Sperling Prostate Center

Prostate Cancer, Coffee, and Fast Caffeine Metabolizers

If you’re wondering what coffee has to do with prostate cancer (PCa) survival, this is the blog for you! I have previously posted about coffee consumption for lowering prostate cancer risk, and its potential to prevent advanced prostate cancer.

Now there’s new evidence that men who are diagnosed with PCa, and who have high coffee consumption, survive longer. But, there’s a catch. It applies more to PCa patients who have a specific genetic constitution for metabolizing caffeine rapidly.

Did you know that when it comes to caffeine intake, some people metabolize it more quickly than others? According to The Sustainable Training Method, “Certain genes can dictate the metabolism of caffeine. Fast caffeine metabolisers take between 4-6 hours to lower caffeine levels by half, the half-life of caffeine. Slow caffeine metabolisers take between 8-10 hours to drop caffeine levels by half.” In other words, some people blow through caffeine quickly (“the jolt”) while others taper off gradually. The difference between fast and slow metabolizers is a gene called the CYP1A2 gene. It regulates a liver enzyme that determines how quickly caffeine is converted to energy in the body. About half the population are born with a variant in this gene that slows it down.

In a new study titled “Coffee Intake, Caffeine Metabolism Genotype, and Survival Among Men with Prostate Cancer,” the authors statistically analyzed a database that tracked 5727 PCa patients from seven US, Australian, and European studies.[i] Patient records included how much coffee they drank (low, high, or very low/none), presence of a particular CYP1A2 gene variant, and greater than six months of follow-up after diagnosis. Among the 5727 cases, there were 906 deaths. Just over half (481) were PCa specific, that is, the patient died from his prostate cancer.

The results were as follows:

  • Compared with slow caffeine metabolizers, fast metabolizers had longer PCa-specific survival, especially for those with high coffee intake.
  • For those with low-risk (localized) PCa, high coffee intake was linked with longer PCa-specific survival.
  • Coffee intake was not significantly liked with longer other-cause survival, but a weak association was suggested between low/no coffee intake and higher risk of PCa progression.

The authors note that their previous studies on the relationship between coffee consumption and prostate cancer demonstrate a PCa-protective benefit attributed to high coffee use, defined as two or more cups per day. In fact, this current study supports their earlier studies. The authors write, “Our prior
work in active surveillance cohorts suggests that coffee intake may be associated with longer progression-free survival for men with the fast caffeine metabolism genotype.” But before you decide to guzzle large amounts of coffee, they also caution that more research needs to be done. Caffeine can have mixed effects on cells, and the pluses may be counteracted by the minuses—though for fast metabolizers this seems less true. They conclude that more research is needed to evaluate coffee and caffeine metabolites, and how these bear on cancer-related outcomes.

In short, if you already enjoy two or more cups of java daily, don’t change what you’re doing based on this blog. Without specific genomic testing, none of us knows whether we get energy quickly or slowly from caffeine. In any case, there is a growing body of evidence that coffee itself has certain anti-cancer benefits. If you’re interested, do your own research—and get your own doctor’s opinion on caffeine in your own situation.

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.

[i] Gregg JR, Kim J, Logothetis C, Hanash S, Zhang X et al. Coffee Intake, Caffeine Metabolism Genotype, and Survival Among Men with Prostate Cancer. Eur Urol Oncol. 2022 Aug 20:S2588-9311(22)00138-9.


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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