Abstract
Objective
To investigate the influence of targeted serum vitamin-D level and omega-6:3 fatty-acid
ratio on prostate-specific antigen (PSA) level in men with prostate cancer managed
with active surveillance by providing a nutritional intervention and vitamin supplementation.
Methods
Sixty-eight patients with biopsy-proven National Comprehensive Cancer Network very-low
or low-risk prostate cancer were enrolled in the prostate cancer nutrition and genetics
clinic at the Cleveland Clinic from July 2013-December 2019. Patients adhered to a
specific dietary regimen devoid of animal-based products and foods containing omega-6
polyunsaturated fatty acids (PUFAs). The supplement regimen consisted of: Omega-3
PUFAs 720mg (3/day); curcumin 2000 mg/day; vitamin D3 dose titrated to achieve serum
level of 60 ng/ml; and vitamin B-complex 1000 mg (4 times weekly). Patients underwent
periodic monitoring of PSA, serum vitamin D, and PUFA levels and had frequent follow-up
with the nutritionist which included a food frequency questionnaire. Interval prostate
biopsy was performed as clinically indicated and/or at 9 months.
Results
The mean and 95% confidence interval of PSA slope and Vitamin D serum levels slope
were 0.11 (0-0.25) ng/mL/month and 4.65 (3.09-5.98) ng/mL/month, respectively. Patients
with higher initial vitamin D levels were twice as likely to have a downward PSA trend
(OR = 2.04, 95% confidence interval 1.04-4.01, P = .04). Fifty-five patients underwent follow-up biopsy, all showing no progression
of disease. Three patients had loose bowel movements that required omega-3 and or
curcumin dose adjustments.
Conclusion
Intensive nutritional intervention with Vitamin D and Omega-3 PUFA supplementation
may benefit men on active surveillance for prostate cancer and further studies are
warranted.
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Article info
Publication history
Published online: June 15, 2021
Accepted:
April 1,
2021
Received:
February 9,
2021
Footnotes
Financial Disclosure: None of the authors have any disclosures or conflicts of interest to report.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
