What should we tell prostate cancer patients about (secondary) prevention?

To briefly summarize the epidemiologic findings of selected lifestyle factors for prostate cancer progression, metastasis, or death, with a focus on behaviors after diagnosis where possible. We conclude by providing guidance on the lifestyle practices that physicians may wish to prioritize for discussion with their patients.

Growing, but still limited, evidence suggests that lifestyle factors after prostate cancer diagnosis may impact prostate-cancer-specific and overall morality. In particular, smoking and obesity may increase the risk of disease progression and mortality, whereas engaging in vigorous physical activity or brisk walking and consuming a diet rich in vegetables (particularly tomato sauce and cruciferous) and vegetable fats may lower the risk.

Patients should be counseled not to use tobacco products; to engage in daily physical activity; to minimize sedentary behavior; to consume plenty of healthy fats (i.e. fish, nuts, vegetable oils, soybeans, avocados, and flaxseed) and vegetables; to focus on getting nutrients from foods rather than supplements; and to limit refined grains, sugars, processed meat, and high-fat dairy.