Health And Wellness - UCSF Department Of Urology

a 30% lower risk of developing lethal prostate cancer than men who consumedthe least. This same study reported that lycopene intake from tomato productswas associated with biological markers of good prognosis in prostate tumorssuch as large, regularly shaped blood vessels. This observation supports the ideathat tomato products have an effect on the prostate and may reduce the risk ofdeveloping aggressive prostate cancer.While a number of studies have linked cooked tomatoes and tomato-basedproducts (such as tomato sauce) with a reduced risk of developing prostatecancer, it is not currently known whether these foods are specifically beneficialfor men after they have been diagnosed with the disease. Fewer studieshave examined post-diagnostic tomato intake in relation to prostate cancerprogression. In the first study, 2 servings of tomato sauce per week after diagnosiswas associated with a 20% lower risk of prostate cancer recurrence. However, nosuch association was found in a second study. Yet, tomatoes—along with otherfruits and vegetables—are part of a healthy diet that is recommended for all men,with or without prostate cancer.DIET & LIFESTYLE RECOMMENDATIONS7

Cruciferous VegetablesWe recommend that men with prostate cancer eat 1 serving (½ cup) ofcruciferous vegetables, such as broccoli, cauliflower, and cabbage, on most days.Common cruciferous vegetables include broccoli, cauliflower, cabbage, Brusselssprouts, kale, mustard greens, chard greens, bok choy, and arugula. Cruciferousvegetables yield compounds that may detoxify carcinogens (cancer-causingagents), stop cancer cells from growing and dividing, and even cause cancercell death. As with tomatoes, greater consumption of cruciferous vegetables isassociated with lower risk of developing aggressive prostate cancer.A promising study further suggested that men with non-metastatic prostatecancer who consumed one serving (½ cup) of cruciferous vegetables a day had asubstantially lower risk of recurrence in comparison to men who consumed none.8HEALTH and WELLNESS: LIVING with PROSTATE CANCER

SoyLimited available data on soy does not suggest much impact on prostate cancerprogression or death; however consuming soy instead of less healthful sourcesof protein, such as processed meat, may offer some overall health benefits (seenext topic).Laboratory studies have shown that compounds in soy called isoflavones inhibitprostate cancer cell growth, invasion, migration, and metastasis. Studies inAsian populations (with higher soy intake than Western populations) also tendto suggest that soy intake (e.g., tofu, soy milk, soy beans) is inversely associatedwith the risk of developing prostate cancer; and one study reported an inverseassociation between total legume intake and risk of advanced prostate cancer. Inparticular, there was a protective effect of soy intake specifically. However, thereis little information on the relationship between soy consumption and the risk oflethal prostate cancer or prostate cancer progression. While additional researchon soy is needed, the available data suggest that increasing soy intake will notaffect the risk of prostate cancer progression.ISOFLAVONES: Naturally occurring compounds oftenfound in plants such as soybeans. In humans, theyfrequently act as phytoestrogens due to their structuraland functional similarity to estradiol.DIET & LIFESTYLE RECOMMENDATIONS9

Processed MeatWe recommend that everyone choose skinless poultry, fish, legumes, and nuts asprotein sources instead of processed meat.Processed meat is a broad category that includes foods such as lunchmeats(salami, bologna, and turkey deli meat), sausage, bacon and hot dogs. Somestudies have indicated a link between processed meat consumption and riskof advanced or lethal prostate cancer. Others, however, have reported noassociation. Nevertheless, there is substantial evidence that suggests regulareating of processed meat products increases the risk of chronic illnesses anddeath. While the exact mechanisms remain unclear, processed meats oftencontain preformed N-nitroso compounds, nitrites, nitrates, and added salt, whichhave cancer promoting properties.10HEALTH and WELLNESS: LIVING with PROSTATE CANCER

CoffeeDrinking coffee is safe and may even improve overall health. However, currentevidence is not strong enough to recommend that non-drinkers take up coffee tolower their risk of prostate cancer progression.Several studies have reported that regular consumption of coffee before diagnosisis associated with a significant reduction in the risk of developing lethal prostatecancer. In fact, one study observed a 60% reduction in the risk of lethal prostatecancer among men who drank 6 or more cups of coffee per day versus menwho drank the least amount of coffee. Interestingly, the results were similar forboth regular and decaffeinated coffee. This association may be due to coffee’santioxidant effects, which may stave off tumor formation.Unfortunately, data on coffee intake post-diagnosis are lacking, and more researchis needed on its effect on prostate cancer progression. Nevertheless, coffeeconsumption is associated with lower risk of a number of illnesses, including gallbladder disease, diabetes, Parkinson’s disease, and overall mortality. The maindrawback to frequent coffee drinking is that consumption later in the day canimpair sleep quality.DIET & LIFESTYLE RECOMMENDATIONS11

FishWe recommend that all men—with or without prostate cancer—eat at least 2servings of fish each week.Several studies have examined fish intake in relation to risk of developing prostatecancer. Among healthy men, these studies suggest that men who regularlyconsume more fish have a lower risk of dying from prostate cancer. In one study,for example, men who ate 1 or more servings of dark meat or other fish per weekwere 30% less likely to die from prostate cancer. In addition, a combined analysisof 4 separate studies reported a 63% reduction in prostate cancer mortality inmen with the highest levels of fish consumption. Other studies, however, havenot identified an association between fish intake and the risk of advanced oraggressive prostate cancer. Nevertheless, when taken together, the data suggestthat fish consumption—especially fish with high levels of omega-3 fatty acids(salmon, sardines, mackerel, and herring)—is beneficial for reducing the risk ofclinically significant forms of prostate cancer.OMEGA-3 FATTY ACIDS: Long-chain omega-3 fatty acidsare a type of fat obtained in the diet, primarily from fattyfish. Also called n-3 fatty acids, eicosapentaenoic acid(EPA) and docosahexaenoic acid (DHA) are long chains of n-3 fattyacids contained in fish and shellfish.Fewer studies have examined post-diagnostic fish intake in relation to prostatecancer progression. In the first study, 2 servings of fish per week after diagnosiswas associated with a 17% lower risk of prostate cancer recurrence. However,no such association was found in the second study. A clinical study among menscheduled for prostatectomy reported that taking fish oil 4-6 weeks beforesurgery inhibited prostate tumor growth. Among men on active surveillance,another study reported that EPA (a long-chain omega-3 fatty acid found in fish)measured in men’s prostate tissue was associated with lower risk of prostatecancer progression, as well as a lower risk of dying from the disease.12HEALTH and WELLNESS: LIVING with PROSTATE CANCER

Dietary FatsGiven the strong evidence that plant-based dietary fats lower the risk ofcardiovascular disease and diabetes, we recommend that all men—with orwithout prostate cancer—replace foods high in saturated fat with healthy sourcesof vegetable fats, such as olive oil and nuts.Studies consistently show that replacing saturated fat with unsaturated fat isbeneficial for overall health. Additionally, several studies have reported thatsaturated fat intake is associated with an increased risk of developing advanced orlethal prostate cancer, while long-chain omega-3 fatty acids (found in

Launched in 1995 by Dr. Peter Carroll at the University of California, San Francisco (UCSF), the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE ) is a longitudinal, observational prostate cancer registry study of over 15,000 men with prostate cancer. Patients have enrolled at 44 community urology practices,