Eating more vegetables during active surveillance for early-stage prostate cancer failed to reduce disease progression, results of a randomized trial showed.
Among nearly 500 patients in the MEAL study, those told to consume seven or more servings of vegetables per day had a similar time to progression as a control group that received usual dietary advice (adjusted HR 0.97, 95% CI 0.76-1.25), reported J. Kellogg Parsons, MD, MHS, of UC San Diego Moores Comprehensive Cancer Center in La Jolla, California, and colleagues.
As outlined in JAMA, 43.5% of those in the intervention arm were free of disease progression at 2 years -- defined as a prostate-specific antigen (PSA) increasing to 10 ng/mL or above, a doubling of PSA in under 3 years, or tumor upgrading on biopsy -- versus 41.4% of the control arm, a non-significant difference.
At the 2-year follow-up biopsy, 89.9% were free of tumor upgrading in the intervention arm versus 90.2% of those in the control arm, again a non-significant difference.
"The behavioral intervention in this study produced robust, sustained increases in carotenoid, cruciferous-rich, and leafy green vegetable intake for 2 years, but did not significantly reduce the risk of clinical progression," Parsons' group wrote. "These data fail to support prevailing assertions in evidence-based clinical guidelines and the popular media that diets high in micronutrient-enriched vegetables improve cancer-specific outcomes among prostate cancer survivors."
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depotdoug
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Yeh agree. So stay away from vegetables, no way. I get my potassium, magnesium, iron, B-vitamins, anti-oxidants, digestive system keep flowing healthy fiber, should I go on? No. I’m continuing my rabbit veggie string diet & lean chicken and lots of fishes.
Yes, two other places like vegetables and some fruits.
1) my heart left atria electrical system AFIB prevention veggie help
2) colon, large and small intestines, stomach inner muscles
3) Feet, ankles, lower legs - aids in my super poly-neuropathy blood circulation
4) my 67.75yo mind, chewing crunching hard vegetables or hard fruits it takes my mind(i.e. brain) off of eating cookies, frozen yogurt, donuts holes, high energy calorie protein bars.
"By 1 year, the intervention group reported increases in their average daily vegetable consumption (2.43 vs 0.45 servings), cruciferous intake (43.10 g vs 6.44 g), and total carotenoids (13,839.31 µg vs 2,030.79 µg, P<0.001 for all), with plasma carotenoids measured at 1 year confirming these self-reported data. And these gains were sustained at 2 years."
I saw the report. One has to be careful not to extrapolate too much from the results. But it is a level-1 evidence and fully entitled to its narrowly-defined conclusion.
Overall benefits of a healthy diet, rich in vegetables and fruits is beyond prostate. Keep in mind that 15-20% of deaths in PCa patients is the results of “other” health issues. (See my post on updated STAMPEDE follow up)
Nalakrats, I’m just a novice to this stuff. And I do thrive on all, all your inputs, knowledge.
Ok I’d apologize. I’ve not the writer, should I extract this flawed article. I do think my Prednisone 10mg / day is over stimulating my energy/mind thought. Really apologize for its(article) contents or mid-intents. I will lay low for now, maybe. I do like broccoli and spinach though
He is remarkably upbeat for someone who has been working on this from 2006 - the MEAL study actually kicked off in 2010-11. It seems that the study was not successful, but the methodology was. The ~500 men (from 91 sites) who were coached by the "call center", sustained their vegetable intake levels for 2+ years. So the methodology will probably be used in other studies.
All the men who were under age 60 had Gleason scores of 3+3. If the intervention was ineffective for those men, it would hardly be expected to benefit men with metastatic disease.
At one point in the interview, Kelly says that the men who ate more veg ate less fat - as though that was a desirable outcome - & less meat. Which suggests that those interventions might not show benefit either.
When PCa is diagnosed, many things have already gone wrong in those cells. If micronutrients contained in vegetables has potential therapeutic value, perhaps they need to be applied at pharmaceutical levels, rather than physiological levels (which clearly has not worked)?
"JAMA. 2020 Jan 14;323(2):140-148. doi: 10.1001/jama.2019.20207.
Effect of a Behavioral Intervention to Increase Vegetable Consumption on Cancer Progression Among Men With Early-Stage Prostate Cancer: The MEAL Randomized Clinical Trial.
