What Most Men with Prostate Cancer Will Actually Die From (and What You Can Do About It)

By Dr. David Samadi

Prostate cancer is a common cancer that 1 in 8 men will be diagnosed with during their lifetime. More than 3.3 million men in the United States are currently living with it. While hearing the words “you have prostate cancer” can be alarming, the good news is that the majority of these men have localized prostate cancer, meaning the cancer is confined to the prostate gland and hasn’t spread. 

Even among those diagnosed with more aggressive forms or metastatic disease, many men still go on to live long lives, especially with advancements in screening, early detection, and treatment.

The American Cancer Society projects that in 2025, approximately 313,780 men will be newly diagnosed with prostate cancer, and an estimated 35,770 men will die from the disease. That’s a sobering statistic, but it’s important to put it in context. While prostate cancer ranks as the second leading cause of cancer death in men (after lung cancer), most men diagnosed with prostate cancer will not die from it.

About 98–99% of men diagnosed with localized prostate cancer will live five years or longer. Many will die with prostate cancer, not from it.

So, what do most men with prostate cancer eventually die from?

The answer may surprise you: heart disease.

Why Heart Disease Remains the Leading Threat to Men’s Health

For men living with prostate cancer—and for men in general—heart disease is far more likely to be the cause of death than cancer. About 1 in 4 men in the U.S. will die from cardiovascular disease. It is the number one killer of men across all racial and ethnic groups, and the risk begins earlier in life than many people realize.

The average age of a first heart attack in men is just 65.6 years, remarkably close to the age at which many men are diagnosed with prostate cancer. This overlap in risk means that men dealing with prostate cancer also need to be especially vigilant about their heart health.

The progression of heart disease begins early in life. While a newborn’s arteries are clean and open, plaque build-up can start as early as childhood and worsen silently over decades. That’s why adopting heart-healthy habits early and maintaining them throughout life is critical.

Fast Facts About Men and Heart Disease

• Men’s hearts are larger and pump more blood per beat than women’s hearts—but they’re not immune to damage from poor lifestyle habits.
• Heart disease is the #1 cause of death for men in the U.S., followed by cancer and unintentional injuries.
• Erectile dysfunction (ED) is not just a quality-of-life issue—it can be an early warning sign of cardiovascular disease. Men with ED have about double the risk of heart attacks, strokes, or death from heart-related issues.
• Half of all men who die suddenly from coronary heart disease had no previous symptoms, making proactive screening and prevention vital.
• Smoking remains a major risk, with about 17% of adult men still lighting up, according to a 2021 study.
• Before age 50, men are more likely than women to have high blood pressure, a key driver of heart disease.
• After menopause, women’s risk increases, but men continue to be at higher risk throughout midlife.

Prostate Cancer Treatments and Heart Health: The Overlooked Connection

It’s also worth noting that some prostate cancer treatments—particularly androgen deprivation therapy (ADT)—can carry the risk of increasing heart disease by affecting cholesterol levels, body fat distribution, and insulin sensitivity. Monitoring a man’s cardiovascular health becomes even more critical for men undergoing prostate cancer treatment.

What Men Can Do to Protect Their Heart Health

While some heart disease risk factors, such as age and family history, can’t be changed, many others can. The following evidence-based lifestyle strategies can significantly reduce a man’s risk of developing or dying from cardiovascular disease, whether he has prostate cancer or not.

1. Prioritize Quality Sleep

Getting 7–9 hours of quality sleep per night helps lower blood pressure, reduce inflammation, and support immune function. Inadequate sleep can contribute to weight gain, insulin resistance, and an increased risk of cardiovascular disease.

Tips to improve sleep:

• Avoid caffeine after 2 p.m.
• Power down electronics an hour before bed.
• Keep your bedroom dark, cool, and quiet.
• Stick to a consistent sleep schedule—even on weekends.

2. Eat Heart-Smart Foods (Including Nuts)

A heart-healthy diet is rich in nutrient-dense foods such as fruits, vegetables, whole grains, healthy fats, and lean protein.

Nuts like walnuts, almonds, pistachios, and macadamia nuts are rich in omega-3 fatty acids and can help reduce LDL (bad) cholesterol. Just a handful a day—about 1 ounce—can make a difference.

Other heart-supportive foods include:

• Fatty fish (salmon, sardines, trout)
• Leafy greens
• Berries
• Olive oil
• Avocados
• Beans and legumes

3. Make Movement a Daily Habit

You don’t need to run marathons to protect your heart. Just 150 minutes of moderate exercise per week—such as brisk walking, swimming, biking, or strength training—can improve cardiovascular fitness and reduce risk.

Bonus tip: Resistance training not only strengthens muscles but may also improve insulin sensitivity and reduce visceral fat, a known risk for heart disease.

4. Manage Stress

Men who suffer from chronic stress may also suffer from high blood pressure and inflammation, both major contributors to heart disease. Daily stress-reduction practices, such as deep breathing, meditation, prayer, or quiet walks in nature, can have a significant impact over time.

Even 10–15 minutes of quiet time each day can help lower cortisol levels and increase feelings of centeredness and calmness.

5. Maintain a Healthy Weight

Men who gain excess weight, especially in the abdominal region, place additional strain on their hearts. Even a modest 5–10% reduction in body weight can lead to improvements in blood pressure, cholesterol, and blood sugar levels.

6. Quit Smoking—For Good

Every cigarette—yes, even the “occasional” one—damages the heart and blood vessels. Within 24 hours of no cigarettes, your heart rate and blood pressure begin to drop. Within one year, your risk of coronary heart disease drops by about 50%.

Need help quitting? Ask your doctor if nicotine replacement therapies or support programs is for you.

7. Enjoy a Glass of Red Wine—Mindfully

A moderate intake of red wine (no more than one 5-ounce glass per day) may benefit heart health due to its resveratrol content. This natural antioxidant may help improve heart function and support healthy blood vessel function.

Not a wine drinker? You can also get resveratrol from:

• Blueberries
• Concord grapes
• Cranberries
• Dark chocolate (70% cacao or higher)

Always talk to your doctor before starting alcohol, especially if you’re on medication or undergoing cancer treatment.

Final Thoughts

A diagnosis of prostate cancer can understandably shift a man’s focus to survival. But it’s just as important to focus on how you live—and that includes protecting your heart. While prostate cancer may be the condition that brings men into the healthcare system, it’s often cardiovascular disease that poses the bigger long-term threat.

The silver lining? Heart disease is largely preventable. By making wise lifestyle choices—many of which also support prostate health—you can reduce your risk and improve your quality of life for years to come.

Stay proactive. Get screened. And don’t just aim to live longer—strive to live better.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.