By Dr. Ronald Hoffman
In previous articles, I have detailed 20 supplements that can help men prevent-and even slow the progression of-prostate cancer.
While it is pretty much acknowledged that lifestyle plays an important role in the causation of most cancers, controversy persists about the roles that diet, exercise, and stress reduction might play for cancer survivors desirous of reducing their risk of cancer recurrence.
Prostate cancer offers a perfect proving ground for the notion that lifestyle matters, even after diagnosis. In 2004 Dr. Dean Ornish was the first to demonstrate in a scientific study that a plant-based diet, coupled with exercise, stress reduction and social support could slow the progression of prostate cancer. Serum taken from experimental subjects had eight times the inhibitory effect on prostate cancer cells than did serum taken from a matched control group not engaged in intensive lifestyle intervention.
My experience confirms this. In the early days of my practice, in the 1980s, I was vegetarian. A 70 year old man with advanced, metastatic prostate consulted with me, and I urged him to adopt a strict vegan macrobiotic diet consisting of vegetables, whole grains, seaweed, and soy products. He did as I said, and returned a year later.
With a mischievous smile, he presented me with his latest x-rays. As I put them up on my light box, I thought I had made a mistake in the chronology of the X-rays. The first set showed multiple "chewed out" areas in his pelvis and rib cage which undoubtedly represented deadly bone metastases. The second set showed a remarkable resolution of the bone abnormalities.
"Are you sure these dates are right?" I asked. He replied that, yes, he had just been to his oncologist who was totally flummoxed by the improvement in the X-rays; the cancer specialist had thought that, by now, the metastases would have progressed. Instead, they had nearly disappeared.
Since then, many of my patients, even those with prostate cancer not previously effectively treated with radiation or surgery, have enjoyed prolonged survivals by adhering to careful diet and lifestyle changes, along with protective supplements.
The success of natural interventions was recently confirmed by the "ProtecT" Trial in which 1800 men with diagnosed prostate cancer following eight specific diet and lifestyle recommendations were compared to 12,000 controls. High intake of plant foods and tomato products in particular conferred protection.
In addition, recent studies looking at Active Surveillance, in which early prostate cancer is managed without aggressive treatment, show that this strategy is safe for most men.
Active Holistic Surveillance, a concept pioneered by my good colleague Dr. Aaron Katz, now Chairman of Urology at Winthrop University Hospital, offers a pathway for certain men with early prostate cancer to prudently harness the benefits of lifestyle modification while under careful medical supervision.
What to eat? In my opinion, it's not necessary to adhere to a strict vegan diet, but an abundance of plant foods is essential. Proanthocyanidins from grapes and pomegranates; sulforaphane and diindolylmethane (DIM) from cabbage-family vegetables; lycopene from tomatoes; carotenoids from green leafy vegetables; lignans from flax and beans; flavonols and allyl sulfides from allium family vegetables; phytosterols from nuts; pectin from fruit; polyphenols from spices, teas, wine, chocolate and coffee; omega 3 fatty acids from fish; and isoflavones from soy have all been shown to be effective against prostate cancer.
The trouble with animal protein may not lie with its protein or fat content, but with the quality of the meat. Modern meat, unlike grass fed organic, is richer in pro-inflammatory Omega 6 fatty acids and laced with toxic residues of hormones, antibiotics, pesticides and herbicides.
While some have raised the issue that excess protein might stoke production of insulin-like growth factor (IGF1), a promoter of many cancers including prostate, I side with those who have highlighted the role of excess refined carbohydrates in raising IGF1. Overall, it's best to eat sparingly of all the macronutrient categories to minimize excess body fat, which is a clear risk factor for cancer recurrence. Avoid calorie-dense foods, and emphasize nutrient- and fiber-rich foods. Eat as if every meal counts!
When it comes to exercise, you can truly walk/run for the cure. Studies show that 30 minutes daily of moderate to intense exercise can reduce men's risk of prostate cancer recurrence by as much as 30%.
Additionally, convincing studies have emerged that link chronic, unrelenting stress to immune-suppression which cripples our bodies? natural cancer surveillance. Meditation, yoga, psychotherapy, and social support have prominent roles in promoting cancer survival.
Avoiding toxic environmental exposures is a promising avenue for reducing risk. Plastics, synthetic fragrances, bug sprays, garden and lawn care products, tainted water sources, cigarette smoke, smog, cosmetics, sunscreens, and foods laced with synthetic chemicals can act as hormone disruptors and xenoestrogens (estrogen mimics). Take inventory of the products you use, and substitute natural alternatives.
Finally, sex is a "lifestyle" factor. Some early studies suggested that having multiple sexual partners increased the risk of prostate cancer-possibly by fostering low-grade, persistent sexually-transmitted infections that subjected the prostate to chronic inflammation. But subsequent studies have pretty conclusively demonstrated that more frequent sex confers protection against prostate cancer. A solution that some men might find more enjoyable than tofu and pushups!
Check out my 2-part podcast on Natural Therapies for Prostate Cancer.
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