Diet in Prostate Cancer: Promising Side Dish or Main Course?

Diet represents a promising yet complex component of prostate cancer prevention and care, with the potential to influence cancer control and cardiometabolic outcomes. Previous studies suggest that plant-based and Mediterranean dietary patterns may be associated with the lower risk of prostate cancer progression among patients with nonmetastatic disease or those on active surveillance. Dietary interventions are also thought to mitigate metabolic toxicity from androgen deprivation therapy, including effects on lipid profiles, blood pressure, body composition, and glucose metabolism, although findings remain heterogeneous. Despite these suggestive findings, definitive conclusions about the role of diet in prostate cancer development and progression remain elusive. Much of the existing evidence comes from observational studies or trials with small sample sizes, reliance on intermediate endpoints, imprecise diet assessment, adherence challenges, and limited funding. Consequently, positioning diet as a standalone therapy risks overstating its benefits. We propose a more pragmatic framework in which dietary interventions are evaluated as complementary to standard prostate cancer treatments, with an emphasis on clinically meaningful endpoints, rigorous study designs, and adequately powered trials. Future research should prioritize adequately powered studies that assess the role of diet in improving disease outcomes, metabolic health, and quality of life, thereby better defining its place within evidence-based prostate cancer management. See related article by Hua et al., Cancer Epidemiol Biomarkers Prev 2026;35:438-46.