Prostate cancer is the poster child for the rational use of an integrative approach not only in reducing risk of primary prostate cancer, but in treating and reducing risk of progression or recurrence. Following a healthy lifestyle program during active surveillance of low-risk prostate cancer may favorably change the behavior of the cancer while at the same time improving health and quality of life. Holding the cancer in this low-risk state could mean foregoing invasive treatments such as surgery or radiation therapy—treatments that significantly reduce quality of life.
In the ProtecT study, men with localized prostate cancer followed for 10 years lived just as long whether they did active surveillance, surgery or radiation therapy.
As Dr. Dean Ornish—a pioneer of lifestyle therapies for heart disease and prostate cancer—puts it: with prostatectomy or radiotherapy “you end up getting maimed in the most personal ways in terms of not being able to have sex because you’re impotent, wearing a diaper because you’re incontinent and getting very little benefit but huge economic and huge personal cost.”1
Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test.
Our goal is to help you live as well as you can for as long as you can using the optimal combination of conventional, complementary and integrative therapies and approaches. Here you'll find resources for prostate cancer. You can also use the search box in the upper right corner of every page or go to Search Therapy Summaries and search for your cancer.
Conventional Prostate Cancer Therapies
Not that long ago, radical surgery and/or radiation therapy were standard care after a prostate cancer diagnosis. Current approaches, even within conventional care, are much less aggressive. Mark Scholz, MD, and Ralph Blum explain that radical surgery and/or radiation therapy may or may not be the best approach for you. Whichever prostate cancer treatment specialist you see, chances are you will get a good explanation of their preferred therapy, but many will not be able to adequately tell you about other options.3
A starting place for the science of conventional therapies:
- National Cancer Institute:
- Cancer.net: Prostate Cancer
Treatment Approaches from Two Leaders of Note
Examples of conventional prostate cancer therapies being used by two leaders in the field:
Dr. Aaron Katz is a urologist specializing in prostate cancer. Known for his program of active holistic surveillance, Dr. Katz is also known for his work with cryotherapy (using cold temperatures therapeutically)5 as a minimally invasive means of treating prostate cancer. He has published research which demonstrated that by four years post cryotherapy, men receiving this treatment report a good quality of life comparable to those who underwent active holistic surveillance.6 We discuss Dr. Katz’s Active Holistic Surveillance Program below.
Dr. Charles “Snuffy” Myers is a noted medical oncologist and prostate cancer survivor who specializes in treating prostate cancer. He practices conventional oncology and also considers lifestyle practices, particularly diet, important for men with prostate cancer. He thinks deeply and innovatively about conventional prostate cancer treatment, such as targeted therapies, as well as the problem of prostate cancers becoming resistant to chemotherapy.
Integrative Cancer Care in Prostate Cancer
Integrative Lifestyle Programs
Most integrative oncology practices prioritize lifestyle changes in their treatment plans. The Block Program is one example. Other outstanding examples of prostate-cancer-specific lifestyle medicine programs are available for men with low-risk disease in active surveillance. Two examples:
Ornish Lifestyle Medicine
The evidence for adopting these healthy lifestyle changes is compelling.
Cardiologist Dean Ornish, MD, originally developed his Ornish Lifestyle Medicine program to reverse heart disease and has since adapted and studied the program in men with prostate cancer. The program looks at four elements of a person’s life:
- What you eat
- How active you are
- How you respond to stress
- How much love and support you have
Simply put, the program urges you to “Eat well, stress less, love more, move more.”
Active Holistic Surveillance Program
Aaron Katz, MD, is a urologist known for his work in prostate cancer, including cryosurgery and his program for Active Holistic Surveillance. For men with low-risk, early stage prostate cancer, Dr. Katz has developed a program in which his patients engage in lifestyle practices, such as diet, exercise and mind-body approaches, as well as take specific dietary supplements to decrease the risk of cancer progressing. As Katz explains:20
Active surveillance is an emergent strategy for management of indolent prostate cancer. Our institution's watchful waiting protocol, Active Holistic Surveillance (AHS), implements close monitoring for disease progression along with various chemopreventive agents and attempts to reduce unnecessary biopsies.
The Role of Lifestyle
The risks from these lifestyle changes are very low, and the potential benefits are great.
A number of reports conclude that lifestyle practices may influence the risk of prostate cancer:
- Eating high amounts of red, processed and charred meats and saturated fats
- Being obese
- Being sedentary
Each of these factors seem to have some relationship to the risk of prostate cancer, including increased risk of having more advanced prostate cancer.