Parsons JK1, Zahrieh D2, Mohler JL3, Paskett E4, Hansel DE5, Kibel AS6, Liu H2, Seisler DK2, Natarajan L7, White M7, Hahn O8, Taylor J8, Hartman SJ9, Stroup SP10, Van Veldhuizen P11, Hall L12, Small EJ13, Morris MJ14, Pierce JP9, Marshall J15.
Author information
1
Department of Urology, UC San Diego Moores Comprehensive Cancer Center and VA San Diego Healthcare System, La Jolla, California.
2
Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota.
3
Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
4
Comprehensive Cancer Center, Department of Medicine, The Ohio State University College of Medicine, Columbus.
5
Department of Pathology, University of California, San Diego, La Jolla.
6
Division of Urology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts.
7
Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health and UC San Diego Moores Comprehensive Cancer Center, La Jolla, California.
8
Alliance Central Protocol Operations, University of Chicago, Chicago, Illinois.
9
Moores Cancer Center, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla.
10
Department of Urology, Naval Medical Center San Diego, San Diego, California.
11
Menorah Medical Center, Midwest Oncology Associates, Overland Park, Kansas.
12
Siteman Cancer Center, Department of Radiation Oncology, Washington University, St Peters, Missouri.
13
UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
14
Memorial Sloan Kettering Cancer Center, New York, New York.
15
Department of Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
Abstract
IMPORTANCE:
Guidelines endorsing vegetable-enriched diets to improve outcomes for prostate cancer survivors are based on expert opinion, preclinical studies, and observational data.
OBJECTIVE:
To determine the effect of a behavioral intervention that increased vegetable intake on cancer progression in men with early-stage prostate cancer.
DESIGN, SETTING, AND PARTICIPANTS:
The Men's Eating and Living (MEAL) Study (CALGB 70807 [Alliance]) was a randomized clinical trial conducted at 91 US urology and medical oncology clinics that enrolled 478 men aged 50 to 80 years with biopsy-proven prostate adenocarcinoma (International Society of Urological Pathology grade group = 1 in those <70 years and ≤2 in those ≥70 years), stage cT2a or less, and serum prostate-specific antigen (PSA) level less than 10 ng/mL. Enrollment occurred from January 2011 to August 2015; 24-month follow-up occurred from January 2013 to August 2017.
INTERVENTIONS:
Patients were randomized to a counseling behavioral intervention by telephone promoting consumption of 7 or more daily vegetable servings (MEAL intervention; n = 237) or a control group, which received written information about diet and prostate cancer (n = 241).
MAIN OUTCOMES AND MEASURES:
The primary outcome was time to progression; progression was defined as PSA level of 10 ng/mL or greater, PSA doubling time of less than 3 years, or upgrading (defined as increase in tumor volume or grade) on follow-up prostate biopsy.
RESULTS:
Among 478 patients randomized (mean [SD] age, 64 [7] years; mean [SD] PSA level, 4.9 [2.1] ng/mL), 443 eligible patients (93%) were included in the primary analysis. There were 245 progression events (intervention: 124; control: 121). There were no significant differences in time to progression (unadjusted hazards ratio, 0.96 [95% CI, 0.75 to 1.24]; adjusted hazard ratio, 0.97 [95% CI, 0.76 to 1.25]). The 24-month Kaplan-Meier progression-free percentages were 43.5% [95% CI, 36.5% to 50.6%] and 41.4% [95% CI, 34.3% to 48.7%] for the intervention and control groups, respectively (difference, 2.1% [95% CI, -8.1% to 12.2%]).
CONCLUSIONS AND RELEVANCE:
Among men with early-stage prostate cancer managed with active surveillance, a behavioral intervention that increased vegetable consumption did not significantly reduce the risk of prostate cancer progression. The findings do not support use of this intervention to decrease prostate cancer progression in this population, although the study may have been underpowered to identify a clinically important difference.
This Post was prompted by the Ginger thread that WSOPeddie began & to which Neal posted:
"... it's the combination of the compounds in a diet including plenty of fruits & veggies that has the greatest, most synergistic effects."
There are two issues. Can fruit &/or vetables lower the risk of PCa occurrence? If so, can they improve survival after diagnosis?
The second of these is of greatest interest to this group, of course.
The standard treatments tend to rely on the generation of ROS (reactive oxygen species). Most of the plant polyphenol studies show that when NAC (a reliable & powerful antioxidant) was added to an experiment, the benefit ceased - indicating that ROS was involved.
To get the ROS effect, the polyphenols must be at levels where they stop being antioxidants & become pro-oxidant.
