PROSTATE
CANCER PREVENTION
AND CONTROL GUIDE
(Updated July, 2018 for use by USMA Classes)
<http://www.west-point.org/class/usma1958-pc/pcprevgd/PCPreventionGuide.htm>
We
are all at significant risk for
cancer, more so as we age. Our cells are mutating all the time. It
comes with
the environment replete with a multitude of chemical and radiological
carcinogens. It only takes one cell to develop into cancer. The
significance to
those of us at our stage of life is that many of us in our 80's have
latent
prostate cancer (PCa), the causes of which are not yet fully
understood. But
there are at least three causative factors: lifestyle choices, genetic
propensity and exposure to carcinogens. Fortunately, we all come
equipped with
an amazing built-in immune system that helps keep latent (histological)
cancer
from becoming symptomatic (clinical) in any of its many forms. That is
unless
we fail to maintain that system properly or we allow it to become
overwhelmed
with more carcinogens than it is designed to handle. And fortunately,
while
there is still much to learn about PCa, we have enough information to
know that
there is a great deal we can do to decrease the chance that it will
ever become
symptomatic, despite popular beliefs to the contrary. We can choose to
apply
that knowledge to modify our diets and our behavior to help prevent it,
or if
need be, help reverse its course after the fact. Fortunately, the
positive
effects of doing so also help us to prevail over most other threats to
our
wellness, and they involve eating right, exercising, avoiding exposure
to
toxins, reducing chronic stress, and getting adequate sleep.
EAT RIGHT
Cancer experts estimate that up to 90% of cancers of the prostate have
a
dietary link. Between various clinical trials and studies of diets
among
diverse populations, a number of food substances have been shown to
inhibit PCa
cell growth and others to promote it. Men in Japan and China, for
example, have
up to 90 percent fewer incidences of prostate cancer than American men.
That is
until they migrate here and assume our lifestyle. The best evidence
points
squarely to a difference in nutrition as a major factor.
To maximize protection, get your carbohydrates by consuming a variety
of fresh
fruits and vegetables. Broaden your selections. Go for a mix of colors
to get a
wide range of different nutrients. Experiment with new choices and
preparations
till you find what appeals. Supplement your carbohydrate intake with
whole
grain cereals, breads, pastas and rice rather than refined products.
Stick to
the monounsaturated fats like olive and canola oil, and avoid the
saturated
fats and the partially hydrogenated oils and trans fats found in
margarines, deep
fat fried foods, many commercially prepared foods, poultry skin, red
meat and
the like. Avoid animal fat.
Polyunsaturated fats have positive health benefits, but we usually get
enough
of those in commercially prepared and restaurant foods. Go light on red
meat,
eggs and dairy products. These have shown to increase prostate cancer
risk.
Fulfill your body's need for protein through lentils, beans, fish,
poultry
white meat, small amounts of lean red meat if the urge persists, egg
white/substitute, cheeses that are fat free, skim or reduced fat, and
soy
products -- soy milk, tofu, tempeh and soy protein powder. Soy products
have
the advantage of containing genistein, shown to aid in fighting PCa.
Then wash
it all down with a glass of red wine a day. Add an 81 mg aspirin a day
on top
of that. And drink some green tea. But watch your weight. There is a
direct
link between obesity and PCa. And there are increasing indications that
high
levels of cholesterol (a building block of testosterone) may be
associated with
PCa risk.
There are some other food substances shown to fight PCa cell growth.
Lycopene,
found in cooked tomato products, tomato concentrates, watermelon,
apricots,
guavas and pink grapefruit, has recently been shown to have little
effect on
preventing localized, early stage PCa. But once the cancer has formed,
high
levels of lycopene (or of carotenoids in general, including lycopene)
may
reduce significantly the risk of the tumor progressing to an advanced
stage PCa.
And that tumor may have started developing well before you are
diagnosed, so
don't wait for a diagnosis.
