CaPLESS & Prostate Cancer

The King of Medicinal Mushrooms: Reishi

[Image from Collective Evolution website]

 

Billions of dollars are sold in medicinal mushroom are sold yearly as these nutritional organism become the hottest functional food to consume.

I too take this dietary supplement everyday which contains ample amounts of my favorite protective mushroom of them all, Reishi.

While we can’t say mushrooms cure or mitigate disease, we know they have protective properties that are useful.

Out of many of the medicinal mushroom consumed by people for nutrition support, including, chaga, cordyceps and turkey tail, Reishi has the most robust science to support its use.

Ganoderma lucidum, commonly known as Reishi, is a favorite medicinal mushroom that has been used for centuries in Traditional Chinese Medicine (TCM) for the prevention or treatment of a variety of diseases.

Reishi mushroom is used by many cancer thrivers to strengthen the immune system.

Some of the published research indicates Reishi has activity against prostate cancer and breast cancer cells.

This published scientific article demonstrate that Reishi inhibits active transcription factors nuclear factor kappa B (NF-kappaB) and AP-1, which resulted in the inhibition of expression of urokinase-type plasminogen activator (uPA) and its receptor uPAR.

In human language that means Reishi mushroom inteferes with numerous pathways that can promote cancer cells.

A meta-analysis study on the use of Reishi in cancer treatment reported immune stimulating effects with this ancient mushroom. This same report indicates a positive response in about 50 percent of patients consuming Reishi mushroom while undergoing radiation or chemotherapy, as compared to those treated with chemo or radiation alone.

One of the conclusion of this reputed conservative journal is this;

Ganoderma lucidum could be administered as an alternative adjunct to conventional treatment in consideration of its potential of enhancing tumor response and stimulating host immunity.

Frequently Asked Questions on the Use of Medicinal Mushroom for Nutritional Support in Prostate Cancer Patients

 

Q: I heard good things about Turkey tail, Chaga and other popular mushrooms, can I take them too?

A: Yes. They are all helpful and have some science to support their use.

 

Q: Why do you have only Reishi mushroom in your formula and not any of the others?

A: I can only fit so many ingredients in one capsule. Reishi, after extensive research and clinical experience, is the king of mushrooms in my opinion and it’s backed by the best quality science for immune function and many other health properties. 

 

Q: Can I take medicinal mushrooms during radiation therapy for prostate cancer?

A: Yes you can, along with numerous others. I recently wrote this article on the use of dietary supplements during radiation and it might be a useful read. Your radiation oncologist will be opposed to you taking ANY dietary supplements during radiation, however.

 

 

Exercise Lowers Prostate Cancer Death & Improves Mental Health – Study

[ My garage gym. Serves as a meditation area for me too]

 

This recent study of over one million people demonstrates that those who exercise experience 43% more mental health than those who don’t.

Let me say that again, 43% better mental health.

Folks, imagine a drug that improves depression by 43%?

By far that would be the most successful pharmaceutical drug for depression to date. The news would be all over the news – headlines everywhere, the top story on CNN and Fox, the front cover of the New York Times (NYT).

But you likely don’t know about this strong association between exercise and mental health until now.

Crazy!

While all exercise in this study decreased what authors called “mental burden,” the most significant associations were seen for popular team sports like soccer and basketball, cycling and aerobic and gym activities.

Activities like yoga and tai chi had a nearly a 23% reduction in poor mental-health days.

For maximal benefit exercise duration was about 45 minutes a day, three to five times per week, according to the study.

Mental health is generally defined as depression, anxiety, post-traumatic stress and general stress.

This recent study was published on one of my favorite and most prestigious journals, the Lancet Psychiatry.

By the way, the association between exercise and mental health is not new. Actually, the science is ridiculously old.

A few months ago in another prestigious journal, JAMA, they looked at close to eighteen thousand middle-age people noticed a significant decrease in depression, death from heart disease and death from heart disease specifically associated with depression.

In addition to mental health, exercise is also linked with lower risk of dying from prostate cancer.

A study that tracked tens of thousands of midlife and older men for more than 20 years has found that vigorous exercise and other healthy lifestyle habits may cut their chances of developing a lethal type of prostate cancer by up to 68 percent. While numerous lifestyle factors such as eating tomatoes, not smoking, eating fewer process meats and exercise contributed to less prostate cancer-related deaths, the connection with exercise was most substantial.

Again, 68% less prostate cancer mortality! Lord!

In addition, I have talked about the benefits of exercise in men undergoing hormone therapy for prostate cancer – HERE is the link.

How to start an Exercise Regimen right for you.

The first thing is to quit making excuses for why you are not physically active.

HERE is a list of common excuses why you are not physically active, and I suggest you stop making them and get going. Seriously.

Physical activity is real medicine and one of the most powerful types to not only prevent many disease but also to treat it.

The other point here is that as one ages building strength becomes essential.

You see, the body wants to muscle waste as one age – a process called sarcopenia – and you need to fight that as your life depends on it because it does.

The best method to fight that is by practicing weight resistant exercises.

Research shows the stronger you are, the longer you live.

 

Two years ago, along with my regular strength training routine, I began Krav Maga (KM), an Israeli martial art.

The reason I began training in KM was because I was itching for something new and completely out of my comfort zone. Additionally, I always enjoyed combat sports so why not try it.

And I love it. There is a community element that is pretty cool. While my fighting partners and I don’t necessarily have drinks together, we do talk about life, fighting, and current events when we are at our KM school.

