On Active Surveillance - Why not non-... - Prostate Cancer N...

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On Active Surveillance - Why not non-invasive aggressive approach?

Shagaru profile image
14 Replies

I'm 53 and in good general health and exercise regularly. Jan 24, 2022 following 1st biopsy last June, and MRI in Oct, I had image guided biopsy primarily to check ROI/Lesion from MRI. Result confirms same as June biopsy of Adenocarcinoma Gleason 6, Grade 1 in about 5 cores (including 1 in ROI) at 30% and PSA holding at 2.6 for a year now. Urologist says active surveillance and to see him in 6 moonths / PSA. I'm going to get an annual physical and full blood workup. Questions:

1. Why not aggressively pursue treatments (no surgery, radiation) to focus on destroying what's there now versus letting it lie and possibly spread?

2. Second opinion - I really think I need to do this and with an oncologist too

3. Have men had success with naturally boosting immune system?

I'm focused on #3 right now - taking fruiting body mushroom extracts - Lion's mane, Turkey tail, reishi, chaga, maitake, shitake, beta-glucans;

Another supplement for my eyes (have cataracts, blurry, wicked floaters - likely linked to the cancer or years of St. John.s wort) called VP Max containing L-Taurine, Eyebrignt Extract, Grape Seed Extract, Querecin Dihydrate Extract, Bilberry Powder, Leutein 5%j, Lycopene 5%

And then Zinc, muliti-vitamin, Flaxseed oil

Finally, following a Mediterranean diet now and have generally cut carbs for years

Thank you in advance!

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Shagaru profile image
Shagaru
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14 Replies
Shagaru profile image
Shagaru

UGGH - I'm finding many posts now that are related to active surveillance so I've got some good details to read up on for now. I still want to know about naturally boosting immune and or other approaches like ultrasound, ablation, heat, cooling - versus watch and wait.

Tall_Allen profile image
Tall_Allen

1. In the longest-running active surveillance trial in North America, 55% of men have been on it for over 20 years so far. They will probably never need treatment.

2. An oncologist would be totally inappropriate for you. They manage men who are incurable.

3. Prostate cancer is immunologically cold. Very little success with immunotherapy, other than Provenge. If big guns are unsuccessful, I seriously doubt that what you're taking can help. But it probably doesn't hurt. So if you feel like you are more in control by taking it, why not? Cut out the multi-vitamin, though.

Magnus1964 profile image
Magnus1964

Skip the flaxseed oil and add a vitamin D3 supplement. At age 53, don't rush into a lot of treatments all at once. Take it slow. Remember, all of these treatments put Pca into remission. Milk each one for all it's worth.

JVARA profile image
JVARA

Hi i’m in a similar situation as you 51 gleason 6 low grade ..out of 5 specialists 4 advised AS and one surgery … I started intermittent fasting and vegetarian diet with fish and fruit ..cut out carbs and sugar ..lost 10 kg in 2 months .., hoping to slow growth as much as possible.

check out some of Dr Bergs videos

m.youtube.com/watch?v=tXmyJ...

addicted2cycling profile image
addicted2cycling in reply toJVARA

Helpful info provided so far AND AGREE with no more multi-vitamin.

I will not add additional info since I am NOT a 3+3 like Shagaru or others but instead here's a bit of my 5+5 PCa humor ---

JVARA wrote --- ".............. I started intermittent fasting and vegetarian diet with fish and fruit ..cut out carbs and sugar ..lost 10 kg in 2 months ... "

For my 5+5 PCa I started with a bilateral Orchiectomy and lost 10 pounds IN MINUTES. 😁

Cooolone profile image
Cooolone

There is debate in the medical field to even stop considering Gleason 6 as cancerous in a sense that it requires intervention at all.

But to offer thoughts on your questions...

#1 - Well, not until some sort of symptoms require it. Note that "ALL" forms of treatment carry with them Side Effect profiles. Not one is immune from it and is patient dependent of course as is all things with health concerns. But if you TREAT be prepared for possible Side Effects! Know that it was your choice to do it, and your choice to risk it.

Soooooooo, this is why with a low grade diagnosis and the low risk of the cancer (grading you have) ever developing into something that might interact with your overall survival... Absent symptoms effecting quality of life... Why would anyone feel the need to act when it's not in their best interest?

It's simple and unfortunately also complicated at the same time. But there is a time for a Hammer and also a Feather! The biggest problems occur when using either when the other is due! You're in the featherweight class! Why would you want to step into the ring with a Heavyweight!?!? Especially when we would all know 99.9% of the time how that will turn out! Yeah, you might get a shot or two in on your opponent, but you're going to get clobbered but good! Best gift will be the lasting legacy of the after effects, broken bones, etc., that take forever, if ever, to heal! Hahahaha, sorry for the analogy!

#2 - no not really. And as noted, they're best reserved for those who need them.

#3 - well, already noted above... But immunotherapy is such a huge field right now it all depends what your asking... Boosting your immune system to offer better health in a general setting, the keep you healthy overall has its benefits. But directly related to treating cancer... Well the jury is still out and even with random control trials and approved drugs the benefit is limited and not something permanent. The biology involved with cancerous cells and tissue is very complex and ever changing. You're trying to battle something with a few months or years of contribution, ie, diet and supplements, but are fighting millennia of evolution! So what do you think will win? Besides, those immunotherapy drugs are only approved for castrate resistant patients! A world away from where you are standing!