Pomegranate juice, a strong antioxidant, has shown promise in lab
tests. But
like grapefruit juice, it may interfere with the body's metabolizing of
certain
prescription drugs. Lupeol, an antioxidant found in fruits including
strawberries, mangoes and figs, may kill existing cancer cells
(apoptosis) and
prevent new tumors from initiating or progressing. Broccoli, a
cruciferous
vegetable, has been shown to reduce PCa risk, including the more
aggressive
forms. Asparagus are an excellent source of the antioxidant
glutathione.
Garlic, onions and leeks have more than 30 different enemies of
carcinogens.
Turmeric or curcumin, the spice found in curry powder, holds real
potential for
the prevention and therapy of PCa, especially when combined with PEITC
(phenethylisothiocyanate), a naturally occurring substance particularly
abundant in watercress, cabbage, winter cress, broccoli, Brussels
sprouts,
kale, cauliflower, kohlrabi and turnips. IP-6 (inositol hexaphosphate),
found
in foods like beans, brown rice, whole-kernel corn, sesame seeds, wheat
bran,
cornbread, grape juice and raisins, inhibits the activity of free
radicals in
the body, which slows the type of abnormal cell division associated
with tumor
and cancer growth. It's also a big help for those undergoing chemo and
radiation therapy. Cranberries and their juice have a number of tumor
blocking
compounds. Whey protein in powder form or in yogurt is another PCa
fighting
nutrient. Even mushrooms have significant amounts of cancer fighting
antioxidants.
Vitamin B6, high in foods such as potatoes, bananas, chicken breast and
prune
juice, has been shown in a recent study to have strong protective
effect in men
with early stage PCa, significantly improving their survivability.
Omega-3 deserves a special mention. Omega-3 and 6 essential fatty
acids, which
your body can't produce, play key roles in the functioning of your
hormonal
systems, and should be in balance with each other. And they were, in
our
ancestors' diets prior to the Agricultural Revolution. Today we get way
too
much omega-6 in our diets particularly from commercial foods prepared
with oils
from corn, soy, sunflower and safflower, all excessively high in
omega-6. You
can increase your omega-3 consumption by eating fatty fish from the
coldest
deep seas— mackerel, anchovies, herring, salmon and sardines. Be leery
of farm
raised salmon as a source. Their feed is often high in omega-6 and
PCBs, with
food coloring later added. Enquire about the source. You may still need
to
supplement cold water fish with omega-3 fish oil capsules on the order
of 2-3
grams per day. Flax seeds are a good source, ground and kept
refrigerated. Add
them to salads, hot cereal or other foods or suspend them in thick
juices such
as tomato or V-8. The lignans found in ground flax seeds inhibit PCa
cell
growth and actually reverse it after the fact. But avoid flax seed oil
in
extract form. It might actually promote PCa cell growth. Walnuts are
another
good source of omega-3 and selenium.
Try to get all your vitamin and mineral needs directly from whole fresh
plant
based foods because they come with other elements in the foods that
enhance
their effectiveness. In the case of vitamin D, from moderate exposure
to sunlight
to allow your body to manufacture and store it.
Where
necessary, round out those needs with supplements. Between the two you
should
be getting on the order of 200 mg of vitamin C, 1,000 IU of vitamin D
or 2,000
IU or more if you are at high risk or have been diagnosed with PCa if
you don't
get much sun exposure, look for D3 choleciferol vs. D2 ergocalciferol),
400 IU
of natural vitamin E with mixed tocopherols (fat soluble, take with
meals),
25,000 IU of mixed carotenes, and 200 mcg (don't exceed 400 mcg) of
organic
yeast bound selenium (take with the E). Excessive selenium may increase
one's
risk for type 2 diabetes.
One caution though, if you are undergoing chemotherapy or radiotherapy
treatment, antioxidants such as vitamins C and E may reduce their
effectiveness.
There is a high correlation between vitamin D deficiency and incidences
of PCa.
