Just talked to my MO. She rated some ... - Advanced Prostate...

Advanced Prostate Cancer

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Just talked to my MO. She rated some things for me

smurtaw profile image
67 Replies

10 Exercise

8 AHA or Mediterranean Diet, others not so good.

8 Fasting (I was surprised it was this high)

5 Statins (Lovastatin)

10 Baby aspirin (I was very surprised it was this high but it is more for the increased cardiac risk that kills many PCa patients)

5 Sulforaphane

5 Metformin

5 Melatonin low dose (1-3 mg) (high dose is probably not harmful)

3 low-risk cancers only. Dutasteride monotherapy. (and with ADT probably a wash 50/50?)

8 D3

5 EGCG (green tea)

3 Rapamycin (low dose – 2 mg weekly) (I would have thought this would have been higher)

"Don't know" Cabergoline (reduces prolactin)

5 American ginseng

5 Garlic

6 Curcumin

5 Lycopene (tomatoes)

5 Pomegranate

3 Dim"

67 Replies
One-Eyed-Jack profile image
One-Eyed-Jack

Your MO is a cool cucumber.

smurtaw profile image
smurtaw in reply to One-Eyed-Jack

She's awesome!

swwags profile image
swwags

smurtaw, Thank you for posting. Did your oncologist elaborate on her definition of fasting? Any specifics?

smurtaw profile image
smurtaw in reply to swwags

She just said that it was for more than cancer. I didn't want to keep her the entire appointment - she's overworked as businesses tend to do. If you are interested in any specifics I can ask her again next appointment (6 weeks).

mrscruffy profile image
mrscruffy in reply to swwags

I do intermittent fasting, 24-36 and sometimes longer depending on workouts. always high protein when I eat

smurtaw profile image
smurtaw in reply to mrscruffy

I eat in a 4-8 hour window. I can fast longer (I hate going more than 40 hours or it gets in the way of working out). I'm going to ask my MO what she thinks about the length.

swwags profile image
swwags in reply to smurtaw

Thx!. For clarity on your above comment, are you saying you eat daily but only within certain hours, say 11am - 6pm? I ask because that's what I've been doing for decades. I only eat a small lunch and then dinner. I do have coffee in the morning.

smurtaw profile image
smurtaw in reply to swwags

Yes. I just started eating and it's 11 here. Tonight will be a little late because of friends. But I should be done by 7.

Black coffee doesn't count as eating.

Londinium profile image
Londinium in reply to swwags

Black coffee/tea (unsweetened and without milk/cream) is fine during the fasting period.

Purple-Bike profile image
Purple-Bike in reply to smurtaw

Did you get to ask your MO about the length of the fasting?

I eat in a 4-6 hour window.

Great list that she compiled, thanks for sharing it.

maley2711 profile image
maley2711 in reply to mrscruffy

does fasting do anything to prolong high QOL life expectancy?

smurtaw profile image
smurtaw in reply to maley2711

I like having muscle mass and low body fat. And I like the fact that my wife likes it (so much so that I sometimes catch her staring at me like a doe-eyed school girl when I'm getting dressed. So, fasting, high protein, and resistance training provide heavily to my QoL.

mrscruffy profile image
mrscruffy in reply to smurtaw

Same situation here, my trainer has nothing but praise for me and my new body composition

London441 profile image
London441 in reply to maley2711

Probably. What’s more certain is that caloric restriction in general (especially less than in typical western diets) absolutely prolongs life. The quality of such a life depends on a combination of that and a few other factors.

maley2711 profile image
maley2711 in reply to London441

so, no great revelation there....lower BMI is better...and of course those with a lower BMI don't need as many calories to maintains that lower BMI. Then again, some men with certain phyiques are underweight at the lower end of "healthy" BMI. per an MD's book I'm reading now, it IS just part of inevitable ageing....loss of muscle mass....evident ADT accelerates that.

London441 profile image
London441 in reply to maley2711

Keep in mind BMI is a unreliable marker. Body composition is what matters. Regular Dexa scans provide the good info. Although most older guys especially only need to measure their waist to know where they stand, if they don’t already. 40+ is considered too much but a lot of us don’t dare go anywhere near that.

