Prostate Cancer

Key Points

  • Conventional treatment for prostate cancer has become much less aggressive in recent decades, preserving quality of life for many men without sacrificing survival.
  • Radical surgery and/or radiation therapy are no longer standard approaches in conventional treatment with a move toward watchful waiting or active surveillance, especially in early stage, low-risk prostate cancer.
  • Integrative therapies during a period of waiting or surveillance, and also during treatment, show significant potential benefit to patients.
  • Increased prostate cancer risk has been linked to diet and lifestyle factors including a high-fat diet, obesity and a sedentary lifestyle.
  • Novel diagnostic tests specific for prostate cancer are available.
  • Rather than “watchful waiting” alone for low-risk prostate cancer, engaging in an active surveillance program including complementary therapies often brings benefit. Examples include the Ornish Lifestyle Medicine Program and Program for Active Holistic Surveillance from Aaron Katz, MD.
  • Some integrative oncology clinicians report encouraging success in extending survival and improving quality of life in individuals with advanced prostate cancer.

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

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.

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Overview

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.

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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

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A starting place for the science of  conventional therapies:

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.

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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.”

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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.

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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

Diet Modification

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

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  • Avoid eating smoked and cured meats.
  • Reduce saturated fats, found in these foods:

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  • Avoid whole-milk products (milk, cheese, butter)

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  • 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

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  • Eat food sources of lycopene (cooked tomatoes, strawberries, watermelon, pink grapefruit, guava and papaya)

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  • Drink green tea

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  • Drink pomegranate juice, which decreases oxidative stress and induces apoptosis in cancer cells

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  • Drink cranberry juice

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  • Add flaxseed to foods

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  • Add turmeric or curry powder to food

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See Eating Well and Mediterranean Diet

Aerobic Exercise

Studies indicate that vigorous exercise at least three hours a week reduces the risk of lethal prostate cancer35 and may lower the rate of prostate cancer progression.36

See Moving More

Smoking Cessation

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

Complementary Therapies

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

  • Isoflavones

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  • I3C (Indole-3-carbinol) and DIM (Moss notes that benefit of these is based on lab, not clinical work.
  • Vitamin D and calcium

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Supplements that are controversial or have not shown positive effect:

  • Flaxseed oil: See the discussion above
  • Omega 3 fatty acids

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It is likely that only specific subpopulations may benefit from vitamin E and/or selenium supplementation.

  • Vitamin E

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  • Calcium and phosphorus

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  • Saw palmetto

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Meditation and Other Mind-body Approaches

See these BCCT summaries:

Sharing Love and Support

See Sharing Love and Support

Hyperthermia

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.

Metabolic Approaches

Clinical trials of the ketogenic diet in prostate cancer are currently in progress as we publish this page. See Ketogenic Diet

Off-Label Drugs

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:

  • Metformin

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  • Non-steroidal anti-inflammatory drugs (NSAIDs)

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  • Propranolol

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  • Statins

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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

Integrative Plans, Protocols and Medical Systems

For more information about plans and protocols, see our Integrative Plans and Protocols page.

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.

Highlighted Video

Dean Ornish, MD: Symington 2017

View All References

More Information

Integrative Approaches to Prostate Cancer Care

Conventional Approaches

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