The effect of diet and lifestyle in prostate cancer progression and mortality

The main objective of this review was to summarize evidence on the effect of lifestyle and diet on prostate cancer progression, recurrence and death. The authors concluded that a variety of factors appeared to affect prostate cancer progression, including not smoking, exercise and healthy body weight.

Prostate cancer is now being detected at very early stages, as such, many men are surviving for many years following a diagnosis. It is therefore important to understand what factors may be associated with prostate cancer progression or recurrence (worsening or return of the disease). The role that diet and lifestyle factors (such as exercise, smoking, body weight) play in prostate cancer progression is not yet clear.

The objective of this review was to summarize current lifestyle and dietary recommendations that may prevent progression and death in men with prostate cancer.

Weight or body mass index (BMI – a measure of body fat that takes weight and height into account) was strongly associated with an increased risk of developing advanced cancer. In a study of 2,546 men, every one-unit increase in BMI was associated with a 10% increase in prostate cancer death compared to normal weight. A BMI greater than 30 kg/m2 was associated with two times the risk of prostate cancer related death. Another study concluded that a 5 kg/m2 increase in BMI was associated with a 20% increased risk of prostate cancer death and 21% risk of recurrence (based on blood tests). 

Vigorous activity (activities that cause sweating and increased heart and breathing rates) was associated with a reduced risk of advanced cancer development. In a study with 2,705 men, those who completed three or more hours of exercise a week had a 61% lower risk of dying from prostate cancer. This was compared to men who exercised less than one hour per week. In another study of 4,623 men with localized prostate cancer (confined to the prostate), men who walked or biked more than 20 minutes a day had a 36% lower risk of prostate cancer death compared to those who exercised less than 20 minutes. 

Smoking was attributed to the increased risk of aggressive prostate cancer and cancer-specific death.  In a study involving 5,366 men, current smoking prior to diagnosis was associated with a 61% increased risk of prostate cancer death and recurrence. 

Studies suggested that a high intake of fish, particularly those rich in omega-3 fatty acids reduced the risk of prostate cancer recurrence and growth. The consumption of coffee was also associated with a significant reduction with the development of advanced cancer, recurrence and progression. In a study involving 47,911 men, those who consumed more than 6 cups a day had a 60% reduction in the risk of advanced cancer compared to men with lower coffee consumption. 

In more than one study, tomato consumption have been associated with a 66% reduced risk of cancer growth and spread and a 28% lower risk of developing advanced cancer. 

Fat from mammal sources (meat, high-fat dairy) was reported to increase the risk of cancer progression or death compared to fat from vegetable sources. Replacing 10% of energy intake from carbohydrates with vegetable fat was associated with a 28% lower risk of lethal prostate cancer.

The authors concluded that a variety of dietary and lifestyle factors appeared to affect prostate cancer progression. This included not smoking, exercise and healthy body weight. It was also concluded that foods such as tomatoes, healthy sources of fats and coffee may also reduce the risk of prostate cancer progression.