Prostate cancer is the second most common type of cancer among men (skin cancer is the most common). In 2020, the American Cancer Society projects approximately 190,000 new cases of prostate cancer, with about 60 percent of cases diagnosed in men over 65 (the condition is rare in men under 40). 
Prostate cancer will affect one in nine men over their lifetime, and tragically, it is the second leading cause of cancer-death in males (second only to lung cancer,) killing one in every 41 men diagnosed. 
Fortunately, early screening and medical imaging advancements have resulted in a five-year survival rate of 100 percent, and a 10-year survival rate of 98 percent. While these tremendous advancements in modern medicine are impressive, prevention is still the best cure.
What can you do with respect to your diet, exercise, and lifestyle to help reduce your risk of developing prostate cancer? If you have been diagnosed, are there any strategies that may help protect you against recurrence? Let’s explore the research.
What increases your risk of prostate cancer? Let’s take a look.
The more overweight or obese you are, the greater your likelihood of developing prostate cancer.  In fact, obesity increases risk of prostate mortality independent of other lifestyle or clinical factors. In the Physician’s Health Study (PHS), a body mass index (BMI) of greater than 30 kg/m2 —the classification for obesity—nearly doubles your risk of prostate cancer death. 
If you’ve already been diagnosed with prostate cancer, weight gain after diagnosis is also associated with a greater risk of prostate cancer recurrence and cancer-specific mortality. 
How does weight gain impact prostate cancer risk? Experts aren’t exactly sure, but some combination of excess insulin or insulin-like growth factor (IGF), altered sex hormones and/or adipokine (hormones secreted by fats cells) output seem to play a role in the disease progression. [5,6]
What all this means is that losing weight has a major protective effect on prostate cancer (if you’re overweight or obese).
Incorporating more movement and exercise into your life exerts a major protective effect against prostate cancer. The Health Professional Follow-Up Study (HPFS) examined 2,705 men with prostate cancer and found that men engaging in three or more hours of vigorous activity per week had approximately 60 percent lower risk of death from prostate cancer (compared to men exercising less than one hour per week). 
In particular, vigorous activity appears to be highly protective against prostate cancer, and most importantly, lethal prostate cancer. Anything that significantly ramps up your heart rate or sweat rate is classified as ‘vigorous’ activity, including jogging, cycling, swimming, and interval-based weight training—with short rest periods of 30-60 seconds between sets.
What if you can’t exercise vigorously at the moment?
Start incorporating more walking into your routine. Men who walked three or more hours per week at a brisk rate (greater than 3 mph) had a 57 percent lower risk of prostate cancer recurrence compared with men who walked less than three hours per week at an easy pace (less than 2 mph).  Furthermore, Swedish men who walked or cycled more than 20-minutes per day had a 36 percent reduced risk of prostate-cancer specific mortality.  Walking appears to support prostate health via positive changes in energy metabolism, inflammation, oxidative stress, and immunity.
Smoking is harmful for your health and this also includes your prostate health, with research highlighting the fact that smoking is associated with more aggressive forms of the disease. [10,11] If you smoke, you’ll have a higher risk of progression of your prostate cancer, a 61 percent greater chance of recurrence, and prostate-cancer specific mortality, as well.  If you do smoke, you’ll need to abstain for 10 years before your prostate-cancer risk drops to the same rate as non-smokers. So, if you’re over 50, it’s time to think long and hard about the best strategy to kick the habit.
What foods may decrease your risk of prostate cancer?
1. Dietary fish intake
The data on fish consumption and prostate cancer suggests a significant association between omega-3-rich fish and reduced risk of clinically significant prostate cancer.  Association does not equal causation; however, it’s encouraging to see pooled data from multiple studies reporting a 63 percent reduction in prostate cancer death in those consuming the highest intake of fish per week.  Aim to include multiple servings of salmon, sardines, anchovies, mackerel, herring, among other species. in your diet every week.
2. Cruciferous vegetables
Eat your greens. You’ve likely heard this common refrain before, and when it comes to protecting your prostate, this sage advice also appears to be highly impactful. Research in animal models highlights the positive effects of isothiocyanates and indoles—compounds found in cruciferous vegetables—at detoxifying carcinogenic compounds and stopping the rapid growth and proliferation of cancer cells.  In humans, several studies have found the greater your consumption of cruciferous vegetable, the lesser your risk of prostate cancer, particularly the more aggressive forms. [14,15] Add more asparagus, broccoli, Brussels sprouts, cabbage, cauliflower, and kale to your plate to reduce your risk.
