Clinical Events in Prostate Cancer Lifestyle Trial: Results From Two Years of Follow-Up

OBJECTIVES Previous research has demonstrated that patients with prostate cancer participating in the Prostate Cancer Lifestyle Trial had a reduction in prostate-specific antigen (PSA) levels, inhibition of LNCaP cell growth, and fewer prostate cancer-related clinical events at the end of 1 year compared with controls. The aim of this Study was to examine the clinical events in this trial during a 2-year period. METHODS The Prostate Cancer Lifestyle Trial was a 1-year randomized controlled clinical trial of 93 patients with early-stage prostate cancer (Gleason score <7, PSA 4-10 ng/mL) undergoing active Surveillance. The patients in the experimental arm were encouraged to adopt a low-fat, plant-based diet, to exercise and practice stress management, and to attend group Support sessions. The control patients received the usual care. RESULTS By 2 years of follow-up, 13 of 49 (27%) control patients and 2 of 43 (5%) experimental patients had undergone conventional prostate cancer treatment (radical prostatectomy, radiotherapy, or androgen deprivation, P < .05). No differences were found between the groups in other clinical events (eg, cardiac), and no deaths Occurred. Three of the treated control patients but none of the treated experimental patients had a PSA level of >= 10 ng/mL, and I treated control patient but no treated experimental patients had a PSA velocity of >2 ng/mL/y before treatment. No significant differences were found between the untreated experimental and untreated control patients in PSA change or velocity at the end of 2 years. CONCLUSIONS Patients with early-stage prostate cancer choosing active Surveillance might be able to avoid or delay conventional treatment for at least 2 years by making changes in their diet and lifestyle. UROLOGY 72: 1319-1323, 2008. (C) 2008 Elsevier Inc.