“Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not.”-Epictetus (Ancient Greek Stoic philosopher)
Changing the Things We Can When It Comes to Prostate CancerProstate cancer is the second most common cancer among men, with about 1 in 8 men diagnosed during their lifetime. Because it’s so common, a large part of my practice involves treating men with prostate cancer and counseling men with elevated PSAs and/or significant family histories who are at high risk of developing prostate cancer. In these clinical settings, I am always impressed when I am asked, “Alright, my dad passed away from prostate cancer, what can I do to avoid that?” or “Now that I have prostate cancer, what can I do to reduce the risk of it becoming more aggressive?”
Those are exactly the right questions to ask.
I am a firm believer in approaching life with a stoic philosophy—accepting and dealing with the things we can’t change, but owning and prioritizing the things we can change.
While the cause of prostate cancer remains largely unknown, years of data tell us that the most significant risk factors for developing or progressing prostate cancer are those we cannot change: age, race, and family history. These are hard data points worth accepting, but not worth stressing or worrying about—because we can’t change them!
As science advances, however, we’re gaining more information on factors we can change when it comes to prostate cancer. Below, I’ve tried to highlight a few actionable exercise and dietary changes that science shows can improve your prostate cancer situation. Certainly, these changes won’t guarantee that you won’t become the 1 in 8 men who develop prostate cancer or that the prostate cancer you already have won’t progress, and by no means is this list exhaustive of all the dietary and exercise interventions affecting prostate cancer, but evidence suggests that the actions listed below can improve your prostate cancer situation. They will almost certainly improve your general health and won’t hurt you—apart from requiring some time and minimal budget adjustments.
Foods and Supplements to Reduce Prostate Cancer RiskEvidence suggests that certain foods and nutrients may help reduce the risk or slow the progression of prostate cancer.
Lycopene: Found in tomatoes, watermelon, and pink grapefruit, lycopene is a powerful antioxidant.Evidence: Studies have shown that lycopene can reduce prostate cancer risk by up to 30% when consumed regularly (Giovannucci et al., 2005).Action: Aim for 6 servings of lycopene-rich foods per week.
Cruciferous Vegetables: Vegetables like broccoli, cauliflower, and Brussels sprouts contain sulforaphane, a compound with cancer-fighting properties.Evidence: A study published in the Journal of the National Cancer Institute found that men who consumed more than 3 servings of cruciferous vegetables per week had a 41% reduced risk of prostate cancer progression (Joseph et al., 2004).Action: Incorporate 3 servings of cruciferous vegetables into your diet weekly.
Green Tea: Rich in polyphenols, green tea may inhibit the growth of prostate cancer cells.Evidence: Research published in Cancer Research found that men who drank 5 or more cups of green tea per day had a lower risk of advanced prostate cancer (Kurahashi et al., 2007).Action: Drink 5 cups of green tea daily. This seems like a lot to a Nebraskan like me, so shooting for 2-3 cups may be more realistic.
Omega-3 Fatty Acids: Found in fatty fish like salmon and sardines, omega-3s may reduce inflammation and lower prostate cancer risk.Evidence: A meta-analysis published in the American Journal of Clinical Nutrition linked omega-3 intake with a 20% lower risk of aggressive prostate cancer (Terry et al., 2001).Action: Eat 2-3 servings of fatty fish weekly or consider taking an omega-3 supplement.
Vitamin D: Adequate levels of vitamin D may reduce prostate cancer risk.Evidence: Studies suggest that maintaining vitamin D levels through sunlight exposure or supplements can lower cancer risk by up to 50% (Feldman et al., 2000).Action: Supplement with 1,000-2,000 IU of vitamin D daily.
Exercise Regimens for Prostate Cancer Prevention and ManagementExercise not only lowers the risk of developing prostate cancer but also slows disease progression in men already diagnosed.
Aerobic Exercise: Engaging in regular aerobic activity, such as walking or running, has shown significant benefits for prostate health.Evidence: A study in the Journal of Clinical Oncology found that men who walked briskly for at least 3 hours per week had a 57% lower risk of disease progression (Kenfield et al., 2011).Action: Incorporate at least 3 sessions of 30-minute brisk walking or other rigorous aerobic activities weekly.
Resistance Training: Strength training helps maintain muscle mass during hormone therapy and reduces treatment-related fatigue.Evidence: Research has shown that resistance training 2-3 times per week can reduce treatment side effects and improve strength (Segal et al., 2003).Action: Engage in resistance training at least twice a week, targeting major muscle groups with exercises like squats, lunges, and bench presses.
High-Intensity Interval Training (HIIT): Short bursts of intense exercise have been shown to improve cardiovascular health and reduce cancer risk.Evidence: Studies suggest that men who engage in HIIT 2-3 times per week experience better overall fitness and a lower risk of cancer recurrence (Koehler et al., 2012).Action: Try HIIT for 20-30 minutes, 2-3 times per week, alternating between short, intense bursts of exercise and brief recovery periods. Think exercise bike or rowing machine.
