Advanced Prostate Cancer
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Vegan Shmegan

A large prospective randomized trial (MEAL) today reported that eating more vegetables and reducing meat intake for 2 years had no effect on progression for men on active surveillance. There may be lots of good reasons to eat more vegetables, but prostate cancer does not appear to be one of them. Maybe it takes longer than 2 years to have any effect, or maybe the results might be different for men with advanced PC - but there is no level 1 evidence of that.

prostatecancerinfolink.net/...

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Hmmm

You mean there were people advocating a vegan diet to ward away prostate cancer?

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This is good news and confirms what our oncologist told my husband several years ago that diet didn't matter in prostate cancer. My guy is meat eater and would prefer no veggies or fillers of any kind. Still I think healthier eating countries have less prostate cancer.

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And some healthier-eating countries have some of the highest rates of PC in the world. e.g., Caribbean countries where diet is rich in fish, fresh fruits and vegetables and low on red meats.

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Yeah - I had to wonder...

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They did not have to do this trial--I could have told you the answer.

Eat like a King for Breakfast[Min 40 gms Protein], a Prince for Lunch[@20 gms Protein], and a Pauper for Supper[Minimal protein, lots of Salads and veggies]. Snack on Pecans, Almonds and Cashews, dried Apricots, and the likes--if you get a sugar craze---beat it back with an apple. If you can on your protein eat Biblically[Kosher Meats and Fish]. Amen!

Nalakrats

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Amen!🙏

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Shalom!

Nalakrats

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I’ve been reading your posts for weeks and I’m always impressed with your wit and thoughtful and research based approach to all subjects Prostate. I have one question (albeit two parts) as to your opinion regarding sugars role in advanced Prostate progression and if so would you put berries and other fruits in the “dangerous sugar” category ? Thanks for all your comments. There’s lots of us out here listening.

Schwah

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There may be many really good reasons to avoid refined and simple sugars in one's diet, but prostate cancer doesn't seem to be one of them. Unlike many other cancers, prostate cancer doesn't metabolize glucose to any increased extent, at least not until very late stages. That's why the FDG PET is pretty useless in detecting PC metastases. FDG= flu-deoxy-GLUCOSE. It is picked up by OTHER cancers that generate most of their energy by glycolysis. But even then, there is no evidence that restricting glucose helps stop those cancers. By contrast, PC metabolizes fats for its primary source of energy, which is why Choline and Acetate PET scans detect it fairly well. I've heard the claim that even if glucose doesn't directly stimulate PC, it stimulates Insulinelike Growth Factor (IGF-1) which does. However, when medicines were tried to block IGF-1 they had no effect. There are multiple growth pathways and just blocking one or another has little effect. So, unless you are diabetic, I hope you will enjoy berries, fruits, chocolate, sugar in your coffee - whatever small pleasures you have that make daily life worth living.

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Well said Tall Allen. Your posts are always worth reading.

Nick

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Thank you for this information. I would like to learn more about PC metabolizing fats. After all these years, I just heard a talk recently about that. The talk was more about different types of fats. For instance, animal vs say avocado.

Another area of question is how to get more oxygen into the cells?

This was such a lively stimulating post. Thanks.. genie

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Like all cells, prostate cancer cells need lipids, sugar and protein to replicate. (BTW - the Axumin PET scan is based on amino acids (FACBC) that the cancer cells uptake preferentially.) Starving cancer cells will starve healthy cells too, and because cancer is a tissue-based disease, signals from healthy cells slow down cancerous proliferation.

The best way to get more oxygen into cells is to exercise. Anti-oxidants can block the beneficial effects of exercise. Hyperbaric Oxygen chambers are sometimes used to force more oxygen in and restore the health of cells. It has been found to be beneficial in radiation patients who experience chronic proctitis.

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Thanks a lot Tall_Allen. I have had Proctitis after 40 exposures to Radiation.i shall try hyperbaric oxygen . How many hours per day? Thanks.

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It's controversial and insurance may not cover it. In this randomized trial, patients received pure oxygen at 2.4 ATM for 90 minutes at a time over 40 treatments:

ncbi.nlm.nih.gov/pmc/articl...

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I believe there is no faculty available where I live, India. I could cook up a slightly higher pressure chamber in my own factory with Industrial Oxygen, but 2 1/2 Atmos. Is too dangerous without a full fledged construction. Besides the Fire Safety lot will have some say too!

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Costly but worth a shot. I did it years before dx . Makes sense to oxigenate

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Thank you Tall_Allen...

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I agree

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I agree, I never miss an opportunity to read your responses and so appreciate you sharing your knowledge with us. Thank you. Steve

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Not at all, dark berries are loaded with anti-oxidants, and their natural sugars are not of the white Sucrose type sugar found on the table or in processed foods with also Fructose, High Fructose 55, High Fructose 45. The body will make sugar from fats/carbohydrates if you deny it enough sugar for cellular energy. There is an on-going argument that Pca cells will consume Glucose sugar---Papers have been written they do and papers have been written they do not.

I avoid the argument with common sense. everything in moderation, avoid the processed foods that have processed sugars, eat healthy, as to adding Fruits and Berries, to the diet remembering, your body has other ways to produce sugar[Glucose], if you deny the body sugars from foods. So there is no sense in denying, what the body will make if you do deny it. See my post on anti-oxidants--I list certain berries.

Nalakrats

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Ə -- gotta love it! as for your question... anything high-glycemic should be eaten with things that slow down the absorption of sugar into the blood stream. i eat fruits with nuts, seeds and anything fatty, like fish or coconut oiled whole grains.

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Aperson🙏

Good Luck and Good Health.

j-o-h-n Tuesday 05/22/2018 5:17 PM EDT

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Aperson 🙏

Good Luck and Good Health.

j-o-h-n Tuesday 05/22/2018 5:20 PM EDT

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My father died a few years ago due to PCa at age 82 and he said the problem with vegetables is that they may be just as carcinogenic if not more so than meat due to the hazards of modern agriculture and our environment. He instead spent his last few years eating cinnamon rolls pastries and other sundry fast foods mostly except when family would visit and cook for him. I don't think he changed his diet an iota. I think a well-balanced diet in proper proportions is the "Standard of Care" such as one they taught in nursing school in the 1920s which is what I learned from my grandmother as she kept my grandfather alive on well-prepared meals.

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This post serves no purpose other than to insult vegans and steer newly diagnosed members down the wrong path. Advising others not to bother eating any vegetables is the wrong message to deliver and is concerning coming from someone who is highly educated in allopathic PCa treatment.

How does an obscure study of low grade cancer patients on active surveillance suddenly become the standard advice for patients in an advanced PCa forum? The constant message from your posts seems to be that anything we do for ourselves outside of our Doctor's primary care is pointless, harmful and likely all in our heads if a benefit is achieved.

Not a message that I can align with.

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I'm just reporting the facts. This was not an obscure study. It is the first Level 1 (large scale randomized clinical trial) that we've EVER had on diet and PC progression. It had some of the biggest names in prostate cancer research attached to it. It was well-designed, scrupulously conducted, and was one of the featured presentations at the AUA meeting. It showed that getting men with early stage prostate cancer to eat more vegetables and less meat had no effect on disease progression.

If you want to argue that it would have had an effect if the patients had advanced disease instead of localized disease, that is a reasonable hypothesis, but you would have to show why that is true. You might argue too that a real vegan diet (not just more veggies and less meat) is needed to have an effect, but that too would have to be proved.

Some of us believe that medical evidence will do more for us than wishful thinking. Aren't men with advanced cancer suffering enough without your needlessly taking away the joys of living?

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Absolutely Tall. My husband enjoys meat & potatoes. Since his diagnosis, I've been feeling a bit guilty when I prepare a ribeye or pork loin for dinner. I have managed to introduce more Mediterranean influences and a fruit plate for dessert occasionally, but I see he's forcing himself to eat it sometimes. This makes me feel much better! I thought the same thing... "He fights so hard every day. If enjoys it, I'll make it for him."

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It is a no Brainer that Fruits and Vegetables are Healthier than Red Meats etc...! And improve overall Health and thus the immune system! And if the learned Gentlemen are so wise why have the the Cancer rates continued to go up! Studies are a Dime a dozen! And are often funded by the same guys that sell the chemicals to treat Cancer! And I would expect they would also have a study that says that says diet have no effect on Dibieties!

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Deaths from cancer on almost all cancers have come DOWN. This study was sponsored by NCI and the Alliance for Clinical Trials in Oncology, which consists of nearly 10,000 cancer specialists at hospitals, medical centers, and community clinics across the United States and Canada.

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Although the overall death rate from all cancers is declining, is it not true that the rate for prostate cancer deaths has stopped declining and is now increasing ?

Take Care, Monty

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No, it is not increasing to any significant degree - it has leveled off after many years of decline. There are 29,430 deaths predicted for PC in 2018. See Figure 6:

onlinelibrary.wiley.com/doi...

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Thanks. So we agree...although there may be a reduction in the death rate for other cancers, currently...there is no decline in the prostate cancer death rate.

Take Care,

Monty

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Th money is in treatments not in a cure. We all know how costly cancer treatments are. I am with ya.

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Very interesting study. Makes sense when I think of it, France has a relatively low PC rate and the French do eat a lot of meat. Very interesting findings.

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500 subjects is hardly large-scale and was done 3-7 yrs ago. The value of a more vegetarian diet is now a given, among those who aren't robots for the AMA. Even the conservative ACS promotes more veggies and fruits... and always has, since 1984. pressroom.cancer.org/index....

Great writing, TA but mis- and dis-info seem to be your specialty. I've seen this defense paragraph of yours almost word for word when anyone questions the validity of a study you post. Dial it back, chum; you're no more an expert than anyone else here or anywhere.

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I couldn't agree with you more ITCandy.

I will say a little about that, but first, I don't interfere in what people choose to do. If they BELIEVE in something, I step back. I feel personally that guilt, worry and fear are not good for their well being either. Our belief system is very powerful. I tell my husband, if you are going to eat something that you have some guilt over.... drop the guilt and enjoy what you are doing. Balance for me is key.... moderation may be part of the equation. We've all met people who are very controlling and uptight about having to have things a certain way, that's okay too. Many people with strong personalities can have this strong will work for them.

As far as diet. I agree that our modern agriculture is a problem. We also see the way our animals are kept, feed and killed being a problem. BUT, when we are talking about plant based alive foods like herbs and vegetables, they are so less likely to create inflammation.

I've held this question now for years, why do all diseases begin with the body overloaded with inflammation. The creation of inflammation is a form of protection. I look at these things symbolically. If there is an injury the body immediately tries to protect that area releasing substances that either will encapsulate the injured area or secrete fluids to hold the area in place. A little aside here, I fractured two lumbar vertebrae back in the early 90s. I was 50 at the time. My body created a stent around from my thoracic area to my sacrum.

It felt like it hardened that area, I was shocked, it was like a rock. My body was protecting my spine from further injury and detrimental movement. I learned a lot from that. The body is always trying to protect or stay in balance.

If one chooses food rich in nutrients with less man made artificial substances in them, it doesn't mean you can never eat a hamburger or steak again.

We each have our way of doing things, there is no judgment, but to wave on by, eating all the meat/fat, pork, sugar, manufactured food, sodas, alcohol without a thought to fighting an inflammatory disease may be something to rethink.

We from the beginning began with better eating. After years, we've gone on and off. Now, in fact, apropos to this conversation, we are about to embark on eating a plant based diet for the most part. Not a purest, tight, controlling diet, but a diet of herbs and food from local farmers.

Since our docs have really not much for us, we decided to take our health, right or wrong, good or bad, into our own hands. My husband was always inclined to eat more produce since his family came to this country 100 years ago and owned a produce store. It's sort of in his blood, so to speak. So, this then becomes natural to him and his pallet.

