Prostate Cancer Wellness Protocol
Other than skin cancer, prostate cancer is the most commonly diagnosed cancer in the United States, with nearly 250,000 men expected to be diagnosed with it in 2012.
Prostate cancer incidence is highly influenced by lifestyle and environmental factors, with a nearly 60-fold higher incidence in the U.S. than among Japanese and Chinese men living in their native countries.
In the U.S., it affects 16% of men and 3% will die from it, representing the 2nd leading cause of cancer death.
Despite this frequent occurrence, most men that have prostate cancer are roughly six times more likely to die from another cause than from prostate cancer itself. In other words, they will die with prostate cancer rather than from prostate cancer. This apparent “overdiagnosis” of prostate cancer has challenged previous recommendations for widespread screening, and also lends itself to the use of lifestyle and nutritional interventions, either used alone or combined with more aggressive treatments when warranted.
Emphasize plant-based whole foods, especially cruciferous vegetables (such as broccoli, cauliflower, cabbage, etc.), and omega-3 fatty acids.
A number of risk factors have been identified for prostate cancer, the most important of which are:
- having a positive family history
- being over age 60
- being African-American
A number of environmental, dietary and lifestyle factors have been found to influence prostate cancer risk:
- Higher intake of refined calories, fat, and animal-based foods have been associated with a significant increase in risk for prostate cancer, while a plant-based diet rich in cruciferous vegetables, soy, micronutrients, and omega-3 fatty acids is associated with a reduced risk.
- Obesity influences multiple hormonal pathways and inflammatory chemicals thought to be involved in prostate cancer progression and development.
- Higher exposure to cadmium has been associated with an increase in risk, while a higher intake of zinc and selenium may have a protective role.
PSA (prostate-specific antigen) - Several large studies have found minimal to no benefit for PSA (prostate-specific antigen) screening, with a significant impact on quality of life as a result of screening and subsequent treatment. However, using PSA to monitor therapy effectiveness and progression, however, is widely accepted.
Biopsy - A biopsy is required for diagnosis, and the Gleason score may help to guide appropriate treatments.
Vitamin D levels - Vitamin D levels have been shown to be predictive of prostate cancer lethality, with higher levels associated with a 57% risk reduction.
STAY ACTIVE Be physically active, every day. Even light intensity exercise has benefit.
Plant-based whole foods rich in omega-3 fatty acids should be the mainstay of the diet. Avoiding refined carbohydrates, including sugar-sweetened beverages, and animal-based foods affects not only the risk of prostate cancer but its progression. Whole milk, for example, has been associated not only with a heightened risk for prostate cancer, but with a more than 2-fold increase in prostate cancer mortality.
- Foods high in beta-carotene, which can then convert to retinol, such as pumpkin, tomato, melon, kale, broccoli, mango, grapefruit, papaya, guava, carrots, spinach, peppers and squash.
- Cruciferous vegetables, such as broccoli, cauliflower, cabbage, etc.
- Whole foods (foods that are as close to their natural form as possible)
- Low sugar/low glycemic diet (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
- Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
- High fiber, from whole grains, beans, vegetables and fruits
- Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
- For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.
- Processed and grilled meats. Also, try to limit intake of red meat
- Fast foods, fried foods, baked goods and packaged, processed foods
- Sugar, sweeteners and artificial sweeteners
- Vegetable oils, shortening, margarine and anything with hydrogenated or partially hydrogenated oils
Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. This list contains those with the greatest evidence-based benefit.
The pharmacologically active component of the spice turmeric, curcumin inhibits tumor growth by multiple mechanisms.
1-2g per day of Meriva® or Longvida® curcumin.,
A number of extracts from cruciferous vegetables (such as broccoli, cauliflower, cabbage, etc.), particularly diindolylmethane (DIM), may explain the benefit of these vegetables on cancer progression, as it has been shown to inhibit multiple mechanisms of cancer growth.,
250mg per day.
In a large cohort of over 35,000 men, use of grape seed extract supplements was associated with a 41% reduced risk of prostate cancer. It is thought to influence hormonal and inflammatory pathways.
