Prostate Cancer Isn't a Death Sentence
Prostate cancer is a slow-moving disease. As I’ve explained here before, men are much more likely to die with it, than they are to die from it. And I couldn’t think of a better time than Prostate Cancer Awareness Month to remind men everywhere of this crucial fact.
The results from a new study published in the Journal of Clinical Oncology pretty much say it all. Researchers at Johns Hopkins University analyzed long-term survival data from nearly 1,300 men with low-risk prostate tumors. And they found that the risk of developing a potentially lethal (but still curable) prostate cancer over a 15-year period was less than 6%.1
Now, compare that with prostate surgery — which carries more than 50% risk of impotence, and as much as 30% risk of incontinence, for starters.2 Not the most balanced risk-benefit ratio, is it?
Not that rational decision making is easy when you’re talking about cancer. The stakes are obviously high. And while it’s important to avoid unnecessary intervention — what I call the “just take it out” approach — aggressive disease calls for swift treatment.
This is exactly where strategies like “watchful waiting” and “active surveillance” enter into the equation. They ensure that you’re pulling the trigger on treatment wisely. And yet, only 30 to 40% of men in this country are choosing this road.
Why? Well I have a few hunches...
Contrary to popular belief, the two terms aren’t one and the same. In fact, “watchful waiting” is a more passive approach, which involves addressing symptoms as they arise. Active surveillance, on the other hand, entails vigilant, regular monitoring whether you’re having symptoms or not. The goal is to be ready to take action should the disease show signs of aggressive growth.
But unfortunately, both terms are often used interchangeably — even by doctors. And this isn’t the only source of confusion, either. As a term, “watchful waiting” implies that you’re just sitting around, wringing your hands while cancer invades your prostate. And that’s a hard prospect for any patient to swallow.
This interpretation isn’t accurate, obviously. You return to your doctor regularly for blood tests, digital rectal exams, and (possibly) biopsies to keep close tabs on disease progression. You also pay close attention to any symptoms you may have.
In other words, active surveillance isn’t just sitting around and waiting for a disaster. It’s knowing your enemy. It’s reconnaissance.
And as the numbers show, it’s the absolute best option for guys who have a cancer that isn’t likely to progress. (If it’s confined to your prostate, and you have a low Gleason score and a stable PSA level, for example.) It’s also an opportunity to address a potential problem before it starts.
In fact, I tend to champion the term “pro-active surveillance” for that very reason. In cases of slow-growing prostate cancer, there’s a lot you can do to fend off disease — without compromising your quality of life with medical procedures that simply aren’t worth the risk. That’s why I’d like to take a little time today to lay out some crucial pro-active strategies for this fight.
It’s simple, really. The key is to make your body a place where cancer can’t easily put down roots. And that begins and ends with lifestyle medicine. I’m talking about proper nutrition, regular exercise, and plenty of sleep — all topics you’re already well acquainted with by now.
But as a naturopath, I always recommend targeted supplementation on top of these lifestyle changes. I have a long list of recommendations in my clinical arsenal. When it comes to bang for your buck, though — I’m talking about affordable supplements any guy can easily integrate into his daily regimen — three nutrients really stand out.
The first of these is vitamin D. It’s the sunshine vitamin, but if you’re like most people who live nowhere near the equator, you’re probably not getting enough the old-fashioned way. (Especially not with winter right around the corner.)
That’s why I recommend supplementing with 2,000 to 4,000 IUs of vitamin D3 (not D2, which your body can’t absorb as well) per day. This is, of course, a minimum. If your levels are really low, you’ll need a lot more. But a large 2012 clinical trial of men diagnosed with early-stage, low-risk prostate cancer showed that supplementing with 4,000 IU of D3 per day can play a critical role in active surveillance protocols. More than half the subjects in this study showed a decline in positive prostate cores at repeat biopsies.3
In other words, their doctors found less cancer in their prostate tissue. That’s a pretty big benefit for a tiny (and very affordable) daily capsule.
Selenium — high-selenium yeast, in particular — is another cheap and incredibly effective supplement for guys on “pro-active” surveillance. I recommend taking 200 mg per day. That’s the same dosage researchers used in the Nutritional Prevention of Cancer (NPC) trial.
This study originally set out to investigate the influence of selenium on skin cancer risk. But results showed instead that selenized yeast can cut prostate cancer risk by as much as 63%. Later research confirmed these findings — particularly among men with lower PSA levels and plasma selenium concentrations.4
And finally, there’s fish oil. I can’t say enough about how important inflammation-quenching omega-3s — in particular EPA and DHA — are in prostate cancer prevention.
As part of one 2007 study, for instance, researchers investigated the impact of dietary fish intake among 6,272 Swedish men over 30 years. Results showed that men who ate no fish had as much as three times the risk of prostate cancer as guys who ate large amounts.5
Another study from the Harvard School of Public Health examined the link between dietary fish intake and prostate cancer spread among 47,882 men. Over a 12-year period, researchers found that eating fish more than three times a week reduced prostate cancer risk. But it had an even greater impact on the risk of metastatic prostate cancer. (In other words, the lethal kind.)
For each additional 500 mg of fish oil consumed, the risk of metastatic cancer dropped nearly a quarter.6
At this point, you may be wondering, “Why can’t I just eat fish?” And the answer is that you can, of course. Wild-caught, coldwater fish should be a regular part of your diet. But depending on access and personal taste, it’s often unrealistic to consume the amount of fish — or the quality, for that matter — you’d need to get the best health benefits.
That’s why I always recommend taking two to four grams of EPA/DHA from high-quality supplements (like Nordic Naturals) per day. It’s one of the single smartest things you can do for your health, regardless of the state of your prostate.
But for guys facing down a cancer diagnosis, it could be a serious game-changer.
Stay tuned and stay well,
Geo Espinosa, N.D., L.Ac, C.N.S., is a renowned naturopathic doctor recognized as an authority in integrative management of male and urological conditions. Dr. Geo is the founder and director of the Integrative Urology Center at New York University Langone Medical Center (NYULMC), a center of excellence in research and integrative treatments for urological conditions.
1. Vernon, Jonathan. "Men with unaggressive prostate tumors 'unlikely to develop, die from prostate cancer'." Medical News Today. MediLexicon, Intl., 1 Sep. 2015.
2. McCullough A. Rev Urol. 2005; 7(Suppl 2): S3–S10.
3. Marshall DT, et al. J Clin Endocrinol Metab. 2012 Jul;97(7):2315-24.
4. Duffield-Lillico AJ, et al. BJU Int. 2003 May;91(7):608-12.
5. Hedelin M, et al. Int J Cancer. 2007 Jan 15;120(2):398-405.
6. Augustsson K, et al. Cancer Epidemiol Biomarkers Prev. 2003 Jan;12(1):64-7.