Stephen J. Freedland, MD, highlights the role of diet in prostate cancer management

In this video, Stephen J. Freedland, MD, a professor of urology at Cedars-Sinai in Los Angeles, California, reviewed evidence on dietary patterns and their relationship to prostate cancer risk and outcomes.¹ He emphasized that no single diet has been definitively proven, through randomized controlled trials, to prevent prostate cancer. Instead, most data come from observational studies, which show modest associations.

Among men without prostate cancer at baseline, healthier dietary patterns appeared somewhat protective. Diets rich in tomatoes, fatty fish, and lower in processed meats were linked with reduced risk, whereas inflammatory or Western-style diets correlated with increased risk. However, the associations were not strong, and some findings were unexpected—such as one study suggesting that adherence to a Mediterranean diet was linked to higher detection of localized prostate cancer, likely due to greater health awareness and screening among those patients. Overall, dietary choices may influence inflammation and, in turn, prostate cancer risk, but the effects are relatively small and not sufficient to prevent the disease outright.

For men who already have a diagnosis of prostate cancer, dietary choices may play a role in disease progression and survival, though evidence again comes primarily from observational studies. Western and highly processed diets were consistently associated with worse outcomes, including higher prostate cancer–specific mortality. Conversely, adherence to Mediterranean or plant-based diets was linked with reduced all-cause mortality and possibly slower progression in men on active surveillance. Diets that lower insulin levels and inflammation—whether plant-based or low-carbohydrate—may share similar biological mechanisms despite differing in composition.

Freedland cautioned that diet should be viewed as one piece of a larger treatment strategy. Although healthy eating may modestly improve outcomes and support overall well-being, it is not a substitute for appropriate medical therapy, particularly in men with aggressive disease.

REFERENCE

1. Lin P-H, Burwell AD, Giovannucci EL, et al. Dietary patterns in prostate cancer prevention and management: A systematic review of prospective cohort studies and randomized clinical trials. Eur Urol. 2025 Aug 19:S0302-2838(25)00433-6. doi:10.1016/j.eururo.2025.07.017