Lifestyle Changes Alter Gene Expression In Men With Prostate Cancer

	June 20, 2008
Lifestyle changes alter gene expression in men with prostate cancer

A study conducted by Dean Ornish, MD, of the Preventive Medicine Research Institute in Sausalito, California, along with researchers at the University of California, San Francisco, found that lifestyle improvements have a beneficial effect on gene expression in men with prostate cancer. The finding was reported in the June 17, 2008 issue of the Proceedings of the National Academy of Sciences.

The investigation involved 30 participants in the Gene Expression Modulation by Intervention with Nutrition and Lifestyle (GEMINAL) study of men with low-risk prostate cancer. For reasons not related to the study, the men had opted for active surveillance of their disease in lieu of surgery or radiation treatment. For a three month period, participants were ask to limit dietary fat to 10 percent of daily calorie intake, adopt a whole food, plant-based diet, engage in 30 minutes per day of walking for six days per week, and practice stress management in the form of stretching, breathing, meditation, imagery and relaxation for 60 minutes per day in addition to a one hour per week group session. Diets were supplemented daily with tofu (from soy), soy protein, 3 grams fish oil, 200 micrograms selenium, 2 grams vitamin C and 100 international units vitamin E. Cardiovascular disease risk factors, including weight, body mass index, waist circumference, blood pressure, lipids, and C-reactive protein, were measured before and after the intervention.

Gene expression in initial prostate biopsies was compared with prostate tissue samples obtained after three months of the lifestyle changes. Forty-eight genes, including those that have disease-preventive effects, were found to be up-regulated, and 453 genes, including oncogenes involved in breast and prostate cancer and other disease-promoting genes, were down-regulated following the intervention. Body mass index, systolic and diastolic blood pressure, lipids and waist circumference significantly improved. Benefits of the regimen were also observable in the participants’ mental health-related quality of life and levels of cancer-associated mental distress.

“Intensive nutrition and lifestyle changes may modulate gene expression in the prostate,” the authors conclude. “Understanding the prostate molecular response to comprehensive lifestyle changes may strengthen efforts to develop effective prevention and treatment. Larger clinical trials are warranted to confirm the results of this pilot study.”

Prostate cancer

Out of every 100 men diagnosed with prostate cancer (PC), approximately 5 will have hereditary PC (HPC). HPC is presently defined by any one of the following three criteria:

Three successive generations with members having PC
Three first-degree relatives, for example, a father and two brothers, three brothers, or a father and two sons with PC
Two relatives with PC diagnosed before age 55

It is not surprising that the incidence of hereditary breast cancer is also about 5% of the total population of breast cancer patients--the same incidence as that of HPC.

HPC is transmitted by a gene from father to son and from father to daughter and then to her son. When HPC is present, nearly half the male offspring will have PC, and many of these will develop PC before age 55. In fact, HPC accounts for approximately 43% of PC diagnosed before the age of 55 years.

Since the transmission of the gene may also occur from father to daughter and then to her son, a sound medical history includes information about the health of the maternal grandfather as well as maternal uncles and maternal cousins regarding any history of PC. Studies of PC within families show a stronger familial inheritance pattern than colon or breast cancer.

It should also be emphasized that men with a history of breast cancer (BC) in their family are also at greater risk for developing PC, just as women with a family history of PC are at greater risk for developing BC.

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