lots of 10 minutes count. Include muscle-strengthening exercise such as body weight exercises, yoga or Pilates. On hormone therapy, gentle resistance exercise with light weights or elastic bands is particularly good.
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NICE recommends supervised strength and aerobic exercise at least twice a week for 12 weeks for men starting or having hormone therapy. The trials used 2 to 3 supervised sessions a week, for 12 weeks to a year.
An international roundtable convened by the American College of Sports Medicine (ACSM) suggests moderate aerobic exercise at least 3 times a week for at least 30 minutes, plus strength training at least twice a week, 2 sets of 8 to 15 repetitions with a moderate weight. For fatigue, strength training twice a week worked well, particularly in prostate cancer.
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NICE's offer and the trials are supervised. Ask your team about an NHS or charity exercise programme near you; if there isn't one, look for a qualified exercise professional or physiotherapist with cancer experience (our suggestion). Prostate Cancer UK can point you to local groups.
Speak to your GP, nurse or hospital doctor before you start, especially if you have joint or muscle problems. Check with your doctor before high-impact exercise such as running, or contact sport, if you're on hormone therapy or the cancer has spread to your bones.
Source 1
Across 18 trials (1,477 men on hormone therapy), supervised exercise improved prostate cancer-specific quality of life and walking compared with no exercise, with moderate certainty. NICE recommends it to reduce fatigue and improve quality of life.
In 57 men already on hormone therapy, 12 weeks of strength and aerobic training increased muscle, strength, walking and balance, and eased fatigue, with no adverse events. In 63 men who started supervised exercise within 10 days of their first injection, 3 months of training kept arm and leg muscle and prevented fat gain (1.4 kg less fat than men who didn't exercise). Both trials were small.
In 100 inactive men on long-term hormone therapy, a 12-week programme improved quality of life, but the gain had gone 6 months after support stopped. The benefit for fatigue lasted.
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A review of 16 trials (1,574 men at all stages) found exercise improved cancer-specific fatigue, fitness and leg strength. No deaths were caused by exercise, and serious side effects were no more common than without it. It found no evidence of benefit for how the cancer progressed, for heart health or for sexual function.
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In 121 men having radiotherapy, 24 weeks of strength or aerobic training both reduced fatigue in the short term, and strength training also improved quality of life, strength and body fat for longer. Pelvic floor exercises are safe during and after radiotherapy.
Across 8 small trials (594 men), exercise didn't change PSA or testosterone levels.
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No trial has shown that exercise slows prostate cancer or helps men live longer. A review found no evidence that it slows progression, and a global trial set up to test survival (INTERVAL-GAP4) closed early after recruiting 145 men, 17% of its target.
At least twice a week, 2 sets of 8 to 15 with a moderate weight (ACSM roundtable), supervised at first if you can (NICE). Start with the chair sit-to-stand, the hip hinge and bands, and after surgery tighten your pelvic floor before each lift.
3D demoSit to stand from a chairBeginner · A bench or box
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoLeg pressBeginner · Strength machine
3D demoStep-upBeginner · A step
3D demoHip-hinge practiceBeginner · No equipment
3D demoDumbbell Romanian deadliftIntermediate · A dumbbell
3D demoIncline push-upBeginner · A bench or box
3D demoChest press machineBeginner · Strength machine
3D demoBand rowBeginner · A band + An anchor point
3D demoSeated cable rowBeginner · A cable machine
3D demoLat pulldownBeginner · A cable machine
3D demoStanding overhead pressIntermediate · A barbell + A dumbbell
3D demoFarmer's carryBeginner · A dumbbell + A kettlebellBuild to 30 minutes on 3 to 5 days a week at a pace where you can still talk (Prostate Cancer UK). After a prostatectomy, ask your surgical team before cycling.
Bone thinning starts in the first 12 months of hormone therapy and increases the longer you're on it. In US records of 50,613 men, 19.4% of those on hormone therapy had a fracture within 5 years, against 12.6% of those not on it. Your doctor may arrange a bone density scan (a DEXA scan), and NICE asks doctors to consider assessing your fracture risk.
