Categories
Prostate Health

Prostate Cancer and Diet & Lifestyle

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What is the prostateProstate cancer at a glance
ProteinInsulin
Dietary FatPhytochemicals
Minerals & VitaminsMeal Preparation
Heart Health & Exercise

Prostatic concerns and cancer have been well documented and observed over the centuries, earlier than one may initially think.

A plethora of medical treatments and surgeries to combat the disease have been researched, executed and pioneered over the years, however it’s been proven that one’s lifestyle, habits and diet can influence ones risk of developing prostate cancer as well as it’s progression in diagnosed patients. The main concern of most cancer survivors may simply be to lead a cancer-free life after the fact; however adopting a healthy diet and regular exercise are integral steps towards attempting to prevent other diseases that commonly occur with ageing.

What is the prostate…

The following article may help to shed light on an important topic that is still undergoing studies and trials. It may serve to inform readers affected by prostate cancer, of nutritional and lifestyle choices that could be potentially beneficial. Before diving in, it is important to have an idea of what the prostate is and its function.

The prostate is an organ that forms a part of the male reproductive system. It is located directly below the bladder, just above the muscles of the pelvic floor and directly in front of one’s rectum.

Due to its proximity to the rectum, doctors are able to examine/palpate the gland directly via ones rectum.

The diagram on the right depicts the prostate (Highlighted in red) being manually examined or palpated.

Upon examination a healthy prostate gland can be said to have a smooth, elastic feel to the touch. This is due to the fact that the prostate is surrounded by a capsule, which is made up of; connective tissue, elastic connective tissue and many smooth muscle fibres.

The prostate is generally found to weigh approximately 15-20 grams and to be the size of a walnut. Generally, ones prostate will measure between 3 and 4cm at it’s widest portion, between 4-6 cm in length, and between 2-3cm in thickness. (Tanagho & McAninch, 378)

The prostate encompasses the urethra which is the conduit between the bladder and the tip of the penis, through which urine and semen flows. Ducts from the prostate gland flow directly into the urethra.

The most important function of the prostate is to produce some of the components of seminal fluid. This fluid helps to nourish and transport sperm cells. During ejaculation, the muscles of the prostate contract and ensure that semen is forced into the urethra and expelled outwards.

The prostate is made up of three different “zones”, that form the entirety of the gland. Expand the sections below to see more on each zone…

Transition Zone

The smallest portion of the gland, the transition zone is at the centre of the organ and surrounds the urethra.


This zone tends to undergo benign (Noncancerous) growth in men of old age. This is medically referred to as Benign Prostatatic Hyperplasia (BPH). This tissue growth can result in the gland pressing up against the urethra or the bladder; often leading to difficulties with passing urine. 

Central Zone

This surrounds the transition zone and makes up about one quarter of the prostate’s mass.

Peripheral Zone

This surrounds the central zone and accounts for about 70% of the gland’s total tissue mass.


Where malignant (cancerous) growths normally occur.

Prostate Cancer at a Glance…

Prostate cancer is one of the most common types of cancer found in men. Ultimately prostate cancer is the result of changes in the DNA of “normal” prostate cells. 

Each and every cell in the human body contains groups of genes responsible for cellular functions. In regards to cancer, the two main groups of genes found within cells responsible for cellular division and apoptosis (programmed cell death) are called, Proto-Oncogenes & Tumour Suppressor genes.

When a mutation occurs within the Proto-Oncogenes of a cell, they then become what is known as Oncogenes. Lacking the required DNA to carry out the necessary cellular functions, oncogenes are responsible for abnormal, rapid cell division.

Tumour Suppressor genes are also responsible for functions that slow down cell division and regulate apoptosis (programmed cell death), but in addition they aid in the repair of possible DNA errors. An outcome of tumour suppressor gene mutation, is uncontrollable cellular growth. This in turn can lead to cancer. 

Protein

Proteins are a macronutrients comprised of amino acids.
Aside from providing the body with a source of fuel, the amino acids aid vital functions within the human body such as the growth and repair of muscle and bone, and the production of hormones and enzymes. 

Various studies and trials have ascertained a link between high intakes of certain sources of protein and an increased risk of developing cancer. Specifically animal (pork, beef and lamb) and dairy based sources of protein. 

This is not insinuating that protein needs to be eliminated from ones diet all together, in order to lower the risk of developing prostate cancer or its progression. Simply, one should ascertain how much protein their body needs and what the appropriate sources are for them as an individual.

