Diet in PCa risk and progression

[pjoshea13]

New paper below [1].

It's encouraging to read that:

"Recent data have further solidified the association between insulin resistance and prostate cancer ..."

& that "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."

{visceral obesity - not BMI, which can be misleading for those on a low-fat diet}

"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."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/308...

Curr Opin Oncol. 2019 May;31(3):222-229. doi: 10.1097/CCO.0000000000000519.

The evolving role of diet in prostate cancer risk and progression.

Kaiser A1, Haskins C1, Siddiqui MM2,3, Hussain A4,3, D'Adamo C5.

Author information

1

Department of Radiation Oncology.

2

Department of Surgery, Division of Urology.

3

Baltimore Veterans Affairs Medical Center.

4

Department of Medicine and University of Maryland Greenebaum Comprehensive Cancer Center.

5

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

[AnnieAppleseed]

This week a friend and I will be presenting at the Integrative Medicine for the Medically Underserved conference (IM4US). We will talk about the value of nutrition (WHAT we eat or don't); Physical Activity (how much we move or don't); and stress (how we handle it). There are so many studies showing that all these things matter, and even a few showing that this combination REALLY matters. And it doesn't matter what type of cancer, stage or age or even the treatment we've had. More of this on my all-volunteer cancer nonprofit Annie Appleseed Project. Especially on our continually updated Facebook page. Newsletter too (opt in at website).

[cesanon]

"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."

Very very interesting.

[tom67inMA in reply to cesanon]

Yes, very interesting indeed considering I had a big serving of pasta for lunch yesterday in an attempt to stop further weight loss. Oh well, nice knowing you guys

[EdBar in reply to tom67inMA]

Thanks for the morning laugh!

[monte1111 in reply to tom67inMA]

There you go. If it tastes good eat it. Just don't eat the whole pizza in one sitting.

[Gemlin_ in reply to tom67inMA]

Yes, low-carb diet will, unfortunately, not help cancer patients. All the different cell types in the body use sugar in their metabolism. Cancer cells often divide quickly and thus use more nutrition than other normal cells. Unfortunately, however, you cannot "starve" cancer cells by avoiding carbs/sugar in the diet. In such cases, the body produces its own nutrition from the muscles of the body. In cancer patients who try to eat "healthy", this is shown, for example, by the muscle mass decreases sharply and people become weak and malnourished.

[tom67inMA in reply to Gemlin_]

Agree completely! For those of us on ADT, we have to focus on keeping what muscles we have left well fed, and trust that the lack of testosterone keeps the cancer under control.

That said, I'm not suggesting it's okay to eat unlimited carbs and calories. You want to avoid the situation where you become insulin resistant and end up with elevated baseline levels of insulin and blood glucose. That sort of makes a smorgasbord for the cancer cells.

[taylor123]

I always thought PCa cella preferred to metabolise fat and protein and only favoured glucose when more advanced.

[Gemlin_ in reply to taylor123]

That is my understanding also. Early prostate cancers rely on lipids and other energetic molecules for energy production. In the late stage prostate cancer will begin exhibiting the Warburg effect and have a high glucose uptake.

[pjoshea13 in reply to taylor123]

Healthy prostatic cells use fatty acids - preferentially palmitic acid - & this doesn't change much as PCa develops. The switch to glycolysis tends to be a late event if it occurs.

Glucose is an issue in PCa only to the extent that chronic glucose spike challenges will lead to insulin resistance, which will result in higher levels of insulin, a PCa growth factor.

The easiest way to check insulin resistance is to calculate the triglycerides:HDL-cholesterol ratio.

Barry Sears of ZONE diet fame has said, as I recall, that triglycerides should never be higher than twice HDL-cholesterol.

With high-normal testosterone, a 1:1 ratio can readily be achieved, in my experience - but that's very unlikely while on ADT.

-Patrick

[cigafred in reply to pjoshea13]

My recollection is that I posted, after years on ADT, a ratio of 69:83 on a pescatorian diet with exercise, to which Nalakrats responded with much better numbers.

[cashlessclay in reply to cigafred]

My trig/HDL ratio is 52/62 on a vegan + limited seafood - fast carb diet.

That is the diet that has stopped my PC progression.

My last pre-diet (that was decent, but not great), had a trig/HDL of 205/39.

Diets matter.

[dockam in reply to pjoshea13]

Just checked my Lipid panel from 04/19:

TRIGLYCERIDE

Your value

100 mg/dL

HDL

Your value

74 mg/dL

So, I'm good to go so far - this may be the best it can ever be, while I'm back on ADT.

[Frigataflyer]

Does it ever.

[Frigataflyer]

Thank you Patrick, because of so many PCa related expenses, I have not been following my cholesterol profile. I am certainly going to get retested and start following the Trig/HDL ratio