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Advanced Prostate Cancer

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Let's change the way we're treated by adding metabolic therapy to SOC

TryGuyCP profile image
31 Replies

Some good recent videos on a subject

Dr. Thomas Seyfried: youtu.be/u2s6z37YIzM?si=UXI...

PCa specific discussion on the same: youtu.be/RbrX_ZrYxJg?si=wTR...

I must add: I've been on low-carb diet (Atkins) since 1999 and recently (August of this year) started keto. I've been physically active (12h/week on average workouts) since 2009. Mostly cycling but now to counter SEs of ADT my focus shifted to resistance (variable) training and much less riding. I started in August with strict keto and limited proteins but month after DEXA body-comp scan showed big drop in muscle mass (along with fat, too!) so I backed of now and try to get to 1g of protein/pound of my weight. this means 160g/day considering average %23 in best sources (eggs, meat) I'd have to eat 1.5lbs of meat daily doing it in one sit (one meal a day) even a bigger challenge.

If you listen to Dr. Seyfried you will understand that diet alone will not take care of it. Some drugs need to be used to address glutamine and the protocol they work on need to be performed in a proper clinical setting. Unless its widely recognized as SOC this won't happen. He speaks of some patients going to Turkey even to get treated in this way.

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TryGuyCP
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31 Replies
MoonRocket profile image
MoonRocket

What is preventing anyone from adding metabolic therapy to SOC? Lots of people engage in these treatment protocols.

Maxone73 profile image
Maxone73

I am doing a metabolic therapy as well (fast mimicking, fasting and intermittent fasting are metabolic, does not have to be keto) and clinical trials (dr. Seyfried is totally wrong here) are on their way and many have been done already and were successful (again, not talking keto, but there are trials about that as well) but as adjuvants, not as the only cure. But still, there are 1 or 2 guys on this site (that I know of) who have been on keto for years before getting prostate cancer...and still they got it. I am afraid that considering cancer only a metabolic disease is too simplistic. But we will see the results.

JohnInTheMiddle profile image
JohnInTheMiddle in reply to Maxone73

Very helpful reply MaxOne! The topic of metabolic and glucose management issues where metastatic prostate cancer is concerned is very important.

Currently I'm wrestling with how-to-balance the need to eat, including fat, food with some of my meds. I'm also wrestling with how to exercise, in terms of volume and catabolic versus anabolic. And I'm adding to that what I have just learned about the need to eat enough protein. I'm thinking of making a full post on this but I crashed because I learned I was eating not nearly enough protein. And we don't want to help sarcopenia!

My new theory is that when you're young, your body is resilient and you can stay up all night. But now it's like walking a tightrope. And I think one can do very well on this tightrope with therapies and maybe some supplements and lots of exercise and sleep etc.But if I don't keep things managed very well then, it's very easy to fall off the tightrope. And recovery takes longer - and maybe there's progression while you're on the floor.

It's possible to walk the tightrope. But it requires discipline and clear thinking and good decisions. (And one doesn't do it alone of course but in the matrix of a family and friends and community.)

But hey, a theory is a theory until my next PSA test. Or worse, progression without any PSA movement 🙄

Maxone73 profile image
Maxone73 in reply to JohnInTheMiddle

I know a thing or two (or six or twelve) about training, just ask me if you need. And don't exaggerate with proteins, remember when they talk about "...grams per kg of weight" they should add "per kg of ideal weight"

JohnInTheMiddle profile image
JohnInTheMiddle in reply to Maxone73

Good point reminding of grams of protein per kilograms of ideal weight. I'm 82 kg now, ideal 72 I think. My goal is 10 hours of exercise a week. Which is approximately 40 METs maybe. This is a lot. Balance between catabolic and anabolic. It's my simplified summary and target so I don't have to think about it. But I think I was eating maybe a half or a little more than half of the protein I needed to maintain this. And last week I kind of crashed, in other words I became super tired in the space of a day.

Maxone73 profile image
Maxone73 in reply to JohnInTheMiddle

Burnout is always a risk, especially if you don’t know your body well yet. I just got myself a scale that can measure body fat. Does not have to be too precise, but consistent as I am more worried about the proportion between fat and lean mass rather than lean mass itself. But 1gram per kg of lean mass is plenty unless you are a bodybuilder on steroids 😜 I have seen people getting even 4 grams per kg….I wonder where their kidneys are by now!

JohnInTheMiddle profile image
JohnInTheMiddle in reply to Maxone73

A good idea to get the scale - I was reading up about them and as you imply some of them aren't super accurate - but then consistency is the thing we want. I was part of a program for a year and got measured on the scale (where's the cool explanation about the electricity going up and around your body). And the whole fat to muscle ratio is critical. I'm trying to build muscle mass and cardio endurance both.

Maxone73 profile image
Maxone73 in reply to JohnInTheMiddle

Eh it’s a big quest keeping balance, probably you need to periodize cardio and mass.

