A UCLA study found that a diet low in omega-6 and high in omega-3 fatty acids, along with fish oil supplements, can significantly slow the growth of prostate cancer cells in men opting for active surveillance, potentially reducing the need for future aggressive treatments.
Researchers from UCLA Health Jonsson Comprehensive Cancer Center have found new evidence that dietary changes may slow cancer cell growth in men with prostate cancer undergoing active surveillance—a treatment approach that involves closely monitoring the cancer without immediate medical intervention.
Prostate Cancer and Dietary Intervention
The study, published today (December 13) in the Journal of Clinical Oncology, revealed that a diet low in omega-6 fats and high in omega-3 fatty acids, supplemented with fish oil, significantly reduced the growth rate of prostate cancer cells in men with early-stage disease.
“This is an important step toward understanding how diet can potentially influence prostate cancer outcomes,” said Dr. William Aronson, Professor of Urology at the David Geffen School of Medicine at UCLA and first author of the study. “Many men are interested in lifestyle changes, including diet, to help manage their cancer and prevent the progression of their disease. Our findings suggest that something as simple as adjusting your diet could potentially slow cancer growth and extend the time before more aggressive interventions are needed.”
The Challenge of Active Surveillance
Many men with low-risk prostate cancer choose active surveillance over immediate treatment, however, within five years, about 50% of these men eventually need to undergo therapy with either surgery or radiation. Because of this, patients are eager to find ways to delay the need for treatment, including through dietary changes or supplements. However, specific dietary guidelines in this area have yet to be established. While other clinical trials have looked at increasing vegetable intake and healthy diet patterns, none have found a significant impact on slowing cancer progression.
Study Design and Dietary Counseling
To determine whether diet or supplements can play a role in managing prostate cancer, the UCLA-led team conducted a prospective clinical trial, called CAPFISH-3, which included 100 men with low-risk or favorable intermediate-risk prostate cancer who chose active surveillance. Participants were randomly assigned to either continue their normal diet or follow a low omega-6, high omega-3 diet, supplemented with fish oil, for one year.
Participants in the intervention arm received dietary personalized counseling by a registered dietician nutritionist, either in-person, through telehealth or by phone. Patients were guided on healthier, lower fat alternatives for high fat/high-calorie foods (such as using olive oil or lemon and vinegar for salad dressing), and on reducing consumption of foods with higher omega-6 content (such as chips, cookies, mayonnaise, and other fried or processed foods). The goal was to create a favorable balance in their intake of omega-6 and omega-3 fats and make participants feel empowered to control how they change their behavior. They were also given fish oil capsules for extra omega-3s. The control group did not get any dietary counseling or take fish oil capsules.
Results of Dietary Changes
The researchers tracked changes in a biomarker called the Ki-67 index, which indicates how fast cancer cells are multiplying—a key predictor of cancer progression, metastasis and survival.
Same site biopsies were obtained at the start of the study and again after the one-year mark, using an image fusion device that helps track and locate the cancer sites.
Results showed that the low omega-6, omega-3 rich diet, and fish oil group had a 15% decrease in the Ki-67 index, while the control group saw a 24% increase.
“This significant difference suggests that the dietary changes may help slow cancer growth, potentially delaying or even preventing the need for more aggressive treatments,” said Aronson, who is also the Chief of urologic oncology at the West Los Angeles Veterans Affairs Medical Center and member of the UCLA Health Jonsson Comprehensive Cancer Center.
Conclusion and Future Research Directions
While the results are promising, researchers did not find any differences in other cancer growth markers, such as Gleason grade, which are commonly used to track prostate cancer progression.
The investigators caution that further research is necessary to confirm the long-term benefits of omega-3 fatty acids and lowering omega-6 in managing prostate cancer. The findings support further, larger trials to explore the long-term impact of dietary changes on cancer progression, treatment outcomes, and survival rates in men on active surveillance.
Reference: “Impact of Obesity on Biochemical Control After Radical Prostatectomy for Clinically Localized Prostate Cancer: A Report by the Shared Equal Access Regional Cancer Hospital Database Study Group” by Stephen J. Freedland, William J. Aronson, Christopher J. Kane, Joseph C. Presti Jr, Christopher L. Amling, David Elashoff and Martha K. Terris, 13 December 2024, Journal of Clinical Oncology.
DOI: 10.1200/JCO.2004.04.181
The study’s senior author is Dr. Susanne Henning, adjunct professor emerita and former director of the nutritional biomarker laboratory at the Center for Human Nutrition at UCLA. Other UCLA co-authors are Tristan Grogan, Dr. Pei Liang, Patricia Jardack, Amana Liddell, Claudia Perez, Dr. David Elashoff, Dr. Jonathan Said and Dr. Leonard Marks.
The study was funded in part by the National Cancer Institute, the UCLA Health Jonsson Comprehensive Cancer Center, Howard B. Klein, and the Seafood Industry Research Fund.
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