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A recent study reports more good news about eating a plant-based diet - that is, one rich in fruits, vegetables, whole grains, nuts, legumes, seeds, but low in meat and dairy foods.

Researchers found that in men who had already been diagnosed with prostate cancer, those eating the most plant-based foods had the least erectile dysfunction, urinary incontinence, urinary irritation, and had better "hormonal health and vitality" (e.g., symptoms such as low energy, depression, and hot flashes). Consuming more plant-based foods was associated with better sexual and bowel function (this last from the fiber in plant-based foods).

Other research already shows that plant-based diets can reduce the risk of prostate cancer, as well as for prostate cancer recurrence and for the cancer progressing. A reason for this could be because a plant-based diet (e.g., Mediterranean style diet) lowers chronic inflammation.

From Medical Xpress: Plant-based diet tied to improved sexual health in men treated for prostate cancer

A diet that limits meat and dairy but is rich in fruits, vegetables, grains, and nuts is linked to less erectile dysfunction, urinary incontinence, and other common side effects seen in prostate cancer patients, a new study shows. ...continue reading "Benefits of a Plant-Based Diet For Men With Prostate Cancer"

A recent large Swedish study found that men who increased their cardiorespiratory fitness had a  significantly lower prostate cancer risk (when compared to men whose cardiorespiratory fitness stayed the same or declined) .

Men who increased their fitness by more than 3% over the course of a year had a 35% lower risk of prostate cancer during the 7 year follow-up. Cardiorespiratory fitness was measured two times (baseline and a year later) by peddling on a stationary cycle and measuring absolute and relative VO2 max - the amount (volume) of oxygen the body uses while exercising as hard as possible.

By the way, other studies also find that cardiorespiratory fitness is associated with the risk of some cancers, as well as dying from certain cancer types. This study did not find an increase in cancer deaths, but it also only followed the men 7 years.

Bottom line: Increase your activity levels! Walking, hiking, bicycling gardening, sports, exercises - it all counts. You can do it!

From Medical Xpress: Increase in annual cardiorespiratory fitness by more than 3% linked to 35% lower prostate cancer risk

An increase in annual cardiorespiratory fitness by 3% or more is linked to a 35% lower risk of developing, although not dying from, prostate cancer, suggests research published online in the British Journal of Sports Medicine. ...continue reading "Improve Fitness To Lower Risk of Prostate Cancer"

Eating your fruits and vegetables, especially a rainbow assortment of them, is associated with a lower risk of prostate cancer as well speeding up recovery in men who received radiation treatment for prostate cancer.

Two recent studies by the same group of Australian researchers found that certain micronutrients found in foods are lower in men with prostate cancer (compared to healthy men). These are lycopene, selenium, lutein, lycopene, α-carotene, β-carotene. Lycopene and selenium appear to be especially important.

Tomatoes and tomato products (e.g., tomato sauce) are an especially good source of lycopene. Other lycopene rich foods are: watermelons, grapefruits, guava, melons, papayas.  Selenium rich foods include Brazil nuts, seafood, organ meats, beef, pork, chicken, turkey, and eggs.

From Medical Xpress: Rainbow of fruit and veg the best prevention against prostate cancer

Men who consume colorful fruits and vegetables on a regular basis are less likely to be diagnosed with prostate cancer (PC), according to new research by University of South Australia scientists.

A rainbow of foods rich in certain micronutrients helps to prevent prostate cancer (PC) as well as speed up recovery among men who undergo radiation treatment for the disease. ...continue reading "Certain Nutrients Associated With a Lower Risk of Prostate Cancer"

Are human papilloma viruses (HPV) causing some prostate cancers? And could getting the HPV vaccine help in preventing some cases of prostate cancer? Sure sounds like it according to a recent study published by Australian researchers.

The researchers reviewed 26 studies and came to the conclusion that while prostate cancer likely has many causes, it appears to also have an infectious viral cause - specifically certain human papilloma viruses (HPVs). They point out that HPV vaccines protect against the high risk HPV types 16 and 18, which cause the majority of cervical cancers, and also appear to be implicated in some prostate cancers.