Maxone73 profile image
Maxone73 in reply to JohnInTheMiddle

FYI this summarizes quite well the results of interventional and observational clinical trials on various fasting techniques:

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

You could enroll in one? You would have free consultations!

spencoid2 profile image
spencoid2 in reply to JohnInTheMiddle

You brought up at least one very good point that answers the question of "i did it all right and i got cancer anyway" Once we are on the tightrope we need all the help we can get.We can't get sloppy and say "oh well it really does not matter what i eat or do, i am doomed" I am being quite strict now about intermittent fasting and am working on the carbs which 90% of Americans are horrible with.

Maxone73 profile image
Maxone73 in reply to spencoid2

Marginal gains...I get all the extra 0.5% gains I can get in every way, as long as I am sure that I am not harming the SOC therapy. Plus there is cancer fight and there is general shape. I work on microbiome even if it's too late to avoid cancer through immune system, but it's worth to try to avoid to get any other disease or even only to limit the toxicity of the therapies.

Tall_Allen profile image
Tall_Allen

Pseudoscience. No evidence for any of it.

JohnInTheMiddle profile image
JohnInTheMiddle in reply to Tall_Allen

Are we talking about some "Metabolic Therapy" as a specific regimen? That was not what I was thinking about. But if one has trouble with sugar management and insulin sensitivity etc. there seems to be reasonable theorization and adjacent evidence that working on this with exercise and diet is worthwhile. As the cliche goes absence of evidence is not evidence of absence.

Tall_Allen profile image
Tall_Allen in reply to JohnInTheMiddle

This is a forum on advanced prostate cancer, so I am only concerned here with metabolic theory as it applies to PCa therapy (not CV health, diabetes, etc.).

There is indeed evidence of no effect. Several powerful IGF inhibitors (cixutumumab, figitumumab, linsitinib, etc.) have been tried and failed to show any effect. We know from metabolic PET indicators, that glucose has no effect. We also know that maintaining insulin sensitivity with metformin has little if any effect.

In addition, there is no evidence of any effect that diet may have on the metabolism of PCa. Can diet have an effect? Possibly - but we have to start from what we already know - and we know a lot. We know that glucose does not drive metabolism in most PCa and we know that blocking insulin has no effect. Some of the oldest and most effective cancer therapies are antimetabolites such as 5- fluorouracil (5-FU), 6-mercaptopurine (6-MP), cytarabine, gemcitabine, and methotrexate. But they are all ineffective for PCa.

Maybe low fat or low protein diets can have an effect? But we know that cancer cells are voracious feeders and depriving them of one nutrient only drives them to switch to another nutrient. We also know that cancer cells create their own fatty acids and proteins. You can't even starve cancer cells of all nutrients - they routinely cannibalize healthy cells for the nutrients they require. Maybe one day drugs will be found that can interfere with fat or protein metabolism of PCa specifically. They don't exist currently. SCD1 and FASN inhibitors are in clinical trials.

JohnInTheMiddle profile image
JohnInTheMiddle in reply to Tall_Allen

Super thanks for your helpful reply Tall Allen! Excellent food for thought (no reference to metabolism intended 😃).

spencoid2 profile image
spencoid2 in reply to Tall_Allen

I agree that trying to starve cancer is not simple. I doubt you can do it by diet. But I do think there is a lot of sense in intermittent fasting and I believe there are already trials to show it help with cancer control. Anyone with a perfect immune system will not get cancer to begin with except in maybe cases of extreme exposure to carcinogens. If our immune systems are working perfectly they can address DNA breaks and rogue cells. Giving them time to do this by intermittent fasting makes a lot of sense to me. Our bodies are amazing but they can not do everything at once. There is a lot of current research into light timed circadian cycles, the importance of regular sleep etc. We evolved for many years responding to and living in a natural environment. So many things have changed in the last 100 years it is no surprise that there is a cancer epidemic. We eat highly processed garbage food all day all year with no regard for how we evolved. We used to get up early spend time out in the morning sun, not eat three meals a day and so on and so on. We eat the same shit during any season because we can ship unripe crap half way around the world. Most animals vary their diet by the seasons and it does not surprise me that we might have evolved along with those restrictions.

To every thing there is a season, and a time to every purpose under the heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance; a time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; a time to get, and a time to lose; a time to keep, and a time to cast away; a time to rend, and a time to sew; a time to keep silence, and a time to speak; a time to love, and a time to hate; a time of war, and a time of peace.

TryGuyCP profile image
TryGuyCP in reply to spencoid2

You spoke my mind! It's not simple indeed and rapid change of our environment is very likely to blame for rising decline of population health.

Maxone73 profile image
Maxone73 in reply to TryGuyCP

ncbi.nlm.nih.gov/pmc/articl... you can find there two tables with the closed and ongoing clinical trials (randomized and open arm) about dietary intervention in relation to cancer (in general, not prostate only), other two are starting in Italy very soon, one from the european institute of oncology

Tall_Allen profile image
Tall_Allen in reply to spencoid2

I'm only aware of this trial of intermittent fasting:

clinicaltrials.gov/study/NC...