An inverse relationship between protein consumption and age has been observed in men suffering from or predisposed to prostate cancer. Men 65 years and younger, who adhere to a low protein intake have a lower risk of cancer and overall mortality. Whereas, men 65 years and older, who have a low protein intake have a higher risk of cancer and overall mortality.

Animal Protein

For the sake of this article, animal protein refers specifically to meat products derived from animals and not their byproducts.

Various studies have found a link between red meat and an increased risk of developing prostate cancer and/or encouraging its growth. It has been observed that men who consume the highest quantities of red meat, are at least 2 times more at risk of developing prostate cancer when compared to men with the lowest intakes of red meat.

Research has shown that the carcinogenic properties of meat most likely stem from industry practices and the methods used to prepare food.

Industry Practice & Methods

Pesticide treated feed and supplements/hormones given to livestock can leave traces of residue in the meat that is intended for consumption.

Although healthier options aren’t always readily available nor the most affordable, it is recommended that when purchasing meat, opt for the following meat products where possible:

  • Organic
  • Grass-fed
  • Free range

Whether or not animal meat is processed after slaughter plays a vital role in the end products nutritional value. Processed meat can refer to a wide variety of products such as cured deli meats, sausages and bacon.
Studies have identified a link between regular consumption of processed meat products and an increased risk of chronic illness and disease.

A reason for this association may be due to the fact that, often processed meat products contain established N-nitroso compounds, nitrates, nitrites and added salt. All of which have properties linked to the promotion of cancer.

Meal Preparation

The way we choose to prepare our food can greatly impact the finished meal. Different cooking methods can imbue our foods with beneficial or harmful properties; cooking any animal meat at high temperatures, especially for extended periods releases carcinogenic compounds.

At approximately 100°C, Heterocyclic Amines (HCA’s) begin to form; this process accelerates significantly from 300°C and above. From temperatures 200°C and higher, Polycyclic Aromatic Hydrocarbons (PAH’s) begin to form; PAH’s are known to be cancer causing compounds.

Pre-clinical studies have found that HCA’s play a role in the increased occurrence of tumours in the following sites:
Prostate, lung, mammory, colon, oesophagus, stomach and pancreas.

Avoid fried foods and foods cooking at high temperatures for long periods of time; instead, opt for cooking methods such as steaming, boiling and roasting.

Plant Protein

Plant protein refers to the nutritional protein content found in plant sources.

It has been established that men with a greater over-all consumption of plant based foods, have a lower risk of developing prostate cancer and significantly more so for developing aggressive/fatal prostate cancer.

Sources of plant based protein:

  • Soybeans
  • Soybean derivatives: tofu, tempeh & edamame beans
  • Spelt & teff (ancient grains)
  • Hemp seeds
  • Quinoa
  • Chia seeds
  • Nuts & nut butters
  • Lentils
  • Beans
  • Nutritional yeast
  • Spirulina
  • Green peas
  • Oats
  • Wild rice
  • Seeds

A diet rich in cruciferous vegetables has also proven to be beneficial. Cruciferous vegetables are low-calorie and rich in folate, vitamins E, C & K and fibre.

Cruciferous vegetables contain anti-carcinogenic phytochemical compounds called sulforaphane and indole-3 carbinol.

Examples of cruciferous vegetables:

  • Broccoli
  • Bok choy
  • Brussel sprouts
  • Cabbage
  • Kale
  • Arugula
  • Cauliflower
  • Collard greens

Insulin

Insulin is naturally produced by the pancreas, which is a gland located in the abdomen, just behind the stomach. Two of insulin’s important functions are, to convert glucose into a readily available source of energy for the body and to store converted glucose as energy reserves in cells, fat, muscles and the liver.

It is a well known medical fact that cancer and sugar (glucose) go hand in hand; sugar facilitates the growth and proliferation of cancer cells. A physiologist by the name of Otto Warburg, established that tumour cells extract glucose from the body at a rate that is 20 to 50 times higher than that of normal cells.

According to scientist Lew Cantley, Ph.D., prostate cancer is no exception to this rule; however, results of their studies suggest that prostate cancer relies more on the amount of insulin present in the bloodstream.

It has been observed that individuals with prostate cancer, have elevated levels of Insulin-like Growth Factor and its receptors.

