South Carolina Statewide Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA.
Cancer Epidemiol. 2012 Apr;36(2):e128-36. doi: 10.1016/j.canep.2011.09.008. Epub 2011 Oct 20.
Nearly 35% of men treated for prostate cancer (PrCA) will experience biochemically defined recurrence, noted by a rise in PSA, within 10 years of definitive therapy. Diet, physical activity, and stress reduction may affect tumor promotion and disease progression.
A randomized trial of an intensive diet, physical activity, and meditation intervention was conducted in men with rising post-treatment PSA after definitive treatment for PrCA. Intention-to-treat methods were used to compare usual care to the intervention in 47 men with complete data. Signal detection methods were used to identify dietary factors associated with PSA change.
The intervention and control groups did not differ statistically on any demographic or disease-related factor. Although the intervention group experienced decreases of 39% in intakes of saturated fatty acid (SFA as percent of total calories) (p<0.0001) and 12% in total energy intake (218 kcal/day, p<0.05)], no difference in PSA change was observed by intervention status. Signal detection methods indicated that in men increasing their consumption of fruit, 56% experienced no rise in PSA (vs. 29% in men who did not increase their fruit intake). Among men who increased fruit and fiber intakes, PSA increased in 83% of participants who also increased saturated fatty acid intake (vs. 44% in participants who decreased or maintained saturated fatty acid intake).
Results are discussed in the context of conventional treatment strategies that were more aggressive when this study was being conducted in the mid-2000s. Positive health changes in a number of lifestyle parameters were observed with the intervention, and both increased fruit and reduced saturated fat intakes were associated with maintaining PSA levels in men with biochemically recurrent disease.
近 35%接受前列腺癌(PrCA)治疗的男性在确定性治疗后 10 年内将经历生物化学定义的复发,表现为 PSA 升高。饮食、身体活动和压力减轻可能会影响肿瘤的促进和疾病的进展。
对接受确定性治疗后 PSA 升高的 PrCA 男性进行了一项强化饮食、身体活动和冥想干预的随机试验。采用意向治疗方法比较了 47 名完整数据的男性的常规护理和干预。采用信号检测方法识别与 PSA 变化相关的饮食因素。
干预组和对照组在任何人口统计学或疾病相关因素上均无统计学差异。尽管干预组的饱和脂肪酸(SFA 占总卡路里的百分比)摄入量减少了 39%(p<0.0001),总能量摄入减少了 12%(每天 218 卡路里)(p<0.05),但干预状态对 PSA 变化无差异。信号检测方法表明,在增加水果摄入量的男性中,56%的男性 PSA 没有升高(而不增加水果摄入量的男性为 29%)。在增加水果和纤维摄入量的男性中,在增加 SFA 摄入量的参与者中,83%的 PSA 增加(而在减少或维持 SFA 摄入量的参与者中,44%的 PSA 增加)。
结果在 2000 年代中期进行这项研究时更为激进的常规治疗策略的背景下进行了讨论。干预组观察到许多生活方式参数的积极健康变化,增加水果和减少饱和脂肪摄入与维持生化复发男性的 PSA 水平相关。