But it may fail because of poor recruitment.

spencoid2 profile image
spencoid2 in reply to Tall_Allen

I didn't even know there was one specific to prostate cancer. I was referring to studies not specific to prostate cancer. I am doing this for general health not to cure my PC. Getting old and a lot of things ain't as good as they used to be. I am m ore interested in intermittent fasting to help with my "severe atherosclerosis" probably brought on by ADT. This may ber a misreading of the CT scan and MO is not concerned but I figure it is time to do whatever to reverse it. clinicaltrials.gov/search?i...

Islandboy2021 profile image
Islandboy2021 in reply to Tall_Allen

I have to agree with TA on diet having any effect on cancer once you have it. Diet can help you stay healthy during your treatments and recovery.

I tried it all including vegan, supplements, no sugar or alcohol no processed foods.

The cancer advanced as expected anyway.

Riding the chemo train again and ignoring the fact it’s terminal.

SimMartin profile image
SimMartin in reply to Tall_Allen

Thanks for that ! I can get myself quite worked up with the bombardment of various theories and tiny studies around diet and nutrition- trying to extract confounding variables- especially in PCa is almost impossible.. I guess the healthier someone is when they develop PCa the better and improving lifestyle and nutrition irrespective of PCa is a good thing and will improve quality and probably length of survival. As a recent urologist speaker on training seminar I was on said at diagnosis this is a unique opportunity education in good health behaviour where the patient is super receptive whereas before they were often deaf!

Gl448 profile image
Gl448

A petition to make something SOC so that it can be properly studied? Isn’t that the exact opposite of how it works? You study something, prove its efficacy in trials, and then propose it as SOC. Or am I confused?

Diet and exercise are great, but neither of them are going to cure advanced Prostate Cancer.

Keto or low carb, and lots of heavy weight lifting much of my life, didn’t stop me from getting Stage 4B and joining this club as someone else mentioned earlier.

You say you’ve been low carb for decades as well, and yet you’re here, too.

Tall_Allen reply here should be an auto response to the many posts on PCa forums about feeding/starving prostate cancer.

I personally put Thomas Seyfried firmly into the “quack” category. You might find these articles about him interesting:

sciencebasedmedicine.org/ke...

scienceblogs.com/tag/thomas...

TryGuyCP profile image
TryGuyCP in reply to Gl448

All good points. thanks for references!

I agree, more attention needs to be given to study this.

Tall_Allen profile image
Tall_Allen in reply to Gl448

The SoC is the control group, not the experimental treatment group.

Gl448 profile image
Gl448 in reply to Tall_Allen

Ah, got it. I stand corrected.

Mike1971 profile image
Mike1971

I’ve seen many suggesting a vegetarian or mediterranean diet would have a positive effect when having APC, which may or may not be true. Only anecdotal of course, but I had been eating strictly vegetarian for about 25-30 years when I was diagnosed.

(I started eating meat, fish etc. again about a year ago simply because I missed it and to help me gain 55 lbs I lost on ADT).

Jalbom49 profile image
Jalbom49

Metabolic therapy in the form of Ancestral diet with carb restriction and avoiding seed oils has been of great benefit to me resolving lifelong morbid obesity and with time restricted eating reversing diabetes to normal A1c off all medication.

It did not stop me from getting oligometastic prostate cancer. I am doing remarkably well with four years of undetectable psa, finishing ADT with Lutron and abaraterone two years ago. Have been on testosterone replacement for eight months.

Since the introduction of refined seed oils into the human diet there has been an explosion of disease including cancer. I speculate that perhaps my treatments including surgery and radiation as well may have been helped by avoiding seed oils which have been found to be involved in deactivating the p53 immune surveillance gene.

Dr Shulz reports on a recent video reports that several of his oligometastic patients on testosterone replacement have done well. He talks of possible cure.

Since I went back on metformin when my ADT started, I am currently reducing the dose and doing keto and time restricted eating to get off drug s and reverse diabetes again.

To avoid seed oils I not only avoid ultra processed foods, but fast food, take out, restaurant food and supermarket chicken and pork. Use coconut oil butter and tallow for cooking.

After fifty years of failure to lose weight and keep it off using recommended diet and exercise, my Ancestral diet has been successful for ten and a half years.

I have enjoyed eating this way and expect I will be doing it the rest of my life

j-o-h-n profile image
j-o-h-n

Eat this, Eat that, Don't Eat this, Don't Eat that, Lift weights, Don't lift weights and the beat goes on, the beat goes on....

Chocolate chip ice cream (two scoops)....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/21/2023 1:40 PM EST

pd63 profile image
pd63 in reply to j-o-h-n

You are lifting weights every time to take the choc chip from the freezer LOL, on a more relevant note follow science not pseudo

j-o-h-n profile image
j-o-h-n

youtube.com/watch?v=V83JR2I...

I did, that's why I went from 1 to 2 scoops...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/21/2023 2:13 PM EST

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