Advanced Prostate Cancer

Healthy lifestyle

Almost 80 percent of cancer patients will experience some form of malnutrition during their treatment, making optimal nutrition an important goal for men with advanced prostate cancer.

Before, during and after treatment

Working toward healthier living before cancer treatment can help you better cope with the effects during and after. Men who eat a healthy diet and stay active are typically able to better manage side effects, have a quicker recovery, reduce their risk of infection and feel better overall. Talking to your doctor or dietitian at the beginning of your cancer journey will help you evaluate your pre-treatment health status and any changes you can start now that will be beneficial once treatment begins.

When preparing for treatment, it’s important to talk about side effects that can affect your nutrition. For men with advanced prostate cancer, side effects commonly include loss of appetite and weight loss. Other men, especially those taking ADT, often gain weight as a side effect. Early detection of nutritional problems can help prevent or reduce these and other side effects. A registered dietitian can suggest healthy food choices that will help you meet your nutritional needs.

Making healthy food choices after treatment can help you regain your strength and help your body heal itself. Eating healthy foods and staying active may also improve your quality of life, lead to a longer life, and help reduce the risk of other cancers and chronic conditions, such as heart disease and diabetes.

Eat a healthy diet

When you’re healthy, eating enough food to supply the nutrients you need is usually not a problem. However, when you’re being treated for cancer, it can be a challenge to maintain good nutrition. For men with advanced prostate cancer, the side effects of treatment and symptoms of the disease commonly cause loss of appetite and weight loss. If your appetite is poor, it’s especially important to choose foods that will help you maintain your strength and energy, lower your risk of infection, tolerate treatment-related side effects, and recover faster. A registered dietitian can help with food choices that will meet your individual nutritional needs. Be sure to tell your doctor or a member of your health care team if you’ve not been able to eat for more than two days.

Some men with prostate cancer may have a good appetite, and men on ADT often gain weight. It’s important to maintain a healthy weight by limiting the number of calories you consume, avoiding some foods and eating a variety of healthy foods. Eating a high number of calories every day provides cells with more energy, which can promote the growth of tumor cells. Also, a diet high in fat can stimulate testosterone in the body, which helps fuel the growth of prostate cancer cells. Try to limit foods that are high in fat and avoid processed meats such as hot dogs, bacon and bologna.

You should also limit your intake of simple sugars, also known as simple carbohydrates. In addition to table sugar, simple sugars are found in candy, cakes, syrups, fruit juices and carbonated beverages. Such foods are often referred to as “empty calories” because they provide no substantial nutritional value or essential vitamins. In addition, a high intake of simple sugars can lead to high levels of insulin in the body, which in laboratory studies has been shown to increase the likelihood that prostate cancer cells will grow.

Protein is essential for helping to build strong muscles and bones, so make sure to include lean protein (i.e., low in fat) in your diet by eating such foods as egg whites, chicken breast and ocean fish.

Be sure to make fruits, vegetables and whole grains the largest part of your diet. When choosing fruits and vegetables, try to choose a variety of colors:

  • red (tomatoes, watermelon)
  • red/purple (pomegranate, grapes, berries)
  • orange (carrots, cantaloupe, sweet potatoes, oranges, peaches)
  • yellow/green (corn, peas, honeydew melon)
  • green (broccoli, cabbage)
  • white/green (garlic, onions, asparagus)

Each color group offers a different type of antioxidant, which can help fight cell damage. Many studies have been done to determine the effect of lycopene, the antioxidant found in red fruits and vegetables, on prostate cancer. Some of these studies have suggested that lycopene can slow the progression of cancer, but no study has definitively proven this benefit. Studies have also shown that cruciferous vegetables – cauliflower, cabbage, watercress, bok choy, broccoli, and other green, leafy vegetables – can slow the progression of prostate cancer. Dark, leafy green vegetables, as well as beans and low-fat dairy products, are also good sources of calcium, a mineral important for bone strength. You also need vitamin D because it helps the body absorb calcium properly, promotes bone health and may also have beneficial effects on other organ systems. So be sure to include healthy sources of vitamin D such as fatty fish (salmon, tuna, sardines and swordfish) and vitamin-D fortified milk and cereals. Some physicians recommend frequently measuring the level of vitamin D in your blood and may also recommend vitamin D supplements.

Several studies suggest that curcumin, a component of the Indian curry spice turmeric, may slow the growth of prostate cancer cells. However, the studies involved animals, not humans, so the benefit to men with prostate cancer still needs to be determined.

What to avoid

Eating a high number of calories provides cells with more energy, and a diet high in fat can stimulate testosterone in the body, both of which may fuel the growth of cancer cells. There is a strong suggestion of a connection between obesity and prostate cancer. Men who grow more obese after treatment may be at greater risk of the cancer growing faster. Try to limit high-fat foods, and avoid processed meats such as hot dogs and bacon. Limit the amount of red meat to no more than three to four servings a week, and avoid smoked and pickled foods. Also, always drink alcohol in moderation; the American Cancer Society recommends limiting alcohol to no more than two drinks per day.

