Journal of clinical medicine. 2019 Feb 06
"Epidemiological studies have shown that obesity is associated with advanced prostate cancer and that obese men with prostate cancer have a poorer prognosis."
Apparently diet and exercise matter w... - Advanced Prostate...
Apparently diet and exercise matter with PCa after all, especially for those on ADT since ADT causes weight gain (and it isn't muscle).
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George71
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Yes, I agree but some foo foo exercise, diet, supplements and lifestyle changes that have shown clinical evidence of improving overall health and slowing cancer growth, because they don’t have double blind studies.
The fact is these lifestyle changes may have the most overall survival impact than all the medical intervention to date for high risk and advanced PCa patients.
A recently published article found that the newer systemic treatments vs older SOC treatments only extend cancer specific survival 6 months in mCRPC patients – no wonder advanced PCa patients are looking elsewhere for complementary and/or alternative treatment. The survival for mCRPC was 2.2 yrs. For older drugs vs 2.8 yrs. with the newer systemic drugs.
urotoday.com/recent-abstrac...
6 months????????? What a shame. This is one of the reasons why I am trying to delay the start of adt so I don’t get to that point mcrpc but I need to start soon anyways
Cut off date of 2nd study was 2013. Zytiga fda approved 2011, xtandi 2012. They don't say what NEW treatments they were studing. A little vague? Some myself included have been on xtandi for more than a year. Zytiga is perhaps a little better than xtandi, but guess jury still out on that. Helping with MY overall survival, don't know. These studies are like coffee sometimes. Good for you, bad for you. I agree good diet and excercise surely help. Some supplements surely help. Right now it seems to be the wild west.
George,
There is no doubt in my mind, after countless association studies, that obesity causes greater cancer aggression & a reduction in survival.
Obesity, as measured by BMI, is actually a surrogate for visceral fat in a number of studies.
There are two problems with BMI:
i) it's inaccurate for some men who don't have the average body proportions.
ii) it doesn't capture men on a high-carb, low-calorie diet - such as the Ornish - who are lean outside but fat inside.
You need a scan to measure visceral fat. Visceral fat - which often comes from the carbohydrate that people eat when they are avoiding dietary fat - affects hormonal balance. The altered hormonal milieu helps promote proliferation.
Men who are on testosterone replacement to high-normal levels have a good chance of restoring the fat:muscle ratio. Men on ADT have little chance, although exercise seems to help.
-Patrick
pjoshea13,
Thanks for the very informative explanation. I do occasional intermittent fasting. I have read compelling studies that 18 or 24 hour fasting helps in many ways including to slow cancer. Are you aware of other health benefits?
George,
Calorie restriction might help, since IGF-I will be lower when the diet is no longer plentiful. But equally so, the disruption caused by the type of fasting you describe might affect IGF-I.
There is a ton of stuff on PubMed regarding PCa & IGF-I (Insulin-like Growth Factor I).
787 hits for <prostate "Insulin-like Growth Factor I">
A good rule in PCa is to stay away from anything that has "Growth Factor" in the name.
6,674 hits for <prostate "Growth Factor">
What about body fat measurements. I lift weights pretty hard while I’m ADT and I’ve lost 10 pounds from 198 to 188 (6’1”) and gained muscle mass. Body fat from 17.5% to 15% and going down. I’d like to measure my visceral fat too as you suggest. But no clue where or how to do that ? Any suggestions?
Schwah
I have never investigated, since I have assumed the scan would be expensive & not covered by insurance.
Just came across this:
dexafit.com/dexau/dxa-dexa-...
"DXA Scans are for more than just bones; they also provide a comprehensive scan for measuring body composition. The scan is FDA approved to quantify dangerous levels of deep belly fat, also known as visceral fat. The fat is found padded in the spaces between abdominal organs and is linked to a number of health problems including metabolic disturbances, the risk for cardiovascular disease, breast cancer (in women), and type-2 diabetes. This fat is also directly linked with higher cholesterol and insulin resistance, and is typically influenced by heredity and hormones."
-Patrick
Had to google Ornish. Thought it might be a Game of Thrones reference.
Are you saying that weight gained during treatment is difficult to lose?
Wayne, Men on ADT often find it difficult to control weight, & there are plausible biological reasons why this would be so IMO. -Patrick
Talked to my Urologist last week and his response some lose quickly, some lose slowly and others not at all. Basically covered his ass on the answer as much as I like him.
Wayne,
My feeling is that:
a) one should follow the recommended dietary guidelines for diabetics, since ADT is driving the body towards diabetes.
b) consider brief (under 10 minutes, but intense) exercise that increases the heart rate (but monitor this). Seems that it can have a profound effect on the blood.
e.g. HIIT: time.com/4893161/hiit-high-...