I once has a discussion with a guy who felt that cancer could be reversed via a diet rich in antioxidants (physiological levels, not pharmacological levels). His hope was that his PCa cells would become better differentiated (more normal - lower Gleason Number). I don't know if that worked out for him.
I decided that I would stick with the studies & use high-dose supplements.
In my sugar post, I point out that fruit comes with a high sugar burden.
Non-starchy vegetables do not cause a glucose surge. The nutrients:calories ratio make them a valuable component of any diet, IMO. But I doubt that they can have much impact on the cancer.
In a study published this week, involving 15 Prospective cohort studies, "52,680 total cases and 3,205 prostate cancer deaths among 842,149 men":
"Results from this large, international, pooled analysis do not support a strong role of fruits, vegetables ..."
"We did not observe any statistically significant associations for advanced prostate cancer or prostate cancer mortality with any food group (including total fruits and vegetables, total fruits, total vegetables, fruit and vegetable juice, cruciferous vegetables, and tomato products), nor specific fruit and vegetables."
In a 2004 EPIC paper (European Prospective Investigation into Cancer and Nutrition):
"Data on food consumption and complete follow-up for cancer incidence were available for 130544 men in 7 countries recruited into EPIC between 1993 and 1999. After an average of 4.8 years of follow-up, there were 1104 incident cases of prostate cancer."
"... results suggest that total consumption of fruits and vegetables is not associated with the risk for prostate cancer."
In a 2010 Japanese study:
"During 1995-1998, a validated food frequency questionnaire was administered to 43,475 men aged 45-74 yr. During 321,061 person-years of follow-up until the end of 2004, 339 cases of prostate cancer were identified. Consumption of fruits or total vegetables was not associated with a decreased risk of total prostate cancer ..."
"This prospective cohort study suggests that consumption of fruits or vegetables may not be associated with the risk of either localized or advanced prostate cancer in Japanese men."
...
Three large studies that no doubt disappoint many.
Because eating fiber rich and vitamin-mineral rich vegetarian diet controls Obesity, lipids ,diabets and Hypertension. A person on ADT is at high risk for all these conditions.
Keeping body weight to ideal weight (BMI below 22) , keeping lipid profile normal, keeping blood sugar low etc. has a certain positive effect on health,,its clear from studies thus keeping immune sysyem in good shape to fight cancer.
Vegetables and fruits are anti inflmmatory foods and now its well known that high systemic inflammation make prostate cancer grow faster and its prognosis worse.
The type of stale, preserved, preservative loaded meat which putrifies easily is highly pro inflammatory . Excessive colon cancer in meat eaters is a testimony to this fact.
See studies about NLR, PLR and CRP and how they affect prognosis of prostate cancer.
We need to take a big picture about vegetarian diet and refrain from tubular vision of one study. And in big scheme of things, vegetarian diet does body good in many ways.
As for proteins...according to top medical texts an average person needs 1 gram/Kg of protein...anything more is unnecessary burden on kidneys. (Athletes and sportman need 1.5 gm/kg)
Milk, yogurt, cheese,lentils,pulses, beans, chickpeas etc can supply more than enough protein to a person.
Well depotdoug....remember these fake researchers maligned Milk and yogurt and now we have a study of over 48000 people which has proven that milk and milk products DO NOT increase growth of prostate cance
(see Tall Allens post " Cow Juice is OK" in which he mentions about this recent huge study .
Read again Tall Allens post about 6 months ago Heading "cow juice is OK" I say its not just OK ..its good..Milk provides proteins, fat and calcium...and now its clearly proven that it does not promote prostate cancer.
You misunderstand the study. It was among men on active surveillance. No one was on ADT. It showed that 2 years of dietary changes had no effect on cancer progression.
Can I do both? Let Diet help. Let Science help. Let Medical technology help. Let exercise help. Let sleep help.
I'm still trying to comprehend my 29.5 days in with 10mg Prednisone steroid pills effects. Yes, do not knock excess energy. It won't last forever. Just my energized thoughts men.
Its not fixation...do not use freudian terms inappropriately. Its informed choice based on sound scientific evidence that vegetarians live longer and have overall healthier life. I can also say that some people are fixated on dead animal body parts/meat.
Meat eating might fulfils their aggressive impulses and suppressed desire for violence . My point is lets not use freudian words ..for a normal human behavior and label people with with terms like "orthorexia" etc.