Interestingly, a recent NYT article demonstrates and aging researcher from Harvard, Dr. Kirk Daffner, trains in Greek Karate ( known as Pankration) with his teacher who is 90 years old. In martial arts, Dr. Daffner explains, not only is there mental stimulation and movement but also social engagement and connection, which is likely therapeutic.

The takeaway for today is to get out of your comfort zone, quit making excuses and start consistently moving your body. Join a group of whatever you like, yoga, cycling, running, martial arts, whatever.

The other thing is to exercise every day. That’s right. Every single day you should do 20 to 60 minutes of something physical. One day you can do stretching, the other day, say, yoga, third-day weight resistance, day four tennis, etc.

Even if its ten minutes a day, that’s good for now. Just go!

You get as much benefit from the volume of exercising (doing it often) as you do from the intensity.

 

Lastly, while I like lifting weights by myself – as it is a form of active meditation for me – my neighbor Scott (above pic) joins me on Sunday mornings for a session we call “lift and learn.”

We made this “lift and learn” thing up. Primarily, we do either barbell squats or deadlifts, with pull ups and push ups then talk about improving our lives as men. Anything from religion to philosophy to raising kids is on the table. I have to say this one of the most enjoyable events of my weeks, and I feel empowered after our Sunday morning sessions. I think Scott does too.

Here’s the bottom line; Implementing the science it what it’s all about. Team activities seem to be extremely beneficial for your health and longevity. But if for whatever reason joining a fitness group is not an option, just put on some sneakers and go for a 10-minute walk. Start somewhere, and you will see how beautifully you will progress and fee.

The Three Recent Blog Post

Nine Reasons to Fire Your Doctor

The CaPLESS Thriver Mindset

Does a Keto Diet Work for Prostate Cancer

Related Posts on Exercise and Prostate Cancer

A Thriver After Prostate Cancer [VIDEO]

Apalutamide, Hormone Therapy and Prostate Cancer

Lifestyle and Exercise prevents Prostate Cancer Mortality – study

Another Study on Exercise and Prostate Cancer

CaPLESS RETREAT (will close for registration tonight, August 26th at midnight)

The CaPLESS Retreat is coming in September 14 – 16, 2018 to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. Prostate cancer is an opportunity to live healthier than before your diagnosis. Learn how. There is limited space.

 

9 Reason’s For Firing Your Doctor

Yesterday I got fired from one of my patients.

This is the third time (that I know of) in my 15-year career that I don’t meet a patient’s expectations and they fire me as their doctor.

His email to me reads like this:

“I’ve decided to go elsewhere and decided you may have a conflict of interest in not addressing supplements RXed by others that are not yours… “

“Conflict of interest in not addressing supplements that are not yours” is likely referring to dietary supplements I prescribe from XY Wellness. That is confusing considering I prescribe supplements from other sources often. Additionally, I don’t ever discontinue patient care when they consume dietary supplements from different equivalent sources.

But this blog post is not about defending my position on yesterday’s occurrence.

Today’s article is about when to fire your doctor, which I believe should happen when the trust is damaged.

Your doctor is fallible. I am too.

Most physicians work hard for their patients. Sometimes I discuss with colleagues the sleepless nights we experience when thinking about our patients. But even then, we never bat 1000, to use a baseball analogy.

In baseball, any player that hits to get on base safely three out of ten times as a batter (hits .300 average), that’s an outstanding player.

One player in the history of baseball ever hit .4oo in one year. That is Ted Williams from the Boston Redsox in 1941 where he hit .406. That’s nearly a perfect average.

Physicians are expected to hit 1000, which, of course, is not possible.

Still, I am the first one to recommend people to fire their doctor if they are not connecting.

There are also other problems with some doctors. I am fully aware that not everyone is perfect and some doctors can and will make mistakes. That’s why it is so important to trust your gut instinct if you think that something is still wrong with you or a loved one. You don’t want to experience a wrongful death just because a doctor told you were fine when you knew that you weren’t. If something like this has happened to you then you should make sure to get yourself a lawyer. If won’t bring back the person but it will provide you with some justice.

My imperfections as a health care provider are not my (ex)patient’s problem. It’s my problem.

While I don’t believe the patient is always right, trust is essential for a good doctor/patient relationship. Once the trust is broken, all bets are off; healing becomes difficult for the patient.

9 Reason’s When You Should Fire Your Doctor

1. When the doctor says your health problem, “ Is all in your head.” While the mind can contribute to disease, it is often not the cause of disease.

2. Physician death sentence. You have X months (pick a timeline) to live. No doctor is God to give a death sentence. A competent physician should always provide reasonable hope. I have patients with stage 4 prostate cancer living way beyond what they supposed according to their oncologist.

3. Physician frustration from your questions. Most patients ask great questions these days. They have access to much information via the internet. Yes, some of the info is crap, but some are good. The physician should answer all questions and provide clarity of the action plan.

4. The physician should look at you in the eye when he/she speaks to you – something becoming less frequent these days with Electronic Medical Records (EMR). Docs typing as they talk to you should not be a deal breaker, everyone’s clinical practice is backed up and avoiding getting behind with patients is the name of the game in most clinics. But there should be some eye contact.

5. Holistic medicine is not scientific – fire your doctor. I’m a little biased here. But all biases aside, there is a plethora of evidence on the benefits of holistic medicine. Your doctor may not care to look into it. Or in fairness has no interest or time to research on anything else. They are struggling to stay abreast on their specialty. Still, to say holistic methods are not scientific or BS is grounds to fire your doc.

