WALNUTS for POWER: Polyphenols, Omega-3 Fatty Acids, Weight Loss, and EneRgy

The overall objective of this study is to test the effect of walnuts added to a usual diet on prostate cancer progression as measured by Ki67 expression in the prostate tissues. Subjects will be randomized 1:1 to usual diet or usual diet with the addition of 2 ounces of walnuts daily. The baseline visit will occur in conjunction with a standard of care visit post-biopsy, the intervention period will range from 4-10 weeks dependent upon the scheduled date of the standard of care radical prostatectomy (RP), and the final visit will occur in conjunction with a standard of care visit prior to RP.

Inclusion criteria

• Pathologically confirmed prostate adenocarcinoma.
• Diagnostic biopsy cores with ≥10 cores with each core examined separately to determine exact tumor location.
• Biopsy grade group 2 or higher (Gleason ≥7).
• Planning to undergo RP.
• Willing to adhere to a usual diet with the possible addition of 2 oz of walnuts per day.
• Reads, writes, and understands English.
• Age 18 or older

Exclusion criteria

• Allergy to nuts.
• History of receiving hormone therapy or antiandrogen therapy.
• Use of 5-alpha reductase inhibitors in the past 6 months.
• Prior prostate radiotherapy (external beam or brachytherapy) or prior prostate cryotherapy.
• Currently enrolled in a modified diet/weight loss program and/or taking dietary supplements that contain omega-3s (e.g., fish oil).
• Other active malignancy, excluding basal cell carcinoma or squamous cell carcinoma
• Significant co-morbidities (e.g., cardiac, pulmonary, liver disease, alcohol/drug addiction, malabsorption syndromes), that in the opinion of the study physician make the patient ineligible.
• Individuals with psychological/mental conditions which can affect the consent process and/or their adherence to the protocol.