New Study Suggests Mediterranean Diet for Men on Active Surveillance

IADT3since2000

Here's some good news about a personal tactic we can use that will probably increase our odds of success against prostate cancer: going on a Mediterranean diet. (Other good diets, such as the vegan and Asian diets, would probably also register good results.)

A new study from MD Anderson, one of the top institutions in the US for prostate cancer, has results indicating better outcomes for men who adhere more closely to a Mediterranean diet, judged by substantially lower odds of progression in their Gleason Grade group scores, and it looks like the greater the proportion of Mediterranean diet food, the lower the odds of progression. That's the bottom line. Here's a link to the abstract of the paper: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.33182 Here is a very helpful commentary on the paper by a well qualified observer who has seen a complete copy of the paper and talked to one of the authors: https://prostatecancerinfolink.net/2021/01/09/mediterranean-diet-active-surveillance-and-low-risk-prostate-cancer-the-details/

While this research involved only men who were in a group being managed on active surveillance, it is reasonable to me from this study that some benefit would likely extend to other prostate cancer patients who were at higher risk than men in this active surveillance group. Recently retired medical oncologist Charles Myers, MD, who ran a large practice dedicated solely to prostate cancer and had a superlative research and pharmacology background, strongly advocated the Mediterranean diet for prostate cancer patients, also acknowledging other good diets, but condemning the typical US diet. I have seen numerous studies suggesting a benefit from being on the Mediterranean diet for prostate cancer patients; none are conclusive, as such studies are hard to do and often involve substantial uncertainty, such as how closely diet questionnaires reflect actual diets; that said, the evidence consistently points toward a substantial benefit. I don't recall ever seeing a study that found fault with the Mediterranean diet for prostate cancer patients.

Also, there is even stronger evidence favoring the Mediterranean diet for heart health, which should be an even greater concern for prostate cancer patients under good management or treatment than concern about prostate cancer; that's because heart issues are a greater risk to our overall health and survival despite being cancer patients. This means we get a double benefit from being on this diet: help against our prostate cancer and help for our cardiovascular health.

There probably are other diets that are also excellent, such as vegan diets (though compliance is difficult for many of us) and the Asian diet; in contrast, evidence suggests that the typical Western diet, widely used in the US, is harmful for prostate cancer patients and also riskier for heart and circulatory system issues (cardiovascular). The study above was done in patients going to a major center in Texas, MD Anderson; due to its location, I suspect that a heavy proportion of patients in the study were from Texas or the south, southwestern portions of the US, and that region is known for beef consumption and a typical Western diet. That said, with statistics, adequate analysis should have been possible to sort those on a Mediterranean diet from those on other diets, most likely predominantly Western diets. This is reasonable speculation on my part, but it is still speculation. Once the complete paper is widely available we should know more.

I did have a friend who had recurrent prostate cancer, whose house decor included a southwest cattle theme, and who refused to alter his typical US diet despite his recurrence. He enjoyed his beef. Unlike the vast majority of prostate cancer patients, he survived only months after his recurrence flared up. It was as if he had no secondary lines of defense against the disease but was just slipping down a greased slide. I suspect his diet played a role in his untimely, regretted death.

I was on a fairly good diet at the time I was diagnosed in late 1999, but that diet included some red meat and daily dairy products. Shortly after diagnosis, I essentially switched to a Mediterranean diet, with no red meat (beef, pork, lamb) and virtually no dairy products for years. It's a diet that I like very much, though I do slightly miss some of the typical elements popular in the US, like a nice juicy cheeseburger. Now that it appears that I have been cured, I am including modest amounts of cheese back in my diet. While I have no proof at all, I suspect that being on a Mediterranean diet has played a substantial role in my success against prostate cancer.

….Jim

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21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.