The Importance of Diet in Beating Prostate Cancer

BY RALPH BLUM

If you are one of the nearly three million men currently living with prostate cancer, you need to know that what you eat really can make a difference. Not only does a healthy diet improve your quality of life and enhance the functioning of your immune system, recent studies suggest that as well as reducing the risk of prostate cancer, good nutrition can help slow the progression of existing cancer.

More often than not, prostate cancer is slow-growing and non-aggressive and, therefore, has one of the highest survival rates of any type of cancer. But why not improve your odds? Some of you may know that I have been living with this disease for over two decades, and that I have not always been conscientious about my diet. However, when my PSA spiked again in 2015, I could no longer ignore the mounting evidence that giving up high-fat and processed foods and eating more fruits, vegetables, whole grains, and fish had real benefits for fighting prostate cancer.

Speaking of fish, I read recently that a New Zealand study found that men who ate no fish had a two to three times higher frequency of prostate cancer than those whose diets included moderate to high amounts of fish. So sorry, guys, take those steaks off the Barbie and get out your fishing rods! Red meat contains more than 50% fat, and high-fat diets increase the level of insulin-like growth factor which in turn increases the risk of prostate cancer.

The National Cancer Institute has spent millions of dollars researching diet in China where the consumption of animal protein--meat, milk, cheese and eggs--is very low. The most significant finding in these extensive studies was this: the more animal protein you eat, the higher your risk of dying of cancer. In the entire Far East, the mortality rates from prostate cancer are eighteen times lower than in the U.S.

Another major offender is sugar. Cancer cells are especially greedy for sugar--a fact dramatically illustrated in a PET scan. The PET scan uses radioactive sugar injected into the blood stream to locate tumors, and the uptake of glucose into the cancer cells occurs so swiftly that they light up like fireworks within ten minutes of the injection. According to nutritionists you can slow cancer growth by lowering the amount of fuel available to the tumor cells.

So what to do? I'm not talking here about going on a strict macrobiotic or vegan diet, just cutting out foods that have been shown to accelerate the pace of cancer cell growth. You can start by throwing out the sugar cookies and Krispy Cremes. Next, substitute that juicy steak with wild salmon, and chow down on a plate of creatively seasoned steamed veggies.

This advice is especially relevant for men who meet the criteria for Active Surveillance and are able to postpone the undesirable side effects of radical treatment. And yes, it's a little boring. But it sure beats being dead.

Risk

BY RALPH BLUM

Prostate cancer is the most common non-skin cancer in the U.S. affecting one in seven men. It is estimated that there are nearly 3 million American men currently living with prostate cancer and it is still not known what causes the disease. However, here are the main factors that might affect your risk level of risk.

Age
Age is the most significant risk factor. Your risk increases exponentially as you get older. In old age, up to 8 out of 10 men harbor microscopic amounts of the disease in their prostate, live with it, and die of something else. In the opinion of one well-known urologist, “If you are over seventy and you don’t have prostate cancer, chances are you’re a woman.”

A Family History of Cancer
Generally speaking if you have a father or brother who was diagnosed with prostate cancer you are twice as likely to develop the disease compared to the average man, while men with two or more relatives with the disease are nearly four times as likely to be diagnosed. If your relatives were diagnosed before the age of 60, this increases the risk slightly. And the younger the age at diagnosis, the more likely it is you have a faulty gene called BRCA2 in the family. Cutting edge research is ongoing to read and interpret the genetic code of prostate cancer.

Race & Ethnicity
Prostate cancer is more common in black Caribbean and black African men than in white or Asian men. The difference seems to be a mixture of inherited genes and environmental factors. African American men are 56% more likely to develop prostate cancer than Caucasian men, and nearly 2.5 times more likely to die from the disease.

Height & Body Weight
Research has shown that taller men have a higher risk of getting aggressive prostate cancer, or prostate cancer that has spread. And there are a number of studies confirming that men who overeat and who are overweight display increased incidence and aggressiveness of the disease.

IGF-1
Insulin growth factor is involved in the regulation of normal cell growth and death. Some studies have shown that men with a higher level of IGF-1 in the blood have a higher risk of developing prostate cancer. So it is not high blood sugar, but rather the high level of insulin triggered by high blood sugar that stimulates rapid cancer growth.

