Preventive medicine is currently a topical issue. Cardiovascular disease is a well-known example. The identification of atherosclerosis as one of the causative mechanisms of cardiovascular disease has resulted in important lifestyle modifications in diet, tobacco use, and exercise. This has led to a significant decrease in the incidence of heart disease in many countries. Prostate cancer potentially represents an ideal target for chemoprevention because of its long latency. Although the use of new biological strategies is being examined in the context of primary prevention and progression of prostate cancer, it has been suggested that nutrition may also have a role. However, does the weight of
Diet and Prostate Cancer current scientific and clinical data support a relation between diet and prostate cancer? Is there enough evidence for us to be able to advise dietary modifications, such as reduced fat and increased soy protein consumption, and the use of nutritional supplements, for example vitamin E and selenium, to reduce the risk of developing or improve outcomes in prostate cancer?
Some of the data are conflicting. In the case of the suggested link between dietary fat and prostate cancer, the balance of the prospective data is at odds with laboratory investigations, international comparisons, and case-control studies. The value of case-control studies is limited because of the potential for recall bias and confounding. Moreover, these studies have been conducted in different populations, have often had different inclusion criteria, and included questionnaires varying substantially from one study to another. Cohort studies have also been subject to bias depending on the methods used. Large randomized trials would provide the most meaningful data, but these are extremely difficult to carry out in this context because of the lengthy follow-up needed with a disease that may take decades to reveal itself.
Though we are not at a stage where we can justifiably advise patients to, say, cut their fat intake to reduce the chances of their developing prostate cancer, we should not ignore what is already known about the benefits of dietary manipulation. So reducing animal fat and consuming more oily fish may or may not prevent prostate cancer, but we know these measures will reduce the risk of cardiovascular disease. Practical and simple dietary changes should always be encouraged by health professionals because they could improve the overall quality and longevity of the lives of their patients. Although controlled enthusiasm about diets and their effect on specific diseases is appropriate, we must not let ourselves get carried away with the hype that is borne of our politically correct times.
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