6. Listen to your gut, not your brain. Your gut instict will tell you if your doc is the right fit for you.

7. Know what you want from your doctor – have appropriate expectations though. Understand the medical system is squeezing physicians to spend no more than 15 minutes per patient. You, the patient, also have to be efficient with your questions. If he / she does not meet your expectations, that doc has to go.

8. Fear mongering. “You will die if you don’t undergo surgery now” type of statement is an out for me. And it should be for you. Nothing is 100% in medicine.

9. Your physician does not respect your time. Some patients wait one or two hours before their 15 minute face-to-face with the physician. Every person’s time is valuable and should be respected. Yes, emergencies happen where a physician may get delayed, but those are anomalies. At minimum patients should get an update on how much longer they need to wait by someone, if not the physician himself.

For any physician reading this post; when a patient is dissatisfied with our service as health care providers that is a moment to break any complacency one may have and improve on how you practice. Maybe communicate more clearly. Or perhaps listening better.

After my recent incident with my disgruntled patient, I am stepping back to look at my clinical holes and fix them.

As a physician, it’s emotionally brutal getting fired by a dissatisfied patient, but it can be an opportunity to improve on what we are meant to do – optimize the health of the sick. And healing patients will help alleviate the sting.

The Three Recent Blog Post

The CaPLESS Thriver Mindset

A Thriver After Prostate Cancer [VIDEO]

Does a Keto Diet Work for Prostate Cancer

 

CaPLESS EVENTS

The CaPLESS Retreat is coming in September 14 – 16, 2018 to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. Prostate cancer is an opportunity to live healthier than before your diagnosis. Learn how. There is limited space.

 

The CaPLESS Thrivers Mindset

 

There’s a misconception between Cure vs. Survival as it relates to cancer.

To most people cure means “ cancer free.” To physicians specializing in cancer, it means “5-year survival.”

That’s absurd.

So, if one is diagnosed with aggressive cancer but they live five years and one-day, poorly lived life mind you, that therapy was a success.

Here’s the reality; complete cancer cure, as in no more cancer, ever, is never the case because there’s always residual malignant cells lingering in one’s body. That’s why long-term survival is uncommon.

In prostate cancer, there’s a very high rate of recurrence. That’s no secret. And cancer’s of the prostate that doesn’t relapse many experts would question if treatment was needed in the first place.

There’s one very famous urologist (will remain nameless) who surgically treated only low-grade non-aggressive prostate cancer. If the Gleason score was an 8 or higher, he’d sent them to another physician. As a result of him “gaming the system” he became known as a famous prostate cancer urologist who “cured” patients from this disease. Crazy!

The bottom line is this; the spreading of prostate cancer (and most tumors) requires the perfect microenvironment. Metastatic cancers go back to an old concept called the “Soil and Seed theory.”

Cancer cells, which typically can only kill when they grow and spread, need a “favorable, dirty terrain” to metastasize. If you manage the microenvironment ( the terrain) the likelihood of cance spreading is minimal.

Of course, I have way too much respect for the “C-word” to oversimply.

But based on extensive, tireless research and experience of seeing patients with PSA from 1.8 with aggressive prostate cancer (yes, despite low PSA) to men with PSA of 3000 (yes, it goes up that high, even higher), the common denominator is continuously applying the lifestyle and behaviors that create a microenvironment hostile to cancer.

And such lifestyle beginnings with a thriver’s mentality, not a survivor one.

If you read my book, you know I am not a big fan of the word “survivor” as in “I am a cancer survivor.” The words you use to describe your experiences matter. Survivor implies, just making it. I am alive, sort of, but just hanging by a thread.

Here’s the bottom line (no really, this is it); For you to live your best life after prostate cancer, you need to be a thriver, not only a survivor. Such a concept is not just a silly, rah rah title of a book; this is real. And it starts with your mindset, then with what you eat, how often you move your body with what intensity, your ability to manage stress and to improve your sleep. These are the pillars of the CaPLESS Method that has worked now for thousands of patients and readers.

Of course, you don’t have to bat one-thousand (to use a baseball analogy) to benefit, but if you improve in one, it will have a domino-effect on another resulting in an unfavorable cancer environment in your body.

7 Main Concepts of the CaPLESS Method for Prostate Cancer:

  1. Eat colored fish, cooked in low heat not too charred.
  2. Eat Plants and unprocessed foods.
  3. Simple sugars, processed grains and flour are the enemy – don’t eat them, even if they are organic.
  4. A high-fat (ketogenic) diet may not work for prostate cancer.
  5. Exercise four hours a week with moderate to high intensity. That means your heart rate will go up to about 120 to 140 beats per minute, depending on age. Everyone needs weight resistance exercise, but those on hormone therapy need at 3 days a week of weight resistance movements.
  6. Consume supplements specific to the condition. Up to 4000mg of curcumin is safe and likely beneficial.
  7. Learn how to calm your brain to better manage stress. Mindful Based Stress Reduction is a good program. We have an expert on this at the CaPLESS Retreat.

The Three Recent Blog Post

A Thriver After Prostate Cancer [VIDEO]

Does a Keto Diet Work for Prostate Cancer

L-Citruline: The Heart and Penis Connection.

CaPLESS EVENTS

The CaPLESS Retreat is coming in September 14 – 16, 2018 to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. Prostate cancer is an opportunity to live healthier than before your diagnosis. Learn how. There is limited space.

 

A Thriver After Prostate Cancer

Chris is one of the most amazing CaPLESS Thrivers I know. When I first met him about six years ago, he was 47 years olds with a PSA of 27.0. After biopsy, we discovered he had Gleason 9 prostate cancer all over his prostate.

