Your Prostate Cancer Handbook

Reducing your risk of prostate cancer

Self-care practices are the foundation of risk reduction, and some complementary therapies may also reduce risk. Please also review the Safety and precautions page within the linked reviews for guidance on safe use. We recommend supervision from a medical professional trained in the use of complementary therapies.

Details of the evidence supporting the statements are available through the image links.

Strong, good, or modest evidence of benefit for reducing cancer risk

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) indicates confidence that the practice or therapy has an effect as noted. Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.

Healthy lifestyle: modest evidence

Eating Well: strong to weak evidence

• Lower risk of prostate cancer among people with higher serum concentrations of enterolactone, a metabolitea substance made or used when the body breaks down (metabolizes) food or chemicals of plant lignansfiber-associated compounds found in many plant families and common plant-based foods, including grains, nuts, seeds, vegetables, tea, coffee, and wine (modest evidence)
• Lower risk of prostate cancer among men with the highest intake of total vegetables or of quercetin or lignan precursors in foods (preliminary evidence)
• Slightly higher risk of prostate cancer, but moderately higher risk of advanced prostate cancer, among people eating the highest levels of red or processed meats (good evidence)
• Higher risk of prostate cancer among people eating higher levels of foods with trans-fats found in most shortening, fried food, margarine, microwave popcorn, and many baked goods (modest evidence)
• Higher risk of prostate cancer, with stronger effects for Gleason grade higher than 6 or higher grade tumors, among people eating a Western dietary pattern (high intake of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, convenience food, and sauces and low intake of low-fat dairy products and whole grains) (weak evidence)
• No evidence of an effect on risk of prostate cancer among people eating higher levels of ultra-processed foods such as pastries, sweet or salty snacks, breakfast cereal, sweetened drinks, sweetened yogurt, hot dogs or meat nuggets, sausages, and other highly processed foods
• Slightly higher overall prostate cancer risk, but no effect on risk of advanced prostate cancer, among people eating higher levels of dairy protein (modest evidence)
• A higher risk of fatal prostate cancer, but no evidence of an effect on risk of overall prostate cancer among people eating the highest levels of eggs (good evidence)

Risk of cancer as a whole:

• Lower risk of cancer among people eating fermented dairy foods (yogurt, kefir, cultured cheese)
• Lower cancer risk among people following anti-inflammatory diets compared to pro-inflammatory diets (good evidence)
• Lower risk of cancer as a whole among people eating the highest levels of olive oil (good evidence)
• Moderately lower risk of cancer as a whole among people eating mushrooms (modest evidence)
• Higher risk of cancer as a whole among people drinking higher levels of sugar-sweetened beverages (modest evidence)
• Higher risk of cancer as a whole among people eating higher levels of ultra-processed foods such as pastries, sweet or salty snacks, breakfast cereal, sweetened drinks, sweetened yogurt, hot dogs or meat nuggets, sausages, and other highly processed foods (good evidence)

Cancer mortality among people without cancer at the start of a study:

• Lower cancer mortality among people regularly eating chili peppers (strong evidence)
• Lower cancer mortality among people following a diet high in vegetables—but not starchy vegetables—and fruits before diagnosis (good evidence)
• Lower cancer mortality among people drinking several cups of coffee per day (good evidence)
• Higher cancer mortality among people eating higher levels of saturated fats (good evidence)

Risk of cancer as a whole:

• A lower risk of a cancer diagnosis among people with higher levels of physical activity (strong evidence)

Cancer mortality among people without cancer at the start of a study:

• Lower cancer mortality among people without cancer at baseline and who had the highest levels of physical activity (strong evidence)

Recommended in a clinical practice guideline; see guidelines below

Managing Stress: mixed evidence

Risk of cancer as a whole:

• Lower risk of cancer as a whole among people with better stress-management skills (good evidence)

Sleeping Well: mixed evidence

Creating a Healing Environment: mixed evidence

• Higher risk of prostate cancer among people exposed to dioxin (TCDD) (modest evidence)
• Higher risk of prostate cancer among people working at night (preliminary (conflicting) evidence)

Risk of cancer as a whole:

• Higher risk of cancer as a whole among people exposed to dioxin (TCDD) (strong evidence)
• Higher risk of cancer, including secondary cancer, among people receiving radiation therapy  (strong evidence)
• Higher risk of cancer as a whole among people exposed to wood dust (strong evidence)
• Slightly higher risk of solid cancers among adults exposed to low cumulative doses  of ionizing radiation (modest evidence)
• Slightly higher risk of cancer as a whole among people living in urban areas characterized by higher concentrations of polycyclic aromatic hydrocarbons (PAHs) (modest evidence)
• Higher risk of childhood cancer among children exposed to PAHs from playgrounds surfaced with poured rubber (preliminary evidence)
• Slightly lower risk of cancer and cancer-related death as a whole among people ever using hair dye (weak evidence)
• Insufficient (conflicting) evidence of lower risk of cancer among adults eating organic foods 
• No evidence of an effect on risk of solid cancers other than melanoma and other skin cancer among people using indoor tanning devices

Cancer mortality among people without cancer at the start of a study:

• Slightly higher risk of cancer mortality among people without cancer at baseline working at night (good evidence)
• Small increases in mortality from cancer as a whole among people without cancer at baseline with higher exposures to particulate air pollutants(modest evidence)

• Higher risk of prostate cancer among married men compared to unmarried men; the study researchers suggest that married men may be supported to seek health care more than unmarried men, leading to a greater chance of diagnosis (modest evidence). Our note: This interpretation is consistent with evidence that married men tend to be diagnosed at earlier stages of cancer and to survive longer after diagnosis.

