Treating Advanced Prostate Cancer with Diet, Part 2; Michael Gregor, MD

nutritionfacts.org/video/tr...

[Sisira]

Very effective and realistic. All the same so simple if one can change the habits.

I use both Petrol and Water in my engine. Petrol burns and water cools. I need both.

Many thanks Manatee.

Sisira

[BrentW]

What, no chicken? I had been warned no red meat already. Is any terrestrial animal protein left? Is this because of the use of growth hormones in the US? Are these banned elsewhere?

[Billash]

I have been trying to change my diet since watching the Vegan movie on netflix, had a blood draw yesterday results Monday, my PSA nadir is about .75 hoping for an improvement. Almost a year on casodex and Eligard with 45 radiation hits. Fatigue is brutal. This seems to support the idea for us with stage 4. I am T3bL1M0, inoperable due to age & size of tumor as well as quad bypass 7 years ago.

[pjoshea13]

I hope that you don't mind me pointing out some holes in Greger's presentation.

But first, he makes impressive claims, and why shouldn't we all try it? We would soon find out if the claims are true.

In 13 years I have come across men with PCa who have switched to vegan. I never heard anyone talk of a drop in PSA, or even a lengthening of PSADT, but if diet change is coupled with conventional treatment, benefit could be hard to spot. One thing I have noticed about vegans, is that they are pretty commited. I don't suppose they would continue if they didn't feel good on it.

The three examples cited by Greger are old. Which makes me wonder why larger follow-up studies did not occur. Study [3] is actually a repeat of [2].

[1a] (2005) - Ornish - "INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER"

[1b] (2008) -Ornish - "Clinical events in prostate cancer lifestyle trial: results from two years of follow-up."

The first study Greger mentions is the one I cited in the "Extreme Diets" post. There were two papers.

In the 12-month paper [1a], Ornish writes that "PSA decreased 4% in the experimental group but increased 6% in the control group" Mean PSA plummeted from 6.23 to 5.98.

Note that these were men with intact prostates. Without knowing the contribution of BPH to PSA, we cannot say that the drop was actually due to the cancer cells. & remember that the majority of Gleason 3+3 cases will not progress anyway.

In the 24-month paper [1b]: "No significant differences were found between the untreated experimental and untreated control patients in PSA change or velocity at the end of 2 years."

"Untreated" means that those who went on to RP or radiation, presumably due to significant PSA increases, were excluded.

So after 2 years, the men who did not progress were pretty much where they were 2 years earlier.

Note that the mean Gleason was 5.7. Gleason 3+3 was the highest, but some men were lower. Why include Gleason 5?

Greger, referring only to the first paper, states that Dr. Ornish was able to show a "reversal in the progression" of the disease. He quickly moves on to the second study.

[2] (2001) - Saxe - "Can diet in conjunction with stress reduction affect the rate of increase in prostate specific antigen after biochemical recurrence of prostate cancer?"

This was published 16 years ago, involved only 10 men and lasted only 4 months.

Three of the men had a drop in PSA. I don't know what to make of the new PSADT of 17.7 months (7.8 to infinity) from 6.5 months. How can the 3 "infinity" cases be included?

[3] (2006) - Saxe again - "Potential attenuation of disease progression in recurrent prostate cancer with plant-based diet and stress reduction."

Five years later & Saxe had moved on to bigger things: 14 patients over 6 months! Alas, he is soon back to 10 men.

"Four of 10 evaluable patients experienced an absolute reduction in their PSA levels"

"Median PSA doubling time increased from 11.9 months (prestudy) to 112.3 months (intervention)."

With only 10 evaluable patients, it would be nice to see individual data, rather than median numbers. After all, 4 of the 10 had a drop in PSA, resulting in an infinite PSADT.

...

Greger mentions PCa stats in the USA compared to countries that eat plant-based diets. It's tempting to blame the U.S. diet, but one researcher, after years of looking at green tea and soy, etc, consumption in Asia, said: "We might as well have been looking at utility poles."

Much is made of the increased risk of Asians in America, as though immigrants switch to American diets, but rates in Asia are increasing with affluence. Affluence changes the balance of the diet. & it's true that affluent Chinese in China increase pork intake. The loser seems to be rice, rather than vegetables. But the quantity of food increases, in relation to energy requirements. Having a well-paid desk job is a risk factor, compared to a low paid laborer's job.

...

Greger mention's arachidonic acid [AA]. Everyone seems to know it as the evil omega-6, but it is misunderstood IMO. The body makes AA, just as it makes cholesterol. The AA & cholesterol in a daily egg will not unbalance the system.

AA is made from linoleic acid [LA] in the body. LA is high in corn oil, e.g. LA intake is associated with a pro-inflammatory state & the risk of chronic inflammatory conditions - including cancer. However, there is a limit as to how much LA will convert to AA.

AA is one of the constituents of the lipid rafts of prostate cells. AA is dangerous if it is not balanced by omega-3 (EPA-DHA) fatty acids in the rafts. For many in America, the diet contain no marine omega-3. And the popular types of fish (non-fatty white fish) contain miniscule amounts of EPA-DHA, if at all.

A vegan diet contains no marine omega-3.

One can eliminate preformed AA from eggs & meat, but AA will end up in lipid rafts.

-Patrick

[1a] prostate-cancer-today.org/f...

[1b] ncbi.nlm.nih.gov/pubmed/186...

[2] ncbi.nlm.nih.gov/pubmed/?te...

[3] ncbi.nlm.nih.gov/pubmed/168...

[Darryl Partner in reply to pjoshea13]

Excellent review.

[patandemma]

something being overlooked by the plant based diet (PBD) bashers is the heavy toll of morbidity/mortality diabetes,hypertension,and coronary artery disease that PCa treatment wreaks on its victims. Maybe there is a marginal benefit from PBD on PCa,maybe not but there appears to be a large consensus that it has a benefit on the major causes of death in PCa patients.

Interestingly,Kaiser Permanente,not the most innovative HMO due to its hidebound adherence to "cost effective" medicine,has recently made it policy to urge its subscribers to switch to a plant based diet

[Hidden]

I think some of these diet changes help us to fight the disease or to stay more healthy if we don't have cancer.

The problem is that the effect is small so it's easy to exaggerate the benefit based on one's preference or beliefs. I don't see a lot of science backing up some of the claims. There are so many other factors that are more significant when it comes to treatment outcomes, disease progression and overall survival. There is so much that is out of our control which I think is part of the reason why there is a lot of focus on diet. It's something that we can control and we can feel good about doing. But we shouldn't create false hopes for ourselves or others.

I'm not saying we shouldn't eat healthy. I do so myself, but I am realistic about expectations. It's probably not going add any time to my life, at best it will hopefully give me a little more energy and make me feel better. I'm not willing to make big changes to my diet if it reduces my quality of life by eating a lot of things I don't enjoy and cutting out a lot things that I do enjoy. I've already given up enough for this damn disease.