EMPOWER Men to Reduce Weight and Inhibit Prostate Cancer Progression

Inclusion Criteria:

Understand and voluntarily sign consent form
Able to adhere to study protocol
Demonstrated use of internet and email
Access to internet at least 4 days per week
Willingness to change diet, physical activity and weight
Willingness to be randomized to immediate start or standard of care
Histologically confirmed diagnosis of adenocarcinoma of the prostate with evidence of biochemical recurrence following local therapy (surgery and radiation will be allowed). Biochemical recurrence will be defined as a PSA >= 0.2 ng/mL.
Surgically treated men must not be eligible for or decline salvage radiation. Men who recurred within 3 years of completion of salvage radiation will be included.
Definitive therapy (surgery or radiation) should be at least 4 weeks from time of consent.
Men who received prior hormone therapy with definitive local therapy (standard with radiation) are permitted if serum testosterone level is >150 ng/dL and hormone treatment was discontinued > 1 year from time of enrollment.
Body mass index >= 25 kg/m2
Eastern Cooperative Oncology Group (ECOG) performance status < 2
Willingness to return for clinical visit at 6 months, 12 months, and 24 months
Men receiving testosterone replacement therapy will be included if they are on a stable dose with testosterone levels in the normal range.

Exclusion Criteria:

Any clinical or radiographic evidence of metastatic disease by computed tomography (CT) of the chest, abdomen and pelvis and technetium-99 bone scintigraphy (bone scan)
MI, stroke or ASCVD procedure within 6 months
Serious medical condition likely to hinder accurate measurement of weight, or for which weight loss is contraindicated, or which would cause weight loss
Unstable angina or medical conditional that would prevent routine exercise
Prior or planned bariatric surgery
Use of prescription weight loss medication (including off label use of medications) or over-the-counter orlistat within 6 months
Chronic use (at least past 6 months) of medications likely to cause weight gain or prevent weight loss (e.g. corticosteroids, lithium, olanzapine, risperidone, clozapine), including androgen deprivation therapy
Unintentional or intentional weight loss within 6 months of enrollment (≥ 5% of body weight)