The Effect of a Period of Physical Exercise on the Plasma and Gene Expression Levels of Hypoxia-Inducible Factor-1 (HIF-1) and Serum Prostate Specific Antigen Levels in Men with Prostate Cancer

Physical exercises play a supportive role in the treatment of prostate cancer by modulating angiogenesis in tumor tissue. The hypoxia-inducible factor-1 (HIF-1) modulates angiogenesis and tumor growth. Prostate specific antigen (PSA) is the most widely available tumor marker for the rapid diagnosis of prostate cancer. The purpose of this study was to investigate the effect of physical exercises in the expression of HIF-1 gene levels in plasma, and the PSA level in the sera of men with prostate cancer. In this clinical trial study, 20 men with prostate cancer were randomly selected from the pathology department of Baqiyatallah al-Azam subspecialty hospital in Tehran, Iran, during the middle 6 months of 2016. Patients were divided into two groups of experimental [age: 63 ± 10 years, weight: 78 ± 11 kg, body mass index (BMI): 28.5 ± 2.4 kg/m2] and control [age = 62 ± 4 years, weight: 79 ± 11 kg, BMI: 27.9 ± 2.9 kg/m2). The experimental group performed 8 weeks of 60 minutes per session training including 3 sessions per week. The workouts were the combination of exercises with resistance and endurance training per session as 60-75 percent of one repetition maximum, and 60-75 percent of maximum heart rate. The control group did not receive any intervention. Blood samples were tested for PSA and HIF-1 using enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR) methods, respectively, and the data were analyzed using dependent and independent t test. Combined exercise significantly decreased the plasma level (P = 0.007) and gene expression (P = 0.005) of HIF-1, as well as serum PSA level (P = 0.005) in the experimental group compared with control group. Considering the importance of PSA in the diagnosis of prostate cancer, and the role of HIF-1 in tumor angiogenesis, the combined exercise can be effective in reducing the progression of prostate cancer by modifying HIF-1 and PSA.