The Link Between Diet and Prostate Cancer

By Simon J. Hall, M.D.

Simon J. Hall, M.D. is Director of the Barbara & Maurice Deane Prostate Health & Research Center at the Mount Sinai School of Medicine in New York City, and Chairman of the Department of Urology and Associate Professor in the Departments of Urology and Gene & Cell Medicine.

[An excerpt from the Foreward to Eat to Beat Prostate Cancer Cookbook]

Since we all control what we eat, taking a look at nutrition is an excellent starting point for engaging positive feelings and proactive behavior towards either the risk or the reality of one’s own prostate cancer. It is clear that what we eat can significantly influence our health. And an understanding of the role of nutrition and how it can impact prostate cancer risk factors, both positive and negative, is important for men who are concerned about their own chances of developing prostate cancer, and also for those already diagnosed.

The interplay of diet and risk factors is complex. In the United States, African-American men have the highest incidence of prostate cancer, while Asian men, those from China and Japan, have the lowest. Interestingly, the autopsy examination of prostate tissues of men from different ethnic backgrounds who die without evidence of clinical prostate cancer reveals similar incidences of small, well differentiated, latent cancers. It is thought that one of the main causes for the conversion of a latent cancer into a clinically significant cancer is the interaction between environmental factors and genetic predilection. Recent studies demonstrating the high incidence of prostate cancer in the Caribbean and West Africa suggest that men with a significant African genetic background have a higher risk and predilection for developing prostate cancer. Ongoing studies are exploring environmental factors, such as nutrition, as a way to further modify this higher risk. When Asian families emigrate to the United States, within one generation the incidence of prostate cancer rises to levels significantly higher than in China or Japan, but not to the levels of that for Caucasians and African-Americans. It is unclear whether this change is due to the protective effects of the Asian diet, which is generally centered on vegetables, grains, fish, soy-based products, and teas, or the deleterious effects of the American diet, characterized by a high intake of animal-based products and a low intake of fruits and vegetables. Evidence exists supporting both theories. In either instance, it is thought that diet may help control the potential conversion of a latent cancer to a clinical cancer.

Clearly, the average American eats far too much meat and associated fats and does not consume enough vegetables and fruits. Avoidance of animal fats appears to reduce the risk of developing prostate cancer as well as colon cancer, and is also important for maintaining cardiovascular health. Other dietary studies, including animal studies, have explored soy and soy products, and have demonstrated that some compounds in soy have anticancer properties.

Dietary life style changes require commitment and patience. Many patients, early in their diagnosis, make substantial changes in their eating routines, only to retreat to former patterns within a year. The deleterious effect of what we eat may not be years in the making, but the benefits of healthy eating, whether to prevent or treat an existing cancer, require almost daily adherence and can only be achieved through a dedicated commitment to a new lifestyle

Diet and the Prostate Cancer Risk

By Alan R. Kristal, Dr. P.H.

Alan R. Kristal, Dr. P.H., is Member and Associate Head of the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center in Seattle, Washington, and Professor in the Department of Epidemiology and Nutritional Sciences Program, University of Washington, Seattle. He is also a senior editor of Cancer Epidemiology, Biomarkers and Prevention and associate editor of the American Journal of Epidemiology.

[An excerpt from the Introduction to Eat to Beat Prostate Cancer Cookbook]

One question many men ask me is whether changes in their diet or the use of dietary supplements can lower their risk of developing prostate cancer, or lower the risk of their cancer recurring if they already have been diagnosed and treated. To answer this, large studies are now underway to examine the role of diet and dietary supplements in both preventing prostate cancer and lessening the chance of recurrence. But for the moment, our current base of scientific knowledge is quite limited. While awaiting the results of these studies, which will continue through the end of the decade, we can make reasonable recommendations about diet, based on two factors: (1) our understanding of the basic molecular events that cause healthy cells to develop into cancer; and (2) scientific studies that have examined prostate cancer in large samples of men.

Even though there is still much work to be done, there are several recurrent themes in studies relating diet to prostate cancer risk. These are:

• Maintain a healthy weight. Balance calorie intake with exercise.
• Eat a variety of vegetables, both cooked and raw.
• Moderate total and saturated fat intakes.
• Moderate consumption of red meat, especially grilled and fried.
• Choose margarine, cookies, crackers, and other processed foods containing no trans-fats.
• Select foods in fast-food restaurants that are not fried in oil containing trans-fats.
• Eat at least one and preferably more servings of dark-fleshed fish per week.
• Choose breads and cereals made with whole-grains.
• Moderate milk and calcium consumption.