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Healthful Lifestyle Reduces Risk of Dying from Prostate Cancer

Almost all North American men will develop prostate cancer if they live long enough. However, fewer than five percent of men diagnosed with prostate cancer will die from that disease and the 15-year survival rate is 96 percent.

Data from the Health Professionals Follow-Up Study show that men who participated most frequently in vigorous exercise had a 30 percent reduced risk of developing advanced prostate cancer and 25 percent reduced risk of dying from prostate cancer than those who exercised the least (European Urology, October 22, 2018). Men in the highest group of intense exercisers did the equivalent of 25 minutes of running daily in various activities including bicycling, swimming, heavy outdoor work or playing sports such as tennis or racquetball.

Nearly 50,000 men, 40-75 years old, were followed for 26 years, during which 6,411 developed prostate cancer and 888 developed the aggressive type that can kill. Half of all prostate cancers contain the gene, TMPRSS2:ERG. If you have this gene, insulin, certain growth factors and other metabolic factors increase your risk for developing prostate cancer. This could explain the link between physical activity and reduced risk for developing or dying from prostate cancer. This genetically-driven prostate cancer now appears to be a metabolic disease and all the rules for preventing and treating diabetes and heart attacks also may help to prevent and treat these cases of prostate cancer.

The same group of researchers published a paper in the same journal issue showing that measuring PSA levels in mid-life can predict the likelihood to develop aggressive prostate cancer later on in African-American men (European Urology, October 22, 2018). The group reported earlier that PSA screening in mid-life can also be used to predict aggressive prostate cancer in Caucasian men.

Lifestyle Factors that Increase Risk for Prostate Cancer
• Most risk factors for diabetes and heart attacks are also risk factors for developing prostate cancer: high blood sugar, high insulin levels, high cholesterol, and diabetes (Horm Cancer, April 2016;7(2):75-83).
• Prostate cancer is six times more common in Western than non-Western countries and in countries that are richer rather than poorer (Eur Urol 2012, 61:1079-1092).
• Obesity is associated with increased death rate, more advanced stage disease, and higher Gleason scores once a man has prostate cancer (Int J Oncol, Mar 2006;28(3):737-45). Doctors look at prostate cancer cells under a microscope and use the characteristics of the cells, called the Gleason score, to predict how likely the cancer is to spread through the body.
• Full fat cells produce high levels of potential cancer causing leptin, interleukin-6 (IL-6), heparin-binding epidermal growth factor-like growth factor (HB-EGF), vascular endothelial growth factor (VEGF) and adiponectin that can cause cancer cells to spread through your body (Int J Oncol, Mar 2006;28(3):737-45 and J Clin Endocrinol Metab, Mar, 2001;86(3):1341-5).
• High blood sugar (fasting sugar over 100) in men diagnosed with prostate cancer markedly increases risk of them dying from prostate cancer (Prostate Cancer Prostatic Dis, June 2013;16(2):204-8).
• Eating a diet that has a high glycemic load (foods that cause a high rise in blood sugar) increases risk of developing prostate cancer by more than 26 percent (Ann Oncol, Jan 2013;24(1):245-51).
• Exercise is associated with reduced risk for both slow growing prostate cancer and the type that can kill (Journal of Urology, November 2009;182(5):2226-2231).

If You Already Have Prostate Cancer
After a man is diagnosed with prostate cancer, the same risk factors associated with the disease also increase risk for the prostate cancer progressing and being fatal. Men diagnosed with prostate cancer are less likely to have the prostate cancer spread and kill them if they:
• avoid smoking, maintain a healthy body weight, exercise regularly and intensely, and eat a high vegetable diet that includes tomato sauce (lycopene), cruciferous vegetables, non-saturated vegetable fats and coffee (World J Urol, 2017 Jun; 35(6): 867-874).
• restrict eggs, red meat and poultry (American Journal of Clinical Nutrition 2010; 91(3): 712-21; American Journal of Clinical Nutrition 2012; 96(4): 855-63; Cancer Prevention Research (Phila) 2011; 4(12): 2110-21). These foods are sources of choline that colon bacteria convert to TMAO, which is a carcinogen.
• restrict saturated fat in meat and eat polyunsaturated fats in vegetables (annual meeting of the American Association for Cancer Research. April 19, 2016).

My Recommendations
Most risk factors for heart attacks are also risk factors for prostate cancer (Journal of the American College of Cardiology: Cardiovascular Imaging, December 2015). I believe that the most beneficial diet to prevent and treat prostate cancer includes eating lots of fruits and vegetables, and restricting refined carbohydrates, red meat and processed meats, and fried foods (BMC Medicine, March 24, 2015;13:3). I also recommend that you try to exercise every day and work to lose excess weight if you are overweight.

November 4th, 2018
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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