Diet, Exercise and Prostate Cancer - December 2019

Tags: Diet and Nutrition, exercise, Prostate Cancer diet

This issue is focused on the role diet and exercise play in managing prostate cancer. As you read this issue, you will note that the recommendations are the same that you would recommend to a typical adult to foster their general health. They are essentially identical to the recommendations a physician might make to a patient with heart disease, diabetes, hypertension or obesity. This is handy because men with prostate cancer are of an age where these other diseases are also common causes of disability and death.

Both a healthy diet and lifestyle appear to improve two distinct problems prostate cancer patients face. First, these appear to slow the pace at which prostate cancer progresses. Second, reducing testosterone stimulation of prostate cancer growth, the goal of hormonal therapy of this disease, also increases the risk of cardiovascular disease. It is common for men on hormonal therapy to develop insulin resistance, visceral obesity (a pot belly) and an elevating blood pressure. While there are drugs to treat each of these problems, every drug adds side effects to a prostate cancer treatment program. Each drug added also increases the cost of treatment.

With these issues in mind, in my practice, we placed a strong emphasis on diet and lifestyle and tried various approaches to get patients to make the needed adjustments. The unfortunate truth is that we were less effective than we would have hoped. Of course, there were highly motivated patients that were able to make major changes in diet and lifestyle and maintain those changes. But a significant proportion either made minimal changes or did so for only a short period of time. Physicians who care for patients with cardiovascular disease, diabetes, obesity and hypertension face similar issues.

 

What can you do to make it easier to make healthy changes in your diet and lifestyle? One step is to become part of a group attempting similar changes. This might include going to an exercise facility and joining an exercise class that you attend on a regular basis. Similarly, you might be eligible for a cardiac rehabilitation program or one that focuses on diabetes. Some of my patients had success with group weight loss programs, such Weight Watchers. I strongly suspect patients who enter clinical trials, like those discussed by our interviewees, will find that just being on the clinical trial helps.

 

On a personal note, I am now out 20 years from the diagnosis of prostate cancer. I am not cured, but for most of this time, I have been in remission with a PSA below 0.1 ng/ml. Over this 20 year span of time, I have periodically deviated from the exercise and lifestyle program and faced an increasing PSA. This provided sufficient motivation for me to go back on the program. So, I found ongoing PSA monitoring has two benefits. First, it allowed early detection of several relapses and strongly motivated me to do what I needed to do. You may also find this might help you.

Charles E. Myers, Jr., MD

Link to Decembers issue of Prostatepedia