Two trials found exercise slowed bone loss in the spine. In 104 men starting hormone therapy, 6 months of supervised strength, aerobic and impact exercise largely kept spine bone density (a 0.4% loss, against 1.6% in men who started 6 months later), though bone at the hip thinned in both groups. In 154 men, a year of impact and strength training about halved bone loss in the spine (about 1% against 2%).
But Prostate Cancer UK says it isn't yet known whether exercise can help prevent bone thinning on hormone therapy, though regular exercise may keep you strong and prevent falls that could break bones. The ACSM roundtable says walking alone isn't enough for bone.
Check with your doctor before high-impact exercise such as running, or contact sport, on hormone therapy or with cancer in the bones. Avoid activities where you could fall, wear well-fitting shoes and take care on uneven ground. The ACSM roundtable warns that impact may not be safe with fragile bones or cancer in the hip or spine, and advises avoiding loaded bending, extreme bending forwards or backwards and fast twisting where bones are fragile.
Without cancer in the bones, and with your doctor's agreement, heel drops are the gentlest start: the heel drop page builds from 20 to 30 drops to about 50 impacts on most days. Add balance work at least twice a week, as our osteoporosis guide suggests (our suggestion for men on hormone therapy).
NICE says bisphosphonates shouldn't be given routinely to prevent bone thinning on hormone therapy, but should be offered if you have osteoporosis, with denosumab considered if they're unsuitable. Exercise works alongside your doctor's checks and medicines, not instead of them.
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At least twice a week, next to a wall or a sturdy chair (our suggestion, as in the osteoporosis guide). Heel drops only without cancer in the bones and with your doctor's agreement.
Prostate Cancer UK says hormone therapy might increase the chance of heart disease, stroke and type 2 diabetes. Observational studies link it with more non-fatal heart disease (about 38% more, across 8 studies), but a pooled analysis of 8 randomised trials (4,141 men) found no extra deaths from heart disease. It's a possible risk to keep an eye on with your doctor; don't stop treatment because of it.
In trials, exercise improved fat, fitness and the cholesterol ratio, but a review found no evidence that it improves heart health outcomes. Prostate Cancer UK says activity and a healthy diet help you stay a healthy weight, though weight gained on hormone therapy can take a long time to lose. Exercise is one part of looking after your heart, alongside the checks your doctor arranges.
In 57 men whose cancer had spread to the bones, 3 months of supervised aerobic, strength and flexibility exercise, planned to avoid loading the affected bones, improved physical function and leg strength, with no fractures and no extra bone pain. The ACSM roundtable asks for a medical check and clearance first, and referral to trained staff. Avoid high-impact exercise and contact sport unless your doctor agrees.
Have new or worsening bone pain checked by your team before you carry on exercising. If the cancer has spread to your bones, know the signs of spinal cord compression, which needs help straight away: our cancer guide's warning signs list them.
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Hospitals give different timings. These are what each source says; your own surgical team's advice comes first.
Cambridge University Hospitals asks men to walk 25 laps of the ward the day after surgery, before going home. Prostate Cancer UK says your surgeon may suggest a short walk each day from the day after.
The catheter usually comes out after 1 to 2 weeks (Prostate Cancer UK) or 7 to 10 days (Cambridge). Until then, keep to light activity and short daily walks, and drink plenty. Prostate Cancer UK says don't do pelvic floor exercises while the catheter is in; East Kent's leaflet says carry on, but you can stop while it's in if they're uncomfortable.
Prostate Cancer UK's activity page says avoid heavy physical exercise for the first 4 to 6 weeks, and its surgery page says avoid lifting heavy objects or manual work for 8 weeks. East Kent's leaflet says no heavy lifting for 4 weeks, and Cambridge's says tissue healing takes 12 weeks. So across hospitals it's 4 to 8 weeks before heavy lifting, and your surgical team decides.
Most men's leaking improves 1 to 6 months after surgery, though some leak for a year or more. Cambridge's leaflet says that after a year, 90% of men are dry. In the ProtecT trial, as NICE reports it, 13 in 100 men offered surgery still had moderate to severe leaking at 6 years.
None of the guidance we checked gives a time for cycling after a prostatectomy. Ask your surgical team first; when they agree, start on a padded saddle or a recumbent bike, and stop if it hurts between your legs or your leaking gets worse (our suggestion).