You should also limit your intake of simple sugars, also known as simple carbohydrates. In addition to table sugar, simple sugars are found in candy, cakes, fruit juices and carbonated beverages. A high intake of simple sugars can lead to high levels of insulin in the body, which has been shown to increase the likelihood that prostate cancer cells will grow.

Be smart about supplements

Vitamins and minerals are necessary to maintain the function and growth of your body’s cells. Your doctor or dietitian may in fact suggest a daily multivitamin to help you get the proper amount of vitamins and minerals, especially if you’re not eating well. Your doctor may also tell you to take calcium and vitamin D supplements to help prevent or manage osteoporosis.

However, many dietary supplements – such as omega-3 polyunsaturated fatty acids, flaxseed, isoflavones (soy), zinc and tea-based supplements – have also been advertised as being able to slow the growth of prostate cancer cells. Although the findings of some studies suggest that these may be beneficial, the conclusions are not clear. For example, flaxseed and its oil have been found to inhibit the growth and spread of prostate cancer, but this finding is from studies of animals. One study did show that cancer growth was reduced in men who ate a low-fat diet and ate flaxseed for about 30 days before prostate surgery. Soy has been shown to reduce the rate of prostate cancer growth but none of the studies have included men with advanced prostate cancer. With so many factors to consider, remember to talk to your doctor before taking any supplements.

Regardless of what vitamins or minerals may be beneficial, it’s always better to get them from food rather than through supplements; eating tomatoes and other red fruits and vegetables is a better way to increase your intake of lycopene than to take a lycopene supplement. Vitamins and minerals in food are absorbed in the body better than supplements, and sometimes the interaction of vitamins and minerals in food sources enhances the beneficial effects. Another disadvantage of supplements is a greater risk of a high dose of a vitamin or mineral in your body, which may be dangerous.

Exercise regularly

Although it’s important to get enough rest, prolonged inactivity may lead to muscle weakness, loss of function and reduced range of motion. Exercise can actually help reduce fatigue so that you feel better physically and emotionally. The level of exercise appropriate for you will depend on the type and stage of cancer you have, your cancer treatment, and your overall fitness level, strength and stamina. If your red or white blood cell counts are low, you may have to postpone certain exercises until it’s safe for you to continue.

Studies have shown that both aerobic and resistance exercises can help to reduce fatigue and other side effects, increase body strength and enhance the quality of life for men receiving ADT or radiation therapy for prostate cancer. In addition, weightlifting can help you build muscle, which, in turn, can help you burn more calories. You should seek professional instruction on how to do resistance exercises and weightlifting to help avoid injury and to ensure that you gain the maximum benefit from your workouts.

Exercises such as walking, running, cycling and swimming can also help to increase your body’s natural levels of antioxidants, which may help slow cancer growth. Although more research on this is needed, these exercises are recommended for their overall health benefits, especially your cardiovascular health. Weight-bearing exercises such as walking, climbing stairs, dancing and weightlifting are also recommended ways to strengthen bone and help slow the loss of bone mass that can occur with hormone therapy.

If you feel like you do not have enough stamina to take part in an exercise program, start by being a little more active each day. Begin with low-intensity activities (such as a walk or bike ride), and balance exercise with rest. Do not lift heavy weights or walk on uneven surfaces, which may put you at risk for injury or a fall. Let your doctor know if you experience swollen ankles, shortness of breath while at rest, or unexplained weight gain, and watch for bruising or bleeding.

Live a healthy lifestyle

In addition to focusing on a healthy diet and regular exercise, making lifestyle changes can improve your long-term health. If you smoke, one of the most important things you can do for yourself is to quit smoking. Your doctor can help you stop smoking, and there are other resources in your community that provide help. If you drink alcohol, try to limit yourself to one or two drinks a day at the most. Other tips that can help you achieve optimal health while living with prostate cancer:

  • Establish a support system of people who understand what you are going through.
  • Protect yourself from sun exposure.
  • Reduce stress.
  • Get help for anxiety or depression.
  • Consider joining a support group.

Make smart choices

It seems as if the media reports every day that certain foods or dietary supplements can slow the progression of cancer, making it difficult to know what’s true. When considering these stories, remember:

  • Much of the research on diet and supplements has been done to determine their effect on preventing prostate cancer. Far fewer studies have been done on their effect on the growth of existing cancer.
  • Benefits of some dietary changes and supplements have been found in animal studies, but human studies have not produced the same results or have not yet been done.
  • Some studies have produced conflicting results because of differences in how the studies were designed or carried out.

Be sure you remember these two important guidelines:

  • One of the best things you can do for yourself is to eat a healthy diet and follow a doctor-approved exercise plan.
  • Talk to your doctor or another member of your health care team about what’s really known about the effects of dietary modifications and supplements.

Staying active, getting enough rest and eating well all contribute to an improved sense of well-being and a healthier you.