Some 40% of men are technically deficient in vitamin D. If you are at
increased
risk for PCa or get very little exposure to sunlight, consider having
your blood
level checked for 1,25-dihydroxyvitamin D. It should be on the order of
30-50
ng/ml.
You need calcium for strong bones and a long-term hedge against
osteoporosis.
The RDA is 1,200 mg total. If you are at high risk for PCa, don't
exceed that.
If you have PCa, consider cutting back. If you are on hormone therapy,
which
tends to accelerate bone loss, consult with your oncologist for the
hard
choices. High calcium intakes, mainly from milk and other dairy
products, may
increase prostate cancer risk by increasing the insulin-like growth
factor-1(IGF-1). IGF-1 in the blood promotes growth and while the rise
in IGF-1
level is an important reason for the bone-building effects of cow's
milk, it
may also promote undesirable growth of cancers. The second thing that
happens,
and this is peculiar, is milk suppresses the actions of Vitamin D.
There is a
cancer-preventive effect of Vitamin D that milk interferes with. Go
light on
milk!
You also need iron. Women need even more. You normally get enough in
your diet.
Too much creates too many free radicals. So do not take an iron
supplement. The
RDA for zinc is 15 mg/day. You normally get enough without taking a
supplement.
Too much increases PCa risk. High doses (>100 mg) more than doubles
the risk
for advanced PCa. Taking glucosamine to relieve osteoarthritis symptoms
is
okay, but avoid chondroitin sulfate which may encourage cancer cell
growth.
With supplements, more is not better. Some have clear toxic levels not
to be
exceeded. Others are more obscure. Recent findings show that more than
one
multivitamin a day may promote advanced PCa, suggesting that some
oxidation is
important and too many antioxidants can be destructive. A recent study
has
shown that neither vitamin E Alpha nor Selenium effectively reduced
prostate
risk. Also bear in mind that it is difficult to know just how much of a
given
vitamin or mineral we are actually getting without measuring our food,
which
few of us do. To complicate matters, many prepared foods are fortified
with
vitamins and minerals. Be aware and don't overdo supplements.
Keep in mind that while some supplements in pure extract form may be
helpful in
rounding out an incomplete diet, they are generally not as effective as
their
source found in the original foods where their effects are enhanced by
acting
in conjunction with other nutrients contained in the fresh food. Go
fresh where
you can. And remember that supplements are unregulated with regard to
purity
and strength. So buy reputable brands from responsible sources.
AVOID TOXINS
On the flip side of dietary intake is the avoidance of toxins that put
unwanted
additional stress on your immune system and in some cases promote and
support
tumor growth. Avoid all manner of tobacco smoke. Check your drinking
water
against EPA standards and filter it as necessary. Thoroughly wash or
peel your
fruits and veggies, and remove pesticide laden outer leaves. Or better
still,
buy organic, especially in place of those products normally known to be
high in
pesticide content – apples, bell peppers, celery, cherries, imported
grapes,
nectarines, peaches, pears, potatoes, red raspberries, spinach, and
strawberries.
Organic, naturally raised, pasture fed meat, poultry and dairy
products, free
of antibiotics and growth hormones and containing omega-3 fatty acids
are also
available at your local health food stores and farmers' markets. They
may cost
more, but so does cancer, and what price do you put on your good
health?
Avoid food preservatives and artificial colorings found in many
off-the-shelf
food products. In fact, many commercially processed foods contain a
variety of
unhealthy ingredients and should generally be avoided in favor of
naturally
raised/grown foods prepared at home. Don't char your meat on the
barbecue.
Don't over-heat cooking oils to the point of smoking and breaking down
into the
bad fats. Wild-caught fatty freshwater fish such as carp, catfish,
bass, and
trout are prime candidates for contamination. Removing skin and bones
from all
fish should eliminate about half of most contaminants. To avoid
ingestion of
low levels of bisphenol A which can cause biochemical changes in
prostate tumor
cells that make treatment for prostate cancer less effective, don't
microwave
food in plastic containers or even "micro-wave able" plastic
ovenware.