We are going to the farmer's market tomorrow. There's a farmer's market here every day of the week. I'll share with you, if anyone is interested. We are going for spinach and kale, lots of parsley, cilantro, ginger, fresh oregano, cucumbers, especially celery.. hydrating the body throughout the day with water, lemon, ginger... teas... coffee will not be stopped until we feel differently. Plenty of fruit and berries, mango, papaya with lemon... We decided we are going to do this for at 3 months and see what happens. For sure, inflammation will be lowered.

There is a 'juice feast program' a friend did who had lived most of her life with swollen lymph nodes, and after a 30 day juice-feast, nourishing her cells with alive foods, the swelling not only disappeared, but she looked about 15 years younger. The aching in her body went away.

Oh yes, add plenty of avocado... and tomatoes....

We are going to experiment, why not, right? Warmer weather is here, which is a good time for this. Plus, the food can be cooked.. it doesn't have to be raw.....

This is what we are doing.. along with some great supplements I've just read about..

We've been in this for quite a while. I honestly will tell you, there is NO judgment for people's choices.. no should or shouldn't.. It's a personal journey. I felt free to add my 2 cents into the conversation along with all the others...

Thanks for you all being here... Good Luck, GREAT Strength... and, Much LOVE..

genie

PS: to Tall-Allen, I was writing as you were writing. I just read your post. I would like to respectfully comment on this sentence you wrote.

" Aren't men with advanced cancer suffering enough without your needlessly taking away the joys of living?" I hear you LOUD and CLEAR.. We've been in this over a decade. We've been through SO much. I GET it.. and we've done many things, taken huge amounts of risky time off, just to have some normalcy in our lives. I don't disagree with you.

What I would like to add to your comment is... we are all sharing our views. There are many, many people reading these posts. We have to trust that we will all gravitate to what we personally believe and how we personally want to live. I don't see anything wrong with adding another point of view. It doesn't have to be made wrong, bad or anything else. I learned something from all of this. When I came into this I had never heard of a PSA test.. I knew nothing. We can get so disgusted with it all that we want to kick at life.... but, there is no one telling anyone what they should or shouldn't do. It is an open discussion knowing we are well past adulthood to even be on this site.... if something is said that touches someone or helps clarify something, or someone may want to try... there is no harm or guilt... This diagnosis/disease does one thing.... it helps us to clarify who we are and our own personal philosophy, whether that is totally listening to their doc... 1/2 listening... or even walking away. We create our own path of where we are inclined to walk.. Peace...

what I am saying is without attitude.. it's a very tough trip down this road...

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"We have to trust that we will all gravitate to what we personally believe and how we personally want to live."

Facts are facts. Fake news that feels good is not. It actually can kill. See for instance quackwatch.com

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cesanon, I'm sorry you made these assumptions about my experience with cancer.

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Your post was way way way too long to read. I was responding to your intro sentence and the sentence I quoted. That's why I quoted it.

Tall Allen's postings are some of the most valuable assets of this Forum.

In my personal opinion many of the inward looking self absorbed postings, not so much.

And some of the ill considered quakery that gets posted here from time to time... Outright Dangerous.

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I agree with you. It was quite long. I don’t write here often but when I do, I’m sharing an aspect of living with the cruelty of this disease, with the fear, loss, and grief that accompany it

We are all responding differently to the subject. I can understand my writing is not the information you are looking for.

Twice now you implied quackery In my post. And then reference some past tense of dangerous quackery.

My post was long, but in fairness to myself, I get the opportunity to share with people who are experiencing life in the balance as we are.

Quackery? Fake news? Long post, yes! I didn’t even realize it till I scrolled it back 😀

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and TA's posts are NOT long? please. the man's as fallible as anyone else here.

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Of course

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Thank you, Genie; nicely said. Something else to remember is that many of us are living with years of constant Lupron or other forms of medical castration. Our metabolism is skewed towards metabolic syndrome if not diabetes itself. A diet may or may not slow our PCa, but it may keep our discombobulated bodies healthier and more able to deal with the cancer within us.

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Thank you. Great point about more able to maintain a stronger body.

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GP , you’re awesome! Clearly a division of thinking here on HealthUnlocked . A clinical “Proven” chemical approach to everything or a holistic train of thought. Kind of like the political split in our country. No mending that fence anytime soon. Two sides to every coin .Some only look at one side. I view both and practice both. There is no medical cure for. APC. So anyone who says they have the way out or answers it blowing their own ego based horn.

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Total agreement!

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Good point RJ-MN, we should keep our bodies as healthy as possible to be able to fight this disease. My diet has improved drastically since my diagnosis in 2014, and I take various supplements like turmeric and grape seed extract. Has this minimized the cancer in my body? Hard to know, as there is no clear scientific way to measure that in me. However, it’s ironic that I feel better eating healthier, despite the metastatic cancer. Probably lots of men feel like I do; that doing something for yourself out of the mainstream treatment is creating a more difficult environment for cancer to thrive in. Whether or not this is true, the power of positive thinking derived from taking better charge of your body has to be worth something...

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Right on ! I’m in complete agreement. Thank you!😎

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"The constant message from your posts seems to be that anything we do for ourselves outside of our Doctor's primary care is pointless, harmful and likely all in our heads if a benefit is achieved."

That is untrue.

Tall Allen's message is if it is not backed by a peer reviewed study in a reputable journal, it is either unreliable, or worse wishful thinking.

Even the peer reviewed research is suspect, until repeated in multiple variations.

No reason railing against reality.

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"A proof is a proof. What kind of a proof? It's a proof. A proof is a proof. And when you have a good proof, it's because it's proven". A famous quote from a not so famous leader.

I'm not looking for science based random double blind studies to decide if every complementary therapy or supplement in my treatment is effective because I wouldn't find them. However by discarding them, I'm convinced that I would be in a much worse off place right now.

Don't get me wrong, I value very much the immense knowledge that TA brings to this forum and educate myself with everything he posts. However as he stated, he only had a small amount of cancer and was cured with radiation, therefore he's got no skin in the game.

He didn't walk out of his Doctor's office at age 50 being told that he's only got 3-5 years to live.

I decided then that I was going to learn everything I could about PCa and the more I learned the more I was convinced that complementary therapies have a place in my goal to delay progression as long as possible while maintaining a great quality of life. In the last three years I've acquired a great understanding of PCa mainly from this site and have adapted to a new lifestyle that has beaten my cancer up badly and has me feeling better than I have in the last twenty years and trust me, it's not from being on ADT.

Not everyone craves steak, pizza, beer and other "comfort" foods. The power of super foods does it for me. When I look in the mirror or have people tell me I look amazing, I know that I am on the right track to enjoy a long and healthy life, far more rich and meaningful than before my diagnosis.

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As for "skin in the game," I watched both my parents die from different cancers, and know first hand what it feels like to lose someone to it. Do you imagine I devote this much time to it because I find the subject amusing?

Medical researchers use a concept called "levels of evidence," which I hope you look up while you're searching for the next fad supplement. An expert's opinion, for example, is at the lowest level, and a large, confirmed randomized clinical trial is at the top. When a high level of evidence study like this comes in, we discard what we only thought we knew based on lower level of evidence. Otherwise, we'd all be taking Vitamin E and causing more prostate cancer.

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Understood and know that your hard work and contributions to this forum are greatly appreciated. I firmly believe that those who truly desire to achieve better results should pursue complementary therapies alongside their standard allopathic care. Maximum information-minimum intervention is the motto I live by. I see my Doctor for ten minutes every four months for my three month lupron shot and am told that my blood work looks great and everything is going well. That's the extent of time I devote to our medical system. All of my time is spent researching and implementing complementary treatments that include diet, supplements, chelating therapies and anything that has a history of anticancer benefits. I believe that I am far better off for my efforts and am not just wasting my time and depriving myself of the so called true joys of life.

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And I still take Vitamin E in tocotrienol form only. The SELECT study was flawed anyway.

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"And I still take Vitamin E in tocotrienol form only. The SELECT study was flawed anyway."

Obviously. The Fools. LOL

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TA, Thank You for supplying us with the facts that you present on a regular basis. Truly a game changer from hearsay. Some who are smarter in their own minds than proven medical science will always disagree. Clearly the Dunning Kruger effect.

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Dear ITCandy

1. Evidence-Based Decision Making. On one side you have evidence-based decision making. Its quality can vary, but it does not rely on unsupported and unsupportable anecdotal storytelling by non-expert untrained patients.

2. Superstition. On the other hand, you have non-rational decision making. It relies on anecdotal storytelling, emotional neediness and often emotion-laden ideology and belief systems. Technically it is superstitious decision making.

Here is the clinical definition of superstition:

en.wikipedia.org/wiki/Super...

Here are countless real-life examples of such decision making in the medical arena:

quackwatch.org

3. Dunning Kruger Effect. Many of the people who ascribe to number 2 above are subject to what is called the Dunning Kruger effect:

(en.wikipedia.org/wiki/Dunning–Kruger_effect)

4. Incontrovertible Evidence. I submit you are utilizing method 2 as opposed to method 1. Here is my evidence to that effect: \

"In the last three years I've acquired a great understanding of PCa mainly from this site and have adapted to a new lifestyle that has beaten my cancer up badly and has me feeling better than I have in the last twenty years and trust me, it's not from being on ADT." ITCandy

LOL, Like Trump admitting why he fired Comey on live TV.

5. My Proposal to You. I submit that while you are at the keyboard typing about prostate cancer, you represent a danger to yourself and more importantly to others, even though you may be in denial of that.

Personally, I think you would be well served to consider a position of quiet humility and listen and learn from what Tall Allen posts here. And thank him for taking the time to do so. The guy clearly has some medical training, he is smart, and he is focused on a subject that is near and dear to all of us.

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So now I've become a threat to you. As another fine member said, "we all make our own beds". When I am dying of old age in 40 years, I'll look back on moments like these and know I was right in my choices to fight this disease.

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ITCandy,

1. "So now I've become a threat to you." I think you are projecting. Do whatever you want. No one is going to stop you.

2. I am just pointing out some flaws in your belief system. Either I am right or I am wrong.

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Thanks for showing me the Dunning Kruger Effect. I know I've been guilty of assuming that everyone knows what I know. It's a mistake I make about "levels of evidence" because it seems so intuitive to me. But one man's "intuitive" is another man's "that can't be true!" I also forget that most people don't understand statistical significance.

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You assume a lot !

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You’re a genius! Your Ego outweighs your knowledge .

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Very well said. I like tall allen's stuff as well. I am also a medical practitioner and I worked in both palliative care and ran an HIV clinic in the early days when most patients died terribly.

They took all sorts of lotions and potions and diets and supplements and died. Science has worked out the stuff of HIV and it is now a chronic illness with about as much risk is killing you as if you are smoking, provided you take the medication.

There will be a cure but probably not in my lifetime.

Prostate cancer will go the same way but it is more complex than HIV. The process to get there is the same, that is the pursuit of understanding of the basic biology and smart teams of people working to think of ways to interfere with that biology or immunology with substances or other treatments.

If the supplement people had the same level of intellectual rigour most of them would be discarded but perhaps some would be useful.

We will never know because they will not allow that to happen because their market would be devastated.

The big pharmaceutical companies are not much better and most of the development for significant treatment for you and me will be from independent and academic institutions. The big pharmaceutical companies will just make the dollars out of it.

Having said that they do put money into research but mostly market research or "me too drugs".

That is drugs that are similar too already patented but effective drugs.

ITCandy I hope you are right and I respect your right to make the decisions you do.

You are no threat to me and if I have ever given you that impression I apologize.

I went to the funerals of 83 patients I looked after in the early days of HIV who mostly had similar strategies.They were hopeful and scared and preyed on by charlatans and supplement pushes..

