What diet is recommended for a patient undergoing radiation therapy for prostate cancer?

Recommended Diet During Radiation Therapy for Prostate Cancer

For patients undergoing radiation therapy for prostate cancer, a diet high in vegetables, fruits, and whole grains with low saturated fat, adequate vitamin D (at least 600 IU daily), and moderate calcium intake (not exceeding 1200 mg daily) is strongly recommended to maintain nutritional status and potentially improve treatment outcomes.

Nutritional Recommendations During Radiation Therapy

Core Dietary Components

• Emphasize micronutrient-rich and phytochemical-rich vegetables and fruits, particularly cruciferous vegetables and tomato products 1
• Include whole grains and beans/legumes in the diet 2, 3
• Maintain low amounts of saturated fat 1
• Ensure adequate vitamin D intake of at least 600 IU per day 1
• Consume adequate but not excessive calcium (not exceeding 1200 mg/day) 1
• Limit alcohol consumption to no more than 2 drinks per day 1
• Avoid tobacco products 1

Implementation Approach

• Individualized nutritional counseling by a trained professional is superior to simply providing supplements or standard care 1
• Nutritional counseling should focus on:
  • Meeting energy and protein requirements
  • Minimizing weight loss
  • Maintaining quality of life 1
• Consider oral nutritional supplements if needed to maintain adequate caloric and protein intake 1

Evidence-Based Benefits

Impact on Treatment and Outcomes

• Proper nutrition during radiation therapy can:
  • Improve nutritional intake and body weight 1
  • Enhance quality of life during treatment 1
  • Help avoid treatment interruptions 1
  • Potentially improve long-term survival (based on follow-up studies showing improved survival in patients who received nutrition counseling during radiotherapy) 1

Plant-Based Diet Benefits

• Preliminary evidence suggests that plant-based diets may:
  • Attenuate disease progression in prostate cancer patients 4, 5
  • Improve PSA doubling time in patients with recurrent prostate cancer 4
  • Increase plasma levels of potentially anticarcinogenic carotenoids 2

Special Considerations

Radiation-Specific Nutritional Challenges

• Radiation to the pelvic region can cause gastrointestinal symptoms in up to 80% of patients 1
• Weekly nutritional assessment during treatment is recommended to monitor for:
  • Weight loss
  • Decreased food intake
  • Gastrointestinal symptoms 1, 6

When to Consider Additional Support

• If oral intake becomes inadequate (less than 60% of requirements) for more than 10 days despite nutritional counseling 6
• If weight loss continues despite nutritional interventions 6
• For patients with severe radiation-induced gastrointestinal symptoms affecting nutrient absorption, referral to a registered dietitian (preferably one who is a Certified Specialist in Oncology Nutrition) is recommended 1

Foods and Supplements to Consider or Avoid

Potentially Beneficial

• Tomato products (containing lycopene) 2, 3
• Cruciferous vegetables 2, 3
• Green tea (modest benefit) 3

Caution or Avoid

• High intake of foods from animal sources, especially those high in saturated fat 1
• Excessive calcium supplementation (>1200 mg/day) 1
• Non-prescribed vitamin and mineral supplements 3
• Processed red meat, eggs, dairy, and poultry with skin (based on observational evidence) 3

By following these dietary recommendations during radiation therapy for prostate cancer, patients may experience improved nutritional status, better tolerance of treatment, enhanced quality of life, and potentially improved long-term outcomes.