But that’s not all.

Three months after his prostatectomy, his PSA was 20.0. [there is no error where the decimal point is placed] This could have been a gloom and doom situation but Chris made a 180 degree change to his lifestyle and today he is a Thriver!

He does Cross Fit at CF 140 in Atlanta with his amazing trainer David Argel who I had the pleasure of speaking with recently.     Check out this video of Chris doing Cross Fit. If you are not inspired by Chris and ready to get going, nothing will. Thrive, Don’t Only Surivive!

 

Does a Keto Diet Work for Prostate Cancer?

[ image from Natural Living Ideas]

 

All cells of the human body require energy in the form of Adenosine TriPhosphate (ATP) to support life. If you remember way back in high school, you learned that the mitochondria are the “powerhouse” of the cell as it produces the majority of ATP. When the mitochondria are impaired, its malfunction is implicated in the majority of today’s most concerning chronic and degenerative diseases including obesity, cardiovascular disease, cancer, and diabetes, to name a few.

What is the ketogenic, mitochondria and health connection?

Initially, ketogenic diets were used to treat seizures, but recent research indicates that benefits related to the management of epilepsy, weight loss, metabolic syndrome, and type 2 diabetes can be achieved with an approach that is less restrictive in carbohydrate and protein, and therefore more satisfying, sustainable, and feasible for the general population.

What is a Ketogenic Diet?

Ketogenic diets (KDs) are diets that mimic the metabolic state of fasting by inducing a physiological rise in the two main circulating ketones, acetoacetate and beta-hydroxybutyrate (BHB).

This is a simple version of how the ketogenic diet works.

When your cells are deprived of glucose (sugar) as its primary source of energy, your body kicks in the next gear and utilizes fat for fuel in the form of ketones.

One can create ketones from either fasting for a prolonged period, anywhere from 16 hours a day or for several days, or from eating a high-fat diet, which is what a ketogenic diet is.

To be clear, a ketogenic diet (KD) is not a high protein diet like paleo form of eating. It is a fat diet where lard is in, along with other oils, coconut being a favorite, butter, avocados, etc.

The Ketogenic Diet and Cancer Connection

KDs target the Warburg effect, a biochemical phenomenon in which cancer cells predominantly utilize glycolysis (burns sugar) instead of oxidative phosphorylation (OXPHOS) to produce ATP (energy). Don’t get caught up on what OXPHOS means or how it works for now but know that healthy cells work by using this metabolic pathway.

Thus, the rationale in providing a fat-rich, low-carbohydrate diet in cancer therapy is to reduce circulating glucose levels and induce ketosis such that cancer cells are starved of energy while normal cells adapt their metabolism to use ketone bodies and survive.

To date, the most reliable evidence for KD in suppressing tumors has been reported for glioblastoma (a type of brain cancer).

The proposed mechanism for how the Ketogenic diet works for cancer is like this.

Cancer cells have dysfunctional mitochondria and lack specific enzymes necessary for effective ketone body utilization. In other words, malignant cells can’t use ketones for energy but healthy cells can.

Free fatty acids and ketone bodies are considered to become a significant fuel for normal tissues of cancer patients as a consequence of developing insulin resistance. Additionally, ketone bodies have been shown to suppress protein catabolism during starvation (more on this further down.)

Ketogenic Diet and Prostate Cancer: Yes or No?

There have been no studies on a KD and prostate cancer.

However, there is a small pilot, non-randomized study going as we speak looking and this dietary approach among a sample of 12 overweight or obese prostate cancer patients on active surveillance. The result will not be available until the Spring of 2021.

Besides there being no studies, should a man with prostate cancer implement a KD?

Yes and no.

Here’s the deal;

In one mice study looking at the effects of a no carbs keto diet (NCKD), 10% carb diet and a 20% carb diet on prostate cancer showed is no difference between low-carbohydrate and no-carbohydrate diets regarding prostate cancer growth and progression.

The other important point is that most types of prostate malignancies are not glycolytic cancers like glioblastoma’s thus the Warburg effect does not apply. Clinically this is relevant, as these cancers will not appear on fluorodeoxyglucose (FGD) PET scans. However, in the late stage, more aggressive metastatic prostate cancer there may be more of a Warburg effect and have a high glucose uptake.

In other words, low-grade prostate cancer and high-grade metastatic prostate are two entirely different animals in how they behave.

Dr. Geo’s Take On the Ketogenic Diet and Prostate Cancer

A low carbohydrate diet, which is what promote in the CaPLESS Method, of about 50 to 60g of carbs total (not sugar, carbohydrates) a day is still, eliminating refined; processed carbs is still essential for early-stage prostate cancer without metastasis or positive FDG PET scan.

The reason why a low carb diet is vital to beat non-metastatic prostate cancer is not that of glucose uptake of cancer cells, but the problems excess insulin and insulin resistance cause in promoting disease. In fact, there are data to suggest that patients with early-onset, type one diabetes mellitus (not type two) whose pancreas is no longer able to produce insulin are significantly less likely to develop prostate cancer, independent of diet changes.

If a huge guy is diagnosed with prostate cancer, then his high basal metabolic index (BMI) increases the risk of not only getting prostate cancer but dying from it.

It is a good idea for an overweight person with prostate cancer to restrict carbs more than most as low carb diets, and a KD has shown to help with weight loss.

Intermittent fasting of 12 to 16 hours a day is an excellent practice for prostate cancer and overall longevity.