So what can you do to inhibit prostate cancer growth?  Unfortunately, the days of eating everything you want are over. There has never been a more important time in your life to eat sensibly.  Your diet can no longer be rich in animal fat, processed and fast food and low in fruit and vegetables. We did not evolve and develop to eat this way.  This doesn’t mean you can never have another piece of pizza.  But it does mean that having less than 10% of calories from animal protein can result in a dramatic reduction in cancer risk.

Bottom line, you are not without power in influencing your level prostate cancer risk.

Concerning Nutrition

BY RALPH BLUM

My last blog but one was about caloric restriction, because there is ever increasing evidence that overeating and being overweight leads to an increase in the incidence of prostate cancer, as well as the aggressiveness of the disease.

If you have been diagnosed with prostate cancer and want to delay radical treatment for as long as possible, I firmly believe that the best thing you can do for yourself is take a good, hard look at your eating habits, and probably make some serious dietary changes.

Despite conflicting medical recommendations concerning the role of diet in the treatment of cancer, men who have gone on strict macrobiotic or vegan diets have shown impressive results. However, most of us are not sufficiently disciplined to go to such an extreme. So I'm just talking here about cutting out foods that have been shown to accelerate the pace of cancer cell growth. And sorry, guys, but the two chief offenders are sugar, and red meat.

Glucose functions like gasoline, fueling all the cells in the body, and nutritionists all agree that cancer cells are especially greedy for sugar because growing cells have even greater energy needs. Dr. Patrick Quillin PhD, RD, CNS, internationally respected expert in the area of nutrition and cancer, claims he has yet to see a cancer patient beat the disease while eating a diet that constantly raises blood glucose levels. However, controlling blood sugar levels is no easy task when sugar is everywhere in our food supply.

While healthy, "essential" fats make the immune cells more likely to recognize and destroy cancer cells, the wrong kind of fat--the kind found in red meat-- increases the risk of disease progression. After extensive studies in China, where the consumption of animal protein is very low, the National Cancer Institute found that the more animal protein you eat, the higher your risk of dying of cancer. In the entire Far East, mortality rates from prostate cancer are eighteen times lower than in the U.S.

It amazes me how often the critically important topic of how diet affects cancer growth is underemphasized in most doctors’ offices. Part of the problem is the overwhelming flood of conflicting and constantly changing information about what does and what doesn’t help control cancer growth.  But the truth is there has never been a more important time in your life to eat well than when fighting cancer. And all the evidence points to a diet low in sugar and animal protein for cancer prevention and control.

I have recently become aware of the buzz about Vitamin D and prostate cancer. Greg Anderson, who in 1984 was diagnosed with stage 4 lung cancer and given 30 days to live, is founder of the Cancer Recovery Foundation International group of charities whose mission is to help people prevent and survive cancer. In the recently updated version of his book, CANCER: 50 Essential Things to Do, Anderson claims that excellent science shows that an adequate level of Vitamin D hinders inappropriate cell division and metastasis, decreases blood vessel formation around tumors, and regulates proteins that influence tumor growth. Additional research, he claims, shows that Vitamin D also enhances the immune system’s ability to fight cancer, and is an effective cancer preventative, particularly for breast cancer and prostate cancer.

Most of us, it appears, do not get adequate vitamin D in our typical diets—especially if we are elderly, dark-skinned, obese, or avoid the sun. Anderson stands firmly behind his recommendation for those dealing with a cancer diagnosis to supplement with vitamin D3 (not D2) at the rate of 5,000 IU daily. He believes that over 50% of all prostate cancers can be prevented with vitamin D supplementation, and that it helps make cancer treatments more effective.

So my advice to you is: cut out the steaks and sugared donuts, and check out your local health food store for Vitamin D3

JUNE IS NATIONAL MEN'S HEALTH MONTH -
Join Mark Scholz, MD at Barnes & Noble - Long Beach Marina Pacifica to discuss Men's Health and Invasion of the Prostate Snatchers. June 26, 2014 @ 7pm
https://groups.google.com/forum/#!topic/prostateoncology/EMCeMwSBvZU

A New Model of Treatment

BY RALPH BLUM

Once you have been diagnosed with prostate cancer, I can’t stress too often the importance of being an active participant in your own cancer care.