Keyhole surgery leaves small cuts in your tummy. East Kent's leaflet asks you to call the specialist nurses for a painful lump at one of the wound sites, especially if you're being sick, which can be a hernia. Bring back sit-ups and heavy lifting gradually once your team allows, breathing out on the effort and tightening your pelvic floor first (our suggestion).
Prostate Cancer UK's routine; the pelvic floor exercise page builds from 8 to 10 of each, 3 times a day. Start 4 to 6 weeks before surgery if you can, and not while a catheter is in.
See the movement on the 3D figure: Pelvic floor exercise (Kegel)
Our pelvic floor guide has the full routine and the men's section.
Prostate Cancer UK suggests starting 4 to 6 weeks before surgery, so you know how to do them properly afterwards; it might also help you stop leaking sooner. After surgery, start again once the catheter is out.
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Prostate Cancer UK suggests a set of slow and quick lifts 3 times a day; Cambridge's leaflet suggests 6 times a day. NICE recommends supervised pelvic floor training for men who leak after a prostatectomy, kept up for at least 3 months before trying other treatments.
Most men's leaking improves over the first months whatever they do, and trials disagree on how much the exercises add. In a Cochrane review of 50 trials (4,717 men), 57% of men still leaking after surgery who trained were leaking a year later, against 62% who didn't, a difference that could be down to chance. In the UK MAPS trial, one-to-one sessions with a therapist made no difference (76% against 77% still leaking at a year). A newer Cochrane review (25 studies, 3,079 men) found combinations of treatments made little difference, with low certainty.
Training before surgery helped at 3 months but not later (12 studies), while a 2026 review of 7 trials favoured training after surgery at a year, with low certainty. NICE still recommends supervised training: it's safe and cheap, and some men benefit.
Tighten your pelvic floor before you cough, sneeze, lift, push, pull or stand up, and hold it until you've finished. If you have to lift something heavy, tighten it at the same time.
Ask your GP or team for a continence adviser or a men's health physiotherapist. NICE says men with troublesome urinary symptoms after treatment should have access to specialist continence services.
NICE says men should have access to specialist erectile dysfunction services after treatment, with tablets called phosphodiesterase type 5 (PDE5) inhibitors tried first. Some men find pelvic floor exercises help with erections, but the evidence is mixed: our erectile dysfunction guide has more.
The strength and balance workout twice a week, plus walking or cycling, is the closest match to NICE's offer on hormone therapy. Do the bone workout's impact moves only without cancer in the bones and with your doctor's agreement. After a prostatectomy, the starter workout suits the weeks after your team allows more exercise.
A 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentStrength and balance in one session: squats, Romanian deadlifts, push-ups, rows, step-ups, back extensions, carries and single-leg balance.
45 minBeginner14 movesA wall, A dumbbellA full-body resistance band workout: squats, presses, pull-aparts, band walks, good mornings and flyes.
25 minBeginner7 movesA band, An anchor pointImpact, strength and balance for stronger bones, following UK osteoporosis consensus advice, with options for every level.
40 minBeginner14 movesA kettlebell, Other / check instructionsBalance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or boxA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA 10-minute session for low-energy days: marching, sit-to-stands, wall push-ups, step-ups and bridges, then a short walk. Doing a little counts.
10 minBeginner7 movesA bench or box, A wallBuild walking towards 30 minutes on 3 to 5 days a week (Prostate Cancer UK). The strength plans suit men on hormone therapy alongside a supervised programme or after it ends (our suggestion).
A 3-day strength plan for men over 40 with power and bone work, two cardio days and mobility, built on research on ageing muscle.
3 training days45 minBeginner6 days a weekA free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginner3 days a weekA 12-week exercise plan for over-65s: strength and balance three times a week, short balance sessions and daily walks, based on falls-prevention trials.
3 training days40 minBeginnerThis is general information, not a diagnosis: your surgical team and specialist nurses know your treatment, so use the numbers they gave you. A&E means accident and emergency. In the US, call 911 where this page says 999.
Contact your hospital team if:
Call 999, and don't drive yourself to A&E, for:
Get help from 111, or ask for an urgent GP appointment, if:
Don't exercise if you feel unwell or have pain, sickness or other unusual symptoms, and stop if they start while you're exercising. Have new or worsening bone pain checked by your team before you carry on, and after a fall with pain or a new limp, get checked, as fractures are more likely on hormone therapy (our suggestion). Our cancer guide's warning signs list the signs of spinal cord compression, which needs help straight away.
