Patient Support
- Support
- Nutrition & Prostate Cancer
Support
You may find that cancer treatment brings on feelings of uncertainty, depression, anxiety, anger, and fear. These emotions do not automatically go away once treatment is over.
Prostate cancer hits many men hard. You may feel less masculine and worry about your ability to have sex again during or after treatment. You may blame yourself for the changes in your life due to your disease. You may feel guilty, affecting the quality of your intimate relationships.
The staff at SCCA can help you and your partner deal with the emotions and issues that surround your cancer, even after you are cured or in remission. We can help with the issues that may be getting in the way of your relationships, including sexual intimacy.
Even when cancer treatment is over, it may take time for life to get back to normal. You may feel the need for support from a mental health professional or a support group. You may want to talk to a nutritionist about dietary changes that can help make you feel better.
SCCA has psychiatrists and psychologists, social workers, nutritionists, and pastoral services available. In addition, SCCA has a dedicated clinical psychologist who works only with prostate cancer patients and their partners.
Advice for Spouses and Partners
The wives, partners, and significant others of men diagnosed with prostate cancer are typically very actively involved in the care of their partners and also in decision-making about treatment. They have a very significant role and they are an important source of support for the patient.
They often keep track of medical information and treatment appointments and bear the responsibility for the patient’s happiness, such as making sure he is doing OK. This is a big responsibility, and they take it willingly, but they need some support themselves. For example, the majority of people with a partner facing prostate cancer will face challenging emotional turmoil themselves, and are in need of support and strategies to help them cope.
A support group can help the partners of men with prostate cancer learn how to deal with changes in their partners, which may include fluctuating moods, symptoms of depression, and anger.
Wives of men with prostate cancer may also face issues such as a partner who is not following his doctor’s treatment recommendations, or the question of what to tell children and grandchildren about the illness.
And, of course, partners need to remember to take care of themselves, which includes dealing with their own fears and insecurities surrounding a husband’s cancer. They may find themselves experiencing excessive worrying, frustration, sadness, tiredness, and anger.
Caregivers need to watch for signs that they are focusing too much on their partner’s well-being and neglecting themselves or other members of the family.
A support group for spouses can help. Come each Wednesday of the month, from 1:15 to 2:15 p.m., on the third floor of the SCCA clinic in room 3102.
Nutrition and Prostate Cancer
For many men, a diagnosis of prostate cancer is a wake-up call to take better care of themselves, by improving their diets, getting more exercise, and breaking bad habits, such as smoking and drinking. A better diet can help you prepare for surgery, help speed your recovery after cancer treatment, and may help keep your cancer from coming back. In addition, a nutritionist can recommend dietary changes to help you deal with side effects of cancer treatment, including:
- Osteoporosis
- Weight gain
- Fatigue, which can be a side effect of hormone therapy, radiation therapy, or chemotherapy
- Nausea, a common side effect of chemotherapy
- Taste changes, sometimes related to chemotherapy
- Constipation, or other gastrointestinal problems, which can result from radiation therapy and other treatments.
"A lot of people in cancer treatment don't realize that nutrition counseling can help them enjoy eating again," says Jean Stern, an SCCA dietitian and patient education coordinator who works with prostate cancer patients. "If you have questions or symptoms, ask for help."
Nutritionists are available to meet with you at the SCCA clinic or at the SCCA Prostate Center at University of Washington Medical Center. Ask your doctor or nurse to refer you for an appointment, or if you have questions, e-mail nutrition@seattlecca.org.
You may want to read more about the services offered by SCCA Nutrition Services or more about nutrition guidelines for men with prostate cancer.
- Fat
- Fruits & Vegetables
- Fiber
- Soy
- Bone Health
- Exercise
- Supplements
- Red Wine
- Vitamin E Clinical Trial
Nutrition and Prostate Cancer
Fat
Everyone needs some fat as part of a healthy diet. Fat contains important nutrients, including vitamins A, D, E and K, and is an important part of each cell in your body.
More research is needed to determine the effect fat has on prostate cancer, but it is probably a good idea to reduce the amount of fat of animal origin (butter, meat) that you eat, while increasing your intake of omega-3 fatty acids. Omega-3 fatty acids are known to reduce the risk of heart attack, but their role in preventing prostate cancer, if any, needs further research.