EXERCISE REGULARLY
A good daily exercise regimen is essential to maintaining your immune
system
and fine-tuning your myriad of complex bodily functions. It should
include
aerobic, anaerobic, strength, and stretching/deep-breathing components.
If you
don't have the habit, now's the time to acquire it. Regular exercise is
one of
the most important things you can do for your health, and requires a
daily
investment. And specifically, there is a positive relationship between
exercise
and wellness from cancer.
A caveat: the following are suggested optimal routines. Do what you can
without
torturing yourself. Whatever you can do will be beneficial—the more,
the
better.
(1) Make exercising a priority. Put it in your daily schedule. Don't
make
excuses such as "I'm too tired." or "I don't have time
today." Ben Franklin had time for daily exercise; we do too. It helps
if
you have a variety of routines, so you don't get bored. Music helps. A
good
club with lots of good-looking women also helps.
(2) Warm up before exercising and stretch afterward. Stretching cold
muscles is
not the best way to do it.
(3) Lift weights. This is as important as cardiovascular exercise, and
is
actually easier. Use machines or free weights. Exercise all major
muscle
groups, each with one set of 8 -12 repetitions, with each repetition
taking six
seconds. If you can lift 13 or more times in a set, you need to add
weight in
your next session. In short, the last repetition should be to failure.
See
anaerobic exercise below, and notice that this is basically a one
minute
anaerobic interval - 10 reps x 6 seconds. Lifting weights to failure
sends all
sorts of good messages to your muscles: "This guy will kill us if we
don't
get stronger." Lift 2-3 days per week. Don't punish the same muscles
two
days in a row. They need rest.
(4) Do aerobic exercise every day, 20 minutes on weight lifting days
and 30-60
minutes on other days. Take your pulse. Aerobic means your muscles are
burning
oxygen, heart rate about 110-120 bpm at our age. Getting your pulse up
to
aerobic level should be easy. Running, biking, swimming, dancing, or
machines
such as treadmills, steppers, ellipticals, rowers and cycles are all
good. To
combat boredom when indoors, use music, TV or an MP3 player. Do not,
however,
just grind away at a steady sub-aerobic or aerobic pace for an hour or
so.
That's actually bad - unless you mix in anaerobics! See Wikipedia for a
good
discussion of anaerobic exercise. What's needed are intervals of
anaerobic
bursts of one minute each at 95% effort or 140 or so bpm depending on
your
condition. A good workout: 10 minute warm-up, then 5 minutes aerobic,
then 1
minute anaerobic, then 4 minutes easy recovery, then another 1 minute
anaerobic, and repeat for the duration of your workout. This does not
have to
be torture. It's actually easier than just grinding away—and much
better for
you.
(5) Play sports that make you go anaerobic. Even at age 70+ we can
still play
sports, if our joints are OK. Tennis, basketball, volleyball,
badminton, squash
and racquetball are good examples.
(6) Spend a few minutes after exercising to stretch and do deep
relaxing
breathing.
(7) Consider adding an activity like yoga, tai chi or Pilates, which
incorporate stretching, strengthening, and balance. If all this seems
impossible,
remember that lots of people do it, and enjoy it. Working out with
friends
helps.
If you want to look good, feel good, and stay in good health, regular
exercise
is the ticket. Get the habit. "Just Do It!" If that seems difficult,
just talk to anyone who has been afflicted with PCa. The experience
will make
you determined to do everything you can to avoid contracting it. And if
you do
get PCa, you'll be better equipped to survive if you're in good shape
and stay
that way.
If you have been ill or have otherwise gone a long time without regular
exercise, consider first getting a complete physical exam, including a
stress
ECG. And if your doctor (preferably a jock himself!) gives the green
light,
then force yourself to get back into it. Take it slowly, one step at
time. But
keep at it. Doing what is comfortable is better than doing nothing.
There are many folks today in their 80's and 90's who work out every
day. More
and more research shows that there is nothing as good for you as
physical
activity.