From Medical Xpress: Potential causal role of human papilloma viruses (HPVs) in prostate cancers

Human papilloma viruses (HPVs) - a common group of viruses known to cause cervical cancers—may also have a causal role in prostate cancer, according to a literature review published in the open access journal Infectious Agents and Cancer, supporting the case for universal HPV vaccination. 

James Lawson and Wendy Glenn, at the University of New South Wales, Australia reviewed results from 26 previous studies on HPVs and their links to prostate cancer. They assessed the existing evidence using a common set of nine causal criteria, including the strength and consistency with which HPVs were associated with prostate cancers and whether HPVs were detected in prostate tissues that later went on to develop cancer.  ...continue reading "Prostate Cancer and Human Papilloma Viruses"

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Prostate, urethra, and bladder Credit: Wikipedia

The results of a recent study in the United Kingdom are in line with what a number of researchers (here, here, and here) have been writing about for a while - that studies show that some cancer screening (e.g. for prostate cancer) of people with no symptoms does not save lives.

The UK study randomly assigned men (aged 50 to 69) to get a PSA test one time or to not get a PSA test (the controls). The PSA test measures prostate-specific antigen in the blood, and is typically used to screen for prostate cancer. It is not done routinely in the UK. They found that while more men were diagnosed with prostate cancer in the PSA group, after 10 years there was no statistical difference in death rates between the two groups. As the researchers themselves said, the PSA screening test resulted in "an increase in the detection of low-risk prostate cancer cases" (the ones that wouldn't cause a problem). But not in the aggressive killer cancers.  However, the researchers are now continuing the study to see if there are differences in the 2 groups after an even longer period of time. From Medical Xpress:

One-off PSA screening for prostate cancer does not save lives

Inviting men with no symptoms to a one-off PSA test for prostate cancer does not save lives according to results from the largest ever prostate cancer trial conducted over 10 years by Cancer Research UK-funded scientists and published today (Tuesday) in the Journal of the American Medical Association (JAMA). Researchers at the Universities of Bristol and Oxford found that testing asymptomatic men with PSA detects some disease that would be unlikely to cause any harm but also misses some aggressive and lethal prostate cancers.

The CAP Trial, which spanned almost 600 GP practices in the UK and included more than 400,000 men aged 50-69, is the largest trial ever to investigate prostate cancer screening. The trial compared 189,386 men who were invited to have a one-off PSA test with 219,439 men who were not invited for screening. After an average of 10 years follow up, there were 8,054 (4.3%) prostate cancers in the screened group and 7,853 (3.6%) cases in the control group. Crucially, both groups had the same percentage of men dying from prostate cancer (0.29%).

While some prostate cancers are aggressive and lethal, others are clinically insignificant and will never lead to any harm or death if left undetected. Ideally, aggressive prostate cancers need to be identified and treated as early as possible. But finding a cancer that would never have caused men harm during their lifetime can have a serious impact on quality of life, including the worry of a cancer diagnosis, the possibility of infection following a biopsy and impotence and incontinence following treatment. ... Dr Richard Roope, Cancer Research UK's GP expert, said: "The PSA test is a blunt tool missing the subtleties of the disease and causing men harm.

Prostate cancer is something that men worry about, especially because it is the most common cancer in men, and because it can take several forms. On one hand, a tumor can be "indolent" or so slow growing that it just needs to be monitored, or sometimes it can be very aggressive and even lead to death. That's why the possibility of a dietary pattern (what a person eats) having an effect on the cancer's progression or aggressiveness is very exciting - if true, it would be something people could do to improve their prostate cancer outcome. Or perhaps even prevent it in the first place. Studies up to this point have been mixed, with no clear results.

A recent large study conducted in Spain found that those men with prostate cancer who had a high adherence to a Mediterranean diet had a lower risk of aggressive prostate cancer, as compared to those following a typical Western diet (large amounts of fatty dairy products, refined grains, processed meat, caloric beverages, sweets, fast food, and sauces) or a Prudent diet (low-fat dairy products, whole grains, fruits, vegetables, and juices). A Mediterranean dietary pattern is rich in fruits and vegetables, and also fish, legumes, boiled potatoes, olives and olive oil, vegetable oils, and a low intake of juices.

