Which dietary modifications are used in the treatment of prostate cancer?

Updated: Oct 11, 2019
  • Author: Mark A Moyad, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

Ornish et al showed that in men with early, low-grade prostate cancer, lifestyle intervention consisting of a vegan diet supplemented with antioxidants, aerobic exercise, and stress-management techniques can lower prostate-specific antigen (PSA) levels by a modest 0.25 ng/mL (or 4%). [91] However, a reduction in PSA production does not always mean that the cancer cells have become inactive.

One of the most interesting, and possibly underappreciated, observations from the Ornish trial is that dietary changes alone appeared to reduce low-density lipoprotein (LDL) cholesterol levels as much as a low to moderate dose of a statin. Indeed, cardiovascular health could be tantamount to prostate health.

Dietary modifications, coupled with exercise and lifestyle modifications, may affect cancer growth rates. These measures can be used in concert with accepted therapy.

Relying on diet alone to treat prostate cancer is unrealistic, but using diet to improve overall quality and length of life, especially in regard to the leading cause of mortality in men and women, is realistic and should be constantly encouraged and embraced. With dietary supplements and cancer prevention, the current mantras of “first do no harm” and “less is more” appear to make more sense. There appear to be more supporting data for using individual dietary supplements to reduce specific side effects of cancer treatment, such as taking American ginseng to reduce cancer-related fatigue (CRF). [92, 93]

In addition, only one extensive randomized, placebo-controlled trial has studied the cancer-preventive effect of a single daily multivitamin (Centrum Silver) in healthy men. The Physicians’ Health Study II (PHSII), which followed over 14,000 participants for 11.2 years, found an 8% reduction in the risk of cancer with multivitamin use (a primary endpoint). [94]

Although the reduction was statistically significant, some would argue that it is not clinically significant. Nevertheless, PHSII showed no increase in prostate cancer incidence or mortality in the multivitamin arm. In fact, there was a non-significant reduction in those outcomes, especially in men with a baseline history of cancer, and a non-significant reduction in fatal cancers overall. Other secondary benefits were found, such as a small but significant reduction in cataracts. [95]

Multivitamin use also has the ability to reduce subtle deficiencies, as may develop in patients taking medications (eg, metformin, histamine 2 blockers, proton pump inhibitors) that can profoundly reduce levels of important nutrients such as vitamin B12 and magnesium. [96]

However, patients who want to use multivitamins for prostate cancer prevention should be warned that more is not better: in some of the largest epidemiologic studies, taking more than one multivitamin pill per day has been associated with an increased risk of aggressive prostate cancer. [97]

Seeking dietary and lifestyle solutions that promote cardiovascular health is a sound guide to measures that could also potentially reduce the risk of prostate cancer. Prominent among those is exercise. Substantial and compelling data support the ability of regular exercise to help prevent prostate cancer or reduce its progression—and this in the context of reducing all-cause morbidity and mortality. If for no other reason, the mental health improvement observed with exercise should encourage readers to incorporate regular physical activity to potentially reduce stress, anxiety, and depression. 


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