The importance of maintaining a nutrient-rich diet for overall health is well established. Proactively eating more vegetables, whole grains, and plant-based foods has shown to positively influence prostate health and aid the overall cancer treatment process. While diet alone cannot cure or eliminate the risk of any cancer, what you eat may impact how well your cancer treatment works. Nutritional guidance from experienced dietitians is just one component of prostate cancer care.
The Role of Diet During Radiation Therapy
Radiation therapy is a type of cancer treatment that shrinks and destroys cancer cells. During radiation, it’s important to eat well to keep the body and its immune system strong, giving it the nutrients it needs to promote the regrowth of healthy tissues. “Food is a part of the medical treatment during cancer therapy,” says Shayna Komar, a registered dietician specializing in oncology. “It helps support a patient’s immune system and decreases side effects."
Radiation can be tiring and tough on the body. However, the nutrients and foods a person needs during cancer treatment vary based on the individual, how their body responds to radiation, the treatment area, and the length of treatment. Your diet during radiation might include foods you wouldn’t normally eat when otherwise healthy because your body’s needs during radiation are different.
Calorie and Protein Needs
Calorie and protein needs increase during radiation to help keep weight stable. It is not uncommon for radiation therapy to zap a patient of their energy and lessen their appetite. Many patients feel nauseous, which also dampens the desire to eat. “Patients should aim to consume 25 to 35 calories per kilogram of body weight,” says Vanessa Lara, a dietician with a background in cancer biochemistry.
Protein helps maintain muscle and supports a healthy immune system - both critical functions needed during radiation. “While every food group is important, protein trumps them all during radiation,” says Komar. It is recommended that individuals get at least 10% of calories from proteins and often a much higher percentage depending on your situation.
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Vitamins and Minerals
Vitamins and minerals also help keep the immune system strong and support healthy tissue repair. Maintaining adequate levels can be important. You should discuss with your doctor whether vitamin supplements are recommended. “Supplements can be a safe way to ensure patients undergoing radiation therapy get enough vitamins and minerals,” says Lara.
Key Dietary Components for Prostate Health During Radiation
Focus on nutrient-dense foods like fruits, vegetables, grains, and lean proteins.
Vegetables and Fruits
Eat a variety of fruits and vegetables including dark-green, red, and orange vegetables, beans, and peas. Make fruits and vegetables the focal point of every meal. If difficulty eating raw fruits or vegetables is experienced, try eating soft steamed or cooked vegetables and canned fruit. Two servings daily of cruciferous vegetables and two servings daily of tomatoes are recommended. Tomatoes and tomato-based products contain the antioxidant lycopene, which may help protect against prostate cancer. One or more servings daily of carotenoid-rich fruits and vegetables are also beneficial.
Whole Grains
One or two servings daily of whole grains are recommended. Whole grains include brown rice, 100% whole-grain breads and rolls, and Steel Cut Oatmeal. Quinoa is a whole grain that is high in protein, lacks gluten, and is easy to prepare. Try substituting Quinoa for white rice in meals to increase your protein intake.
Legumes and Beans
One or more servings daily of legumes or beans is recommended.
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Protein-Rich Foods
Eat a variety of protein-rich foods that are low in fat. Include seafood, lean meat and poultry, Greek yogurts, eggs, beans, soy products, and unsalted nuts and seeds. Some soy products are highly processed and not as good for you as other types of soy. Edamame (young soybeans in a pod) would be a good choice for adding healthy soy to your diet.
Dietary Adjustments for Common Side Effects
Radiation therapy can change how a patient’s body accepts certain foods and uses nutrients. Pay attention to your side effects and how they affect your appetite. Throughout your treatment, listen to your body and adjust your diet according to what it is telling you. You may find only some foods taste good on a given day. “Do not approach radiation treatment with a strict food plan,” says Komar. Your radiation diet may include switching to a bland diet or adding lots of flavorful foods to your meals.
Softer Foods
When radiation is directed towards the mouth or throat, it can cause irritation and mouth sores, making it difficult to eat certain foods. In such cases, eating soft and moist foods that are easy to swallow is advisable. Avoid raw vegetables and fruits, and other hard, dry foods such as chips or pretzels. It’s also best to avoid salty, spicy, or acidic foods if you are experiencing these symptoms.
