Mayo Clinic Q And A: Treating Prostate Cancer That Spreads
DEAR MAYO CLINIC: I am 63 and was diagnosed with prostate cancer two years ago. I had my prostate removed shortly after the diagnosis. I found out recently the cancer is now in my lymph nodes. What can I do to prevent it from spreading further?
ANSWER: When prostate cancer spreads out of the prostate gland, the most common places for it to occur are in the lymph nodes and bones. Although prostate cancer that has spread can be difficult to cure, treatment is available that may help slow or stop further spread of the cancer.
Prostate cancer is cancer that occurs in a mans prostate gland a small walnut-shaped gland that makes fluid to nourish and transport sperm. Prostate cancer is one of the most common types of cancer in men. It often grows slowly and remains confined to the prostate gland in its early stages. But the cancer may spread if cancer cells break away from the tumor in the prostate and travel to other areas of the body through the lymph system or the bloodstream.
When prostate cancer spreads to the lymph nodes, as in your case, treatment often includes hormone therapy. Radiation therapy or surgery may be necessary in some people, too, depending on an individuals circumstances.
Hormone therapy usually is continued for as long as the treatment works. Over time, prostate cancer may adapt to hormone therapy and begin growing despite treatment. If that happens, your doctor may suggest a different combination of hormone therapy drugs to see if the cancer responds.
Can Any Foods Help With My Prostate Cancer
You may have heard that certain foods might help slow down the growth of prostate cancer or lower the chance of it coming back after treatment, including:
- soya beans and other pulses
- green tea
- tomatoes and lycopene
- cruciferous vegetables
- pomegranate.
With all of these foods, there is some evidence to suggest they might be helpful for men with prostate cancer, but other studies havent shown any effect. This means we cant say for sure whether any of these foods can help. Until theres more evidence that any individual food has an effect on prostate cancer, its best to have a balanced diet that contains all of the food groups.
Avoid Supplements That Your Health Care Provider Has Not Recommended
“A recent survey reported that over 70% of cancer survivors take dietary supplements. But dietary supplements aren’t recommended for cancer prevention or in the cancer survivorship setting,” says Dr. Mussallem. “We want cancer survivors to eat a healthy diet and get all the antioxidants, phytochemicals, vitamins and minerals they need from nutritious food.”
It’s important that people living with and after cancer discuss over-the-counter supplements with their health care provider before adding them to their health regimen, as there could be associated risks, including drug interactions.
“There are a lot of false claims out there. Cancer patients are a good target for this $32-billion industry. There are multiple studies that show that some supplements can actually cause harm,” says Dr. Mussallem.
If you are new to your survivorship journey, making these changes to your diet can feel overwhelming, but Dr. Mussallem encourages you to discuss a nutrition plan with your health care provider and seek support from your network to ensure long-term change.
“As a cancer survivor, I get excited when I make my own healthy plant-based meals and when I work with patients,” says Dr. Mussallem. “It’s exciting to be able to feed and nurture the body. And patients feel better while on a whole-food, plant-predominant diet. To me, that’s the most important outcome: to enjoy life and feel good.”
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Stay Active To Support Prostate Health
In addition to eating a healthy diet, you should stay active. Regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer. And although relatively few studies have directly assessed the impact of exercise on prostate health, those that have been done have concluded, for the most part, that exercise is beneficial. For example:
Get more information and the latest news about prostate health at www.HarvardProstateKnowledge.org.
Newer Treatments For Early
Researchers are looking at newer forms of treatment for early-stage prostate cancer. These new treatments could be used either as the first type of treatment or after unsuccessful radiation therapy.
One treatment, known as high-intensity focused ultrasound , destroys cancer cells by heating them with highly focused ultrasonic beams. This treatment has been used in some countries for a while, and is now available in the United States. Its safety and effectiveness are now being studied, although most doctors in the US dont consider it to be a proven first-line treatment for prostate cancer at this time.
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Mayo Clinic Study Finds Dairy Associated With Higher Risk Of Prostate Cancer
A high consumption of dairy products, like milk and cheese, appears to be associated with an increased risk of prostate cancer, according to new research by the Mayo Clinic published in the Journal of the American Osteopathic Association.
The researchers reviewed 47 studies published since 2006, comprising more than 1,000,000 total participants, to better understand the risks of prostate cancer associated with plant- and animal-based foods. While patterns of association emerged, more investigation is needed to understand the nature and strength of those associations, said John Shin, MD, a Mayo Clinic oncologist and lead author on this study.
Researchers note that prior studies have shown dairy products are the primary source of calcium in Western countries, where rates of prostate cancer are high. Conversely, there are lower rates of prostate cancer in Asian countries, where intake of dairy products is low.
