Being a rabid road-cyclist raises a lot of questions in the context of prostate cancer. It is hard not to worry about the potential for prostate problems when riding a narrow bike seat (not much more than a pole). Does road biking contribute to prostate cancer? What about PSA testing and biking? I've been treated for prostate cancer...are my days of riding over?
Here are my thoughts...
Causality
Like most men who are avid cyclists I wondered if there was any correlation between my prostate cancer and my riding. Did I do this to myself? There have been many studies done, some of which have found correlation but the studies are not conclusive.PSA testing
Every man who has a PSA test wants to ensure that the test is as accurate as possible. Inaccurate results can lead to anxiety and unnecessary biopsies. Can cycling change the PSA level? There have been a number of studies in this area as well. Some of which have concluded that PSA levels are sometimes higher when there has been recent (within a few days) cycling activity. In my own case this seems to be true. During my first two worrisome PSA testing episodes I did the PSA the day after cycling and repeated the test after staying off the bike for a week. In both cases my PSA level dropped ~1.5 ng/ml (5->3.5 and 12->10.5).Post-treatment riding
Given my passion for cycling I was anxious to get back on the bike after surgery (robotic prostatectomy). Cycling has many benefits for me and one of the most important is the emotional value: cycling gets my endorphins going. When I discussed with my urologist post-surgery he was very supportive of resuming cycling. He wanted to make sure I was healed before starting but after that it was simply a matter of "you can ride if it doesn't hurt". My doctor asked that I wait 8 weeks. I had an unusually painful recovery period (see Recovery) so I was careful about my re-entry. I decided to try one of several "prostate friendly" seats first. This worked but the ride was awful. I found forums that suggested you can get "use to it" but I seriously doubt that. In addition to the very awkward position they can really throw off your balance since there is nothing between your legs.
I then tried one of the many more conventional "ergo" seats. Selle SMP (not to be confused with Selle Italia) offers a full line of these. This was much better. These saddles take a lot weight off the perineum and distribute it to the sitz bones. The effect is, as expected, a lot of weight on the sitz bones.
In the end I found a seat that I loved that was pretty close to my old seat...just a bit more ergo [read: a slit down the middle to offer some relief to my perineum].
It took a couple more months for my prostate to feel 100% but eventually biking felt the same as pre-surgery. All good.
UPDATE [August 2018]: Professional riders adopting new seats
