POSTED: June 13, 2017

Diet, Lifestyle + Prostate Cancer

mtzchan-218-3-optcroppedDr. June Chan is a Professor in the Departments of Epidemiology and Biostatistics and Urology at the University of California, San Francisco.

Her research focuses on how diet, exercise, and lifestyle factors contribute to prostate cancer aggressiveness, progression, and death.

Prostatepedia spoke with her about the impact of diet and lifestyle on prostate cancer.


What do we currently know about 
the relationship between diet, lifestyle, and prostate cancer?

Dr. Chan: We have observed that there are some relationships between diet and exercise and the risk of clinically relevant prostate cancer. As our studies evolved—and the field evolved alongside the development of PSA screening in the United States—it became important to define and focus on clinically relevant prostate cancer as an outcome.

Back in the early to mid-1990s
when some of our first studies
came out, we were just looking at specific dietary factors and the risk
of overall development of prostate cancer. With PSA screening came the understanding that there are indolent tumors and overdiagnosis; we needed to adjust to that in the field.

Part of my work as a postdoctoral fellow was to collect detailed data
in large cohort studies so we could classify men in a more clinically meaningful way. We collected details on stage, grade, and subsequent PSA values so that we could try to distinguish more indolent tumors from more aggressive tumors.

Once we started to do that, it became more interesting because we really started to refine our questioning.
The question isn’t just, “Is vegetable intake associated with overall risk?” The question becomes: “Is vegetable intake associated with the risk of having bad prostate cancer? A cancer that will do harm.” As studies have matured, we’ve focused on the risk of developing metastases and prostate cancer-specific mortality.

The field had to change as we started to understand the biology of prostate cancer better. Some of that early observational data that came from us looking at total prostate cancer risk needed to be looked at again. That is the stage we’re in now. We look at those questions differently now that we have more clinically relevant outcomes with more time.

What do we know about the impact diet and lifestyle have on the risk of developing prostate cancer? What do we know about the impact diet and lifestyle have on progression? About the risk of developing aggressive versus low-risk disease?

Dr. Chan: I’ll focus on what we know about clinically relevant cancer or, at least, some of the findings that have persisted over time.

The first thing, which is not discussed as much, is that smoking is potentially related to the risk of fatal prostate cancer. Some of the earliest data come from autopsy studies. They looked at people who had not necessarily been diagnosed with prostate cancer but had died for some other reason. They were able to correlate smoking history with
a worse-looking grade and worse- looking features of prostate cancer.

Dr. Stacy Kenfield published a paper looking at the risk of fatal prostate cancer and smoking history. Her work showed that smoking has a broad effect —not just on respiratory cancers. Smoking elevates your risk of other cancers as well.

Some of our work indicates that exercise may be important for deterring the risk of having recurrent or fatal prostate cancer. The story started with two reports that we put out in 2011. Dr. Kenfield led one team and Dr. Erin Van Blarigan led the other. (I was mentoring both researchers.) We had the opportunity to ask about exercise and prostate cancer survivorship in two distinct populations. The results were somewhat complementary.

In one study, it appeared that vigorous physical activity was associated with a benefit or reduction in the risk
of metastatic fatal prostate cancer among men diagnosed with localized disease.

The other study had a shorter follow-up, so we weren’t able to look at metastasis and death, but we did look at a combined outcome of recurrence, metastasis, and death —or the initiation of secondary treatment after primary therapy
in prostate cancer survivors.

While there was a trend toward
a benefit for physical activity, what was particularly interesting was that we saw a benefit from brisk walking versus slower walking pace. It suggested that there was something specific about aerobic exercise, or cardiopulmonary exercise, that offered a benefit. We’ve been pursuing that in other studies.

What do you mean by benefit?

Dr. Chan: In one study, there was a reduced risk of prostate cancer recurrence. In the other study, there was a reduced risk of prostate cancer death.

Join Prostatepedia to read Dr. Chan’s interview.

4 Comment

Andrew Black

I read the PCF “Health and Wellness – Living with Prostate Cancer” with interest. I thought it was generally very good.
I have T3b Prostate Cancer diagnosed 7 years ago. I have been on a double blockade of hormone therapy ever since. I am now undergoing radiotherapy. I have been following all the dietary advice given by Dr Chan and her colleagues. I also play 18 holes of golf every week (walking approx. 20 miles a week) and in the summer I wear short sleeve shirts and shorts and so get plenty of sunshine to aid my vitamin D.
There is one item, however, which I feel needs some expansion and that is “Diary/Calcium”.
My GP sent me for a DEXA scan some 6 years ago and I now have one every other year. They show that I have osteopenia which I understand is as a result of my hormone therapy. To counter this I have been prescribed Calcium Carbonate/Colecalciferol tablets twice a day each of which is equivalent to 600mg of calcium. So I am way over the 1000 mg of calcium a day.

Posted: Jun 20, 2017

John Amante

“Join Prostatepedia to read Dr. Chan’s interview.”

I already am a member…how do I access?

Posted: Jun 18, 2017

james r kiseda

Why cant I see the whole article by Dr Chan on diet? It only gives me a short summary and tell me to join Prostapedia to see whole article.

I already have joined ou reWhy don’t you know this?

Posted: Jun 18, 2017

Girish Bhatnagar

What to do with fluctuating PSA , negative biopsy and 86 gm. Prostat while taking urimax ?

Posted: Jun 14, 2017

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