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Diet and Prostate Cancer Prevention

Diet and Prostate Cancer Prevention. Mr Shomik Sengupta MB MS, FRACS (Urol) General, Oncological and Minimally Invasive Urological Surgeon Director of Training & research, Austin Hospital , Urology Unit Oncology Advisory Group leader, USANZ University of Melbourne, Department of Surgery

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Diet and Prostate Cancer Prevention

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  1. Diet and Prostate Cancer Prevention Mr Shomik Sengupta MB MS, FRACS (Urol) General, Oncological and Minimally Invasive Urological Surgeon Director of Training & research, Austin Hospital , Urology Unit Oncology Advisory Group leader, USANZ University of Melbourne, Department of Surgery Ludwig Institute for Cancer Research

  2. Overview • Background • Evidence • Nutrients • Food groups • Medications • The “Prostate” diet

  3. Introduction • Prostate ca. epidemiology (‘09) • 5609 cases – commonest • 816 deaths – 3rd (2nd for men) • Risk factors • Age • Family history • Race • Country of residence

  4. What patients ask • High PSA – “what can I do to bring it down?” • New diagnosis of cancer • “Are there natural treatments?” • “What can I do to improve my chances?” • Treatment failure –> the search for the miracle “cure”

  5. The evidence • Principally – epidemiologic • Regional/ethnic variation • Migrant studies • Cohort studies (eg Health professionals study) • Case-control studies • Very limited numbers of randomised trials

  6. Macronutrients / foods The Good The Bad • Fat – esp saturated • Red meat – esp charred • Total energy • ?Dairy products • Fibre • Isoflavones (soy) • Lycopenes (tomatoes) • Green tea • Cruciferous vegetables • Pomegranate juice

  7. Micronutrients / vitamins The Good The Bad • Vitamin E • ?Selenium • ?Calcium • ?Vitamin A (esp high dose) • Vitamin C • ? Zinc • Vitamin D • ?Fish oil/omega-3 FA

  8. Medications • Aspirin • COX-2 inhibitors • Statins • 5-alpha reductase inhibitors: Dutasteride & Finasteride •  cancers, but •  high-grade cancers

  9. So… what to tell patients? • Preventing prostate cancer • Likely long lag-time • i.e. needs “public health” approach • “Bringing down the PSA” • Irrelevant & dangerous! • After diagnosis – surveillance/treatment/recurrence… • The Prostate Diet??

  10. The cardiac-prostate axis • The no. 1 cause of death among prostate cancer patients: Cardiac disease • “Heart healthy is prostate-healthy” – Dr Mark Moyad

  11. My advice to patients • Regular exercise  healthy wt • Balanced “pyramid” diet: • Minimise fat & refined sugar • Reduce meat • 3 serves dairy – low fat • Fresh fruit & vegetables (2+5) • Fibre-containing carbohydrates • Alcohol in moderation

  12. My advice… cont’d • ?Standard multivitamin • ?Vit D / Calcium – only if deficient / consider strongly for ADT patients • Statin if indicated for lipid profile • Aspirin if indicated for cardio-vascular risk

  13. Thank You Mr Shomik Sengupta MB MS, FRACS (Urol) Urological Surgeon Director of Training & research, Austin Hospital , Urology Unit Oncology Advisory Group leader, USANZ University of Melbourne, Department of Surgery Ludwig Institute for Cancer Research

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