This newsletter is for the express purpose of entertaining and educating of my immediate male relatives and friends. The information provided is believed to be accurate but it is always wise to check with you own doctor.

It’s true, prostate cancer.


How long have you known? Well, my brother called me about July 1 and insisted that I get my PSA (Prostate Specific Antigen) checked (his brother-in-law had just had a prostatectomy). 7/2 I went to Dr. Abraham Kryger (our wellness doc) and he took the blood sample. On 7/11 he called and said my PSA was 5.7 and that I should take myself to Dr. Shaheen a urologist. Because of our travels, I didn’t see Shaheen till 8/8. He interviewed and examined (DRE – Digital Rectal Exam) me and asked me to come back 8/16 for an ultrasound directed prostate biopsy. Once the results were back we connected for a conference on 8/23 where the news was good and bad: they found cancer cells in one sample (13% of total biopsy length) from the right lobe, but my Gleason score was only a 6 (more on these measures in a moment).

This appears to be an early stage cancer. Both my PSA and Gleason are relatively low. A look at the ultrasound image from the biopsy shows one dark anomaly about the size of a pea in the right lobe of the prostate. Dr. S stuck that spot and spots around it as well as the left lobe during the biopsy. Since only a small percentage of the biopsy material on the right side was cancerous it appears to be localized in the right lobe. A Gleason score is the sum of the grades of two samples (under the microscope) of the bad stuff. Grades 1 and 2 are quite slow growing, almost benign. Grades 4 and 5 are very aggressive. My samples were both graded 3 (thus the total of 6 for the Gleason) and “moderately differentiated,” meaning that my tumor cells are moderately different from normal cells. Prostate cancers of my type are, in general, slow growing and “very treatable.” This diagram would classify my PC as Stage T2a: the cancer can be felt on DRE but involves only one side of the prostate and is less than 1.5 cm (0.6 inches) in size.

I have embarked on a two pronged approach: information gathering and diet/medication treatment.

At the urging of Dr. S I attended two meetings of the local PC support group (total of about 500 guys). At the first meeting (about 40 in attendance) we heard from PC cancer survivor Will Connell who has written a book about PC, treatment options, and strategies for deciding what to do.

The second meeting (about 20 in attendance) was a subgroup of late stage PC patients. Dr. John Hausdorff, the oncologist that is working with many of the attendees, was there as well. Most of the meeting was devoted to the attendees (ages 55 to 88) relating their case histories and treatments. Fascinating stuff. Most are on some kind of hormone blockade. PC, while slow moving seems to be a persistent bugger. Most have had some sort of primary treatment (surgery or radiation) and while the PC appeared gone for a while (varying from months to 20 years) it eventually returned (as indicated by rising PSA scores). All were in good spirits and carrying on with most of their favorite activities.

Diet/medication wise I am following the advice of Dr. K. who prescribed a Progesterone cream that is applied scrotally each night. There is evidence that Progesterone will interrupt the Testosterone/DHT cycle which in turn will inhibit the PC growth. The Progesterone approach is equivalent in effect to the more standard hormone treatment in which Lupron is injected once a month to reduce the Tostesterone output, but without the side effects. Tosterterone encourages PC growth
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As a complement to the Progesterone cream, I have added Flax seed meal (an element of which has been shown to act as an anti-PC compound), grapeseed oil and vitamin E (high in antioxidants), soy milk, and zinc to my diet. The paper by the leader of the Santa Cruz PC group includes a rational for these and other inclusions.

Most people I have talked to and much of what I have read indicates that a diet low in fat also has a retarding effect.

I have one more doctor to see, Peter Carroll at UCSF. After that I will see both Shaheen and Glover one more time to complete my option/decision spreadsheet. Then it will be decision/action time.

Questions, comments, suggestions — send them along to me or give me a call – 831-372-8323! If you’d like to accompany me to a PC group meeting - they are the first Monday of each month from 5 - 7 PM here in Monterey.

Till the next issue, stay well! And if you are over 40 and related to me, get your PSA checked! Its a simple blood test, just a little stick – takes 5 minutes. Its important, cause their is good evidence that PC is at least partially inherited and now we know its in the genes

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