Lifestyle Changes Enhance Outcomes in Early Prostate Cancer

An intensive life-style program could gradual and even halt the development of early, low-grade prostate most cancers in males, in response to knowledge introduced on the International Conference on Nutrition in Medicine (ICNM), held in Washington, DC, August 14-16, 2025.

Dean Ornish, MD, scientific professor of drugs, University of California, San Francisco (UCSF), in San Francisco, and president and founding father of the nonprofit Preventive Medicine Research Institute in Sausalito, California, described his analysis, which he positioned throughout the broader context of analysis he has performed on different ailments and circumstances.

“The program we studied for prostate cancer, is similar to the program we developed that has been proven effective in reversing heart disease and Alzheimer disease,” Dr Ornish defined (interview at ICNM; August 2025). “We’ve been researching the impact of this program on these conditions for 47 years. After decades of studies, I have arrived at a unifying theory, which is that these seemingly disparate conditions share many of the same underlying biologic mechanisms, such as chronic inflammation, oxidative stress, and angiogenesis, and all are influenced by how we eat, how we respond to stress, how much we exercise, and how much love and social support we have.”

Lifestyle Intervention Superior to Usual Care

To examine the affect of an intensive life-style intervention on prostate most cancers, Dr Ornish teamed up with Peter R. Carroll, MD, MPH, professor of urology and Ken and Donna Derr-Chevron Distinguished Professor in Prostate Cancer, UCSF School of Medicine, to give attention to a cohort of Dr Carroll’s sufferers with early low-grade prostate most cancers who had opted to not bear typical remedy.¹

The sufferers (n=93), all of whom had serum prostate-specific antigen (PSA) scores ranging between 4 and 10 ng/ml, Gleason rating lower than 7, and stage T1 or T2 illness, had been randomly assigned to both an experimental group that obtained the intensive life-style intervention or to a management group that obtained ordinary care.¹

“These patients had opted for what used to be called ‘watchful waiting,’ but is now called ‘active surveillance,’ in which they’re monitored carefully because they don’t need surgery, radiation, or chemotherapy immediately,” Dr Ornish commented.

Active surveillance refers to repeat monitoring of the affected person for indicators of illness development via conducting common PSA screening, prostate examinations, multiparametric MRI, and periodic biopsies.² The objective is to mitigate “common adverse effects associated with treatment, such as urinary incontinence, urinary irritative symptoms, and erectile or bowel dysfunction.”² In truth, energetic surveillance is at the moment the “preferred management for low-grade prostate cancer.”² 

Dr Carroll, who introduced along with Dr Ornish on the panel at ICNM about prostate most cancers, mentioned that the sufferers within the examine had been thought to be having “low-risk disease — meaning that their disease would generally appear to be indolent, slowly progressive, and the hypothesis being tested was to decide whether the lifestyle [intervention] changed the outcome of those patients” (interview at ICNM; August 2025).

The intervention the experimental group adopted consisted of a vegan eating regimen supplemented day by day with soy (1 serving of tofu plus 58 gm of a fortified soy protein powdered beverage), fish oil (3 gm), vitamin E (400 IU), selenium (200 mcg), and vitamin C (2 gm); average cardio train (strolling for half-hour 6 days per week); stress administration strategies (light yoga-based stretching, respiratory, meditation, imagery, and progressive leisure); and participation in a weekly 1-hour help group. A registered dietitian was accessible for dietary training and counseling.¹

Serum PSA was measured at baseline after which at 1 12 months. LNCaP [lymph node carcinoma of the prostate] cells had been grown and in addition measured. LNCaP cells mannequin vital levels of prostate most cancers development, shedding gentle on prostate tumorigenesis, metastasis, and remedy response.³ 

None of the members within the intervention group wanted to bear typical remedy as a result of a rise in PSA and/or illness development (as decided by MRI imaging), whereas 6 sufferers within the management group underwent typical remedy for these causes. PSA decreased by 4% within the intervention group vs a rise of 6% within the management group (P =.016).¹ Moreover, LNCaP cell development was inhibited by serum from the intervention group virtually eight instances greater than serum from the management group (70% vs 9%; P <.001).¹

Patients within the intervention group reported improved high quality of life, important decreases in physique weight, and enhancements in lipid profile, in contrast with these within the management group. “This lifestyle intervention therefore had beneficial effects beyond its impact on prostate cancer,” Dr Ornish commented. 

