Diet, nutrition, and primary and secondary prostate cancer prevention


Primary prostate cancer prevention strategies are ones designed to minimize the risk of getting this cancer in the first place. Secondary prevention strategies are those designed to minimize the risk for disease progression after diagnosis (whether one actually has any form of treatment or one simply follows some form of monitoring strategy).

Although there is a constant stream of articles (in the scientific literature and in the media) about how eating different types of food and taking one or more of a huge variety of supplements may be able to affect one’s initial risk for prostate cancer or one’s health after diagnosis, a recent review article by Masko et al. in European Urology makes it clear that, in reality, we have very few accurate and well established data that can be used to suggest that there is some form of “ideal” diet or lifestyle that can reliably reduce risk for either one’s initial risk or one’s risk for disease progression/recurrence.

Masko et al. carried out an extensive review of the research literature on the relationships between diet and prostate cancer published prior to June 2012. Their basic findings were that:

  • Current data show a trend suggesting that consumption of carbohydrates, saturated and ω-6 fats, and certain vitamin supplements may promote initial risk for diagnosis and progression of prostate cancer.
  • Current data also show a trend indicating that consumption of many plant phytochemicals and ω-3 fatty acids seems to slow the risk for diagnosis and progression of the disease.
  • Consumption of other nutrients seems to have no effect or the available data are inconclusive.

Individual patients (and individual physicians) will often have strong personal views on the value of supplement X or vitamin Y, but the fact of the matter is that there are almost no good data from randomized clinical trials to support such beliefs. Indeed, the randomized trials that have actually been carried out have almost invariably shown no benefit for specific supplements and nutrients.

Masko et al. point out that, “Because diets are made of multiple macro- and micronutrients, further prospective studies are warranted, particularly those investigating the relationship between whole foods instead of a single nutritional component.” However, execution of such trials would be extremely difficult because of the long time frames and the difficulty of maintaining men on the specific types of diet over years.

At present, as we have said many times before, the best guidance that we believe we can offer men who are otherwise healthy and at “average” risk for prostate cancer is to maintain a healthy weight, exercise regularly (which doesn’t mean you need to be a marathon runner), and eat a diverse, “heart healthy” diet that is relatively low in things like carbohydrates and saturated fats and relatively high in vegetable and fruit content. A similar strategy appears to be advisable in helping to prevent recurrence or progression of prostate cancer after diagnosis.

We expect a variety of readers to “weigh in” with comments about their favored beliefs regarding specific supplements and vitamins. However, please bear in mind that the senior author of this review by Masko et al. is a leading expert on diet and nutrition and its relationship to prostate cancer risk. We are just the messenger! And this is far, far from being the first review article of this type to come to a set of very similar conclusions.

9 Responses

  1. After my prostatectomy in November 2011, I decided to “play it safe” and alter my diet. I removed a lot of bread and pasta, added a lot of fruits and vegetables, and mostly restricted protein to poultry and fish. I also take a daily omega-3 supplement as well as a low-dose aspirin (because I had read about an association between taking aspirin and a reduction in the risk of recurrence). Whether all these changes will really help me avoid a recurrence of the cancer I don’t know, but at least I’ve seen one benefit: I dropped 20 pounds over the course of about 8 months. Since then, my weight has been stable.

  2. Hi Mike. I do watch my diet and excercise regime very carefully. I know there is still a lot of debate but I figure that the more involved I am in my well being and the better I feel physically — that it can only be good for me!

    Only question I have is concerning carbohydrates. In the books I have read from Australia and UK, there is not really any mention concerning avoiding/reducing these in a preventive regime. Can you enlighten me a bit on this?

    Cheers

    Philip

  3. Generically, the diet of American males is suspect, to say the least. I am pretty healthy, eat well, work out at a gym and play sports at 64 years old. I avoid red meat but will have some once a month, avoid fried foods but will eat a french fry once in a while, and am really leary of any herbal claims with no double blind study. Bullshit walks.

    When a family member had a medical event this year, along with my diagnosis of prostate cancer, our nutrition focus became more acute. We bought a major blender, and every morning blend fruit with “green goop” made up of kale and other vegetables from the local farmer’s market. We add blueberries, frozen mango, papaya, strawberries, bananas, etc. Also have oatmeal, almonds, use olive oil and take omega-3 capsules. Make sure it has considerable DHA and EPA.

    Ya know how everyone talks about eating fish? For six weeks we ate fish, salad, and vegetables every single night … including salmon at least 3 days a week. You can get fresh wild fish flash frozen at Costco or the like that is fabulous if fresh isn’t available.

    We still ate Christmas cookies, too, but the answer to any “diet’ is a moderate “amount” of food. Buy “”plates” for home with patterns on it to fool your eyes. At a restaurant, never finish the entire plate. Share meals. Eat something every 2 hours so you never get “very” hungry. Simple. If you are working out, have a protein shake as one of your “meals” every 2 hours.

    The results were dramatic. My cholesterol dropped to 165; my son lost 30 lbs and is ripped; and now I am 4 months away from Medicare, I am ripped too. My ego is now stroked by the fact that I am cancer free, and will be in our softball tournament next week against teams that could be my grandchildren … and in 2 weeks I’ll be skiing in Tahoe. How bad do we want to feel good?

  4. Philip:

    Don’t over-think this. The base point is only that many men in the Western world will eat very large quantities of carbohydrates (commonly in the form of things like French fries and other forms of potatoes, pasta, white bread, and the like). If you are watching your diet and exercising regularly, it is unlikely that you are over-doing the carbohydrates.

  5. What about inositol hexaphosphate (IP-6), found primarily in wheat bran, brown rice, and other high fiber foods. While officially not a vitamin, considerable evidence (pre-clinical) indicates that if consumed in sufficient quantities it will slow if not reverse early stage prostate cancer. Whole grain foods, who would have thought?

  6. I believe that the debate over the impact of diet and prostate cancer is moot. Diet cannot cure cancer. However, a primary plant-based diet void of simple sugars, processed food, fast food, soda pop, etc., will most certainly improve the quality of your life. Will it extend your life if you have advanced prostate cancer? Most likely it will, considering that many men with advanced disease die from complications of obesity, diabetes, and heart disease.

    I have battled advanced, metastatic disease for 11 years. After diagnosis, I changed my life. My diet is a plant-based diet with fish two or three times per week. I began a regular exercise program consisting of aerobic exercise and vigorous weight training three times per week. I now weigh what I weighed in college. I am physically strong, active, and energetic despite 10 years of anti-androgen therapy. I hike, bike, play squash and snowboard at the age of 63. The changes I have made give me a sense of well being even though the elephant (incurable progressive disease) will always be in the room.

    Bottom line: a healthy plant-based diet and regular activity and exercise will help you optimize your body’s defenses, improve the quality and the length of your life whether you have cancer or not.

    Fight this disease with every available tool you have.

    I wished you the best.

    John

  7. John, may I ask what your Gleason score was at initial diagnosis?

  8. Chuck,

    I was diagnosed in 2002 with an initial PSA of 4.6 and Gleason of 6. I had seminal vesicle invasion of the cancer and one bone metastasis in my thoracic spine. Treatment has consisted of prostatectomy, pelvic floor salvage radiation, and radiation to the thoracic lesion. I have been on ADT with Lupron monotherapy since. My most recent PSA test was 0.039. I do believe that diet and exercise has helped me significantly. I feel very fortunate.

    John

  9. John:

    May I ask you what your PSA nadir was after your operation?

    Thank you

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