100-200mg per day.
Vitamin D levels are associated with risk of dying from prostate cancer. In a trial of men given 4000 IU per day for 1 year, vitamin D levels increased from 33ng/mL to 66ng/mL, over half had a decrease in the number of positive cores or Gleason score on biopsy.
Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.
This tomato-based antioxidant has been shown to inhibit cell proliferation via several pathways.,, Pasta sauce containing 30mg per day increased cancer cell death in patients prior to prostatectomy.
30 mg per day.
Green Tea Extract
Catechins, antioxidants found in green tea, particularly ECEG (epigallocatechin-3-gallate), have been shown to increase prostate cancer cell death by at least two mechanisms.
1g EGCG and mixed catechins per day.,
Found in red wine and grapes, this antioxidant has inhibited prostate cancer cell growth and metastasis. It also appears to improve the effectiveness of radiotherapy.
100-200mg per day.
Omega-3 Fatty Acids
Omega-3 fatty acids have been shown to reduce the risk of prostate cancer, and higher intakes have been associated with greater survival. Several grams of DHA/EPA have been used in clinical trials. Additionally, GLA, another omega-3 found in Evening Primrose oil, helps to maintain balance in the fatty acids and enhances the anti-inflammatory effect.,
200-400mg, three times per day.
Silymarin and silibinin from milk thistle have anti-proliferative and anti-metastatic properties.
At least 500mg silymarin per day.,
This antioxidant found primarily in onions has been shown to inhibit invasion and metastasis of prostate cancer cells.
200-400mg, three times per day.
A hormone, supplemental melatonin intake has improved survival in a number of cancers, and may enhance conventional therapy effectiveness.
At least 3mg at night, preferably time-released.
Various components of vitamin E have shown anti-cancer properties. Although alpha-tocopherol is often used in clinical trials, when given alone it may deplete other important components of vitamin E.,
200-400 IU per day of mixed tocopherols and tocotrienols.
Vitamin K-2 (MK-7) has the longest half-life, meaning it is the most stable, of all forms of vitamin K. Shown to improve bone and cardiovascular health, higher intakes of this form have also been associated with reduced cancer incidence & fatality, and may improve effectiveness of other therapies.,,
100 mcg vitamin K-2 (MK-7).
 Brawley OW. Trends in prostate cancer in the United States. J Natl Cancer Inst Monogr. 2012 Dec;2012(45):152-6.
 Wilson KM, Giovannucci EL, Mucci LA. Lifestyle and dietary factors in the prevention of lethal prostate cancer. Asian J Androl. 2012 May;14(3):365-74.
 Sandhu GS, Andriole GL. Overdiagnosis of prostate cancer. J Natl Cancer Inst Monogr. 2012 Dec;2012(45):146-51.
 Bosire C, Stampfer MJ, Subar AF, et al. Index-based Dietary Patterns and the Risk of Prostate Cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol. 2013 Mar 15;177(6):504-13.
 Ma J, Li H, Giovannucci E, et al. Prediagnostic body-mass index, plasma C-peptide concentration, and prostate cancer-specific mortality in men with prostate cancer: a long-term survival analysis. Lancet Oncol. 2008 Nov;9(11):1039-47.
 Hurst R, Hooper L, Norat T, et al. Selenium and prostate cancer: systematic review and meta-analysis. Am J Clin Nutr. 2012 Jul;96(1):111-22.
 Julin B, Wolk A, Johansson JE, et al. Dietary cadmium exposure and prostate cancer incidence: a population-based prospective cohort study. Br J Cancer. 2012 Aug 21;107(5):895-900.
 Lin YS, Caffrey JL, Lin JW, et al. Increased risk of cancer mortality associated with cadmium exposures in older Americans with low zinc intake. J Toxicol Environ Health A. 2013;76(1):1-15.
 Joshi AD, Corral R, Catsburg C, et al. Red meat and poultry, cooking practices, genetic susceptibility and risk of prostate cancer: results from a multiethnic case-control study. Carcinogenesis. 2012 Nov;33(11):2108-18.
