What's Next & Food for Thought

Greetings Again, Friends and Family,

Note to Readers:  Because it pertains to lifestyle--ours and maybe yours--this is, perhaps, one of the more important posts we have written to date.  Over the past several months we have accumulated a lot of information about cancer in general, and prostate cancer in particular.  We are always open to sharing what we have learned with anyone who has questions or can benefit from the information.  We would also very much appreciate learning any information you would like to share with us.

So, while the following three paragraphs are more about our personal journey, the rest of the post is more specific about changes we have been making to implement an anti-cancer lifestyle.  We hope this healthy lifestyle information will be useful to you as well.

Now that we are back home, there is time to reflect a bit more on what we have gone through and what lies ahead.  On Thursday, April 26, I had appointments with my primary care physician and the lab, as I transitioned back to the Petersburg Medical Center for local care.  It is hard to express what a pleasure this experience was compared to dealing with the large size and complexity of the urban health care system.  I will receive a hormone blocker injection here in mid-July.  Beyond that, nothing is set in stone.  We will schedule appointments with my oncologist in Oregon for a routine follow-up visit sometime in late September or early October when we return south for our fall visit.  We will also schedule an appointment with my urologist in Oregon in mid-November for another hormone blocker--most likely a one-year implant. 

Since returning home I have been asked by several folks if I'm cured.  That is an excellent question to which I can honestly respond, "After what we have gone through, I certainly hope so".  However, the official answer is a bit more complicated, and we won't know for sure for at least two years.  The cancer I had was "highly differentiated".  Which means that the tumor was made up of cells that were very different from the prostate cells it had taken over.  Cancer can be very dangerous at that stage and, even though undetected by the scans, the probability of micro tumors having formed outside of the prostate is quite high.  That is the primary reason my treatment lasted so long, to treat both the prostate and the surrounding area.  We have faith that the radiation treatment of the margins got rid of any micro tumors that may have formed, but can't be certain at this time.

Most, but not all, prostate cancer cells require testosterone to reproduce.  As a result, I will remain on a testosterone blocker for the next two years.  This will greatly slow or stop the growth of any remaining tumors.  After that, I will discontinue the blocker, and they will closely monitor both PSA and testosterone levels.  An initial PSA "bounce" is expected as hormone levels return to normal.  A drop in the PSA level after the bounce will indicate that I'm cured.  If the PSA level stays high, or if it goes up, there will be more work to do.  If the cancer returns, the secondary treatment after radiation is called "salvage" and current methods of dealing with the return of prostate cancer after radiation have not been shown to be that effective.  However, new treatment methods are being developed all the time and in two years the cure rate for salvage treatment is sure to improve dramatically.  A logical question at this point is, "Why not just stay on hormone therapy forever?"  For one thing, that would entail a permanent life change and would take very careful consideration.  Also, because not all prostate cancer cells require testosterone to multiply, cancer could still grow, although it would likely take longer to become life-threatening.  Continuing hormone therapy for two years past radiation is the current method used to reduce the risk of the cancer recurring.  Stopping the therapy at that point provides a benchmark to evaluate the outcome of the treatments, and to determine whether additional treatment is necessary.

Is there anything I can do in the meantime to reduce the risk of the cancer returning?  Fortunately, the answer is yes.  Keep in mind that everyone has cancer cells in their bodies, but not everyone develops cancer.  If we avoid self-induced risk factors such as tobacco use, being around second hand tobacco smoke, or working around carcinogenic materials, there are six primary variables that determine whether or not a man develops prostate cancer.  These are race, genetics, age, diet, exercise, and stress.  Unintentional exposure to environmental contaminants can also be a factor, but the three main factors that a person can control are to eat a healthy diet, exercise regularly, and reduce stress. 

  

Diet:  I will have to admit that Kathy has been encouraging me to rethink my diet for a long time.  Much as a diabetic or heart attack victim finally wakes up to the need for a healthier lifestyle after-the-fact, it took the diagnosis of advanced prostate cancer to finally wake me up.  There is no way to know for certain if my penchant for sweets and fatty foods caused, or even contributed to, my cancer.  I do know that I wish I had taken diet more seriously starting at least 12 to 15 years ago, when the cancer most likely began to develop. 

