Do experts say lifestyle changes can reduce prostate cancer risk?

Yes, many experts have published evidence that there is a powerful connection between lifestyle choices and prostate cancer risk. Lifestyle includes diet/nutrition, exercise, stress management, and strong social support, a lifetime program encouraged by Dr. Dan Sperling and Dr. Eric Walser at the Sperling Prostate Center.

A leading expert is Dr. Dean Ornish, founder and president of the nonprofit Preventive Medicine Research Institute (Sausalito, CA). Dr. Ornish is most famous for his programs that are proven to lower the risk of heart disease and Alzheimer’s disease. In addition, he nearly 20 years of published research specifically presenting the ways in which lifestyle changes slow or even halt early-stage prostate cancer.

When did Dr. Ornish first believe that lifestyle change can impact prostate cancer?

Since the 1990s, Dr. Ornish and his colleagues had evidence from their own work and that of others that diet was connected with prostate cancer risk. They theorized a more comprehensive program of lifestyle changes would have “therapeutic potential in early prostate cancers.”^[i] 

In 1997, they launched a pilot study to test the safety of a program involving low-fat, soy-supplemented vegan diet, stress management, group support and exercise for men with low-risk prostate cancer. Their safety results encouraged designing a formal clinical study.^[ii]

Did Dr. Ornish launch a clinical study to determine the impact of lifestyle on prostate cancer?

Yes, in 2003 Dr. Onish and colleagues launched the GEMINAL (Gene Expression Modulation by Intervention with Nutrition and Lifestyle) study, which ran from 2003-2007.

Thirty men diagnosed with slow-growing, low-risk prostate cancer were enrolled. All of them had already decided, independent of the study, to go on Active Surveillance.

Instead of a treatment intervention, participants were put on a 3-month program of comprehensive lifestyle changes that included low-fat, whole-foods, plant-based nutrition; stress management techniques; moderate exercise; and participation in a psychosocial group support. During the program, normal health tests were done to track weight, blood pressure, PSA, etc.

Each participant had a baseline needle biopsy at the start of the program, and again at three months. The purpose of the biopsy was to extract genomic prostate material (mRNA) for analysis. This differs from a typical prostate biopsy. The purpose of study biopsies was to see the impact on the genes that influence cancer tumor activity, which is called gene expression.

This study design was original and unique for its time because it was an analysis of lifestyle changes at a genetic level to see how they affected health and cancer genes in prostate cancer patients. Study results could help explain exactly why healthy diet and other lifestyle practices lower prostate cancer risks.

What did the GEMINAL study reveal?

The GEMINAL study revealed something remarkable. In only three months, Dr. Ornish and his team found that about 50 genes linked with suppressing tumor activity became more expressed. At the same time, almost 500 genes that promote tumor activity were less expressed.

In fact, many more than just cancer-promoting genes were affected. Gene expressions implicated in conditions like heart disease and inflammation were switched off while disease-prevention genes were switched on.

However, the focus of the study was prostate cancer itself.  The authors concluded “that intensive nutrition and lifestyle changes may modulate gene expression in the prostate.”^[iii]

What is the message for patients?

In a June, 2011 patient newsletter published by a then-existent prostate cancer patient support program, Dr. Ornish wrote:

Because we looked at normal tissue within the prostate (rather than the prostate tumor cells), it is likely that our findings may be generalized beyond men with prostate cancer. … [W]e need larger, longer-term studies—but it’s already clear that you may be able to alter, at least to some degree, how your genes are expressed simply by changing your diet and lifestyle.”^[iv]

Have there been more studies to explore longer-term healthy changes?

Yes. In 2013, five years after the GEMINAL study, 10 of the original participants were compared with a control group composed of 25 men with low-risk prostate cancer who had not been part of the original study. For this later study, Dr. Ornish and his team investigated the length of telomeres.

Telomeres have been likened to the plastic caps on the ends of shoelaces to keep them from fraying. According to the National Human Genome Institute, “A telomere is a region of repetitive DNA sequences at the end of a chromosome. Telomeres protect the ends of chromosomes from becoming frayed or tangled.