 Catsburg C, Joshi AD, Corral R, et al. Polymorphisms in carcinogen metabolism enzymes, fish intake, and risk of prostate cancer. Carcinogenesis. 2012 Jul;33(7):1352-9
 Kilpeläinen TP, Tammela TL, Malila N, et al. Prostate Cancer Mortality in the Finnish Randomized Screening Trial. J Natl Cancer Inst. 2013 Mar 11. [Epub ahead of print]
 Ilic D, Neuberger MM, Djulbegovic M, et al. Screening for prostate cancer. Cochrane Database Syst Rev. 2013 Jan 31;1:CD004720.
 Freedland SJ. Screening, risk assessment, and the approach to therapy in patients with prostate cancer. Cancer. 2011 Mar 15;117(6):1123-35.
 Shui IM, Mucci LA, Kraft P, et al. Vitamin D-related genetic variation, plasma vitamin D, and risk of lethal prostate cancer: a prospective nested case-control study. J Natl Cancer Inst. 2012 May 2;104(9):690-9.
 Fang F, Kasperzyk JL, Shui I et al. Prediagnostic plasma vitamin D metabolites and mortality among patients with prostate cancer. PLoS One. 2011 Apr 6;6(4):e18625.
 C B, M M, R D, et al. Cross-Sectional & Longitudinal Associations between Light-Intensity Physical Activity & Physical Function Among Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013 Mar;22(3):475-6.
 Drake I, Sonestedt E, Gullberg B et al. Dietary intakes of carbohydrates in relation to prostate cancer risk: a prospective study in the Malmö Diet and Cancer cohort. Am J Clin Nutr. 2012 Dec;96(6):1409-18.
 Freedland SJ, Aronson WJ. Dietary intervention strategies to modulate prostate cancer risk and prognosis. Curr Opin Urol. 2009 May;19(3):263-7.
 Song Y, Chavarro JE, Cao Y, et al. Whole milk intake is associated with prostate cancer-specific mortality among U.S. male physicians. J Nutr. 2013 Feb;143(2):189-96.
 Marshall DT, Savage SJ, Garrett-Mayer E, et al. Vitamin D3 supplementation at 4000 international units per day for one year results in a decrease of positive cores at repeat biopsy in subjects with low-risk prostate cancer under active surveillance. J Clin Endocrinol Metab. 2012 Jul;97(7):2315-24.
 Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.
 Yang CM, Lu YL, Chen HY, et al. Lycopene and the LXRα agonist T0901317 synergistically inhibit the proliferation of androgen-independent prostate cancer cells via the PPARγ-LXRα-ABCA1 pathway. J Nutr Biochem. 2012 Sep;23(9):1155-62.
 Teodoro AJ, Oliveira FL, Martins NB, et al. Effect of lycopene on cell viability and cell cycle progression in human cancer cell lines. Cancer Cell Int. 2012 Aug 6;12(1):36.
 Giovannucci E. Commentary: Serum lycopene and prostate cancer progression: a re-consideration of findings from the prostate cancer prevention trial. Cancer Causes Control. 2011 Jul;22(7):1055-9.
 Kim HS, Bowen P, Chen L, et al. 2003 Effects of tomato sauce consumption on apoptotic cell death in prostate benign hyperplasia and carcinoma. Nutrition and Cancer 47 40– 47.
 Gupta K, Thakur VS, Bhaskaran N, et al. Green tea polyphenols induce p53-dependent and p53-independent apoptosis in prostate cancer cells through two distinct mechanisms. PLoS One. 2012;7(12):e52572.
 McLarty J, Bigelow RL, Smith M, et al. Tea polyphenols decrease serum levels of prostate-specific antigen, hepatocyte growth factor, and vascular endothelial growth factor in prostate cancer patients and inhibit production of hepatocyte growth factor and vascular endothelial growth factor in vitro. Cancer Prev Res (Phila). 2009 Jul;2(7):673-82.
 Bettuzzi S, Brausi M, Rizzi F, et al. Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study. Cancer Res. 2006 Jan 15;66(2):1234-40.
