My story is typical. My primary doctor referred me to a urologist when my PSA exceeded 4. I had a biopsy with 10 cores, 3 of which showed "Low Grade" cancer in 30% of the cells. I was given the lecture on treatment and since it was golf season and this was supposed to be slow growing, I procrastinated until November. During that time, however, I attended Prostate Support Groups, went to two local symposiums, scoured the internet, and read books. It became clear to me that the treatment may well be worse than the cure.
In November I decided to have a second opinion at one of the big hospitals in Boston with a Urologist familiar with Watchful Waiting. He told me that they use the Johns Hopkins guidelines and that I qualified in all categories except for one. I had three cores showing cancer as opposed to the recommended two. He would however go along with my decision since I had no psychological problem carrying cancer around in my body.
He wanted an immediate Endorectal coil MRI and another biopsy in July of 2011. They found no visible tumor in the MRI and a 51 cc prostate that was not that inconsistent with men of my age. I have had no urinary or erectile problems.
I told him I was not going to just sit and wait. Rather I had already begun a regiment of low glycemic diet, exercise, and supplements but I needed him to prescribe Finasteride to block the testosterone. Surprisingly, he had no problem with my request. I was aware they prescribe this to men with BPH (Benign Prostate Hyperplasia) and no cancer and to men with aggressive cancer, but not to men with low grade non-aggressive cancer. That was due to some conclusion based on some study that made it appear that finasteride may have caused low grade cancers to become aggressive. In one of the symposiums I attended an Oncologist thought the conclusion was awfully speculative, and it made no sense to me, and since I wanted to attack the cancer in all known ways they find it to grow, I wanted to block the testosterone. [The study to which Peter refers arose from the Prostate Cancer Prevention Trial (PCPT) which was terminated early because although the initial results demonstrated a reduction in the number of cases of prostate cancer diagnosed, it appeared that those that were diagnosed were more aggressive. There was considerable disagreement about these findings which has never been resolved.]
Side effects were minimal. My libido has been reduced but all else functions well when needed.
I read all the Active Surveillance stories on YANA and a pattern appeared at least to me. Men who restricted sugar either by becoming a Vegan or going on the so called Mediterranean diet, who exercised, and took supplements seemed to restrict the growth of the cancer and this is definitely my intent.
I doubled the recommended exercise of walking 30 minutes a day, changed my diet to avoid sugar as much as possible, started taking supplements recommended by Snuffy Meyers, and take finasteride. My next PSA test and biopsy is this summer and we'll see what gives.
Good News. Had my second biopsy in August 2011 with no cancer found in any of the 12 cores. PSA dropped to 1.5. Life style change seems to be working. Will continue with Active Surveillance. Next Biopsy in two years.
Just had my 6 month PSA test results and it continues to drop [now 1.0] with my regiment of low glycemic diet, one hour of walking per day, finasteride, and supplements that support the immune system [probiotics, vitamins C and D]. I also get my Lycopene from 1 tsp tomato paste three times a day.
I am continually amazed that many men on Active Surveillance do nothing to change their life style and diet. [Some suggestions are at Dr Myers' Managment] The medical profession can do nothing for us, we have to take action ourselves.
Also, I am on a two month holiday from finasteride with the idea of mitigating the muscle and bone loss that accompanies testosterone blocking medications. If my PSA remains low, I plan to increase the holiday periods.
Completing my third year on Active Surveillance having had the major life style change. I have been following it pretty well with little problems. It parallels Dr. Snuffy Meyers "Prostate Cancer Arrest Program" I found on his website. My diet is closest to the "Paleo" diet, since I firmly believe an ultra low glycemic diet is the most effective against the cancer progression. My most recent PSA was 1.5 and it has stayed between 1.0 and 1.5 since my last update. I am scheduled for my third biopsy in April. My objective is to delay treatment as long as possible. Every year without treatment is a good year in my opinion. As long as the cancer remains encapusulated and there is no indication it is progressing, I will remain on Active Surveillance.
I had my third biopsy in April 2013 and results showed one core positive with 15% gleason 6. Cancer is still there but holding steady. My PSA; remains at 1.5. My surgeon urologist agrees with my decision to continue with Active Surveillance. He has me scheduled for a fourth biopsy in three years as long as my PSA; remains constant. I am personally convinced that a low glycemic diet coupled with exercise and finisteride is keeping the cancer in check. My doctors still poo poo the idea of the effect diet has on the progress of pc but when I started three years ago, I had three cores positive, 10%, 20%, 30%, and a PSA; of 4.3. They still think the finisteride has reduced the PSA; even though when doubled it is still lower than when I started. Of course the small samples from the tiny needles is the reason only one core was found. Yada Yada Yada. I don't care what they think, I will still maintain my regimen.
I had my third biopsy last spring with one of twelve cores showing 15% positive gleason 6. My most recent PSA; in Dec 2013 came back 0.9. With these numbers my surgeon was comfortable with continuing AS scheduling a fourth biopsy in spring 2016. I credit my low glycemic diet and finasteride for these results. I would also like to note that my prostate size has been reduced from 55 cc at disgnosis to 35 cc at last biopsy.
Continuing Active Surveillance Plus. PSA test every 6 months. Last PSA 0.9. Next biopsy scheduled spring 2016. (the "plus" is my four pronged approach)
There is no single magic pill to slow or stop the progression of PC. For me its a combination of a 4 pronged attack which the medical community has yet to figure out and doctors like Snuffy Meyers who are getting close are not listened to. Here it is: 1. Zero Carb diet 2. Exercise equivalent to walking one hour per day. 3. Avodart or Proscar prescription. 4. Vitamins C and D at least 3000 mg per day.
Carbohydrates are Killers. This is the single most important part of my program. I know if it is working by requesting a glucose test each time I get my PSA tested. I want my glucose in the low 90's. and if it is not I am consuming too many carbs - as my glucose rises so does my PSA.
Exercise I surmise, regulates the glucose in the bloodstream removing excess as it is consumed by the muscle cells.
Proscar or Avodart will impede the activity of the prostate cells and reduce their cell size as well as reduce the size of the prostate as a whole.
Vitamin C and D I believe, has boosted my natural immune system, and I know my immune system has strengthened, by the rare number of colds I now experience (compared to pre diagnosis) despite frequent contact with my 6 small grandchildren.
One prong will not do much. Combine all four and in three months you will see the effect. Even if you think it is a stretch to believe your low risk PC can be controlled by doing this, what harm can it do? As an aside, my regular doctor is pleased as punch with my other numbers (cholesterol, lipids, blood pressure, weight, etc.). Meanwhile you may see your PSA drop and your biopsies stabilize as did mine.
My 6 month recent PSA - 1.4. I continue to maintain my regiment of zero carb diet and excercise which has me convinced that this has maintained my low PSA while on AS. l will have my fourth biopsy in March and am now on a three year biopsy schedule.
Peter's e-mail address is: firstname.lastname@example.org