Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Apr 6;4(4):385-416.
doi: 10.1002/bco2.237. eCollection 2023 Jul.

The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review

Zach Dovey  1 , Amir Horowitz  2 , Nikhil Waingankar  2
Affiliations
Review

The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review

Zach Dovey et al. BJUI Compass. .

Abstract

Background: The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions. Current evidence suggests appropriate changes in lifestyle including diet, physical activity (PA) and stress reduction with or without dietary supplements may improve both disease outcomes and patient's mental health.

Objective: This article aims to review the current evidence on the benefits of all lifestyle programmes for PCa patients including those aimed at reducing obesity and stress, explore their affect on tumour biology and highlight any biomarkers that have clinical utility.

Evidence acquisition: Evidence was obtained from PubMed and Web of Science using keywords for each section on the affects of lifestyle interventions on (a) mental health, (b) disease outcomes and (c) biomarkers in PCa patients. PRISMA guidelines were used to gather the evidence for these three sections (15, 44 and 16 publications, respectively).

Evidence synthesis: For lifestyle studies focused on mental health, 10/15 demonstrated a positive influence, although for those programmes focused on PA it was 7/8. Similarly for oncological outcomes, 26/44 studies demonstrated a positive influence, although when PA was included or the primary focus, it was 11/13. Complete blood count (CBC)-derived inflammatory biomarkers show promise, as do inflammatory cytokines; however, a deeper understanding of their molecular biology in relation to PCa oncogenesis is required (16 studies reviewed).

Conclusions: Making PCa-specific recommendations on lifestyle interventions is difficult on the current evidence. Nevertheless, notwithstanding the heterogeneity of patient populations and interventions, the evidence that dietary changes and PA may improve both mental health and oncological outcomes is compelling, especially for moderate to vigorous PA. The results for dietary supplements are inconsistent, and although some biomarkers show promise, significantly more research is required before they have clinical utility.

Keywords: biomarkers; cancer outcomes; diet; mental health; physical exercise; prostate cancer; stress reduction.

PubMed Disclaimer

Conflict of interest statement

Dr. Zach Dovey is Medical Director and stock owner (with certificate of shares) of Medtech Holdings Ltd.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram for the influence of Lifestyle Interventions Mental Health and Oncological Outcomes Literature Search.
FIGURE 2
FIGURE 2
PRISMA flow diagram for the influence of lifestyle interventions on the Complications of Treatment and Biomarkers and Metabolic Imaging Literature Search.
FIGURE 3
FIGURE 3
Mosaic plot representing the proportions of successful interventions by type on mental health outcomes for prostate cancer (PCa) patients for all studies summarised in Table 1.
FIGURE 4
FIGURE 4
Mosaic plot representing the proportions of successful interventions by type on prostate cancer oncological outcomes for prostate cancer (PCa) patients for all studies summarised in Table 2. The width of each column is proportional to the number of studies for each intervention type. Bar on right represents the entire group or the success rate of all lifestyle and physical activity interventions.
See this image and copyright information in PMC

References

    1. EAU Guidelines ‐ Prostate Cancer [Internet]. 2022. [cited 2022 Nov 8]. Available from: https://uroweb.org/guidelines/prostate-cancer
    1. Blanc‐Lapierre A, Spence A, Karakiewicz PI, Aprikian A, Saad F, Parent M‐É. Metabolic syndrome and prostate cancer risk in a population‐based case–control study in Montreal, Canada. BMC Public Health. 2015;15(1):913. Available from: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2260-x - DOI - PMC - PubMed
    1. Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Parretta E, et al. Effect of metabolic syndrome and its components on prostate cancer risk: meta‐analysis. J Endocrinol Invest. 2013;36(2):132–139. Available from: http://link.springer.com/10.1007/BF03346748 - DOI - PubMed
    1. Preston MA, Riis AH, Ehrenstein V, Breau RH, Batista JL, Olumi AF, et al. Metformin use and prostate cancer risk. Eur Urol. 2014;66(6):1012–1020. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0302283814004084 - PubMed
    1. Vidal AC, Howard LE, Moreira DM, Castro‐Santamaria R, Andriole GL, Freedland SJ. Obesity increases the risk for high‐grade prostate cancer: results from the REDUCE study. Cancer Epidemiol Biomarkers Prev. 2014;23(12):2936–2942. Available from: https://aacrjournals.org/cebp/article/23/12/2936/116941/Obesity-Increase... - PMC - PubMed

LinkOut - more resources