Diet is such a big factor in the cause of cancer that a review of all data on epidemiology shows that "the principal difference between populations with the highest cancer rates and those with the lowest was their food".*  Simply put, certain foods tend to either feed tumors directly or contribute toward building the ancillary blood vessels necessary to supply a tumor.  Other foods tend to have the opposite effect.  When I first became convinced of the connection between diet and cancer and we started on a primarily anti-cancer diet several months ago, I joked that the diet is very simple--if it tastes good, spit it out.  That turned out to be untrue, and it did not take long to lose my craving for highly processed, overly sweet, or fatty foods.

It is no coincidence that the recommended diets to prevent all four lifestyle-induced epidemics of the western world--cancer, heart disease, obesity, and type-2 diabetes are so similar.  In fact, if you were to overlay the recommended diets to combat these four diseases, in a lot of respects it would be difficult to tell them apart.  In a nutshell, we have minimized our consumption of foods made with white flour, sugars, and corn syrup; fatty foods (particularly those high in omega 6 fatty acids); highly-processed foods; most fatty dairy products (particularly bulk cheeses); all processed meats; as well as feedlot beef and mass-produced chicken.  We have maximized our consumption of whole grains (cereals, breads, brown/basmati rice, etc.), fruits and vegetables (organic when available), wild fish, legumes, fat-free organic yogurt, and much smaller amounts of organic chicken and free-range, grass-fed beef.  We stray from the diet occasionally, but we don't feel deprived in any way on the basic healthy diet. 

 There are several cancer "super foods", which have been shown to reduce incidence of cancer to almost negligible levels where they are staples in a healthy regional diet.  We try to add at least some of them to our diet nearly every day.  These include, garlic, cruciferous vegetables (broccoli, brussel sprouts, cabbage, etc), turmeric (a key ingredient in curry), pomegranate (100% juice), olive oil, highly-colored berries, green tea, most soy products, and red wine (in moderation).  Dark chocolate is also good.  It turns out that there are synergistic benefits when some of these foods are combined with other foods.  Examples are: broccoli is more effective if eaten with hot mustard, horse radish, or wasabi (wasabi itself has anti-inflammatory properties); turmeric is much more effective if used in an dish which also contains olive oil and fresh-ground black pepper.  I like to think that a square of 72% cocoa Belgian dark chocolate paired with a 4-oz glass of a good merlot has tremendous synergistic benefits, both for the anti-oxidant food value as well as a great stress reliever. 

I'm not saying that if I stick to any particular diet, my cancer will not return.  In fact, it has been shown that diet is more effective in preventing cancer in the first place than it is in keeping cancer from recurring.  I certainly wish I'd been convinced of that before hand.  Regardless, if I can reduce the possibility of recurrence by even a small amount, it is more than worth it to me.  If nothing else, our risk of developing diabetes and heart disease, or becoming obese will diminish greatly, and we'll feel a lot better doing it.

  

Exercise: Moderate exercise is recommended to help prevent and to reduce the risk of recurrence of all cancers.  For some reason, as yet unknown, it requires even higher levels of regular exercise to show positive benefits toward reducing the recurrence of prostate cancer.  Achieving high enough levels of exercise to be beneficial will be a major challenge for a while, at least until my stamina has increased.  You all have permission to remind me to get out there and "just do it".

Stress:  Avoiding stress is very important because the adrenaline produced, particularly during continuous high stress levels, can actually create pathways which promote cancer growth.  If you find that you can't avoid stress in your life (most of us can't), mindfulness meditation and other forms of meditation and relaxation (such as yoga) are highly recommended methods of reducing stress.  To date, I've been very slow at working toward this.  I know from the literature that the potential benefits are great enough that I'm very encouraged to check it out.  In the meantime, I'll be content to put on some soft music, break off a small piece of dark chocolate, pour a small glass of red wine, sit back, relax, and contemplate the many blessings in our lives. 

Keep in mind that these lifestyle changes are to be considered in conjunction with, not as a substitute for, professional medical care.  As pointed out above, these changes will provide great benefits even if you don't have major medical issues.

 Peace and Love to all of you,

      Barry and Kathy

P.S.  We found the book listed below, and quoted in the text, to be very helpful to us.  It's easy to read, well-documented, contains encouraging anecdotal information, and has easy-to-understand color charts and graphs of the anti-cancer foods.  Take the opportunity to read the reviews on Amazon for a snapshot of the book.  We have purchased and/or recommended it to several of our family members and friends.  We will be ordering copies for the Petersburg Public Library.

* Anti cancer - a new way of life, by David Servan-Schreiber, MD, PHD, (p 106).