Prostate Cancer

What you do, what you eat, and how you handle stress impact your overall state of well-being.

Other than skin cancer, prostate cancer is the most commonly diagnosed cancer in the United States, with nearly 250,000 men expected to be diagnosed with it in 2012.[1]

Prostate cancer incidence is highly influenced by lifestyle and environmental factors, with a nearly 60-fold higher incidence in the U.S. than among Japanese and Chinese men living in their native countries.[2]

In the U.S., it affects 16% of men and 3% will die from it, representing the 2nd leading cause of cancer death.

Despite this frequent occurrence, most men that have prostate cancer are roughly six times more likely to die from another cause than from prostate cancer itself. In other words, they will die with prostate cancer rather than from prostate cancer. This apparent “overdiagnosis” of prostate cancer has challenged previous recommendations for widespread screening,[3] and also lends itself to the use of lifestyle and nutritional interventions, either used alone or combined with more aggressive treatments when warranted.

HEALTHY DIET
Emphasize plant-based whole foods, especially cruciferous vegetables (such as broccoli, cauliflower, cabbage, etc.), and omega-3 fatty acids.[4]

Causes/Contributing Factors

A number of risk factors have been identified for prostate cancer, the most important of which are:

  1. having a positive family history
  2. being over age 60
  3. being African-American

A number of environmental, dietary and lifestyle factors have been found to influence prostate cancer risk:

  1. Higher intake of refined calories, fat, and animal-based foods have been associated with a significant increase in risk for prostate cancer, while a plant-based diet rich in cruciferous vegetables, soy, micronutrients, and omega-3 fatty acids is associated with a reduced risk.
  2. Obesity influences multiple hormonal pathways and inflammatory chemicals thought to be involved in prostate cancer progression and development.[5]
  3. Higher exposure to cadmium has been associated with an increase in risk, while a higher intake of zinc and selenium may have a protective role.[6][7][8]
AVOID CERTAIN FOODS
Reduce animal-based and high fat food consumption, and avoid cooking at high temperatures.[9][10]

Relevant Diagnostic Testing

PSA (prostate-specific antigen) Several large studies have found minimal to no benefit for PSA (prostate-specific antigen) screening, with a significant impact on quality of life as a result of screening and subsequent treatment.[11][12] However, using PSA to monitor therapy effectiveness and progression, however, is widely accepted.[13]

Biopsy A biopsy is required for diagnosis, and the Gleason score may help to guide appropriate treatments.

Vitamin D levels Vitamin D levels have been shown to be predictive of prostate cancer lethality, with higher levels associated with a 57% risk reduction.[14][15]

STAY ACTIVE
Be physically active, every day. Even light intensity exercise has benefit.[16]

Dietary Action Plan

Plant-based whole foods rich in omega-3 fatty acids should be the mainstay of the diet. Avoiding refined carbohydrates, including sugar-sweetened beverages, and animal-based foods affects not only the risk of prostate cancer but its progression.[17][18]  Whole milk, for example, has been associated not only with a heightened risk for prostate cancer, but with a more than 2-fold increase in prostate cancer mortality.[19]

Emphasize:

  1. Foods high in beta-carotene, which can then convert to retinol, such as pumpkin, tomato, melon, kale, broccoli, mango, grapefruit, papaya, guava, carrots, spinach, peppers and squash.
  2. Cruciferous vegetables, such as broccoli, cauliflower, cabbage, etc.
  3. Whole foods (foods that are as close to their natural form as possible)
  4. Low sugar/low glycemic diet (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
  5. Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
  6. High fiber, from whole grains, beans, vegetables and fruits
  7. Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
  8. For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.

Avoid:

  1. Processed and grilled meats. Also, try to limit intake of red meat
  2. Fast foods, fried foods, baked goods and packaged, processed foods
  3. Sugar, sweeteners  and artificial sweeteners
  4. Vegetable oils, shortening, margarine and anything with hydrogenated or partially hydrogenated oils
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Prostate Cancer Supplement Program

Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Supplement Info

 

Includes:

  • Vitamin D
  • Lycopene
  • Green Tea Extract
  • Curcumin
  • Resveratrol
  • Omega-3 Fatty Acids
  • Milk Thistle
  • Diindolylmethane (DIM)
  • Quercetin
  • Grape Seed Extract and/or Pycnogenol
  • Melatonin
  • Vitamin E
  • Vitamin K2
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[1] Brawley OW. Trends in prostate cancer in the United States. J Natl Cancer Inst Monogr. 2012 Dec;2012(45):152-6.