Lastly, ketones from fasting would be contraindicated in cancer patients with rapid weight loss (cachexia) unless higher fat intake is consumed to avoid further weight loss. Additionally, ketone bodies have been shown to suppress protein catabolism during starvation – meaning that one can maintain muscle from breaking down while utilizing ketones for energy.

Adding medium-chain triglyceride (MCT) to KD in a study to five severely cachectic cancer patients for one week induced a significant weight gain of 2 kg and improved their performance status.

The bottom line is this: A low-carbohydrate, non-ketogenic diet is recommended for prostate cancer with few exceptions: one if the patient has a high BMI, or if prostate cancer is more advanced and shows on glucose dependant PET scan.

My Favorite Books on the Warburg Effect, Metabolic Approach, Ketogenic Diet on Cancer

Three Recent Blog Post

The Real Cause of Prostatitis and How to Treat it Naturally

Prostate Cancer: Late night eating increases the risk.

How to Prevent a Heart Attack: Part one

 

CaPLESS EVENTS

The CaPLESS Retreat is coming in September to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. Prostate cancer is an opportunity to live healthier than before your diagnosis. Learn how. There is limited space.

Prostate Cancer: Late Night Eating Increases the Risk

I spend much of my clinical time talking to patients about nutrition and helping them choose what to eat.

As always, I challenge my knowledge to do better for my patients and my family.

As of late, the conversation on eating has shifted a bit not only on the what to eat but also on when to eat.

Here’s the deal; it turns out the earlier your meals, the less likely you will get prostate cancer or breast cancer based on this new study.

Study Details:

  1. Case-controlled based study conducted in 12 Spanish regions in 2008–2013
  2. 1,738 breast and 1,112 prostate incident cancer cases
  3. People working night-shift (which increases prostate and breast cancer risk) were excluded from the study to control for the possibility of night shift work being the cause of cancer and not nighttime eating

CONCLUSION: Those who ate their last meal of the day before 9 p.m. was found to have a 20 percent lower risk of breast and prostate cancers than compared to those who ate after 10 p.m. or went to bed right after dinner, those

Dr. Geo’s take on Late Night Eating for Cancer

This is not the first study suggesting against late night eating for disease prevention.

In a group of over four hundred overweight participants, late eaters had a more difficult time losing weight compared to early eaters despite having similar age, appetite, hormones values, food intake, sleep duration, etc.

Another study observed that those who ate late at night had 55% higher risk of heart disease compared to the early eater.

Interestingly, in Traditional Chinese Medicine (TCM), which I trained in as well, digestion is a yang activity, and nighttime is yin – doing a yang activity doing yin time contributes to disease in TCM.

The ill effects of eating late are not necessarily what I want to hear as nighttime eating can feel soooo gooood.

Here are some holistic but realistic tips:

  • Know that doing the right things, i.e., exercising, last meal early, taking good supplements it’s not supposed to be always fun, but its essential to do if the goal is to live longer and function optimally. Some pain, psychological or physical is OK.

 

  • Life happens. Sometimes is a toss-up between coming home late from work and not eating or having a meal with your family even though it’s 10 pm. I would opt with eating with my family, eat light and not eat again for 12 to 16 hours later (intermittent fasting). Implement this same advice with late-night dinner meetings and holidays.

 

  • Eat less protein at night and more carbs. Yeah, I know this is tough to do at a steakhouse and anti-paleo but here’s the story; protein gives you energy, carbs have a calming effect by secreting more serotonin, a precursor to the sleep hormone melatonin. Now, if you eat too many carbs, especially processed carbs (i.e. bread, pasta, etc.) you will have a carb hangover the next morning – that awful, dragging feeling as if you downed ten shots of tequila. Eat small portions of whole carbs like sweet potato, rice, etc.

 

  • Get to bed early. The longer you’re up, the more you will want to eat.

 

  • Take the dietary supplement, 5-hydroxytryptophan (5-HTP) if you crave food at night. Tryptophan is an amino acid precursor to serotonin, and it has been my experience it reduces cravings at night. There might be some sleep benefit there as well.

You only get one shot at living your best life. You don’t always have to like doing the right things – do them anyway. Don’t eat after 8 pm, most days of the week. Change is good. Purposeful, smart pain is good too. Enjoy the benefits. Trust the process. Also, often what is good for prostate (and breast cancer) prevention is also good after the diagnosis of these diseases as well.

Three Recent Blog Post

How to Prevent a Heart Attack: Part one

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It’s time to Exercise. No Excuses.

 

CaPLESS EVENTS

The CaPLESS Retreat is coming in September to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. I to connect with you there. There is limited space.

Prostate Cancer: The Truth On Dietary Supplements During Radiation Therapy

[image from Science Life, University of Chicago Medicine]

 

One of the challenges I have when working with a patient undergoing radiation for prostate cancer is whether or not to have them take dietary supplements.

You see, radiation works by producing oxidative stress (free radicals) in an effort to kill cancerous cells. So, in theory, if you take, say, 500mg of vitamin C, an antioxidant, that would protect the cancerous cells from radiation treatment.

The premise that antioxidants from dietary supplements protect cancerous cells from radiation therapy is a lousy theory.

Allow me to explain…

How Radiation Treatment Works for Prostate Cancer

The ultimate goal from radiation treatment (RT) either by external beam RT or brachytherapy (seeds) for prostate cancer (CaP) is to cause irreparable damage to the DNA of the cell and thereby to cause cell death.

