I have been taking PSA tests every couple years since 2007. It's a routine blood test recommended for men as they get older.
PSA stands for Prostate Specific Antigen. Elevated readings may indicate evidence of prostate cancer. Any reading under 3.0 is normal but some doctors may say 4.0 and others 2.5. It's not an exact science to be sure.
My test in August of 2012 was elevated (6.65). Another test in October was also elevated (7.13)
My regular doctor strongly recommended a biopsy.
The biopsy showed I had cancer. My "Gleason Score" was 6. The surgeon that performed the biopsy (Dr. G) strongly recommended surgery. He gave me a cost of $20,000.
What follows is my general understanding of methods of dealing with prostate cancers and problems that may result from treatment.
Do your own due diligence and consult a doctor if you are in a similar situation.
Problems With Surgery
Prostate surgery can cause all sorts of complications including loss of sexual functions and urinary incontinence. I had not yet started dating following the death of my wife Joanne in May of that year.
Imagine telling a date "Hi, I'm Mish. I have prostate cancer", or worse yet "I'm impotent and have urinary incontinence thanks to prostate surgery".
Even if there are no complications, the very best one can hope for with prostate surgery is loss of ability to ejaculate (a 100% given), then perhaps with drugs like Viagra, Cialis, or Levitra an erection or orgasm can be achieved.
My doctor recommended radiation therapy. Unfortunately, the complications are similar, and costs higher, especially for proton beam therapy.
For a discussion of proton beam therapy, please see the Cancer.Org discussion Is proton beam therapy for prostate cancer worth the cost?
This is my general understanding after talking with doctors and reading countless articles: With surgery, complications arise immediately, with radiation therapy, additional complications may arise years down the road.
Three Options
My own research showed three potential options.
- Surgery
- Radiation Therapy
- Wait and See
I wanted other opinions, so I talked to an oncologist. Oncology is a branch of medicine that deals with cancer.
The oncologist informed me that we caught the cancer "very early". He also stated "based on your conditions, there is no statistical evidence that strongly favors any one course of action. Equal results are obtained by surgery, by radiation therapy, and by waiting".
Hmmm. No statistical difference between the three options?
Actually, there is a difference, but for those who have an aggressive form of cancer then just let it go. Otherwise, until you find out whether it's aggressive or not, it's point blank wrong to rush to surgery. So I didn't.
Yet, I also decided "wait and see" was not doing enough. So I spent at least 60 hours researching things one could try. I discovered some interesting studies and elected to try a cocktail of the most promising things, but I also wanted to keep up with regular PSA tests to monitor for aggressive forms of cancer.
My own doctor was against the cocktail idea (but was willing to go along with it provided I kept up the PSA monitoring). The oncologist said "the cocktail would not do me any good but would not hurt either".
I informed the oncologist that I was going to have a PSA test every month. He commented something along the lines of "Why do you want to do that? Every six months is sufficient. The tests are not that reliable." That is not an exact quote, but is best as I can remember.
My thought - which I did not express - was "What kind of mathematical silliness is that? The more unreliable a test is, the more tests one should take to weed out erroneous outlier results."
My next PSA reading one month later was a disaster (17.65). At that point I was pretty sure I had an aggressive form of prostate cancer but I still wanted to try my "do something" program for one more month.
Mentally I prepared myself for surgery.
In December, my PSA crashed, as did three subsequent scores. Here are the dates and results.
Date | PSA Reading |
---|---|
11/29/2007 | 1.77 |
3/20/2010 | 1.66 |
8/1/2012 | 6.65 |
10/16/2012 | 7.13 |
11/15/2012 | 17.65 |
12/13/2012 | 2.99 |
1/24/2013 | 2.39 |
3/6/2013 | 2.35 |
7/11/2013 | 1.94 |
Given that my December and January results were normal, I was quite happy with my alternative program.
The surgeon, "Dr. G" was not. In January, he wanted another biopsy immediately and sent me a later stating "If you intend to continue to be evaluated by our office, you need to schedule the requested biopsy without delay. If you wish to see another urologist we would be happy to forward your records, but otherwise please contact our office to schedule an appointment."
That is an exact quote. It marked the end of my relationship with "Dr. G".
I had two more PSA readings, in March and July, each normal, and each lower than the one before.
In a recent followup conversation with the oncologist, he informed me the series of PSA tests was not conclusive.
I had my own doubts as well. I was wondering if something I was taking may be artificially lowering my PSA readings.
I decided to have another biopsy, but with a different surgeon.
Before I get to the result, I need to mention other possible explanations for the 7.13 PSA reading: Drugs like Viagra, Cialis, or Levitra can elevate the numbers. So can sex.
In case I needed surgery, I wanted to know in advance how my body would react to such medications. I was on Levitra at the time of the elevated reading.
