DOD PROSTATE: Prostate Cancer Patients Should Heed Cardiovascular Risk Factors

ATLANTA, Sept. 12 -- An early prostate cancer diagnosis should be a cardiovascular wake-up call, said researchers here.

Whether prostate cancer patients are treated with expectant management or definitive treatment, they are more likely to die of non-prostate cancer causes, particularly cardiovascular, said Stephen Freedland, M.D., an assistant professor of urology and pathology at Duke.

"When people hear they have prostate cancer, all their concentration and energy is focused on the cancer," he said at a symposium sponsored by the Department of Defense Prostate Cancer Research Program.

Yet Dr. Freedland noted that 170 out of 100,000 men who are diagnosed with prostate cancer. But, he added, just 32 of those 170 men actually die of prostate cancer. The other 138 men die of something else -- and usually that is cardiovascular disease.

"Non-prostate cancer mortality remains the greatest threat to overall health," said Dr. Freedland. "While all prostate cancer treatments can worsen quality of life, particularly sexual function, dietary and lifestyle interventions can actually improve overall quality of life and have been shown to improve erectile function."

"Given that dietary and lifestyle interventions are known to reduce the risk of heart disease, these therapies for men with low-risk disease are likely to have a greater impact on improving overall survival than any prostate cancer related treatment," he said.

He noted that many patients when told they have prostate cancer, but have opted for expectant management are uncomfortable about doing nothing. "By including dietary and lifestyle modification as part of their treatment, the patient will have an active role in improving his health," Dr. Freedland said. He also said there are studies that indicate weight loss, exercise and dietary changes may improve the course of the cancer itself.

"It is unlikely that such changes will be bad for course of the cancer, and there is a chance that it will be good," he said.

He said that he tells his patients who have elected to undergo expectant management -- and even those who have curative treatment, that they should attempt to lose weight, reduce saturated fat intake, reduce intake of refined carbohydrates, exercise more and stop smoking.

"Men diagnosed with prostate cancer should work on improving their cardiovascular health because more men with prostate cancer will die of heart attacks and strokes than of their cancer," noted Capt. E. Melissa Kaime, M.D., of the U.S. Navy Medical Corps, and deputy director of the Congressionally Directed Medical Research Programs.