I had, until I stopped working, many HIV patients who are still very well on antiviral treatment. I would swap diseases in a heart beat.

I am very scared at times as well and not hopeful at all. Just realistic.

I am spending my hard earned on good life improving fun and taking shitty treatment like ADT, abiraterone and Lutetium (which will keep me on the planet a bit longer) and reading with joy Christopher Hitchens. He was a legend!

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Thanks for the insight on your experiences with Aids patients. I can't imagine having to deal with what you've experienced in a lifetime and now have to battle cancer yourself. I'm deeply humbled as I've had a pretty easy life comparatively speaking and the cancer I have seems to be tamed and under control.

I'm quite amazed at the reactions I've experienced to my approach to dealing with this disease. While under standard allopathic treatment and under a Doctors care, I've chosen to become as healthy as I can possibly be, build up my immune system and make my body very difficult for cancer to flourish in. For that the reaction seems to be that I'm a Rebel without a clue and that I behave foolishly. Go figure.

I've heard of Hitchens but never really knew much about him other than he didn't spend a lot of time in church.

I think I'll pick up the book as well.

Take care of yourself.

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I hate the concept of " battling cancer".

Militaristic metaphors like " fighting" "battling" "struggling" and "breakthroughs" fill me with sadness as I have seen the disastrous decisions people make for themselves and their relatives when they follow this thinking style.

I prefer living well with cancer and doing what I can within reason to extend my life provided it doesn't wreck my enjoyment of life in the meantime.

I get very angry also when good meaning people pray for me.

Religion and militarism seem to go hand in hand.

Try hitchens book of essays.

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Living well , very good.

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Some experience you’ve had there .I like the compassionate tone. Nobody is a threat to anyone else here. All of us adult men make our own choices. Peace to the ranks..

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you're a classic example of a hero-worshipper. so far, we all have the right to express ourselves, what we've learned and how we've put our unique collection of facts together, to synthesize our own care and treatment... mainly because mainstream medicine is far too often bought and sold to the highest bidder. you don't like what IT says or what i'm saying right now? tough tarts, ignore or stand and fight like a man. screw that, i'm done with you and TA -- cut from the same egotistic molds.

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Relying on "Alternative facts" can be deadly when dealing with a diagnosis of cancer.

Everything that I read from Tall Allen has some basis in fact.

Wishful thinking has a history of mixing poorly with cancer. See generally, quackwatch.com

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Amen.

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I'm also unsure why Tall Allen is so in love with this study. The men had low risk disease, they were called three times to report what they ate over the last 24 hours, and the amount of vegetables and legumes they consumed went from barely minimal to a few. (Like when Reagan called ketchup a vegetable so it appeared kids were eating more veggie servings in the school cafeteria.)

Everyone on this site with Stage 4 disease knows there is a big jump from the garden variety PC the study participants seem to have and the metastatic cells of Stage 4 disease.

I looked at the study and also the foot noted (linked) references and don't see where he's finding this "well designed, scrupulously conducted" study result. Maybe if you have low grade disease with a doubling time <3 years it gives you a reason to keep eating the standard American diet (mainly because they weren't going to die of PC anyways) but I just don't see how this relates to those with Stage 4 disease.

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If eating more veggies and cutting down on meat wasn't able to slow down low risk disease, which progresses like the puff of a dandelion, how much effect do you suspect it will have on metastatic disease, which progresses like a landslide?

I don't know what you looked at, but here's how the intervention was designed:

"The dietary targets for the intervention arm are designed to be challenging yet achievable. Men randomized to the intervention diet are encouraged to consume daily at least 7 servings of vegetables (including at least 2 servings of cruciferous vegetables and 2 servings of tomatoes), 2 servings of fruit, 2 servings of whole grains, and 1 serving of legumes. To maximize the intake of potentially beneficial bioactive food components, intervention participants are encouraged to consume “bold” (“big color” and “strong flavor”) vegetables and fruit. In addition to cruciferous vegetables and tomatoes, these foods include dark green leafy vegetables, deep orange vegetables and fruits, allium vegetables (onions, garlic), berries, and citrus fruit. Servings are defined as a half-cup cut up raw or cooked vegetables, fruit, or 100% vegetable juice; one cup raw leafy green vegetable; a half cup cooked whole grain, or legume; 1 slice whole-grain bread. Because of lower content of potentially beneficial bioactive food components, iceberg lettuce, white potatoes, and fruit juices are not counted toward the daily goals."

"A separate team of telephone assessors evaluate the diets of all study participants at baseline, 12 months, and 24 months by a series of 3 separate 24-hour dietary recalls collected via telephone interview, which uses the Nutrition Data Systems for Research (NDS-R, current version 2010, University of Minnesota Nutrition Coordinating Center, University of Minnesota, Minneapolis, MN) software and nutrient database. Fasting blood samples are collected at baseline, 12 months, and 24 months and analyzed for plasma carotenoid concentrations—a biomarker of vegetable and fruit intake and thus an effective method for measuring compliance—using high-performance liquid chromatography methodology.25 We are measuring the following carotenoids as biomarkers: total carotenoids, α-carotene, β-carotene, lutein, lycopene, and cryptoxanthin."

All 478 men at 91 study sites had their PSAs tracked and were biopsied for progression at the end of the study. If you've ever seen anything like it, I hope you will share it with the rest of us. If you're not impressed, you should be.

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Yes, we read the same study. You summarized what I said above: they strived to eat 3 1/2 cups of veggies or juice, which in my opinion is a VERY small amount but from the comments here appear to be a Herculean task; they were called 3 times and had to remember what they ate the day before; and they had a couple of blood tests. I remain unimpressed. They also had a cancer type that was fairly benign. Once you get to Stage 4, the cancer cells mutate and transform and get lethal. Diet won't stop the progression and as much as

people qould like to think doctors know how to cure them, the reality is that doctors still don't know what drugs to take, in what sequence, in what amount and with what combo. But early stage disease is a different story and most will find their disease progression slowed or halted eating a plant based diet with minimal white flour, sugar, meat, etc. The unspoken part is they will feel a lot better with more energy and vitality. But that's another subjective study we won't see any time soon.

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"But early stage disease is a different story and most will find their disease progression slowed or halted eating a plant based diet with minimal white flour, sugar, meat, etc." If you believe that after seeing this study, it is religion, not science.

If you BELIEVE that some diet you believe in will have a benefit, I think that in itself is good enough reason to follow your beliefs - treating the mind IS important. I don't think veggies are bad for anyone, and for many reasons unrelated to PC, reducing meat intake may be beneficial. The science is there for others who find the kinds of diets you believe in to be a burden too far, and prefer to have good evidence before undertaking it.

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I agree , if one BELieves that organic food and remedies help more power to them .You are so intellectual . I can’t belive that you can’t find another horse to beat .Instead of all of us getting bogged down in the Symantec’s of diets and nutrients and personal choices .. Please accept my apology for brashness or rudeness on my part. Nothing personal. So if it’s a religion as you say and not a science , show respect for that religion. That’s it .

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I’m with you my wife. Take care of that guy.

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I have my cholesterol numbers as reference. My numbers went to half of previous test in 3 months; I cut out dairy, processed foods (white flour), sugar, red meat. Eating non sprayed foods/non antibiotic/non growth hormone seem a good idea. Why add more mutations (free radicals)? Does it slow PC? Maybe.

Craig

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That is basically what I am doing. Though I still do milk, mostly grass fed though.

I have one reservation about the free radical stuff. The free radicals are one of the natural ways to kill cells.

So shouldn't they be helpful to our bodies in killing cancer cells? If we lose s few good cells in the process, do we really care?

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Dear cesanon:

From what I've read, free radicals tend to promote mutations in cells. The more "stuff" we take in that promote free radicals in the body, the higher chance one of the mutations will be "the gene mutation of forever life" (apoptosis shut off). It's a "numbers game".

Craig

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Craig-

That ship has sailed. Once cancer progresses to metastatic, further genetic breakdown becomes unstoppable. Free radicals are what your cells use to make apoptosis happen. By blocking your body's ability to produce free radicals, you assure apoptosis shuts off. Free radicals are also how your killer T cells kill cancer cells. You tamper with it at your peril.

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Oh no, missed another ship!

You are pointing out all the free radicals (Independent molecules with "hungry" unpaired electrons) made by the body, like those produced by liver or neurons. I'm talking about free radicals that one might breathe in from pollutants or have created in a cell from radiation.

From what I've read, abnormally high concentrations of free radicals can cause unwanted genetic mutations, among other damages.

Our bodies make antioxidants and take in antioxidants from diet to regulate the activity of our free radicals.

So, they can be positive or negative for our cells and body health.

This seems a good summary:

cancer.gov/about-cancer/cau...

Regards,

Craig

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That's right. It's a matter of balance, and interfering with the natural balance may be perilous. Radiation only heals cancer BECAUSE it creates free radicals - it's not something you would want to interfere with by taking supplements.

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Spot on, with radiation. I have read of radiologists that ask patients to stop all supplements and high antioxidant foods during radiation.

My point was that when a body is "out of balance" and has high amounts of free radicals, the chance that the "wrong" mutation will take place, due to free radical damage increases. Cancer started.

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I eat very well with lots of vegetables and small amount of meat and lately less refined carbohydrates such as pasta etc. I have reduced the pasta to try and reduce my weight which has gone up on ADT plus abiraterone plus prednisolone. I have solved the problem with cholesterol by not measuring it. I know my coronary arteries are in reasonable condition as I had them investigated when I was diagnosed because I presented with chest pain which was due to metastatic disease not coronary artery disease. Therefore my coronary arteries are not going to be the cause of my death so I don't care what my cholesterol is. The reason I eat well is because I like the food and I don't want to get any fatter. I don't get caught up with the free radical issues. Free radicals are implicated in the development of cancer yet some authors suggest they may be implicated in killing cancer. Who knows. Some folks suggest that we should all have high intakes of antioxidants to decrease the effect of the free radicals. There was a trial done in South Australia somewhere where patients were given high doses of vitamin E as an antioxidant in an attempt to reduce coronary artery disease and low and behold it increased coronary artery disease a little. Also there was evidence in a population study suggesting that a diet high in beta-carotene decreased the progression and development of lung cancer. Because of this, patients with lung cancer were involved in a trial taking high amounts of beta-carotene supplements. They did worse. Maybe there are things in food such as the colouring of capsicums or zucchini that have an effect that we don't know about and the beta-carotene was a surrogate marker for other things in the food. We have to be very careful about such information.

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I love to learn and a

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Adjust my ideas accordingly. I learned a lot from this conversation on free radicals. Takes me back to my youth, when I was one!

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Diet might not be proven to be very effective against prostate cancer itself. But ... ADT is a standard treatment for advanced prostate cancer. Some of the effects of that (and the low T it produces) can lead to weight gain, insulin resistance, high cholesterol, etc. All of these problems can lead to cardiovascular events -- clogged arteries, heart attacks, etc. So while a sensible diet (and exercise) might not cure the cancer it could very well keep your heart healthy and ticking. That said, I'm not going down the vegan path myself. Just eat in moderation, watch my weight, and keep fit, and try to limit daily intake of those chocolate nuggets.

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WSOPeddie, what I found astounding was that we were at one of the top ten medical centers... and after 4 years of ADT etc.. there was NO mention or check up on cardiovasular.. no discussion of living with undetected testosterone and the effects of that.. I thought that was crazy... everything was so compartmentalized... it's ONE body..