All too often, the old model of care involved rushing mindlessly into whatever radical treatment your doctor recommended, often without understanding your options, and nervously hoping that the treatment the urologist chose would get rid of the cancer. The entire process was focused on the tumor; minimal attention was given to you as a person, or to the underlying factors that may have predisposed you to getting the prostate cancer in the first place. In fact you were, as we say nowadays, “disempowered”- you played no role in your own healing.

Conversely, the emerging new model of cancer care recognizes the important role you can, and should, play in your recovery. The emerging model understands that simply attacking the cancer is not enough; that when you feel empowered, when you regain a sense of control by engaging in your own recovery, it optimizes your body’s healing potential. Unfortunately, not all cancer specialists have adopted the new model.

So now that you know for sure that you’ve got prostate cancer,  what do you need to do?

First, find a cancer doctor who gives you confidence, listens to you, and who understands that you need to take the central role in your treatment choices and recovery process.  Then, do your own “due diligence” thoroughly research all your treatment options, check, and recheck with a second opinion your doctor’s recommendations, and  only then, choose the treatment program you believe in.

Equally important, your role in your recovery doesn’t stop with your choice of treatment. Cancer survivors agree that taking charge of their entire health and well-being by focusing on nutrition, exercise, support-and-attitude, enhanced their immune system and laid the foundation of the healing process.

The emphasis on lifestyle choices has been one of the most significant shifts in cancer care in the last decade. A cancer diagnosis is a heads-up to launch a nutritional makeover, and a regular, moderate exercise program. Nothing extreme is called for.  But it’s not enough to depend solely on medical treatment to fight your cancer.

When it comes to support and attitude I realize I’m getting into territory where most men are inclined to think, “B.S!”  But plenty of research demonstrates the benefits of supportive friendships, and intimate relationships that support and nurture us. And a great many cancer survivors report that they a direct link between a positive attitude and successful recovery.

The emerging model of cancer care recognizes that psychological and emotional states are as important to your healing as nutrition and exercise. A sense of optimism and hope strengthen and inspire the will to live, and actually impact the body on a physiological level. Inevitably there will be times during treatment when you feel fearful, depressed, exhausted and yes, hopeless. When that happens, instead of going into denial, allow yourself to feel the feelings, but refuse to get stuck in negativity. Surround yourself with supportive friends, believe in your treatment, and know that you are making lifestyle choices that support your healing.

It cannot be stated too often: reclaiming a sense of being in charge of your life and your health provide a vitally important foundation for the healing process— and the rest of your life.

How the Caveman Lived

BY RALPH BLUM

My concern—and hence our looking backward in time— is with the beneficial impact of reduced caloric intake on retarding, and in some cases reducing, the spread of prostate cancer. Dietary restriction, as I noted in our last blog, seems to trigger an ancient strategy written into all animal genomes, that when food is scarce, resources are switched from breeding to tissue maintenance.

In recent years biologists had considerable success in identifying the mechanisms by which cells detect the level of nutrients available to the body. One goal now is to find drugs that trick these mechanisms into thinking that famine is at hand. The positive results even include evidence that the immune system benefits from reduced caloric intake, and that there is a connection between brain function and adipose tissue in relation to obesity.

A recent study in PLOS Biology discusses the relationship between LDL, hunger, leptin, the brain, and the benefits in a number of areas: there is a ubiquitous receptor in the brain, adipose, and liver called the low-density lipoprotein receptor-related protein 1 (LRP1) which regulates leptin signaling. LRP1 has some of the following properties: lipoprotein metabolism, neurotransmission, synaptic plasticity (adaptability of the neuronal junctions), clearance of beta amyloid. (note the variant epoE4 of epoE is associated with Alzheimer's Disease), and basic cell survival.

There is now a small subculture whose members seek good health through a selective return to the habits of their Paleolithic ancestors.  Or as they sometimes refer to themselves, “dietary cavemen.” Their interpretation of this metaphor involves fasting between meals to approximate the lean times that his distant ancestors faced between hunts. Vegetables and fruit are appropriate, but they avoid foods like bread and pasta that were unavailable before the invention of agriculture. These Dietary Cavemen are convinced that the human body evolved from a hunter-gatherer lifestyle, and that our survival in today's world depends weaning ourselves off many millenniums of bad habits.

Now imagine if you will that you are a caveman, out innocently picking berries when you suddenly come nose to nose with a saber-tooth tiger. While you were simply gathering, the tiger was actually hunting, and the sight of you makes his mouth water.

