Abstract
BackgroundProstate cancer (PC) incidence and progression may be influenced by dietary factors, but little is known about the acceptability of dietary modification to men at increased risk of PC. Qualitative interviews with men participating in the ProDiet study were undertaken to explore the feasibility of implementing dietary interventions for the prevention of prostate cancer.MethodsAn interview study nested within the ProDiet randomised feasibility trial of dietary interventions to prevent a PC diagnosis. Men (n = 133) who previously participated in community based prostate specific antigen (PSA) testing without PC but who were at increased risk of the disease were randomly allocation to both lycopene (lycopene or placebo capsules or lycopene rich diet) and green tea (green tea or placebo capsules or green tea drink) for 6 months. Semi-structured interviews were conducted with participants shortly after randomisation, to investigate attitudes towards dietary modification for PC prevention and dietary information. Interviews were audio-recorded, transcribed and analysed to identify common themes.ResultsInterviews were conducted with 21 participants aged 52-72 years with PSA levels between 2.5 and 2.95 ng/ml, or a negative prostate biopsy result. Most men identified the major causes of cancer in general to include diet, environment, ageing and genetic factors. This contrasted sharply with men’s uncertainty about PC aetiology, and the function of the prostate. Men were confused by conflicting messages in the media about dietary practices to promote health overall, but were positive about the potential of lycopene and green tea in relation to PC prevention, valuing their natural components. Furthermore these men wanted tailored dietary advice for PC prevention from their clinicians, whom they considered a trusted source of information.ConclusionMen at elevated risk of PC reported uncertainty about PC aetiology and the role of diet in PC prevention, but enthusiasm for dietary modifications that were perceived as ‘simple’ and ‘natural’. The men looked to clinicians to provide consistent disease specific dietary advice. These factors should be taken into consideration by clinicians discussing elevated PSA results with patients and those planning to embark on future trials investigating dietary modification interventions for the prevention of a PC diagnosis.
Highlights
Prostate cancer (PC) incidence and progression may be influenced by dietary factors, but little is known about the acceptability of dietary modification to men at increased risk of PC
Men (n = 133) who were without evidence of PC but at elevated risk of subsequently developing PC; (PSA levels between 2.5 and 2.95 ng/ml; or above 2.95 ng/ml combined with a negative prostate biopsy result) previously identified as part of community-based prostate specific antigen (PSA) testing in the ProtecT (Prostate Cancer testing and Treatment study) [19] were recruited into the Prostate and Diet (ProDiet) trial from nine primary care practices in the South West of England, between December 2009 and May 2010
Three major themes were identified during the analyses: knowledge of cancer risk factors; attitudes towards green tea and lycopene for PC prevention; and preferences for dietary information for PC prevention
Summary
Prostate cancer (PC) incidence and progression may be influenced by dietary factors, but little is known about the acceptability of dietary modification to men at increased risk of PC. Qualitative interviews with men participating in the ProDiet study were undertaken to explore the feasibility of implementing dietary interventions for the prevention of prostate cancer. Prostate cancer (PC) is most prevalent among high income countries and diet and lifestyle may play a significant role in its development [1]. More high quality research is needed before disease-specific dietary recommendations can be developed [6]. There have been a range of observational studies regarding other dietary components (e.g. green tea) which showed reduced prevalence in countries with high consumption [7]. A number of epidemiological studies have suggested that green tea intake may reduce the risk of prostate cancer [8,9]. Men diagnosed with PC have expressed positive attitudes towards behavioural (diet and exercise) interventions [12] and a need for more information on a “prostate friendly diet” [13]
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