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My husband has been treated for 5+ years at MSKCC and no one has ever mentioned diet or nutrition to us - not even once! I find that absolutely stunning. He lost almost 60 lbs in 4 months (became castrate resistant and was put on a trial that gave him severe insomnia- the combo of the cancer metastisizing and his inability to sleep for more than 2 hours a night was horrendous.) I have spent the last 4 months just trying to put some weight back on him and I’m cooking like a maniac ( some people stress-eat, I stress-cook! ) He has put back almost 20 Ibs and is almost at a perfect weight for his frame ( 6’2” 183 lbs) - I’m trying to keep his diet balanced and relatively healthy, but mostly I’m trying to tempt him with anything that appeals to him, not paying too much attention to fat/sugar content or nutritional value ( though I have been cooking with lots of garlic ginger turmeric tomatoes beets etc along with plenty of chocolate shakes and cheeses burgers!) I have been asking for nutritional guidance from our MO but she insists that “anything he’ll eat” should be what guides us -she prefers he take no vitamins or supplements at all. I get most of my guidance from this group, and my own instincts. It sure is baffling though that they don’t seem to consider diet/nutrition as a part of treatment.

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Michael Morris, the eminent MO at MSK, was one of the co-authors of the study. MSK conducts much of the top medical research on all cancers. I'm sure that if they thought that some particular diet were useful, they would tell you. It sounds like she gave you great advice. Some supplements are harmful and many have drug interactions - why put his life at risk for uncertain benefit if any? Cachexia can be life-threatening, so getting him to consume any kind of calories is the #1 priority -- it sounds like you're doing a great job with it.

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I’m heeding her advice and have only given him the things I learn about here (and with her knowledge- Dr. Slovin is our MO) But his cholesterol must look more like a zip code at this point! Seeing his cardiologist next week just to make sure- Thanks Tall Allen for your always insightful and encouraging posts- I’ve been following you for several months and you’re a beautiful writer ( and a role model on how to live with this shit!) 🌹

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It depends where you get treatment. My husband goes to cancer center if America and you meet with a naturopath, dietary, given what supplements your body is low on , cooking classes, and pain management all within one roof and much more.. I’m so sorry no one reached out to you in that way. Glad you are on here , some very smart people and knowledgeable . ❤️

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Thank you 🌹 I’m glad I found this amazing group too. I wish I had done so 5 years ago when my husband was diagnosed - but we all spend so much time wishing for things that may have been, and it’s so futile... onward is the only direction we can allow ourselves to head.

We are in NYC at MSKCC and that’s why I find it so incredulous that there’s so little nutritional support. It’s supposed to be one of the top cancer hospitals in the world ( they have a travel department for patients who travel here from all over for treatment) with an entire building just dedicated to prostate and bladder cancer yet whenever I’ve asked anything about diet/supplements/etc I’m met with a lot of blank stares. Medical marijuana is legal in NY State now, and I know how helpful it is for all kinds of issues- pain, insomnia and especially loss of appetite - they absolutely DO NOT prescribe it at MSK, and our MO is vehemently opposed to its use in any form ( my friends in Seattle and LA have helped us out enormously!) I have used my own research ( now mostly done here with the collective wisdom and knowledge of this incredible group) and my own gut instincts to help Jordan put back 20 lbs of the crazy amount of weight he lost, and he’s now able to sleep through most of the night.

I have learned to ALWAYS ask questions when I don’t understand something- to voice every concern I have, and to keep at it until I get an answer ( we have never had a PET scan and are finally scheduled for one after our next cycle , 3 weeks on, one week off of Docetaxel and Carboplatin and we just finished our 3rd cycle, because of my insistence.

I know now that my instincts about my husband are as valid, and valuable, as hers, and I have finally demanded that they be heard. I just regret not knowing this way earlier. We lost so much time and went through so much hell because of our “blind devotion” to the oncologist.

Anyway, I could literally RANT my head off but that doesn’t help anything either- I’m just thankful to have found this group now- I hope I will be able to be as supportive and helpful as everyone has been to me. I am truly grateful 🙏🏼❤️

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I can’t imagine what people go through that don’t have a care advocate. Cancer or any illness is a fight and some of that fight includes finding a Dr that is a team player. I k ow it is so hard to believe that we are still so aged out in medical and holistic approach . Most are aware of mind, body, soul connection by now and the power of those working together for the greater good.

Cancer is a money maker, so more and more centers are popping up, but not all are created the same ..

Good luck to you and your husband and happy you found a good support forum here, I’m fairly new myself.

Kim

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They don’t look at the entire body. It’s a shame, never to think out of the box. Peace to you ..

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I think that there is a human drive to do mildly or sometimes even significantly unpleasant things when there is a threat to one's existence. There is almost a drive to do a deal with whatever deity you believe in or if you don't believe in any (like me ) to do a deal with nature.

The more unpleasant and restricted the diet, or the more loss felt by the removal of things that give pleasure, the belief is there will be more benefit.

This might be rooted in a belief that some suffering will result in God or the universe extending life.

My view has always been that it will not extend life but there might be a perception that life is longer because it is so miserable!

I know of people who do quite extraordinary things like coffee enemas and eating chopped up dried grass stems.

I understand this illogical emotional attempt to deal with the distress of a highly threatening illness.

It is very pleasing for me however to see that there is no evidence that will stop me from enjoying the gorgeous Shiraz that is sitting in front of me and the very fatty high-protein delicious spaghetti carbonara that awaits me.

It will have very fresh parsley out of my garden and very fresh delicious pungent basil as well but this is purely for the delight it will give me. My diet for my whole life has been pretty "healthy".

I do have very little of the 2 white powders my father told me I should avoid.

Salt and sugar. This probably helped protect me from cardiovascular disease but clearly did not protect me from metastatic prostate cancer.

So my advice my poor brothers in suffering is seek evidence for restricting enjoyment and if there is none eat, drink and be merry and stop making the charlatan supplement sellers rich!

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I love your zest for food. My husband loves tastes and goes to bed at night thinking about breakfast and that great cup of coffee he is going to have. It’s a great way to live. It’s one of my joys to see this interest. We laugh about it because I’m just the opposite. I personally think it’s great medicine to have such passion.

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Fantastic post, Metungboy. Brilliant, in fact. Utterly rational.

I was diagnosed with MPC less than 3 months back. My family and friends were stunned.

I was told I HAD to do three things if I wanted to survive.

One, candle therapy. What's that ? Buy a few candles and go pray to the Virgin Mary

and assorted other saints/angels. If I did not do that, I would die a painful death and

suffer even more in Hell.

Two, give up eating ALL kinds of meat, fish and dairy products and turn vegetarian.

No compromise possible. Just do it. Or die. Painfully.

Three, exercise therapy. Work out, work out, work out. Cardio, weight training,

running miles, swimming miles, etc, etc, etc. (Till I drop dead ??)

Sooooo, there you have it, guys. What did I choose ?? What do you think I chose ? :-)

Cheers everyone. Enjoy life.

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Thanks whatsinaname

I am an evidence seeker and largely stick to evidence based treatment. Fortunately for me I mostly enjoy exercise and really enjoy how it makes me feel in such a short time. The fact that there is good evidence of survival benefit is a bonus. The benefit is greater than docetaxel which I have had and certainly did not enjoy but endured for the benefit. I have had two doses of lutetium which hasn’t knocked me around very much but doesn’t give me as much joy as exercise. The evidence for this at my stage of disease where I am still said to be hormone sensitive is laking. I think the evidence for significant pain relief in people who have had all of the treatments and those treatments have failed is reasonable. I think it is plausible that it would be of benefit but this is the major evidence free treatment I am having. Exercise has way better standard of evidence. If you don’t like exercise then that makes it difficult for you. As Tim explained in he’s very good post there is no evidence for dietary change benefit. I know that there is a continuing tension between people like me and people who believe in supplements. Believing in something doesn’t make it work. There is some plausible argument for some of the supplements but mostly it is very poor evidence and is a mishmash of pseudoscience and marketing. Massage has better evidence.

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What is the dope on "massage", Metungboy ? Is there evidence that "massage" actually helps prostate cancer patients ? If yes, the link, please, if possible. Which "massages" are most useful ? Any help will be greatly appreciated. Thank you.

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Thanks for the reply with the "link". I am going to do some reading up on this topic. Thank you, Metungboy. I replied here because for some reason I am not able to reply to your private ping.

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Wow! Did you get a great conversation started or what!!?? Good job! 😁

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Living with ADT is hard. Since of course i do not know how long I'll live I'm gonna eat what i want. When i want to loose weight i will eat more salad and chicken. If i dont I'll eat what i want. We need some kind of comfort while battling this monster. I'll leave my food alone.

Thomas

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Interesting debate here. Good points made on all sides of the issue without being unduly uncivil towards one another even when we have widely divergent views of the same issue. To paraphrase Bob Dylan, “we all see the same things, we just see them from a different point of view.” When we receive information, study results, etc. in here, it is to inform, and possibly provide new options, not to say that this is the only path to take. It is up to each of us to digest (pardon the food pun) the info and make our own decisions as to what to do with it.

I want to remind everyone in here that this is a forum to not only share information we have found, and express our ideas and opinions, but (most importantly) support each other... sharing our victories, no matter how minor, in this battle, and commiseratie and sympathize with each other when things aren’t going so well. To quote myself, “We are all riding on the same train. We’re just in different cars.” OK, I probably plagiarized that line from someone else, but the point is, each of us is different. The etiology and path of our cancers is somewhat different. There is no one size fits all answer. Some of us respond to certain drugs and therapies, others don’t. Some of us have metabolic syndrome or Type 2 diabetes, others don’t. If you want to go vegan, by all means do it. If you want to do a Mediterranean diet, do it. If you want to eat Twinkies for breakfast with sugar in your coffee do it. Whatever you do, as Tall_Allen said, do it for the right reason, not specifically because it might (or might not) be good as a dietary adjunct to our prescribed cancer treatment. If it makes you feel good, do it. There’s much to be said about the placebo effect and how it actually helps patients even in the absence of any quantifiable benefits. I enjoy spending time with my amazing wife, who is fighting her own cancer battle, my little 🐶doggy buddy, golfing⛳️ (badly), and going to my church ⛪️. These things, I’m told, release endorphins that heighten our sense of well being, relieve stress , lower blood pressure, and just plain make us feel good. In short, they enhance our quality of life in the absence of medical science being able to prove that they really work.

The clock is ticking more rapidly for us than it does for other people. Follow your heart and your best judgment. Just be sensible with whatever diet choices you make, and try to squeeze every ounce of enjoyment and happiness out of life while we still can. God is great. Life is good. And we are blessed to have each other in this group.

Amen.😇😎🏌️

Mark

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Your link leads to a report on men who reported (self-report studies are treacherous because of the social desirability effect) "reduced" meat intake (presumably this means they kept eating some meat but the amount is not specified), and "...ate significantly higher levels of carrots and tomatoes.". The counseling service intervention clearly failed but that is not admitted. I don't see the word vegan. This "higher vegetable" consumption study did not work. Where are the cruciferous vegetables? Why was meat permitted in light of extensive research on its consumption. (see videos below)

Sulfurophane from kale, broccoli, cauliflower, etc., is important as any vegan knows and can impact prostate cancer cells but apparently this intervention did not require minimal daily intake.

The late Prof. Bill Watt at Berkeley in research design would have crushed me with a critique that would have left me having nightmares if I proposed this study and claimed I was studying a "veganism" intervention in advanced prostate cancer patients.

Here are videos that every prostate cancer patient should carefully review.

nutritionfacts.org/video/tr...

nutritionfacts.org/video/tr...

No happy news here meateaters:

nutritionfacts.org/video/re...

Tomatoes combined with capsaicin intake provide a one-two punch of prostate cancer cells:

nutritionfacts.org/video/to...

hoajonline.com/jctr/2049-79...

Your happy vegan, CalBear74

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Cal,

I have been eating (for about a month now on a daily basis) 3/4 cup organic tomato sauce mixed with garlic, onions, broccoli, avocado, eggplant, turmeric and black pepper. My question is after seeing this article about capsaicin how much Hot Chili Pepper would be a good amount to add to my concoction.