It is our good fortune that millions of years of evolution have endowed you with a set of responses that take over automatically in the event of an emergency. Faced with the tiger, your hypothalamus sends a message to your adrenal glands and within seconds, you can run faster, hit harder, hear more acutely, think faster, and jump higher than you could only seconds earlier.

The transformation is instantaneous. In a heartbeat, so to speak, your heart is pumping at two to three times the normal speed, sending nutrient rich blood to the major muscles in your arms and legs. The tiny blood vessels (called capillaries) under the surface of your skin close down so you can sustain a surface wound and not bleed to death. Even your eyes dilate so you can see better.

In the same instant, all functions of your body not required for the life-saving struggle about to commence are shut down. Digestion stops; ditto sexual function; even your immune system is temporarily turned off. If necessary, excess waste is eliminated to make you light on your feet.

Your suddenly supercharged body is designed to help improve the odds of survival, with the result that you narrowly escape death. Once the danger is past, you find a safe place to lie down and rest your exhausted body. Much the same situation appears to apply when your “attacker” is prostate cancer.

In my next blog I will consider the elements of a diet that increases the possibility of such survival.

The Potential Benefits of Caloric Restriction

BY RALPH BLUM

There has been a lot written about the benefits to prostate cancer patients of eating mindfully. Boiled down to simplest terms, the notion translates as “Just eat less.”

I am always a bit uncertain when I read how mice prosper on some regime or treatment. Like the diet known as “caloric restriction,” which has all the normal healthy ingredients and food groups, but contains 30 percent fewer calories than usual. A New York Times article of July 10, 2009 stated that “mice kept on such a diet from birth have long been known to live up to 40 percent longer than comparison mice fed normally.”

Well and good. Further up the chain than flatworms. But still a long step from human results with caloric restriction. The next step was to use such a diet with rhesus monkeys to learn whether primates responded the same way as rodents. However, since rhesus monkeys have an average life span of 27 years and a maximum of 40, these experiments require patience.

Dietary restriction seems to set off an ancient strategy written into all animal genomes, that when food is scarce resources should be switched to tissue maintenance from breeding.

The rhesus monkey experiment requires another 15 years before the last monkey is expected to die. An eon, compared to flatworms, which have a life expectancy of about three weeks.

Twenty years after the experiment began, two studies, conducted by a team led by Ricki J. Colman and Richard Weindruch at the University of Wisconsin, reported in Science that the monkeys were showing many benefits, including significantly less diabetes, cancer, and heart and brain disease. “These data demonstrate that caloric restriction slows aging in a primate species,” the researchers wrote, which makes it likely that one could expect the biology of caloric restriction to produce similar benefits for humans.

While caloric restriction holds great promise, few people can keep to a diet with 30 percent fewer calories than usual. So biologists have been looking for drugs that might mimic the effects of caloric restriction, conferring the gain without the pain, so to speak. In recent years researchers have had considerable success in identifying the mechanisms by which cells detect the level of nutrients available to the body. The goal is to find drugs or compounds that trick these mechanisms into thinking that famine is at hand, hence the need for a severely restricted diet.

One such compound is resveratrol, a substance that can, apparently, duplicate in people some of the effects of caloric restriction. A member of a group of plant compounds called polyphenols, resveratrol is thought to have antioxidant properties that protect the body against the kind of damage linked to increased risk for conditions, including cancer since resveratrol is thought to limit the spread of cancer cells and trigger the process of cancer cell death or apoptosis.

The problem was that resveratrol, found primarily in the skin of red grapes (other sources include peanuts and berries) and, hence, in red wine, is present in quantities too small to have any effect, unless you drank about three bottles at a sitting. I have long been a fan of reveratrol, although I have despaired of acquiring enough of the compound to have a measurable effect on my system.

When it comes to resveratrol supplements, there isn't any specific dosage recommendation, and dosages can vary from supplement to supplement, although they are typically far lower than the amounts that have been shown beneficial in research studies. Most supplements contain 250 to 500 milligrams of resveratrol. To get the equivalent dose used in some animal studies, you would have to consume 2 grams of resveratrol (2,000 milligrams) or more a day. Not impossible. And arguably not a risk.

Now, Sirtris, a company based in Cambridge, Mass., has developed several chemicals that mimic resveratrol and can be given in concentrated doses. One such compound, the drug rapamycin, was reported to significantly extend life span in elderly mice, though it is not yet clear whether rapamycin sets off the same circuits as those that increase longevity in caloric restriction when ingested by humans. But there’s hope!