DNA damage is caused both by the direct and indirect effect of RT. About two-thirds is an indirect effect produced from the ionizing radiation creating active oxygen radicals (free radicals) such as hydroxyl radicals that may increase oxidative stress, not only to cancer cells but the whole body of the patient.

The oxidative stress is the primary cause for most side effects that include secondary cancers, urinary and fecal problems experienced by prostate cancer patients during and after radiotherapy.

If prohibition of using antioxidant from dietary supplements during  RT  by radiation oncologist a theory, then we can also theorize that antioxidants help protect healthy, non-cancer cells from the damage of  RT. No?

Patients are going to use dietary supplements during and after RT for cancer in hopes to improve their outcome. About 81% of RT cancer patients do so without ever telling their physician.

Can Antioxidants Help or Hurt During  Radiation Therapy

On this paper  Dr.Kenneth Conklin, MD, Ph.D. from the University of California, Los Angeles (UCLA) Medical Center, questions the theoretical basis for the argument against concurrent anti-oxidant usage.

Dr. Conklin acknowledges that radiation does indeed kill cells by generating high levels of free radicals, but this does not necessarily preclude the use of antioxidants as adjuvant dietary supplements during treatment. Conklin points out that radiotherapy is most useful in well-oxygenated tissues.

Antioxidants, as a class, improve blood flow and therefore promote the normal oxygenation of tissues, thereby rendering tumors more—not less—susceptible to radiation.

Numerous studies have shown that vitamin E and selenium protect against radiation-induced cancers.

A precise combination of antioxidants can help decrease damage expected from radiotherapy, including the formation of other cancer, especially in high-dose radiation since RT reduces tissue antioxidants.

In laboratory animals, for example, radiation exposure has demonstrated to reduce cellular vitamin E levels.

In other studies, radiation has shown to reduce bone marrow vitamin C and E levels, and in clinical studies in breast cancer patients, vitamin A, C, and E and selenium levels were found to be reduced during cancer radiotherapy.

Dr. Charles Simone, a radiation oncologist, surveyed the peer-reviewed literature on the use of supplements and antioxidants administered with chemotherapy and radiation therapy from 1996 through 2003.

He identified 280 peer-reviewed articles on this topic, of which 50 were clinical trials involving a total of nearly 9000 patients. Dr.Simone concluded that these studies have “consistently shown that non-prescription antioxidants and other nutrients do not interfere with therapeutic modalities for cancer.”

In fact, according to Dr. Simone, antioxidants enhanced the effectiveness of standard therapeutic modalities while diminishing adverse effects and protecting healthy tissue.

In 15 of the studies reviewed by Dr. Simone and his group, close to 4000 patients who took nonprescription supplemental antioxidants not only did not fare worse from dietary supplement intake but improved survival.

Major Study on Antioxidants during Radiation Therapy for Cancer

There is one major study I suspect most physicians extrapolate from to conclude against antioxidant use during RT.

Bairati and colleagues set out to determine whether supplementation with antioxidants (alpha-tocopherol (vitamin E) and/or beta-carotene) significantly mitigated adverse effects of radiation in 540 patients undergoing treatment for head and neck cancer.

Superficially reading this paper you’d think antioxidants promote worse outcomes when taken during RT since patients receiving supplementation in addition to radiation had a higher rate of second primaries and local recurrences while receiving the vitamins.

A closer reading of the Bairati study, in fact, shows that by the completion of the study, eight years after the start of radiotherapy, there were fewer second primaries or recurrences in the supplementation group compared with those receiving a placebo (113 vs. 119 participants, respectively).

Also, there was a 62% reduction in severe adverse effects to the larynx and other anatomical sites in those who were randomized to receive both antioxidants.

These mitigating facts were generally downplayed or ignored in a storm of negative publicity that was generated around the Bairati trial, after publication on the Journal of Clinical Oncology.

A 2006 study further analyses of the group studied by Bairati showed that during the follow-up period (average 6.5 years), 179 deaths were recorded in both groups. All-cause mortality, not only cancer-related in the vitamin E group was increased by 38%.

These results, the authors said, concurred with their earlier reports suggesting that high-dose vitamin E could be harmful in head-and-neck cancer patients receiving conventional therapy.

That conclusion is no surprise.

Synthetic alpha-tocopherol vitamin E should not be consumed especially in higher quantities than 50 IU a day.

The term vitamin E describes a family of eight antioxidants (called isoforms)

4 – tocopherols (alpha-, beta-, gamma-, and delta-) and 4 tocotrienols (alpha-, beta-, gamma-, and delta-)

Alpha-tocopherol is the only form of vitamin E that was studied in the SELECT trial and the Bairati study.

In a study of over 10,000 men at the prestigious Johns Hopkins School of Public Health, men who had the highest blood levels of gamma-tocopherol were five times less likely to get prostate cancer (Helzlsouer et al. 2000).

In the SELECT trial, 400IU of synthetic vitamin E was given a group of patients, eventually causing worse prostate cancer.

I have written extensively about the SELECT study, here, here and at the Natural Medicine Journal.

Another Study conceded numerous pathways of most plant chemical antioxidants, far from being pure scavengers of free radicals also induce cancer cell death. A few of these pathways, however, may also lead to tumor cell survival. These authors concluded that although patients should avoid what they call “unnecessary supplementation” during and after radiotherapy, using antioxidants to improve the therapeutic index of radiation is a reasonable and commendable goal.

Studies on Dietary Supplements for Prostate Cancer during Radiation Therapy

Until date, there is one randomized trial looking at the effects of antioxidants supplementation during RT specifically for CaP.

