Abstract

Prostate cancer is the most common cancer in men in the US and UK. Most patients are diagnosed with clinically indolent tumours without lethal potential. Substantial evidence suggests that risk factors for lethal prostate cancer differ from those for indolent disease. Growing, but still limited, scientific evidence suggests that exercise and other lifestyle practices after prostate cancer diagnosis may affect prostate cancer specific and overall mortality. Our team at the University of California, San Francisco (UCSF) has collectively built a translational portfolio of research to grow the evidence base through rigorous observational and interventional studies; identify biological mechanisms underlying associations of lifestyle and cancer; and disseminate information to patients via tested methods to improve clinical and psychological outcomes. Factors associated with a possible higher risk of aggressive prostate cancer include body fatness, smoking, and intake of processed meat, saturated fat, selenium supplements, or high-fat dairy; while factors associated with possible lower risk include vigorous physical activity and consumption of vegetable fats, cruciferous vegetables, fish, or cooked tomato products/lycopene. We have initiated several randomised controlled lifestyle-focused trials at UCSF and with external US collaborators and international partners to test whether select factors affect prostate cancer biology and improve patient outcomes, and whether web and text-based approaches can change behaviors. In the future, personalised lifestyle programmes may be provided to patients as adjunctive therapy to standard management options to improve cancer survivorship.