I remember when I was growing up, my Catholic classmates, like Dicky Doyle, ate no meat on Fridays. I reckon that at the very least, the meatless 24 hours gave their digestive systems a rest. Seen as a mild form of caloric restriction, meatless Fridays might well have had an impact on human longevity.

Perhaps if I can find a copy of the Beverly Hills High School alumnae, I can discover who is still around as we enter our 80s. And if they are still in possession of their faculties, perhaps I can learn what and how they’ve been eating for the last half century.

Meanwhile, there is evidence that those of us who eat as our ancestors ate do better in avoiding or fighting a variety of ills, prostate cancer among them.

In my upcoming blogs, I will revisit the eating habits of cave dwellers.

Detoxing for Jocks

BY RALPH BLUM

Recently my friend Michael Crocker—who is 59, a serious athlete (He calls himself “an over-the-hill jock”) and, because of his family history, at risk for prostate cancer—decided that he was not paying half enough attention to the  his diet. He was exercising and getting regular PSA evaluations, but he was eating as he always had, gaining weight and feeling that something in his diet was causing him bloating  and discomfort. He decided he might be having an inflammation reaction from foods that, while not allergy based, created a food intolerance that might be irritating his gut, leaving him depressed—and adding undesirable calories/weight. He put himself on what the profession calls “a food restriction diet.”

Michael made a list of what he called possible “food triggers” and going one week at a time, began eliminating them from his diet—and watching for improvement like decline in acid reflux, better sleep, more energy.

Here is Michael’s list of foods removed from his detoxing diet. He began by subtracting soy, then moved on to wheat and dairy and shellfish, He severely limited his sugar intake, cut out artificial sweeteners entirely, allowing himself honey in small amounts.

After about eight weeks, Michael told me, “I’m eating lean and clean, and probably eating more vegetables and fruit than I ever have before in my life.”

He started reading labels, something he had never done before. (“Jocks don’t read labels. Or at least they didn’t use to.”) He discovered that the FDA had called for labeling of “food allergens” in any packaged food (most of his items) and that even if items like soy were not specifically branded, they must be labeled somewhere on the package.

By the end of three months, Michael was eating limited amounts of lean meats, concentrating more on vegetables and fruits, and adding a side order of brown rice or sweet potato when he craved carbs. He rarely felt hungry on this diet. He dealt with his craving for snacks by carrying a bag of “Trail Mix” in his briefcase.

Here is a menu he found from Dr. Amy Shah on “RiseEarth”. As Dr. Shah writes in mindbodygreen

 A typical day may look like this:

 •    When you wake up: 1 glass green juice

•    Breakfast: Chocolate Cherry (Green) Smoothie: spinach, raw cacao, frozen organic cherries, chia seeds, coconut milk

•    Snack: Herbal tea

•    Lunch: Large salad with avocado, olive oil, balsamic dressing, and tomato soup

•    Dinner: 3 to 5 Black bean burgers (no bun) with guacamole, and salsa. (Optional: sweet potatoes, veggies, and kale chips)

 

•    Dessert: 1 serving of dark chocolate (my favorite is Green and Black's 85% dark)

Michael found that he was never hungry on this type of diet, and that while he wasn’t sure exactly which of “the usual culprits” had been causing his discomfort, he was happy to live with the results (including significant weight loss) of what he calls “The Aging Jock’s Anti-Inflammatory Detox Diet.” Aka AJAIDD.

What Diet Can Do For You

BY RALPH BLUM

Since my latest scare, when my PSA spiked and a color Doppler MRI showed a small but discernable growth in my tumor, my immediate focus has been on whether or not to begin treatment with IMRT. At the same time my wife, Jeanne, has been drawing my attention, once again, to my diet, and to which supplements can slow cancer growth.

It amazes Jeanne how this critically important topic is underemphasized when treating prostate cancer, despite overwhelming evidence that diet affects cancer growth. And even knowing what I know, I have been paying scant attention recently to my diet. Clearly now is the time to change that.

