Nutritional Pearls: Tomatoes for Prostate Cancer?

Answer: Tomatoes and tomato sauce could help to lower the risk of developing prostate cancer.

Not all cancers are created equal. The word "cancer" is an umbrella term that includes all of the cancers you've heard about, from breast to pancreas to prostate cancers, but the truth is that every cancer type is very different from the others (this is why research into specific cancers is so important). To make matters worse, the individual cancers can vary within each type. You may have heard about estrogen-receptor-positive breast cancer, for example.

Prostate cancer also has distinct subtypes. About half of all prostate cancers are marked by a specific gene fusion known as trans-membrane protease, serine 2 (TMPRSS2):v-ets avian erythroblastosis virus E26 oncogene homolog (ERG) fusion, or TMPRSS2:ERG.

Several years ago, a study looked at the link between higher fruit and vegetable consumption and the risk of developing benign prostatic hyperplasia.¹ The active ingredient, so to speak, of those fruits and vegetables is their antioxidant content, which include beta-carotene, lutein, vitamin C, and lycopene. Tomatoes are very high in lycopene (it's the major red pigment in fruits and vegetables), and cooking tomatoes helps release the antioxidant—one case in which cooking the food makes it healthier.

The Research

Some research has shown that higher lycopene intake is related to a lower risk of prostate cancer. An international team of researchers looked at data drawn from the Health Professionals Follow-up Study (a long-term, large-scale, prospective study of over 50,000 male health professionals) to see if lycopene intake, specifically from tomato sauce, could be correlated with one's risk of developing TMPRSS2:ERG-positive prostate cancer².

The authors made use of the food frequency questionnaires of the 45,000 men who had no cancer diagnosis at the start of the study and grouped those men into 5 increasing levels of both lycopene intake (from all sources of lycopene) and 5 increasing levels of cooked tomato sauce. They then looked specifically at the diets of those men who were diagnosed with prostate cancer and received radical prostatectomy as a treatment, which allowed assessment of their TMPRSS2:ERG status.

The Results

After taking into account a range of variables, from race to medical history to whether they took vitamin E supplements, the authors found that both the highest quintile of lycopene intake and the highest level of tomato sauce intake were associated with a lower risk of prostate cancers of all types. But while higher lycopene intake reduced the men's risk by about 5%, higher intake of tomato sauce reduced their risk by 10%. Among those cases that were analyzed for ERG status, once again tomato sauce proved more protective than lycopene intake.

What’s the “Take-Home”?

We've seen that it's better to get your antioxidants from food rather than in pill form, and this research certainly supports that. To prevent prostate cancer, get your lycopene from cooked tomatoes. 

References:

1. Rohrmann S, Giovannucci E, Willett WC, Platz EA. Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. Am J Clin Nutr. 2007;85(2):523-529.

2. Graff RE, Pettersson A, Lis RT, et al. Dietary lycopene intake and risk of prostate cancer defined by ERG protein expression. Am J Clin Nutr. 2016;103(3):851-860.