Risk of cancer as a whole:

• Higher risk of cancer and cancer mortality among people with lower levels of social support, with some differences between men and women and between white and black Americans (good evidence)

Manage depression: good evidence

Manage high blood sugar and insulin resistance: good and modest evidence

Cancer mortality among people without cancer at the start of a study:

• Higher cancer-specific mortality among people without cancer at baseline with poorer markers of blood sugar balance and insulin sensitivity (good evidence)

Cancer as a whole:

• Insufficient (conflicting) evidence of an effect on risk of cancer as a whole among people drinking green tea, although some evidence shows lower risk of cancer mortality among women but not men

Mediterranean diet: mixed evidence

Metformin: mixed evidence

Risk of cancer as a whole:

• Lower risk of cancer as a whole among people with diabetes treated with metformin (modest evidence)

Cancer mortality among people without cancer at the start of a study:

• No evidence of an effect on cancer-specific mortality among people at high risk of type 2 diabetes treated with metformin in a very large study

Time in nature: modest evidence

Vitamin C levels and intake: mixed evidence

Risk of cancer as a whole:

• No evidence of an effect on risk of cancer as a whole among people treated with oral vitamin C in large controlled studies
• Modest evidence of a link between low vitamin C levels and risk of cancer as a whole

Vitamin D: mixed evidence

Risk of cancer as a whole:

• Lower risk of cancer among healthy adults aged 70 years or older taking vitamin D supplements (modest evidence)
• Lower risk of cancer among people with higher 25(OH)D levels (weak evidence)

Cancer mortality among people without cancer at the start of a study:

• Slightly lower cancer mortality among people without cancer at baseline taking vitamin D supplements (strong evidence)
• Lower cancer mortality among people without cancer at baseline with higher 25(OH)D levels (good evidence)

Preliminary or weak evidence for reducing cancer risk

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, although substantial uncertainty remains. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that a high degree of uncertainty remains about the links between the practice or therapy and the outcomes described.

No evidence or insufficient evidence of benefit for reducing cancer risk

Resveratrol ›

Risk of prostate cancer:

• No evidence of an effect on prostate size or circulating levels of prostate-specific antigen (PSA) among middle-aged men with metabolic syndrome treated with resveratrol

Cancer as a whole:

• No evidence of an effect on risk of cancer as a whole among people without cancer at baseline with the highest levels of urinary resveratrol from diet in a mid-sized study

Further therapies reported to reduce risk of cancer

These therapies are reported to reduce risk of prostate cancer. We have not fully assessed the evidence, although we provide preliminary reviews as linked.

How integrative experts approach cancer risk

Clinical practice guidelines

Physical activity is beneficial for the prevention of several types of cancer, with limited evidence of a protective effect against prostate cancer.

Recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer

The current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. 

Published programs and approaches

Lise Alschuler, ND, FABNO, and Karolyn Gazella

Keith Block, MD

Lorenzo Cohen, PhD, and Alison Jefferies, MEd

Gerald M. Lemole, MD; Pallav K. Mehta, MD; and Dwight L. McKee, MD

Commentary

Eggs and prostate cancer risk

Cancer researcher and CancerChoices advisor Ralph Moss, PhD, comments on a series of observational studies that suggest a correlation between egg consumption and prostate cancer in men in North America. A follow-up study in 2015 “found a 47% increased risk of life-threatening prostate cancer . . . A 2016 study from the same group similarly found that high intake of eggs was associated with a doubled risk of advanced prostate cancer.”⁶Moss R. Eggs and prostate cancer…a word to the wise. October 18, 2022. Viewed March 26, 2023.Moss emphasizes that observational studies are not proof. Interestingly, in China, egg consumption is the highest in the world, yet the prostate cancer rates are low.

The studies did not take into account the quality of the eggs consumed, and Moss wonders if commercial egg factories produce eggs that are more unhealthy. Moss concludes his commentary: “Could the increased diagnosis of fatal prostate cancers be limited to factory farm-produced eggs in the United States and Canada? Definitely. But, in the meantime, I recommend erring on the side of caution: I would suggest that all PC [prostate cancer] patients, or others at high risk, cut back or eliminate their consumption of all eggs, especially the yolks. It is the prudent thing to do.”⁷Moss R. Eggs and prostate cancer…a word to the wise. October 18, 2022. Viewed March 26, 2023.

Cui K, Li X et al. Chemoprevention of prostate cancer in men with high-grade prostatic intraepithelial neoplasia (HGPIN): a systematic review and adjusted indirect treatment comparison. Oncotarget. 2017 May 30;8(22):36674-36684.

Keep reading about prostate cancer

Learn more