Bloating and Diarrhea
Sometimes radiation can cause bloating or loose stools, requiring patients to adjust their diet to avoid gas-producing foods. “The low-residue diet consists of lower fiber, soft, mostly cooked foods without added spices,” says Komar. For prostate cancer patients, it is recommended avoiding foods that cause gas since this might affect preparation for treatment. Foods that cause gas include asparagus, beans, beer, broccoli, cabbage, corn, cucumbers, eggs, fish, milk, mushrooms, nuts, peppers, and spicy foods.
Taste and Smell Changes
Reduce the smell of foods by eating cold or room temperature meals. If you have a metallic taste in your mouth, try using plastic utensils and avoid canned foods. If you have a salty or bitter taste, add honey, agave nectar, or jam to foods. If foods taste too sweet, increase salty or tart flavors with lemon, citrus fruits, vinegar, pickled foods, or salt.
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General Eating Tips During Radiation
- Change your eating habits and times.
- Eat smaller meals, more often, is helpful when you are experiencing side effects from radiation therapy. “Resting sitting up after meals also allows proper digestion,” says Lara.
- Break usual mealtime traditions by eating long-established meals at different times during the day. On the other hand, you might feel like eating breakfast foods for dinner. “It’s important for patients to adopt an attitude of exploration during this time,” says Lara.
- Chew your food slowly.
- To make sure you’re getting enough calories during radiation, ask yourself, “What can I add to this meal to make it more nutrient-rich?” Think about topping your dishes with dressings and sauces.
- Some salt, ideally unrefined, is needed in all diets.
- If you are receiving radiation therapy for head and neck cancer, refrain from consuming foods that may get stuck when swallowing.
Hydration
Hydration is an important aspect of a healthy radiation diet. It is recommended that individuals drink 3-4 quarts of liquid every day. “Good hydration flushes toxins out of the body and reduces treatment side effects such as nausea, weakness, bowel changes, and fatigue,” says Komar. Keep a filled water bottle with you at all times and drink, drink, drink. Some Jello, pudding, popsicles, and juice products are additional hydration sources, but be cautious of their sugar content.
Foods to Limit or Avoid
What you exclude from your diet is just as important as what you include. Studies show that maintaining a diet high in vegetables and low in animal fats may impede tumor growth. In addition to foods to avoid that are listed above, spicy foods can cause gastrointestinal problems during radiation therapy.
It is also advisable to limit red meat, sugar, processed foods, and alcohol.
The Importance of a Healthy Lifestyle
A healthy lifestyle is an important part of overall wellness. Reaching and maintaining a healthy body weight are keys to overall good health. Eating a balanced diet and exercising can help you do this. Being overweight or obese can lead to advanced prostate cancer. Advanced prostate cancer is cancer that spreads or comes back.
Reaching and Maintaining a Healthy Body Weight
Reaching and maintaining a healthy body weight is one of the most important things you can do for your health. You can do this by eating a balanced, mostly plant-based diet, limiting red meat, and avoiding processed meat.
Understanding BMI
BMI is a measurement of the amount of fat in your body. It is based on your height and weight. This can help you learn if your weight is healthy or not. If your BMI is above 25, look for the weights that match a healthy BMI for your height. That should be your target weight. Keep in mind that BMI is only one health measure. Other measures include waist-to-hip ratio and waist circumference. These look at weight in your abdominal (belly) area. Extra weight in the abdominal area can increase your risk for certain illnesses, even if your BMI is healthy.
Knowing Your Caloric Needs
Your caloric need is the number of calories your body needs every day. Knowing your caloric needs can help you make a meal plan to gain, lose, or maintain your weight.
Managing Your Portion Sizes
It’s important to pay attention to serving sizes when you eat or drink.
Guidelines for Healthy Eating
Balance Your Plate
The balance of foods on your plate is important when trying to eat healthy. At least two-thirds of your plate should be vegetables, fruits, whole grains, or beans. You can also substitute plant proteins, such as beans, instead of eating animal protein. Just keep in mind the ideas of “mostly plant-based” and “portion controlled” for all meals.
