Prostate Cancer Choices Spur Questions On Genomics And Diet

When a physician becomes a patient, the world of medicine can suddenly feel unfamiliar, even daunting. That was the reality for Dr. Francisco M. Torres, an interventional physiatrist at the Florida Spine Institute and Wellness, who found himself on the receiving end of a prostate cancer diagnosis. Despite years spent guiding others through medical uncertainty, Torres quickly discovered that navigating his own treatment options was anything but straightforward.

Prostate cancer, one of the most common cancers among men, presents a maze of therapeutic choices. As Torres recounts, the list is long: active surveillance, surgery, radiation, focal therapies, and genomic classifiers. "These were all tools and terms I had heard for years, but I had never considered them from a personal perspective," he wrote in an article published on January 16, 2026. Each option, he realized, came with its own set of caveats and uncertainties—an experience that left him feeling unexpectedly overwhelmed.

One of the most complex decisions Torres faced was whether to undergo genomic prognostic testing. These tests, designed to analyze tumor genetics and estimate the likelihood of cancer metastasis, offer a risk score that can help guide treatment. For Torres, the results brought initial relief: his score was on the lower end, suggesting a reduced chance of his cancer spreading. "For a moment, it felt like someone had cracked open a window in a very dark room," he recalled.

But that relief was quickly tempered by a new kind of anxiety. As Torres explained, "A low score can whisper, 'You’re fine. You don’t need to take immediate action.'" The temptation to become complacent, to relax monitoring and assume the best outcome, was strong. Yet, he recognized the danger in letting his guard down. "A low score does not eliminate risk, it does not replace careful monitoring. It does not allow one to take one’s foot off the gas."

This sense of uncertainty is not unique to Torres. According to a 2023 survey published in a medical journal, both patients and doctors often struggle with genomic testing—grappling with how to interpret results and how to use the data in decision-making. For many, the science behind the scores remains opaque, even as the technology becomes more common in clinical practice.

The financial implications of genomic testing add another layer of complexity. These tests are expensive, and insurance coverage is far from guaranteed. Torres noted, "Insurance companies, skeptical of their still-emerging clinical significance, often refuse to cover them. This financial burden creates a significant ethical dilemma for both clinicians and payers." For patients, the cost can represent yet another hurdle at a time when clarity and support are most needed.

Torres’s experience took on a new dimension when a coworker, herself facing a cancer diagnosis, sought his guidance about her own genomic test results. "Her voice trembled as she asked, 'Can you help me understand what I’m supposed to do with this?'" he remembered. In that moment, Torres saw his own vulnerability reflected back at him. The encounter underscored how genomic data can generate not just numbers, but emotional weight—a burden patients often carry in silence.

"She wasn’t asking for statistics. She wasn’t asking for a lecture on molecular biology. She was asking for something far more human: reassurance that she wasn’t alone in the confusion," Torres wrote. Sometimes, he realized, the most meaningful support isn’t an answer, but a willingness to listen and share in the uncertainty.

As genomic science continues to evolve, so too does the conversation around other aspects of prostate cancer management. On January 17, 2026, Dr. Adam B. Weiner hosted an episode of The UroOnc Minute featuring Dr. Stephen J. Freedland, professor of urology at Cedars-Sinai Medical Center, to discuss the role of diet and nutrition in prostate cancer risk and outcomes. It’s a topic that patients frequently raise in clinic, but as Freedland pointed out, the evidence base remains limited.

Drawing from a recent systematic review published in European Urology in 2025, Freedland explained that while observational studies suggest potential benefits from healthier, lower-inflammatory eating patterns—often plant-forward or Mediterranean-style diets—the results are inconsistent. "High-quality data linking specific diets to prostate cancer prevention or progression remain limited," Freedland emphasized. Randomized trials have generally been small and focused on intermediate endpoints, making it difficult to draw firm conclusions about the impact of diet on long-term outcomes.

Despite these limitations, Freedland advocates for core lifestyle principles that are supported by broader evidence: reducing simple sugars, avoiding trans fats, maintaining a healthy weight, exercising regularly, and quitting smoking. "For patients seeking more detailed guidance, he highlights the importance of involving dietitians and exercise physiologists to provide individualized, evidence-based support beyond brief clinic conversations," according to Urology Times.

Looking ahead, Freedland is optimistic that ongoing and future research will help clarify the role of nutrition in prostate cancer care. He referenced emerging prospective clinical trials, such as those evaluating fasting-mimicking diets in patients with metastatic hormone-sensitive prostate cancer (NCT05832086). These studies are examining endpoints like deep prostate-specific antigen (PSA) responses, which have been correlated with survival. While challenges remain in studying complex dietary patterns, Freedland anticipates that future trials will bring much-needed clarity to this area of cancer management.

The convergence of genomic testing and lifestyle interventions highlights a broader truth about cancer care: information is powerful, but it can also be overwhelming. Patients and clinicians alike must navigate a landscape where science offers probabilities, not certainties. As Torres observed, "Numbers can guide us, but they can’t replace vigilance. They can inform us, but they can’t remove active management of our health conditions. And they certainly don’t tell the whole story."

For Torres, the journey through prostate cancer has been as much about humility and vulnerability as it has been about medical knowledge. His experience serves as a reminder that even the most advanced tools cannot replace the need for empathy, clear communication, and shared decision-making. And for patients facing the uncertainty of a cancer diagnosis, perhaps the greatest comfort comes not from the promise of certainty, but from knowing they are not alone in their search for answers.