Over time abdominal fat gets easier to gain and harder to lose, speaking of ‘no great revelation’😀. On the other hand weight loss without effort when older is usually not a good sign, unless one is very old when food often loses its appeal.

And yes loss muscle mass is a normal part of aging, but that should only make us more determined to slow it down!

smurtaw profile image
smurtaw in reply to London441

When I did bodybuilding 40 years ago my BMI put me in the obese category. 6% fat but obese?

Scale and fat calipers are easy to use and inexpensive.

London441 profile image
London441 in reply to smurtaw

Honest use of a mirror even easier and even less expensive 😀

maley2711 profile image
maley2711 in reply to London441

fingers work for checking surplus fat!!!!

smurtaw profile image
smurtaw in reply to maley2711

Most of the time. Sometimes.... Fingers don't stretch that far.

maley2711 profile image
maley2711 in reply to maley2711

I thought most men here had 22-23 BMI......maybe 6' and 170? Distant dream for a few of us......if I can just get back to 190 ?

smurtaw profile image
smurtaw in reply to maley2711

My BMI is 26.2. I'm about 13% bodyfat. I'm up around 210 now.

Since diagnosis, I have lost some fat and gained a lot of muscle. I thank intense exercising and a cleaner diet for the recomp.

No_stone_unturned profile image
No_stone_unturned in reply to maley2711

-At dx I was 225 with a 30bmi and climbing. -2 years later I am 170lb, 23bmi (6’ tall)

This is the healthiest I’ve been in my entire life, I feel Amazing. I’m going to have the best looking corpse out of all of my friends. Lol

Good luck warriors.

smurtaw profile image
smurtaw in reply to No_stone_unturned

PCa can be such a stinking weird thing. I wasn't in bad shape in my 40s and 50s but I'm in far better shape now. Look great on the outside, cancer-riddled on the inside. My wife is 17 years my junior and complains that she looks older than me.

mrscruffy profile image
mrscruffy in reply to maley2711

Not sure, with my meds I just don't need to eat so much. I actually feel better when fasting and the longer I am into my fast the easier it is. My MO attributes my good health to that and being in the gym daily. I fast after six weeks of bulking where I typically gain a little weight along with muscle.

Scout4answers profile image
Scout4answers

Had a recent discussion with my RO and he mentioned (10 Baby aspirin) as something they had studied @ U of Chicago with an ( RCT) ??? and found it effective against PCa, perhaps for the same reason you suggest. I have found him quite open to talk about ideas but very conservative re: SOC and ADT

One-Eyed-Jack profile image
One-Eyed-Jack in reply to Scout4answers

I don't understand (10 Baby aspirin). Thanks.

Spyder54 profile image
Spyder54 in reply to One-Eyed-Jack

@one eyed jack. Yes, not clear to me either. Guess she is rating different non SOC treatments on a 1 to 10 scale. My guess n

smurtaw profile image
smurtaw in reply to Spyder54

Yes. 1-10 scale. I gave her a list of things and asked her to rate each one. Baby aspiring ranked a 10.

maley2711 profile image
maley2711 in reply to smurtaw

Ie...you prompted her to advise these things?

smurtaw profile image
smurtaw in reply to maley2711

I did not "prompt" her to advise them. Nor did I "prompt" her to discredit them. I asked for her objective rating based on her opinion of the evidence.

When I titled the post "I asked my MO to rate some things for me". I meant that I asked her to rate the list of items that I gave her. Most of the items on my list are high on cancer.gov and/or RCTs. Some aren't and she ranked most of them 6 or lower. She rated fasting much higher than I would have expected and statins much lower.

Teufelshunde profile image
Teufelshunde in reply to Scout4answers

Who is your RO at UC? Mine is Liauw. Just curious.