Goals
- Choose healthy fats, including monounsaturated fats and polyunsaturated fats. These can lower LDL (“bad”) cholesterol and increase HDL (“good”) cholesterol.
- Limit your intake of saturated fats and avoid trans fatty acids. These can increase LDL cholesterol.
- Eat foods containing omega-3 fatty acids two to three times weekly. The omega-3 fatty acids in fish (EPA and DHA) appear to provide protection against prostate cancer and heart disease. Ground flaxseeds contain a different form of omega-3-fatty acid (alpha-linoleic acid = “ALA”). There is some evidence that ground flaxseeds, but not flaxseed oil, may be protective against prostate cancer. Ground flaxseeds are also rich in fiber.
Types of Fat
| Poly-unsaturated Fat (good) |
Mono-unsaturated Fat (good) |
Omega-3 Fatty Acids (good) |
Saturated Fat (limit) |
Trans Fat (aviod) |
| Olive oil Olives Canola oil Peanut oil Almonds Cashews Hazelnuts Peanuts Peanut butter Pine nuts Walnuts Avocado |
Corn oil Soybean oil Safflower oil Cottonseed oil Fish Pine nuts Walnuts Flaxseed |
Mackerel Salmon Trout Tuna Flaxseed oil Flaxseed Walnuts Walnut oil Wheat germ Soybean oil Canola oil |
Whole milk Butter Cheese Cream cheese Cream Half and Half Ice cream Red meat Chocolate Coconut Coconut milk Coconut oil Palm oil Palm kernel oil |
Most margarines (especially stick margarine) vegetable oil baked foods (cookies, crackers, chips, cake mixes, some cereals and frozen entrees) |
Fruits and Vegetables
Some research studies have found that eating fruits and vegetables may reduce your risk of developing prostate cancer. Other studies have found a significant association between eating vegetables and a lower risk of prostate cancer. In particular, eat yellow or orange vegetables and those in the cruciferous family, which includes broccoli.
Fruits and vegetables provide the vitamins, minerals and fiber that your body needs. They're also packed with hundreds of disease-fighting phytochemicals—natural substances that work as a team to protect good health. Only fruits and vegetables, not pills or supplements, can provide all of these nutrients together.
The different colors of fruits and vegetables—green, yellow/orange, red, blue/purple and white—all contain unique varieties of disease-fighting phytochemicals that work together to protect your health. Here are some examples of the phytochemicals found in various fruits and vegetables. Try to eat a variety of “colors” each day.
Carotenoids
Carotenoids are found in red, yellow or orange fruits and vegetables, such as tomatoes, sweet potatoes and carrots.
Lycopene
Lycopene is found in tomato-based foods, such as tomato sauce and tomato paste, as well as in watermelon, pink grapefruit, papaya and apricots.
Lutein and zeaxanthin
Lutein and zeaxanthin are found in leafy greens, such as spinach and romaine lettuce.
Flavenoids
Flavenoids are found in brightly colored fruits and vegetables, such as blueberries, cherries and strawberries.
Further research is needed to study the role of lycopenes in reducing prostate cancer risk. The evidence that eating lycopenes will reduce your risk of developing prostate cancer is weak. Studies have not been controlled for total vegetable intake, and the actual amount of lycopene intake has been difficult to quantify. The best advice currently is to consume a variety of fruits and vegetables every day, as part of an overall wholesome diet.
Cruciferous vegetables appear to protect against prostate cancer. These include broccoli, cauliflower, cabbage, Brussels sprouts, kale, chard, collards and mustard greens. They contain compounds that boost the production of certain enzymes that can protect cells against cancer-causing agents.
What’s a serving size?
Use these measurements to determine a serving size:
- 1 cup salad greens
- 1/2 cup cooked legumes or peas (lentils, pinto beans, kidney beans, black beans, etc.)
- 1/4 cup dried fruit
- One medium piece of fruit or 1/2 cup cut-up fruit
- 3/4 cup or 6 ounces fruit juice.
Fiber
Dietary fiber comes from the parts of plants your body can't digest. There are two types, soluble fiber and insoluble fiber.
