Abrams Donald I
Division of Oncology, Department of Medicine, Zuckerberg San Francisco General Hospital and UCSF Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA.
J Altern Complement Med. 2018 Sep/Oct;24(9-10):872-880. doi: 10.1089/acm.2018.0169.
The mostly indolent natural history and long overall survival associated with a diagnosis of prostate cancer provides a unique opportunity for men to explore diet and lifestyle interventions to alter the trajectory of their disease. As many patients may be appropriate for postponing conventional therapy, the effects of various integrative interventions can be investigated. In addition, treatment of prostate cancer with surgery, radiation, or androgen deprivation therapy, all may produce physical or psychological side effects that could be amenable to complementary therapies. This article serves to review salient information in the published literature.
A review of published research was conducted.
A plant-based antioxidant-rich diet with an emphasis on cruciferous vegetables, tomatoes, soy, pomegranate, and marine omega 3 fatty acids while avoiding saturated fats, including dairy products is the best option. Supplementation with vitamin D3, omega 3, and some nutraceutical-based preparations may be advised. It is likely prudent to avoid vitamin E and selenium supplements. Physical activity has been shown to have multiple benefits in men diagnosed with all stages of prostate cancer from strengthening bones, improving body habitus, and enhancing overall wellbeing. Yoga, combining physical activity with a mind-body component, has been shown to have a salutogenic effect in both prostate cancer patients and their caregivers. Traditional Chinese Medicine may be particularly useful in managing side effects of conventional treatments, especially the hot flashes associated with androgen deprivation therapy. Although the long natural history, availability of a useful blood marker of disease progression and prolonged survival are overall positive features, they also combine to allow men to live for a long time with diagnosed cancer, fear of progression, or recurrence and fixation on changes in their prostate-specific antigen level. The resultant stress can be deleterious to general health as well as possibly the natural history of their disease. Mind-body interventions to reduce stress, including mindfulness-based stress reduction and support groups may be useful adjunctive therapies.
Men with prostate cancer may benefit from lifestyle and complementary interventions integrated with their conventional care.
前列腺癌诊断所具有的大多进展缓慢的自然病程和较长的总体生存期，为男性探索饮食和生活方式干预措施以改变疾病发展轨迹提供了独特机会。由于许多患者可能适合推迟传统治疗，因此可以研究各种综合干预措施的效果。此外，用手术、放疗或雄激素剥夺疗法治疗前列腺癌，都可能产生身体或心理副作用，而这些副作用可能适合采用补充疗法。本文旨在综述已发表文献中的重要信息。
对已发表的研究进行综述。
最好选择以植物为基础、富含抗氧化剂的饮食，重点是十字花科蔬菜、番茄、大豆、石榴和海洋欧米伽3脂肪酸，同时避免饱和脂肪，包括乳制品。可能建议补充维生素D3、欧米伽3和一些基于营养保健品的制剂。避免补充维生素E和硒可能是谨慎之举。体育活动已被证明对诊断为各个阶段前列腺癌的男性有多种益处，包括增强骨骼、改善身体状况和提高整体幸福感。瑜伽将体育活动与身心调节相结合，已被证明对前列腺癌患者及其护理人员都有有益健康的作用。传统中医在管理传统治疗的副作用方面可能特别有用，尤其是与雄激素剥夺疗法相关的潮热。尽管疾病进展缓慢、有可用的疾病进展血液标志物以及生存期延长这些总体特征是积极的，但它们也使得男性在被诊断患有癌症后长期存活，担心疾病进展或复发，并执着于前列腺特异性抗原水平的变化。由此产生的压力可能对总体健康以及疾病的自然病程都有害。减轻压力的身心干预措施，包括正念减压和支持小组，可能是有用的辅助疗法。
前列腺癌男性患者可能会从与传统治疗相结合的生活方式和补充干预措施中受益。
