1. Cancer is a rising burden in men 

Across the world, cancer in men is a growing concern. 

By 2050, the number of new cancer cases in men is predicted to rise by 84 per cent to 19 million, with cancer-related deaths expected to almost double to 10.5 million—a 93 per cent increase (Bizuayehu et al 2024). 

In Australia, men have a significantly higher risk of developing cancer—one in three by age 75 and one in two by age 85 (AIHW 2023). 

The most commonly diagnosed cancers in men include prostate (28 per cent), melanoma (12 per cent), bowel or colorectal (nine per cent) and lung cancer (eight per cent) (AIHW 2024a). 

While rare, breast cancer can occur in men. 

Male-specific cancers such as prostate, penile and testicular cancers can also affect some trans women and nonbinary people assigned male at birth. 

While cancer predominantly affects men aged 60 and over, incidence is rising among younger men, particularly for bowel and prostate cancers (AIHW 2024b). 

Men are also 50 per cent more likely to die from cancer than women (AIHW 2024b). 

Cancer is now the leading contributor to disease burden in Australian men, exceeding cardiovascular, mental health and musculoskeletal conditions (AIHW 2023). 

2. Physiotherapists play a key role in cancer prevention and early intervention 

Rising cancer incidence and disease burden for men are a result of multiple factors, many of them modifiable. 

Lifestyle-related risks such as physical inactivity, overweight and obesity, tobacco use, poor nutrition and workplace exposures contribute to higher cancer rates in men (Khong et al 2025). 

Despite advancements in early detection and the availability of free national screening programs in Australia, men remain less likely to engage in preventive healthcare and early screening services (Davis et al 2012). 

This highlights the critical role physiotherapists can play in addressing the gender gap in cancer outcomes by integrating prevention and rehabilitation into routine practice. 

Physiotherapists are ideally positioned to engage and support men throughout the cancer continuum, from risk reduction to survivorship. 

Their role includes: 

• supporting behaviour change through goal-oriented, person-centred care
• assisting in early detection by identifying clinical red flags and facilitating timely referral for diagnostic testing
• prescribing evidence-based physical activity and exercise to reduce recurrence and improve survival • delivering prehabilitation to optimise function and readiness for cancer treatment
• providing early management of cancerrelated impairments such as fatigue, lymphoedema, neuropathy, pain, pelvic dysfunction and sarcopenia and facilitating referral for further support services as needed
• advocating for integrated, multidisciplinary rehabilitation from diagnosis to end of life. 

3. Physiotherapy supports men’s physical recovery from cancer 

Cancer and its treatments can cause significant physical impacts in men. 

Common challenges include fatigue, muscle loss, reduced cardiovascular fitness, joint stiffness and pain (Baladaniya & Baldania 2025, Cormie et al 2017). 

Chemotherapy may cause peripheral neuropathy, leading to balance difficulties (Kleckner et al 2018). 

Radiotherapy may cause fibrosis and reduced tissue elasticity, while surgery can cause scarring, tissue restriction and lymphoedema if lymph nodes are removed. 

Hormonal therapy for prostate cancer can trigger loss of muscle and bone mass, weight gain and fatigue (Edmunds et al 2020). 

Physiotherapy can address these physical side effects through individualised programs combining aerobic, resistance and flexibility training. 

Tailored exercise helps to improve mobility, muscle and bone strength, endurance and fatigue (Stout et al 2021). 

Pelvic floor muscle training helps to restore urinary continence and sexual function after prostate cancer surgery or radiotherapy (Baumann et al 2022). 

Other physical impairments can be addressed by specialised interventions such as balance training for neuropathy, manual therapy for joint and tissue mobility, and complete decongestive therapy for lymphoedema (Ferioli et al 2018, Stout et al 2021). 

4. Exercise is medicine for men with cancer 

For men with a cancer diagnosis, exercise should be integrated as part of standard cancer care. 