Soluble fiber
When eaten regularly as part of a low-fat, low-cholesterol diet, soluble fiber can help lower blood cholesterol. Oats have the highest proportion of soluble fiber of any grain. Foods high in soluble fiber include oat bran, oatmeal, beans (legumes), peas, rice bran, barley, citrus fruits, strawberries and apple pulp.
Insoluble fiber
Insoluble fiber doesn't seem to help lower blood cholesterol. However, it's an important aid in normal bowel function. Foods high in insoluble fiber include whole-wheat breads, wheat cereals, wheat bran, rye, rice, barley, most other grains, cabbage, beets, carrots, Brussels sprouts, turnips, cauliflower and apple skin. Read food labels to help you estimate and increase your daily fiber intake.
Soy
There is some evidence that soy may help prevent prostate cancer, and more evidence that it can help to reduce heart disease. However, we do not know how much soy you need to eat in order to help prevent cancer.
Soy contains phytonutrients called isoflavones. Researchers think that isoflavones may prevent more advanced stages of prostate cancer from developing.
Soy may cause some gastrointestinal upset (such as gas), so if you do not eat soy foods regularly now, it may be better to introduce them to your diet gradually over several weeks.
Sources of soy (in order of most to least amount of isoflavones):
- Soynuts, dry roasted, 1/2 cup
- Edamame (green soybeans), 1/2 cup
- Tempeh, uncooked, 4 ounces
- Soy protein powder, 1 ounce
- Soy flour, 1/4 cup
- Tofu, 4 ounces
- Soy milk (1 cup or 8 ounces)
- Miso dry soup mix, 1 ounce
- Soy cheese, 1 ounce.
Bone Health
Prostate cancer treatment may result in a loss of bone density. It is important to consume enough calcium and vitamin D to help keep your bones strong. Exercise is also important to prevent osteoporosis.
Calcium
The role of calcium in prostate cancer is unclear. Too much may increase the risk of prostate cancer, while too little calcium may increase the risk of colon cancer. Avoid consuming more than 2000 mg. of calcium daily from food and supplements.
Your calcium requirements will vary, depending on whether or not you are receiving hormone therapy and whether or not you have osteoporosis.
If you have had a normal DEXA scan [2.1.4.8] and you are not receiving androgen suppression therapy, you need between 1000 and 1200 mg. of calcium a day.
If you have osteoporosis or osteopenia [2.1.4.8] or are receiving androgen suppression therapy, you need 1500 mg. of calcium per day.
An SCCA dietitian can give you more information about calcium from foods and calcium supplements. If you do not consume enough calcium in food, you should take a supplement. Divide your intake of calcium supplements throughout the day to maximize absorption, and try not to take more than 500 mg. at a single time from food and supplements. Calcium carbonate supplements should be taken with meals for best absorption. Calcium citrate can be taken between or with meals.
Vitamin D
Vitamin D is a hormone that, with adequate sun exposure, can be manufactured in the body. However, if you wear sunscreen you may not make enough vitamin D. In addition, as you grow older your ability to manufacture vitamin D declines. Vitamin D helps the body utilize calcium and phosphorus to build bones and teeth. Preliminary research suggests that vitamin D may reduce the risk of breast, prostate and colon cancers. Many people, especially those over 60, are deficient in vitamin D. Therefore, it is best to get vitamin D from food, a multivitamin supplement or a calcium supplement that includes vitamin D.
Daily Vitamin D requirements:
- Males under 70: 400-600 IU
- Males, 70 years and older: 600 IU
- Males with osteopenia, osteoporosis or who are receiving androgen suppression therapy: 800 IU. Sources of vitamin D include:
- Fortified milk, soy milk or yogurt
- Fortified orange juice
- Fortified cereal
- Multiple vitamin supplements or a calcium supplement with vitamin D. Check labels of fortified foods for vitamin D content (Hint: “25 percent DV” = 100 IU vitamin D).
Exercise
Physical activity is important for weight management, muscle maintenance, keeping bones strong and reducing your risk of heart disease. Staying active will also help with balance, will improve your sleep and help reduce anxiety.
You can lose extra weight and keep it off by increasing your resting metabolic rate (RMR), the rate at which your body burns calories when you are resting. Your resting metabolic rate accounts for 60 to 75 percent of your daily calorie expenditure, so even a small increase in RMR will help burn off more calories.