The study authors found no clear association of increased risk of prostate cancer linked to other animal-based foods, including red and white meat, processed meats, and fish. However, they identified a decreased risk of prostate cancer associated with plant-based diets.
The lifetime risk of prostate cancer in the U.S. is 11.6 percent. It has the highest incidence and second highest mortality rate of all cancers in men, with more than 30,000 deaths annually.
History Of The Keto Diet
Over one hundred years ago Dr. Wilder, a doctor at the Mayo Clinic, developed the ketogenic keto diet to treat children with severe epilepsy. Since then, the keto diet has been successfully used around the world to treat drug-resistant epilepsy. In the 1970s, the diet became popular for weight loss thanks to the Atkins diet, which catapulted keto into the weight-loss limelight. While the Atkins diet recommends slowly reintroducing carbohydrate-containing foods back into your eating plan, the keto diet strictly limits these foods at all times.
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Are Carbs Bad For You
Carbohydrates are often thought of as the boogeymen of nutrition contributing to weight gain and high blood sugar, but our bodies rely on carbs to turn glucose into energy. A low-carb diet, such as the keto diet, will be higher in fats. In moderation, carbs are not bad for you and do have nutritional benefits, but it is important to be wary of the types and amount of carbs you are consuming.
What Is The Keto Diet
The keto diet typically limits carbohydrates to less than 50 grams per day , with the remaining calories coming mostly from fat and a moderate amount from protein. Jason Ewoldt, RDN, LD, a wellness dietitian at Mayo Clinic Healthy Living Program explains, When you switch to a high-fat, low-carb diet, your body, by necessity, shifts away from burning carbs for fuel and instead uses fat for energy. This process is called ketosis hence the diet’s name.
When you consider the average American eats 248 grams of carbs a day, and that most of these carbs are coming from highly processed and refined grains, its not surprising weight loss occurs when you cut out large amounts of soda, white flour and baked goods.
So, what does high-fat, low-carb look like on your plate? Think bacon and eggs for breakfast, salami and blue cheese salad for lunch, and fried chicken in creamy zoodles for dinner. What you wont typically find is fruit, cereal, bread, pasta, beans, or even potatoes. Many of these foods may be difficult to weed out of your normal diet making you more likely to have trouble sticking with them over long periods of time. Consequentially, the results that you may have gained while practicing the keto diet can be quickly lost.
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What Types Of Treatments Are Used For Prostate Cancer
If youre diagnosed with prostate cancer, your doctor will help to develop a treatment plan thats right for your individual situation. Its possible that a combination of different treatment options may be used.
They may recommend something called expectant management if your cancer doesnt cause symptoms. During this time, they may monitor your cancer using a variety of tests. Treatment will begin when you develop symptoms or when test results find the cancer is growing.
Other potential treatment options can include:
- Surgery. If you only have cancer in your prostate, your doctor may suggest surgery to remove the tumor or your prostate.
- Radiation therapy. In radiation therapy, high energy radiation is used to kill cancer cells.
- Cryotherapy. During cryotherapy, a special probe is used to freeze and kill cells in your prostate, including cancer cells.
- Hormone therapy. This treatment focuses on blocking hormones that can encourage cancer growth.
- Chemotherapy.Chemotherapy drugs can kill cancer cells or slow down their growth.
- Immunotherapy.Immunotherapy harnesses your immune system to help treat prostate cancer. A type of immunotherapy called sipuleucel-T may be used to treat some types of prostate cancer.
- Targeted therapy. Targeted therapy blocks the activity of certain proteins on or in cancer cells. Drugs called PARP inhibitors may be used to treat some types of prostate cancer.
Whats The Outlook For Prostate Cancer
When prostate cancer is found early, the outlook is quite good. According to the National Cancer Institutes Surveillance, Epidemiology, and End Results Program, the overall 5-year survival rate of prostate cancer between 2011 and 2017 was
SEER breaks down these statistics further based on the extent of the cancer at diagnosis:
- Localized. When cancer remains in the prostate, 5-year survival is nearly 100 percent.
- Regional. If cancer is in the prostate and nearby lymph nodes, the 5-year survival rate is still nearly 100 percent.
- Distant. When the cancer has spread to other organs and tissues, the 5-year survival rate drops to 30.6 percent.
Most prostate cancers are diagnosed when theyre either localized or regional.
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Increase Your Vitamin D
Most people dont get enough vitamin D. It can help protect against prostate cancer and many other conditions. Vitamin D-rich foods include cod liver oil, wild salmon and dried shitake mushrooms. Since the sun is a better, more readily available source of vitamin D, many experts recommend getting 10 minutes of sun exposure every day. Doctors often recommend vitamin D supplements. However, you should talk to your doctor before taking any vitamin or supplement.