Limit Sugar in Your Diet
All the cells in our bodies use glucose (a form of sugar) for growth and energy. Diets high in sugar and calories can lead to increased insulin and hormone levels. This may allow tumors to grow. Limit sugars from foods and drinks and your total calories. Eating too much sugar, or too much of any food, can also cause you to have extra body weight. This comes in the form of fat. Being overweight or obese can increase your risk of getting cancer.
Monitor the Fat in Your Diet
Some fat in your diet is necessary and healthy. There are different types of fat. Some are healthier than others. The type of fat you eat can be as important as the amount. High-fat foods are calorie dense. It’s important to avoid eating too many calories and to choose healthier types of fats. Most people do not need to avoid fat in their diet. For people with certain medical conditions, limiting fat may be helpful.
Include Fiber in Your Diet
Fiber helps lower cholesterol and regulate bowel movements (poop) and prevent constipation. It also helps with weight loss. Fiber can help you feel full after eating and can lower the risk for diabetes, heart disease, and obesity. Plant foods, such as fruits and vegetables, are the best sources of fiber. Whole grains, cereals, nuts, seeds, and legumes, such as beans, peas, and lentils can also provide the fiber you need.
Limit Salt and Sodium
Eating foods with a lot of salt may raise your blood pressure. It can also increase your risk for stroke, heart failure, and kidney disease. Eat less than 2,300 milligrams (mg) of sodium (about 1 teaspoon of salt) per day.
Include Calcium and Vitamin D in Your Diet
Having calcium in your diet every day keeps your bones and teeth strong and your muscles and nerves healthy. When you do not get enough calcium from your diet, your body takes calcium from your bones. This can make your bones weak and brittle and cause a disease called osteoporosis. Osteoporosis puts you at greater risk for bone fractures. Vitamin D helps your body absorb the calcium in your diet.
Limit Your Alcohol Intake
The amount of alcohol you drink can affect your risk for cancer of the esophagus, mouth, and head and neck. It can also affect your risk for cirrhosis of the liver. Alcohol is also high in calories.
Nutritional Supplements
Vitamin, mineral, and herbal supplements may interfere with certain treatments for prostate cancer. Always check with your healthcare provider before taking any nutritional supplements.
Multivitamins and Mineral Supplements
Multivitamins with high levels of selenium, vitamins C and E, and beta-carotene, may interfere with chemotherapy and radiation therapy. Eat whole fruits and vegetables to get the vitamins you need without interfering with your treatment.
Carotenoids
Lycopene is found in tomatoes, guava, pineapple, and watermelon. Studies suggests that lycopene from foods may reduce prostate cancer risk. Beta-carotene is found in dark green leafy vegetables, and yellow or orange vegetables like carrots and sweet potatoes. Beta-carotene rich foods and supplements are unlikely to have any significant effects on the risk of prostate cancer. It’s safe to eat foods with beta-carotene. Avoid taking beta-carotene supplements and juicing foods rich in beta-carotene.
Flaxseed
Flaxseed has can help reduce the growth and spread of prostate cancer. It is a good source of omega-3 fatty acids and fiber. Ground flaxseeds give the best health benefits. Your body cannot absorb whole flaxseeds. Flaxseed oil does not have the same benefits as ground flaxseeds.
Folate
It’s important to take the right amount of folate. Adding just the right amount of folate (400 micrograms) in your diet can slightly lower your risk for prostate cancer. Taking folic acid supplements can make it twice as likely to develop prostate cancer. Eat a balanced diet with folate-rich foods, such as fortified breakfast cereals and grain products. This also includes asparagus, avocado, legumes, liver, nuts, and dark green leafy vegetables.
Green Tea
Green tea is unlikely to reduce the risk of prostate cancer, but more research is needed.
Selenium and Vitamin E
Selenium and vitamin E are antioxidants. They are found in seafood, whole grains, vegetable oil, margarine, nuts, seeds, eggs, whole grain breads, and cereals. It’s best to get selenium and vitamin E from food sources rather than supplements.
