How Lifestyle Impacts Prostate Cancer Survival: What a 20-Year Study Reveals

When it comes to prostate cancer, the conversation often centers around PSA scores, Gleason grades, and treatment plans. But a growing body of research—and this time, a landmark 20-year study—points to something more within our control: lifestyle. While healthy habits might not prevent a prostate cancer diagnosis, they could dramatically shift the odds of surviving it.

Let’s break down the six key lifestyle factors from the study, what they mean for those at risk or already diagnosed, and why some small choices might yield life-saving returns.

The Study That Changed the Game

In May 2022, the European Urology Journal published a long-term study that followed 12,000 men over 20 years. The researchers tracked lifestyle choices using regular questionnaires and measured two outcomes: how many men developed prostate cancer and how many died from it.

What they discovered was unexpected but crucial:

• Lifestyle choices didn’t significantly impact the likelihood of developing prostate cancer.
• But lifestyle had a dramatic effect on prostate cancer mortality.

In fact, men with poor lifestyle habits were 2 to 4 times more likely to die from prostate cancer, even if their diagnosis mirrored someone with healthier habits.

The Six Lifestyle Factors That Matter Most

The study identified six behaviors that significantly influenced mortality outcomes. These weren’t groundbreaking or exotic—they’re the same pillars of health we’ve been hearing about for decades. Yet, this time, we have long-term data tying them directly to prostate cancer survival:

1. Smoking status
2. Exercise habits
3. Weight/BMI
4. Intake of processed meats
5. Fish consumption
6. Tomato-based (vegetable-rich) diet

Each factor was given a score, and the overall "lifestyle score" helped categorize participants from healthiest to least healthy. The better your score, the better your chances of living longer with prostate cancer—or even outliving it entirely.

The Disconnect: Why Healthy Habits Don’t Stop Cancer from Forming

It might be surprising to learn that a healthy lifestyle didn’t prevent prostate cancer from developing. But that finding is consistent with how prostate cancer behaves. Many types—especially Gleason 6, non-aggressive forms—are slow-growing and often don’t pose immediate threats.

The bigger issue is how the disease progresses. While men from all lifestyle categories were diagnosed at roughly the same rate, those who followed poor habits were far more likely to face aggressive, metastatic progression—or death.

Even more compelling? Men with genetic predispositions to high-risk prostate cancer saw dramatically reduced mortality by adopting healthy lifestyle measures. The study offers hope for those with family history: genetics load the gun, but lifestyle can take it out of your hand.

Why Processed Meats and Animal Fats Are a Red Flag

The study didn’t explain why animal products increase mortality, but other research fills in the gaps. Prostate cancer cells appear to thrive in environments rich in animal fats and proteins. Unlike some cancers that feed on sugar, prostate tumors respond more vigorously to these dense nutrients.

It's not about cutting out all meat—moderation still matters. Eggs or occasional lean meats in a mostly plant-based diet may not pose a problem. But when someone builds their diet around heavy, daily consumption of red or processed meats, risk compounds.

Can Diet Really Lower PSA Levels?

Although not covered in the study, some clinical experiences suggest diet might also influence PSA levels, especially in men with recurrent prostate cancer post-surgery. Without a prostate gland, a rising PSA points to residual cancer.

In several cases, patients who adopted strict vegetarian diets saw slower PSA increases—or plateaus. While not a universal solution, it’s another data point supporting diet’s role in cancer progression.

Mediterranean vs. Vegetarian Diet: Which Is More Effective?

When recommending diet shifts, structure helps. Many patients benefit from following established eating patterns, and two popular frameworks come up often:

• Mediterranean Diet: Rich in vegetables, fruits, whole grains, fish, and healthy fats
• Vegetarian Diet: Emphasizes plant-based whole foods while eliminating meat

Both approaches are beneficial, but for men with advanced or recurrent prostate cancer, more rigorous vegetarian-style diets (sometimes labeled “macrobiotic”) appear to offer stronger protective effects. Mediterranean diets still help—but may not pack the same punch.

Lifestyle Change Has a Dose-Response Effect

This is one of the most actionable takeaways: the study found that even partial changes made a difference.

• Men who adopted all six lifestyle measures saw an 80% reduction in mortality.
• Those who implemented half of the measures still saw a 50% drop in mortality.

It’s not an all-or-nothing game. Each healthy habit you build into your life—quitting smoking, getting back to regular workouts, shifting to more fish and veggies—adds up.

Weight Loss, Hormone Therapy, and Tools Like Wegovy

Obesity was one of the six critical risk factors in the study, and managing weight—especially for men on hormone therapy—can be a struggle. Hormone therapy tends to promote fat gain and muscle loss, which can affect both outcomes and quality of life.

Medications like Wegovy (also known as Ozempic) are showing promise in this space. Though formal studies on hormone-treated prostate cancer patients are lacking, there’s no current reason to believe these GLP-1 receptor agonists wouldn’t work. They’ve been shown to reduce appetite and support weight loss across diverse populations.

Resistance Training: The Overlooked Lifestyle Factor

Exercise isn’t just about cardio. Resistance training—using weights or body weight to build muscle—has enormous benefits, especially for aging men with prostate cancer.

Muscle mass counters age-related weakness, supports balance, boosts metabolic rate, and even improves cognitive health. For men undergoing hormone therapy, resistance training can offset muscle loss, improve strength, and maintain independence.

It’s not just about fighting cancer—it’s about staying functional and energetic while doing so.

Citations:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8923151/

https://www.cancer.gov/about-cancer/causes-prevention/risk/diet