-Patrick
And who would of guessed It? One of the things most studies linking fats to health and disease fail to do, is to distinguish between plant sourced fats and those from animal sources. I suspect source is an important factor? Be Well - cujoe
I wasn't fat until they hit me with 2 years of ADT.... go figure
Amen to this recommendation. ADT does increase likelihood of belly fat. I swim laps every other day to try to combat this.
Thanks for posting!
Does "try" mean you are failing? I eat little and walk about 3 miles a day. Still my weight creeps up. Has 15 years of ADT (currently on Zytiga) altered my metabolism?
I’ve lost 20 pounds since taking ADT. I’ve continued to swim laps 6 to 7 days/week (2+ miles total) which I was doing prior to diagnosis and ADT. I eat a healthy diet but nothing extreme. My muscle tissue seems to have declined but the exercise has kept my strength up and, I’m convinced, minimized ADT side effects.
After being diagnosed with prostate cancer last year I started attending a gym. I hadn’t seen the inside of one since my 20’s but was suffering fatigue following surgery and was told it was the only way to get rid of it. A local woman has completed a study that proves there is a relationship. I had been happy not to have seen the inside of one for most of my life. 7 years ago i managed to lose six stone nearly 40kg without increasing exercise. 80% of weight gain is what we eat and exercise only applies to about 20%. According to the exercise bike a good 20 minutes on it might be equal a chocolate biscuit. When I told the surgeon of the weight I had lost given his comments it became clear to me that I had probably saved my life by losing it. Cancer is much harder to treat in obese people and often operations are not possible. However having been one I can tell you that pointing it out to me wasn’t much good other than to make me more depressed. Life however has to continue to be worth living. So far I’ve been told stop drinking coffee, eating chocolate ( in fact just eat a lot less) anything spicy, anything tomato based ( love Italian food) don’t drink alcohol to much, and while you’re at it maybe consider becoming vegetarian. One person even sent me a piece saying that lemons were as good as chemotherapy. I’m beginning to think that all of the people that love to nag about these things ( and I don’t mean you or anyone here) double up on the nagging when they find out we have cancer. There are several menopausal women attending the weight loss class I attend and they find it much harder to lose weight or not gain it. I only say that cause I don’t know any man on hormone treatment locally. There’s no prostate cancer support group near me. My cancer is now in a lymph node in my left lilac area and a multi disciplinary team is considering my next treatment today. I have a consultation in the afternoon. It’s tough at times to keep everything in perspective.
I guess it always takes a study. American cancer society has been saying obesity and prostate cancer are not a good mix for a long time. I think automatic dietary counseling should be included when someone goes on hormone. Bill ended up 60 pounds up... not entirely from ADT. 2 years ago said enough. Went on low carb, low fat, medium protein protocol. Got a scale that monitors fat percent, muscle, etc. lost it. Walks 10,000 steps a day, usually bikes 10 miles, does arm and abdominal strengthening. It is a total challenge to maintain strength and muscle mass. He weighs 180, so I try to get 90 grams of protein in a day. Still on low carb. We do not believe in the Keto Diet of high fat, but the keto program of low carb, low fat... both promote fat burning. We Re going more to plant based protocol, lots of vegan ideas, but not vegan. He is stage 4, in remission, hitting 5 year mark.
Sorry,thanks nalakrats,been going to planet fitness for 3 years never thought of silver sneakers, I go al least 3 times a week,walk every day,feel good after,I still have pc,on jevtana now ,you got to do what ever it takes
IMO, nothing is ever so obvious it doesn’t bear stating clearly, and repeating regularly.i thought this should be obvious, but then I dismissed that.
Wierd...I lost 10lbs with just the diagnosis last fall.....stress is what I figure accounts for most... Excercise transfers distress to eustress is my longtime theory. I do a fair bit but have tapered down with the joint pains that started after Eligard. Wish someone could explain that to me...I’m much better now...I had to crawl up on the upper sauna bench which I absolutely treasure as part of my cryothermo treatment. That’s the other thing....I’m a cold freak...I immerse myself daily in glacial cold water between steams....it’s been my lifelong natural panacea...have no opinion on whether it helps or hurts..I just love it. 🥰
Although I believe ths to be true for exercise, remember these newer drugs were given at very late stages. Now proper sequencing an c ombining these drugs early on will increase overall survival. Rocco
My husband was an athlete, 170 pounds soaking wet at 6'2. Never smoked, ate healthy- not big on sweets. No other health issues- very healthy prior to diagnosis. I guess there are always exception to the rules.
Eating and being healthy should always be top priority. Heart disease, diabetes, cancer and a slew of other diseases are affected or caused by poor diet and a sedentary life style.
