Prostate cancer prevention. Diet, Exercise, Low Body Mass Index. 10
How to prevent prostate cancer? How to reduce risk of prostate cancer progress? Leading cancer expert explains prostate cancer prevention methods that were proven to work. Dr. Anton Titov, MD. How to prevent prostate cancer? What are lifestyle, nutrition, maybe chemoprevention strategies that have been shown to prevent prostate cancer? Dr. Mark Emberton, MD. How to prevent prostate cancer is a question that most patients ask their urologist at least once. And our answers are not very satisfactory to the patients. Because the patients want to do something to change their lifestyle. They want to change their dietary habits. They want take a supplement that they feel will arrest the progression of prostate cancer. Only one intervention has been shown to change the natural history of prostate cancer. And that’s dutasteride. In the REDUCE study, dutasteride reduced the period prevalence of prostate cancer by 24% over a period of time. Dutasteride is a soft hormone. So men randomized to dutasteride had 25% reduction in the presence of prostate cancer on repeat biopsy. That study was quite controversial. We don’t have time to go into the details. Dr. Mark Emberton, MD. The FDA chose not to recommend dutasteride as a chemoprevention method for prostate cancer. Despite a 25% reduction in prostate cancer. Had they done so, I think we would all be taking dutasteride. It would be in wide use. But it’s not. But that’s the only one that’s been shown truly to work in a tight, well-designed, randomized clinical study. There is other signal that seems to be quite strong. This is largely being derived in men with higher-risk prostate cancer. It is being of low weight, of low Body Mass Index seems to have a favorable effect on prostate cancer-specific survival and overall survival. Low body mass index can be achieved through exercise or through diet, or both. And many of the regimens are out there. It is a non-medical advice. They do involve diets that reduce Body Mass Index. It may be that the resting blood glucose may be important in affecting progression of cancer. Glucose obviously comes down through diet and exercise. Dr. Anton Titov, MD. These clinical trials are very hard to do. You need many many many thousands of men. There’s lots of contamination. And dietary clinical trials are a huge challenge. But there is a signal suggesting that low weight helps to reduce prostate cancer. It’s certainly been shown in animals, in many many animal models. I think there’s a strong signal that low BMI prevents cancer. People ask me, “What can I do to stop prostate cancer progress”? I tell them the thing they don’t want to hear. I tell them to lose weight and exercise. Dr. Anton Titov, MD. Sounds like a generic answer, but it comes up again and again in many diseases and in many cancers. Dr. Mark Emberton, MD. Correct! That’s something that has been shown to work. Dr. Mark Emberton, MD. Correct! Actually, if patients aren’t able to lose weight and exercise after cancer diagnosis, they never would. So it’s a good opportunity. We call it “a teachable moment”. That phase after diagnosis is where they’re going to be most motivated to change their lifestyle.
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