Prostate Awareness Foundation
Prostate Self Help
Monthly Bulletin
October 2009
A Recap of the Recent Prostate Cancer Research Institute (PCI) Symposium:
We have attended most of the annual PCRI Symposiums in Los Angeles since their inception at the beginning of the decade. There was a time not long ago that none of the speakers addressed the nutritional component, the dramatic incidence of incontinence and sexual dysfunction or presented cautionary information about undergoing a treatment path prematurely. At September’s symposium these were all “front burner issues”! It seems like each year the mission and recommendations of PAF (The Prostate Awareness Foundation) become more in the prostate health mainstream.
We have selected below four of the lectures we felt were the most important. You can call PCRI at 800-641-PCRI or help@pcri.org to obtain a DVD with the below and other lectures from the symposium.
Inhibiting Cancer With Diet
David Heber, MD, UCLA Center for Human Nutrition
Author of “What Color Is Your Diet”
Our gene structure has not kept up with changes in our diet and lifestyle, it takes over 50,000 years for our genes to change. Originally our genes were designed to protect us against starvation and infection, but has now resulted in excessive inflammation.
Prostate inflammation is one of the primary causes of prostate cancer. The problems:
Increased abdominal fat – caused by our diets and lifestyle. Increased intake of Omega 6 fatty acids. Low intake of anti-inflammatory vegetables and fruits. You need eat at least 9 servings per day. Inadequate intake of detoxifying enzymes from cruciferous vegetables.
Decreased fiber intake, you should get at least 25g of fiber daily.
Abdominal fat is associated with cholesterol and pc disease progression. Statin drugs can help with cholesterol. Decreased intake of anti-inflammatory spices, use more curry powder, rosemary & oregano.
These deficiencies also influence diabetes, Alzheimer’s, heart disease and other cancers.
You don’t have to look fat to be fat. MRI’s reveal fat around the organs. Abdominal fat is a pro-inflammatory tissue. To guard against or reduce abdominal flat: build muscle by resistance training with weights, get aerobic exercise, and eat an anti-inflammatory diet.
Benefits of fish oils: reduces pc cell growth. Eat fish 3 times per week or take 5 grams of fish oil, avoid farm raised fish.
Pomegranates are loaded with ellagitannins and have the highest anti-oxidant value of any food.
Transrectal Ultrasound for Cancer Detection, Staging, Biopsy and Future Developments / Duke Bahn, MD / Prostate Institute of America
To determine your prostate gland volume: W x H x L x’s .5
To predict allowable PSA level: Gland Volume x’s .1
Where is your cancer located: transitional zone cancers are normally confined to the gland and are good candidates for active surveillance. Cancers in the Apex of the gland are more difficult as the sphincter is close by and conventional interventions can cause incontinence. Cancer close to the nuro-vascular bundles are difficult to deal with as intervention can compromise sexual potency.
Men with lower risk disease who are good candidates for active surveillance:
Gleason of 6 or less (3+4=7 can be ok)
PSA less than 10
Stages T1c and T2a
Less than 1/3 of cores are positive
Less than 50% tumor invasion
PSA doubling time of 2 years or more
Tumor volume of 1cc or less
Urine PCA3 gene test less than 35
Elastoplasty diagnostic test measures stiffness of tissue and are now being used along with ultrasound to diagnosis prostate cancer and progression.
The correct characterization and staging of your prostate cancer results in the best choice of therapy and outcome.
Erectile Dysfunction:
John Mulhall, MD
Director of the Male Sexual & Reproductive Medicine Program
Memorial Sloan Kettering Cancer Center
Author: Saving Your Sex Life – A Guide for Men with Prostate Cancer:
Doctors are generally just as uncomfortable talking about sexual dysfunction as their patients, you need to bring it up with your doctor.
The number one regret from prostate cancer patients after treatment is sexual function.
70% of men 70 years old have sex.
Penile shortening is a real problem with conventional treatments, doctors rarely discuss this problem, and it can often appear as a delayed reaction after treatment.
Peyronie’s disease is the curving of the penis on erection and is common after RP.
Erectile tissue is a muscle. Use it or loose it.
Your choice of a doctor is critical, for best results from a RP use a surgeon who has done at least 250 of them.
After surgery the nerves can go into a coma for 12-24 months.
4-6 months of ADT can cause irreversible erection tissue damage.
It can take from 3-5 years to get back normal sexual function after radiation.
Emotionally, most men are only as good as their last erection.
To maximize sexual function preservation: 3 strategies: pre-treatment, during treatment, post treatment.
At Sloan Kettering they are now using a specific program which includes pre and post operative counseling, Viagra, Muse injections, and penile pumps. This program has proven dramatically successful in treating sexual dysfunction.
One needs to institute this type of protocol within 6 months of treatment or the success rate goes down dramatically.
We need to demand better care after treatment.
Second Line Hormone Blockade:
Charles Myers, MD
Director: The Foundation for Cancer Research & Education
Editor: The Prostate Forum Newsletter.
When ADT hormonal blockade therapy fails, there are a number options superior to chemotherapy. These therapies are less toxic than chemo and the benefits can last for years. The proper use of these drugs requires attention to detail of drug doses, schedules and drug interactions and should only be used under the guidance of a skilled specialist.
The most thing to remember is not to delay when ADT no longer is working.
Ketoconazole is an antibiotic that has proven effective in treating advanced pc.
Estrogen therapy, including DES and estrogen patches have proven effective.
Be careful of blood clots and vascular problems when using DES.
Leukine is a natural hormone proving effective in controlling advanced prostate cancer.
A 70% response rate to a combination of Leukine and Ketoconazole has been reported by Eric Small, MD at UCSF Medical Center.
There are reports of complete remissions from bone metastasis using combinations of these medications.
Prostate Awareness Foundation
2166 12th Ave, San Francisco, CA 94116
www.prostateawarenessfoundation.org
415-675-5661 / kamalik@sbcglobal.net