Active surveillance (AS) is an attractive alternative to immediate treatment for men with low-risk prostate cancer. Thus, the identification of environmental factors that promote the progression of indolent disease towards aggressive stages is critical to optimize clinical management. Epidemiological studies suggest that calcium-rich diets contribute to an increased risk of developing prostate cancer and that vitamin D reduces this risk. However, the potential effect of these nutrients on the progression of early-stage prostate tumours is uncertain, as studies in this setting are scarce and have not provided unambiguous conclusions. By contrast, the results of a preclinical study from our own group demonstrate that a diet high in calcium dose-dependently accelerated the progression of early-stage prostate tumours and that dietary vitamin D prevented this effect. The extent to which the conclusions of preclinical and epidemiological studies support a role for calcium and vitamin D and the relevance of monitoring and adjustment of calcium and/or vitamin D intake in patients on AS require further investigation.
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The authors are grateful to the Association pour la Recherche sur les Tumeurs de la Prostate (ARTP), the Institut Européen d’Expertise en Physiologie (IEEP), INSERM, the Centre National de la Recherche Scientifique (CNRS), and the University Paris Descartes for funding support of this project. They also thank the numerous colleagues who participated in the preclinical study described herein and L. Sackmann Sala for critical reading of the manuscript. T.C., N.B.D., N.P., and V.G. are members of the French Network for Nutrition and Cancer Research (NACRe network, team 63).
The authors declare no competing interests.
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Capiod, T., Barry Delongchamps, N., Pigat, N. et al. Do dietary calcium and vitamin D matter in men with prostate cancer?. Nat Rev Urol 15, 453–461 (2018). https://doi.org/10.1038/s41585-018-0015-z
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