At 2 years of follow-up, 27% of these within the management group and 5% of these within the intervention group had undergone typical prostate most cancers remedy (radical prostatectomy, radiotherapy, or androgen deprivation remedy; P <.05).⁴ Of the handled management sufferers, 3 had a PSA degree of 10 ng/mL or greater and 1 had a PSA velocity of greater than 2 ng/mL/y earlier than remedy, in contrast with not one of the handled sufferers within the intervention group for each markers.⁴ 

“The results of this study extended our earlier findings to show that measurable benefits by making changes in diet and lifestyle, in the form of fewer prostate cancer-related clinical events, were evident 2 years after study entry,” Dr Ornish mentioned.

More Recent Research

Dr Carroll cited further analysis suggesting that consuming diets which might be richer in plant-based meals is helpful for males with prostate most cancers. For instance, Dr Carroll and his colleagues studied 2062 males with nonmetastatic prostate most cancers, drawn from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) — a longitudinal observational examine.^5,6 Participants accomplished a complete eating regimen and life-style questionnaire that included a validated meals frequency questionnaire. The researchers used the general plant-based eating regimen index (PDI) and the healthful plant-based eating regimen index (hPDI) scores to evaluate the dietary patterns of the members.⁵

During a median follow-up of 6.5 years (vary, 1.3 to 12.8 years) after members accomplished the questionnaire, 190 development occasions and 61 prostate cancer-specific mortality occasions occurred. Men who scored within the highest quintile of PDI had a 47% decrease danger of development, in comparison with these within the lowest quintile (P for development =.003). The researchers concluded {that a} greater consumption of plant meals was related to decrease danger of most cancers development.⁵

Dr Carroll additionally pointed to a potential examine of greater than 3500 males with prostate most cancers who had participated within the Health Professionals Follow-Up Study (1986-2016).⁷ A better PDI was related to modestly higher scores for sexual operate, urinary irritation/obstruction, urinary incontinence, and hormonal/vitality. 

Nutritional Guidance for Patients With Prostate Cancer

Dr Carroll introduced dietary steering for sufferers with prostate most cancers, noting that the identical suggestions may additionally be useful in sufferers with different forms of cancers, in addition to sufferers with coronary heart illness. 

Vegetables and fruits are really useful for all circumstances — particularly a wide range of plant-based meals — with an emphasis on uncooked and cruciferous greens and cooked tomatoes for deadly prostate most cancers. Fiber and entire grains; wholesome plant-based proteins (eg, beans and nuts), fish, seafood, low-fat or fat-free dairy, and skinless protein; and liquid, nontropical plant oils are additionally really useful.^8,9

Foods to keep away from embrace saturated fats (eg, high-fat dairy, butter, animal fats, tropical oils), trans fats (eg, partially hydrogenated fats, animal fats); drinks with added sugar or sugar-sweetened drinks; processed and purple meat; extremely processed meals/refined grains; and alcohol, which ought to be consumed sparsely if in any respect.^8,9

The eating regimen members in Dr Ornish’s examine adopted was vegan, consisting predominantly of fruits, greens, entire grains (advanced carbohydrates), legumes, and soy merchandise and was low in easy carbohydrates. Only roughly 10% of energy got here from fats.¹ An identical dietary routine was investigated in his examine on life-style adjustments in Alzheimer illness¹⁰ and his analysis into coronary heart illness.¹¹ The eating regimen, at the side of the opposite interventions, contributed to reversal of the circumstances. 

Today, Dr Ornish’s program is thought to be robustly evidence-based. It is roofed by Medicare and a variety of different insurance coverage firms. Some insurers additionally cowl this system for sufferers with early-stage Alzheimer illness. Dr Ornish describes his unifying principle at size within the ebook Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (Ballantine Books; 2019).

“It’s been said that what’s good for the heart is good for the brain,” Dr Ornish concluded. “I can add that what’s good for the heart and brain is also good for the prostate. And the only ‘side effects’ are beneficial ones.”

Dr Carroll believes that energetic surveillance ought to be provided to all males with low-risk illness and lots of with intermediate-risk illness, and that life-style modifications “should be offered to all patients as primary or complementary care.” In addition, assets for healthful consuming, train, and different life-style suggestions from the Department of Urology at UCSF can be found here.