The researchers also discussed that there are many similarities with breast cancer and prostate cancer, including risk factors. They found in an earlier study in Spain that eating a Western diet is associated with breast cancer risk, the Prudent diet is not associated with breast cancer, and the Mediterranean diet seems to be protective for breast cancer. From Medical Xpress:

A more complete Mediterranean diet may protect against aggressive prostate cancer

In a new study published in The Journal of Urology, researchers determined that men who followed a Mediterranean diet, rich in fish, boiled potatoes, whole fruits, vegetables, legumes, and olive oil, and low consumption of juices had lower risk of aggressive prostate cancer (PC) than those who followed other dietary patterns like Prudent or Western diets. ..."Our results show that a diet oriented towards the prevention of aggressive tumors in the prostate should probably include important elements of the Mediterranean diet such as fish, legumes, and olive oil, and suggest that a high intake of fruits, vegetables, and whole grains might not be enough."

The authors explored the relationship between the risk of having PC and dietary patterns as part of the MCC-Spain study, a Spanish case-control study that involved 733 patients with histologically confirmed PC and 1,229 healthy men with a mean age of 66 years from seven Spanish regions. Anthropometric, epidemiologic, and dietary data were collected.

Adherence to the three dietary patterns of Western, Prudent, and Mediterranean, which characterize the dietary habits of the Spanish population, was evaluated, The Western [dietary] pattern includes consumption of large amounts of fatty dairy products, refined grains, processed meat, caloric beverages, sweets, fast food, and sauces. The Prudent pattern involves consumption of low-fat dairy products, whole grains, fruits, vegetables, and juices. Finally, the Mediterranean pattern consists of high consumption of fish, boiled potatoes, fruits, vegetables, legumes, and olive oil, and low consumption of juices. The diets were graded according to the degree of adherence to each pattern and assigned to four quartiles from lower to higher adherence within each pattern.

Only a high adherence to Mediterranean dietary pattern appeared to be associated with a lower risk of aggressive PC. Prudent and Mediterranean dietary patterns showed different effects in low and high grade tumors. 

PC was assessed using Gleason scores of tumor aggressiveness (<6 or ?6) and clinical stage (cT1b to cT4). A Gleason score of <6 typically indicates a less aggressive tumor with generally good prognosis. Lower clinical stage (cT1-cT2a) indicates a tumor that has not spread. Results indicated that for more aggressive and more extensive tumors (Gleason >6 and stages cT2b to cT4), only high adherence to the Mediterranean diet showed a statistically significant protective effect. All other dietary patterns and tumor characteristics showed little or no correlation and did not achieve statistical significance. [Original study.]

Another reason exercise is good for you: A large study found that men who exercise after a diagnosis of prostate cancer (but which is not metastatic) had a lower risk of dying from prostate cancer - as compared to those men who don't exercise.

So get out there and do something that gets you moving - and yes, walking is an exercise (Note: 1 mile = 20 minutes of walking, thus 3 miles = 1 hour).

In this study the average age at diagnosis was 71, but studies find that exercise has numerous benefits at all ages. Some doctors even think of exercise as "anticancer therapy" (here, here). Also, exercise has anti-inflammatory benefits, and current thinking is that chronic inflammation is linked to cancer.

The American Cancer Society in its cancer prevention guidelines recommends that adults should be physically active, and get at least 150 minutes of moderate physical activity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

From Medscape: Exercise Linked to Lower Mortality With Early Prostate Cancer

Men with nonmetastatic prostate cancer may have longer survival the more they exercise, a recent study suggests. For these men, regular moderate or vigorous physical activity was associated with 31 percent to 37 percent lower likelihood of death during the study, compared to more modest amounts of exercise.

“This confirms and expands on previous work that shows an inverse association between recreational physical activity after diagnosis and risk of prostate cancer-specific mortality,” said lead study author Ying Wang of the American Cancer Society in Atlanta, Georgia, in email to Reuters Health.

