Adherence to the Mediterranean diet and grade group progression in localized prostate cancer: An active surveillance cohort

Abstract

Background The Mediterranean diet (MD) may be beneficial for men with localized prostate cancer (PCa) on active surveillance (AS) because of its anti‐inflammatory, antilipidemic, and chemopreventive properties. This study prospectively investigated adherence to the MD with Gleason score progression and explored associations by diabetes status, statin use, and other factors. Methods Men with newly diagnosed PCa on an AS protocol (n = 410) completed a baseline food frequency questionnaire, and the MD score was calculated across 9 energy‐adjusted food groups. Cox proportional hazards models were fit to evaluate multivariable‐adjusted associations of the MD score with progression‐free survival; progression was defined as an increase in the Gleason grade group (GG) score over a biennial monitoring regimen. Results In this cohort, 15% of the men were diabetic, 44% of the men used statins, and 76 men progressed (median follow‐up, 36 months). After adjustments for clinical factors, higher adherence to the MD was associated with a lower risk of GG progression among all men (hazard ratio [HR] per 1‐unit increase in MD score, 0.88; 95% confidence interval [CI], 0.77‐1.01), non‐White men (HR per 1‐unit increase in MD score, 0.64; 95% CI, 0.45‐0.92; P for interaction = .07), and men without diabetes (HR per 1‐unit increase in MD score, 0.82; 95% CI, 0.71‐0.96; P for interaction = .03). When joint effects of the MD score and statin use were examined, a similar risk reduction was observed among men with high MD scores who did not use statins in comparison with men with low/moderate MD scores with no statin use. Conclusions The MD is associated with a lower risk of GG progression in men on AS, and this is consistent with prior reports about the MD and reduced cancer morbidity and mortality.

Kava root extracts hinder prostate cancer development and tumorigenesis by involvement of dual inhibition of MAO-A and LSD1

“…In addition, over one-third of prostate cancer is slowly growing or progressing over several decades. This group of patients without cancer-related symptoms do not warrant aggressive, immediate treatment [2] . Instead, they are closely monitored for their indolent status using prostate-specific antigen (PSA) kinetics, periodic biopsies for histologic progression, and possibly surveillance magnetic resonance imaging (MRI) until further treatment is needed as judged by physicians.…”

“…Instead, they are closely monitored for their indolent status using prostate-specific antigen (PSA) kinetics, periodic biopsies for histologic progression, and possibly surveillance magnetic resonance imaging (MRI) until further treatment is needed as judged by physicians. This emergent strategy for the management of indolent prostate cancer is called active surveillance [2] . Men on active surveillance have high anxiety, depression and doubts about the possible progression of the disease and are highly motivated to prevention approaches using dietary or pharmacological means or positive lifestyle changes [3] .…”

“…This emergent strategy for the management of indolent prostate cancer is called active surveillance [ 2 ] . Men on active surveillance have high anxiety, depression and doubts about the possible progression of the disease and are highly motivated to prevention approaches using dietary or pharmacological means or positive lifestyle changes [ 3 ] . Therefore, men on active surveillance have been thought to be an ideal population for chemo/dietary prevention methods to further reduce disease progression and anxiety during the period of active surveillance.…”

Narrative review of Mediterranean diet in Cilento: longevity and potential prevention for prostate cancer

“…Recently, findings from Gregg et al have shown that adherence to the basic principles of the MD may lower the risk of Gleason grade progression among US men with localized PCa on active surveillance. 65 Further studies are needed to verify patient and cancer-specific effects of MD adherence in men with early-stage PCa. In addition, future studies should evaluate MD adherence with tools that include not only food consumption but also the evaluation of lifestyle factors and cultural subtexts.…”