Reducing your risk of prostate cancer
If you don’t have a cancer diagnosis, you may want to know what you can do to reduce your risk of developing cancer. Perhaps you have a family member with prostate cancer, or you’ve been told you’re in a high-risk group.
Top practices and therapies we have reviewed for reducing your risk of cancer
These practices and therapies have at least modest evidence for reducing your risk of cancer or of prostate cancer specifically. We add to this list as we complete new reviews of practices and therapies.
Self-care practices
Complementary therapies
Metformin › (mostly among people with diabetes)
On this page
Risk factors for prostate cancer
Several factors increase your risk of prostate cancer. Some you may be able to modify, but others may be beyond your control.1Perdana NR, Mochtar CA, Umbas R, Hamid AR. The risk factors of prostate cancer and its prevention: a literature review. Acta Medica Indonesiana. 2016 Jul;48(3):228-238; Pernar CH, Ebot EM, Wilson KM, Mucci LA. The epidemiology of prostate cancer. Cold Spring Harbor Perspectives in Medicine. 2018 Dec 3;8(12). pii: a030361.
Medical conditions
High serum levels of insulin-like growth factor (IGF-I)
Sexually transmitted infections
Obesity
Diabetes (conflicting results across studies)
Lifestyle behaviors
Smoking
Alcohol consumption
Diet: see Eating Well below
Medical treatments
Vasectomy: slightly increased relative risk in some studies
Beta blocker metoprolol2Krönig M, Haverkamp C et al. Diabetes and beta-adrenergic blockage are risk factors for metastatic prostate cancer. World Journal of Surgical Oncology. 2017 Feb 21;15(1):50.
Environmental exposures
Light at night
Higher levels of particulate air pollution
Dioxins, and specifically TCDD
See Creating a Healing Environment below
Unmodifiable characteristics
Age (increasing risk with aging)
Family history of prostate cancer in your father or brother
Race and ethnicity, with men of African-American descent, West African ancestry from the Caribbean and men from South America showing higher incidence and mortality of prostate cancer than white men; Asian men have lower incidence
Factors with no evidence of an effect or with a favorable effect on risk of prostate cancer
Testosterone replacement therapy: modest evidence of more favorable-risk prostate cancer and lower risk of aggressive prostate cancer among people receiving prescriptions for testosterone replacement therapy; this is considered a surprising finding by many oncologists, for conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy treatment of prostate cancer often aims to reduce testosterone3Loeb S, Folkvaljon Y et al. Testosterone replacement therapy and risk of favorable and aggressive prostate cancer. Journal of Clinical Oncology. 2017 May 1;35(13):1430-1436.
Night-shift work4Dun A, Zhao X et al. Association between night-shift work and cancer risk: updated systematic review and meta-analysis. Frontiers in Oncology. 2020 Jun 23;10:1006.
Indoor tanning devices
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
Find strategies for creating a healthy lifestyle in this handbook.
Specific to prostate cancer:
- Lower risk of lethal prostate cancer, but not overall prostate cancer, among people with high genetic risk following a healthy lifestyle of a healthy weight, vigorous physical activity, not smoking, and a healthy diet (good evidence)
Eating Well: strong to weak evidence
Some foods and eating patterns are linked to lower risk of cancer, while others are linked to a higher risk. Find strategies for eating well in this handbook.
Risk of prostate cancer:
- Lower risk of prostate cancer among people eating more cruciferous vegetables (broccoli family), yellow-orange vegetables, or legumes (modest evidence), although no effect from eating 1 serving of cruciferous vegetables per week
- 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)
Moving More: strong to preliminary evidence
Find strategies for moving more in this handbook.
Risk of prostate cancer:
- Lower risk of prostate cancer among people with higher levels of physical activity (preliminary 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
Find approaches for managing stress in this handbook.
Risk of prostate cancer:
- Lower risk of prostate cancer among people with lower levels of distress (good evidence)
- No evidence of an increased risk of prostate cancer among people with work stress in a combined analysis of studies
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
Find approaches to promote better sleep in these handbooks.
Risk of prostate cancer:
- Moderately lower risk of prostate cancer among people with long sleep durations (9 hours or more) (good evidence)
Cancer mortality among people without cancer at the start of a study:
- Slightly higher cancer mortality among people without cancer at baseline with sleep durations of 6 hours or less (preliminary (conflicting) evidence)
- Slightly to moderately higher cancer mortality among people with long sleep durations (good evidence)
- No evidence of higher cancer mortality among people with insomnia symptoms or who take daytime naps in combined analyses of studies
Creating a Healing Environment: mixed evidence
Many environmental exposures are linked to a higher risk of cancer, while a few are linked to a lower risk. Find approaches for creating a more healing environment in this handbook.
Risk of prostate cancer:
- Higher risk of prostate cancer among people living in areas with higher levels of particulate air pollution (modest 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)
Sharing Love and Support: good and modest evidence
Find approaches for enhancing the love and support in your life in this handbook.