Wang and colleagues pulled data from a large, long-term study group established by the American Cancer Society in 1992, focusing on 7,000 men who were diagnosed with prostate cancer between 1992 and 2011. The average age at cancer diagnosis was 71, and there were 2,700 deaths through 2012, including 450 due to prostate cancer and 750 due to heart disease. The average time from diagnosis to death was about eight years for those who died from cancer and 10 years for those who died from other causes.

Men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Both before and after diagnosis, walking accounted for 73 percent of the physical activity that men did, followed by 10 percent for cycling and 5 percent for aerobic exercise, according to the report online now in European Urology.

Based on exercise levels before diagnosis, moderate to vigorous exercise, including walking, was linked to lower risk of death from prostate cancer, but only for men with lower-risk tumors. But after the diagnosis, the same levels of exercise were linked to lower risk of death from prostate cancer for all men, although the apparent benefit of walking was no longer statistically meaningful. [Original study.]

This is a thought-provoking study that looked at environmental quality and cancer incidence in counties throughout the US. The researchers found that the more polluted the county, the higher the cancer incidence. An increase in cancer rates was associated with poorer air quality and the "built environment" (such as major highways). They correctly point out that many things together can contribute to cancer occurring - and this is why looking at how polluted the air, water, etc. together is important.

They looked at the most common causes of cancer death in both men (lung, prostate, and colorectal cancer), and women (lung, breast, and colorectal cancer). They found that prostate and breast cancer demonstrated the strongest associations with poor environmental quality. [Original study.]

The researchers point out that about half of cancers are thought to have a genetic component, but therefore the other half have environmental causes. Other studies already find that environmental exposures (e.g., pesticides, diesel exhaust) are linked to various cancers. But this study was an attempt to look at interactions of various things in the environment with rates of cancer - because we all are exposed to a number of things simultaneously wherever we live, not just to exposures to one thing. Thus this study looked at associations in rates of cancer. 

Of course there is also a lifestyle contribution to many cancers that wasn't looked at here (nutrition, alcohol use, exercise). They also pointed out that many counties in the US are large and encompass both very polluted and non-polluted areas - and that those counties should be broken up into smaller geographic areas when studied. [More air pollution studies.] From Science Daily:

Poor overall environmental quality linked to elevated cancer rates

Nationwide, counties with the poorest quality across five domains -- air, water, land, the built environment and sociodemographic -- had the highest incidence of cancer, according to a new study published in the journal Cancer. Poor air quality and factors of the built environment -- such as the presence of major highways and the availability of public transit and housing -- -- were the most strongly associated with high cancer rates, while water quality and land pollution had no measurable effect.

Previous research has shown that genetics can be blamed for only about half of all cancers, suggesting that exposure to environmental toxins or socioeconomic factors may also play a role. "Most research has focused on single environmental factors like air pollution or toxins in water," said Jyotsna Jagai, research assistant professor of environmental and occupational health in the University of Illinois at Chicago School of Public Health and lead author of the study. "But these single factors don't paint a comprehensive picture of what a person is exposed to in their environment -- and may not be as helpful in predicting cancer risk, which is impacted by multiple factors including the air you breathe, the water you drink, the neighborhood you live in, and your exposure to myriad toxins, chemicals and pollutants."

To investigate the effects of overall environmental quality, the researchers looked at hundreds of variables, including air and water pollution, pesticide and radon levels, neighborhood safety, access to health services and healthy food, presence of heavily-trafficked highways and roads, and sociodemographic factors, such as poverty. Jagai and her colleagues used the U.S. EPA's Environmental Quality Index, a county-level measure incorporating more than 200 of these environmental variables and obtained cancer incidence rates from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program State Cancer Profiles. Cancer data were available for 85 percent of the 3,142 U.S. counties.

The average age-adjusted rate for all types of cancer was 451 cases per 100,000 people. Counties with poor environmental quality had higher incidence of cancer -- on average, 39 more cases per 100,000 people -- than counties with high environmental quality. Increased rates were seen for both males and females, and prostate and breast cancer demonstrated the strongest association with poor environmental quality.