Although the role of diet and lifestyle in prostate cancer is not fully understood, enough evidence shows that commonsense lifestyle changes are likely to help improve health in those with prostate cancer as well as reduce risk for other chronic diseases. The risks from these lifestyle changes are very low, and the potential benefits are great. Every integrative oncology clinician we follow recommends his/her prostate cancer patients adopt specific lifestyle practices, including a diet such as that described below.
Evidence-informed Lifestyle Changes
Some of the more conservative cancer information services downplay the role of diet in prostate cancer, such as ASCO’s statement: “There is not enough information right now to make clear recommendations about the exact role eating behaviors play in prostate cancer. Dietary changes may need to be made many years earlier in a man’s life to reduce the risk of developing prostate cancer.”23 We disagree. Although all the mechanisms and details are not understood (they seldom are in science), enough evidence has emerged to make recommendations.
Choices in diet associated with prostate cancer outcomes:
- Eat less red meat
- Avoid eating smoked and cured meats.
- Reduce saturated fats, found in these foods:
- Avoid whole-milk products (milk, cheese, butter)
- Eat fish high in omega-3 fatty acids (sardines, wild salmon and anchovies)
- Eat more cruciferous vegetables (broccoli, cabbage, kale, cauliflower, Brussels sprouts)
- Eat soy
- Eat food sources of lycopene (cooked tomatoes, strawberries, watermelon, pink grapefruit, guava and papaya)
- Drink green tea
- Drink pomegranate juice, which decreases oxidative stress and induces apoptosis in cancer cells
- Drink cranberry juice
- Add flaxseed to foods
- Add turmeric or curry powder to food
See Moving More
According to Meir Stampfer at Harvard, of the risk factors that you can change, “smoking within the previous 10 years is one of the big ones.”37 A 2018 study found that “current smokers at the time of primary curative treatment for localized prostate cancer are at higher risk of experiencing biochemical recurrence, metastasis, and cancer-specific mortality.”38
Some evidence shows complementary therapies and healing practices can be useful to enhance treatment effectiveness, improve quality of life and even extend life.
Use of Supplements
- I3C (Indole-3-carbinol) and DIM (Moss notes that benefit of these is based on lab, not clinical work.
- Vitamin D and calcium
Supplements that are controversial or have not shown positive effect:
- Flaxseed oil: See the discussion above
- Omega 3 fatty acids
It is likely that only specific subpopulations may benefit from vitamin E and/or selenium supplementation.
- Vitamin E
- Calcium and phosphorus
- Saw palmetto
Meditation and Other Mind-body Approaches
See these BCCT summaries:
Sharing Love and Support
Heat may be used to treat cancer, such as many forms of electromagnetic energy to heat tumors. Heat may be used either through local or regional application or by heating the whole body. All forms of hyperthermia are widely available in German cancer clinics, some Mexican clinics, Kleef Klinik in Austria and also some individual practitioners. Local and regional hyperthermia is being used in the US, particularly for prostate cancer. Ralph Moss, in his Prostate Cancer Report, gives information on its use at Cancer Treatment Centers of America, University of California San Francisco UCSF) and the Orange County Immune Institute. At UCSF, hyperthermia is combined with radiation therapy to treat prostate cancer.
Clinical trials of the ketogenic diet in prostate cancer are currently in progress as we publish this page. See Ketogenic Diet
Off-label drug use happens when a physician prescribes a drug for a disease or condition not approved by the FDA. It is legal to prescribe drugs off-label if sufficient evidence indicates its usefulness for the condition/disease prescribed. However, different state medical boards have varying standards regarding off-label use of specific drugs. An off-label use may benefit you, so talk to your doctor if this approach interests you.
Some of the off-label drugs that may be helpful in prostate cancer:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
Other Complementary Therapies Used in Prostate Cancer Plans, Protocols and Medical Systems
Select “prostate cancer” as you search our therapy summaries database
Examples of Oncology Practices
Examples of medical oncology practices focusing on prostate cancer, using minimally invasive procedures and/or some integrative therapies:
Prostate Oncology Specialists
Medical oncologists Mark Scholz, MD; Richard Lam, MD; and Jeffrey Turner, MD, run an integrative oncology practice in Marina del Ray, California. Though BCCT has not been to their clinic to evaluate their work, one of BCCT’s advisors, a medical advocate, is impressed with their integrative, individualized approach. Doctors Scholz, Lam and Turner state:
As medical oncologists rather than surgeons, we do not have a preset agenda toward a specific treatment. All treatments, including active surveillance, hormone therapy, immunotherapy, surgery, radiation, brachytherapy, cryotherapy, focal therapy, proton therapy, nutritional and alternative therapies, HIFU and chemotherapy are given equal consideration depending on the unique needs of each individual patient.
Their Prostate Oncology Specialists website, books and publications provide a wealth of information on making decisions about prostate cancer treatment, and shedding light on innovative, integrative approaches to prostate cancer care. Find more information about their resources and publications below.