I Beat Prostate Cancer
As you can surmise by the title of this post, my latest biopsy, about a week ago, came back benign.
Below, I list what supplements I took and why. First let's wrap up some loose ends.
Is Surgery Recommended for Gleason 6?
Those in my situation may wish to read What is a Gleason 6 Prostate Cancer and also WatchWait.Com.
From the above link: "Does prostate cancer need to be treated? For most men, the answer may be NO!"
American Society of Clinical Oncology Chimes In
The American Society of Clinical Oncology chimes in with Gleason Score 6 Adenocarcinoma: Should It Be Labeled As Cancer? Read the first paragraph below carefully.
Overtreatment of low-grade prostate cancer (Gleason score ≤ 6) is a recognized problem today, with systematic prostate gland sampling triggered by prostate-specific antigen (PSA) measurements. The extent to which overtreatment is caused by fear of death resulting from cancer, fear of litigation from undertreatment, and misaligned incentives that reimburse more for treating rather than monitoring when appropriate is not known. Nevertheless, fear of death resulting from cancer likely plays some role, and removing the label “cancer” could reduce unnecessary treatment of low-grade disease. On the other hand, undertreatment of prostate cancer and a missed opportunity for cure in those who could benefit is a real risk of relabeling a cancer as noncancer. We have decided on an alternative modification of the Gleason scoring system and herein present the arguments for and against removing the label of cancer from Gleason 6 tumors. ....Interested parties may wish to read the rest of the article.
Data demonstrate that using a time horizon of 10 to 15 years, less than 3% of men diagnosed with Gleason score ≤ 6 and classified as low risk (based on a PSA < 10 ng/mL and stage ≤ T2a) will die as a result of prostate cancer whether treated or not. The evidence calls into question the need for treating men with Gleason score 6 tumors (graded in the modified system) who have a life expectancy of fewer than 10 to 15 years, especially if considered low risk.13 But the reality is that today, men older than age 65 years with Gleason score 6 tumors on needle biopsy are treated as though they harbor a tumor with the same biologic potential as those with a Gleason score ≥ 714,15—a one-size-fits-all approach that is inconsistent with medical evidence suggesting that physicians and patients view a Gleason score 6 cancer today as a lethal phenotype in most cases.
Why the Rush and Pressure for Surgery?
The answer is easy: $20,000 each.
Let's put it this way: "Dr G" is very skilled at them.
By the way, in my first conversation with the oncologist I stated the biopsy showed I was 10% cancerous. He said "say that again". So I repeated "Dr. G said I was 10% cancerous".
The oncologist replied "That's not correct. Of the 12 samples, only one had cancer and one was questionable. The cancerous sample was 10% cancerous."
Now that is a hell of a lot different than being 10% overall cancerous wouldn't you say? I had a witness for the conversation with Dr. G.
First Biopsy Results - October 2012
On December 17, 2013, I finally saw the actual results of the first biopsy!
Dr. G would only release them to another doctor, not to me, unless I went in to sign a release. The oncologist had already seen them, but shouldn't Dr. G have shown them to me immediately?
First Biopsy Results
Twelve samples were taken. Ten were benign. Here are the two non-benign samples exactly as written on the report.
- G: Prostate, Needle Biopsy, Right Base; Prostatic Adenocarcinoma, Gleason Score 3+3=6, Involving 10% of One Core (See Comment)
- A: Prostate, needle biopsy, left lateral base; High Grade Prostatic Intraepithelial Neoplasia (PIN)
- Comment G: Combined immunostain (PIN 4) for racemase, and bsasal cell markers, p63 and HMWCK (performed at Centegra Hospital McHenry, Illinois) supports the diagnosis of adenocarcinoma; the glands strain strongly for racemase and basal cell strains are negative. No perineural invasion invasion is identified in this case. This case was included in the pathology Integrated Quality Assurance Program.
Doctors Treat Patients as ATMs
I now understand there was absolutely nothing in that report that remotely suggests a need for immediate surgery.
I have posted on this before already. Please see Unnecessary Surgeries? You Bet! Doctors Treat Patients as ATMs; US Healthcare System Explained in Six Succinct Points
My Prostate Research
Here are two key articles I found in my research.
Resveratrol -Powerful Protection Against Prostate Cancer
Good news for men concerned about prostate cancer: resveratrol is a supplement that blocks it at every stage, from beginning to end. A polyphenol found in grapes and other plants, resveratrol was first identified as a multistage protector in 1997, and now is considered a leading agent against prostate cancer by researchers at Houston’s MD Anderson Cancer Center and other institutions. Resveratrol works through more than a dozen different anticancer mechanisms and selectively targets cancer cells. This single supplement modulates hormones, has several mechanisms that stop cancer cells from multiplying, and even has the ability to destroy cancer cells.Can Resveratrol Prevent Prostate Cancer
Resveratrol originally gained notice when researchers suggested that it is the agent in wine that protects against heart disease. Because of its antioxidant and anti-inflammatory actions, resveratrol also was investigated as a possible anticancer supplement. Since research began in earnest in the 1990s, resveratrol has been the subject of hundreds of scientific papers, making it one of the most intensely studied supplements on the market today.
