COMMENTARY

Lifestyle Intervention: 5-Year Benefit in Prostate Cancer

Kathy D. Miller, MD

Disclosures

November 07, 2013

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Hi. It's Dr. Kathy Miller from Indiana University. Today I want to bring to your attention another fascinating study from Elizabeth Blackburn's group. Elizabeth Blackburn is the Nobel laureate who first identified telomerase and showed us the importance of telomerase and telomere length in various diseases, including malignancy. Several years ago, her group did a small pilot study[1] looking at 30 men with low-grade prostate cancer who elected to undergo active surveillance. They asked those men to participate in a lifestyle intervention geared towards improving the health of their diet, decreasing stress, increasing exercise, and increasing social support. They measured the physiologic effect of those lifestyle changes on the immune system, specifically by measuring how telomerase becomes activated in the peripheral blood mononuclear cells and the lengths of telomeres of those cells. Longer telomeres suggested that they were more robust and that those cells were likely to be more active and live longer, and they did see those effects.

They recently gave us 5-year follow-up results of 10 of the men who were in the original lifestyle intervention study, comparing telomerase activity and telomere length in their peripheral blood mononuclear cells with 25 age-matched men with low-grade prostate cancer who elected active surveillance but did not get that intervention. They still saw increased telomere length and increased telomerase activation in those men 5 years after a 3-month intervention. If you have been part of the crowd that thinks that lifestyle interventions won't be helpful and won't impact our patients, take a look at this study. It is admittedly small but has provocative data that I think need to challenge our assumptions about the importance of lifestyle in the lives of our patients and ourselves as well.

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