The role of nutrition in management of prostate cancer patients on ADT


The precise roles of nutrition and exercise in the prevention of prostate cancer (if any) and in the management of the health of men with prostate cancer (at various different stages) are a subject of constant concern to the patient community — and to the caregiver community too.

Unfortunately, the scientific and medical evidence that might lead to well-defined guidelines regarding the roles of nutrition and exercise in the management of prostate cancer has long been limited and less than compelling when it comes to the details.

A new review by Barnes et al. in the journal Prostate Cancer and Prostatic Diseases has once again come to the conclusion that:

Current evidence for dietary interventions to mitigate ADT side effects is limited. Further investigations are warranted to explore the impact of changes in dietary intake on ADT side effects before practice guidelines can be considered.

In compiling data to support this review, Barnes et al. found that:

  • 16 published articles met the inclusion criteria for their review.
  • 12/16 studies used interventions that combined diet with other actions (e.g., exercise, medication, and/or counseling).
  • 4/16 studies examined the effects of diet alone of side effects of ADT.
  • 1/16 studies suggested that daily caffeinated drinks improved cancer-related fatigue.
  • 2/16 studies showed no effect of isoflavone suypplements on hot flashes, quality of life, body mass index (BMI) or blood lipid levels.
  • None of the articles measured the impact of diet on long-term effects of ADT.
  • The methodological quality of the 16 studies assessed was very varied.

For many years, your sitemaster has consistently stated that what we seem to actually know is the following:

  • Eating a “healthy” Mediterranean-type diet that is relatively low in things like red meat, fat, and starches and relatively high in things like cruciferous vegetables, tomatoes, fruit, nuts, etc., is probably wise (if only because it is good for your heart).
  • Dietary variation is also wise. In other words, don’t eat exactly the same things all the time and don’t eat any one food type to the exclusion of everything else.
  • Frequent, regular exercise that is as vigorous as you and your doctor believe to be safe for you as an individual is generally a good idea.
  • Some men may find that certain types of diet or supplement work for them (but that doesn’t mean it will work for everyone else).

The bottom line is that meaningful, prospective, long-term studies of diet and exercise in the management of prostate cancer are still urgently needed, and this is true across the prostate cancer spectrum — for men on active surveillance just as much as for men on ADT or other forms of more advanced prostate cancer.

2 Responses

  1. AnCan has long recommended UCSF’s Nutrition and Prostate Cancer pamphlet as required reading; 375 accompanying citations can be found here

    You can watch UCSF’s cancer nutritionist, Greta Macaire, speak about nutrition and prostate cancer at this link.

  2. Dear Rick:

    Good nutrition is always a wise idea, but I would draw to your attention the very important third word in the UCSF pamphlet: it is the word “may”.

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