Prostate Institute of America
Dr. Duke Buhn with the Prostate Institute of America provides “options that include minimally invasive therapies, including cryotherapy, as a means of treatment that increase survivability and may reduce side effects and complications.” According to one of BCCT's medical advocacy advisors, Dr. Buhn has been performing cryotherapy for prostate cancer for many years. He is also a master at noninvasive methods to gather information, such as Harmonic Doppler Ultrasound.
Charles “Snuffy” Myers, MD
Charles “Snuffy” Myers, MD, is a medical oncologist known for his deep and innovative work in medical treatment of prostate cancer. Though his approach has primarily been through insightful use of conventional treatments, he gives great credence to diet and other lifestyle practices. He is now editor-in-chief of an information and resource website for those with prostate cancer, Prostapedia. He has also written a cookbook specifically for prostate cancer (see below).
Clinical Practice Guidelines
- National Comprehensive Cancer Network:
- American Society of Clinical Oncology: Genitourinary Cancer
Integrative Plans, Protocols and Medical Systems
|For more information about plans and protocols, see our Integrative Plans and Protocols page.|
- Plans, protocols and programs
- Abrams & Weil integrative medicine approaches: (chapter 22: Prostate Cancer: An Integrative Approach)66
- Alschuler & Gazella complementary approaches67
- Block program68
- Chang strategies69
- Cohen & Jefferies Mix of Six anticancer practices: risk reduction70
- Elsegood LDN guidelines71
- Geffen Seven Levels of Healing72
- Lemole, Mehta & McKee prostate cancer protocol73
- McKinney prostate cancer protocol74
- list specific protocols
- Ornish Lifestyle Medicine
Advocacy and Support Groups
National Comprehensive Cancer Network: Advocacy and Support Groups; select prostate cancer or another topic of interest from the dropdown menu.
Written by Laura Pole, RN, MSN, OCNS, and reviewed by Nancy Hepp, MS; most recent update on September 27, 2018.
Dean Ornish, MD: Symington 2017
Integrative Approaches to Prostate Cancer Care
- Katz's Corner with Dr. Aaron Katz
- What is Holistic Urology? Interview with Dr. Aaron Katz in “Ask the Doctor” series of Winthrop-University Hospital
- Katz A. Diet and Supplements for Men with Rising PSA. Grand Rounds Urology. January 2015.
- Abrams, A. An integrative approach to prostate cancer. The Journal of Alternative and Complementary Medicine. Volume 24, Numbers 9 and 10, 2018, pp. 872–880.
- Berg CJ, Habibian DJ et al. Active holistic surveillance: the nutritional aspect of delayed intervention in prostate cancer. Journal of Nutrition and Metabolism, 2016;2016:2917065.
- Werneburg GT, Kongnyuy M et al. Patient-reported quality of life progression in men with prostate cancer following primary cryotherapy, cyberknife, or active holistic surveillance. prostate cancer and prostatic diseases. 2018;21(3):355–363.
- Charles “Snuffy” Myers:
- Beating Prostate Cancer (Hormonal Therapy & Diet). 2007.
- The New Prostate Cancer Nutrition Book. 2012.
- Prostapedia Journal requires paid subscription. However, access to blog and weekly email updates is free.
- Scambia J, Darves A, Katz A. Chapter 22: Prostate cancer: an integrative approach. In Abrams DI, Weil AT. Integrative Oncology, 2nd Edition. New York, NY: Oxford University Press. 2014.
- Scholz M, Blum R. Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Sexual Potency. 2010.
- Scholz M. The Key to Prostate Cancer: 30 Experts Explain 15 Stages of Prostate Cancer. 2018.
- Foundation for Alternative and Integrative Medicine: Fatty Acids and Prostate Cancer Risk
- Tyson MD, Penson DF, Resnick MJ. The comparative oncologic effectiveness of available management strategies for clinically localized prostate cancer. Urologic Oncology, 2017 Feb;35(2), 51–58.
- Myers CE, Basu G, Wright B, Mahanes J, Spinelli A. Successful treatment of advanced metastatic prostate cancer following chemotherapy based on molecular profiling. Case Reports in Oncology. 2012 Jan-Apr;5(1):154–158.
- National Cancer Institute: Contact Us for Help
Information specialists at the NCI Contact Center are available to help answer your cancer-related questions in English and Spanish whether you are a patient, family member or friend, health care provider, or researcher. We also respond to questions and requests for information about NCI and its programs and provide support in quitting smoking.
- Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
- The Lord Symington Foundation with Healing Circles and The New School at Commonweal: Dean Ornish, MD: Symington 2017
- September 2018 Issue of the Journal of Alternative and Complementary Medicine