In one review of resveratrol, University of Wisconsin researchers set out six criteria for a good anticancer agent: it should a) have no toxic effects in healthy cells; b) work against different types of cancers; c) be administered orally; d) have known mechanisms of action; e) be inexpensive; and f) be acceptable to humans.4 Resveratrol met all six criteria.
One remarkable aspect of resveratrol is that it can be very toxic to cancer cells but does not harm healthy cells; in fact, a person taking resveratrol for protection against prostate cancer may receive cardiovascular benefits as a side effect.
Another important aspect of resveratrol is that it may be combined with other phytofactors to potentially enhance its effects. Resveratrol naturally occurs with other polyphenols such as quercetin in plants such as grapes. Quercetin may enhance resveratrol’s bioavailability and cancer-killing effects. Another plant extract, indole-3-carbinol, or I3C, may work synergistically with resveratrol to kill more cancer cells because I3C stops cell growth at one point in the cell cycle while resveratrol stops it at another point. Physicians employ this same concept when prescribing combinations of chemotherapeutic drugs for their patients—each drug halts cancer cell growth at a different stage of the growth cycle
Resveratrol, on the other hand, has multiple, anti-prostate cancer effects. Resveratrol halts the growth of hormone-positive and -negative cancers; works through multiple mechanisms to stop cancer cells from multiplying; is effective from the earliest to the latest stages of cancer; protects DNA from damage; and may inhibit cancer metastasis. Combined with quercetin and the powerful anti-hormonal agent I3C, resveratrol may be the best cancer-preventive approach available today.
Next consider Can Resveratrol Prevent Prostate Cancer?
Resveratrol is repeatedly in the headlines as a potent anti-aging nutrient and I have written about this extensively in my article, Is Resveratrol the Fountain of Youth? A new cell study shows that resveratrol1 can block the transition of cancer cells into the form that becomes aggressive prostate cancer that is more likely to kill.Mish the Guinea Pig
This study builds on earlier prostate cancer cell research that showed prostate cancer cell suppression and the induction of death signals in various types of prostate cancer cells. The new research shows that resveratrol communicates to the core gene signal, NF-kappaB , turning it down so as to turn down the key molecular mechanism involved in the progression of prostate cancer (the overexpression of NF-kappaB ).
As I have previously pointed out, the common doses of resveratrol that show benefit and safety in animal studies range from 2.5 mg – to 10 mg per kilogram. This translates to an approximate dose range of 150 mg – 700 mg per day for a 150 pound adult, a sensible and safe dose range until more data is in.
It is generally assumed that most nutrients have inherent wisdom, meaning that they can help knock out possible that very high doses of resveratrol may be able to induce cell death in healthy cells instead of cancer cells while keeping healthy cells alive – which is certainly true for resveratrol. However, it is the generally assumed anti-aging benefit. Until more human data is in, I would keep the dose to no more than 1000 mg per day.
Preventing cancer was not an option for me. I already had it. My goal was to kill it.
What follows is the cocktail that it took. It is based on the above research as well as numerous other articles. The first four items in my cocktail mix list were mentioned above.
I also took a few other things for other reasons. Explanations follow my list.
This is not a recommendation. Consult your doctor.
Mish Cocktail
- Resveratrol: 250 mg twice daily
- Indole-3-Carbinol: 200mg twice daily
- Bromelain: 500mg twice daily
- Querceten: 300mg twice daily
- Turmeric Extract: 300 mg twice daily
- Vitamin D3: 5,000 IU twice daily
- Vitamin K2: 100mcg twice daily
- Vitamin B12: 100mcg twice daily
- Selenium: 50mcg twice daily
- Sodium bicarbonate orally: One half teaspoon twice daily - 1 hour in the morning right after I get up, and again in the evening right before bed – empty stomach
#1-9 were taken with meals.
#10 was on an empty stomach so as not to buffer stomach acid digestion.
Blood tests showed I was deficient in B-12 and D3. My regular doctor wanted me to to take periodic shots. He claimed studies show that as people get older, pills won't be absorbed.
I said, let's try the pills and see.
The results are in: every blood test since then shows I have more than enough B12 and D3. That simple test saved me once-a-month shots.
On his recommendation, I lowered my D3 dosage to the amount shown above. Vitamin D can be toxic in doses too high.
#10 is the most controversial item on the list. If you do a bit of research on the internet you can find numerous articles on baking soda treatments for prostate cancer. "Get alkaline" is the general thesis. The way most of them describe how it works is ludicrous. Cancer is not a "fungus" as one proponent of baking soda says.
