Rebecca A.Campbell1 JianboLi12 LindsayMalone3 David A.Levy4
1Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
2Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
3Department of Nutrition, Case Western Reserve University School of Medicine
4Chesapeake Urology, Hanover, MD
Abstract
Objectives
To investigate the influence of targeted serum vitamin-D level and omega-6:3 fatty-acid ratio on prostate-specific antigen (PSA) level in men with prostate cancer managed with active surveillance by providing a nutritional intervention and vitamin supplementation.
Methods
Sixty-eight patients with biopsy-proven NCCN very-low or low-risk prostate cancer were enrolled in the prostate cancer nutrition and genetics clinic at the Cleveland Clinic from July 2013-December 2019. Patients adhered to a specific dietary regimen devoid of animal-based products and foods containing omega-6 polyunsaturated fatty acids (PUFAs). The supplement regimen consisted of: Omega-3 PUFAs 720mg (three/day); curcumin 2000 mg/day; vitamin D3 dose titrated to achieve serum level of 60 ng/ml; and vitamin B-complex 1000 mg (four times weekly). Patients underwent periodic monitoring of PSA, serum vitamin D, and PUFA levels and had frequent follow-up with the nutritionist which included a food frequency questionnaire. Interval prostate biopsy was performed as clinically indicated and/or at nine months.
Results
The mean and 95% confidence interval (CI) of PSA slope and Vitamin D serum levels slope were 0.11 (0-0.25) ng/mL/month and 4.65 (3.09-5.98) ng/mL/month, respectively. Patients with higher initial vitamin D levels were twice as likely to have a downward PSA trend (OR=2.04, 95% CI 1.04-4.01, p=0.04). Fifty-five patients underwent follow-up biopsy, all showing no progression of disease. Three patients had loose bowel movements that required omega-3 and or curcumin dose adjustments.