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Here are the specs of the study. It was the largest, best designed study of its kind ever done. It wasn't vegan, but it was high vegetable, low meat. If you prefer to cherish your random internet sites as a valid source of information, that's up to you. Some of us want to rely on more convincing data.

ncbi.nlm.nih.gov/pmc/articl...

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I’ve been reading this exchange with interest and always come away from this site having learned something. But I just have to comment here. Having spent my career in science I really balk at the words “high vegetable, low meat”. At best this looks like a qualitative study with way too many variables to draw a substantial conclusion...

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Quickest way to die is to abandon meds and go Vegan. Veganism is a religion that gives false hope, just like all the snake oils and religious extremes.

in 2005, a Vegan friend in LA gave me a website from the McDougall foundation that had testimonies of cancer cures going Vegan. He told me to take a medication holiday and go Vegan. I did, and within 3 months, I started seeing my first bone met which I later treated with radiation. Now, every time he says dairy products are preventing my cure, I remind him of that 3 month self trial I did.

Later, some new meds that just cleared clinical trials almost cured me and gave me a long remission. Beware of all the snake oils out there.

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I agree no sensible patient would view a vegan regimen as a substitute for traditional oncology. I am an opponent of alternative medicine. Everything I recommend as a natural supplement is complementary to traditional treatment. The "holiday" concept is poorly conceived and would be dangerous for some patients. Complementary medicine is a distinct field of study.

Veganism is not quackery or "snake oil" unless someone is deceiving people about sensible nutrition.

I am also opposed to vegans who state their rationale as an expression of humane animal treatment. I believe in hunting and as dairy farmers populate my family ancestry, I say let them squeeze udders unhindered. Just don't ask me to eat dairy products!

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The swipe at Vegans was gratuitous and uncalled for, The full text of the paper is conveniently not available at the link provided, so it is difficult to mount an effective critique of this study.

EVERY study has flaws and limits, and thoughtful criticism provides a valuable service to the community.

As CalBear points out, even the very limited information available showed that vegan diets were not part of the study.

A study based on self-reported behavior is subject to all sort of biases. If your doctor tells you to eat less meat, and 6 months later some pushy stranger calls you on the phone and demands to know if you are doing as your doctor said, you are more likely to report eating less meat.

This appears to be a study that was carefully designed to produce a null result. Limiting the enrollment to low risk men, where the 10-year survival rate is well above 90%, and then watching them for only 2 years makes it all but impossible to measure any statistically significant differences.

There are plenty of well done studies that establish links between diet and the risk of prostate cancer, and many other cancers. The notion that diet can play a role in causing the disease, but plays no role at all in its progress, is risible.

The first rule of medicine is "do no harm." Speaking strictly for myself, I would never advise men with prostate cancer to eat whatever the hell they want. The chances that some of them would sicken and die (heart attacks kill you just as dead as prostate cancer) would weigh far too heavily on my conscience.

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Let me make this very clear - this is the only large scale randomized clinical trial that I have seen that proves that adding vegetables and reducing meat in one's diet had no effect on progression in active surveillance. As I wrote, there may be other reasons to alter one's diet in this manner, but prostate cancer is not one of them.

It was actually a very well done study. All participants received calls and filled in diaries - whether they were treatment or placebo. If they lied on their diaries, why would the treatment group lie any differently than the placebo group? This is the power of scale and randomization that is lacking in all those studies you imagine are "well done." In fact, blood was drawn to confirm that the high vegetable group had more carotinoids in their serum. They did.

The primary outcome was not, survival, as you imagine. It was progression from active surveillance to needing treatment. It was reported at the plenary session of the AUA conference in San Francisco last week because it was considered to be so important. You are free to wait for the published version.

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And where will I find "Vegan Shmegan" in the published version?

I don't object to the study, but any study deserves scrutiny and criticism.

I didn't write that the study endpoint was survival; even the limited information available specified progression. The survival rate for low risk men is above 90% at 10 years. Both statements are true.

What I object to is gratuitous insults. This is a support group. I don't agree with everything every man here does, but I support their right to choose, and I do what I can to offer positive support and helpful information. Ridicule is not support.

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"Vegan Shmegan" I think it was a failed attempt at humor.

I doubt Tall Allen had any idea that he would offend the fundamental belief systems of some many people here when he used that title.

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If it was a failed attempt at humor, then change the title of the post and issue an unconditional apology.

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I would have changed the title a while back.

Though somehow I would never see myself apologizing for it. No more than apologizing for mocking the concept of cordovan shoes.

All it is is a choice of dietary regime. It isn't like you are mocking Sharia law or the flying spaghetti monster, or something deserving of dignity like that.

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Poe's law. I can't tell if you are joking or not.

I'm not joking: I don't see any place for mockery and insults of those battling cancer in a cancer support group.

Even the authors of the study understood some of the potential benefits of changes in diet. Note below that they don't condition their reasons on a positive outcome of the study.

"Moreover, because prostate cancer diagnosis is a source of considerable anxiety and diminished quality of life, dietary intervention also may encourage patients without clinical progression to remain on active surveillance rather than choosing treatment. Many patients with no objective PSA or pathologic criteria for progression will nonetheless opt for treatment, presumably due to anxiety associated with their diagnosis. For these patients, diet change potentially provides an intervention or therapy on which to focus, possibly dissuading otherwise lower risk men from pursuing unnecessarily aggressive, morbidity-generating treatments."

ncbi.nlm.nih.gov/pmc/articl...

That same point has been made by several people in this thread. The value of taking charge of one's life cannot be measured by this study, and even the authors of the study understand that.

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Failed attempt at humor? I thought it was pretty good myself. We Jews have a long history of humor in the face of tragedy. Humor makes life tolerable. So if my culture clashes with yours - too bad for you.

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A few random thoughts: This in NOT a clinical trial. It is a poor example of an interventional study. It does not "prove" anything. The study certainly doesn't say anything about veganism. Veganism is not a religion but a nutritional strategy. Enthusiasm is not equivalent to religion.

Diaries in research science have limited value. Lying isn't the issue; people have flawed memories and the social desirability effect can be at work and the subjects in the study many times are not aware of their distortions - they want to please the investigators. The best of interventional studies on diet control the food distribution/consumption.

You might enjoy reading the Adventist Studies that began in the 1970's. You will be impressed by the "power of scale" in these studies.

en.wikipedia.org/wiki/Adven...

The Adventists of Loma Linda, CA constitute one of the world's Blue Zones as described by Buettner in his book "The Blue Zones". Modest review of the data will result in you finding surprising data on cancer, heart disease, etc., showing dramatic differences with other American populations. Adventists are largely vegetarians; only 4% or so are vegans. We remain a small subset of persons choosing a carefully focused approach to nutrition.

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A few words you may wish to look up: "Clinical trial" refers to any trial in humans in real life situations. As I said, several times, the study was about increasing vegetable intake and decreasing meat intake. I'm sorry that you don't like the title I gave the post.

Veganism is part of he religious belief of millions of Hindus and other religions. Adherence to a set of rules based on firmly held beliefs rather than objective facts pretty well defines religion.

As someone who did market research for 20 years, I'm surprised to learn from you that diaries are useless. Perhaps you should inform Nielsen. What you are completely missing is that it was randomized - if the diaries are skewed, they are skewed in the same way for both cohorts - that is the power of randomization that is lacking in every link you provide. What's more, they didn't only rely on diaries, they did blood tests to confirm it. Blood doesn't lie.

I know several Adventists who I like very much. But religion is religion and science is science.

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You will find this discussion of clinical trials helpful; the subsection on "double-blind" as a hallmark of the clinical trial is excellent and instructive. It appears this interventional study lacked that safeguard against spurious findings.

testosteroneresource.com/ar...

I thought I would be encountering Hindus in your response. Diet among Hindus and Adventists is doctrinal. I have no idea of what your last two sentences mean in this context. Science has been applied to Adventist lifestyle and food choices. The results are impressive.

From Wikipedia: "Diary studies might generate inaccurate recall, especially if using the elicitation type of diary studies, because of the use of memory triggers (e.g. taking a photo and writing about it later). There is low control, low participation and there is a risk of disturbing the action. In feedback [this study qualifies as a feedback study] studies, there is also low control, and it can be troubling and disturbing to write everything down.[7]

These authors argue below, quite correctly and following the lead of the Mayo Clinic, that nutrition studies involving diary recall are "fundamentally and fatally flawed" and are "essentially meaningless" (The language of the Mayo in "Mayo Clinic Proceedings".)

vox.com/2015/6/9/8753839/se...

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You fail to comprehend (although I wrote it several times) that this was a RANDOMIZED study - which is an entirely different thing. Neither the investigators nor the patients knew in advance which group they were assigned to. The participants did not know how the content of their f/u calls were different from the other group's calls. Patient reported outcomes - questionnaires and diaries -are considered to be the best way of ascertaining them. They are widely used in all medical research.

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Hey, are you guys sure that your your testosterone levels are low? 😊

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"this is the only large scale randomized clinical trial that I have seen that proves that adding vegetables and reducing meat in one's diet had no effect on progression in active surveillance."

Nonsense. This study doesn't prove anything. It got a null result. It found no evidence that modest changes to diet affected the study's definitions of clinical progression and time to progression over a very short period of time.

Absence of evidence is not evidence of absence.

This study failed to detect something. That doesn't mean it isn't there. It may be too small an effect to see in such a small group, it may be too short a time, or it could be that clinical progression and time to progression don't capture the benefits. If the men who had progression were more likely to die in the control arm, this study wouldn't detect that. If the men who ate more vegetables and progressed were less likely to develop distant metastases, the study would not detect that.

The list of things this study did not and could not detect is long.

When the paper is available for review, I will be very surprised if the authors indulge in gratuitous insults to men who eat more vegetables. Nor do I expect them to use words like "proof."

Real scientists are careful and nuanced in their choice of words. Real scientists are humble. Why? Because real scientists are wrong most of the time, and they know it. That's why they choose their words carefully and avoid sweeping generalizations that cannot be supported by their difficult, demanding work.

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I do not pretend to be a doctor, and I'm sorry for you that I lack sufficient gravitas. But attacking me personally only detracts from your case. This study absolutely proved exactly what I said. Research always uses "the null hypothesis" - they proved that the chances are less than 1 in 20 that the treatment and the control were any different in progression, and that the lack of difference was a statistical fluke. This proves that the diet with fewer veggies and more meat was not inferior to a diet of more veggies and less meat.

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Too many studies and to many opinions. I really appreciate what has been said here as it helps me to temper what I am doing. My PSA velocity has been slow and is now stable at 10 for two years. I have been doing the pescatarian route and supplements. My urologist wanted to do removal one year ago but now says I have time to consider other options. I am looking at laser at the Sterling, photodynamic light therapy[Tookad} and electro something or other being done at the Princess Grace in London. I would prefer to heal myself but don't know if it is totally possible, I must try. I do eat meat very seldom but locally grown organic and humanely killed if there is such a thing. I do drink a glass or two of red once in awhile. I eat chocolate in moderation. I try to enjoy and heal. Thanks

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I have a few words to say regarding this post. First it's an insult to the vegan life style. Second it's TOTAL BS. The provided link is shady at best. You think people would have better things to do than spread false information. This poster just lost all credibility with me and many others. Vegan Shmegan? Not funny at all. All I can figure is that the poster decided to disparage hundreds of group members for no valid reason. So Tall_Allen, stuff whatever you please in your mouth, (no pun intended) it's your life.

