This month, Prostatepedia talks about things you can do to help yourself—diet and exercise. There is a clear consensus that it is a good idea to get thin and exercise. First, it is good for your general health as it reduces the risk of hypertension and diabetes as well as the cardiovascular complications associated with both of these diseases. Exercise has also been shown to preserve cognitive function and is beneficial for common neurologic diseases like Alzheimer’s and Parkinson’s.

Second, exercise helps minimize the side effects of most of the treatments used for prostate cancer. Finally, as several interviewees discuss, exercise is associated with a lower risk of death from prostate cancer.

In my experience, it is not difficult to convince prostate cancer patients that they should exercise. However, it is very difficult for patients to initiate and maintain an exercise program that is comprehensive and vigorous on their own. It turns out that it is very important to join an exercise facility and get professional guidance.

Ideally, you would have a personal trainer tailor your program to your abilities and needs. However, this can be expensive. A sound alternative is to attend group exercise sessions. Water aerobics classes are very gentle on knee and hip joints and practical for even very obese patients. Spin or indoor cycling sessions can offer a very intense cardiovascular workout with less risk of knee or hip trauma than running. Resistance exercise is important and, done properly, weight lifting has a relatively low risk of injury. However, most patients do not know how to squat or deadlift properly, so professional supervision is again important.

In his conversation, Dr. Stephen Freedland states that successful weight loss requires a diet that the patient can stick with long term. I would add that a diet is more likely to be successful if you believe in it yourself. In other words, there is a strong placebo effect. This is not to say that anything goes. A diet based on cured meats, cookies, and cinnamon buns would not be healthy and would not promote weight loss. Some low carb diets do end up including cured meats like bacon.

In my clinic, we ended up recommending a Mediterranean diet as most patients found that easy to maintain over a period of years. The major pitfall was that some patients overate foods like pasta, leading to overly high carbohydrate intake. As a result, we emphasized moderate carbohydrate intake.

Dr. Myers

Link to December's issue.