Extensive studies have proved that while certain foods are helpful in reducing PSA levels and cancer growth, other foods are not. First among the “not helpful” foods is animal protein that, particularly in the form of red meat, has been associated with an increasing incidence of prostate cancer. Other animal proteins—milk, cheese and eggs—also fuel the pace of cancer cell growth. As do all sugars, fats, and processed foods. In other words my basic food groups! But I can’t ignore the evidence. Dr. Dean Ornish, of cardiac diet fame, has achieved significant reduction of PSA levels in men with prostate cancer who went on his program consisting of a vegan diet (vegetarian, non-dairy) supplemented with antioxidants such as lycopene and selenium.

So given I intend to up my intake of “cruciferous vegetables”—in other words, broccoli, brussel sprouts and cabbage--that have been associated with a 50% reduction in prostate cancer risk, which supplements should I add to my diet?

Well, eating tomato sauce, which is high in lycopene would be a good start. A compilation of multiple studies measuring the amount of tomatoes in the diet, particularly cooked tomatoes, showed a 20% reduction in prostate cancer risk with increased consumption. (Lycopene can also be taken as a supplement.) And along with lycopene, selenium has strong antioxidant properties. Higher levels of selenium in the blood are associated with a 50% reduction in the incidence of prostate cancer. But as I am not a big consumer of Brazil nuts, clams, turkey or mushrooms, I am pleased to note that selenium can also be bought as a supplement in any good health food store.

There is increasing evidence that vitamin D inhibits prostate cancer growth. In studies using pharmacologic doses of synthetic vitamin D in men with relapsed prostate cancer, PSA levels stabilized and even declined in some men. Mark suggests a supplement of 2000 IU daily. He also advises against taking multivitamin or multimineral supplements as in some cases they may accelerate cancer growth.

It is much easier to swallow a pill than to change the dietary habits of a lifetime, but I intend to cut out red meat and eat more leafy greens and cooked tomatoes. And then there is pomegranate juice. According to Erik P Castle M.D., a urologist at the Mayo Clinic, early research suggests that drinking 8 oz of pomegranate juice daily may slow the progression of prostate cancer. And if you’re concerned about all that sugar, there is, of course, a pomegranate pill!

By the way, from everything I have read, dark chocolate is packed with flavonoids, a group of phytochemicals that act as antioxidants. I will take a closer look at chocolate in my next blog.

Nervous-Making Moments

BY RALPH BLUM

I’m interrupting my series of Blogs on “Stress” to give you a bulletin from the front. It concerns my latest PSA. It caught me off guard and gave me a bad moment.

I talk about these nervous-making moments often enough with men who contact me after reading “Snatchers.” But that’s them. This is me, my prostate.  And there it is: the sinking feeling in the gut, half-panic, half “Oh s--t!” Not that this toxic cocktail is new to me. But it is never quite something that even my long experience with prostate cancer never lets me to take in my stride.

This time, the moment is triggered by an email from Mark: 

Hi Ralph, 

I have been away on vacation.  Just got back.  Did anyone discuss your elevated PSA with you?  It was elevated to 26.  Can you give me a call today? 

Mark

I realized I had stopped breathing. No, no one has discussed my elevated PSA with me. 26! Ouch! In less than three months—for no reason I can think of—that’s up by more than 40%!

Dialing Mark, I thought what my friend, Harvey, would say: “Well, my PSA is 60—and I don’t even have a prostate! Consider yourself blessed. . . . You’re going to die in your sleep in 20 years after dinner out and a good movie.”  

Yeah, well, I still feel like I’ve eaten rotten fish.

Mark doesn’t sound concerned. He wants to know if I’ve noticed any symptoms of an enlarged prostate. No. Done any heavy lifting? Negative. “Well, let’s put you on an antibiotic for ten days—you tolerate Cipro alright—and then have you see Duke Bahn_for a Doppler MRI. He’s taking Medicare again. Then in about three weeks we’ll do a repeat PSA.”

Makes sense. But the panic is still there; the fear that perhaps I have tempted fate one too many times by not going for a cure.

When I tell my wife, Jeanne, who has a degree in Traditional Oriental Medicine and practices an ancient form of acupressure, her reaction is professional and predictable, but hardly comforting. “You’ve got to stop eating pork. And start eating tomatoes; you’re getting no lycopene. Diet, diet diet.”

And then it occurs to me: There may be an obvious explanation for the PSA spike.  I’ve had the flu for two weeks. Some fever along with the usual symptoms. Was that enough to spike my PSA? It happened once before when we were living in Hawaii. Or is this my body telling me it is finally time to do something?

