Prostate Cancer and Heart Attacks Share Lifestyle Factors

A study of 90,494 U.S. veterans with prostate cancer found that more than half suffered from uncontrolled risk factors for heart attacks (JAMA Netw Open, Feb 24, 2021;4(2):e210070). Almost 30 percent of these high risk patients received no medication or treatment to help prevent a heart attack and its association with cancer progression. Common laboratory indicators of both heart attack and prostate cancer risk include:
• blood pressure higher than 140/90 mm Hg
• LDL cholesterol higher than130 mg/dL
• hemoglobin A1c (an indicator of diabetes) over 5.7

Men who suffer from prostate cancer:
• have a very high rate of heart attack risk factors and heart disease (J Clin Oncol, 2020;38(suppl 6):364; Circulation, 2016;133(11):1104-1114).
• smoke and/or are obese, major risk factors for both heart disease and prostate cancer (J Oncol, 2015;2015:820403).
• are far more likely to die of a heart attack than from prostate cancer (Prostate Cancer Prostatic Dis, 2012;15(1):106-110).

All Men Will Develop Prostate Cancer If They Live Long Enough
More than 180,000 North American men will be diagnosed with prostate cancer this year but only a very small percentage will die from it. More than 50 percent of North American men will develop prostate cancer by age 60 (J Natl Cancer Inst, (2013) 105 (14): 1050-1058). A review of 29 studies showed that five percent of men already have prostate cancer at age 30, while 60 percent of men will have that cancer by age 80 (Int J Cancer, 2015 Oct 1; 137(7): 1749-1757). Prostate cancer, unlike most other cancers, tends to grow very slowly and does not kill the majority of men who have it. In the United States, the average age for men when first diagnosed is 66.

All men should be told that the American Cancer Society and the American Urologic Association recommend that anyone with prostate cancer should be checked for heart attack risk factors (Circulation, 2010;121(6):833-840) and be put on a lifestyle heart attack prevention program (Circulation, 2016;133(5):537-541). This will save lots of lives because prostate cancer is usually a slowly progressive disease and men are more likely to die from a heart attack. Ten years after being diagnosed with prostate cancer, the vast majority of men will survive whether they were treated with surgery, radiation, or “watchful waiting” where they were followed and not treated unless their cancer progressed (New England Journal of Medicine, September 14, 2016).

An Anti-Inflammatory Lifestyle Helps to Prevent or Treat Prostate Cancer and Heart Attacks
Inflammation means that your immune system is active all the time. Your immune system is supposed to be good for you because it prevents germs from getting into your bloodstream, and it seeks out and destroys the millions of defective cells (cancer cells) that everybody produces every day. However, an overactive immune system (too much inflammation) can use its cells and proteins to attack and destroy the DNA in healthy cells, altering them so they may become cancer cells that can overgrow, invade healthy tissue and kill you.

Most recent research shows that an anti-inflammatory lifestyle reduces risk for both developing and dying from prostate cancer. Prostate cancer occurs more often in people with lifestyles that cause inflammation, and people who have been diagnosed with this cancer live longer when they adopt anti-inflammatory lifestyles. A 10-year follow up study shows that men with prostate cancers that are most likely to kill them (Gleason scores 7-10) live longer when they adopt an anti-inflammatory diet (Int J Cancer, May 31, 2016). The Gleason score is a grading system for how abnormal the cells from a prostate biopsy look under a microscope, on a scale from 1-10.

Anti-Inflammatory Lifestyle Rules
To dampen down an overactive immune system:
• Eat a diet that is high in anti-inflammatory foods and low in pro-inflammatory foods
• Get enough vitamin D
• Avoid tobacco
• Restrict or avoid alcohol
• Avoid high blood sugar levels
• Avoid being overweight
• Try to exercise every day

Diet: Anti-inflammatory foods that you should eat include fruits, vegetables, nuts, whole grains (not ground into flour). beans, coffee, tea, and fatty fish such as salmon, mackerel, tuna or sardines. Pro-inflammatory foods to restrict include sweetened beverages and sugar-added foods, foods made with flour and other refined carbohydrates, red meat (meat from mammals), processed meats, fried foods, butter and margarine (BMC Medicine, January 8, 2015;13(3)).

Avoid Vitamin D Deficiency: Vitamin D deficiency blocks insulin receptors to raise blood sugar levels and increase risk for diabetes. Men who have low blood levels of vitamin D are at increased risk for prostate cancer and specifically for the type of prostate cancer that kills (Clinical Cancer Research, May 1, 2014).

Restrict Alcohol: Limiting alcoholic drinks to no more than two per day for men and one per day for women was associated with reduced obesity-related cancers, and particularly breast, prostate, and colorectal cancers (Cancer Causes & Control, January 6, 2015). Data from the Nurses’ Health Study and the Health Professionals Follow-up Study show that small amounts of alcohol increase prostate cancer risk in smokers (British Medical Journal, August 18, 2015).

Keep Blood Sugar Levels Low: Prostate cancer is associated with everything that raises blood sugar levels: metabolic syndrome, diabetes, obesity and weight gain (Cancer Causes and Control, May 14, 2014), lack of exercise, and lack of vitamin D. A high rise in blood sugar causes a marked increase in insulin and IGF-1, hormones that cause cells to multiply and grow to increase cancer risk.

Avoid Being Overweight: Obesity is associated with increased death rate from prostate cancer, more advanced stage disease and higher Gleason scores (Int J Oncol, 2006 Mar;28(3):737-45). Full fat cells produce high levels of potentially cancer causing leptin, interleukin-6 (IL-6), heparin-binding epidermal growth factor-like growth factor (HB-EGF), vascular endothelial growth factor (VEGF) and adiponectin that can cause cancer cells to spread through your body.

Try to Exercise Every Day: A study from Harvard showed that men who participated most frequently in vigorous exercise had a 30 percent reduced risk of developing advanced prostate cancer and 25 percent reduced risk of dying from prostate cancer, compared to those who exercised the least (European Urology, October 22, 2018). Exercise is associated with a lowered risk for prostate cancer and its recurrence (Cancer Epidemiology, Biomarkers & Prevention, January 28, 2015).

My Recommendations
Most of the risk factors for prostate cancer are also risk factors for heart attacks. Every man should try to reduce his risk for both prostate cancer and heart attacks by decreasing his chances for inflammation with the anti-inflammatory lifestyle rules listed above.
Lifestyle Changes Do Help to Prevent Cancers and Heart Attacks
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