Tomatoes are a rich source of the antioxidant lycopene, which has demonstrated the ability to inhibit prostate cancer growth and spread in some studies.  While many people incorrectly assume raw vegetables have greater nutrient bioavailability, cooking tomatoes and consuming them with oils (i.e. extra-virgin olive oil) increases lycopene absorption.  Men who consume the most tomato products, or tomato sauces, saw a 28 percent reduction in prostate cancer mortality compared to men who ate the least.  A simple way to increase your lycopene intake is to add more tomato-based soups and stews to your nutritional arsenal, as well as more tomato-based sauces to your protein and vegetables dishes. Of course, at The Paleo Diet, we recommend making your own tomato sauces and soups. Store-bought and canned tomato products are generally very high in both salt and added sugar. Nothing beats fresh tomatoes.
Can supplements help to protect against prostate cancer? There is limited data on whether supplements may provide a protective effect against prostate cancer or the progression of the disease. The Physician’s Health Study (PHS), in a randomized trial, did find a small but significant 8 percent reduction in total cancer risk in men who took a multi-vitamin daily.  More interestingly, of the subset of men with a history of previous cancers, there was a 27 percent reduction in total cancer. The available evidence does suggest a multi-vitamin is safe and may provide some benefit, however, no other supplements to date appear to provide any significant benefits. Also, while we understand that addressing a cancer diagnosis is a unique situation, in general we do not recommend multi-vitamins for improved health.
Modern medicine has come a long way in its ability to diagnose and treat prostate cancer. However, it remains one of the most common causes of cancer in men. A few simple modifications in your diet, exercise, and lifestyle can go a long way to protecting you from this disease. Be pro-active and take charge of your health.
- Peishch, S ,et al. Prostate cancer progression and mortality: a review of diet and lifestyle factors. World J Urol. 2017 June ; 35(6): 867–874.
- Ma J, Li H, Giovannucci E, Mucci L, Qiu W, Nguyen PL, et al. Prediagnostic body-mass index, plasma C-peptide concentration, and prostate cancer-specific mortality in men with prostate cancer: a long-term survival analysis. Lancet Oncol. 2008; 9:1039–1047.
- Joshu CE, Mondul AM, Menke A, Meinhold C, Han M, Humphreys EB, et al. Weight gain is associated with an increased risk of prostate cancer recurrence after prostatectomy in the PSA era. Cancer Prev Res (Phila). 2011; 4:544-551
- Margel D, Urbach DR, Lipscombe LL, Bell CM, Kulkarni G, Austin PC, et al. Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes. J Clin Oncol. 2013; 31:3069–3075.
- Roberts DL, Dive C, Renehan AG. Biological mechanisms linking obesity and cancer risk: new perspectives. Annu Rev Med. 2010; 61:301–316.
- Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol. 2011;29:726–732.
- Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res. 2011; 71:3889–3895
- Bonn SE, Sjolander A, Lagerros YT, Wiklund F, Stattin P, Holmberg E, et al. Physical activity and survival among men diagnosed with prostate cancer. Cancer Epidemiol Biomark Prev. 2015; 24:57–64.
- Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E. Smoking and prostate cancer survival and recurrence. JAMA. 2011; 305:2548–2555.
- Rieken M, Shariat SF, Kluth LA, Fajkovic H, Rink M, Karakiewicz PI, et al. Association of cigarette smoking and smoking cessation with biochemical recurrence of prostate cancer in patients treated with radical prostatectomy. Eur Urol. 2015; 68:949–956.
- Szymanski KM, Wheeler DC, Mucci LA. Fish consumption and prostate cancer risk: a review and meta-analysis. Am J Clin Nutr. 2010; 92:1223–1233.
- Higdon JV, Delage B, Williams DE, Dashwood RH. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res. 2007; 55:224–236.
- Kolonel LN, Hankin JH, Whittemore AS, Wu AH, Gallagher RP, Wilkens LR, et al. Vegetables, fruits, legumes and prostate cancer: a multiethnic case–control study. Cancer Epidemiol Biomark Prev. 2000; 9:795–804.
- Richman EL, Carroll PR, Chan JM. Vegetable and fruit intake after diagnosis and risk of prostate cancer progression. Int J Cancer. 2012; 131:201–210.
- Zu K, Mucci L, Rosner BA, Clinton SK, Loda M, Stampfer MJ, et al. Dietary lycopene, angiogenesis, and prostate cancer: a prospective study in the prostate-specific antigen era. J Natl Cancer Inst. 2014; 106(2):djt430
- Gann PH, Ma J, Giovannucci E, Willett W, Sacks FM, Hennekens CH, et al. Lower prostate cancer risk in men with elevated plasma lycopene levels: results of a prospective analysis. Cancer Res. 1999; 59:1225–1230.
- Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, Mac-Fadyen J, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012; 308:1871–1880.