What is insulin-like growth factor 1? Insulin-like Growth Factor 1 or IGF-1 is a polypeptide hormone, that shares a structure similar to that of insulin. In conjunction with human Growth Hormone (GH), IGF-1 promotes anabolic (re: Anabolism – the building of tissues and organs) processes thus promoting tissue growth and development. Levels of IGF-1 and GH are much higher in children and adolescents, as they are still growing. As we begin to stop growing and continue to age, these levels drop and so do their subsequent signalling throughout our bodies; however, various conditions can cause IGF-1 and GH levels to increase.

Individuals diagnosed with the following: obesity (morbid or not), metabolic syndrome, and cancer, have detectably higher levels of IGF-1 and its receptors, present in their bodies.

As a prostate cancer patient, consult with your urologist/oncological team as how best to naturally reduce levels of IGF-1. Common suggestions include consistent low intensity exercise, caloric restriction or intermittent fasting.

Dietary Fat

There are four major groupings of dietary fat, and they are as follows: Saturated fats, transfats, monounsaturated fats and polyunsaturated fats.

Consistent evidence, proves time and time again that replacing saturated fat with unsaturated fat has significant health benefits.

Bad fats

  • Saturated fats
  • Transfats

Good/better fats

  • Polyunsaturated fats
  • Monounsaturated fats

Over the years, numerous studies have taken place to try and assess the impact of dietary fat intake on cancer patients/survivors, specifically more so prostate cancer patients/survivors. Earlier studies yielded mixed results, with no conclusive answers; however, this changed once Medical Professor, E. Giovannucci and his colleagues published their findings in 1993, from their prospective analysis of dietary fat on prostate cancer risk.

Using a semi-quantitive food frequency questionnaire to assess dietary fat intake of men, Giovannucci and his colleagues were able to determine that fat consumption as a whole was associated with advanced cancer risk. This paved the way for further research, since 1993 it has been established that animal fat and saturated fat poses the most threat to prostate cancer patients/survivors.

Interestingly enough, results from following studies and research were able to establish that dietary fat intake and circulating levels of IGF-1 in the body were positively associated. Ergo, as dietary fat intake increases so does the amount of IGF-1.

As of late, medical science is still trying to decipher the intricacies of all cancers. Research is still underway; for now, evidence points towards all stages of prostate cancer patient/survivor benefitting from a low intake of dietary fats. As a prostate cancer patient/survivor endeavour to limit saturated fats and trans fats in your diet.

Omega-3 Fatty Acid

Omega-3 fatty acids fall under the category of unsaturated fats. We obtain Omega-3 from sources such as fatty fish (Salmon for example), nuts and seeds, and plant oils.

Omega-3 is a beneficial dietary fat for heart health; additionally, it has been proven that consistent intake of Omega-3 fatty acids has been linked to a lower risk of aggressive/fatal prostate cancer and/or it’s recurrence. It is recommended that men consume omega-3 rich fish sources several times a week. Be sure to keep preparation methods in mind

Omega-3 supplementation is also an option for those who find fish to be unpalatable. Moderation is key, however; the recommended daily intake of Omega-3 is 250-500mg/day.

Dietary sources of Omega-3:

  • Salmon
  • Mackerel
  • Herring
  • Tuna
  • Sardines
  • Certain fortified foods
  • Flaxseed
  • Chia seeds
  • Walnuts
  • Soybean oil
  • Canola oil
  • Flaxseed oil

Phytochemical

Plants produce compounds called phytochemicals. (“phyto-” is derived from the greek word, “phytón”, which means “plant”)
Phytochemicals are found in; fruits, vegetables, grains, beans and other plants.

Certain phytochemical’s are believed to help protect our cells from cancer causing damage. The following information identifies which phytochemicals are believed to be beneficial and why.

Isoflavones

Isoflavones belong to a group of polyphenolic plant compounds that make up the Flavonoid family.

Isoflavones are considered to be phytoestrogens, the reason for this is due to the fact that it has both oestrogen-agonist and oestrogen-antagonist properties (For more information on this, follow this link).

The three main isoflavones are: daidzin, genistein and glycitein; of the three, genistein is the most prolific and plays the biggest role in prostate health. Genistein has an effect on various aspects of growth and proliferation mechanisms of prostate cancer cells, this includes epidermal growth factor (EGF) and IGF-1 metabolic pathways. In simple terms, genistein has been found to play a role in the inhibition of prostate cancer cell growth and metastasis.