I remember something Mark wrote in “Snatchers” that is somewhat reassuring: “How the cancer behaves over time is the most important predictor. It supersedes Gleason score, it supersedes stage and PSA. . . In your case, Ralph, we’ve had two decades to observe its behavior, and that behavior has to trump all the stats. 

In Mark’s experience, cancers do not tend to change their stripes after twenty years. “It’s like having new neighbors,” he once said. “With time you learn that they keep their property neat, that their dog won’t poop on your lawn, and that if you want to borrow a cup of sugar, sugar is what you’ll get. Well, the same with prostate cancer.”

Well, maybe prostate cancer has been my closest neighbor for long enough. I am once again in uncharted waters, and ultimately, there is risk in whatever I do. If I do nothing, I risk the cancer progressing. If I chose treatment, I risk unpleasant (or worse) side effects.

What’s the old-time carnival barker’s challenge? “You pays your money and you takes your choice.”

Time for long thoughts.

The Legacy of the Saber Tooth Tiger: A Few Unkind Words About Stress

BY RALPH BLUM

Whatever the problem—heart, cancer, diabetes—stress is arguably Public Enemy #1 for half of what ails this nation. And when it comes to immune system health, stress rings cash registers. Advertising budgets dedicated to pushing the stress button are worth what Ted Turner would call “serious cash money.” The root briar of an estimated 20 billion dollar a year volume of advertising, stress is Big Business.

It is now more or less common knowledge that the most potent immune system suppressor is stress. Especially chronic stress—the kind suffered by all of us from the moment are diagnosed with prostate cancer. So manufacturers of specialty foods, supplements, herbs and minerals are climbing onto the bandwagon and claiming that their products are “immune system boosters.” However, if you look carefully you will see that 90% of their claims are laced with hedge-your-bet qualifying terms like “might,” “perhaps,” “could” and “can sometimes.” This is the stuff that scams are made of these days.

So when you don’t know whether your job is being abolished, and you are seeing your savings dwindle to nothing, and your anxiety over your children’s future is keeping you awake at night, and then, on top of all that, you are diagnosed with prostate cancer, how can you hope to cope with this kind of chronic stress barrage? What can you do that will genuinely assist your immune system to function efficiently?

The three tried and true stress busters are simple enough. They are diet, exercise, and meditation. You don’t have to pump iron or run marathons, or subsist on tofu, berries, and leafy greens. But in order to fight cancer successfully, you do need to eat a healthy diet and find a type of exercise you enjoy. And, at least as important, you need to find some kind of meditation that you can live with—it can be as little as fifteen minutes a day!—because it does reduce the stress that inevitably ramps up with a cancer diagnosis.

If you’re interested, you might check into the fairly new field of Psychoneuroimmunology. You’ll learn about the legacy of the saber tooth tiger, and how to distinguish the activity of the adrenal system from that of the immune system. Because there are two distinct conditions: there’s growth and there’s protection, but you can’t have both at the same time. And when any threat mobilizes the body with the old “fight or flight” response, the adrenal (stress) hormones directly repress the action of the immune system. Result: almost every major illness has been linked to chronic stress.

It is now fairly well established that what goes on in our minds absolutely affects our bodies.  There is no question that our thoughts and our beliefs generate a cascade of chemicals that can act to either harm us or heal us. So my best recommendation to you is to believe wholeheartedly that whatever treatment you decide on will be totally successful. And when the stress gets to you, you don’t have to sit crossed-legged on the floor and repeat a mantra provided by a guru in the Himalayas. Just turn on some relaxing music, breathe slowly and deeply, and imagine yourself walking on a beach, or in a forest—whatever works for you—and see yourself relaxed and healthy. Relieving the chronic stress of living with prostate cancer is arguably taking a long step on the road to recovery.

The Big Shift: “Eating to Live”

BY RALPH BLUM

For many men, a diagnosis of prostate cancer is a wake-up call to make lifestyle and dietary changes. If you have been diagnosed with the Low-Risk and even Intermediate-Risk form of the disease, and you have decided to delay radical treatment, it is particularly important to follow a diet known to inhibit cancer growth.

While it is not clear exactly what role diet plays in a man’s getting prostate cancer, once diagnosed, there is increasing evidence to support the effectiveness of diet in counteracting the disease.