The Importance of Plant-Based Foods
The healthiest eating is mostly based on plant foods like vegetables, fruits, whole grains, beans, and nuts/seeds. They also include healthy protein sources, such as beans, fish, or poultry, while limiting red and processed meats.
Vegetables and Fruits
Vegetables (including beans) and fruits are full of vitamins, minerals, fiber, and other substances that may help prevent cancer. Eating vegetables and fruits may also control weight, since they are low in calories, high in fiber, and have lots of water.
Whole Grains
Whole grains keep all parts of the original grain, so they have more fiber and nutrients than refined (or processed) grains. These include things such as whole wheat, brown or wild rice, oats, and corn. Studies show that eating whole grains might lower the risk of colorectal cancer.
Dietary Fiber
Dietary fiber is found in plant foods such as beans, whole grains, fruits, vegetables, nuts, and seeds. Eating these foods may help prevent excess body weight, which can lower the risk of cancer.
Processed and Red Meats
Processed meat has been cured, smoked, salted, or fermented to improve or preserve flavor. Examples include bacon, sausage, hot dogs, and deli meats. Evidence that red and processed meats increase cancer risk has existed for decades, and many health organizations recommend limiting or avoiding these foods. Because of this, it is recommended eating more protein from fish, poultry, and beans instead of red meat.
Managing Side Effects Through Diet
Many cancer patients lose weight unexpectedly during radiation therapy because they struggle with side effects caused from treatment. Getting the right amount of protein is very important during radiation treatment. Staying hydrated makes side effects less severe and lowers your chances of missing or delaying cancer treatments. All non-alcoholic beverages count toward keeping you hydrated. If you don’t enjoy drinking water, try flavored waters or waters infused with fruit or vegetables to improve the taste. If you are going to consume caffeinated drinks like tea or coffee, it is recommended having no more than 1 to 2 glasses a day as it may make dry mouth worse. This is a common side effect during treatment.
Side effects and diet recommendations vary based on the location of the tumor and the location of your body where you’re receiving radiation.
Nausea and Vomiting
Eat small, frequent meals throughout the day. Drinking clear liquids or eating bland foods such as dry toast or crackers may also help. Avoid fatty, fried, spicy, or very sweet foods. Try drinking liquids between meals instead of with your meals.
Mouth/Throat Pain
Eat soft and moist foods that are easy to swallow. Avoid raw vegetables and fruits, and other hard, dry foods such as chips or pretzels. It’s also best to avoid salty, spicy, or acidic foods if you are experiencing these symptoms.
Mouth Dryness
Keep water nearby so you can take frequent sips and rinse your mouth between meals. You can also rinse or spray your mouth using artificial saliva or baking soda. Maintain good oral hygiene. Use baking soda and salt rinses four to six times a day. This helps the pH balance and reduces bacteria in your mouth. Brush your teeth with a soft toothbrush after every meal and at bedtime. Avoid commercial mouthwashes that contain a large amount of salt or alcohol. You can also try ice chips, sugarless hard candies, or sugarless chewing gum.
Seeking Professional Guidance
Meeting with a registered dietitian/nutritionist (RDN) can be very helpful for you and your caregiver(s). RDNs can help you plan what to eat and what foods to limit or avoid. They can also provide help if you are losing or gaining weight due to treatment. Undergoing cancer treatment can be a long and difficult journey that can affect every aspect of your body. Radiation therapy for prostate cancer can often cause gastrointestinal problems and other issues that affect your diet and appetite.
Nutrition After Treatment
Once you have finished treatment, it is just as important to maintain a healthy diet and weight as it was before and during treatment. After treatment, continue to follow a diet of fresh fruits and vegetables and other unprocessed, low-fat foods to help you regain strength. Healthy eating can also reduce the risk of heart disease, high blood pressure, obesity, and diabetes.
Recent research suggests that making healthy food choices in your survivorship may lower your risk of recurrence and help you live longer. According to many experts, the types of foods that may help prevent prostate cancer are the same ones that may protect against prostate cancer recurrence. These experts recommend: plant-based foods (such as fruits, vegetables, and whole grains), lean protein, low-fat dairy products, and avoiding highly processed foods and red meats as much as possible.