Diet and Prevention of Prostate Cancer
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Diet and prevention of prostate cancer is a very topical and very important issue.
The main message I get through to my patients is that what is good for your heart is good for your prostate1.
Diet involves decreasing saturated fats and calories2.
Increasing weight and increasing body mass index has been associated with increased aggressive of cancer, decreased cure rates and an increased risk3.
So hence it is very important for patients with prostate cancer to exercise.
Specific dietary measures that are considered to be beneficial include the use of soya proteins, such as tofu, meso and soya milk.4
These contain phytoestrogens which are protective.5
Phytoestrogens are also found in wholegrain food and red clover.
Cruciferous vegetables including broccoli, cabbage and cauliflower have been shown to possibly be of benefit6.
Other dietary factors include the use of antioxidants such as green tea and lycopenes.7
Lycopenes can be found in cooked tomatoes.
Correcting vitamin D deficiency is very important by either sunlight exposure or the use of supplements and this has been shown in some studies8,9 to slow down the activity of prostate cancer and prevent the spread.
Vitamin E and selenium has been extensively studied for prostate cancer.
It was hoped that these two products would decrease the risk of prostate cancer but a large study performed in the United States has shown that increased side effects with the use of these medications10 and hence in my practice I don’t recommend them at this stage.
A brand of prescription medication has been extensively studied as to whether it decreases the risk of prostate cancer.
Unfortunately the study although showing that the overall incidence of prostate cancer decreased there was a subset of people that had more aggressive cancers.11
Note it has been argued that this may have been an artefact of the study but at this stage our advice to patients is probably not to this particular prescription medication for prostate cancer prevention.
Finally statins, drugs that are used to decrease cholesterol have been shown to be possibly effective in decreasing the incidence of prostate cancer.1
So there’s a lot of work in terms of diet and drugs for prostate cancer prevention.
The main message I get through to my patients that it is very important to lose weight, have a diet that’s healthy for your heart.
What’s good for your heart is good for your prostate.
Increase your exercise, decrease weight, decrease saturated fats, that is the main message for diet and prostate cancer in terms of prevention of prostate cancer and for patients who have a diagnosis of prostate cancer.
Diet and Prevention of Prostate Cancer
The headline message Dr Kooner gives patients is simple: what is good for your heart is good for your prostate.1 That means reducing saturated fats and excess calories,2 maintaining a healthy body weight, and exercising regularly - a higher body mass index has been linked with more aggressive prostate cancer, lower cure rates, and higher risk.3
Dietary measures that may help
- Soya proteins such as tofu, miso and soya milk4 - these contain phytoestrogens,5 which are also found in wholegrain foods and red clover.
- Cruciferous vegetables - broccoli, cabbage, and cauliflower have been shown in some studies to possibly be of benefit.6
- Antioxidants - green tea and lycopenes.7 Lycopenes are found in cooked tomatoes.
- Vitamin D - correcting vitamin D deficiency is important, through sunlight exposure or supplements. Some studies suggest it may slow prostate cancer activity and reduce spread.8,9
Supplements and medications to be cautious about
- Vitamin E and selenium were once hoped to reduce prostate cancer risk, but a large US study found increased side effects with these supplements.10 Dr Kooner does not currently recommend them.
- A widely studied prescription medication reduced the overall incidence of prostate cancer, but a subset of the men in the study had more aggressive cancers.11 Although this finding may have been an artefact of the study, current advice is generally against using this medication specifically for prostate cancer prevention.
- Statins (cholesterol-lowering drugs) have been shown to possibly reduce prostate cancer incidence.1
The bottom line
Research into diet and drugs for prostate cancer prevention continues, but the practical message is consistent:
- Lose excess weight.
- Eat a heart-healthy diet - lower in saturated fat.
- Exercise regularly.
This advice applies both to prevention and to patients already diagnosed with prostate cancer.
References
- Heart healthy equals prostate healthy and statins, aspirin, and/or metformin (S.A.M.) are the ideal recommendations for prostate cancer prevention - Mark A Moyad and Nicholas J Vogelzang - National Library of Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577591/
- Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality - Erin L. Richman, Stacey A. Kenfield, Jorge E. Chavarro, et al. - National Library of Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935610/
- Body mass index trajectories and prostate cancer risk: Results from the EPICAP study - Céline Lavalette, Emilie Cordina Duverger, Fanny Artaud, et al - Cancer Med (2020) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476828
- Soy Consumption and the Risk of Prostate Cancer: An Updated Systematic Review and Meta-Analysis - Catherine C. Applegate, Joe L. Rowles, III, Katherine M. Ranard et al - NLM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793268/
- Phytoestrogens and risk of prostate cancer: An updated meta-analysis of epidemiologic studies - Qiang Zhang, Hongliang Feng, Bakare Qluwakemi, et al - Int. J. Food Sci. Nutr. 2017 - https://pubmed.ncbi.nlm.nih.gov/27687296
- A prospective study of whole grains, fruits, vegetables and colon cancer risk - Marjorie L McCullough, Andrea S Robertson, Ann Chao, et al - Cancer Causes & Control (2003) - https://pubmed.ncbi.nlm.nih.gov/14750535/
- Tea and lycopene protect against prostate cancer - Le Jian, Andy H Lee, Colin W Binns - Asia Pac J Clin Nutr. 2007:16 Suppl 1:453-7 - https://pubmed.ncbi.nlm.nih.gov/17392149/
- Vitamin D in prostate cancer - Donald L Trump and Jeanny B Aragon-Ching - Asian J Androl. 2018 May-Jun; 20(3): 244–252 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952478/
- Does Prostate Volume Correlate with Vitamin D Deficiency Among Men Undergoing Prostate Biopsy? - Adam B. Murphy, Yaw A. Nyame, Ken Batai, et al - Prostate Cancer Prostatic Dis. 2017 Mar; 20(1): 55–60 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303144
- Selenium and Vitamin E Cancer Prevention Trial (SELECT) - Eric A. Klein, MD; Ian M. Thompson, MD; Catherine M. Tangen, et al - JAMA. 2011;306(14):1549-1556. doi:10.1001/jama.2011.1437 - https://jamanetwork.com/journals/jama/fullarticle/1104493
- Association of finasteride with prostate cancer - Lei Wang, Yonghua Lei, Yanyao Gao, et al - Medicine (Baltimore). 2020 Apr; 99(15): e19486. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220188/