 Killian PH, Kronski E, Michalik KM, et al. Curcumin inhibits prostate cancer metastasis in vivo by targeting the inflammatory cytokines CXCL1 and -2. Carcinogenesis. 2012 Dec;33(12):2507-19.
 Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7.
 DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.
 Sheth S, Jajoo S, Kaur T, et al. Resveratrol reduces prostate cancer growth and metastasis by inhibiting the Akt/MicroRNA-21 pathway. PLoS One. 2012;7(12):e51655.
 Fang Y, DeMarco VG, Nicholl MB. Resveratrol enhances radiation sensitivity in prostate cancer by inhibiting cell proliferation and promoting cell senescence and apoptosis. Cancer Sci. 2012 Jun;103(6):1090-8.
 Epstein MM, Kasperzyk JL, Mucci LA, et al. Dietary fatty acid intake and prostate cancer survival in Örebro County, Sweden. Am J Epidemiol. 2012 Aug 1;176(3):240-52.
 Aronson WJ, Kobayashi N, Barnard RJ et al. Phase II prospective randomized trial of a low-fat diet with fish oil supplementation in men undergoing radical prostatectomy. Cancer Prev Res (Phila). 2011 Dec;4(12):2062-71.
 Xu Y, Qian SY1. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014 May-Jun;37(3):112-9.
 Biomed J. 2014 May-Jun;37(3):112-9. Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Int J Cancer. 2000 Mar 1;85(5):643-8.
 Vidlar A, Vostalova J, Ulrichova J, et al. The safety and efficacy of a silymarin and selenium combination in men after radical prostatectomy – a six month placebo-controlled double-blind clinical trial. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010 Sep;154(3):239-44.
 Flaig TW, Glodé M, Gustafson D, et al. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients with localized prostate cancer. Prostate. 2010 Jun 1;70(8):848-55.
 Beaver LM, Yu TW, et al. 3,3′-Diindolylmethane, but not indole-3-carbinol, inhibits histone deacetylase activity in prostate cancer cells. Toxicol Appl Pharmacol. 2012 Sep 15;263(3):345-51.
 Wang TT, Schoene NW, Milner JA et al. Broccoli-derived phytochemicals indole-3-carbinol and 3,3′-diindolylmethane exerts concentration-dependent pleiotropic effects on prostate cancer cells: comparison with other cancer preventive phytochemicals. Mol Carcinog. 2012 Mar;51(3):244-56.
 Senthilkumar K, Arunkumar R et al. Quercetin inhibits invasion, migration and signalling molecules involved in cell survival and proliferation of prostate cancer cell line (PC-3). Cell Biochem Funct. 2011 Mar;29(2):87-95.
 Brasky TM, Kristal AR, Navarro SL, et al. Specialty supplements and prostate cancer risk in the VITamins and Lifestyle (VITAL) cohort. Nutr Cancer. 2011;63(4):573-82.
 Park SY, Lee YH, Choi KC et al. Grape seed extract regulates androgen receptor-mediated transcription in prostate cancer cells through potent anti-histone acetyltransferase activity. J Med Food. 2011 Jan-Feb;14(1-2):9-16.
 Cutando A, López-Valverde A, et al. Role of melatonin in cancer treatment. Anticancer Res. 2012 Jul;32(7):2747-53.
 Ju J, Picinich SC, Yang Z, et al. Cancer-preventive activities of tocopherols and tocotrienols. Carcinogenesis. 2010 Apr;31(4):533-42.
 Yang CS, Suh N, Kong AN. Does vitamin E prevent or promote cancer? Cancer Prev Res (Phila). 2012 May;5(5):701-5.
 Nimptsch K, Rohrmann S, Kaaks R, et al. Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2010 May;91(5):1348-58.
 Nimptsch K, Rohrmann S, Linseisen J. Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2008 Apr;87(4):985-92.
 Zhang H, Ozaki I, Hamajima H, et al. Vitamin K2 augments 5-fluorouracil-induced growth inhibition of human hepatocellular carcinoma cells by inhibiting NF-κB activation. Oncol Rep. 2011 Jan;25(1):159-66.