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Prostate Cancer: Diet and Prognosis

A limited number of studies have addressed diet's possible influence on survival after diagnosis. Overall, the evidence suggests that low-fat, plant-based diets may be helpful.

Observational studies show that higher saturated fat intakes are associated with a 3-fold higher prostate cancer mortality, compared with the lowest intake.40,41 Prospective studies have found an inverse association with monounsaturated fat intake.42

Limited evidence suggests a substantial improvement in prostate cancer survival with diets that emphasize whole grain, legumes, and vegetables and avoid dairy products and meats.43 In a small clinical trial, diet treatment increased PSA doubling time from 6.5 months to 17 months.8 Similarly, in a randomized clinical trial using a vegan diet and stress reduction in 93 men with early prostate cancer who had elected not to undergo other treatment, the intervention group experienced a mean PSA reduction of 4%, compared with a 6% increase in the control group. None of the experimental-group patients required medical treatment during the trial, but 6 control-group patients required conventional treatment, due to rising PSA concentrations or evidence of disease progression on magnetic resonance imaging.7

Growing evidence indicates that obese men treated for prostate cancer are at greater risk of recurrence, compared with those nearer normal weight.44 Studies also suggest that higher body mass index (BMI) is associated with more aggressive cancer progression (ie, high-grade disease, positive surgical margins, extraprostatic extension, and lymph node metastasis).45 See Obesity chapter for healthful weight control measures.

The benefits of a low-fat, plant-based diet and exercise take on particular significance in light of the fact that cardiovascular disease remains a leading cause of death in prostate cancer patients.46 (See Coronary Heart Disease.)

Orders

See Basic Diet Orders.

Moderate physical activity and stress reduction may also be beneficial.

Limit alcohol to 0-2 drinks per day.

What to Tell the Family

Prostate cancer is increasingly common. Diet and lifestyle factors may influence the risk of developing the disease, particularly in its more aggressive and invasive forms. Cancer risk is not limited to the identified patient, however. A low-fat, plant-based diet and regular exercise habits, adopted early in life, may reduce cancer risk and improve the overall health of the entire family.

 

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