Nelson Vergel
Founder, ExcelMale.com
Stephen Freedland joins Alicia Morgans to discuss the Carbohydrate and Prostate Study 2 (CAPS2), a randomized controlled trial of a 6-month low carbohydrate intervention on disease progression in men with recurrent prostate cancer. This study is part of a series of studies looking at the role of low carbohydrate diets in prostate cancer. The study involved taking men with rising PSA after failed surgery or radiation and randomizing them to a low carb diet, which is considered less than 20 grams of carbs a day. The primary outcome was to look at PSA doubling times. Dr. Freedland explains the details and implications of the study and why it is so important to pay attention to the emerging data that lifestyle, diet, and exercise matter.
Randomized Controlled Trial of a 6-month low carbohydrate intervention on disease progression in men with recurrent prostate cancer: Carbohydrate and Prostate Study 2 (CAPS2).
April 7, 2020
Both weight loss and low carbohydrate diets (LCD) without weight loss prolong survival in prostate cancer (PC) models. Few human trials tested weight loss or LCD on PC.
We conducted a multi-site randomized 6-month trial of LCD vs control on PSA doubling time (PSADT) in PC patients with biochemical recurrence (BCR) after local treatment.
Eligibility included BMI ≥24 kg/m2 and PSADT 3-36 months. LCD was instructed to eat 20 g/carbs/day; controls were instructed to avoid dietary changes. Primary outcome was PSADT. Secondary outcomes included weight, lipids, glucose metabolism, and diet.
Of 60 planned patients, the study stopped early after an interim analysis showed futility. 27 LCD and 18 controls completed the study. At 6-month, while both arms consumed similar protein and fats, LCD reduced carbohydrates intake (-117 vs. 8g, p<0.001) and lost weight (-12.1 vs. -0.50Kg, p<0.001). LCD reduced HDL, triglycerides, and HbA1c with no difference in total cholesterol or glucose. Mean PSADT was similar between LCD (21 months) vs. control (15 months, p=0.316). In a post-hoc exploratory analysis accounting for pre-study PSADT, baseline PSA, primary treatment and hemoconcentration, PSADT was significantly longer in LCD vs. controls (28 vs 13 months, p=0.021). Adverse events were few, usually mild, and returned to baseline by 6-month.
Among BCR patients, LCD induced weight loss and metabolic benefits with acceptable safety without affecting PSADT suggesting LCD does not adversely affect PC growth and is safe. Given exploratory findings of longer PSADT, larger studies testing LCD on disease progression are warranted.
Clinical cancer research : an official journal of the American Association for Cancer Research. 2020 Feb 27 [Epub ahead of print]
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Randomized Controlled Trial of a 6-month low carbohydrate intervention on disease progression in men with recurrent prostate cancer: Carbohydrate and Prostate Study 2 (CAPS2).
April 7, 2020
Both weight loss and low carbohydrate diets (LCD) without weight loss prolong survival in prostate cancer (PC) models. Few human trials tested weight loss or LCD on PC.
We conducted a multi-site randomized 6-month trial of LCD vs control on PSA doubling time (PSADT) in PC patients with biochemical recurrence (BCR) after local treatment.
Eligibility included BMI ≥24 kg/m2 and PSADT 3-36 months. LCD was instructed to eat 20 g/carbs/day; controls were instructed to avoid dietary changes. Primary outcome was PSADT. Secondary outcomes included weight, lipids, glucose metabolism, and diet.
Of 60 planned patients, the study stopped early after an interim analysis showed futility. 27 LCD and 18 controls completed the study. At 6-month, while both arms consumed similar protein and fats, LCD reduced carbohydrates intake (-117 vs. 8g, p<0.001) and lost weight (-12.1 vs. -0.50Kg, p<0.001). LCD reduced HDL, triglycerides, and HbA1c with no difference in total cholesterol or glucose. Mean PSADT was similar between LCD (21 months) vs. control (15 months, p=0.316). In a post-hoc exploratory analysis accounting for pre-study PSADT, baseline PSA, primary treatment and hemoconcentration, PSADT was significantly longer in LCD vs. controls (28 vs 13 months, p=0.021). Adverse events were few, usually mild, and returned to baseline by 6-month.
Among BCR patients, LCD induced weight loss and metabolic benefits with acceptable safety without affecting PSADT suggesting LCD does not adversely affect PC growth and is safe. Given exploratory findings of longer PSADT, larger studies testing LCD on disease progression are warranted.
Clinical cancer research : an official journal of the American Association for Cancer Research. 2020 Feb 27 [Epub ahead of print]
A Randomized Controlled Trial of a 6-month low carbohydrate intervention on disease progression in men with recurrent prostate cancer: Carbohydrate and Prostate Study 2 (CAPS2).
Both weight loss and low carbohydrate diets (LCD) without weight loss prolong survival in prostate cancer (PC) models. Few human trials tested weight loss or LCD on PC.
