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Prostate Cancer
Nutrition Care

Cancer Nutrition Care (CNC) oncology dietitians have found that prostate cancer patients tend to have lots of questions about what to eat, what not to eat, and what supplements to take. Many are ready to put a plan into place, and take action, but don’t always know what to do or where to start.

CNC oncology dietitians have the specialized training and experience to address prostate cancer diet and nutrition questions. Given the ever-changing nature of oncology nutrition, having access to the right evidence-based cancer nutrition information sources is key. CNC dietitians can quickly and competently provide for the comprehensive needs of prostate cancer patients from diagnosis through cancer treatment and into post-treatment survivorship.

Cancer patients who work with dietitians that have oncology nutrition experience have improved overall outcomes, quality-of-life, and a better patient experience. * *

Prostate Cancer Overview

The prostate is a walnut-sized gland that produces seminal fluid. It’s this fluid that helps facilitate fertilization by keeping sperm hydrated and nourished. Located below the bladder and in front of the rectum, the prostate partially surrounds the urethra, the tube that transports urine from the bladder. The prostate gland also plays a role in the regulation of urine flow.

Cancer of the prostate is one of the most common cancers among men. What causes prostate cancer is not well understood at this time. What is known is that most prostate cancers are “adenocarcinomas”, cancers that originate in the first layer of tissue cells that line organs. The risk of prostate cancer is higher when there’s a family history of the disease. Certain genetic factors could increase one’s risk of developing prostate cancer. Genetic counseling might be worth investigating if you have a family history of prostate cancer.

Prostate Cancer Nutrition Research (Strong Evidence)

Prostate Cancer and Weight

There is strong evidence that being overweight, or obese, increases your risk of getting advanced prostate cancer. Generally speaking, maintaining a healthy weight is one of the most important things one can do to help prevent the onset of many cancers, not just prostate cancer. Maintaining a healthy weight can also help slow the growth of cancer and lower the risk of recurrence.

One source of evidence is the Cancer Prevention Study that included about 70K men. The study concluded that men with a body mass index (BMI) of 30 to 35 (compared with men at 25 or less) had a roughly 55% greater risk for fatal prostate cancer. It was also discovered that obese men who had undergone prostatectomies experienced a much higher incidence of treatment failure, meaning their cancers spread. A doubling of prostate cancer risk was also observed for those dealing with obesity-related diseases like insulin resistance and diabetes.

Prostate Cancer and Beta Carotene

There is also strong evidence that consuming beta carotene, either in supplement form or in foods, is unlikely to have much of any impact on the risk of prostate cancer. This conclusion comes from the American Institute for Cancer Research’s Continuous Update Project (CUP) which is focused on analyzing research on cancer prevention and survival. The CUP panel reviewing prostate cancer research found a variety of good quality studies on diet and supplement use that consistently failed to demonstrate any benefit from beta carotene intake.

Prostate Cancer and Diet

Oncology nutrition research studies indicate that high fat diets, especially those eating patterns that are high in foods containing animal fats, may increase your risk of getting prostate cancer. On the other hand, diets high in fruits & vegetables may decrease your risk of getting prostate cancer. It is also well known that poor diets can lead to inflammation of the prostate, a condition that may not lead directly to cancer but, one to avoid.

Maintaining a healthy weight, eating less processed meats and more fruits & vegetables, while exercising regularly, may reduce your prostate cancer risk.

One of the main insights in nutrition sciences learned over the last 20 years or so, is that healthy diets support healthy lives! More and more research is adding to an ever-increasing evidence-base that dietary factors can play a significant role in the prevention, progression, and recurrence of many types of cancer. Notably, healthy eating patterns like the Mediterranean diet, rich in plant-based foods, whole grains, and healthy fats, have been shown to be cancer protective. Healthy eating patterns can also help one avoid a host of other chronic diseases like diabetes and heart disease. A wide variety of plant-based foods have been shown to offer cancer protective qualities. Some examples include:

  • Cruciferous vegetables, like broccoli and Brussels sprouts, have been shown to inhibit the growth of cancer cells.
  • Allium vegetables, like onions and garlic, contain organosulfur compounds which have been shown to induce “cell cycle arrest”. This is breaking the cancer growth cycle so that cancer cells can no longer divide or duplicate.
  • Soy foods like tofu, tempeh, and soy milk can help in reducing inflammation.
  • Green tea compounds, known as catechins, have been shown to be cancer protective.

Prostate Cancer and Dairy Products

The Continuous Update Project (CUP) identified over 20 relevant research studies that looked at the relationship between dairy product consumption and prostate cancer. Roughly 3 out of 4 of these studies showed a statistically significant relationship between the consumption of dairy foods and prostate cancer. The increased risk was calculated at +7%. When CUP researchers analyzed the data by prostate cancer type, the risk relationship disappeared. For this reason, dairy products are said to have a “limited evidence-base” when it comes to increasing one’s cancer risk.

