Inherited genetic factors explain 58% of variability in prostate cancer incidence [i]. Because of this significant impact, in the below study, the authors investigate how lifestyle factors may mitigate the genetic risk of developing prostate cancer.
American Association for Cancer Research (AACR) Annual Meeting 2021
This research was presented at the 2021 AACR Annual Meeting. This prospective study involved over 10,000 men from the Health Professionals Follow-Up Study. Participants were given a polygenic risk score (PRS) using genotype data to represent genetic risk of developing prostate cancer. They were also given a lifestyle score, with a higher score indicating healthy weight, vigorous physical activity, high consumption of tomatoes and fatty fish, low consumption of processed meats, and lack of smoking. Genetic risk was divided into quartiles and lifestyle score was divided into least healthy, moderate healthy, and most healthy. The authors looked at overall and lethal prostate cancer incidence, with lethal defined as metastatic disease or prostate-cancer specific death, for up to 22 years [i].
The authors found:
1. 2,111 cases of prostate cancer and 238 cases of lethal prostate cancer
2. Those in the highest genetic risk group had a 5.4 times increased risk of overall prostate cancer and a 3.4 times increased risk of lethal prostate cancer compared to those in the lowest genetic risk group
3. Of those in the highest genetic risk group, a healthy lifestyle was associated with a decreased risk of lethal prostate cancer. These individuals had a 3% lifetime cumulative lethal prostate cancer incidence, compared to 6% for those in the least healthy lifestyle group
4. There was no association between healthy lifestyle and decreased risk of overall prostate cancer [i]
For the Patient and Caregiver
In this research, a high healthy lifestyle score includes maintaining a healthy weight, engaging in vigorous physical activity, intake of fatty fish and tomatoes, decreased intake of processed meats, and lack of smoking.
–To help maintain a healthy weight, aim to include vegetables at most of your meals and snacks, lean proteins to keep you satisfied for longer, and measure out healthy fats such as olive oil and nuts, which are very nutritious but have a lot of calories in a small portion.
-Fatty fish include fish such as salmon, tuna, and sardines and are recommended two times per week.
-Processed meats include meats such as bacon, sausage, deli meats, hot dogs, and pepperoni. Try swapping these for other proteins such as fish, grilled chicken, eggs and egg whites, and edamame or tofu.
-Physical activity intensity is measured in metabolic equivalents (METs). Some examples of vigorous physical activity include cycling, hiking, tennis, soccer, and shoveling [ii]. Discuss the intensity of your physical activity with your healthcare team and learn more about physical activity here.
For the Healthcare Team
The authors found that for those in the highest genetic risk category, having a healthy lifestyle attenuated the risk of lethal prostate cancer to 3%, which is half the risk for those with the least healthy lifestyle, and similar to the population average. This is promising as it depicts that those who have a genetic predisposition to developing lethal prostate cancer may mitigate this predisposition through maintaining a healthy lifestyle. One of the study authors, Plym, explains, “men with a high genetic risk may benefit from a targeted prostate cancer screening program, aiming at detecting a potentially lethal prostate cancer while it is still curable” [iii]. More research regarding genetic risk and overall prostate cancer risk is warranted.
[i] Plym A, Zhang Y, Stopsack K, Delcoigne B, Kibel AS, Giovannucci E…Mucci LA. (2021). Can the genetic risk of prostate cancer be attenuated by a healthy lifestyle? [abstract]. In: Proceedings of the 112th Annual Meeting of the American Association for Cancer Research; 2021 April 10-15. Philadelphia (PA): AACR; 2021. Abstract nr 822. https://www.abstractsonline.com/pp8/#!/9325/presentation/1890
[ii] Harvard T.H. Chan School of Public Health. Examples of moderate and vigorous physical activity. https://www.hsph.harvard.edu/obesity-prevention-source/moderate-and-vigorous-physical-activity/
[iii] AACR (2021, April 10). Healthy lifestyle may offset risk of lethal prostate cancer in men with high genetic risk. https://www.aacr.org/about-the-aacr/newsroom/news-releases/healthy-lifestyle-may-offset-risk-of-lethal-prostate-cancer-in-men-with-high-genetic-risk/