The Role of Naturopathic Medicine During Active Surveillance in Prostate Cancer

Background: Active surveillance (AS) is increasingly used in low-risk prostate cancer, presenting an opportunity for integrative interventions to delay progression and improve overall health. This review explores the role of diet, exercise, and nutritional supplements in AS. Methods: A narrative review of clinical and observational studies on dietary patterns, physical activity (PA), and nutritional supplements in AS and pre-surgical prostate cancer research. Results: Plant-based and Mediterranean diets may reduce Gleason-grade progression, though randomized controlled trials (RCTs) show mixed results. Exercise, particularly high-intensity interval training (HIIT), may influence prostate-specific antigen (PSA) kinetics. Nutritional supplements such as vitamin D, green tea polyphenols, lycopene, mushroom mycelium extract, glucoraphanin, and fish oil show potential but inconsistent effects. Cardiovascular disease mortality surpasses prostate cancer mortality in men with localized disease, underscoring the need for cardiometabolic support alongside AS. Multimodal approaches integrating diet, exercise, and supplementation may offer the greatest benefit. Conclusion: While no single intervention is proven to prevent prostate cancer progression, a comprehensive, personalized approach, including diet, exercise, and additional integrative therapies, may optimize outcomes in motivated patients. Future research should focus on evaluating multimodal integrative strategies in AS.