Risk of prostate cancer:
- Less advanced prostate cancer at diagnosis and better survival among married men (good 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 anxiety: good evidence
Find approaches for managing anxiety in this handbook.
Risk of cancer as a whole:
- Increased risk of cancer among people experiencing anxiety (good evidence)
Manage your body weight: modest evidence
Find approaches for managing your body weight in this handbook.
Risk of prostate cancer:
- Excess body weight is associated with an increased risk for aggressive prostate cancer.
Manage depression: good evidence
Find approaches for managing depression in this handbook.
Risk of cancer as a whole:
- Higher risk of cancer among people with depression (good evidence)
Cancer mortality among people without cancer at the start of a study:
- Higher risk of cancer-specific and all-cause mortality among people with depression (good evidence)
Manage high blood sugar and insulin resistance: good and modest evidence
Find approaches to manage high blood sugar and insulin resistance in this handbook.
Risk of prostate cancer:
- Higher risk of prostate cancer among people with high serum levels of insulin-like growth factor (modest evidence)
- A link between higher fasting insulin levels, insulin resistance, and prostate cancer (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)
Don’t smoke: good evidence
Cancer as a whole:
- A clear link between tobacco use and risk of cancer as a whole (good evidence)
We have not yet published our Don’t Smoke handbook; this statement is from our research so far.
Aspirin: good evidence
Prostate cancer risk:
- Lower prostate cancer risk, especially of advanced or lethal cancer, among people using aspirin (good evidence)
Mediterranean diet: mixed evidence
Specific to prostate cancer:
- Insufficient evidence of lower risk of prostate cancer among people with the highest adherence to the Mediterranean diet
Cancer as a whole:
- Lower risk of cancer or cancer mortality among people without cancer at baseline with higher adherence to a Mediterranean diet (good evidence)
Metformin: mixed evidence
Most of metformin’s benefit in cancer risk is seen among people with diabetes or prediabetes.
Specific to prostate cancer:
- Insufficient evidence of an effect on risk of prostate cancer among people with diabetes treated with metformin
- Insufficient evidence of an effect on risk of prostate cancer among people (not specific to diabetics) treated with metformin
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
Prostate cancer risk:
- Lower risk of prostate cancer among people with higher levels of residential greenness (modest evidence)
Cancer mortality among people without cancer at the start of a study:
- Lower cancer mortality over 8 years among women without cancer at baseline living near higher levels of vegetation (modest evidence)
Vitamin C levels and intake: mixed evidence
Prostate cancer risk:
- No evidence of an effect on prostate cancer risk among people with higher levels of vitamin C intake from diet and/or supplements in very large studies
- No evidence of an effect on prostate cancer risk among people with genetically predicted higher levels of circulating vitamin C levels in a very large analysis
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
Prostate cancer risk:
- Higher risk of prostate cancer among men with low 25(OH)D levels (good evidence)
- Lower risk of aggressive prostate cancer among African-Americans or people with low body mass index taking the highest levels of vitamin D supplements, but not among other people (modest evidence)
- No evidence of an effect at 3 months on free or total PSA among healthy men taking vitamin D in a small study
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.
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.
Grape seed extract
Finasteride: brand names Proscar, Propecia, and Propecia Pro-Pak, plus other 5-alpha reductase inhibitors
Vitamin K antagonists—drugs that reduce blood clotting by reducing the action of vitamin K; the most common are coumarins such as warfarin with brand names Coumadin and Jantoven
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
Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
This book includes an approach for reducing risk of prostate cancer.
Keith Block, MD
Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.
The integrative Block Program has recommendations to people who are at different places along the cancer continuum:
- Those who’ve been recently diagnosed
- Those in treatment
- Those who’ve concluded treatment and need to remain vigilant to prevent recurrence
Lorenzo Cohen, PhD, and Alison Jefferies, MEd
Cohen L, Jefferies A. Anticancer Living: Transform Your Life and Health with the Mix of Six. New York: Viking. 2018.
This book introduces the concept of the Mix of Six, which is identical to six of our 7 Healing Practices ›
Dr. Cohen and Ms. Jefferies explain that while each plays an independent role, the synergy created by all six factors can radically transform health, delay or prevent many cancers, support conventional treatments, and significantly improve quality of life.
The book describes a risk-reduction program.
Gerald M. Lemole, MD; Pallav K. Mehta, MD; and Dwight L. McKee, MD
Lemole GM, Mehta PK, McKee DL. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
These doctors present easy-to-incorporate lifestyle changes to help you “turn on” hundreds of genes that fight cancer, and “turn off” the ones that encourage cancer, while recommending lifestyle approaches to address each type.
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.”5Moss 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.”6Moss R. Eggs and prostate cancer…a word to the wise. October 18, 2022. Viewed March 26, 2023.
Helpful links
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References
