Western Dietary Pattern, Prudent Dietary Pattern, and Cancer-Specific Quality of Life in Prostate Cancer Survivors in the Health Professionals Follow-Up Study

Abstract

Background:

Prostate cancer survivors often experience reduced health-related quality of life (QOL). Diet is related to QOL in the general population and prostate cancer survivors, with benefits observed from greater consumption of a plant-based diet after treatment. We examined whether postdiagnostic Western and prudent dietary patterns were associated with cancer-specific QOL.

Methods:

We studied 1,032 participants in the Health Professionals Follow-Up Study diagnosed with nonmetastatic prostate cancer (2005–2014). Diet scores were cumulatively averaged from validated food frequency questionnaires after diagnosis. QOL was assessed with the Expanded Prostate Cancer Index Composite Short Form 2 to 5 years after diagnosis/treatment (2010–2016). We assessed associations between the two diet patterns and cancer-specific QOL domains (sexual function, urinary irritation/obstruction, urinary incontinence, bowel function, hormonal/vitality function), adjusting for patient, tumor, and lifestyle characteristics.

Results :

Median age at diagnosis was 75 years; 93% had clinically localized cancer. Higher Western diet scores were associated with worse bowel function by 3 points (P trend = 0.02), below the 4 to 6 point threshold for clinical relevance, with suggestive trends among radiation-treated patients (P trend = 0.07). Higher prudent diet scores tended to be associated with better bowel function (P trend = 0.09). Neither diet score was associated with bowel function among patients receiving radical prostatectomy or active surveillance. There were no associations with sexual, urinary, or hormonal/vitality function.

Conclusions:

Among survivors of nonmetastatic prostate cancer, dietary patterns were largely unrelated to cancer-specific QOL across domains and treatment subgroups.

Impact:

In the 2- to 5-year window, QOL was largely unaffected by postdiagnostic dietary patterns, warranting further research with longer follow-up to assess potential latency.

Western Dietary Pattern, Prudent Dietary Pattern, and Cancer-Specific Quality of Life in Prostate Cancer Survivors

Hua, Q., Bauer, S. R., Stopsack, K. H., Fu, B. C., Shreves, A. H., McGrath, C. B., Loeb, S., Mucci, L. A., & Lagiou, P. (2026). Western dietary pattern, prudent dietary pattern, and cancer-specific quality of life in prostate cancer survivors in the Health Professionals Follow-Up Study. Cancer Epidemiology, Biomarkers & Prevention, 35(3), 438–446. https://doi.org/10.1158/1055-9965.EPI-25-1393