Prostate Cancer and Calcium

When deciding if limiting dairy foods in your diet is wise, it’s good to know of any other research that might be helpful. In particular, information about root cause mechanisms can be insightful. Understanding what might be driving a specific outcome adds to overall confidence when making personal decisions. Regarding dairy foods, it’s well known that higher calcium levels in the body can influence Vitamin D levels. Dairy products are a rich source of calcium, which is widely known to down-regulate the production of Vitamin D in the body. This is significant since Vitamin D appears to slow the progression of prostate cancer cells and limit their spread.

Prostate Cancer and IGF-1

Another root cause mechanism of interest is related to “insulin-like growth factor”, commonly referred to as IGF-1. This is a human growth hormone which has been shown to increase prostate cancer risk. CUP researchers stated in their latest report on prostate cancer that, “greater consumption of milk increases blood levels of IGF-1, which has been associated with increased prostate cancer risk in recent pooled and meta-analyses.” This puts milk, and other dairy products containing milk, in the category of a modifiable risk factor as one can choose to reduce, or eliminate, dairy products in their diet.

Prostate Cancer and Testosterone

It is well known that “androgens” can stimulate prostate cancer cell growth. One of the main androgens is testosterone, which is mainly made in the testicles but prostate cancer cells can also make significant quantities of testosterone. Lowering androgen levels, or blocking them from entering prostate cancer cells, can make prostate cancers grow more slowly over time and actually shrink them in some men.

Regarding androgens and diet; high fat, low fiber diets, which are widely consumed by Americans, have been shown to elevate blood testosterone levels. Conversely, it has been shown that men who adopt low fat, high fiber diets can lower their testosterone levels. Studies have shown average testosterone reductions of about 15% among men who adopt lower fat, higher fiber diets!

Prostate Cancer and Supplements

Regarding dietary supplements, it’s absolutely critical that prostate patients inform their medical team of any supplements they may be taking. Also, it’s important for cancer patients to know that, at this point in time, there’s a lack of evidence to recommend any dietary supplement for the prevention or treatment of prostate cancer. Finally, when considering supplements, one needs to consider both safety and efficacy. If you’re wondering about supplements you’re taking now, or plan to take, please reach out to one of our CNC oncology dietitians, they can help you understand what your supplements represent and if they’re unsafe to consume, given your specific situation.

Dietary Supplements and PSA Levels

The accuracy of PSA screening tests can be significantly compromised by certain supplements known to influence PSA levels. Saw Palmetto and Lycopene, for instance, are two supplements that can lower PSA levels. Some drugs have the same effect, like finasteride (Proscar) and dutasteride (Avodart). On the other hand, prostatitis (inflammation of the prostate), urinary tract infections, prostate biopsies, and prostate surgery can all increase PSA levels.

Many men take a variety of dietary supplements not knowing that some of these products can affect their PSA blood levels, which is used to detect, and monitor, prostate cancer

At this time, there is no clear consensus as to what PSA value should be used to recommend certain procedures, like a prostate biopsy. Part of the reason for this is that there is no “normal” or “abnormal” PSA level in men. Generally speaking, however, the higher the PSA level the more cause for concern that prostate cancer may be present.

Prostate Cancer, Vitamin E and Selenium

As mentioned above, supplements can be unsafe, some can actually increase your risk of cancer. Consider one example, a large clinical trial concluded that men who took a vitamin E supplement had an increased risk for prostate cancer compared to men that did not take vitamin E supplements. The same research study found that men who had higher than normal levels of selenium in their bodies had an increased risk for high grade prostate cancer. Keep in mind these studies looked at supplements, not food products. Food sources containing vitamin E and selenium are absolutely considered safe and don’t have to be avoided.

“The evidence supporting the efficacy of most dietary [supplement] factors appears inadequate to recommend their use.” **

Supplements & Prostate Cancer

When it comes to supplements and prostate cancer, don’t take any chances. There is information on many dietary supplements and their impact on prostate cancer, but almost all of it is limited, to the extent that conclusions can’t be drawn. This includes studies on lycopene, retinol, folate, vitamin C, iron, zinc and a variety of others. An assessment of your supplements is a service Cancer Nutrition Care (CNC) provides. CNC oncology dietitians have access to trusted information regarding supplements and cancer and can help you better understand what your supplements represent. CNC dietitians can also determine if an adjustment to your micronutrient intake (vitamins and minerals) is advised. Contact us today for a free initial consultation.