SLEEP WELL
Sleep is critical for maintaining an effective immune system. It's our
body's
natural mechanism for restoring its homeostatic balance and recovering
from the
impact of daily life on our physical and mental systems and feelings of
well-being.
Aging takes an added toll on our ability to get adequate, restorative
sleep.
BPH gets us up to urinate several times a night (nocturia). We don't
produce
brain chemicals in the same amounts, and the brain doesn't respond to
these
chemicals as effectively. We have more on our minds, we get stressed
out by
more complex issues, and we're more apt to be depressed.
Here are some helpful suggestions: If you have trouble falling asleep
after
about 30 minutes, get out of bed and do something else until you feel
tired. Go
to sleep and get up about the same time every day, varying not more
than an
hour on weekends. Put at least two hours between dinner and going to
bed,
especially if you are prone to heartburn or indigestion. Blue light
from screen
watching a couple of hours before bed time reduces melatonin production
that
can inhibit sleep. If you have nocturia, stop drinking liquids early in
the
evening. Avoid caffeinated drinks and alcohol three hours before bed
time. Be
cautious about using sleeping pills; older people are at higher risk of
side
effects. For example, for those with BPH, the use of diphenhydramine,
an
antihistamine (found in brand names like Nytol, Sominex, Sleepinal,
Compoz) as
a sleep aid can make it difficult to urinate. However, if BPH is not an
issue,
Benadryl, an antihistamine, is well tolerated, not habit-forming, has
no after
effects, and may aid in getting to sleep for most people. Being tired
from a
good workout may be helpful, but avoid busy or stressful activities
late in the
evening; rather unwind and relax. Get a short afternoon nap in, but not
beyond
3 p.m. If you have a sleep disorder such as sleep apnea, get it
treated. If
there are physical or emotional issues interfering with your developing
and
maintaining consistent, effective sleep patterns, learn how to overcome
them,
get them resolved, and seek professional help if need be.
Melatonin, the hormone which regulates the circadian rhythm to
determine when
we fall asleep, is often found to be at reduced levels in those with
PCa and heart
disease. It has also been shown to block PCa cell growth in lab
studies. If
your melatonin level is low for whatever reason, if you have frequent
jet lag
or poor vision, or if you typically operate on a reverse cycle,
consider
melatonin supplementation. Dosage levels have not been established, and
too
much may cause anxiety and irritability. So start with a very low dose,
follow
timing guidance, and check for interactions with other drugs. Or
alternatively,
meditation may cause melatonin levels to rise and can be a valuable
addition to
the treatment of PCa.
AVOID CHRONIC STRESS
Stress is good—up to a point. It keys our bodies to perform at higher
levels of
efficiency, be it the fundamental fight or flight response to danger or
responding to sudden pressures imposed by the work place or modern day
environmental factors, and it prepares us to meet a tough situation
with focus,
strength, stamina, and heightened alertness. Adrenaline and cortisol
are
released into the bloodstream to speed up heart rate, breathing rate,
blood
pressure, and metabolism. Blood vessels open wider to let more blood
flow to
large muscle groups, putting our muscles on alert. Pupils dilate to
improve
vision. The liver releases some of its stored glucose to increase the
body's
energy. And sweat is produced to cool the body. All of these physical
changes
prepare us to react physically in a quick and effective manner to
handle the
pressure of the moment.
In today's environment, however, our stressors and responses thereto
tend to be
more emotional than physical. And ongoing emotional stress and response
can
produce chronic stress symptoms, which is bad. The continued low level
release
of hormones over time without accompanying physical exertion adversely
affects
our immune system and tends to elevate our PSA levels. Yes, there is a
direct
correlation between PSA and stress levels.
If chronic stress is a major part of your life, make a concerted effort
to
eliminate or attenuate the stressors. Change your lifestyle where
appropriate.
Seek control, information, predictability and solutions. Where these
are
elusive, find outlets for relieving stress -- exercise, prayer,
meditation,
yoga, psychotherapy, guided imagery, sports, music, and the like.
