"Recent data have further solidified the association between insulin resistance and prostate cancer with the homeostatic model assessment of insulin resistance."
"Given the recently available data regarding insulin resistance and adipokine influence on prostate cancer, dietary strategies targeting metabolic syndrome, diabetes, and obesity should be further explored. In macronutrient-focused therapies, low carbohydrate/ketogenic diets should be favored in such interventions because of their superior impact on weight loss and metabolic parameters and encouraging clinical data."
Curr Opin Oncol. 2019 Mar 15. doi: 10.1097/CCO.0000000000000519. [Epub ahead of print]
The evolving role of diet in prostate cancer risk and progression.
Kaiser A1, Haskins C1, Siddiqui MM, Hussain A, D'Adamo C2.
Author information
1
Department of Radiation Oncology.
2
Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Abstract
PURPOSE OF REVIEW:
This overview examines the rationale for dietary interventions for prostate cancer by summarizing the current evidence base and biological mechanisms for the involvement of diet in disease incidence and progression.
RECENT FINDINGS:
Recent data have further solidified the association between insulin resistance and prostate cancer with the homeostatic model assessment of insulin resistance. Data also show that periprostatic adipocytes promote extracapsular extension of prostate cancer through chemokines, thereby providing a mechanistic explanation for the association observed between obesity and high-grade cancer. Regarding therapeutics, hyperinsulinemia may be the cause of resistance to phosphatidylinositol-3 kinase inhibitors in the treatment of prostate cancer, leading to new investigations combining these drugs with ketogenic diets.
SUMMARY:
Given the recently available data regarding insulin resistance and adipokine influence on prostate cancer, dietary strategies targeting metabolic syndrome, diabetes, and obesity should be further explored. In macronutrient-focused therapies, low carbohydrate/ketogenic diets should be favored in such interventions because of their superior impact on weight loss and metabolic parameters and encouraging clinical data. Micronutrients, including the carotenoid lycopene which is found in highest concentrations in tomatoes, may also play a role in prostate cancer prevention and prognosis through complementary metabolic mechanisms. The interplay between genetics, diet, and prostate cancer is an area of emerging focus that might help optimize therapeutic dietary response in the future through personalization.
PMID: 30893147 DOI: 10.1097/CCO.0000000000000519
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pjoshea13
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Just to throw out some anecdotal evidence, I lost 10 lbs at the start of treatment due to side effects and have had a fantastic PSA response. I've never been close to obese, but have suspected myself of being "skinny fat" with the fat I do have being in the wrong places.
Since you brought up diet, let's all spend about 7 1/2 minutes with nutrition doctor, Michael Greger, MD, where he reviews research on dairy and cancer, primarily focused on prostate cancer. (All cited sources are noted at the bottom of the video.)
Dairy & Cancer - Michael Greger M.D. FACLM March 13th, 2019 Volume 46
Greger a "nutrition doctor"? More specifically, he is a propagandist for veganism. As such, he uses a lot of spin.
e.g. he refers to the "Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention" study [1]. Watch out when he quotes from a Dean Ornish PCa study. "all patients had a Gleason score of 6". Dr. Myers, speaking of Gleason 6 once suggested: "Don't call it cancer." What relevance is a Gleason 6 study to men with advanced disease? In one PCa intervention study, Ornish even included men with Gleason <6!
He uses the Aune paper [2] "Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies." to show that supplemental calcium is not a PCa risk factor. But the problem of calcium itself occurs when PCa cells have suppressed the internal conversion of calcidiol to calcitriol. Excess calcium suppresses kidney conversion, which effectively starves the cells of hormonal vitamin D. Exactly what the cancer wants.
Greger does not mention Giovannucci [3] "Calcium and Fructose Intake in Relation to Risk of Prostate Cancer".
"Higher consumption of calcium was related to advanced prostate cancer [multivariate relative risk (RR), 2.97 ... for intakes ≥2000 mg/day versus <500 mg/day ...] and metastatic prostate cancer (RR, 4.57 ...). Calcium from food sources and from supplements independently increased risk."
If you place your trust in Greger, watch out.
There is no question that men with PCa should avoid the growth factor IGF-I, but to suggest that non-vegan IGF-I is the sole risk factor & vegan calcium is safe is unnecessary & irresponsible. But Greger can't help himself.
Without question Greger is a "nutrition doctor", and one with a definite and openly expressed point of view. The question to ask might well be: Is an MD who knows little to nothing about nutrition better or worse than a "nutrition doctor" when it comes to advice about diet and lifestyle?
Calcium aside, when it comes to dairy, we seem to be the only species of mammals that drink milk after infancy. (Except, maybe, our pets that we seemingly want to mimic our dietary habits?). So, I guess evolution will eventually have the last word, but in the meantime, I'll get my not-to-exceed RDA calcium elsewhere. Be Well - cujoe
PS you got me on the Ornish reference, re: Advanced PCa. As for why this is useful to advanced PCa patients? Well, while not consistently conclusive, (how many other diet/supplement/hormone/enzyme issues could we say the same about?) there is enough evidence that calcium intake IS an important issue in PCa progression, advanced or regular flavored. And the presence of antibiotics and rBGH in most dairy milk and the implication for the increased inflammation they can cause, would in and of itself, seem to be enough of a reason to shun dairy products. As always, just my 2 cents.
My point re: "nutrition doctor" is simply that Greger will cherry pick for the vegan cause. As long as those who watch his videos know that. It's a good idea to pause the screen when a paper flashes by & pull up the text from PubMed. IMO, he is unreliable regarding PCa.
You & I agree that milk is bad for PCa. The only food that comes with a growth hormone. Does milk actually cause cancer? Maybe not, but when PCa happens that IGF-I growth factor kicks in.
Men with PCa often take vitamin D. Seems to be common knowledge that it might improve survival. Dr. Myers was an early adopter, I believe. But most men seem not to know that the kidneys must be coaxed into making calcitriol. Taking vitamin D & excess calcium can be counterproductive.
For some reason, Greger felt the need to deny that calcium was a problem.
Greger put in a good word for greens as a natural calcium source. Notice that he excluded greens with a significant oxalic acid content. He mostly meant spinach, IMO, but chard is another one. The calcium binds to it. Calcium oxalate kidney stones can be an issue. Too bad - I like spinach more than I like collards, etc.
"Your body doesn't absorb calcium well from foods that are high in oxalates (oxalic acid) such as spinach. Other foods with oxalates are rhubarb, beet greens and certain beans. These foods contain other healthy nutrients, but they just shouldn't be counted as sources of calcium."
Patrick, I know first-hand about the oxalates in spinach, as after my ER visit for kidney stones, I found that the spinach I had been using extensively for salads was at the top of most lists of plant foods to avoid. As a result, I switched over to kale which, as you outline above, has a superior nutrition profile. I now prefer it to spinach and use it for salads, smoothies, and sandwich garnish on a daily basis. For better or worse, I likely get about half my RDA calcium from dairy milk alternatives, organic and non-GMO when I can find it.
As I noted above, there is little doubt that Greger cherry-picks his research. As a result, whenever I suggest his website as a source for nutrition information, I usually state that upfront. (I guess you would rest easier if I formulated a standard warning statement to include on anything from him that I post here?) He does list all the sources for his videos and the comments section are useful as they often point out weaknesses and present contradictory points of view. (And similar to your suggestion above, before I realized he listed sources, I used to pause and write down research titles, so I could find them online.)
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Vitamin D and PCa mortality risk. 
The Dermatologist - The God Diet - PCa
Advice for stopping/slowing PCa progression. 
biopsy - fragmented cores and progression risk 
Diet and Cancer Progression