I used to immediately after I stopped drinking alcohol (lots and lots of alcohol) due extreme Oreo Cookie eating. The whole package. Extreme cookies add extreme ice cream indulging too. Not doing glutinous indulgence since 2014. Got to stay food habits strong.
Vegetables are not curatives for cancer only a way of reducing the odds. This article lacks any real structure. The idea is not to eat domestic animals or animal byproducts which contain growth hormones to make them grow bigger, fatter and faster. These growth hormones cannot be good for a hormone fed cancer. Eating a plant based diet over time can reduce the odds of getting cancer.
There may not be any "credible " evidence to satisfy you but after 27 on a vegetarian diet and surviving beyond all expectations is all the evidence I need.
I don't understand what your problem is with a vegetarian diet. I have received praise from doctors for my diet.
Eating hormone fed meat from domestic animals to me is counterintuitive for someone with Pca. It's equivalent to someone with with lung cancer who continues to smoke.
Absolutely no problems with vegetables and fruits and nuts and nutritious non-hormone fed food animals. Fish Tuna, Salmon, Sea bass are favorites. Throw in a non -hormone injected ‘no nothing’ in the bird that’s great. Just chicken breast lean no fat no skin no grease. I do love my custom salads I make for lunch.
I have no problem whatever with a vegetarian diet. It's certainly a valid and probably a heathful choice. I'm only saying that there is no credible evidence that it has any oncological benefit for men with prostate cancer. I further believe that men with advanced prostate cancer have enough to deal with without others telling them that there is such evidence that dietary changes will extend their life. What is counter-intuitive to you is just your intuition, not science.
Mag: This site is for those of us who have advanced prostate cancer, so your post is a little off, not withstanding that there is no support for your supposition that eating plants will prevent cancer, but if you have some scientific based research and study outcomes that support what you state, please get it to us here, for we are ALL looking to get cured!!!!
There is enough amino acid ,Taurine in Milk products...vegetarians who consume milk and yogurt can not become taurine deficient.
Being that I have Metastatic castration-resistant prostate cancer, does it really matter wtf I eat? I'm not going to deny myself of foods I enjoy for an extra 6 months of life. I want to die with a cheeseburger in my pocket and face down in a bowl of ice cream.
We don't, that's why I'm eating what I like, not what is supposedly anti cancer food. I'm not going to be on my deathbed wishing I had a double cheese pizza. I'm eating what I like now because I have no idea when my number is going to get called.
Great answer, Fran2020. I’m leaving in 60m for my Church intense Bible academic study group. Never know when, never. But I’m not slowing down until something slows me down. Prednisone 10mg is not.
Yes, I too am Metastatic Castrate resistant Stage 4 PCa, now in Pelvic lymph nodes big time and lesser lymph nodes abdominal. I started The LIVESTRONG Cancer Survivor/patient program at one of my local Y’s this Monday. Tomorrow 09:30 -11:00 a cancer Fitness Health Attitude Focused LIVE - - STRONG.
I’m not eliminating a box of Frozen Chocolate Fudge Yogurt bars or Sausage Biscuits and Gravy Friday AM. Appreciate your attitude Fran2020! From one PCa guy to another PCa guy
Are there any MEAL-like trials for ice cream? I mean really, how do we know whether or not adding extra ice cream to our diet will lower PSA or even reduce bone mets? I volunteer to be in the control group with hot fudge.
Control group in hot fudge clinical research? That would be a 1st for that trial. What if there was an error. Do we start over again? Or change the baseline to cookie dough chocolate chip cones?
Seriously, moderation in dairy foods, I prefer the filet mignon part of the dairy producing animal.
If there is a McDonald's on a MARATHON COURSE I leave the race to get a M&M McFlurry AND double/double Espresso as a chaser then rejoin while eating and drinking.
Well I've been studying hard for my LIVESTRONG fitness assessment test tomorrow @ 09:30. One test is a fast 6 min walk, guess thats's how far you can walk fast.
And balance testing standing on one foot for how long then the other foot for how long? How do you practice for a fitness assessment test for Cancer Survivors like us in The LIVESTRONG program. First step is go to bed Doug. 0:600 Thursday AM is right around the corner, 8 hrs out. Thanks for all the support today guys. It has been a joy to absorb the good the not so good and not so ugly. All useful healthy attitude lifting advices.
No fitness tests for me and never have had a Stress Test in 69.5 years so far but my 177 miles of bicycle riding last Saturday was its own Fitness AND Stress Test in combo.
Sorry to hear your story but thank you for your post.