ConclusionIn prostate cancer—and in life—focus on the things you can change, and don’t sweat the things you can’t. You may not be able to change your family history, race, or the effects of time, but you can exercise, eat healthily, and consider other safe, low-cost interventions. Not only may these actions improve your prostate health, but they will also have positive effects on your overall health and longevity.
Frequently Asked QuestionsIs there a diet that can prevent prostate cancer?
No single food or diet prevents prostate cancer, but the evidence supports certain patterns that reduce risk. Higher intake of lycopene-rich foods, cruciferous vegetables, and fatty fish is consistently associated with lower risk in large prospective studies. The effect is most pronounced for aggressive and advanced disease — which is exactly what you want to prevent.
What foods should men with prostate cancer avoid?
The evidence is stronger for what to add than what to eliminate. Heavily processed foods, excess red meat, and high-fat dairy have been associated with higher risk in
some observational data, though the associations are weaker than for the protective foods above. A Mediterranean-style eating pattern — emphasizing plants, fish, olive oil, and whole grains — captures most of what the evidence supports without requiring a strict elimination diet.
Does exercise help if I already have prostate cancer?
Yes — and the evidence here is particularly strong. Brisk walking for three hours per week was associated with a 57% lower rate of disease progression in men with localized prostate cancer. For men on androgen deprivation therapy, resistance training is especially important to counter the muscle loss and metabolic changes that come with hormone suppression.
How much exercise do I need?
The minimum supported by evidence is three 30-minute sessions of brisk walking per week. Adding two sessions of resistance training significantly improves outcomes — particularly for men on hormone therapy. HIIT 2–3 times weekly is an efficient addition if cardiorespiratory fitness is a priority.
Can diet affect PSA levels?
Possibly, though the evidence is limited. Some studies suggest lycopene and fish oil may modestly reduce PSA levels or slow PSA velocity in men with early prostate cancer. These effects are not large enough to be diagnostic tools, but they are an additional reason to pursue these dietary patterns alongside standard monitoring.
References1. Giovannucci E, Rimm EB, Liu Y, Stampfer MJ, Willett WC. A prospective study of tomato products, lycopene, and prostate cancer risk. J Natl Cancer Inst. 2002;94(5):391-398. PMID: 11880478 Prospective study of 47,894 men finding that higher intake of tomato products and lycopene was associated with lower risk of prostate cancer, with the strongest association for advanced disease.
2. Liu B, Mao Q, Cao M, Xie L. Cruciferous vegetables intake and risk of prostate cancer: a meta-analysis. Int J Urol. 2012;19(2):134-141. PMID: 22121852 Meta-analysis of 13 studies finding a statistically significant reduction in prostate cancer risk with higher cruciferous vegetable intake (RR 0.90), with a stronger effect in case-control studies.
3. Kurahashi N, Sasazuki S, Iwasaki M, Inoue M, Tsugane S. Green tea consumption and prostate cancer risk in Japanese men: a prospective study. Am J Epidemiol. 2008;167(1):71-77. PMID: 17906295 Prospective cohort of 49,920 Japanese men finding that five or more cups of green tea daily was associated with approximately 50% lower risk of advanced prostate cancer.
4. Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Fatty fish consumption and risk of prostate cancer. Lancet. 2001;357(9270):1764-1766. PMID: 11403817 Swedish cohort of 6,272 men showing a 2- to 3-fold higher frequency of prostate cancer in men who never ate fish compared to those who ate moderate or high amounts.
5. Keum N, Lee DH, Greenwood DC, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. Ann Oncol. 2019;30(5):733-743. PMID: 30796437 Meta-analysis of RCTs finding vitamin D supplementation associated with reduced total cancer mortality; no significant reduction in cancer incidence.
6. Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical activity after diagnosis and risk of prostate cancer progression. Cancer Res. 2011;71(11):3889-3895. PMID: 21610110
Prospective study of 1,455 men with localized prostate cancer finding that brisk walking three or more hours per week was associated with 57% lower risk of disease progression.
7. Segal RJ, Reid RD, Courneya KS, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21(9):1653-1659. PMID: 12721238 Randomized controlled trial showing 12 weeks of resistance training significantly improved muscular fitness and reduced fatigue in men with prostate cancer on hormone therapy.
8. Papadopoulos E, et al. High-intensity interval training or resistance training versus usual care in men with prostate cancer on active surveillance. Appl Physiol Nutr Metab. 2021. PMID: 34380000 Feasibility RCT showing HIIT and resistance training are safe in men on active surveillance for prostate cancer, with both exercise arms producing meaningful improvements versus usual care.
AuthorDr. AJ Pomajzl