Scout4answers profile image
Scout4answers in reply to Teufelshunde

Same -great guy he designed a target pattern that avoided the aortic arteries as much as possible

Teufelshunde profile image
Teufelshunde in reply to Scout4answers

I have my final 1 yr follow up with him next week. I think I then get referred back to URO or MO? I guess I will see. Also, I am calling this week to get into Block Center as my Medicare w/supp starts Monday. Not 100% sure about this place but will report.

Magnus1964 profile image
Magnus1964

That's a great list. She rocks.

Teufelshunde profile image
Teufelshunde

Nice.

NickJoy profile image
NickJoy

This is really helpful- thank you.

Canoehead profile image
Canoehead

I had a script for rapamycin from my naturopathic doc, but my insurance refused to pay for it. The stuff is very expensive.

Smarty, I guess I have done something right, my husband is taking and doing 3/4 ‘s of her list, at least. Metformin, green tea , statin, exercise , M diet, baby asprin , Curcumin and more🙏

smurtaw profile image
smurtaw in reply to

Good job Smartarrito!

in reply to smurtaw

I just laughed at your comment, sometimes not so much.! Watermelon, such an awesome fruit… don’t skip it and a little pom juice until Pomegranates are in season. Eat the seeds! Armenian Pomegranate Wine doesn’t count!😉

Nusch profile image
Nusch

I do most, but don’t understand all. What is, please, Rapamycin, AHA, Dim, Cabergoline? What’s the dose of baby Asperine?

smurtaw profile image
smurtaw in reply to Nusch

AHA is American Heart Association. I should have written it out...

Baby aspirin dose is 81mg. Taking it at night is probably best. My primary care physician put me on it 30 years ago.

Rapamycin is an mTOR inhibitor. DIM is a substance in broccoli. Cabergoline is a medicine that reduces prolactin.

I'm surprised she ranked Rapamycin so low.

Cabergoline is probably only indicated for CRPC.

Nusch profile image
Nusch in reply to smurtaw

Many thx again! I eat broccoli daily and will think about adding asperin. I‘m still hormone sensitive, so will skip Cabergoline.

Garbonzeaux profile image
Garbonzeaux in reply to Nusch

DIM=diindolylmethane

leebeth profile image
leebeth

Lovastatin is an interesting statin choice. The oldest currently available statin, it has the highest side effects and the lowest efficacy. They are all quite affordable now. I would love insight into that specific recommendation!

smurtaw profile image
smurtaw in reply to leebeth

The reason that I take lovastatin is that the others that I tried gave me terrible insomnia.

It is one of the ones with the greatest observational PCa evidence. So I worked my way down a list until I found one that worked for me.

leebeth profile image
leebeth in reply to smurtaw

Reading your list, it sounded like your doctor specifically recommended Lovastatin which completely surprised me, as it is rarely used anymore, due to the superiority of the others. Of course individual experience is the decision maker in your case! I assume you take the Lovastatin at night, unlike atorvastatin and Rosuvastatin that are usually taken in the morning. I wonder if that is a factor in your tolerance? Interesting side effect that occurs very rarely. So sorry that you experience this!

in reply to leebeth

Leebeth,my husband takes Atorvastatin 40mg in the morning.

leebeth profile image
leebeth in reply to

So do I! 😊

smurtaw profile image
smurtaw in reply to leebeth

Thanks! Insomnia is a rare side effect and my doctors seemed convinced that I was imagining it. But I checked it and rechecked and read studies on the net. Rare but if it happens to you, 100%.

She might have been looking at studies that show lovastatin is the best one for PCa adjunct therapy. I take it at night. 40 mg a night has my cholesterol at 117. Too low IMO. I'm going to moderate my dose (maybe take a full dose but only every other week?).

She didn't rank statins very highly though. I was a little surprised since statin use for cardiac risk seems effective. So, why did she like aspirin so much and why didn't she like statins? Maybe the risk of sides. I didn't want to ask a bunch of questions and keep her at the appointment - it was almost 1 and she still hadn't had lunch.

leebeth profile image
leebeth in reply to smurtaw

Many doctors don’t know that baby aspirin has the same risk as apixaban for major bleeds. (AVERROES study) They are comfortable with it, but too comfortable in my opinion. The minute I saw that study I took my 90+ yr old aunt off of her unnecessary baby aspirin. She said Dr Oz had recommended it. 😀

smurtaw profile image
smurtaw in reply to leebeth

Dr Oz :) I prefer getting my drug advice from Jerry Springer. He's louder.