Yet, just because someone describes reasons wrong, does not mean there is no merit.
Still, my oncologist specifically warned "Do not try to change your pH. This is exceptionally dangerous and can kill you. Your body will maintain a pH strictly between 7.35 and 7.45. Urine pH will be determined by diet, exercise and other things in your body. There is no reason whatsoever for you to try to change it and attempting to do so can be dangerous to the point of killing you."
I decided to take baking soda, but not in huge amounts.
The bag of Arm & Hammer reads ...
- Active Ingredient: Sodium Bicarbonate
- Purpose: Antacid
- Stomach Warning: To avoid serious injury, do not take until powder is completely dissolved. It is very important not to take this product when overly full from food or drink. Consult a doctor if severe stomach pain occurs after taking this product
- Directions: 1/2 teaspoon to 1/2 glass (4 fl. oz.) of water every 2 hours or as directed by a physician.
- Do not take more than the following amounts: seven 1/2 teaspoons (three 1/2 teaspoons if over 60 years).
- Do not take the maximum dosage for more than 2 weeks
For 6 months I took 1 teaspoon of baking soda twice daily. Since then I have been taking 1/2 teaspoon twice daily.
My oncologist stated "A little bit of baking soda (sodium bicarbonate) is harmless and 1/2 to 1 tsp a day is probably having no effect on your pH. Your kidneys will simply excrete the extra bicarbonate. Baking soda injections are pure quackery and dangerous unless given by a physician for very specific health reasons - none of which you have. Taking in too much bicarbonate will overwhelm your kidneys ability to excrete it all and can kill you."
Cancer Free
The latest biopsy has 12 samples, all identically labeled "Benign, prostatic tissue. No malignancy Identified."
Technically, I am not "cancer free". A more accurate way of stating things is "the biopsy did not detect any cancer". That is good enough for me (because it doesn't get any better).
I believe the first four items on the list is what produced the results. I am not sure if baking soda did anything or not. Serious questions remain.
Serious Questions
- Did I have cancer in the first place?
- If so, is it really gone or did the second biopsy miss it?
My Personal Conclusions:
It's highly likely I did have cancer. Low-grade cancer in light of spiking PSA readings seems reasonable.
Similarly, I believe it's highly likely I had cancer and it is now gone. Four consecutive crashing PSAa and a benign biopsy suggest just that.
Once again: Nothing above constitutes a recommendation. I listed what I took, and what my results were. Consult your doctor before attempting anything similar.
Reflections On Medical Research
On my first visit to the oncologist, he stated "Until there is data in human beings with prostate cancer, there is no reason to believe that resveratrol has any activity whatsoever in treating or even preventing prostate cancer. Feel free to take it if you wish as it appears to be safe."
I strongly suspect he would not consider me as "human data". I do, even though I clearly do not constitute as scientific study.
So why aren't there more studies on these supplements given the articles I cited? The answer is big pharmaceutical companies are not interested in anything they cannot patent.
They would rather find a $20,000 drug that works 5% of the time (that they can patent) rather than something cheap that works 80% of the time that they can't.
In fact, the big pharmaceutical companies have attempted numerous times to regulate nutritional supplements. If it was up to them, I never would have been able to try what I did.
Individual doctors vary, and I have a great urologist now, but much of the industry is about maximizing patient costs for profits (patients be damned).
Even the insurance companies are short-sighted. They would have paid for prostate surgery but they would not pay for the repeated PSA tests. Fortunately the PSA tests and supplements are very cheap.
Final Thoughts
Had I listened to Dr. G., I would not have a prostate right now. I would be out my deductible portion of $20,000 and the insurance company would be out the rest. And on top of it all I might have run into serious complications.
I have two close friends who had prostate surgery. One came out fine, the other didn't. The friend who did not come out fine has both incontinence issues and sexual performance issues.
The friend who came out fine went to the best surgeon he could find. Is that the right approach? It seems reasonable if you need surgery, but what if you need an opinion on whether surgery is needed? How did these guys get skilled? Was it by doing too many needless surgeries?
Similar questions apply for those considering radiation therapy.
I have a great urologist now: Nejd F. Alsikafi, M.D., F.A.C.S. at UrologySpecialist.
I am on a monitoring program with PSA tests every three months and biopsies every two years (more frequently if my PSA trend changes). He agrees the treatment proposed by Dr. G was not warranted.
Finally, few, if any, doctors are likely to recommend the cocktail regimen I am on. They may go along with them, if you bring them up, but they won't recommend them. The doctors want clinical studies. Yet, Alsikafi readily admits it's not in the interests of big pharmaceutical companies to do them.
Here's the key lesson: Even if you find a great doctor, it's still very important to be your own health care advocate.
Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com
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