(1) A whole foods, plant-based diet can help prevent and treat prostate cancer by avoiding alcohol and dairy while emphasizing fiber from vegetables, beans, fruits, and whole grains. Exercise also boosts survival and reduces progression. (2) Dean Ornish found that a low-fat vegan diet halted and reversed prostate cancer progression in some men. (3) Stress management techniques like mindfulness meditation, yoga, spending time in nature, and social support can benefit prostate cancer prevention and treatment by reducing stress.

1. Lifestyle Medicine for
Prostate Cancer
ASHWANI GARG, MD
LIFESTYLE MEDICINE, FAMILY MEDICINE
NORTHSHORE UNIVERSITY LINCOLNWOOD MEDICAL GROUP
FELLOW, INTEGRATIVE MEDICINE

2. Disclaimer
• I am not funded by any corporation, nor would any pharmaceutical corporation
want to fund me.
• The views expressed do not reflect the views of my employer or academic
medical center
• Please discuss any treatment with your own physician
• Some of the treatments discussed are purely experimental and I am not
suggesting their use, but merely presenting them for discussion purposes.

5. To Heal is to “make whole”
• Biopsychosocial approach to medicine
• Many people that are ill are also “broken”
• We need to be alert for the places where someone is broken and to help make
them whole. (Kintsukuroi – Japanese for “Golden Repair”)
• Pain is universal, but suffering optional.

6. General principles of cancer
prevention and treatment
• (1) Heavy alcohol drinking is associated with increased prostate cancer and poor survival of
prostate cancer patients (double the mortality) – ditch the alcohol
• (2) Ditch the dairy and consume soy foods instead. Dairy boosts cancer growth while soy
inhibits prostate cancer cell growth and prevents the formation of the active form of
testosterone (5a-DHT)
• (3) Ditch the low fiber foods, favor the fiber in vegetables, beans, fruits, whole grains,
nuts/seeds. Nutrients inhibit cancer growth and fiber filters out excess hormones – recipes at
CANCERPROJECT.ORG
• (4) Be fit for life – exercise boosts survival and reduces progression! Men diagnosed with
localized prostate cancer who engaged in vigorous activity at least three hours each week had
a 61% lower chance of dying from the illness, compared to men who engaged in vigorous
activity less than one hour a week. (Health Professionals Study)

7. Dean Ornish – early pioneer of
prostate cancer treatment by lifestyle
• Dean Ornish, MD had found that a low fat vegetarian diet could halt and even
reverse heart disease in 4/5 of patients, put prostate cancer to the test next.
• 93 participants with early stage prostate cancer “watchful waiting” following
PSA
• ½ followed lowfat vegan (plant-based) diet along with stress management and
moderate exercise
• NO ONE in the treatment group needed treatment, and PSA fell while 6 of the
nontreatment group needed treatment due to progression of cancer, and PSA
rose 6% in the nontreatment group.

8. FULLPLATELIVING.ORG
Free / paid program that aims for fiber 40gm or more

10. Nutrient Composition
Plant and Animal-Based Foods (Per 500 Calories of Energy)

11. 1. USDA Nutrient Database for Standard Reference.
http://ndb.nal.usda.gov/ndb/.
2. Holden JM, Eldridge AL, Beecher GR, et al. “Carotenoid content of U.S.
foods: an update of the database.” J. Food Comp. Anal. 12 (1999): 169–
196.
3. The exact food listings in the database were: Ground Beef, 80% lean
meat/20% fat, raw; Pork,fresh, ground, raw; Chicken, broilers or fryers,
meat and skin, raw; Milk, dry, whole; Spinach,raw; Tomatoes, red, ripe, raw,
year-round average; Lima Beans, large, mature seeds, raw; Peas,green,
raw; Potatoes, russet, flesh and skin, raw.
Nutrient Composition
Previous Slide References
nutritionstudies.org

14. A Whole Foods Plant-Based Diet: What
to Eat
"One of the most fortunate findings from the
mountain of nutritional research I’ve encountered
is that good food and good health is simple. The
biology of the relationship of food and health is
exceptionally complex, but the message is still
simple. The recommendations coming from the
published literature are so simple that I can state
them in one sentence: eat a whole foods, plant-
based diet, while minimizing the
consumption of refined foods, added salt
and added fats.”
- T. Colin Campbell, PhD
nutritionstudies.org