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I didn't mean to insult you for choosing a vegan lifestyle. Religious belief is important to me, and if being vegan is part of yours, I admire that. As I said, eating more vegetables and reducing meat may be a good idea, but not because of prostate cancer. This was not at all a "shady" study - it represented the collaborative effort of many of the top researchers and is highly regarded by those of us who understand research methods.

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Looks like a nest of hornets. LOL

Maybe you should just alter the title of the post?

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Sorry - the title amuses me - and it obviously attracted a lot of interest. If more people read the study because of it, I think it was a service.

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LOL

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Keep the title, Tall_Allen. I find it humorous too.

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I have adapted my diet. More vegetables and more fruit. No red meat or sugar.

I'm sure he will not help me with my cancer. But I think it will help me to be healthier. And, mentally, it helps to think that I'm doing something for me.

I asked the doctor about the diagnosis. What can I do for myself? the doctor told me it was good attitude and nothing else. But I made the decision to: modify food, do all the exercise I can and pay a psychologist to help me. None of this will cure me, but it sure helps me somehow.

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I think you put your finger on the single best reason for making dietary changes for prostate cancer. Cancer robs us of all semblance of control -- we have been betrayed by our own bodies. It is chaos, and our minds don't like chaos - we like order and control. If making dietary changes is what it takes to re-establish a positive attitude to life, that is a great reason. Exercise also enhances mood and re-establishes the feeling that we are able to make healthful changes in our lives. I am also a big fan of psychotherapy, especially when it is geared towards living in the present.

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Superb post, Tall_Allen. Deep and insightful. Thanks again.

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Thank you Tall Allen...

I'm pretty sure it's a "gotta take control" issue more than anything else. Sometimes I have found my most relaxing times to be when I have had NO control...when I let go. I remember going into surgery once and thinking...as the anesthesia hit...I don't have to do anything. I don't even have to breathe ...they'll be doing it for me. It was a moment of rapture before I was out completely. Letting go and accepting that one doesn't always have control is a hard thing. I am seeing with my particular path on the Advanced Aggressive Stage 4 Prostate cancer journey....that I am NOT getting the results I want from tests...not getting a lot of things I want...but I am feeling good most of the time ....and I have something I consider to be super important for healthy living... incredibly regular and good looking bowel movements...(shit that is)...even through Chemo I ate what I felt like (within reason) and I made sure to have enough fiber to "keep things moving"....and I never was even nauseous during chemo...EVERY BODY is different...but I think making sure you "keep things moving" and keep a "joy" to eating is super important. Every time I eat meat ...I "thank" the animal for it's sacrifice. I could never kill and animal to eat it...I'd probably cut off my leg to feed a starving animal first...BUT, I eat meat...beef, chicken, pork, lamb, mutton, fish (of all kinds) and I love the texture, smell and taste of it. I am a foodie from an early age...was cooking at about 8 years old. I do think being "vegan" takes the place of religion for a lot of people...giving them something to believe in. I look at the world and see all of good, bad, ugly and think it's ALL part of the tapestry of life (and death) which is ultimately what this is about...fighting the inevitable. I do not want to die....we finally got all our "ducks in a row" and life is great...I'd like to go on for a long time...BUT, in the words of an old spiritual song from my childhood...."whatever my lot, thou has taught me to say...it is well, it is well with my soul"...I don't want to fight my destiny I want to embrace it with Joy. I am researching and hoping for a long journey....actually I'd like this "journey" over with. I'm totally tired of Lupron and it's horror....I want a miracle....and, crazy as it seems...I've seen them happen!

Everyone should follow their heart! Your post yesterday made me feel wonderful and gave me hope!

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Well said, greatjohn, I thoroughly empathize.

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I believe in miracles. Also~ one of my very favorite songs:

When peace like a river, attendeth my way,

When sorrows like sea billows roll

Whatever my lot, thou hast taught me to say

It is well, it is well, with my soul

It is well

With my soul.

Love this post. 💕

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It is my belief that the term, "vegan smegan" was an attempt at alliterative humor. Most/many of us who are not vegans are not entirely cognizant of the spiritual aspect of veganism. It is my belief that this thread is helpful to our community. For any who might be offended, apologies from the forum administrator. We are all brothers here, no matter what our beliefs or treatment choices. My reply here is merely to stem any "nasty" comments that may stray us from the greater value created by this thread.

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With all due respect Darryl, I don't think any value was created by this thread. Somethings are left best unsaid and this post is one of them. All this thread has done is create discord among our members. It is my belief that "vegan smegan" is a deliberate slap in the face to those who choose a vegan lifestyle. Hopefully this posting will fade into the groups archives and we can all resume our quest for a common goal.

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I respectfully disagree, Bill48162. I wish this thread is read by as many people as possible, particularly advanced prostate cancer patients. Cheers !!

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It is my belief that you are wrong. Tall__Allen has explained himself very well, and I might add with more reserve than I might have shown, in view of the personal nature of the attacks on him. I for one am very grateful for all the time and effort he has devoted to this site and I hope he continues. It has been a big help to me in my stressful journey fighting this disease. We are all free to share our opinions and accept or reject any opinions we disagree with. A little more civility would be nice.

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This post very clearly was designed to divide us more than to unite us. The fact that you won’t at least force the author to change the offending title speaks as many volumes about you as the author’s refusal to change it speaks about him. I am using a separate account to make this comment because I feel I would be unfairly singled out for my plant-based diet, which by the way has nothing to do with religion. It is sad that so many men close their eyes to the truth and hang their hats on the latest study that supports what they have already chosen to believe.

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I've got to say, I have been advocating eating lots of veggies and fewer meats for a long time, and I still do. The study actually disproved my own beliefs. But I know they were only my beliefs (religion) rather than proven facts (science). I still believe there is good reason to eat like that - cardiovascular disease is 20 times the killer of older men than prostate cancer is.

The fact that there are 125 posts on this thread, with some liking the study it refers to and a few disliking it, is a wonderful thing! Conflict forces us to verbalize our beliefs and test whether they are persuasive. You don't have to agree with the study, but I'm glad I at least encouraged you to notice it. Thanks for posting using whatever name you feel comfortable with.

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Posts Smots...TallunderscoreAllen is my hero. So Double Dip Chocolate Chip Ice Cream is on the house for everyone.

Sidebar: Dr. Michael Morris is my Oncologist at MSKcc and I've broached the subject of a diet for me . His response was "eat sensibly". IRMC

Good Luck and Good Health.

j-o-h-n Tuesday 05/22/2018 5:42 PM EDT

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May i offer a word of praise to T Allen. Thanks for the advice to take Tamoxifen after lump in cheast from cosudex tablets, 50mg one day. The tomoxifen advice worked for me & Thank You for that as oncoligist has now learnt something also.

Keep up the good work

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Absolutely, Bray. Tall_Allen has been extremely generous with his time and knowledge. He deserves wholehearted praise. Thank you, Tall_Allen.

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here's to meat and drink,ive always said eat and drink what you want and be happy....nobody has the answers. If someone did we wouldnt be here on this site,hearty beef stew and cheers guys.

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For me, its a 10 ounce filet mignon, medium-rare with a grilled asparagus on the side. For dessert, a creme brulee. Washed down with a large Lagavulin 16, single malt Scotch.

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now we are talking....nice

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I love all of that stuff too. I just don’t partake anymore except on a special occasions.

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More like rare( that is run through a warm kitchen). The rest sounds great.

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All those different foods sound so good! What I try to eliminate from my food are all the chemical additives and highly processed. We have grass fed (no chemicals added) beef at local market. Cold water (way north or south) fish tend to be freer of pollutants. No spray vegetables. I do tend to eat mostly plants. But, Ben and Jerry's Chunky Monkey Dairy Free= the best!

Craig

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Chunky is the shizle...

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To T_A ..not the first time in history that Vegans have been called shmegans.... . A little insult goes a long way. Doesn’t really help towards healing each other... So spark up the Bar-be and ice cream machine for summer because it hasn’t been clinically proven to help PC..

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Well, those two words pretty well sum up the trial results. I guess some have had their senses of humor surgically removed along with their prostates. When objective facts bruise one's ego, one should question just why ego has gotten in the way.

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Still have my prostate. But I lost most of my ego .T_A sir if we can’t laugh about the ironies and tragedies of APC at ourselves and our life’s and loses while living with APC it’s a depressing subject for most men and their spouses. I don’t have the right to be criticizing or belittling others diets or beliefs because they differ from my own . You feel the facts speak for you. Your interpretation lacks thoughtfulness for others. God bless you in your journey.

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Once you think that medical science "criticizes or belittles others diets or beliefs" you are in quicksand. That is an attitude that may be injurious to your own health, and if you spread it, to others.

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Your mind is in a box...

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It's called a "skull." I'd like to keep it in there as long as possible.

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You will

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As usual Tall Allen you are a ray of sunshine. I have been in this fight for 25 years. In all that time I have read nothing but benefits in being vegan or at least eating only fish.

Prostate cancer is a hormone Fed cancer. With all of the growth hormones Fed to cows, chickens, and pigs to make them grow bigger, fatter and faster, this cannot be good for prostate cancer. I will choose to error on the side of caution.

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You Sir, are a ray of light! Thanks!

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Many of us here have been "preached" at by the diet religious in an attempt to save us and convert us over to their religion. I've been subjected these kinds of lectures more than once. Some people seem to feel that because you have cancer and they don't, they have the right to lecture and you are obligated to listen. Obviously, whatever you are doing is a failure because you have cancer blah blah blah.

This trial comes as a relief to many who have already been using common sense to guide their diet decisions. I do advocate for healthy living including eat healthy. I eat lots of fruits and vegatables, salads, etc. right along with red meat.

This just reminds us all again to look at the science before making decisions regarding our treatments whether it's medications, supplements or diet.

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Tall_Allen, you’ve opened up a real “can of worms” here – worms by the way are supposed to be quite edible but I’m not volunteering and that’s as far as my humour extends in this reply.

These “objective facts” that you talk about are way too sparse in the reporting of the trial to be called that:

1.We don’t know how the progression or otherwise of the participants’ cancer was measured – all we are told is that the men were on active e-surveillance through to telephone-based intervention which was somehow “validated”. All measures have their problems anyway.

2.We are told that the counselling service “clearly did significantly change the diets of the men”, but not how far their nutrition varied from the traditional U.S diet.

3.We don’t know the extent to which the participants reduced their consumption of animal protein or eliminated it entirely. For example: the widely-cited, billion-dollar, three-decades-long Nurses’ Health Study in the U.S. found no correlation between dietary fat and fibre including vegetable and fruit consumption and incidence of breast cancer - wow! What they didn’t tell you was that virtually all of the women involved consumed a diet very rich in animal-based foods, even richer than the average American (av. protein intake of 19% of calories vs U.S. average of 15-16%) which is far too high to be considered healthy anyway. Look to The China Study by Campbell and Campbell and you will see one example after another of death rates from cancers and other diseases by country and their extremely high correlations to animal protein uptake. Ok, the men in the MEAL trial ate more vegetables (how much more? For most Americans vegetable consumption equals tomato base on a pizza!) but to what extent did they reduce or eliminate the animal protein in their diet? – this we are not told.

4.There’s no mention of “vegan” vs vegetarian diet in any of this, by the way.

The authors do admit that perhaps the “very low-risk nature of the patients enrolled into this trial already made their risk for disease progression to be so low over a 2-year timeframe that dietary change alone over that timeframe [might] not have been sufficient to change their risk level” – probably the truest thing said in the whole report!?

This is poor reporting and possibly poor science – we don’t know about the latter – it’s just too short on so-called “objective facts”. Perhaps I shouldn’t be so harsh, after all the report is headed Initial Results … however I wouldn’t have released it in this form. Nevertheless, I look to the full report with interest.

