Exercise interventions in men with prostate cancer during and after oncological treatment

Prostate cancer is the most frequently diagnosed malignancy among men worldwide. Despite improved survival, patients often experience persistent adverse effects such as cancer-related fatigue, reduced muscle strength, impaired physical fitness, and decreased health-related quality of life (HRQoL), particularly during and after radiotherapy and androgen deprivation therapy (ADT). This systematic review aimed to evaluate the effects of structured exercise interventions on physical function, physical fitness, cancer-related fatigue, and HRQoL in men with prostate cancer during and after oncological treatment. The review was conducted in accordance with PRISMA 2020 guidelines. PubMed/Medline, PEDro, and Scopus were searched for studies published up to December 2025. Randomized and non-randomized controlled trials and pre-post intervention studies were included if they implemented structured exercise programs in patients with prostate cancer. Methodological quality was evaluated using the McMaster Critical Review Form. Five studies met the inclusion criteria. Most interventions involved supervised aerobic and/or resistance exercise delivered during radiotherapy, ADT, or survivorship. Exercise was associated with improvements in cancer-related fatigue, muscular strength, and physical fitness, with moderate-to-large effect estimates for fatigue and strength. HRQoL outcomes were mixed. Structured exercise appears to be a feasible and clinically relevant supportive care strategy; however, further well-designed randomized controlled trials with standardized protocols are needed.