New findings on lifestyle and prostate cancer outcomes

Today, I am excited to share some important findings from a recent study on prostate cancer risk conducted through the Million Veteran Program (MVP). This study provides valuable insights into how lifestyle choices can impact prostate cancer (PrCa) outcomes, so let’s take a closer look…

Study Overview

The study analyzed data from over 280,000 men enrolled in the MVP, one of the largest and most diverse health record-linked biobanks globally. Participants were primarily male (90.4%) with an average age of 61.9 years. The study included men of various ancestries, with 10.9% being of African ancestry.

Key Findings

1. Smoking and Prostate Cancer Risk:
• Smoking was significantly associated with an increased risk of both metastatic PrCa and fatal PrCa
• Among men with high genetic risk, smokers had a higher lifetime cause-specific mortality rate at age 85  
2. Exercise and Prostate Cancer Risk:
• Regular exercise was associated with a reduced risk of fatal PrCa.
• The protective effect of exercise was most significant among those with nonmetastatic PCa at enrollment.
3. Impact on Different Ancestries:
• Black men or men of African ancestry who did not smoke had a reduced risk of metastatic PrCa and fatal PrCa.
• The absolute reduction in risk was greater for men of African ancestry and those with high genetic risk.
4. Body Mass Index (BMI) and Diet:
• Higher BMI was associated with a slightly reduced risk of fatal PrCa
• Diet did not show a significant independent association with PrCa outcomes in this study.

Thoughts & Takeaways

This study underscores the importance of a healthy lifestyle in reducing prostate cancer risks, especially for those with higher genetic predispositions or of African ancestry. As advocates for our health, making informed lifestyle choices can significantly impact our well-being and longevity.

Some of these are obvious, like quitting smoking. Others are surprisingly simple and powerful, like staying active.

Finally, while diet alone did not show a strong independent association in this particular study, we shouldn’t take that to mean that nutrition doesn’t matter. As I have explained here before, diet and prostate cancer can be a tricky subject. And keep in mind that BMI is also an imperfect measure of risk, for a few reasons.

Where BMI falls short

BMI is a simple calculation based on height and weight. It does not differentiate between muscle mass and fat mass. As a result, individuals with high muscle mass (e.g., athletes) may have a high BMI but low body fat, leading to a misleading classification of "overweight" or "obese."

 

BMI also does not account for the distribution of body fat. Central obesity (fat around the abdomen) is more strongly associated with health risks, including prostate cancer, than fat distributed in other areas. Two individuals with the same BMI can have very different fat distributions and health risks.

 

Finally, some individuals with a high BMI may have a healthy metabolic profile (e.g., normal blood pressure, cholesterol, and insulin sensitivity), while others may have a poor metabolic profile. This concept is often referred to as "metabolically healthy obesity" versus "metabolically unhealthy normal weight." 

 

The bottom line is that a healthy weight is different for everyone and the relationship between BMI and cancer risk specifically is complex and not entirely understood yet. Some studies suggest that higher BMI may be associated with a lower risk of fatal prostate cancer, while others indicate an increased risk of aggressive forms of the disease.

This inconsistency can be due to various factors, including how BMI is measured and the influence of other health behaviors and genetic factors. And ultimately, your risk is going to hinge on a number of these factors.

That’s why it’s essential to address all the elements of wellness in your prostate cancer journey. Stay proactive and keep prioritizing your health. Prostate cancer can be an opportunity for better health, not a death sentence.

Much Love!

Dr. Geo, Co-founder & Medical Director

P.S. My upcoming webinar, How to Improve Sleep for Better Prognosis, is right around the corner! On Wednesday, 9/11 at 9 p.m. EST, I’ll be talking about evidence-based strategies and practical tips to enhance sleep quality and improve overall well-being for prostate cancer patients—including the impact of prostate cancer on sleep, sleep hygiene principles, nutritional considerations, and more. So if you haven’t registered yet, you can do so here—you won’t want to miss this.

Reference:

Pagadala MS, Lui A, Lynch J, Karunamuni R, Lee KM, Plym A, Rose BS, Carter H, Kibel AS, DuVall SL, Vassy J, Gaziano JM, Panizzon MS, Hauger RL, Seibert TM. Healthy lifestyle and prostate cancer risk in the Million Veteran Program. Cancer. 2024 Jun 12. doi: 10.1002/cncr.35434. Epub ahead of print. PMID: 38865417.