The researchers found that high levels of air pollution, poor quality in the built environment and high levels of sociodemographic risk factors were most strongly associated with increased cancer rates in men and women. The strongest associations were seen in urban areas, especially for the air and built environment domains. Breast and prostate cancer were most strongly associated with poor air quality.

Surprising results (to me at least) from research comparing various diets and incidence of several cancers in 11,082 individuals in the Netherlands over a 20 year period. I expected the daily meat eaters to have higher rates of the 3 cancers studied, but no....

According to this study, looks like frequent meat consumption is OK when looking at lung, postmenopausal breast, and prostate cancer. Meat consumption did not increase the risk for these cancers.

Their main conclusion: vegetarians, pescatarians (eats fish, but no meat), and low-meat consumers did not have a reduced risk of lung, postmenopausal breast, and overall prostate cancer when compared with individuals consuming meat on a daily basis. This is after taking confounders such as smoking into account (because smokers have higher rates of cancers such as lung cancer).

The researchers do point out that some other similar studies had mixed results, but that perhaps those studies did not take confounders (variables that distort the results) such as smoking, physical activity levels, alcohol consumption, etc. into account.

From the European Journal of Clinical Nutrition: Vegetarianism, low meat consumption and the risk of lung, postmenopausal breast and prostate cancer in a population-based cohort study

The few prospective studies that examined lung, female breast and prostate cancer risk in vegetarians have yielded mixed results, whereas none have studied the effects of low meat diets. ... The Netherlands Cohort Study—Meat Investigation Cohort (NLCS-MIC)— is an analytical cohort of 11,082 individuals including 1133 self-reported vegetarians (aged 55–69 years at baseline). At baseline (1986), subjects completed a questionnaire on dietary habits and other risk factors for cancer and were classified into vegetarians (n=691), pescetarians (n=389), 1 day per week (n=1388), 2–5 days per week (n=2965) and 6–7 days per week meat consumers (n=5649).

After 20.3 years of follow-up, 279 lung, 312 postmenopausal breast and 399 prostate cancer cases (including 136 advanced) were available for analyses. After adjustment for confounding variables, we found no statistically significant association between meat consumption groups and the risk of lung cancer. As well, no significant associations were observed for postmenopausal breast and overall prostate cancer. After adjustment for confounders, individuals consuming meat 1 day per week were at a 75% increased risk of advanced prostate cancer compared with 6–7 days per week meat consumers.

Vegetarians, pescetarians and 1 day per week meat consumers did not have a reduced risk of lung, postmenopausal breast and overall prostate cancer compared with individuals consuming meat on a daily basis after taking confounders into account.

Although vegetarian diets are primarily defined by the absence of meat and fish, they are also shown to be associated with high intakes of fruits and vegetables and a favorable distribution of non-dietary factors.1, 2 Consequently, vegetarian diets may reduce the risk of different types of cancers through multiple mechanisms, depending on the etiology and preventability of the tumor.3, 4

We previously reported a nonsignificantly reduced risk of vegetarian and low meat diets on colorectal, and especially rectal, cancer5 and set out to study its effect on three other major cancers.

Although meat consumption has been hypothesized to be implicated in the etiology of lung, female breast and prostate cancer, data are not consistent across studies and meat subtypes.6, 7, 8However, on the basis of the existing body of literature, vegetarians may be at a lower risk of developing lung cancer (because of lower smoking rates) and to postmenopausal breast cancer (because of lower alcohol consumption, lower body mass index and higher physical activity levels).

Results from this prospective cohort study showed that, in age- and sex-adjusted models, vegetarians and pescetarians were at a reduced risk of lung cancer compared with individuals consuming meat on a daily basis. This effect disappeared after taking confounders, especially smoking, into account. We did not observe an association between the meat consumption group and the risk of post-menopausal breast and overall prostate cancer.