Have been fighting PC since 2004. Gleason 9 did radiation and adt. When diagnosed was a triathlete and competitive swimmer. Started weight lifting at docs suggestion during radiation. Tried to do tri s after radiation but was not competitive...Weight ballooned up but now I have managed to get it back down to my previous levels with diet and exercise. Thinking of trying triathlons (international distance) again at age 74.....Have started swimming and expect to bike and run once the snow is gone...Think this has helped me keep the psa down. Also helps a lot with my attitude.
in reply to SUPERHEAT12
Have you been on ADT or anything else?
SUPERHEAT12 in reply to
I am on avodart, metformin, lipitor, lisinopril, and various supplements.
in reply to SUPERHEAT12
Thanks for the response. Is it working. My MO is not wild about avodart and metformin.
What do you think?
George71 in reply to
tceinvestments, and SUPERHEAT12,
Both of your stories are a great inspiration. tceinvestments, if I understand -- you are currently on Avadart and you dropped the intermittent Cassodex ?? and your PSA is under 1.0 ?
Am doing similar to you guys. Avadart, Metformin, supplements, diet and exercise. 3 years post RP 0.5 PSA (had 4 of 10 lymph nodes positive -- post surgery. Any advice?
in reply to George71
Hi George:
I have been on Cassodex only for 6 years. My PSA is 1.6. The bad news is my latest scans showed 2 new mets - 6 total on my bones. We have upped my Cassodex to 150 mg day to see if that helps. If not - probably Lupron - ick - had it before radiation and hated it. I am very curious about Avodart and metformin. What does it do to help the cause.
Thanks for the input.
George71 in reply to
I have read where spot radiation on up to ten mets all over the body is being done.. And I had dialog with another HU member who is a retired RO that had it done to several spots and is 14 years out and doing well. Dr. Kwon at Mayo in Minn. has seminar on youtube you can watch.. I will look into it if I ever develop mets.
George71 in reply to
I am taking Avadart and it has held my PSA from 0.4 to 0.6 over 18 months. Actually it dropped to 0.5 the last PSA (a week ago) there are studies that confirm it helps. Dr. Meyers was an advocate for it years before it was recognized as beneficial.
recent article about the benefit:
"This discovery could benefit tens of thousands of men each year in the United States by identifying a drug that can safely and effectively prevent prostate cancer,"
SUPERHEAT12 in reply to
Understand. My current MO is not a big fan however lets me continue. Dr. Myers believed that Avodart controlled the form of testostorene that PC eats while a Swiss study found that Metformin showed a 28% reduction in PC in some patients. Seems to work for me.
in reply to SUPERHEAT12
Thanks so much. Your information is so helpful. How did you find out about avodart? What ADT are you on?
George71 in reply to
nothing but Avadart, Metformin, diet, supplements
Click on link below -- Snuffy Meyers -- really good
in reply to George71
Amazing George
Thanks so much for your input
Have you had surgery or radiation
What was the highest your of your PSA when you were detected
George71 in reply to
RP April 2016 PSA pre surgery was 10.1 -- post surgery PSA 0.033 (4 of 10 lymph nodes positive final pathology report). Supplements and diet til PSA got to 0.6 Sept 2017 added Avadart - one daily -- dropped PSA to 0.4 where it stayed till 7/2018 went to 0.5 till 1/2019 went to 0.6 till 2/2019 down to 0.5
in reply to George71
That is such great news George. How are your scans?
George71 in reply to
I had a F18 pet CT and A PSMA last August and they were clear -- that is the dilemma -- there is no where to aim if I do radiation now -- opposed to SBRT when it shows up which could be tomorrow or on average 8 years. With the high likelihood that immunotheropy will make a breakthrough if we can all just hang on a little longer.
Look at the link below about SBRT to radiate up to 10 mets. and find youtube video of Dr. Kwon who has gerat results with it.... some are becoming undetectable after treatment
medicalxpress.com/news/2018...
in reply to George71
Thank you so much George. You are so helpful. I am currently seeing the chief MO at Mayo Scottsdale. He say spot radiation will only help pain. I will do more research on Dr. Kwon at Mayo Rochester. You seem so knowledgeable. How did you learn so much? I have had this disease for 17 years and just now thinking about ADT for my 1.5 PSA and 6 mets.
Thanks.
George71 in reply to
I'm like the rest of us with this dreaded disease, just looking at all the options, clinical trials new discoveries -- hoping for breakthroughs and better treatments--it's changing rapidly. I have been to a bunch of top PCa doctors and nothing is etched in stone, they all have differing approaches some are completely 180 degrees in their opinions and none are admit about what to do.
