Adopting a healthy lifestyle after being diagnosed with prostate cancer (PCa) can reduce the risk of dying from the malignancy, researchers concluded in a presentation at the 2016 Genitourinary Cancers Symposium in San Francisco.
To realize this survival benefit, PCa patients need to engage in frequent vigorous physical activity, abstain from smoking, maintain a healthy body weight, and consume a diet rich in cruciferous vegetables, healthy fats from vegetable sources, coffee, and wine, according to a research team led by Stacey A. Kenfield, ScD, of the Harvard School of Public Health in Boston. Patients should reduce intake of processed meat, poultry with skin, and whole milk and avoid excess supplemental selenium.
Dr. Kenfield’s group based their findings on a study of 3,583 men in the Health Professionals Follow-up Study who were diagnosed with non-metastatic PCa from 1986 to 2008 and followed through 2012. The median follow-up was 11 years. Of these men, 240 died from PCa.
The investigators calculated scores based on patients’ adherence to 11 low-risk factors, each of which was assigned a score of 1 point. These factors included not currently smoking or quit 10 or more years ago; a body mass index less than 30 kg/m2; 3 or more hours per week of vigorous activity and/or brisk walking for 7 or more hours per week; consuming 1 or more servings per day of cruciferous vegetables; consuming 3 or more servings per week of nuts and oil-based salad dressing; consuming fewer than 2 servings per week of processed meat; 0 servings per week of poultry with skin or chicken/turkey sandwiches; intake of less than 140 µg per day of supplemental selenium; consuming less than 4 servings per week of whole milk; drinking 4 or more servings per day of coffee; and drinking 7 or more servings per week of wine.
In multivariable analysis, patients who had a score of 4–7 and 8–11 had a 48% and 75% decreased risk of a PCa death compared with those who had a score of 0–3, the investigators reported.
“There is a profound impact of prudent diet and exercise choices to reduce the risk of lethal prostate cancer,” Dr. Kenfield told Renal & Urology News. “These results should be empowering to men with this diagnosis and can serve as a reminder to clinicians to counsel their patients on health behaviors.”
Regarding how changes in diet and lifestyle might influence the PCa death risk, Dr. Kenfield observed: “These healthy behaviors potentially act through similar biologic mechanisms including hyperinsulinemia, insulin resistance, insulin-like growth factors and associated binding proteins, sex hormone regulation, inflammation, adipokine production and signaling, and oxidative stress.”
Scientific evidence that diet and lifestyle practices may slow PCa progression is mounting, she said. In November, the Prostate Cancer Foundation, in collaboration with the University of California San Francisco and Harvard T.H. Chan School of Public Health in Boston, published a diet and lifestyle guide called “Health and Wellness: Living with Prostate Cancer” for patients and caregivers. (The guide is available at http://www.pcf.org/atf/cf/%7B7C77D6A2-5859-4D60-AF47-132FD0F85892%7D/PCF_H&W_Guide.pdf.)
“We hope this guide increases awareness among both patients and urologists/oncologists regarding the state of the science on numerous dietary and lifestyle factors and medications for prevention of prostate cancer progression,” Dr. Kenfield said. “There are potential benefits of nutrition and exercise that can be adopted to enhance prostate cancer survivorship and to complement clinical management.”