The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review

Abstract

Background The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions. Current evidence suggests appropriate changes in lifestyle including diet, physical activity (PA) and stress reduction with or without dietary supplements may improve both disease outcomes and patient's mental health. Objective This article aims to review the current evidence on the benefits of all lifestyle programmes for PCa patients including those aimed at reducing obesity and stress, explore their affect on tumour biology and highlight any biomarkers that have clinical utility. Evidence acquisition Evidence was obtained from PubMed and Web of Science using keywords for each section on the affects of lifestyle interventions on (a) mental health, (b) disease outcomes and (c) biomarkers in PCa patients. PRISMA guidelines were used to gather the evidence for these three sections (15, 44 and 16 publications, respectively). Evidence synthesis For lifestyle studies focused on mental health, 10/15 demonstrated a positive influence, although for those programmes focused on PA it was 7/8. Similarly for oncological outcomes, 26/44 studies demonstrated a positive influence, although when PA was included or the primary focus, it was 11/13. Complete blood count (CBC)‐derived inflammatory biomarkers show promise, as do inflammatory cytokines; however, a deeper understanding of their molecular biology in relation to PCa oncogenesis is required (16 studies reviewed). Conclusions Making PCa‐specific recommendations on lifestyle interventions is difficult on the current evidence. Nevertheless, notwithstanding the heterogeneity of patient populations and interventions, the evidence that dietary changes and PA may improve both mental health and oncological outcomes is compelling, especially for moderate to vigorous PA. The results for dietary supplements are inconsistent, and although some biomarkers show promise, significantly more research is required before they have clinical utility.

The Impact of Physical Activity on the Outcomes of Active Surveillance in Prostate Cancer Patients: A Scoping Review

“…Specifically, observational studies have consistently shown that vigorous exercise after cancer diagnosis leads to more favorable oncological outcomes [29,[38][39][40]. While a recent systematic review conducted by Dovey et al revealed a positive influence of PA on mental health for PCa patients, with 10 out of 15 articles supporting this connection; additionally, concerning oncological outcomes, 26 out of 44 studies demonstrated a positive impact, especially for moderate to vigorous PA, further emphasizing the potential benefits of exercise in the context of PCa [41]. Consequently, it has been incorporated into the ASCO Clinical Practice Guidelines for Prostate Cancer [42].…”

Factors affecting the prognosis of prostate cancer in the United States: results from the national health and nutrition examination survey in 1999-2016

“…In addition to advanced drugs and precise surgery, some common life factors also perform great in uence on the outcomes of patients, such as alcohol consumption, smoking status and BMI [5][6][7]. Although studies have demonstrated the appropriate lifestyle could provide bene ts for the prognosis of individuals with prostate cancer, it's still di cult to make perfect personal life recommendations for patients due to the heterogeneity of this disease and the inconsistent research results [8,9], so we conducted this study to investigate the effects of alcohol consumption, smoking status and BMI on prostate cancer.…”