Here is Dr. Kwon -- it is right you your alley on treating mets. The med community is changing in this regard -- I hope the RO on here sees our dialog and chines in for you --he was apparently cure of all evidence of disease by RO Dr. Buttler Methodist Houston who I have met with on 4 occasions about possible nymph node radiation.
in reply to George71
Dr. Kwon is at Mayo Rochester correct. George you are the best thank you so much for all of your input
Tom
George71 in reply to
yes, Mayo, Rochester Minn. Dr. Kwon Direct # 507 266 2066
in reply to George71
Thanks George you're very thoughtful
George71 in reply to
you bet -- keep us updated -- you are doing great -- I hope I can last 17 years with only 1.6 PSA -- and very little treatment like you have. I am surprised that you have 6 mets with such low PSA even if you are on Cassodex. None of us on here are a doctor -- we are all just like you -- comparing treatments, researching and sharing experiences.
Sometimes we need things repeated because we get tons of info at once without knowing what is relevant, only what is salient, even confusing the two. Or we forget. Or we don’t realize the significance at first hearing. Or have LUPRON brain. We need the obvious repeated ad nauseam.
I read these studies years ago and agree with them. One thing that newadvanced prostate cancer patients need to be aware of is that when they talk to their medical oncologist the medical oncologist might give them bad information which discourages the patient. When I spoke to one of the most famous medical oncologist in the world that Sloan-Kettering he's told me now that you're on ATT you're going to start to develop a pooch or fat stomach overtime in your lower abdomen. It's been three years on lupron now and my abs are flat as a board. the problem is is that the medical oncologist draw conclusions based on what the norm is for the patients that they see so they if they see a lot of patients that don't take care of themselves and they're going to assume that that's due to the medication when in reality it's actually due to bad eating and exercise habits among a lot of the patients. So don't believe everything that the oncologist tells you.
in reply to GeorgeGlass
Agreed George - Have not gained a pound but you have to change your eating habits to have success.
I was ALWAYS heavy. Diagnosed 13, years ago at age 45. My highest known weight was 351, height 5’ 5”. I had gastric bypass and have lost 210 lbs. My PCa is back; I am watching the weight.
I've been on a diet for a whole week and lost seven days.
Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 02/14/2019 5:20 PM EST
I've told my story several times before but it's worth telling again since we have a lot of new members here. After both rovotoc RP and salvage RT failed, my doctor told me that I needed to go on ADT. This freaked me out as I was still able to enjoy a meaningful sex life up to that point. I immediately stopped working, went full on vegan diet with lots of guru approved supplements and started walking 6 to 10km a day. In 6 weeks after initial talk with doc, and before actually starting ADT I lost 10kg (90 to 80) but PSA went up from 2.5 to 7.5. Never fear, you cant expect a good diet to have immediate effect after decades of bacon and egg and beer, but veganism + ADT is sure to work. Many men here achieve PSA nadir of 0.1 on ADT and they are not all on strict vegan diets surely I will do better than that.
Six weeks after starting ADT I lost another 10kg (now Dow to 70kg). And I felt fantastic. But 6 months after ADT, my PSA has gone from 7.5 to 15. With liver mets and peritoneal disease. WTF?? Doesnt ADT last for a few years? Especially when my immune system has been supercharged with a great diet and supplements.
So my doc put me on docetaxal. At the same time I started on an exercise-based clinical trial consisting of 3 supervised gym sessions per week in addition to my normal walking and tennis program.. Well the gym sessions went great. My muscle mass increased by 4kg and bone density increased by a few percent. So ADT can be managed, it DOES not mean automatic weight gain and bone density loss. It's hard work bit you can beat ADT. As a side benefit, I had virtually zero side effects from chemo (9 cycles). I had no fatigue, no nausea and didn't miss an exercise session.
But... after reaching a PSA nadir of 1.8 after 6 cycles of docetaxal, I reached a resistance point and PSA started doubling every 4 weeks. So do took me off docetaxal after 9 cycles.
So I would recommend good diet and good exercise to everybody. I dont think that there is any dispute that good health and fitness helps us deal with the side effects of cancer, and also the side effects of the treatments we use. However there is less evidence that exercise and diet will impact disease progression. My wife now believes that good eating and good exercise has made EVERY cell in my body stronger, both normal cells and cancer cells. And when you think about it - why not? You know how you feel better after a good work out, how would those feel good hormones differentiate between normal and cancer cells?
This is just my personal experience and we all react differently to our treatments. What works for me might not work for you (and vice versa). But good luck with whatever path you chose to follow.
It's not just about being overweight....it's, literally, about the fat (adipose). We have a very complicated disease, gents, and one based in the endocrine system. Adipose tissue actually creates hormones... well, here's a sleeper if you want to read it: "Androgens and Adipose Tissue in Males: A Complex and Reciprocal Interplay"...
hindawi.com/journals/ije/20...
Enjoy. I keep a PDF copy simply to pop up on the screen for when my wife walks by so she thinks I'm smart....
Don’t forget LiveStrong is a good starting point and introduction to a gym lifestyle with cancer.
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