Body-weight is a major factor. A number of studies conclude that over- eating and being overweight lead to an increase in the incidence of prostate cancer, as well as the aggressiveness of the disease. But until recently, I had done little to change my diet. What did it take to get this mule’s attention?

Over 50 million people in the United States are obese. I am 5’9” and, as of this writing, I weigh 205, which registers as “obese” on any grading system. My wake-up call was watching a 60 Minutes segment about children in Florida living within sight of Disney World, who were going to bed hungry night after night. It hit me like a sucker punch: Being obese in such a world is more than unhealthy and shameful; it is obscene. That same day I not only changed the way I eat but my attitude where eating was concerned, replacing eating for pleasure with eating to live.

To borrow a phrase from Bette Davis, making serious dietary changes “ain’t for sissies.” The approaches we men take to “the food thing,” as one doc I know calls it, range from rigorous, restricted diets on the one hand, to intelligent and moderate monitoring of their intake on the other. I am not talking here about going on a strict macrobiotic or vegan diet, just cutting out foods that have been shown to accelerate the pace of cancer cell growth. What makes a diet most effective is not what you eat, it’s what you abstain from eating.

According to all nutritionists the worst offender is sugar. Cancer cells are especially greedy for sugar—a fact dramatically illustrated in a PET scan. The PET scan uses radioactive sugar injected into the blood stream to locate tumors. Well, the uptake of glucose into the cancer cells occurs so swiftly that they light up like fireworks within ten minutes of the injection.

Sorry guys, but next on the “foods to avoid” list is red meat. Red meat contains more than 50% fat, and high fat diets increase the level of insulin-like growth factor which in turn increases the risk of prostate cancer. I have gone “cold turkey” on red meat, chicken, and almost all fish.

The National Cancer Institute has spent millions of dollars researching diet in China, where the consumption of animal protein—meat, milk, cheese and eggs—is very low. The most significant finding in these extensive studies was: the more animal protein you eat, the higher your risk of dying of cancer.  In the entire Far East, mortality rates from prostate cancer are eighteen times lower than in the U.S. 

So what to do? Start by throwing out the sugar cookies and Krispy Cremes, and cut way down on the booze (Did I forget to mention booze? Sorry). Next, take that steak off the barbie, and chow down on a plate of delicious and creatively seasoned steamed veggies, with a side order of adzuki beans for a shot of pure protein. It took my sense of shame to move me to act. But I’ve stuck with it. And, yes, it’s a little bit boring. But nothing to compare with being dead.

Summertime

BY MARK SCHOLZ

The PCRI Conference is less than month away!   Every summer I scurry around making preparations.  Speakers have to be coordinated, exhibitors lined up, registrations fulfilled, entertainment scheduled. 

For this year we have significantly expanded the agenda:

Friday:  We have added introductory sessions that will be presented by our seasoned helpline facilitators, Jim O’Hara and Nathan Roundy.

Saturday Morning: Features the treatment of localized disease with various forms of radiation including seed implantation as well as covering high intensity focused ultrasound (HIFU).  In addition we will hear from the preeminent expert in the world on Active Surveillance, Dr. Laurence Klotz.  The morning will be rounded out with an update on the latest breakthroughs in imaging.

Saturday Afternoon: Will cover a multitude of recently FDA-Approved treatments for advanced prostate cancer presented by Eugene Kwon from the Mayo Clinic and Charles Drake from Johns Hopkins and yours truly. Amazing improvements have been made into medications that block testosterone, stimulate the immune system and poison cancer cells.

Saturday Evening: PCRI presents AdMeTech Foundation's “Dance for a Cure” with a LIVE performance by Jonathan Roberts and Anna Trebunskaya from the ABC hit series "Dancing with the Stars".

Sunday Morning: Our esteemed conference moderator Mark Moyad presents his latest thoughts on diet and supplements.  Snuffy Myers will talk about PSA Relapse. Stephen Auerbach discusses sexual rehabilitation.  Tim Wilson from the City of Hope updates us on robotic surgery.

Sunday Afternoon:  Breakout sessions with extensive Q & A will address the following topics: Diet, Focal Therapy, PSA Relapse, Active Surveillance, Radiation and Surgery. We will close with a round table of experts answering questions from the audience and discussing a selected clinical case.

I hope the rest of you are getting sand in your bathing suits and a mildly irritating sunburn.  See you in September.