I HAVE REPEATED MANY TIMES ON THIS SITE, that there is NO cure, NO supplement treatment, including no how much and what one eats that will keep advanced prostate at bay, beyond any short term temporary reduction.
I think it is really important to eat properly in order to assist your body in the war, but also to not go overboard in terms of time spent and the endless search for some magic pill that does not exist-as of today.
I am supportive of any medical treatment that can be proven to actually work, and this testing, by scientific means, not some personal day timer or kitchen recipe.
I also warn against false prophets, some who come onto this site to promote themselves and/or some alternative but unproven treatment, i.e. taking mountains of supplements without any guidelines as to how much to take, how long to take it, when to take it, and when to stop taking his supplement.
Sadly, snake oil salesmen abound, even against those who face the terrible war that is advanced prostate cancer.
Live large Doug, live well and rock on for as long as you can, doing as much as you can!!!
billyboy3 wrote --- "... I am supportive of any medical treatment that can be proven to actually work, and this testing, by scientific means, not some personal day timer or kitchen recipe..."
All I know is that after eating some really fine tasting protein of the 4 legged variety I feel crappier than from the 2 legged variety with the fin type being most beneficial along with the root class.
There is no doubt that proper eating habits make for better living!!!!
We are what we eat. During the early stages with advanced prostate cancer, I believe it important to forgo some of life's pleasures as cancer treatments take a huge toll on our bodies, and we should make every effort to assist it in the war.
That said, at some point, when the dots clearly line up for demise, then put being a glutton on your bucket list-sadly, at that stage, most food does not taste good, or taste at all, so what is one to do??? Live large boys, rock and roll while the sun shines!!!
I am not commenting on anybody else's posts only the original study posted on. I am not a big fan of this study. The only food controlled appears to be the an increase of vegetables. Many other food groups such as sugar, meat, dairy products, saturated fats, and lifestyle factors probably drowned any marginal benefits in noise.
After reading the above posts, I went and had a steak yesterday, for the first time in almost two years. It was a great experience and even though I am now suffering because my system can no longer handle cow, it was still a living memory, damn, there is little better in life than a rare grilled steak!!! -with crispy French fires, and of course some broccoli-had to have some colour!!!!!!
Seriously, I believe there to be some connection to diet and pc, as well as other cancers, for we are what we eat, smoke and drink, again, whenever one negatively impacts the body and/or brain, there will be consequences. That said, for most of us on this site, living large with what will be a shortened life, only makes sense, while we can still ROCK AND ROLL!!!!!!
Cohort study of diet, lifestyle, and prostate cancer in Adventist men.
Mills PK1, Beeson WL, Phillips RL, Fraser GE.
Author information
Abstract
Dietary and lifestyle characteristics were evaluated in relation to subsequent prostatic cancer risk in a cohort of approximately 14,000 Seventh-day Adventist men who completed a detailed lifestyle questionnaire in 1976 and who were monitored for cancer incidence until the end of 1982. During the 6-year follow-up period, 180 histologically confirmed prostatic cancers were detected among some 78,000 man-years of follow-up. Increasing educational attainment was associated with significantly decreased risk of prostate cancer in this study; age at first marriage was also inversely associated with risk, although this was not significant. There was no relationship between body mass index (as measured by Quetelet's Index) and risk. A history of prostate "trouble" was associated with a 60% increase in risk which was highly significant. Although there were suggestive relationships between increasing animal product consumption and increased risk, these results did not persist after accounting for the influence of fruit and vegetable consumption. Nor was exposure to the vegetarian lifestyle during the childhood years associated with alterations in subsequent risk. However, increasing consumption of beans, lentils and peas, tomatoes, raisin, dates, and other dried fruit were all associated with significantly decreased prostate cancer risk.
Like they say all's far in Love and War. Or is it to each his own?
In our case, mine at least. My mind is on overload with Prednisone 10mg/day guy. Yeh, I'm taking super B-complex vits 2tabs twice daily(metabolism and neuropathy helpers). Magnesium 400mg/day to keep me out of AFIB(maybe). Throw in a Calcium 600mg and a Potassium tab and and and.
That's my opinion and i'm sticking to it. Its time to ingest my 2nd Prednisone. Energy surge in the bottle. Should I bring this up to my MO/RN-MO Monday??
Always ate my share of meat. Not particular about which kind. I loved them all. My radiation oncologist swears and preaches vegetarianism. He is healthy looking. My medical oncologist looks like me. He must eat a lot of vegetables.
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