The UroOnc Minute: Diet and Prostate Cancer, with Stephen J. Freedland, MD

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, speaks with Stephen J. Freedland, MD, professor of urology at Cedars-Sinai Medical Center, Los Angeles, California, about the role of diet and nutrition in prostate cancer risk and outcomes—one of the most common topics patients raise in clinic.

Freedland reviews the current evidence base, noting that despite widespread interest, high-quality data linking specific dietary patterns to prostate cancer prevention or progression remain limited. Drawing from a recent systematic review that he and his colleagues published in European Urology,¹ he explains that observational studies suggest potential benefits from healthier, lower-inflammatory eating patterns, often plant-forward or Mediterranean-style diets. However, results are inconsistent, and randomized trials have generally been small and focused on intermediate end points rather than hard clinical outcomes.

The conversation then shifts to real-world clinical counseling. Freedland outlines a pragmatic approach to patient discussions, emphasizing core lifestyle principles such as reducing simple sugars, avoiding trans fats, maintaining a healthy weight, exercising regularly, and smoking cessation. For patients seeking more detailed guidance, he highlights the importance of involving dietitians and exercise physiologists to provide individualized, evidence-based support beyond brief clinic conversations.

Looking ahead, Freedland points to a growing shift toward prospective clinical trials in nutritional oncology. He discusses emerging studies evaluating dietary interventions such as fasting-mimicking diets in patients with metastatic hormone-sensitive prostate cancer (NCT05832086), with end points including deep prostate-specific antigen responses, which has shown to be correlated with survival. While challenges remain in studying complex dietary patterns, Freedland anticipates that ongoing and future trials will help clarify how nutrition can be meaningfully integrated into prostate cancer management.

REFERENCE

1. Lin PH, 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;88(6):571-588. doi:10.1016/j.eururo.2025.07.017