Exercise has
the fastest and most dramatic effect on reducing stress. Find sources
of social
affiliation and support. As the Cadet Prayer encouraged us, "Grant us
new
ties of friendship… Kindle our hearts in fellowship with those of a
cheerful
countenance…" And the AA prayer pretty well sums it up -- "God, grant
me the serenity to accept the things I cannot change, courage to change
the
things I can, and wisdom to know the difference."
If need be, get professional help through the many hospitals, medical
schools
and freestanding clinics offering programs that help you learn various
techniques for stress management. One of these is therapeutic
biofeedback to
help develop the ability to monitor and control certain physiological
processes
through structured stress and anxiety reducing interventions. There are
interactive computer software programs that apply biofeedback
techniques
available for home computer use.
KNOW WHERE YOU STAND
By all means, get PSA and DRE tests once a year. Don't be content
with
being told that "Your PSAT score is normal." Get your current
and previous three year numbers and look for change or
"velocity". At our age an annual increase of 0.6 ng/ml or
more (0.4 for the <60s) is a definite red flag, even if you are
within the
so called normal range -- <4.0, or <3.0 with a family history of
PC. But don't panic. An elevated PSAT score could be caused
by a
benign infection that a few weeks of antibiotics may remedy. Or it
could be
elevated by having had an orgasm within 48 hours prior to the test or
by a
recent trauma to the prostate such as a catheter insertion. Or your
provider
may have switched labs having differently calibrated instruments or
different
interpretation standards. Be consistent. Be aware that to start
taking
statins to control cholesterol, or saw palmetto or various drugs to
control BPH
may produce a change from your previous baseline and affect
interpretation of
your numbers. Consult your urologist on that. Beyond the daily 81 mg.
of
aspirin, taking a dose of aspirin or other NSAID before a PSAT can
reduce the
score and affect interpretation. Diurnal variations may be avoided by
being
consistent in the time of day being tested. Seasonal variations too can
affect
the score by as much as a 0.5 ng/ml rise in the summer.
If it is determined that a biopsy is in order, then go for
it. Be
guided by one of Gen. Creighton W. Abrams' memorable aphorisms:
"I
have never known bad news to improve with age." If PCa is caught
in
its early stages, your treatment options and likelihood of an effective
cure
are greatly enhanced.
Conversely, at our advanced age, if you are pretty sure you are going
to die of
something else within the next five years, you may want to forego
testing, or
use the test results to signal the need for lifestyle change and forego
the
biopsy.
Some 10% of white males (20% of black males) have elevated PSA levels
due to
elevated levels of parathyroid hormone that regulates calcium in the
blood and
can produce prostate cell growth without prostate cancer. If your PSA
is
consistently high, that may be the reason, in which case a biopsy is
not
indicated. Remember, it's the change in PSA level, the velocity that
counts.
For those who have consistently elevated PSA levels and have had one or
more
standard transrectal prostate biopsies (TRPB) with negative results, if
yet
another biopsy is called for, ask for the newer stereotactic
transperineal
prostate biopsy (STPB) which has shown in a recent study to have a
greatly
enhanced level of confidence in detecting the presence or absence of
cancer,
and more specifically, the exact location of the cancer within the
prostate.
RISK FACTORS
Risk is a major consideration in testing for PCa and choosing to take
preventive measures, and there is a strong genetic component involved.
If you
have one or more family members who have been diagnosed with PCa or
ovarian or
breast cancer, you probably have a greater risk of contracting PCa as
well.
Being genetically predisposed does not mean you will get PCa yourself.
But it
does mean the triggers are more sensitive and you need to take greater
precautions in lifestyle choices and being tested for PCa. Early male
pattern
baldness in one's 20's is also an indicator of increased risk.
An age 40 baseline of 4 ng/ml or more suggests a potentially higher
risk
suggesting that PSA testing should continue into older age.