“Each time a cell divides, the telomeres become slightly shorter. Eventually, they become so short that the cell can no longer divide successfully, and the cell dies.” This process leads to aging and many aging-related diseases such as heart disease, diabetes, Alzheimer’s disease—and cancer.

When the researchers compared telomere length between the lifestyle-change group and the control group, they found that even after adjusting for age and length of follow-up, the control group had lost more telomere length than the lifestyle-change group. This was true even if adherence to lifestyle changes had not been maintained since the study!^[v] 

What’s the most recent study on lifestyle changes and prostate cancer risk?

In 2025, at a professional conference Dr. Ornish and teammate Dr. Peter Carroll (Professor of Urology, University of California San Francisco) presented the results of their 2-year study with low-risk prostate cancer patients who were on Active Surveillance. The 93 participants were randomly assigned to receive either usual care or to an intensive lifestyle intervention as described above.

As reported in a news story, during the study only 5% of those in the lifestyle intervention group went on to conventional surgery or radiation, compared with 27% in the usual care group.

In addition, “Patients in the intervention group reported improved quality of life, significant decreases in body weight, and improvements in lipid profile, compared with those in the control group.” This demonstrates that the lifestyle participants had additional overall health benefits.

What does the Sperling Prostate Center say about lifestyle and prostate cancer risk?

Under the leadership of Dr. Dan Sperling and Dr. Eric Walser, the Sperling Prostate Center supports the efforts of Dr. Ornish and other experts to affirm that a healthy lifestyle not only promotes better prostate cancer outcomes but also overall robust wellness.

As one blog post puts it, it’s an Influence Your Own Prostate Cancer Party to celebrate “the possibility of a long and happy life thanks to wise choices in what we eat, how often and vigorously we move our bodies, and the ways in which we reduce the impact of negative stress on our quality of life.” In short, up with lifestyle change, down with prostate cancer.

Q: Why is a plant-based diet emphasized in nutritional change?

A: Research evidence on the benefits of plant-based eating continues to accumulate. For example, a Sperling Prostate Center blog describes a 2024 analysis of over 2000 prostate cancer cases showing that that men in the highest 20% of plant-based eating had 47% less risk of PCa progression, and for those with Gleason grade 7 or higher at diagnosis, those in the highest 20% of plant-based diets had 55% lower risk compared with those in the lowest 20%. The authors conclude, “In this cohort study of 2062 men with prostate cancer, higher intake of plant foods after prostate cancer diagnosis was associated with lower risk of cancer progression.”

Q: What does stress management have to do with prostate cancer risk?

A: Today’s life and work pressures generate a constant low-grade “hyperadapted” state. It’s actually a state of anxiety in which the body is on high alert. During this state, levels of certain inflammatory hormones remain higher than in a normal resting state. Creating chronic inflammation in the body sets up conditions for heart disease, diabetes, and cancers such as prostate cancer. On the other hand, effective stress management lowers the inflammatory hormone levels and helps lower disease risks.

Q: Is there a simple way to manage stress?

A: The concept of managing stress sounds simple, but understanding what stress does in the body is not enough. Just as learning a new sport requires practice to improve, so does learning to manage stress. The Sperling Prostate Center offers a free ebook on managing stress, particularly as it relates to prostate cancer.

Content reviewed by Dr. Dan Sperling, M.D., DABR — updated March 2026.

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] 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.
[ii] Ornish DM, Lee KL, Fair WR, Pettengill EB, Carroll PR. Dietary trial in prostate cancer: Early experience and implications for clinical trial design. Urology. 2001 Apr;57(4 Suppl 1):200-1. 
[iii] Ornish (2008), ibid.
[iv] Dean Ornish, M.S. “Changing Your Lifestyle can Change Your Genes.” Prostate Cancer Communication 27:2 (June 2011) pub. by PAACT, Grand Rapids MI, p. 19.
[v] Ornish D, Lin J, Chan JM, Epel E et al. Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. Lancet Oncol. 2013 Oct;14(11):1112-1120.

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.