17. Cancer fighting foods
• Dr. William Li, EatToBeat.Org

18. From Dr. William Li, EatToBeat.Org

22. Cannabinoids and prostate cancer? Something to
discuss with your physician.
• The role of cannabinoids in prostate cancer: Basic science perspective and potential
clinical applications (Indian J Urol. 2012 Jan-Mar; 28(1): 9–14.) Juan A.
Ramos and Fernando J. Bianco
• prostate tissue possesses cannabinoid receptors and their stimulation results in anti-
androgenic effects
• Prostate cancer cells possess increased expression of both cannabinoid 1 and 2
receptors, and stimulation of these results in decrease in cell viability, increased
apoptosis, and decreased androgen receptor expression and prostate-specific antigen
excretion
• Possible effect on cancer related pain (bony metastases)

23. Human breast milk for
prostate cancer? No human
research, but people are
trying this. Research in lab
indicates TNF-related
apoptosis inducing ligand
(TRAIL), a pleiotropic
cytokine, which plays a key
role in the immune system
as well as in controlling the
balance of apoptosis and
proliferation in various
organs and tissues is 100x
higher in breast milk than
blood serum

24. Feet: Exercise
• Goal
• 150 minutes / wk moderate intensity
or 75 min/wk of vigorous intensity
• Greater benefits with 300
minutes/week of moderate or 150
min/wk of vigorous activity
• Muscle strength 2d/week
(https://www.cdc.gov/physicalactivity/basics/adults/index.htm)

25. Sleep health and cancer
• In a study in Iceland (CancerEpidemiology, Biomarkers & Prevention) researchers
found that men with sleep problems were about 1.6-2.1 times more likely to be
diagnosed with prostate cancer
• Sleep medications including Tylenol pm, Benadryl, zzzquil, Xanax, Ativan,
ambien, etc. are linked to cancer
• Natural sleep is best (promote sleep hygiene)

26. Stress
• 70% of primary care visits are related to stress and lifestyle
• Stress can make it less likely to engage in healthy habits
• Healthy habits can improve mood
• Perceived Stress Scale
• 10-question assessment to identify those who need closer follow-up
• 0-13: low
• 14-26: moderate
• 27-40: high

28. Nonpharmacologic stress management
Mindfulness, meditation, relaxation, contemplation
Abdominal breathing
Yoga/tai chi
Spirituality/fellowship
Nature therapy (Shinrin-Yoku)

29. Mindfulness
• Be like an observer of yourself
• Being present in the current moment
• Self-awareness, self-regulation
• Nonjudgement
• 10 minute mindfulness practice daily
• Mindfulness based stress reduction – group classes, usually 8 weeks, 9 sessions

30. Stress management - mindfulness
• Mindfulness is a state of active, open attention on the present. When you're
mindful, you carefully observe your thoughts and feelings without judging them
good or bad. Instead of letting your life pass you by, mindfulness means living in
the moment and awakening to your current experience, rather than dwelling on
the past or anticipating the future.
• The basis of mindfulness is found in the writings of the Greek Stoics and in the
writings of Siddharta Gautama (also known as Buddha) in India.
• Northshore offers a 4-week course in mindfulness (highly recommend) with Dr.
Robert Farra, PhD.

31. TO BE IS TO INTERBE

32. Love
• “Everybody says they love someone else, but nobody says they love themselves”
• Breathe in peace, breathe out love.
• May I be happy.
• May I be safe.
• May I be healthy, peaceful, and strong.
• May I give and receive appreciation today.

33. Love
• Compassion: maintain attitude of kindness, friendliness, gentleness towards self and
others
• Loving, caring relationships are essential in healing, both interpersonal and group
• Alone, we go faster
• Together, we go farther
• Showing compassion to others helps yourself and better outcomes for patients
• Healing presence
• Attitude of gratitude

34. Lifestyle Medicine:
Forks, Feet, Fingers, Stress, Sleep, Love
• Six Habits That Can Add Years to Your Life
• https://www.huffingtonpost.com/david-katz-md/healthy-lifestyle_b_884062.html