Being overweight is not a threat. However, obesity (a Body Mass Index
of 30 or
more) not only increases PCa risk, but it tends to distort PSAT score
readings
downward (lower PSA concentrations per volume of blood) and increase
the
possibility of advanced cancer. Again, look for year to year PSA change.
MIND-BODY CONNECTION
If you have been diagnosed with PCa, the above guidance becomes doubly
important to follow. But you also have yet another tool in your
arsenal to
apply to enhancing your immune system's performance--your mind.
We're not
sure how it works, but there is a definite link between your immune
system and
your mind. It's called the mind-body connection, and we are all
familiar
with one of its subsets, the "placebo effect." We often hear
the terms "miraculous cures" and "spontaneous
remissions." They are neither miraculous nor spontaneous.
Rather they are most often the result of a sick individual making major
life
style changes and becoming convinced in his mind that they will enable
him to
prevail. Those changes could be in the form of diet, exercise,
the
developing of supportive social relationships, the application of
religious
faith, the use of visualization techniques, or implicit faith in one's
doctors
and treatments, or a combination thereof. The net result is the
mind
triggering that mind-body connection, however it works, to boost the
immune
system. It may not always bring about a cure, but it will certainly
help the
process. And for the mind to best do its job, we need to keep it
sharp as
we age. That means exercising it with such activities as
crossword
puzzles, Sudoku, learning a foreign language or musical instrument,
problem
solving, memorizing a poem or passage and the like--anything that
challenges
your intellect. Reducing stress, expanding social relationships, proper
diet to
include antioxidants and omega-3, exercise, and the judicious use of
alcohol
(1-2 drinks max per day) have also shown to help keep the mind sharp as
we age.
MAKING CHANGES
"People only accept change when they are faced with necessity, and only
recognize necessity when a crisis is upon them." — Jean Monnet
Be the exception. Don't wait for the crisis. For most of us, acting on
the
advice given here requires a significant degree of behavioral
modification.
Change can be scary. It entails giving up that which is known and
comforting to
us for the unfamiliar and therefore seemingly difficult and/or
unpleasant.
Doing so effectively can only come from doing your homework,
understanding the
facts, assessing the risks and rewards normally associated with
alternative
behaviors and deciding that change is in one's overall best interest.
What is
the current likelihood of your contracting PCa? What are the probable
consequences if you do? What changes are you willing to make in order
to avoid
these? The problem is we don't really know the answer to that first
question
until it's too late, in which case this guide becomes doubly important
to
follow to enhance your chances of survival, when the question then
becomes what
changes are you willing to make to survive? Bear in mind that a
diagnosis of PC
is a wake-up call, a stark reminder that your ongoing lifestyle up to
that
point did not afford you the protection necessary to avoid contracting
the
cancer, given whatever circumstances may have led to the diagnosis.
It's high
time for some major changes. The First Rule of Holes—when you're in
one, stop
digging!
An excellent companion to this guide is Dr. Dean Ornish's book "The
Spectrum"
which provides the "why" and the "how' to the guide's
"what". To paraphrase Ornish, don't think of change in terms of
deprivation and sacrifice, but rather what we gain is so much more than
what we
give up. Be motivated by the joy of living, not the fear of dying. And
remember, it doesn't have to be all or nothing. Every little bit helps.
AND FINALLY…
We hope this guide will help to point you in the right direction for
achieving
and maintaining wellness and avoiding PCa or stopping it in its tracks
once
diagnosed. Volumes have been written and exhaustive studies have been
conducted
on the many subjects we have touched upon. There are still many
unknowns
surrounding the causes, prevention and treatment of PCa, and this guide
is a
consensus of what we as informed laymen consider to be the best
information
available at this time. As new and better information becomes
available, we
will do our best to disseminate it, and if you acquire information that
you
believe is relevant, please let us know. If you would like references
for
further understanding of the subjects discussed here, or if you have
suggestions for improving the utility of this document, contact the PC
list
moderator for assistance. The best thing you can do for yourself, your
family
and friends is to get informed and get involved.
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