[2] Wilson KM, Giovannucci EL, Mucci LA. Lifestyle and dietary factors in the prevention of lethal prostate cancer. Asian J Androl. 2012 May;14(3):365-74.

[3] Sandhu GS, Andriole GL. Overdiagnosis of prostate cancer.  J Natl Cancer Inst Monogr. 2012 Dec;2012(45):146-51.

[4] Bosire C, Stampfer MJ, Subar AF, et al. Index-based Dietary Patterns and the Risk of Prostate Cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol. 2013 Mar 15;177(6):504-13.

[5] Ma J, Li H, Giovannucci E, et al. Prediagnostic body-mass index, plasma C-peptide concentration, and prostate cancer-specific mortality in men with prostate cancer: a long-term survival analysis. Lancet Oncol. 2008 Nov;9(11):1039-47.

[6] Hurst R, Hooper L, Norat T, et al. Selenium and prostate cancer: systematic review and meta-analysis. Am J Clin Nutr. 2012 Jul;96(1):111-22.

[7] Julin B, Wolk A, Johansson JE, et al. Dietary cadmium exposure and prostate cancer incidence: a population-based prospective cohort study. Br J Cancer. 2012 Aug 21;107(5):895-900.

[8] Lin YS, Caffrey JL, Lin JW, et al. Increased risk of cancer mortality associated with cadmium exposures in older Americans with low zinc intake. J Toxicol Environ Health A. 2013;76(1):1-15.

[9] Joshi AD, Corral R, Catsburg C, et al. Red meat and poultry, cooking practices, genetic susceptibility and risk of prostate cancer: results from a multiethnic case-control study. Carcinogenesis. 2012 Nov;33(11):2108-18.

[10] Catsburg C, Joshi AD, Corral R, et al. Polymorphisms in carcinogen metabolism enzymes, fish intake, and risk of prostate cancer. Carcinogenesis. 2012 Jul;33(7):1352-9

[11] Kilpeläinen TP, Tammela TL, Malila N, et al. Prostate Cancer Mortality in the Finnish Randomized Screening Trial. J Natl Cancer Inst. 2013 Mar 11. [Epub ahead of print]

[12] Ilic D, Neuberger MM, Djulbegovic M, et al. Screening for prostate cancer. Cochrane Database Syst Rev. 2013 Jan 31;1:CD004720.

[13] Freedland SJ. Screening, risk assessment, and the approach to therapy in patients with prostate cancer. Cancer. 2011 Mar 15;117(6):1123-35.

[14] Shui IM, Mucci LA, Kraft P, et al. Vitamin D-related genetic variation, plasma vitamin D, and risk of lethal prostate cancer: a prospective nested case-control study. J Natl Cancer Inst. 2012 May 2;104(9):690-9.

[15] Fang F, Kasperzyk JL, Shui I et al. Prediagnostic plasma vitamin D metabolites and mortality among patients with prostate cancer. PLoS One. 2011 Apr 6;6(4):e18625.

[16] C B, M M, R D, et al. Cross-Sectional & Longitudinal Associations between Light-Intensity Physical Activity & Physical Function Among Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013 Mar;22(3):475-6.

[17] Drake I, Sonestedt E, Gullberg B et al. Dietary intakes of carbohydrates in relation to prostate cancer risk: a prospective study in the Malmö Diet and Cancer cohort. Am J Clin Nutr. 2012 Dec;96(6):1409-18.

[18] Freedland SJ, Aronson WJ. Dietary intervention strategies to modulate prostate cancer risk and prognosis. Curr Opin Urol. 2009 May;19(3):263-7.

[19] Song Y, Chavarro JE, Cao Y, et al. Whole milk intake is associated with prostate cancer-specific mortality among U.S. male physicians. J Nutr. 2013 Feb;143(2):189-96.

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