Prostate Cancer

Key Points

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  • 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 shift 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.

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In the ProtecT study, men with localized prostate cancer who were followed for 10 years lived just as long whether they did active surveillance, surgery or radiation therapy.

Prostate cancer is a prime example 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 can significantly reduce quality of life.

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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Integrative Care in Prostate Cancer

Before investigating integrative care in prostate cancer, we recommend reviewing integrative cancer care in general.

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.

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Clinical Practice Guidelines

Integrative Plans, Protocols and Medical Systems

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

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Examples: Treatment Approaches from Noted Specialists and Practices

We note examples of prostate cancer teatment approaches used by leaders in the field. Some use minimally invasive conventional procedures with some integrative approaches, while others are more fully integrative in approach.

Aaron Katz, MD, and the Active Holistic Surveillance Program

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Ornish Lifestyle Medicine

Compared to men under active surveillance who didn’t make lifestyle changes, those who followed Ornish’s program had favorable biological markers, including lower PSAs.

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Charles “Snuffy” Myers, MD

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Prostate Oncology Specialists

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Prostate Institute of America

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Integrative Therapies in Prostate Cancer

7 Healing Practices: The Foundation

The 7 Healing Practices listed here all promote wellness and tend to make your body terrain less hospitable to the development and progression of cancer. Some practices address cancer symptoms and side effects.

Eating Well

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7 Healing Practices

Moving More

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The risks from these lifestyle changes are very low, and the potential benefits are great.

Managing Stress

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Sleeping Well

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Creating a Healing Environment

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Sharing Love and Support

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Exploring What Matters Now

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Other Lifestyle Associations

Obesity

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Tobacco Smoking

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Finding Reliable Information about Prostate Cancer

As research continues to identify best practices in prostate cancer prevention, detection and treatment, advice has changed considerably over the last couple of decades.

However, quite a lot of information that is either outdated or inaccurate is still available online and is passed along through social media.

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Beyond the 7 Healing Practices: Further Integrative Therapies

Complementary therapies and lifestyle practices can be useful to enhance treatment effects, improve quality of life and possibly even extend life for those with prostate cancer.

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Therapies are grouped according to their effects:

  • Treating the cancer
  • Managing side effects and promoting wellness
  • Reducing risk

We present natural products and off-label, overlooked and novel cancer approaches (ONCAs) in five categories:

  1. Good evidence of efficacy & safety, easy access
  2. Good evidence of efficacy & safety, limited access
  3. Limited evidence of efficacy but good safety, used in leading integrative plans
  4. Limited evidence of efficacy, or significant cautions, but potential significant benefit
  5. Evidence of no efficacy or may be dangerous

Other integrative therapies and approaches are described but not categorized. See the full summaries as linked for more information on each of these therapies.

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Conventional Prostate Cancer Therapies

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Natural Products

Category 1: Good evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

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Category 2: Good evidence of efficacy & safety, limited access

(None)

Category 3: Limited evidence of efficacy but good safety, used in leading integrative plans

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Category 4: Limited evidence of efficacy, or significant cautions, but potential significant benefit

May be used in leading integrative oncology plans. Therapies in this category may need more medical oversight and surveillance.

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Category 5: Evidence of no efficacy or may be dangerous

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Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

Category 1: Good evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

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Category 2: Good evidence of efficacy & safety, limited access

Some may require a prescription, for example.

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Category 3: Limited evidence of efficacy but good safety, used in leading integrative plans

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Category 4: Limited evidence of efficacy, or significant cautions, but potential significant benefit

May be used in leading integrative oncology plans. Therapies in this category may need more medical oversight and surveillance.

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Category 5: Evidence of no efficacy or may be dangerous

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Diets and Metabolic Approaches

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Therapies using Heat, Sound, Light or Cutting-edge Radiotherapy

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Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Natural Products

Category 1: Good evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

(None)

Category 2: Good evidence of efficacy & safety, limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative plans

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Category 4: Limited evidence of efficacy, or significant cautions, but potential significant benefit

May be used in leading integrative oncology plans. Therapies in this category may need more medical oversight and surveillance.

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Category 5: Evidence of no efficacy or may be dangerous

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Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

Category 1: Good evidence of efficacy & safety, easy access

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Category 2: Good evidence of efficacy & safety, limited access

Some may require a prescription, for example.

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Mind-Body Approaches

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Manipulative and Body-based Methods

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Energy Therapies

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Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Risk factors for prostate cancer include these:199

Expand list

Conventional Prostate Cancer Therapies

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Natural Products

Category 1: Good evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Read more

Category 2: Good evidence of efficacy & safety, limited access

(None)

Category 3: Limited evidence of efficacy but good safety, used in leading integrative plans

Read more

Category 4: Limited evidence of efficacy, or significant cautions, but potential significant benefit

May be used in leading integrative oncology plans. Therapies in this category may need more medical oversight and surveillance.

Read more

Category 5: Evidence of no efficacy or may be dangerous

Read more

Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

Category 1: Good evidence of efficacy & safety, easy access

(None)

Category 2: Good evidence of efficacy & safety, limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative plans

(None)

Category 4: Limited evidence of efficacy, or significant cautions, but potential significant benefit

May be used in leading integrative oncology plans. Therapies in this category may need more medical oversight and surveillance.

Read more

Commentary

In his Grand Rounds Urology lecture, Aaron Katz, MD, cites the literature supporting vitamin D’s positive effect in reducing disease risk, including prostate cancer. Dr. Katz’s practice is to “obtain [baseline] vitamin D levels on all of my [prostate cancer] patients that are on active surveillance, whether it be in the recurrent cases or in primary [cases]l. Then. . . restore about 1,000 units of vitamin D, [to] give you just a bump [in blood levels] up of around 10. Most people in the field believe that the therapeutic range is somewhere between 40 and 50. I have not had any problem going straight to 5,000. If you look in the vitamins, if you’re on multivitamins and you look at how much vitamin D is in your vitamin capsule, it’s about 200 units of vitamin D. I will start with 5,000 per day and then repeat the vitamin D [blood test] in three months.”238

Keith Block, MD, says that calcitriol, which is the most active form of vitamin D, is of particular interest in prostate cancer.239 Dr. Block prefers to get at the root of inflammation using diet and other non-drug approaches, but in certain situations, he uses Celebrex to block the COX-2 enzyme, “since the inflammatory chemicals the enzyme spawns play a major role in blocking the effectiveness of chemotherapy and radiation.”240 It is important to note that NSAIDs can have serious, even life-threatening side effects. Therefore, use them only under medical supervision.241

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 Nancy Hepp, MS; most recent update on January 14, 2019. BCCT is grateful for the KNOW Oncology resource used in creating this summary.

Highlighted Video

Dean Ornish, MD: Symington 2017

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View All References

More Information

Integrative Approaches to Prostate Cancer Care

Conventional Approaches

More from Our Resources Database

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