In a group of nearly 140 patients, using green tea extract (500– 750mg BID, standardized to 80% catechins), melatonin (20 mg daily at bedtime), vitamin C (500–1000 mg TID), and vitamin E (200–400IU BID) no adverse events were observed after two years from the supplement group vs. the non-supplement group.

Curcumin during radiation for prostate cancer

There are protective effects of curcumin during radiation therapy. In one study supplementation in one study, the curcumin group experienced much milder urinary symptoms compared with the placebo group. No bowel symptoms or sexual function difference was noticed.

In addition to likely protecting against unwanted urinary symptoms, curcumin use can probably have a radiosensitive effect on cancer cells making them more vulnerable during treatment.

For the scientifically minded reader;  curcumin increases radiation sensitivity was possibly associated with the inhibition of radiation-induced elevation of growth factors, cytokines, cyclins, NF-κB, PKC, TNF-α, and inhibition of cell cycle at the G2 + M phase, increased apoptosis, and some other unknown mechanisms

There is a possibility that curcumin can protect normal tissues against deleterious effects of ionizing radiation as an antioxidant while enhancing the sensitivity of cancer cells to the radiation by mechanisms mentioned above.

A randomized study showed that showed that curcumin improves the antioxidant status of patients with prostate cancer without compromising the therapeutic efficacy of radiotherapy.

The researchers also observed a  significant inverse relationship between the antioxidant levels and urinary symptoms in patients after RT. In other words, curcumin seems to have protected the healthy cells of the urinary system where less urinary problems were noticed after RT.

Dr. Geos Take on the Use of Dietary Supplements During and After Radiation Therapy for Prostate Cancer

Almost every day of my life I am asked questions regarding supplements during RT.

Radiation oncologist vehemently discourage patients from taking antioxidants during radiation treatment in an effort to provide maximal therapeutic benefit with little interference with the treatment. Still, a majority of patients undergoing RT will take one supplement or another while fighting against their disease.

The problem is I’m not sure the patient benefits much from eliminating the careful use of antioxidants during radiation therapy. In fact, the proper combination of antioxidants can protect healthy cells from becoming damaged or malignant and likely enhance, not interfere, with more cancer cell death in conjunction than RT alone.

When counseling prostate cancer patients undergoing RT on supplements my primary goal is to cause less confusion to the patient and their family while providing a sustainable health plan.

Cancer treatment is a frustrating maze and the last thing I want is to induce more angst to the patient by recommending a dietary supplement regimen when the radiation oncologist makes strong recommendations against it.

Such confusion only causes more frustration for the patient and his family.

However, a one hundred million dollar randomized study proving or disproving the effects of antioxidants during RT for prostate cancer will never happen.

I’m confident with the available data and having tracked patients who courageously have gone against physician advice showing that proper combination of antioxidant use does not block the effect of RT but enhances it and likely protect healthy cells from damage.

Detailed Recommendations on AntiOxidant During and After Radiation Therapy for Prostate Cancer.

  • Report to all your doctor’s supplements you are taking.
  • Seek the help of a nutritionally oriented healthcare expert who works with an oncologist.
  • Naturopathic and functional medicine doctors are well-trained in nutrition and non-conventional approaches, but not all are versed in oncology. An organization of doctors who are experts in oncological nutrition is OncANP.
  • Synthetic alpha-tocopherol vitamin E should NOT EVER be used for cancer regardless of treatment for cancer.  There is no reason to use anything other than mixed tocopherol.
  • Vitamins with antioxidant capacity should be used in combination with others. For example, vitamin C, vitamin E, zinc, and alpha lipoic acid work synergistically and prevents too much pro-oxidation.
  • If your radiation oncologist digs her heels into the ground and not allow you take dietary supplements, and you are not working with a nutritionally oriented doctor, take curcumin, about 1000mg to 3000mg a day with food.
  • Print this blog post or forward it to your physician. Maybe they will be open in allowing you to consume the right combination of dietary supplements after reading

 

Good Luck!

 

 

7 Easy, No BS Ways to Staying Healthy on the 4th of July.

[image above from successfully fit]

 

Stay focused on what’s important on this 4th of July; a celebration of your patriotism to the United States ( if you live in the US) and a time to spend with friends and family.

With that in mind, here are the;

7 Realistic, no BS Tips to Staying Well on the 4th of July

1. Take easy on eating grilled animal products, like burgers and chicken. Look, I like these foods too, I am not going to lie. But you have to admit; often there’s nothing special about these foods. Usually, its just a bunch of unseasoned burgers, chicken, and hot dogs doused in ketchup or mustard. Let’s be real; there’s nothing special about that. Plus, the charring on animal products when grilling is a pro-carcinogen.
Tips: Grill portabella mushrooms. They are meaty in texture and taste delicious when seasoned correctly.

HERE’s a good recipe for making portabello mushrooms..

2. Go easy on the booze. I know the 4th of July is a festive moment but over drinking is not worth it. The World Cancer Research Fund makes alcohol as a pro-carcinogen.

I am not saying you need to be a monk at the holiday party. Just be mindful of your alcohol intake and don’t overdo it. Besides, you will start acting silly and embarrassing yourself. ( I see you :))

3. Don’t forget to exercise. I know, I know, its the holidays and you should take it easy and have fun. Guess what; the disease process doesn’t take holidays. You shouldn’t either. Go for a 30-minute workout, especially if you are going to consume less than optimal foods.

The bottom line is that exercising should be part of the holiday fun. If it’s not, do it anyway. It’s good for you, and we sometimes have to do things we don’t like.