Our null findings regarding post-menopausal breast cancer risk are in line with other prospective studies comparing vegetarians with non-vegetarians and a pooled analysis of five cohort studies on breast cancer mortality. In contrast, the UK Women’s Cohort Study reported a lower post-menopausal breast cancer risk among non-meat consumers compared with high meat consumers,14 although this was not observed in their dietary pattern analyses.15 Vegetarian diets are rich in fiber and soy. Fiber was associated with a reduced risk of breast cancer in a meta-analysis of prospective studies,19 and soy contains isoflavones, which have previously been associated with a significant reduced risk of postmenopausal breast cancer in Asian populations.20 However, compared with the average soy intake in four Asian countries (ranging from 38 to 134 g/day21), the soy product intake among vegetarians in our population was likely too low to exert an effect (~15g per day).

We've all heard of immunotherapy as a possible future treatment for many cancers, but other possible treatments are also being tested. Two possibilities caught my eye.

The first study is looking at exercise for advanced prostate cancer - to extend life, and the other is testing a vaccine for those with prostate cancer who haven't yet treated it (they've just been doing "active surveillance" instead).  And since the studies are occurring now, and people are still joining, then the results are still unknown and won't be known for years.

But one can hope.... Exercise as anticancer therapy? A vaccine after cancer diagnosis?

From Medical Xpress: Exercise, future anticancer therapy?

At age 70, Alfred Roberts plays hockey twice a week. Nothing special, right? Except that for three years he has had advanced prostate cancer, which has spread to his bones. "I've always been active. Hockey keeps me in shape and keeps my mind off things. I've got friends that have played until age 80, and my goal is to beat them!" said the veteran stick handler.

Several studies have demonstrated the benefits of exercise to improve the quality of life of people with cancer. But Dr. Fred Saad, urologist-oncologist and researcher at the University of Montreal Hospital Research Centre (CRCHUM), goes further. He believes that physical exercise has a direct effect on cancer, as effective as drugs, for treating patients with prostate cancer, even in advanced stages of the disease.

"Typical patients with metastases often become sedentary. It is thought that this affects cancer progression," he said. Together with Robert Newton, professor at the Edith Cowan University Exercise Medicine Research Institute in Australia, Dr. Saad is leading the first international study which aims to demonstrate that exercise literally extends the life of patients with metastatic prostate cancer....In the coming weeks, some sixty hospitals across the world will begin recruiting patients. In total, nearly 900 men with advanced prostate cancer will participate.

"We will study exercise as if it were a drug added to standard treatments. All patients will be treated within the latest scientific knowledge for this type of cancer. They will continue to follow their therapies and take their medications. But half of the patients will receive psychosocial support with general recommendations on physical exercise. The other half will also follow a high intensity exercise program," he explained.

The exercise medicine expert Professor Robert Newton has designed a specific strength and cardiovascular training program for patients in the "exercise" group. "They will have an hour of aerobic and resistance training three times a week. An exercise specialist will supervise them for the first 12 months, and then they will continue without direct supervision. We will evaluate quality of life, appetite, and treatment tolerance in relation to their improved physical condition," said Professor Newton, who is co-director of the Edith Cowan University, Exercise Medicine Research Institute.

The hypothesis is that exercise has a direct impact on cancer progression in addition to helping patients better tolerate therapy. Ultimately, they will live longer. The results of this large study, which involves some one hundred researchers in Canada, the US, Australia, Ireland, the Netherlands, and the UK, will not be known for five years. Could the findings be extended to other types of cancer? It is too early to tell, but researchers are betting that exercise could well become the next anticancer therapy. Alfred Roberts is also convinced that exercise helps defy the odds: "As long as I can skate, I'll play hockey!"

From Medscape:  A Treatment Vaccine for Low-Risk Prostate Cancer

A Louisiana-based biopharmaceutical company is betting that its experimental immunotherapeutic vaccine can keep previously untreated prostate cancer in check. The company, OncBioMune Pharnaceuticals, Inc, in Baton Rouge, is planning to test the vaccine, dubbed ProscaVax, in a phase 2 trial for patients with previously untreated prostate cancer and in a second trial for patients with recurrent or hormone-refractory disease. The trial of a treatment vaccine in untreated, low-risk prostate cancer patients is novel.