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.

对于患有低风险前列腺癌的男性，主动监视（AS）是立即治疗的一种有吸引力的替代方法。因此，确定促进惰性疾病向侵袭性阶段发展的环境因素对于优化临床管理至关重要。流行病学研究表明，富含钙的饮食会增加患前列腺癌的风险，而维生素D会降低这种风险。但是，这些营养素对早期前列腺癌进展的潜在影响尚不确定，因为在这种情况下的研究很少，并且没有得出明确的结论。相比之下，我们小组的临床前研究结果表明，高钙饮食依赖剂量加速了早期前列腺肿瘤的进展，而饮食中的维生素D阻止了这种作用。临床前和流行病学研究的结论在多大程度上支持钙和维生素D的作用，以及AS患者中钙和/或维生素D摄入量的监测和调整的相关性需要进一步研究。