Exercise, Diet and Lifestyle

Your waist-to-hip ratio is also a good indicator of health; research has shown that people with ‘apple-shaped’ bodies (with more weight around the waist) tend to face more health risks than those with ‘pear-shaped’ bodies (more weight around the hips). For a man, a waist-to-hip ratio of 0.9 or less is good. Men with a ratio greater than 0.9 will face a higher risk of heart disease and stroke.

Can Lifestyle Influence Prostate Cancer Progression?

There is now emerging evidence to suggest ‘yes’, but probably not for everyone. Each patient and their stage, grade and biological pattern of their disease is unique. What works for one person may not work for another. The good thing is though, even if a healthy living programme does not help your cancer it will certainly help with many of the side effects of cancer treatments, help your body in other ways and empower you with a sense of self determination. Many biochemical pathways are triggered during and after exercise, most of them having direct or indirect anti-cancer effects.

Major journals are publishing trials which highlight the benefits of lifestyle after cancer. The most important of these trials have been collected in a formal evidence review, commissioned by Macmillan Cancer Support led by Professor Robert Thomas, consultant Oncologist at Bedford and Addenbrooke’s Cambridge University Hospitals. He has also summarised the lessons learnt from these trials into evidence-based recommendations. See his latest book ‘Keep Healthy after Cancer’ 2020 edition available via www.cancernet.co.uk.

Physical activity and Exercise

Many trials evaluating exercise programmes have concluded that moderate activity can reduce fatigue and improve mood, psychological well-being and body composition. Other trials have linked exercise, especially if combined with other lifestyle manoeuvres, with a reduced rate of PSA progression in men on active surveillance, and a reduced risk of relapse after radical treatments.

Physical activity and exercise improve the flow of blood supply, even gardening (the green gym) or cleaning the house can be beneficial. A minimum of 30 minutes of exercise a day, 5 times a week is recommended, a combination of moderate and vigorous exercise. If you can do it, 3 to 5 hours a week of mostly vigorous exercise can be more beneficial.

There is growing evidence of the beneficial effects of exercise. In a USA study of 2705 men over a 10-year period, the number of deaths were 36% lower in men who walked on average one hour per day; recurrence of cancer was 49% lower in men taking 3 or more hours of vigorous activity per week; and 61% fewer died from cardiac events.

You might find it more fun to exercise with other people. Ask a friend to come with you or join a sports team or running group. If you often drive or take the bus for short journeys, try taking a brisk walk instead. Try to spend less time sitting down. You could move about while you watch TV or choose more active video games. And don’t forget to stand up regularly if you sit down to work.

You may think you are fit, but could you run for a bus or climb several flights of stairs? As we get older our muscles become weaker, but partly because we do less.

To keep fit you need to do more. Just walking may not be enough. As well as aerobic exercise one needs strengthening and toning exercises and activities to maintain joint mobility, flexibility, balance and coordination. At least 2 days a week should include resistance training to help strengthen your muscles.

Find a sport or activity you enjoy or do lots of different ones so you don’t get bored. Do not try too much at first, build up gradually.

Going to the gym is commendable, with a personal trainer if affordable, but here are some other ideas: brisk walking, running e.g. find a ‘park run’ near you at www.parkrun.org.uk, walking football, golf, Nordic walking, dancing, swimming, using fitness bands at home, or attending organised exercise classes such as Pilates or Tai Chi.

You may also be able to ask your doctor for a referral to the local municipal gym on the National Exercise Referral Scheme for a 12-week supervised programme. If you are unfit, build up gradually; a fitter body will help you live longer and better.

     Physical activity and impact on Prostate Cancer

    • For adults, at least 150 minutes (2.5 hours)
      of moderate intensity
      activity (in bouts of
      10 minutes or more) a week… or 75 minutes
      of vigorous intensity activity spread across
      the week
    • or combinations of moderate and vigorous
      intensity activity
    • Adults should also undertake physical activity
      to improve muscle strength on at least 2 days
      a week.

