Results: Over a median 10.2 years, we observed 219 PCa deaths. Each additional point of one of the PCa-specific health behaviour scores (2015 PCa Behaviour Score) was associated with a 19% reduced fatal PCa risk (HR: 0.81, 95%CI: 0.68-0.97). The 2021 PCa Behaviour Score and scores integrating national recommendations were not associated with fatal PCa.
Conclusions: While a PCa-specific health behaviour score was associated with a reduced risk of fatal PCa, we did not otherwise observe strong evidence of associations between post-diagnostic scores and fatal PCa. Avoiding tobacco, healthy body size, and physical activity may decrease PCa death risk, but further research is needed to inform cancer survivorship recommendations
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cigafred
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'... a cancer diagnosis represents a potential “teachable moment”'.
My observation over the years has been that a PCa diagnosis often (invariably?) leads to some change in behaviour. e.g. this might be as undramatic as taking a vitamin D supplement, or as dramatic as a complete overhaul of one's diet. Sometimes, as with vitamin D, there is a body of PCa scientific evidence to support this, but other-times, as with dietary changes, the trigger might be unrelated to actual PCa evidence - there is a diet guru for every taste.
From the "Background":
"Over 3.1 million men live with diagnosed prostate cancer (PCa) in the United States" - yes, for nonmetastatic PCa, U.S. 5-year survival really is >99%. So why bother to make changes? The fear of a PCa death may be a strong motivator, and maybe even a small change will have an impact over five or more years? From the "Discussion": "It could be that current health behaviours are more important than past behaviours when considering PCa survival in men already diagnosed with PCa."
The "cohort included 4518 men diagnosed with nonmetastatic PCa". "Over a median 10.2 years, we observed 219 PCa deaths." Less than 5% PCa mortality!
From the "Discussion":
"Among the scores evaluated, the 2015 PCa Behaviour Score demonstrated the strongest inverse relationship with fatal PCa. In contrast to the 2021 PCa Behaviour Score that included total physical activity, the 2015 PCa Behaviour Score was operationalized based on vigorous physical activity and brisk walking. The latter also included three dietary factors (processed meat, tomatoes, and fatty fish) that the former did not. Interestingly, the inclusion of processed meat, saturated fat, whole milk, and wine intakes in the 2021 PCa Behaviour Score Including Diet yielded results similar to the score without diet. These results suggest that: (1) dietary factors may contribute less to risk reduction than the combined effects of not smoking, exercise, and body size; and (2) there may be very specific dietary factors or patterns associated with PCa mortality. Unfortunately, there are few studies with data on post-diagnostic diet in men with PCa ..."
***
Dr. Myers pushed a Mediterranean diet, though there is no PCa study. (His own 25 (?) year survival is a testament.)
It is well-known that men with PCa who do not die of it, have a higher risk of death from CVD. Dr. Moyad has often said that "Heart healthy equals prostate healthy," and the PREDIMED study has shown that a Mediterranean intervention diet can lower the risk of CVD events.
If a Med-diet can reduce CVD mortality - & also reduce PCa mortality (I believe that) - what then would we die of?
According to old rodent studies, energy-restricted diets might dramatically extend life-span. Could be more helpful than any of the tinkering with diet that we do.
I was wondering if anyone would rise to the bait. "... what then would we die of?"
I was expecting someone to suggest some more terrible form of cancer. lol
I check out the obituaries in the Times each day. I can't remember if I ever read of someone dying of old age, but I suppose it must happen.
I used to think that my goal in this fight was to “live to die of something other than prostate cancer”. I now understand that I probably have a higher risk of dying from ASCVD than from PCa. (Personal and family history of hypertension and hyperlipidemia, high EBCT coronary calcium score, etc).
That is not an acceptable ending for me. I have been very aggressive in managing by all available modalities including medications (BP meds, high dose statin, low dose Aspirin). My diet choice is a Mediterranean variation, though I do eat substantial red meats and drink wine. Alternating with periods of ketogenic also.
If you are interested in the affects of psychology on cancer I would suggest YOU CAN FIGHT FOR YOUR LIFE by Lawrence LeShan. It's an old book but worth the read.
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