4. Drink 8 to 10 glasses of water. It’s hot out there, and you can quickly dehydrate. If you are craving a beer or soda, drink a full glass of water first. Then have the beer if you wish. (Reread # 2) You know if you are drinking enough water if your urine is clear. The darker yellow the urine, the more dehydrated you are. Keep your urine clear.

5. Eat something nourishing before the party. Do not, I repeat, DO NOT wait for the party to eat. That is a recipe for disaster. Don’t go hungry at the party. Make a nice protein smoothie or something and eat before the event. If you go hungry, all bets are off, and you will go crazy with eating nasty burgers with ketchup.

6. Take your dietary supplements. Pills don’t replace good eating and exercise, I get it, but it does counter some of our nutritional deviations. Be disciplined, and down those protective pills.

7. Enjoy the company. Have a good time with people you love is what life is all about. It’s less about the food and drink (although that is a component of it) and more about connecting with amazing people in your life.

 

Three Recent Blog Posts

It’s time to Exercise. No Excuses.

Testosterone and Prostate Cancer; New Study.

Prostate Cancer: How and Why Brocolli helps.

 

CaPLESS EVENTS

The CaPLESS Eats event was a huge success I think. Thank you to all who came. There will be more. As always, we want to help prostate cancer (CaP) thrivers to live their best life by implementing science-based lifestyle practices.

It’s time to Exercise – No More Excuses.

[Image of me training at 4:36 AM. It’s not what I like doing, but what I have to do.]

 

I’ve noticed people making all sorts of excuses not to exercise.

And it’s not because there is no evidence that exercise helps us live longer and better.

The scientific literature is packed with proof that exercise helps prevent and manage depression, cardiovascular disease, cancer and promote longevity.

Despite the plethora of evidence, less than 25% of people exercise.

That’s insane.

Why is that?

After observing the behaviors of thousands of people at my clinic and in my personal life during the last fifteen years or so, I think I have some answers.

Top 5 Reason’s Men Don’t Exercise and What to Do About it

 

  • When “this happens” then I will exercise. I know someone who has purchased every exercise gadget imaginable to exercise at his home. All the fitness books are appropriately lined up on his bookshelf, pull-up bar ready to go, push up bar – everything he needs. He says, “once I get all the equipment and books I need, then I’ll get started.” It’s been three years and he still hasn’t gotten started. There’s no perfect scenario to get going. The time is now. All you need to do is go.

 

  • Fear of looking weak. Men hate vulnerable situations. The discomfort of going to a gym and pushing weight next to a muscle head lifting 400 pounds can be paralyzing. Same with not having the developed stamina to go for a run and deal with the unconformability of gassing out. Fight your vulnerabilities.

             In fact, I’d argue that your best life will only occur with you facing your discomforts instead of shying away from them.

Of course, I’m not saying to jump out of a plane without a parachute. That wouldn’t be smart and extremely painful (or deadly). I am saying the more you challenge yourself and get out of your comfort the better you will live. Resist comparing yourself to others and focus on achieving your personal best.

I consider myself a physically strong guy – I can deadlift 350 pounds, bench press 250 pounds, etc. And still, when I go train at a gym, I’m often one of the weakest there. That’s OK. I am happy with my mental and physical gains.

  • I’m not the physical type. I have noticed that some people are more cerebral than physical. These are your philosophers, computer geeks, scientists, etc. People in this category were likely a bit nerdy in school. They didn’t play many sports growing up and probably felt awkward doing so. One personality type does not have to exclude the other. While some people are apparently more physical and athletic than others, we all need to be both. Find a particular physical activity you enjoy and do it frequently.

 

  • I’m too busy. This is probably the number one excuse. And the biggest BS one of them all. The reality is we all have time for what we value. Once exercising is considered important in one’s life, then doing it is planned for until it becomes a habit. Schedule it in your calendar as if it’s a meeting with the most important person in for your business. Make it so that your life depends on it. Because it does.

 

  • Avoiding physical pain. Some people are trying to prevent pain from soreness, gasping for air on a run or joint pain that sometimes come after working out. Others don’t exercise for fear of getting hurt. Here’s the deal; you can’t live your life in fear. Of course, you can hurt when trying new physical activities. Injuries often occur when one is simply walking down the street too.  However, you can perfect the technique of a particular exercise, don’t do too much too soon and reduce the risk of injury. Also, you are going to experience pain regardless if you opt out of exercising. In fact, the more sedentary you are, the more pain you’ll experience. So, might as well do something that will keep you optimally functional and help you live longer. Make sense?

Lastly, let me say this;

There is no perfect way you should feel before you get going. Frankly, there are many days I’m not up for training. Do it anyway. You don’t always have to be in the best mood to get a workout in. If you are tired from work, life, etc,  go for 10 – 15 minutes and get it in. If the feeling of exhaustion is overbearing, then that’s the only time you rest and not exercise. Know the difference between being tired vs. being exhausted.

If you are starting from zero, the most crucial element of exercising is frequency. In other words, focus less on intensity and duration and more on going out and exercising consistently. Don’t stop.  Just go for a 10-minute brisk walk every day. Or to your gym, you pay or it anyway. Make it a habit of moving your body consistently.

Yes, if you are beyond starting point zero, there’s a prescribed dose on intensity and duration that is important. But even the best exercise regimen only works when you are consistently doing it. The prescriptive dose for exercising is for a different blog post on a different day.

Just do it. – Nike (Best three-word slogan ever)