 

  Aerobic exercise      Strengthening and 
                                   toning exercises

Exercise Program

  Joint mobility                Balance and
  and flexibility                coordination

Obesity

Being overweight increases the risk of developing prostate cancer in the first place. There is also evidence that obese men present with more aggressive types (higher Gleason grades), increasing the complexity of treatments. This means they have to take Hormone therapies for longer, increasing the risk of hot flushes and further weight gain. Obese men also have a higher risk of PSA relapse after radical treatments.

Diet

There is an increasing emphasis on reducing calorie (energy) excess. Not only does this lead to obesity, but it produces changes in the blood stream, such as a rise in insulin-like growth factor (IGF), which cancers love. As well as total calorie intake, the type of food is important. Foods which are rapidly absorbed, such as processed sugar, and refined wheat in bread and pasta are the worst culprits. Colourful fruits, berries and tomatoes have a lower risk of prostate cancer; flavanoid-rich foods such as beans, pulses, legumes show a lower risk of aggressive types of prostate cancer. Foods grilled at high temperature are known to be carcinogenic and should be avoided.

A Mediterranean diet has enormous health benefits and improves the immune system. It can reduce the risk of cardio-vascular disease. It is plant-based, rich in fruits and vegetables, nuts and oily fish. It provides for moderate intake of poultry and only low intakes of red or processed meat, low intake of dairy foods and the avoidance of fizzy drinks.

Gut health is also very important. Live yoghurt can help to maintain the correct levels of healthy bacteria within the gut.

Pomi-T trial

A substantial percentage of prostate cancer survivors and those on Active Surveillance are attracted to the potential benefits of a food supplement, ‘Pomi-T’, which is made from polyphenol-rich whole foods, namely pomegranate seed, green tea, broccoli and turmeric. This combination of food extracts has been shown, in a controlled trial, to help fight prostate cancer and slow PSA rise.

 

Minerals, vitamins and other chemical extracted foods

Vitamin E and selenium, once thought to be helpful have now been shown to have an increased prostate cancer incidence. High doses of zinc were also associated with an increased risk of prostate cancer in the study. The NCRI (National Cancer Research Institute) has stated that long-term vitamin and mineral consumption should be discouraged. Saw palmetto and genistein have not shown any benefit for either prostate cancer or BPH. Likewise, the two most recent trials of lycopene extracts among men on active surveillance or watchful waiting found no difference in PSA progression, nor were there any links with the reduction in the risks of breast cancer with regular intake.

There is still a lot of research needed in this area, especially as there may be benefits for selected vitamin and mineral supplements in cases of known deficiencies.

Most of us, for example, are deficient in Vitamin D3. Sunshine is the best source (up to half an hour per day is sufficient), so a moderate supplement in the winter months may be logical. Vitamin D can also be obtained from oily fish, whole grains, nuts, seeds and eggs.

Dairy versus non-dairy

Although there is no clear evidence that dairy products are harmful, it is now looking increasingly likely that there is a case for at least considering either complete avoidance, or reduced intake, of these. The Chinese do not consume any dairy products, but if they start to adopt a western diet, the incidence of western diseases increases. It is believed that IGFs (Insulin-like Growth Factors) in dairy products are a possible cause. Significant evidence, however, is still lacking. Nevertheless, many prostate patients keep off dairy (including cheese, yoghurts etc.), switching to alternatives based on soya, oats, rice and almond. If not, consider changing to organic dairy products.

We each have natural internal resources that, when supported in
the right way, can have a powerful effect on our health and well-being.

Penny Brohn Cancer Care

Based in Bristol, their Whole Life Approach recognises that to be healthy we need to pay attention to all parts of ourselves. Specifically, our mind, body, spirit and emotions, which are all closely connected and work together to support our immune system and its ability to keep us well. We strengthen our immune system by eating well, physical activity, doing the things we love and managing stress.

By learning how to self-care and increase our resilience, we are better able to face whatever life throws at us. This powerful knowledge offers hope and a sense of control for those with a cancer diagnosis. It doesn’t mean we are offering the promise or expectation of cure, but it does mean we can confidently say we each have natural internal resources that, when supported in the right way, can have a powerfu leffect on our health and well-being.