**Source: An evidence-based review of randomized controlled trials of the ability of dietary supplements to influence PSA concentrations in men with prostate cancer. Full citation below.

Prostate Cancer Nutrition: During Treatment

Individual responses to cancer treatment can vary widely so it’s important to understand what specific nutrition related issues you may face. Your medical team and/or a Cancer Nutrition Care oncology dietitian can help you understand potential nutrition impact issues and develop a personalized plan of action for you. The two main goals during prostate cancer treatment are:

Prostate Cancer In-Treatment Nutrition Goals

#1 Optimize nutrition status to boost treatment tolerance and effectiveness.
#2 Manage problematic nutrition impact symptoms.

Nutrition Impact of Prostate Cancer Chemotherapy

The impact of chemotherapy on nutrition status is dependent on the specific chemo drugs used. Impacts could include nausea, diarrhea, mouth sores, taste and flavor changes, poor appetite or other conditions. Working with an oncology dietitian can help with managing these potential conditions, and others too.

Nutrition Impact of Prostate Cancer Radiation Treatments

Pelvic radiation exposure to the rectal wall can cause bowel irregularity, excessive flatulence, cramps, and diarrhea. Nutrition counseling may help alleviate some or all of these side effects. Personalized nutrition care plans sometimes include modifications of dietary fat & fiber intake and the use of probiotics to minimize gas and diarrhea.

Nutrition Impact of Prostate Cancer Surgery

The potential nutrition impact symptoms associated with surgery include weight loss, poor healing, and muscle loss. Care plans typically include dietary prescriptions for adequate calories, protein, and micronutrients. These plans are always tailored to the unique needs of the individual.

Nutrition Impact of Androgen Deprivation Therapy (ADT)

ADT is sometimes associated with a loss of bone density and muscle mass, greater insulin resistance, and an increase in high‐density lipoprotein levels, weight gain, and fatigue. Nutrition counseling can often play a valuable role in addressing all of these.

Metabolic Syndrome and Androgen Deprivation Therapy (ADT)

Metabolic syndrome has also been associated with ADT therapy. Metabolic syndrome is a cluster of conditions which include high blood pressure, high blood sugar, excess body fat, and abnormal cholesterol levels which increases your risk of heart disease, stroke, and diabetes. Guidelines for the prevention and treatment of metabolic syndrome target lifestyle modifications and pharmacological therapies.

Take the first step today, contact CNC and schedule your free discovery call with one of our oncology dietitians.

Prostate Cancer Nutrition: After Treatment

#1 Weight & Body Composition

Prostate cancer recurrence and mortality rates are higher for those prostate cancer patients that are significantly overweight. Emerging research suggests that metabolic changes associated with weight gain may promote prostate cancer progression. A post-treatment focus on achieving, and maintaining, a healthy body weight and composition is very important as these factors may lower the risk for prostate cancer progression.

Being overweight (not clinically obese) is also associated with worse prostate cancer health outcomes. Greater body fat is strongly associated with advanced prostate cancer. A weight gain of greater than 4 pounds, after a prostatectomy, has been shown to double the risk of prostate cancer recurrence. Generally speaking, a weight gain of 5%, or more, is associated with almost a doubling of the risk of prostate cancer mortality.

#2 Plant Based Diet

Nutrition research continues to evolve but findings to date strongly suggest that consuming a whole food, plant-based diet can be an effective approach to maintaining a healthy weight. Research also suggests consuming a whole food, plant-based diet can lower your cancer risk due to the regular intake of fiber, antioxidants and phytochemicals. Cancer Nutrition Care (CNC) oncology dietitians can help you set specific dietary goals and develop an individualized nutrition plan of action to best meet your needs. Take the first step today by (1) completing the CNC Quality of Diet Screening to evaluate the current quality of your diet then (2) scheduling a free discovery call with one of our oncology dietitians.

#3 Physical Activity

Some research studies have suggested that physical activity may decrease the risk of prostate cancer recurrence, improve cancer‐specific and overall cancer survival rates, quicken recovery from treatment side effects, and prevent long‐term side effects. Other exercise related intervention studies among cancer survivors show that exercise can improve fatigue, anxiety, symptoms related to depression, self‐esteem, happiness, and overall quality of life. More specifically, it has been shown that just 3 hours of vigorous activity per week is associated with lower mortality among prostate cancer survivors! Aerobic and resistance exercises have also been shown to alleviate the side effects of Androgen Deprivation Therapy (ADT). Cancer Nutrition Care oncology dietitians can help prostate cancer patients develop and implement personalized food & fitness plans.

This overview brought to you by:

CANCER NUTRITION CARE

The Oncology Nutrition Specialists

*Source: ASSOCIATION OF COMMUNITY CANCER CENTERS

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