Summary:
Prostate cancer is one of the most commonly diagnosed cancers in men worldwide. It primarily affects older men as risk increases significantly with age. While survival rates are generally good when detected early, many men experience treatment-related side effects that can persist during and after therapy. These side effects range from gastrointestinal discomfort, fatigue, changes in body weight, and reduced quality of life. To help mitigate this, nutrition and lifestyle interventions are increasingly being incorporated into cancer care. However, good quality evidence specifically focused on men receiving radiotherapy remains limited. This study is a systematic review that evaluated nutrition and lifestyle interventions in adults undergoing radiotherapy for prostate cancer. Multiple major databases were searched and 19 relevant studies were included that were both randomised and non-randomised studies. Across the included studies, individualised dietary support during radiotherapy showed potential benefits for reducing weight gain and helping manage gastrointestinal symptoms. Some restrictive dietary approaches improved bowel-related symptoms but were also linked to reduced energy intake and poorer nutritional status. Supplementation with tomato juice increased lycopene levels, although this was not consistently associated with clinical improvements. In studies that included mixed treatment settings, dietary interventions were associated with improvements in weight, blood lipids, and glucose control. Broader lifestyle programs were also linked to improvements in psychological wellbeing, urinary symptoms, and overall quality of life. Overall, the evidence suggests that nutrition and lifestyle strategies can help manage treatment-related side effects and support metabolic and quality of life outcomes during prostate cancer radiotherapy. However, the findings are inconsistent across studies, highlighting the need for higher-quality, radiotherapy-specific randomised trials with standardised outcome measures.
Abstract:
Background: Radiotherapy for prostate cancer often leads to gastrointestinal toxicity, weight gain, fatigue, and reduced quality of life. Nutrition and lifestyle interventions are increasingly used in cancer care, yet evidence specific to men receiving radiotherapy remains limited. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library to June 2025 for studies evaluating nutrition and lifestyle interventions in adults undergoing radiotherapy for prostate cancer. Study quality was assessed using the Cochrane Risk of Bias tool, Newcastle–Ottawa Scale, and ROBINS-I. Results: Nineteen studies were included. In radiotherapy-specific trials, individualized nutrition interventions showed potential to attenuate weight gain and manage gastrointestinal symptoms, while restrictive dietary modifications alleviated bowel complaints but were associated with declines in energy intake and nutritional status. Tomato-juice supplementation increased lycopene levels without consistent clinical benefit. In mixed-modality cohorts, dietary modifications were associated with meaningful weight loss and favorable changes in triglycerides, HDL, and HbA1c. Comprehensive lifestyle programs improved psychological distress, urinary symptoms, and quality of life. Conclusions: Nutrition and lifestyle interventions show promising signals for improving weight control, symptoms, metabolic profiles, and quality of life during radiotherapy. Given the heterogeneity of evidence, more robust, radiotherapy-specific randomized trials with standardized endpoints are needed to confirm efficacy.
Article Publication Date: 03/03/2026
DOI: 10.1080/01635581.2026.2637661