There's been studies that show cancer patients consume the most supplements, but there's also studies that have shown supplementers don't help the patient do any better either. Best example is that guy who had it all, and was diagnosed at a stage where standard of care could have saved his life. He chose the alternative path and paid for it. Yeah... Mr. Jobs! An extreme example I know, but relevant to your question.

Again, for general health, sure, go for it. But thinking your immune system will conquer cancer is a mistake IMO. We aren't there just yet!

Best Regards

dadzone43 profile image
dadzone43

You ARE aggressively engaging your overall health. Awesome!

NYC_talker profile image
NYC_talker

As dadzone said, you are aggressively engaging -- that's the "active" in active surveillance. What you're doing now you will do no matter what treatment you choose: monitoring, PSA tests through the future, etc.

But I actually wanted to address your response, in which you said you read more on the site and learned more about AS. I'd say: keep reading. You mentioned "ultrasound, ablation, heat, cooling - versus watch and wait."

The former are all still not quite there yet, and/or have much higher likelihood of recurrence and/or have side effects that can be equal or worse than other treatments. And likely are not covered by your insurance. Read more and you'll find out experiences here and the studies that have been done. Look at Tall_Allen's site. If and when you seek further treatment, from what you stated at the outset, I'd think you'd want something that has the best chance of keeping PCa from recurring.

PTvsPC profile image
PTvsPC

For 100% G6, AS is a no-brainer. Yes, you could be "cured" with surgery, radiation and/or other treatments, but they ALL have major side effects. Doctors will tell you that with some PT and drugs, you can likely have "normal" functioning. I don't like their definition of "normal". haha G6 has a much lower chance of spreading/metastasizing and turning into more aggressive cancer. That being said, DO NOT become complacent. Stay on top of all your PSA tests and checkups. That's the key.

1. The main reason not to apply treatment now is that in your case, the treatment would be worse than the disease.

2. There's never a bad reason to get a second opinion. In your case, I'm not sure what you're seeking with a second opinion. If you're thinking of getting a second opinion on the pathology report, that might make sense. The only thing you might get is a worse diagnosis. I don't think most doctors would push you toward treatment at your stage. It's possible your insurance wouldn't cover it, so if you decide you can't live each day knowing you have cancer, you should contact you insurance first.

3. There is substantial evidence to show that changing one's lifestyle can slow or even stop the progression of cancer. Limiting or stopping consumption of animal products, eating broccoli sprouts and/or taking sulforaphane supplements, walking briskly 30-40 minutes 5 days a week, improving your sleep, intermittent fasting, etc, all have shown benefit. Here's the thing: even if those things don't slow or stop the cancer in your case, there's no downside to becoming healthier. I've been 100% plant-based now for nearly 5 years (I'm 57) and I have essentially zero inflammation in my body (according to blood tests) and my joints feel great, I sleep better, my athletic ability improved substantially, etc.

One word of caution about certain supplements, esp extracts: there are numerous studies that show taking extracts can cause the opposite result. Lycopene and pectin extracts specifically were shown in some studies to PROMOTE cancer. Scientists aren't completely sure why lycopene or pectic seem to fight cancer. They do know that there is some kind of interaction of these chemicals within the whole food that contains them. In other words, it's important for lycopene to interact with other parts of a tomato or carrot. It's the combination of it being in the food that makes it effective. Separating it out loses it's effectiveness and potentially does the opposite.

OTOH, I take turmeric in capsule form. That's not an extract. It's literally turmeric. The same is true with sulforaphane capsules. I do eat a lot of tomato sauce, though, and that's how I get my lycopene daily.

I hope this helps!

Shagaru profile image
Shagaru in reply toPTvsPC

Another very EXTREMELY helpful reply. I can't thank you and everyone on here enough to help me with my journey. A truly appreciate the details as well on diet, supplements, and info on the results.

PTvsPC profile image
PTvsPC in reply toShagaru

I'm glad! I'm just giving back because I've gotten such useful information on this site.

JVARA profile image
JVARA in reply toPTvsPC

Hi PVvsPC, I am on a similuar diet to you since being diagnosed with PC back in December 2021. G6 with PSA 3.2..last week had my PSA checked again and its now 2.3..so its gone down..I cant say however if any of the supplements I am taking is masking or not but my dr was happy. But I have been doing a lot of praying and change of diet to greens and fish and tomato sauce as you mentioned.

PTvsPC profile image
PTvsPC in reply toJVARA

One thing to keep in mind is that fish is still meat, so depending on how much you eat per week, it will cause a spike in TMAO levels in your blood. When I changed my diet, I continued eating salmon, but stopped because of the TMAO and other toxins found in fish in general. The benefits derived from eating fish, esp salmon, can be found in other foods like avocado, walnuts, soybeans, etc, it it's a no-brainer for me.

Shagaru profile image
Shagaru

All - Great News! My PSA dropped a full point, now 1.6 and was 2.6 in both October and June last year. Changes I've made - out of an extremely abusive, toxic relationship, little red meat, more fruit & veg, lower carbs, nuts, more coffee, supplements: mushrooms - turkey tail, reishi, maitake, shitake, chaga, lions mane (did 1 month of Shiagga - didn't like how I felt and its expensive) flax oil, zinc, multi-vitamin, no alcohol last 2 months, daily power walk, 2x a week rigorous exercise (increasing) joined a gym, and basically not giving a F#(*!

Full physical and bloodwork only shows Cholesterol as a minor issue.

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