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martinvs-

Given the length of this thread, you are forgiven for missing the fact that all your points have previously been addressed. Since you are probably not alone, I will simply repeat what I wrote above:

"The dietary targets for the intervention arm are designed to be challenging yet achievable. Men randomized to the intervention diet are encouraged to consume daily at least 7 servings of vegetables (including at least 2 servings of cruciferous vegetables and 2 servings of tomatoes), 2 servings of fruit, 2 servings of whole grains, and 1 serving of legumes. To maximize the intake of potentially beneficial bioactive food components, intervention participants are encouraged to consume “bold” (“big color” and “strong flavor”) vegetables and fruit. In addition to cruciferous vegetables and tomatoes, these foods include dark green leafy vegetables, deep orange vegetables and fruits, allium vegetables (onions, garlic), berries, and citrus fruit. Servings are defined as a half-cup cut up raw or cooked vegetables, fruit, or 100% vegetable juice; one cup raw leafy green vegetable; a half cup cooked whole grain, or legume; 1 slice whole-grain bread. Because of lower content of potentially beneficial bioactive food components, iceberg lettuce, white potatoes, and fruit juices are not counted toward the daily goals."

"A separate team of telephone assessors evaluate the diets of all study participants at baseline, 12 months, and 24 months by a series of 3 separate 24-hour dietary recalls collected via telephone interview, which uses the Nutrition Data Systems for Research (NDS-R, current version 2010, University of Minnesota Nutrition Coordinating Center, University of Minnesota, Minneapolis, MN) software and nutrient database. Fasting blood samples are collected at baseline, 12 months, and 24 months and analyzed for plasma carotenoid concentrations—a biomarker of vegetable and fruit intake and thus an effective method for measuring compliance—using high-performance liquid chromatography methodology. We are measuring the following carotenoids as biomarkers: total carotenoids, α-carotene, β-carotene, lutein, lycopene, and cryptoxanthin."

All 478 men at 91 study sites had their PSAs tracked and were biopsied for progression at the end of the study. If you've ever seen anything like it, I hope you will share it with the rest of us. If you're not impressed, you should be.

ncbi.nlm.nih.gov/pmc/articl...

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Hi Tall_Allen

You neglected to mention that the authors of the study quoted two separate studies with different results to their own: “In one of these studies, a small (n = 93, [still a good number depending upon whether you want to then analyse sub-samples]) group of active surveillance patients who implemented extreme lifestyle changes—including a low-fat, plant-based diet—experienced decreased serum PSA concentrations and rates of progression to standard treatment for up to 2 years following the intervention.

"Gene expression profiling in a sample (n=30) of these men comparing pre- and post-intervention prostate biopsy tissue identified significant post-intervention changes in biological processes related to carcinogenesis, suggesting the possibility that nutritional and other lifestyle changes may alter tumorigenesis.

"Additional follow-up studies of these patients have also hinted at intriguing links between lifestyle change in prostate cancer patients and telomeres, protective DNA-protein complexes at the end of chromosomes that promote chromosomal stability. Shorter telomere length is a prognostic marker of disease, aging, and premature morbidity; telomere shortening is counteracted by the cellular enzyme telomerase. Analyses in 24 and 10 of these patients demonstrated significantly increased telomerase activity and longer telomeres, respectively, in peripheral blood mononuclear cells in response to the lifestyle intervention, intimating that nutritional changes may beneficially influence chromosome stability.”

These are both telling results.

Also as I said earlier, there is no mention at all in the study you quote of participants’ animal fats intake other than “switching to a diet that emphasises vegetable intake and de-emphasises meat and fat intake”. Their vegetable intake, while laudable by U.S. standards, is still not great and we really have NO idea as to how much meat or animal fats they continued to consume. Extra vegetable consumption is very unlikely to make a blind bit of difference if the participants’ animal protein intake is still too high. This is the point if it wasn’t clear before that I’m really trying to make.

As no doubt you know, cancer has three stages: initiation, promotion and progression. Colin Campbell, one of the discoverers of dioxin (one of the most toxic carcinogens) and author of "The China Study" and his colleagues (who received over 74 grant-years of funding from NIH and other groups which they condensed into 35 years and have authored or co-authored over 350 scientific articles), undertook experiments on two groups of rats dosing them with the carcinogen aflatoxin (a mould toxin found in peanuts and corn) at increasing rates over 100 weeks (the normal lifespan of a rat is two years). They then fed one group on casein (which accounts for 80-85% of the protein in cow’s milk) equivalent to 20% of their diet (the average American consumes 15-16% of his/her diet as protein) and the other group again on casein but only 5% of their diet. At the end of 100 weeks all rats fed on the 20% diet were dead or near dead from cancer tumours; all those fed on the 5% casein diet were alive and active with sleek coats – almost 100 to zero score in terms of difference in rates of death! They then undertook further experiments altering the rate of casein consumption and found that they could turn cancer foci production “on” and “off” through such nutritional manipulation. But rats are not the same as people, you say? Rats were used in these experiments because the protein required for growth in young rats and humans as well as the protein required to maintain health for adult rats and humans is remarkably similar.

Campbell’s "The China Study" takes the nutrition theme further. He and his team went into 65 counties across China and sampled the blood and urine of 6,500 adults and administered questionnaires. They gathered data on 367 diet, lifestyle and disease (cancer, heart disease, etc) variables and found over 8,000 statistically-significant correlations at the 95, 99 or 99.9% level! The results were astonishing – for the dozen cancers researched the incidence between the best and worst counties was not 10% or so which would alarm us here in the West, but 2,000-10,000% or 20-100 times. So what part does genetics play? The authors determined that less than four percent of cancer risk was due to genetics (not unlike the 2-3% presented in another study to the US Congress) and 87 per cent of Chinese are ethnic Han. It was nutrition and lifestyle factors accounting for the huge variation.

Many of those responding to your entry are clearly coming away with the conclusion that nutrition plays a miniscule role in the initiation, growth and progression of cancer. What I read, following on from "The China Study", is that it’s key to cancer and almost every other major disease. My assessment of the study you quote is that it falls short in design, but the authors also find that they cannot make the claims that you have made.

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I certainly am aware of those other small studies. Why do you suppose this study was undertaken in the first place? The authors wanted to prove definitively that increasing vegetable intake and reducing meat intake made a difference in prostate cancer progression. Their study disproved their hypothesis.

I suggest you read about "levels of evidence." In medical science, there is a hierarchy of evidence. Studies higher in the hierarchy trump studies lower in the hierarchy. It is time for you to accept the results and move on. It is also why we discard rat studies and epidemiological studies like the ones you cited when we have better evidence. Rats are not humans. There are enough physiological similarities to make them useful for hypothesis-generation, NOT to change clinical practice. Epidemiological studies are similarly useful for hypothesis-generation only. There are way too many variables and combinations of variables that occur over a lifetime to be captured and controlled for. And most importantly, association is not causation. That's why ONLY a large randomized clinical trial like this one can be used to prove causation. As you educate yourself, I'm sure you will understand this better.

One of the principles of causality is that there is a usually a dose response. That means for a given medicinal intervention (in this case, via diet), more of the intervention is expected to give a better response (up to a point). Here we see that there is no such response - those who ate more vegetables and less meat had the same rate of progression. If you would like to believe that "if they only ate MORE vegetables , or if they only ate LESS meat, there would have been an effect," recognize that that is just a belief, not science.

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‘As you educate yourself, I'm sure you will understand this better.“

Totally Amazing how you go out of your way to insult members with practically every post you make.

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Ad hominem attacks are what people who don't have strong arguments resort to.

"Levels of evidence" is taught in every medical school in the world, is used by every professional medical organization, every peer-reviewed medical publication, and every governmental institution responsible for medical policy (e.g., NIH, FDA, CDC, WHO, etc.). Yet it seems that a few who post low-evidence studies on this site seem to be unaware of the consensus. If you already know about it - great! If not, it is your best tool for separating the gold from the dross. I think that if you take the time to learn about it, it will improve your ability to help yourself and others using the ocean of studies available on the Internet.

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Well, actually Tall_Allen, I am reasonably well-educated - one of my majors is in Multivariate Statistics and that's what this all boils down to in the end, mate! And thank you, ITCandy and FCoffey for your responses.

Your words: “Most importantly, association is not causation. ONLY a large randomised clinical trial like this one [sample=418] can be used to PROVE causation. As you educate yourself, I’m sure you will understand this better”. WRONG! Increasing the sample size is not going to help you prove causation. There can always be a third or fourth (perhaps unknown) factor which is highly correlated that is the actual cause, no matter the size of your sample. However Austin Hill, a British medical statistician, suggested nine minimal conditions necessary to accept the likelihood of a causal relationship. A very high correlation coefficient and strength of statistical significance is one condition: I’d far rather, for example, take the fact that one of “The China Study” authors’ findings amongst 8,000 statistically-significant results (from sample=6,500) relating to diet, lifestyle and disease was that “animal protein intake was convincingly associated with the prevalence of cancer” at the 99.9% level (or 999 cases in 1,000) than your study.

But, getting back on track! Your words: “The authors wanted to prove definitively that increasing vegetable intake and reducing meat intake made a difference in prostate cancer progression. Their study disproved their hypothesis”. WRONG! They didn’t disprove their hypothesis, they just didn’t prove it. In fact, they admitted that “It may be that the very low-risk nature of the patients enrolled into this trial already made their risk for disease progression to be so low over a 2-year time frame that dietary change alone over that time frame could not have been sufficient to change their risk level”. In fact, they conclude: [For] “many patients with no objective PSA or pathologic criteria for progression, diet change potentially provides an intervention or therapy on which to focus, possibly dissuading otherwise lower risk men from pursuing unnecessarily aggressive, morbidity-generating treatments” and “this study holds the potential to substantively inform the treatment of early stage prostate cancer”.

Your words: ‘If you would like to believe that "if they only ate MORE vegetables, or if they only ate LESS meat, there would have been an effect," recognise that that is just a belief, not science’. WRONG! Those weren’t my words. This is now the THIRD time that I am writing to say that in the study there is NO mention of the extent to which participants reduced their ANIMAL protein consumption or whether they eliminated it at all. I repeat myself: “Extra vegetable consumption is very unlikely to make a blind bit of difference if the participants’ animal protein intake is still too high. This is the point if it wasn’t clear before that I’m really trying to make”.

Your words: “Rats are not humans”. Hey, very observant, very clever. The fact that rats and mice are the species used in 95% of clinical studies is for good reasons, aside from the obvious ones. This from emice.nci.nih.gov: “Examining similarities and differences in cancer development between rats and mice, and among human, mice, and rats provides even more evidence for the importance of an observation about cancer than does investigation of a single species”. Prof Campbell’s words again: “the protein required for growth in young rats and humans as well as the protein required to maintain health for adult rats and humans is remarkably similar”. And when I read in multiple articles that casein in cow’s milk is a carcinogen, promoter and progressor of cancer in humans and is closely linked with PCa, it’s not too much of a step to at least consider eliminating cow’s milk as a means of potentially no longer feeding the cancer or simply containing it. But you know better, don’t you: Rats aren’t humans, so forget it!

I’m quickly gaining the impression that you’re hanging your hat on this one study, coming to conclusions that the researchers themselves are not making and are blind to whatever is offered as an argument to the contrary. Now that’s not scientific!

This study is just one study, definitely not gold and doesn’t seem well-designed in the first place. “Levels of evidence taught in every medical school” won’t take you away from poor research design. And on the subject of what’s taught in medical school, nutrition definitely is not one of the subjects – education on that equates to only a couple of days over 5-7 years’ study for the average American doctor. After all, if you can’t burn or cut it out or administer a pill, there ain’t no money in it! Your average vegetarian knows far more about nutrition than your average doctor and it’s a pity that health education has come to that. Which camp do you fall into Tall_Allen?