What To Expect During Your Appointment
Typically, patients with prostate cancer would need to make a few appointments with specialists at different locations to learn about treatment options. At Wellstars STAT Clinic for Prostate Cancer, men and their partners meet with multiple specialists to discuss treatment options in the same place, on the same day. Heres what to expect:
What is active surveillance?
Advanced treatment & technology
Wellstar invests in state-of-the-art technology to give men with prostate cancer access to leading treatments, including those delivered by CyberKnife, TrueBeam and da Vinci robotic technology as well as brachytherapy, SpaceOAR Hydrogel and innovative genetic therapies.
Da Vinci technology
Hydrogel
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Start With A Balanced Diet That Includes Vegetables Fruits And Whole Grains
“For cancer survivors, we recommend the same diet we recommend for cancer prevention: a low-fat, whole-food, plant-predominant diet that is rich in colorful vegetables and fruits, whole grains, beans and nuts. This diet pattern is essential for optimal health and is good for prevention, treatment and reversal of some chronic diseases, not just cancer,” says Dr. Mussallem.While every patient is different and food preferences vary from person to person, a variety of fruits and vegetables benefit people who have had cancer. Cruciferous vegetables like broccoli, cauliflower, brussels sprouts, cabbage and kale are rich in fiber, which has been shown to lower colorectal cancer risk, and phytochemicals that may protect cells from damage.
“When it comes to creating a plant-based diet, it’s different for each individual and family,” says Dr. Mussallem. “Some people may want to eat 100% plants. Others may want to include some eggs, low-fat dairy, fish or poultry.”
Reduce Sugary Or Processed Beverages
The trouble with fruit juice and other highly processed drinks is that they are low in nutritional value and high in concentrated, sugary calories. Even when juice is labeled as 100% fruit juice, the processing yields something closer to sugary water with few added nutrients.”
“When it comes to juices, you’re stripping away some of the most vital benefits of fruit, and that’s the fiber. Eat the whole fruit. Don’t waste your money on the juice,” says Dr. Mussallem.
The same can be said for soda and other sugary sports drinks, which can contribute to obesity and excess weight. Maintaining a healthy weight can reduce your risk for various types of cancer, including cancers of the breast, prostate, lung, colon and kidney.
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Drugs To Prevent Prostate Cancer
Men with benign prostatic hyperplasia are often treated with dihydrotestosterone -lowering drugs called finasteride or dutasteride. These drugs have been studied extensively to determine whether they can prevent prostate cancer, and results suggest that they could reduce cancer risk by about 25 percent. Patients who develop cancer while on the drugs are more likely to get an aggressive form of the disease, so discuss the advantages and disadvantages with your doctor.
Tips For Nutrition During Cancer Treatment
- Maintain a healthy weight. For many men, this means avoiding weight loss by getting enough calories on a daily basis. For men who are overweight and are obese, this may mean losing some weight. If you are trying to lose weight, it should be moderate, meaning only about a pound a week.
- Get essential nutrients the body needs, such as protein, carbohydrates, fiber, vitamins, minerals, phytonutrients, such as carotenoids, and water. Not only will your body function better, you will feel better.
- Be as active as you can, such as taking a daily walk. If you sit or sleep too much, you may lose muscle mass and increase your body fat, even if you are not gaining weight.
If you are struggling to eat enough or are eating too much, nutrition counseling may help you get essential nutrients, such as protein, vitamins, and minerals into your diet and maintain a healthy body weight. Ask your health care team for a referral to a registered dietitian or nutritionist. Dietitians and other members of the health care team work with people to meet their nutritional needs.
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Five Foods To Protect Your Prostate
Good news if youre worried about your prostate health: What you eat can make a difference. There is plenty of strong evidence that good nutrition and an active lifestyle can reduce the likelihood of prostate cancer and slow its progression, says Mitchell Sokoloff M.D., Chair of the Department of Urology and Professor at the University of Massachusetts Medical School.
There are a few categorical changes you can make to your diet that make a big difference in overall health, as well as prostate health. What you eat can potentially disadvantage your prostate health e.g. foods you might want to avoid or protect the prostate in various ways. The Science of Living Well, Beyond Cancer recommends a diet that is high in colorful vegetables, low in sugar and processed carbohydrates, and moderate in animal-based protein . Some might refer to this as a version of the Mediterranean Diet. PCF-funded epidemiologist Lorelei Mucci, M.P.H., Sc.D., at Harvard T.H Chan School of Public Health notes that people in Mediterranean countries not only eat more vegetables and fruits they also eat less fatty foods, processed food, and red meat categories that can increase insulin resistance, increase inflammation, raise cardiovascular risk and be a part of a dietary pattern that may increase obesity, as well.