Your RMR is closely linked to the amount of muscle you have. Muscle burns 35 to 50 times more calories than fat. So if you increase your muscle mass, you will raise your RMR. Raising your RMR can help you lose weight and can help prevent weight gain.
Strength training
Strength training, also known as resistive exercise, can help you increase your muscle mass and therefore increase your resting metabolic rate. Strength training is also important for healthy bones and for improving balance (and thus preventing falls).
Types of strength training include biking, carrying bags of groceries and working out with weights. Talk with your doctor about the level of strength training that is safe for you.
Aerobic training
Aerobic exercise (such as fast walking, dancing, hiking, swimming, running and cross-country skiing) causes your calorie expenditure to increase during the workout and for a few hours after the workout. By doing aerobic exercise, your body burns calories at your resting metabolic rate plus the additional number of calories burned by the aerobic exercise.
How much exercise?
Although physical activity does not need to be vigorous to provide health benefits, the health benefits you gain are directly related to the amount of regular physical activity you get. Physical activity might include bicycling, dancing, doing active household chores, climbing stairs, gardening and working at a job that has physical demands.
Examples of moderate activity include playing volleyball for 45 minutes, raking leaves for 30 minutes, swimming laps for 20 minutes, playing basketball for 15 to 20 minutes, or running 1.5 miles in 15 minutes. These examples illustrate the balance between duration and intensity. You must perform less strenuous activities for longer periods of time to achieve the same caloric expenditure.
The American Heart Association recommends gradually working up to exercising at least three to four times a week for 30 to 60 minutes at 50 to 80 percent of your maximum capacity. Whatever exercise you choose, you must continue it (or some variation) for the rest of your life in order to produce lasting benefits. Many people find that if they can stick with their activity program for six months, it becomes an important part of their daily lifestyle.
Supplements
Food is the best sources of nutrients. If you choose to take supplements, be sure to choose supplements with appropriate amounts of vitamins, minerals or other chemicals. Remember, an appropriate dose of a supplement for one disease may not be the correct dose for another disease.
Multiple vitamin and mineral supplements
If you avoid specific groups of foods, such as meat, milk, cheese, eggs or fruit, you may need to take a multiple vitamin/mineral supplement in order to get some of the nutrients these foods supply. A multiple vitamin/mineral supplement is also a good source of vitamin D. Look for a supplement with 100 percent of the daily value for most of the vitamins and minerals.
Selenium
The role of selenium supplements in reducing the risk of prostate cancer is not clear. One study showed that only people with low blood selenium levels benefited from taking selenium supplements. Other studies have suggested a potential increased risk of some types of cancer for persons taking selenium supplements. Based on current knowledge, the best source of selenium is food. Foods rich in selenium include Brazil nuts, wheat germ, bran, brown rice, whole wheat bread, barley, onions, garlic, turnips, soybeans, mushrooms, fish and eggs.
Vitamin E
Studies of the role of Vitamin E in prostate cancer prevention have reached various conclusions. Some showed that vitamin E had no effect; others showed a positive effect or a positive effect only for former smokers. The amounts of vitamin E given to participants in these studies were 50 mg. or less.
One study currently underway to evaluate the effectiveness of selenium and vitamin E supplements in prostate cancer prevention may provide further information. Until more is known regarding the role of vitamin E supplementation in prostate cancer, focus on consuming foods rich in vitamin E. These include nuts (such as almonds, hazelnuts and peanuts), vegetable oils (olive and canola), seeds, wheat germ and whole-grain products, and spinach and other dark, green leafy vegetables.
Lycopenes
The safety of lycopene supplements in prostate cancer has not been tested. Lycopene supplements are also fairly expensive. As a result, it is better to consume lycopene-rich foods as part of a diet high in fruits and vegetables. Tomatoes and tomato products (such as tomato sauce, tomato juice, tomato paste, salsa, tomato soup and spaghetti marinara sauce) are major sources of lycopenes. Watermelon, pink grapefruit, papaya and apricots also contain lycopenes.
Logistical Support
Emotional Support
|
|
|
Medical Support
|
|
|