“Sinners, repent and be saved!” A revivalist movement began around the mid-19th century. It consisted of traveling preachers and evangelists who would set up a large tent, and draw in church congregation members whose pastors hoped to reinvigorate their flocks. During a marathon couple of days, frenzy would mount as attendees witnessed emotional individual conversions, healings, and recommitments to accept salvation. The film “Elmer Gantry”, with Burt Lancaster pitching repentance, conveys how tangibly these meetings gained scored of converts.

Well, I’m not writing to preach repentance, but my aim is to advocate a path to “salvation” for the humble prostate gland. The prostate is often the victim of an unwitting owner whose poor eating habits and lack of sufficient exercise are slowly setting up inflammatory processes that can lead to cancer in the prostate or other organs. Today, researchers have revealed a lifestyle Good Book on how to prevent prostate cancer (PCa), but they are not out there dramatically thumping that bible. Instead, they quietly publish the results of compelling studies in academic journals that rarely get the word out to the flock that needs the message: the rest of us. That’s why I’m sharing the Good News in this blog.

The road to prostate salvation

In April, 2023 the respected British Journal of Urology International (BJUI) carried a systematic review of published papers, titled “The Influence of Lifestyle Changes (Diet, Exercise and Stress Reduction) on Prostate Cancer Tumour Biology and Patient Outcomes.”^[i] The authors declare, “The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions.” In other words, most PCa is slow-growing, so the time is now to change your ways if they’re not helping your prostate—or the rest of your body.

What’s particularly good about the BJUI article is its focus on the physiological effects of a healthy lifestyle at the most basic level of the cell and its contents. They brilliantly condense current evidence—much of which I have been citing all along in my blogs—on how diet, exercise and stress management can reduce your odds of developing PCa, and improve outcomes if you already have it.

By focusing on cellular biology, including tumor cells, they get to the heart of the problem: an inflammatory internal environment driven by unhealthy lifestyle choices slowly generates biochemical and genetic alterations that foster the onset of PCa. We’ve known this for 15 years, thanks to a landmark 2008 study by Ornish, et al.^[ii] He and his team demonstrated that a comprehensive lifestyle program they designed actually changed gene expression. The authors of the BJUI paper rely heavily on the findings of what became known as the “Ornish protocol” and the numerous studies that sprang from this seminal work. The experimental, 3-month Ornish protocol featured:

• A vegan diet (with 10% of calories from fat
• Physical activity (walking 30 minutes a day for 6 days a week)
• Stress reduction (yoga, progressive relaxation, breathing, meditation)
• Dietary supplements (vitamins C and E, soy, fish oil, selenium)
• A weekly support group to provide advice and sustain adherence to the program.

The BJUI paper details the Ornish findings when a control group was added and the study extended out for two years. For those on the experimental protocol the results included:

✓4% drop in PSA vs. 6% PSA increase in the control group
✓Decrease in the number of circulating PCa cells in the blood for those on the protocol, vs. no change or increase for the control group

In addition, the Ornish study and others that followed showed that patients with biochemical PCa recurrence (rise in PSA following treatment) had slower rates of PSA increase, and lower PSA values, when compared to recurrent patients not on the program. Also, for Active Surveillance (AS) patients, sticking to the recommended lifestyle changes produced fewer upgrades in repeat AS monitoring biopsies, and lower rates of going off AS in order to receive treatment, with better treatment outcomes for those who did. Finally, as an added bonus, mental and psychological health benefits occurred, too.

Although the BJUI findings did not seem to make their way into the popular media, a medical news story summarized the paper, and concluded that “… the review’s findings support guidelines from, for example, the National Institute of Clinical Excellence (UK), the Center for Disease Control, and the American Cancer Society who are all firm advocates of improved diet and exercise for all cancer patients.” The paper’s authors themselves acknowledge that it’s hard to design a universal program drawn from the 75 studies they reviewed because of variances in study protocols. Nevertheless, the BJUI team writes that “… the evidence that a reduction in body fat with improved diet and PA [physical activity] may reduce the risk of PCa and improve both mental health and oncological outcomes is compelling, especially when interventions include moderate to vigorous PA.” [Emphasis mine.]

What more proof do we need in order to revive prostate salvation? We don’t need a preacher to drive home the message. It’s already out there, and I’m glad to be able to help promote it.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Dovey Z, Horowitz A, Waingankar N. The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review. BJUI Compass. 2023 Apr 6;4(4):385-416.
[ii] Ornish D, Magbanua MJ, Weidner G, Weinberg V et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci U S A. 2008 Jun 17;105(24):8369-74.