Nutrition & more for living well with metastatic prostate cancer?

Diet is very important in controlling your disease. You should stop eating red meat right away. Going vegetarian or vegan would give you the best chance of keeping your cancer from spreading. Eating chicken or fish is acceptable, but not quite as good. As an example, they have a super broccoli soup in Australia, that you only have to drink once a week, but it prevents DNA changes which stops cancer from growing.

You don’t mention your Gleason score. That really is critical in knowing how aggressive your cancer is

You should discuss with a radiation oncologist, having your metastasis zapped with SBRT radiation. if you have too many, they may not want to do it, but it can stop them from growing

I can’t imagine your insurance company would not allow you to take Zytiga. The generic version is quite inexpensive and it is really the first line of defense with all the metastasis you have, it can stop them from growing and give you time.

Holistic approaches like vitamins and acupuncture can help with issues with your treatment, but will not have an effect on your cancer growth. If you take Zytiga you also take prednisone and should start taking calcium and vitamin D, something your doctor will tell you about.

You are an advanced case with all the metastasis. I’m not sure where you were getting your care but you should make sure you have a Genito Urinary oncologist handling your case. They specialize in prostate cancer and when you have a lot of metastasis, you want that kind of specialist.

Thank you so much for this information! My PSA is 36. Gleason score was 9, and aggressive that is why the urologist removed the prostate but unfortunately it has spread. I am seeing an oncologist and there are too many areas to radiate.
Why is the Gleason score relevant at this point? Thanks

(Layperson here.)

Scientifically, no. There's no reproducible evidence that any diet or supplement affects the spread of prostate cancer. You'll find very-confident personal anecdotes here in the forum, and you can take them for what they're worth — a diet with X or without Y might have made a person feel better purely by power of suggestion, or because it helped with something different (irritable bowel, reflux, lactose intolerance, diabetes, etc) that the person wasn't aware of.

That said, a normal healthy diet is always a good idea, with or without cancer — just follow your grandma's rule of covering at least 50% of your plate with vegetables, 25% with a starch (potato, rice, etc) and 25% with a higher-protein source (meat, tempeh, beans, etc). Cancer's complicated; eating doesn't have to be.

Also, it's worth considering adjusting your portions so that you're eating just until you're no longer hungry instead of eating until you're stuffed; you might find you have more energy that way (obviously, this doesn't apply if you're getting chemo or experiencing another medical condition that makes it hard to eat and you're at risk of undernourishment; in that case, don't slap portion limits on yourself).

If you get radiation or surgery to your prostate, you might experience urinary-tract irritation or incontinence. In that case, you might want to reduce potential urinary-tract irritants for a while, like caffeine, alcohol, carbonated beverages, and spicy food, just until the irritation stops. I had to cut down to one cup of tea/day for a while in summer 2023 due to radiation cystitis (bladder damage), which was rough, but I no longer need to limit it.

A score of nine is very aggressive and tells you that you really need to do as much as you can to stop your cancer from growing and spreading. You need to treat your cancer aggressively in order to live a long life. Some people with Gleason nine die within a short time others live for a decade or more.

Lots of oncologist are medical oncologist, and do not specialize in prostate cancer. That’s why I mention you should speak to a genito urinary oncologist to get the best future treatments.

I know people that have had as many as 15 metastasis zapped Not all at once they do a few at a time. Some oncologist and radiation oncologist will do that.

At this point, you should be getting PSA tests every month to see what’s going on. Orgovyx can bring it down to below one quickly but you need a second drug like Zytiga to control it longer term. The Taxotere chemotherapy is part of triplet therapy,, but that also requires Zytiga to be triplet, The fact that you found out your PSA was 36 and it had not been managed before that is a problem. After surgery, you should’ve had PSA tests every month so that rising PSA was caught quickly, before the metastasis propagated and it hit 36.

Knowing that your Gleason score was nine should’ve Informed your medical team that the PSA test should be scheduled monthly after surgery.

Actually, diet has been discussed in multiple webinars about prostate cancer. Search YouTube for PCRI conferences, where they discuss it.

Stopping red meat and going vegetarian or vegan can control the speed at which your prostate cancer grows.

I’ve seen at least four webinars where they discussed this and how it affects prostate cancer directly

Those are webinars and a few isolated studies or lit reviews (which often contradict each-other and/or aren't reproducible), not a large body of scientific evidence. I'm not saying that they won't eventually have a large body of research to support something like that, but also, they might discover that people who eat lean red meat are actually slightly better off, because anemia is one of the common side-effects of ADT, and red meat is more effective than supplements for raising your blood iron. 🤷 (Note that I'm a vegetarian, so I have no personal stake in this.)

Right now, it's still a guessing game. Some doctors will have strong personal opinions either way, but the body of proper scientific evidence isn't there yet to resolve the question.

Note that there *is* a demonstrated correlation between eating excessive amounts of red meat and colon cancer, so reducing red meat consumption could be helpful if you don't want to deal with a second cancer battle. But I don't see general scientific consensus yet on a link between any dietary element and prostate cancer progression (again, writing as a layperson, as, I assume, you are too).

I’m disappointed that you are so negative about this. Red meat in particular as well as many deli style meats are well known to feed prostate cancer.

This is not guessing, there is research that has been done about this, I suspect you’ve never seen the webinars that discuss these issues.

After 13 years I switched over to almost a complete vegetarian diet. Three years with Zytiga and I was only undetectable one time (I get monthly PSA tests). I’ve now had nine months in a row undetectable. You could say it was not diet, but that was the major thing I changed.

@otisc, your asking great questions. I expanded the title of your discussion to reflect your questions. You may also be interested in this related discussion:
- - Cancer and working with integrative medicine https://connect.mayoclinic.org/discussion/a-possible-solution/

You want to live well with metastatic prostate cancer and ask what more you can do regarding nutrition, supplements and acupuncture. These approaches are sometimes referred to as "integrative oncology".

More and more cancer centers and oncology specialists are open to discussing and integrating complementary medicine in programs called Integrative Medicine or Integrative Oncology. Integrative medicince is offered at many cancer centers of excellence, including Mayo Clinic.

Here's a link to more information about Mayo Clinic's Integrative Medicine programs
– Integrative Medicine and Health https://www.mayoclinic.org/departments-centers/integrative-medicine-health/sections/overview/ovc-20464567

In this Mayo Clinic Q & A Podcast. Dr. D'Andre talks about how integrative oncology can be incorporated into conventional cancer care at Mayo Clinic.

Have you asked about integrative medicine at your cancer care center?

I d say you may need doxitaxel or Pluvicto in the future since it’s spread. Forget what your eating, it needs attention like now.

I'm glad it's working out for you (sincerely).

In my case, I haven't eaten red meat since 1997, and my prostate cancer still progressed so fast that it was at stage 4b before it was detected, and in the 5 days between admission to hospital and debulking surgery, the metastasised tumour on my spine grew to the point that I was paralysed from the ribs down.

That's the problem with anecdotal evidence: we all have different anecdotes to tell. 🙂