The CHALLENGE trial, a phase III randomised controlled trial, demonstrates that structured and supervised exercise can reduce the risk of cancer recurrence—improving diseasefree survival by nearly 30 per cent and increasing overall survival by almost 40 per cent in patients with stage II or stage III colon cancer (Courneya et al 2025). 

Exercise before treatment builds physiological reserve, reduces complications and speeds recovery (Ezenwankwo et al 2025). 

During treatment, it helps manage side effects such as fatigue, incontinence and psychological distress. Exercise after treatment accelerates recovery, improves continence and sexual health, and provides psychological benefits. 

It also reduces recurrence risk and prevents chronic disease progression. 

International exercise guidelines (Campbell et al 2019, Cormie et al 2018, Hayes et al 2019, Ligibel et al 2022) recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise and two to three strength training sessions per week, targeting major muscle groups. 

It is important to recognise when it is not safe to exercise, such as during episodes of fever, low blood counts or recent worsening of treatment side effects (Mina et al 2018). 

5. Confidence and body image can be rebuilt in men with cancer 

Cancer undermines masculine identities, particularly when fertility, strength or bodily function is compromised. 

In advanced prostate cancer, men describe feeling ‘not man enough’ due to incontinence, impotence and dependency, leading to loss of social status and isolation (Salifu et al 2023). 

Cultural expectations of stoicism reinforce these disruptions, discouraging men from seeking psychological or supportive care. 

Similarly, men with breast cancer report stigma from the perception of it as ‘a woman’s illness’, resulting in concealment and disrupted identity (Abboah-Offei et al 2024). 

Younger men with testicular cancer often face enduring psychological distress, including body image concerns, fertility anxiety and threats to self-worth (Doyle et al 2022). 

For men with lung cancer, stigma linked to smoking histories impairs psychosocial adjustment, though resilience can buffer these effects and support adaptation (Li et al 2025). 

In advanced disease, masculine norms of selfreliance and not wanting to burden others may limit engagement with palliative care, delaying vital interventions (Gott et al 2020, Toohey et al 2023). 

Physiotherapists develop trusted relationships with patients and are well positioned to engage in supportive conversations. 

Physiotherapy also promotes re-engagement, reducing fatigue and restoring function. 

Importantly, body image and masculinity can be positively influenced, helping to rebuild confidence and self-perception (Bowie et al 2022). 

Through exercise prescription, specialised rehabilitation and self-management education, physiotherapists play a key role in restoring function, reducing treatment side effects and improving quality of life for men living with and beyond cancer. 

>> Germaine Tan MACP is the national chair of the APA Cancer, Palliative Care and Lymphoedema group and an APA Titled Cancer Physiotherapist with training in oncology, haematology and cancer rehabilitation (PMCC, Pinc and Steel). She was awarded an NHMRC Postgraduate Scholarship in 2023, investigating the impact of cancer rehabilitation timing on patient and health service outcomes. 

>> Laura Cheung APAM is a physiotherapist at the Melbourne Eastern Private Hospital and works casually in domiciliary rehabilitation with Rehab Ready Healthcare. Laura is currently enrolled in the Graduate Diploma in Clinical Rehabilitation at the University of Melbourne and is a member of the Victorian branch of the Cancer, Palliative Care and Lymphoedema group. 

>> Lizzie Eastwood APAM is the clinical lead oncology physiotherapist at Ramsay Health Plus Hollywood in Perth. She has completed advanced training in lymphoedema, Pinc and Steel cancer rehabilitation and Restore oncology scar therapy. She is the Western Australian chair of the Cancer, Palliative Care and Lymphoedema group and a member of the Australasian Lymphology Association. 

>> Kirsty Kirkland APAM is a private practitioner in Adelaide with a focus on cancer rehabilitation and lymphatic therapy. Kirsty is an accredited decongestive lymphatic therapist and has training in cancer rehabilitation (Pinc and Steel) and scar therapy. She is the South Australian chair of the Cancer, Palliative Care and Lymphoedema group and a member of the Australasian Lymphology Association. 

Quick links: 

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Course of interest 

• Cancer and exercise rehabilitation—part A