The richest source of isoflavones are soybeans and it’s derivatives. Studies have linked the intake of non fermented soy products to a decreased risk of developing prostate cancer.

It is recommended that men include about two servings of soy based foods per day.

Dietary sources of isoflavones:

  • Soybeans (main source)
  • Mung beans
  • Black beans
  • Lentils
  • Lima beans
  • Peas

Sulforaphane & Indole-3 Carbinol

Sulforaphane and Indole-3 Carbinols are phytochemicals with known anti-carcinogenic properties.

Together, these nutrients induce the production of enzymes with antioxidant properties, which aids in protecting cells from oxidative stress and damage.

Apoptosis of damaged/cancerous cells is induced by sulforaphane; and animal studies have shown that indole-3 carbinol possess properties that help prevent the proliferation and metastasis of cancers.

Quercetin

Quercetin is another polyphenolic plant compound from the Flavonoid family.

Results regarding the efficacy of quercetin in prostate cancer and it’s risk are still unclear; however, quercetin compounds interest doctors due to their anti-inflammatory properties which have yielded some positive results for prostate cancer patients/survivors and those diagnosed with BPH.

Dietary sources of quercetin:

  • Citrus fruits
  • Apples
  • Onions
  • Parsley
  • Sage
  • Tea
  • Olive oil
  • Grapes
  • Dark cherries
  • Blueberries
  • Blackberries

Lycopenes

Lycopenes are considered to be a main dietary antioxidant. They are a part of the Carotenoid family. Carotenoids are a group of pigments found in plants.

Lycopene is responsible for the pigmentation of various red fruits and vegetables. As a powerful antioxidant, lycopene is attributed with the ability to protect our cells from damage.

Studies that focused on the impact of consistent dietary/supplemental lycopene intake in men diagnosed with prostate cancer, yielded favourable results. A decrease in risk and growth of prostate cancer cells, additionally they found that there was a reduction in PSA levels.

Lycopene has the ability to act on various pathways within the body, which contributes to its anti carcinogenic properties. Most notably are their ability to induce and initiate apoptosis. Be sure to include dietary/supplemental sources of lycopene in your diet.

Dietary sources of lycopene:

  • Tomato
  • Watermelon
  • Pink grapefruit
  • Pink guava
  • Papaya
  • Dried apricots
  • Pureed rosehip

Minerals & Vitamins

Minerals are naturally occurring elements found on Earth, and in food and water. Certain minerals aid our body’s development and help the body function.

Zinc

Zinc (Zn) is a naturally occurring mineral humans require for various functions within the body.

Due to the fact that humans do not produce or store zinc, it is considered to be an essential nutrient. Zinc is naturally found in a wide array of dietary sources which is why supplementation if often unnecessary. The recommended daily intake of zinc for adult men is only 11mg/day.

Zinc toxicity is often found in individuals who exceed recommended intake amounts. In order to avoid overconsumption, steer clear of high-dose supplements.

Studies have yet to yield definitive results regarding the role that zinc plays in prostate cancer patients/survivors. Evidence has suggested that zinc plays an important role in maintaining healthy prostate cell function.

Dietary sources of zinc:

  • Mushrooms
  • Spinach
  • Chicken
  • Oysters
  • Crab and lobster
  • Cocoa powder
  • Grass-fed beef
  • Kefir or yoghurt
  • Cashews
  • Oatmeal
  • Eggs
  • Tofu
  • Chickpeas
  • Pumpkin seeds

Selenium

Selenium (Se) is a mineral that the human body requires in very small amounts. Selenium plays roles in many bodily functions such as reproduction and the immune system.

Selenium is an essential trace element found in food sources, soil and water. Selenium has been attributed with many health benefits due to the role it plays in various bodily functions. One of the purported benefits of selenium is its cancer fighting properties; this is due to the antioxidant properties of selenium and the effect it has on the immune system, DNA repair, apoptosis, the endocrine system.

Various studies have sought to ascertain a definitive answer as to whether or not selenium reduces all risks regarding prostate cancer development, growth, proliferation and recurrence; unfortunately medical science has yet to yield conclusive answers as to whether or not selenium is beneficial for prostate cancer patients/survivors. For now, doctors advise that patients meet their selenium intake requirements but should not consider it to be a preventative/curative cancer therapy.

Calcium

Calcium is an element that is essential to humans and most living beings; of which our body’s require rather large quantities.