[Rhetorical question]

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I spent 20 years of my business career working wit multivariate statistics, but statistics is not the issue here. I think you agree that their findings met the 95% confidence level of statistical significance.

I am not wrong that a large randomized clinical trial like this proves causation. The large size contributes statistical confidence and helps assure that both observed cohorts are similar, but it is the RANDOMIZATION that proves causation. When you have two cohorts and the only difference between them is the treatment, you have great confidence that any difference in outcomes is BECAUSE of the treatment. This is why we throw out epidemiological and rat studies you are fond of citing when we have evidence like this. Again, I suggest you educate yourself about levels of evidence. Statistics only show association, not causation. It is randomization that proves causation.

If you actually want to know more about this and are not here to simply exercise your confirmation bias, may I suggest you spend time on the following website:

cebm.net/category/ebm-resou...

As for your other points, they are easily dealt with:

• "They didn’t disprove their hypothesis, they just didn’t prove it." WRONG (as you say). If you do indeed have a degree in multivariate statistics, you would know that studies are designed to reject the "null hypothesis" that the treatment had no effect. They were able to do this with 95% confidence.

• I do agree that it only proves that increased vegetable intake and reduced meat intake had no effect on progression for those doing it for 2 years while on active surveillance - that's exactly what I wrote. If you believe that it might have some effect on those who have metastatic disease -that would mean that those dietary changes could stop a bomb when they couldn't stop a firecracker - but there is nothing here to disprove your belief (based on no evidence). It also is silent about the length of treatment beyond 2 years - if you believe (based on no evidence) that 10 years of the diet will have an effect but 2 years won't.

• Let me again state that the authors undertook this very expensive and time-consuming trial because they hoped it would work. That is why they wrote, as you quote, "...diet change POTENTIALLY provides an intervention or therapy on which to focus, POSSIBLY dissuading.. ." and "this study holds the POTENTIAL..." Those were their hypotheses, which unfortunately are not the case in reality.

• "there is NO mention of the extent to which participants reduced their ANIMAL protein consumption or whether they eliminated it at all." The authors wrote: "specifically, switching to a diet that emphasizes vegetable intake and de-emphasizes meat and fat intake—might decrease the risk of clinical progression." "De-emphasis" in this study meant coaching sessions with personal diet counselors, employing strategies adopted from social cognitive theory. Motivational interviewing techniques were utilized to help participants assume and maintain responsibility for their own behavior change. Not only were they asked about kind and amount of all the food they ate, their blood was analyzed for fats. I'm sure the full text results will show the exact amounts if that is what you are waiting for.

• Rats? Really? Again, please read up on levels of evidence. (I'm sure the drug companies will be relieved to learn from you that rat studies can be substituted for human trials.

• Yes, you are right that this one very large, well-designed study trumps all the lower levels of evidence you cite. Again, learn about levels of evidence, and stay open to the truth. Confirmation bias CAN harm you.

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Many thanks, Tall_Allen for some very good reasoning. Please disregard the insulting comments by some and continue to post your very interesting posts. Thank you.

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This might be a stupid question, but do rats and mice get prostate cancer naturally? It seems like so many things they do with mice and rats in this area don't work with humans.

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Many of the lab experiments on cancer in small animals involve first either giving them human strains of cancer cells, or breeding the small animals to have genetic defects that make certain cancers more likely to occur.

I'd imagine it would be very tedious to assign graduate students the task of doing DREs, PSA tests, biopsies, pathology reports, and imaging on mice or rats before using them in any early phase Study. :-) Ha. Ha.

Charles

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They have to find the student with the smallest finger.

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It's a good question, but I don't know the answer. I know it does occur in dogs. Mice are just a convenient screening tool - if it doesn't work on xenografts of human PC cells into mice, it probably won't work in humans. But only a small fraction of interventions that do work in mice have any efficacy in humans.

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Very good martinvs, average western American doctors don’t know much or care much about nutrition, only surgery , drugs, RT, chemo, all things that can be helped by proper eating and nutrition. Our good friend has told me that everything that I’m doing is wrong.. My Doctors tell me “whatever you are doing? Keep doing it!” It takes an open mind to realize that natural foods are the best medicine .. Pharmaceauticals are nessesary for most with APC in order to live another day. Nutrition and eating real foods can make our days more pleasant and strengthen our immunities. Some people I Guess eat cheese burgers and milkshakes, I choose to pamper my body with organic vegetable based diet.. I broke down and ate a Rueben the other day.. No redeemable cancer fighting properties there. Take all technical directive hear with a grain of salt.. anyone such as myself who so far has had some success wil tout and offer others there beliefs. I listen to the 20yr vets that post. They know much. These are personal choices. You can lead a horse to water? I look back at all of the junk that I’ve eaten in my life, a lot of sugar. For three years now eating holistically and following a great nutrient plan , (besides the APC side effects) my digestion system is great compared to prior Dx and eating the typical American diet. I won’t ever go back. A self appointed critic of others beliefs doesn’t hold any water amongst those that understand , Food is Medicine.... My doctors say” besides the PC, you’re in great shape.. Whoo hooo! Adt &no T rules my life. Still I am happy to be alive. It rained today here in the desert , first time in 3months. A good day. Thanks for posting ... Live well 🌵

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Thanks Lulu700! A Reuben? - hope it wasn't too painful ;-). I've written another reply to Tall_Allen - no doubt he'll do his usual and take potshots at me and mostly ignore the message. Desert? - You want some of our water? Too much flooding down here in NZ, but today is brilliant and clear and the mountains are covered in snow :-)

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Nothing nicer than snow on the peaks. Sounds beautiful.. I’ve been very slim eating of animal proteins for 3yrs now. I ate half of the Rueben. But it wasnt like one from the Carnegie deli or even that great. So my craving for a Rueben was a bust.. I love all foods. Even the ones that are the worst for us.. I was a foody . Life sucked initially dietarily when I first made the transition. Now, I find lot if organic alternatives to my old bad choices,,Believe it or not , we can make a great tasting Rueben with a Rueben flavored Templar instead of meat. Dam good. ,! With no guilt...I

cheat a bit, ice cream is my weakness. I lost 35 pounds . Unfortunately mostly muscle. But I feel much better eating a plant based diet and organically as much as possible. Take care in that beautiful homeland of yours.. peace..

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Unfortunately there is a lot of misinformation even in the vegan community that a vegan diet prevents prostate cancer. As a vegan for 9 years (my husband as well), this pisses me off. Eating meat or not has no effect on prostate cancer obviously. Rob was diagnosed almost 2 years ago now. He is stage 4 since it spread to a near by lymph node, found after prostate removal.

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I agree - the amount of misinformation about these things is staggering, but I don't blame people for their confirmation bias when so much is at stake. There are a lot of excellent reasons for increasing vegetable intake and decreasing meat intake. I'm not vegan personally, but I do eat a lot of vegetables relative to other nutrients. Whatever effect diet has on prostate cancer, and I suspect there is an effect, occurred over a lifetime. Two years is just not long enough to reverse that, if it is at all possible.

I hope your husband is meeting with a radiation oncologist and considering whole pelvic salvage radiation.

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As always eating healthier and more fruits and veggies is only beneficial for our bodies.

Yes, Rob had his first Eligard shot almost 2 weeks ago, radiation in the fall.

Thanks Allen.

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Science. smaience!,,,

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To T_A === Science Smaience! You know a lot, but you don’t know it all amigo! Have a great day!

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Seems I read that post recently somewhere...thats cool, As always, thanks for all your post, I really really respect your dedication to information,as the youngin's say "your'e the bomb!" (that's a great guy) Always wishing you to be healing well!

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Thanks! Yes, I copy and paste between the sites - saves me time. When I think that something will get used a lot, I just add it to my blog or Infolink, and post the link.

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Tall_Allen, give me epidemiological studies on the impact of nutrition (specifically looking at whole populations and the big picture on cancer and dietary fat intake) and rat studies (on the impact of how we might modify that nutrition) any day.

How do you try and control humans in so-called “clinical” studies?! Phoning them to see how they’re sticking to their diets as in the study you venerate? You’re assuming levels of control and measurement sophistication that just don’t exist. It’s all outside of a laboratory – at least with rats it is clinically controlled. And what if the design was flawed in the first place? You miss my whole point about the infinitely-large nurses study in the U.S. which couldn’t find correlations between diet and disease primarily because all of them consumed relatively high levels of animal protein, certainly higher than the US and much higher than the global average.

The fact is that the typical Western diet, heavy in animal protein, refined foods and lack of fibre, is killing us. Look at The China Study by Campbell and Campbell and you will see just this fact in graph after graph. You will also read about the 360 scientific articles that Dr Campbell Snr and his team have authored or co-authored over 30-plus years including studies on rats where they found that they could turn cancer on and off through varying levels of animal protein, namely casein, the main protein in cow’s milk which we Westerners are so fond of drinking and off which we are rarely weaned. [Oh yes rats! Wonder how the medical research profession would view your writing off the contribution of experiments of rats to science.]

Instead you hang your hat on a single and not large study and draw inferences from it that the authors daren’t make. In fact, they seem almost apologetic about the design of their study.

Some of the other points you make:

1.you state “randomisation proves causality”. Two of the criteria which need to be met are STRONG RESEARCH DESIGN and CONSISTENCY (as in multiple studies showing the same thing) – we haven’t got either here!

2.Studies are “designed to reject the Null hypothesis”, i.e. there is no correlation between the variables under study. Ordinarily I’d agree with you, but a key word here is “designed” and if the study isn’t well-designed in the first place, it’s a bit like “GARBAGE IN, GARBAGE OUT”.

3.And again, you miss my point (for possibly the fourth time), there is no mention as to what extent participants reduced their ANIMAL protein intake and whether it was possibly still in excess of levels globally. “De-emphasis” of them is not good enough. If blood levels were analysed for fats, did they equate to levels still above the world average? – more than likely.

4.Yes, the authors hoped to find that a change in nutrition would help, but a) the change is not clearly delineated particularly with regard to ANIMAL protein consumption, b) the participants are hardly “clinically” controlled” – the measuring systems importantly with regard to sticking to the protocol – are lousy

5.“This very large, well-designed study trumps all the lower levels you cite. Confirmation bias CAN harm you”. But it’s not large, it’s not well-designed, and it’s one study. Can I strongly suggest instead that you’re the one with confirmation bias, particularly given the treatment you’ve apparently chosen for yourself.

Most of what you say is actually very dangerous both from a statistical and treatment point of view.

I’m actually tired of the repeated insults in which you engaged from the get-go (I wish you’d just stick to the subject) and I won’t be drawn in again to reply.

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1. It was actually the largest study of its kind and extremely well designed by anyone's standards who knows about such things. You are correct that,if confirmed, it will be elevated to level 1a, grade A status, from its current level 1b Grade A status.

2. Again, the best designed and implemented diet study - ever.

3. You will have to order the full text publication to get the exact figures. The fact that they weren't highlighted usually means there was nothing there of significance.

4. I have no idea what you mean by not clinically controlled. Half the respondents got the intervention, half got calls but no intervention - that is what the word "control group" means.

5. I can't have confirmation bias because I had always advocated such a diet for myself and others. I still eat this way. The results surprised me as much as they apparently surprised the researchers. With data this convincing, one has to let one's preconceived notions go.Hey, maybe after 5 years they will detect a benefit - I'm open to that. but as of 2 years, there is none. It is also possible, although I think unlikely that there is a benefit for men with more advanced cancer. I hope that's the case.

Here's a good way to counter confirmation bias. Ask yourself - what if this is true, instead of looking for non-existant flaws.

I don't know what you perceive as insults - that you are ignorant of levels of evidence? We aren't expected to know everything, and I provided you with some links to help you instruct yourself about it. I think you will find it enlightening if you take the time.

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