A cancer diagnosis, treatment and changes to your body can affect your mood. If you're thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988. Prostate Cancer UK's specialist nurses are on 0800 074 8383.
Across 8 trials (594 men), exercise didn't change PSA or testosterone levels. Hard exercise or cycling just before a PSA test is a separate, short-lived issue, which our guide to exercise for men covers.
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NICE recommends supervised strength and aerobic exercise at least twice a week on hormone therapy, and supervised exercise improved quality of life and walking in trials. Prostate Cancer UK calls light weights and bands particularly good.
No trial has shown that. A review found no evidence that it slows progression, and the trial set up to test survival closed early. The benefits shown are for fatigue, strength, fitness and quality of life.
The ACSM roundtable says walking alone isn't enough for bone, and strength plus impact training slowed bone loss in the spine in two trials. Even so, Prostate Cancer UK says it isn't yet known whether exercise prevents bone thinning, and impact needs your doctor's agreement on hormone therapy.
Most men's leaking improves over months whatever they do, and trials disagree on how much the exercises add. NICE still recommends supervised training for at least 3 months; it's safe, and some men benefit.
Prostate Cancer UK says try it once or twice to find the right muscles, but don't do it regularly, as it could cause problems emptying your bladder.
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Yes, it's usually safe at every stage, including during treatment. Speak to your GP, nurse or hospital doctor before you start, especially if you're on hormone therapy, the cancer has spread to your bones, or you have joint problems.
Prostate Cancer UK suggests starting with 10 to 15 minutes and building to 30 minutes of moderate exercise on 3 to 5 days a week, plus muscle-strengthening exercises. If you're on hormone therapy, NICE recommends that you're offered supervised strength and aerobic exercise at least twice a week for 12 weeks.
A mix of strength training and aerobic exercise. In trials it built muscle, limited fat gain, eased tiredness and improved quality of life. Light weights and resistance bands are a good place to start.
It isn't known yet. Two trials found strength and impact training slowed bone loss in the spine, but Prostate Cancer UK says it isn't yet known whether exercise protects bones; staying strong and steady may help prevent the falls that break bones. Check with your doctor before high-impact exercise, and ask about bone checks.
No: in 8 trials, exercise didn't change PSA or testosterone levels. It works alongside your treatment, not instead of it. Our guide to exercise for men covers how to prepare for a PSA test.
No trial has shown that it does. A large trial set up to test survival closed early, so the answer isn't known. What exercise does reliably is help you feel less tired, stay stronger and cope better with treatment.
Short walks from the day after surgery, and light activity for the first couple of weeks. Prostate Cancer UK says avoid heavy exercise for 4 to 6 weeks and heavy lifting or manual work for 8 weeks; East Kent's hospital leaflet says no heavy lifting for 4 weeks. Your own surgical team's advice comes first.
Ideally 4 to 6 weeks before surgery, so you know how to do them. Afterwards, Prostate Cancer UK says start once the catheter is out; East Kent's hospital leaflet says you can carry on with it in if they're comfortable. Keep going for at least 3 months.
Tighten the muscles you'd use to stop wind and to stop the flow of urine, so the base of your penis dips and your scrotum lifts. Do up to 10 slow lifts held for up to 10 seconds, then up to 10 quick lifts, about 3 times a day, standing when you can. Only stop your flow once or twice to find the muscles.
Most men see an improvement within 1 to 6 months, though some leak for a year or more. In a large trial, 13 in 100 men offered surgery still had moderate to severe leaking at 6 years. If it isn't improving, ask for a continence adviser or a men's health physiotherapist.
None of the guidance we checked gives a time, so ask your surgical team first. When they agree, our suggestion is to start on a padded saddle or a recumbent bike, and stop if it hurts between your legs or your leaking gets worse.
Yes, with the right support. In a trial of 57 men with cancer in their bones, exercise planned around the affected bones improved strength and physical function with no fractures. Get specialist guidance first, avoid high-impact exercise and contact sport unless your doctor agrees, and report any new bone pain.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
