A proactive approach to localized prostate cancer

A proactive approach to localized prostate cancer

Many men given a prostate cancer diagnosis, often say it was a “wake-up call.” Luckily, a large percentage – up to 90% – of men’s prostate cancer will be confined to the prostate gland, known as localized prostate cancer. Localized prostate cancer includes stage 1 and stage 2 and is considered unlikely to grow or spread for a long time or possibly ever. 

Because this type of prostate cancer has not grown into nearby tissues or to distant parts of a man’s body, one management approach is called active surveillance. Active surveillance is when a man and his doctor make the determination and decision to monitor the cancer instead of using invasive treatments such as surgery or radiation. 

How is localized prostate cancer monitored?

Men, who are “treating” their prostate cancer using active surveillance, will see their doctor about every six months.  At each visit, a prostate specific antigen (PSA) blood test and a digital rectal exam will be done to monitor any changes noted in the prostate gland. If the cancer is stable, active surveillance can continue. 

Sometime within the first year, a repeat prostate biopsy is likely done and may be repeated in the future too. Depending on what the biopsy results are will determine whether to continue with active surveillance or if other alternative treatments are necessary.

From passive to proactive

While active surveillance may seem to be a ‘passive’ treatment for prostate cancer, it doesn’t have to be. A proactive choice is a better approach then to do nothing.  Men wanting to improve their outcome by choosing to be proactive will be more confident and self-assured in outsmarting cancer. 

Also, men, with prostate cancer, choosing to be proactive with their health, are far more likely to thrive better than men who don’t.  

Here are 3 proactive approaches on ways men can be ‘actively’ participating on preventing  localized prostate cancer from spreading while thriving at the same time: 

  • Quit smoking

Men diagnosed with prostate cancer and continue to smoke, are more likely to develop aggressive prostate cancer.  Smokers, especially after a prostate cancer diagnosis, have a greater risk of the cancer spreading beyond the prostate gland, increasing the risk of death. The good news is that when men stop smoking, their risk of dying from prostate cancer returns to that of someone who has never smoked. 

Studies have shown that when compared with men who had never smoked, men who were smoking cigarettes at the start of the studies had almost twice the risk of dying of prostate cancer in the future. Men, who currently smoke, should seek help from their physician on how to quit. 

  • Switch to a Mediterranean diet

At this time, there is no specific diet for prostate cancer.  But several studies have shown that men, who adopt certain dietary habits, can influence their prostate cancer growth. 

One dietary improvement is to start following a diet based on the Mediterranean way of eating. The Mediterranean diet follows an approach that looks at diet as a whole – it encourages low intakes of red meat, processed meats (sausage, bacon, bologna, etc.) and sugar, both of which can cause inflammation, and instead recommends eating more whole fruits and vegetables, legumes, fatty fish, and grains. 

Mainly known for promoting heart health, the Mediterranean diet looks to be beneficial for men with localized prostate cancer. A 2021 study published in Cancer, found that men with localized prostate cancer and who followed the Mediterranean diet, fared better than men who followed a more “Western” diet. This echoed what a 2018 observational study in The Journal of Urology suggested that eating in a Mediterranean style was helpful for men with localized prostate cancer. The researchers compared three types of eating patterns – Western, prudent, and Mediterranean on almost 2,000 men, average age of 66 and who either had prostate cancer or were healthy.

The Western diet included large amounts of fatty dairy products, refined grains, processed meat, caloric beverages, sweets, fast food, and sauces. The Prudent diet had low-fat dairy products, whole grains, fruits, vegetables, and juices. The Mediterranean diet consisted of fatty fish (high in healthy omega-3 fatty acids), fruits, vegetables, legumes, olive oil, and low consumption of juices.

After five years, the researchers found that men who strictly followed a Mediterranean diet had a much lower risk of aggressive prostate cancer, while men who ate the other two diets did not see the same benefits. 

It is speculated that the Mediterranean diet was best for beating back prostate cancer since it emphasizes core foods, like fruits and olive oil, that lower inflammation which may reduce the chances that cancer will grow or spread.

  • Increase intensity of exercise 

Exercise is a great way to influence a wide range of biological processes, including anti-inflammatory and insulin pathways that may be linked to a lower risk of prostate cancer.  This has been further strengthened thanks to a 2018 study found in European Urology that found that vigorous activity may offer the greatest benefit.

More than 49,000 medical records were analyzed of men ages 40 to 75 years old that were followed for 26 years. The men answered questions biennially that included questions about their diet, health, and physical activity. Among the participants, more than 6400 developed prostate cancer and 888 had aggressive prostate cancer – cancer that spread or caused death during the study period. 

The results showed that men who engaged more frequently in vigorous activity had a 25% lower risk of developing aggressive prostate cancer compared with men who exercised the least. On average, men in the highest category of vigorous activity did about 25 minutes of running per day.  Other activities comparable to this, depending on duration and intensity, include cycling, swimming, heavy outdoor work, and playing sports like tennis or racquetball.

The increased intensity of physical activity appears to lower prostate cancer risk by promoting weight management but also might affect prostate cancer on a cellular level. The study also looked at the impact exercise had on a common molecular alteration in prostate tumors called TMPRSS2:ERG, a gene fusion that occurs in the tumors of about half of prostate cancer patients. The results showed that long-term vigorous physical activity was specifically associated with a lower risk of developing TMPRSS2:ERG. 


Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911. 

Dr. David Samadi | Robotic Prostate Surgeon


ProstateCancer911.com is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.


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