Originally published Dec. 13, 2016The 2016 blog below reported a theoretical concept that a technology-based program could help overweight men lower prostate cancer (PCa) risk by losing weight. Great idea, but its time apparently had not yet come.In 2020, a team from several notable academic centers designed and tested “a remotely delivered web-based behavioral intervention among men with prostate cancer.”[i]
They enrolled 160 patients who were randomly assigned to four levels: 1) website only, 2) website + personalized diet/exercise prescription, 3) website, personalized prescription, Fitbit, text messages, 4) all of the preceding plus two 30-minute phone calls, 1 with exercise trainer, 1 with registered dietician.
Participants completed questionnaires at baseline, 3 months, and 6 months follow-up. Results: most participants were satisfied with the intervention (lowest in level 1, highest in level 4).
There were small improvements in diet and exercise at 3 months for level 4 participants, suggesting that a thorough program with more personal contact produced best results.
The authors concluded that such a program is feasible, but more study is needed to strengthen the effect and create greater sustainability.
In 2024, a Canadian team designed and tested a 6-month home-based program called PC-PEP (Prostate Cancer—Patient Empowerment Program) (PC-PEP).[ii] 128 PCa patients undergoing treatment were enrolled.
The program consisted of “182 daily emails with video-based exercise and dietary (predominantly plant-based) education, live online events, and 30 min strength training routines (using body weight and elastic bands).”
Wow. The authors found high adherence to the program, leading to significant weight loss compared to men who had only standard of care treatment without PC-PEP.
Do you see yourself as taking responsibility for your health? Do you believe you can reduce the chance of developing prostate cancer—or any cancer, for that matter? Are you aware that being overweight not only puts you at risk of cardiovascular disease, but also of prostate cancer?
The connection between above-normal body mass index (BMI) and greater prostate cancer risks is well-established. Men who have a very high BMI (in other words, are obese) have greater odds of dying from prostate cancer than do men of normal weight. In addition, carrying extra body fat increases the possibility of more aggressive disease, and recurrence after prostate cancer treatment. However, those men who are extremely overweight may be in denial about their bodies. A new study found, among other things, that “overweight and obese men perceived their weight as more normal than their BMI category suggests.”[iii]
The study consisted of administering a survey that gathered information about men’s health history, diet and exercise (and perception of their own habits), current and previous efforts toward healthier behavior, and technology use. The survey also records demographic information such as age, family history of prostate cancer, etc. The goal of the study was to assess possible interest in a technology-driven program for weight loss in order to reduce prostate cancer (PCa) risk.
A total of 109 men returned completed surveys. The data revealed the following statistics about those who took the survey:
- Family history of PCa 25%
- History of elevated PSA 26%
- PCa survivors 22%
- Need for healthier diet 74%
- Want to lose weight 65%
While the researchers found a discrepancy between how men see themselves and how much they really weight, developing a technology-based solution posed a challenge. The survey results indicated a “need and willingness for lifestyle modification and suggest a need for evidence-based weight loss strategies” and a way to address the self-perception inaccuracies, access to technology was inconsistent. The majority of participants had access to internet (92%), but text messaging (60%) and smartphone use (40%) were less used, particularly among men ages 60 and above. Still, the authors believe technology offers possibilities: “A male-tailored intervention that implements technology could improve energy balance, hold men accountable to healthy behavior change, and promote dietary patterns in order to reduce prostate cancer risk.”
At the Sperling Prostate Center, we are incorporating diet and lifestyle information into our prostate imaging and image-guided treatment services. In particular, because we offer Focal Laser Ablation (FLA), we believe that educating our patients on the value of healthy self-care is essential. We can provide a treatment that destroys cancer and preserves quality of life, but when treatment is complete patients must do their part to attain longevity with high quality of life. The above study did not speak to how men who know they carry too much fat will be inspired and energized to lose it. At our Center, we believe that knowledge is motivational.
Many of the patients who come to us are already health-conscious before they even walk through our door. Others, however, find that the possibility of having prostate cancer comes as a wake-up call, and an opportunity to find out how health factors such as being overweight, inadequate exercise habits, and poor nutrition can and should be changed.
Our commitment is to the whole person. Achieving and maintaining a normal BMI is an important investment not just in the walnut-sized prostate gland, but in vitality and long life.
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] Chan JM, Van Blarigan EL, Langlais CS, Zhao S et al. Feasibility and Acceptability of a Remotely Delivered, Web-Based Behavioral Intervention for Men With Prostate Cancer: Four-Arm Randomized Controlled Pilot Trial. J Med Internet Res. 2020 Dec 31;22(12):e19238.
[ii] MacNevin W, Ilie G, Rendon R, Mason R et al. PC-PEP, a Comprehensive Daily Six-Month Home-Based Patient Empowerment Program Leads to Weight Loss in Men with Prostate Cancer: A Secondary Analysis of a Clinical Trial. Curr. Oncol. 2024, 31, 1667-1688.
[iii] Schleper A, Sullivan DK, Thrasher JB, Hoszbeierlein JM et al.Weight Management to Reduce Prostate Cancer Risk: A Survey of Men’s Needs and Interests. Cancer Clin Oncol. 2016 May;5(1):43-52.
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.
