Dr. Hamilton-Reeves on the role of diet and exercise in patients with prostate cancer


"The point is healthy, adaptive changes that are sustainable, that you can keep off, because we don't want that rebound/regain," says Jill M. Hamilton-Reeves, PhD, RD, CSO.

In this video, Jill M. Hamilton-Reeves, PhD, RD, CSO, shares the take-home message from the Journal of Urology paper “Impact of Weight Management on Obesity-Driven Biomarkers of Prostate Cancer Progression.” Hamilton-Reeves is an associate professor of dietetics and nutrition at the University of Kansas Medical Center in Kansas City.


What is the take-home message for the practicing urologist?

I work with a lot of different patient groups and prostate cancer survivors and people that are going through prostate cancer, and there's a lot of conversation about the role of diet and exercise. And sometimes, I think that it's important for clinicians to realize the agents of change that they really can be, that if patients are asking them, "I'm going to do all these things, I'm going to do what you say. We've decided together that this is the best treatment approach. What else can I do for my health?" To have that conversation and [tell them], "There are some early data suggesting that if you really work to make your diet as healthy as you can, and move more, and make those changes and get the support you need to really take care of yourself, you might just overall feel better, like emotionally, and then also, your body might withstand this better." I really think that's probably the key take-home message from that. I feel like that's also what my ambassadors and patients have reported back to us after this trial, because we keep talking to them, we follow up with them. At first, it was every 6 months, and then every year afterwards, because we do want to see if there's differences in rates of recurrence. And at that time, we also asked them what their efficacy is for keeping these kinds of dietary habits. Did they learn what they needed to learn? Are they still able to make those choices? Same thing with exercise. What technology are they still using to assist them? And that's been really interesting to hear how different people have taken what they've learned, and they've made it their own to be a lifestyle change for them.

Is there anything you would like to add?

I didn't mention that a lot of the cardiovascular disease markers did also change. I think I probably said that with the assuming role that if they lost that amount of weight that they would. We did find things like cholesterol and other markers like that to improve with this intervention as well. So I think that's probably an important take-home message. I also think it's important to mention the population data that we looked at to justify this trial. There have been population studies, or when you look at large cohorts of patients at 1 time point or a couple of time points, and there have been some interesting data showing that visceral adipose tissue is related to increasing the risk of fatal prostate cancer. Even though I can't say that if you lose that tissue, that would decrease your risk of dying from fatal prostate cancer, I think that understanding that that was part of the justification for why we wanted to focus on diminishing that visceral adipose tissue or that abdominal tissue. I think another thing that's important is that sometimes people have unhealthy relationships with food and exercise. And so the healthy aspects of coping are what we were trying to promote, and having a coach and someone there to kind of rein people in if they went a little too far was also really helpful. If you're a person that goes to extremes, like all in all not, knowing that, having a coach or a dietitian help you might be a good idea so that you really maximize the goodness out of making these lifestyle changes. The last thing is, one of the reasons our design was different than some of the prior work that looked at weight loss prior to prostatectomy is we really wanted to help the guys keep that weight off after surgery, because there are, again, some population studies that have shown that if you gain weight after prostatectomy, that that increases your risk of prostate cancer recurrence. And so I want to drive home the message that we're not going for like a Hail Mary bootcamp, like how much you can lose, and then you gain it right back, because that's not the point. The point is healthy, adaptive changes that are sustainable, that you can keep off, because we don't want that rebound regain. That might be as harmful as being obese in the first place, I don't have data to say like apples to oranges or anything like that. But there are data saying obesity is related to progression and there are data saying regain of weight is related to progression as well.

This transcription was edited for clarity.

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