Our body’s require calcium for a host of different functions, the most notable being;

  • The development of strong healthy bones
  • Basic blood vessel, muscle and nerve functions
  • Sending signals from one cell to another
  • Releasing hormones

Adults between the ages of 19 and 64 generally require 700mg of calcium a day, many make the mistake of exceeding this amount thinking it’s beneficial to their health.

Although our bodies require large quantities of calcium, studies have shown that excess calcium intake can increase ones risk of proliferating and/or developing aggressive or even fatal prostate cancer. Studies linked high in-takes of calcium and dairy products to an increased risk of aggressive prostate cancer. Consistently exceeding ones daily intake requirement for calcium can result in the eventual formation of calcium oxalate kidney stones and in rare cases, calcium toxicity.

Unless your health care practitioner advises that you increase calcium intake by means of supplementation; it is advised that you meet your daily calcium intake requirements by eating a balanced, varied healthy diet.

Dietary sources of calcium:

  • Dairy products
  • Kale
  • Okra
  • Broccoli
  • Almonds
  • Beans & lentils
  • Whey protein
  • Fortified soya drinks
  • Fish containing bone (eg. Sardines)
  • Breads made with fortified flour
  • Fortified juices
  • Rhubarb
Age (years)Calcium (mg/day)
17-491000
50-701200
70+1200
Calcium requirements – Sources: Surgeon General’s Report on Bone Health and Osteoporosis and National Academy of Sciences.

Vitamin D

Vitamin D is a fat-soluble vitamin, produced naturally by the body as a response to sun exposure. Amongst many other biological effects, vitamin D is responsible for increasing intestinal absorption of calcium, magnesium and phosphate. In addition, it plays a role in the development of healthy bones and teeth.

Vitamin D is broken down in the human body to form a compound called calcitriol. Calcitriol is the active form of Vitamin D3 .

A study from 2009 showed a link between sun exposure and prostate cancer. The men with the least amount of sun exposure, almost invariably had more severe or aggressive prostate cancer when compared to men with higher amounts of sun exposure.

Another study from 2017 observed that men with the lowest levels of vitamin D had more aggressive prostate cancer as well as higher levels of inflammation than that of men with higher levels of vitamin D. Although supplementation won’t change the outcome of a cancer diagnosis; the anti-inflammatory properties of vitamin D suggest that it may prevent or slow down the growth of prostate cancer.

Sources of Vitamin D
  • Sun Exposure: it is recommended that 5-30 minutes of exposure during the brightest time of day is ideal. Over-exposure results in skin damage and can possibly lead to the development of skin cancer. Remember to always wear sun block.
  • Fortified dairy products
  • Fortified cereals
  • Lean meats
  • Nuts and seeds
Age (years)Vitamin D (mcg/day)
19-495
50-7010
70+15
Vitamin D requirements – Sources: Surgeon General’s Report on Bone Health and Osteoporosis and National Academy of Sciences.

Heart Health & Exercise

Heart health should be paramount for any individual concerned with living a healthy life. The number one cause of death in men is cardiovascular disease (CVD), which is responsible for more fatalities than any other cancer. Ones chances of surviving cancer, specifically prostate cancer, are significantly increased if patients make a conscientious effort to improve or maintain good heart health.

Factors to consider when keeping heart health a priority:

  • Monitor blood pressure
  • Monitor cholesterol
  • Low intensity/resistance weight lifting
  • Diverse intake of fruit and vegetables
  • Monitor or reduce sodium intake
  • Managing stress levels
  • Maintaining a healthy weight
  • Exercise and increased movement
  • Consume more fibre
  • Adopt healthy cooking methods
  • Monitor or reduce alcohol intake
  • Quit smoking!

Maintain a healthy weight

A healthy heart is not only determined by ones waist circumference, many other factors will come into play; however, we cannot escape the fact that being overweight (for reasons unrelated to a medical condition) is intrinsically linked to leading an unhealthy and/or sedentary lifestyle.

In the context of developing cancer, maintaining a healthy weight and lifestyle is your best preventative measure. The same can be said for those fighting cancer; this does not to imply that a healthy lifestyle and weight will cure a cancer diagnosis, however it does give your body the best fighting chance during and after treatment.

Overweight men are more prone to prostate cancer and other life threatening diseases. Subcutaneous (just below the skin) fat is less worrisome than visceral (internal) fat; subcutaneous fat is also easier to lose in comparison. Losing weight will incur many benefits, ranging from lower blood pressure to improved mood.