Does Lifestyle Affect Prostate Cancer Outcomes?

Race, Ethnicity, Lifestyle Mortality for Localized PC Patients

Does Lifestyle Affect Prostate Cancer Outcomes?

Healthy Lifestyle Choices Linked to Longer Survival in Nonmetastatic Prostate Cancer Patients

A recent study published in JAMA Network Open highlights the role of healthy lifestyle choices in improving overall survival among men with nonmetastatic prostate cancer. Conducted by researchers including Dr. Anqi Wang and colleagues, this study analyzed data from the Multiethnic Cohort Study to determine the impact of postdiagnostic lifestyle and dietary behaviors on survival rates.

Key Findings:
The study followed 2,603 men from diverse racial and ethnic backgrounds for a median of 10.9 years. It found that:

  • A higher 2021 Prostate Cancer Behavior Score was associated with a 31% lower risk of all-cause mortality and a 33% lower risk of cardiovascular disease (CVD)-related mortality.

  • Among African American participants, a healthier lifestyle was linked to a 54% lower risk of prostate cancer-specific mortality, a benefit not observed in other racial or ethnic groups.

  • Diets high in hyperinsulinemic foods (which cause spikes in insulin levels) were associated with increased mortality risk, while plant-based diets correlated with a lower overall death rate.

Why This Matters:
Although prostate cancer is often slow-growing, 85% of deaths in the study were due to causes other than prostate cancer, reinforcing the importance of managing overall health. Cardiovascular disease remains a leading cause of death among men with prostate cancer, making lifestyle interventions a crucial part of long-term care.

Practical Steps for Patients:
Based on these findings, men diagnosed with nonmetastatic prostate cancer may benefit from:

  • Adopting a plant-based or anti-inflammatory diet rich in whole grains, vegetables, and healthy fats.

  • Reducing foods that contribute to high insulin levels, such as processed sugars and refined carbohydrates.

  • Engaging in regular physical activity to improve cardiovascular health.

  • Managing comorbidities like high blood pressure, diabetes, and obesity, which can increase the risk of mortality.

Looking Ahead:
While this study provides valuable insights, the authors acknowledge limitations, such as the lack of data on cancer recurrence and progression. More research is needed to understand how lifestyle choices influence long-term prostate cancer outcomes.

For men in our support group, these findings serve as an encouraging reminder that everyday choices matter. By prioritizing a healthy lifestyle, you can improve not just your survival but also your quality of life. If you have questions about implementing these changes, consider discussing them with your healthcare team at our next meeting.


 


Can Healthy Lifestyle Choices Improve Survival in Nonmetastatic Prostate Cancer?

Edited by Katie Lennon
medscape.com

TOPLINE:

Healthier lifestyles were associated with improved overall survival but not prostate cancer–specific survival in a multiethnic cohort of patients with nonmetastatic prostate cancer.

METHODOLOGY:

  • Behavioral scores combining multiple risk factors have been developed to examine associations with prostate cancer outcomes, with studies in White populations suggesting benefits from healthy lifestyle patterns. Researchers identified a need to evaluate whether findings from predominantly White populations generalize to other racial and ethnic groups.
  • Researchers conducted a prospective cohort study among men aged 45-75 years enrolled between 1993 and 1996 in the multiethnic cohort study, with participants completing questionnaires after nonmetastatic prostate cancer diagnosis (2003-2008).
  • Analysis included 2603 men with nonmetastatic prostate cancer (mean age, 69.6 ± 7.1 years), comprising African American (19.1%), Japanese American (29.0%), Latino (22.2%), Native Hawaiian (5.0%), and White (24.8%) participants.
  • Investigators assessed lifestyle and dietary patterns after diagnosis using three prostate cancer behavior scores and 13 dietary indices, with four prioritized scores: The healthy eating index-2015, healthful plant-based diet index, dietary inflammatory index, and empirical dietary index for hyperinsulinemia.
  • Participants were followed for a median of 10.9 years (interquartile range [IQR], 6.8-12.7) from questionnaire return and 14.5 years (IQR, 11.8-18.0) from diagnosis, with researchers documenting 1346 deaths.

TAKEAWAY:

  • The 2021 prostate cancer (PCa) behavior score was associated with reduced risks for all-cause mortality (hazard ratio [HR], 0.69; 95% CI, 0.63-0.77) and cardiovascular disease (CVD)–related mortality (HR, 0.67; 95% CI, 0.56-0.79).
  • Among African American men, the PCa behavior score showed a lower risk for PCa-specific mortality (HR, 0.46; 95% CI, 0.24-0.88), but this association was not observed in other racial and ethnic groups.
  • The empirical dietary index for hyperinsulinemia was positively associated with all-cause mortality (HR, 1.37; 95% CI, 1.02-1.84) and CVD-related mortality (HR, 1.96; 95% CI, 1.15-3.33) when comparing highest vs lowest scores.
  • The healthful plant-based diet index showed an inverse association with all-cause mortality (HR, 0.75; 95% CI, 0.58-0.97) for highest vs lowest scores.

IN PRACTICE:

“Notably, 85% of the observed deaths during follow-up were due to causes other than prostate cancer, highlighting the importance of managing comorbidities,” the authors of the study wrote.

SOURCE:

This study was led by Christopher A. Haiman, ScD, Department of Population and Public Health Sciences, Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California in Los Angeles. It was published online in JAMA Network Open.

LIMITATIONS:

According to the authors, a significant limitation was the absence of information on prostate cancer progression or recurrence, which constrained their ability to assess the influence of postdiagnostic lifestyle and dietary patterns across the prostate cancer continuum. Additionally, the relatively small sample size of participants with prostate cancer reduced statistical power in analyses stratified by race and ethnicity.

DISCLOSURES:

Erin Van Blarigan, ScD, and Iona Cheng, PhD, disclosed receiving grants from the National Institutes of Health during the conduct of the study. June Chan, ScD, reported receiving nonfinancial support from Veracyte outside the submitted work, and disclosed that her husband is a full-time employee of Adela, Inc. Loic Le Marchand, MD, reported receiving grants to his institution from the National Cancer Institute during the conduct of the study. This study was supported by grants from the National Cancer Institute, the American Cancer Society, and the Helen Diller Family Chair in Population Science for Urologic Cancer at the University of California San Francisco.

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This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

 

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