The doctors or the patients should pay attention to their clotting factors and their platelets. Most doctors don't though so it's up to us.

Murph256 profile image
Murph256

I have heart issues so I was prescribed baby aspirin. But due to my EBRT along with the aspirin, I developed a low platelet count (112), which led to odd side effects such as excessive bruising and gum bleeding. Due to the side effects, I stopped the aspirin and my platelet count has since recovered to 132. So my question is, should I be taking aspirin as a supplement for PC, even at the risk of a low platelet count?

smurtaw profile image
smurtaw in reply to Murph256

No! The cardioprotective effects assume that your platelets are normal or high.

Murph256 profile image
Murph256 in reply to smurtaw

Got it. Thanks!

MrG68 profile image
MrG68 in reply to Murph256

I assume the aspirin is for blood thinning?

You could possibly consider taking nattokinase instead of the aspirin. Or eat natto - I assume that you'll prefer the supplement form of nattokinase though.

Murph256 profile image
Murph256 in reply to MrG68

Yes. After my heart attack, I had 3 stents put in. The aspirin was for blood thinning to prevent clotting around the stents. But how low is too low? My platelets were already low ever since my full pelvic radiation. My cardiologist agreed that I should drop the aspirin. But I was unaware that aspirin was also beneficial toward treating PC.

smurtaw profile image
smurtaw in reply to Murph256

Some research indicates that aspirin is beneficial for PCa. But most of that is due to the clotting and platelet reduction. My MO didn't talk about the PCa benefits of aspirin. She was adamant that it was for cardiac risk reduction.

If your platelets are low, I don't think that you should take aspirin. But talk to your cardiologist to make sure.

No_stone_unturned profile image
No_stone_unturned in reply to MrG68

I take dan shen supplement as a natural blood thinner.

dhccpa profile image
dhccpa

Why is American Ginseng better than other forms of ginseng?

smurtaw profile image
smurtaw in reply to dhccpa

It might reduce cancer-related fatigue.

American ginseng (Panax quinquefolius) is an herb that grows in North America. It has been shown to reduce cancer related fatigue (CRF).

References

1. American Ginseng in Treating Patients With Fatigue Caused by Cancer - Full Text View - ClinicalTrials.gov

originalText

2. American ginseng board of Wisconsin

originalText

3. Ginseng for the Management of Cancer-Related Fatigue: An Integrative Review - PMC

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4. American Ginseng Improves Cancer-related Fatigue | Natural Medicine Journal

originalText

5. The use of ginseng supplements with short duration (< 6 weeks) and lower dose (< 1,000 mg/day) showed no significant efficacy. Longer durations with higher doses showed efficacy: Efficacy of Ginseng Supplements on Fatigue and Physical Performance: a Meta-analysis - PMC

originalText

6. Wisconsin ginseng (Panax quinquefolius) to improve cancer-related fatigue: A randomized, double-blind trial, N07C2 — Mayo Clinic

originalText

dhccpa profile image
dhccpa in reply to smurtaw

Thanks. I've read folks recommend ginseng, but have only seen American Ginseng mentioned very recently.

Currumpaw profile image
Currumpaw

Thanks for posting. I practice intermittent fasting with a tweak. In the morning through the afternoon I drink black coffee or green tea, sometimes black tea, strong of course and anything that has any caloric value, (which is negligible), that can be used as nutrition is also noted as hostile to cancers. I use the fast to take supplements known to be harmful to cancers.

Curumpaw

KocoPr profile image
KocoPr

I used to fast until now that I am on darolutamide I have to take it with food every twelve hours.I can’t see a way around this.

smurtaw profile image
smurtaw in reply to KocoPr

2-2.5x absorption with food. accessdata.fda.gov/drugsatf...

Ask your MO if there is anything you can do.

MateoBeach profile image
MateoBeach

She is very nice to do that.

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