Hello from a difficult patient in London

@handera I’m nervous now! I hope you enjoy it.

@paulsweeney

…through the first 8 chapters….excellent!

One of the most interesting parts (so far IMO) is how adamant your first physician, along with an 8 person multi-disciplinary team, were that you MUST get immediate treatment only to completely REVERSE their opinions and recommend continuing active surveillance, three years AFTER you had demonstrated no progression!

That certainly was a vindication of your process and must have been something of a “aha moment”…similar to how I felt when my urologist dismissed the fact that my original PIRADS 3, PIRADS 4 and PIRADS 5 lesions were ALL no longer visible in a 28 month follow up mpMRI…only to comment “….well mpMRI’s are notoriously inaccurate”.

Really appreciate how you footnote each cited statistic and medical conclusion with detailed reference to original journal published medical research papers.

BTW: Excellent writing skills and personal anecdotes…don’t know how many times I’ve exclaimed “Nailed it” or “Exactly!”

…and I’m only halfway through…

All the best!

Amazing feedback. Much appreciated.

Paul

I already downloaded it on my Kindle. I start 3 weeks Rehab post surgery on Tuesday so I plan to make it my evening read during my stay there.

@paulsweeney

….well….after finishing your book my one word response is WOW!!!

Succinct, thoughtful, balanced, honest, informative; with actionable recommendations, based on direct evidence and implemented experience.

Managing the uncertainties of AS in a manner that maximizes reward while minimizing risk…. yet recognizing and willing to adapt to definitive treatment if/when one’s personal medical evidence warrants, based on clear surveillance/risk tolerance protocols.

IMHO your action oriented, disruptive thinking approach is really the only logical way to rationally deal with a cancer diagnosis

Your book beautifully captures the latest evidence related to dealing with a prostate cancer diagnosis.

I’d say ALL PCa men, whether just diagnosed and considering AS or even those who have already undergone definitive treatment, would benefit from reading and implementing the concisely and convincingly enumerated, evidence driven protocols in your book.

I’ve read and watched hundreds of hours of great stuff from many physicians familiar with AS, but your book is the first I’ve seen from a man WITH Gleason 3+4 who deals with evidence according to a risk tolerance strategy that mirrors my own approach.

Thanks for putting in the massive amount of time and energy to assemble this book and your website.

You are going to make a difference in the minds of many who are in our shoes!

All the best!

@handera thank you so much. I’m so pleased you thought the book was helpful.

Thought I post some of my results...

I've been implementing an "ERASE RCT based" protocol for the last 2.5 years. Besides the mpMRI lesion disappearing act (already mentioned), my PSA velocity has been negative since diagnosis and implementation of my protocol.

As you say in your book its hard to determine EXACTLY what is most significant when implementing exercise/diet evidence based interventions, but I am seeing many overall beneficial side effects, especially regarding fitness, as measured by VO2 Max and reduced average heart rate during my HIIT and Zone 2 5K's runs (see attachments).

Regarding diet, I eat daily portions of a homegrown broccoli/kale/radish sprout blend, a large variety of fruits, vegetables & nuts and drink matcha ceremonial green tea, coffee, kombucha and 100% cranberry juice. All foods that I enjoy, thus they’re sustainable in my diet….I’ve dropped some “good stuff” simply because I don’t like the taste….

Once I achieved a BMI of 23 (lost 30lbs in 4 months & have maintained ever since), I reintroduced animal protein (primarily chicken and salmon and the occasional steak).

I also drink one glass of red wine every day, along with 5 small slices of cheese & whole wheat crackers...my cheat 🙂

The only supplements I take are 5000 IU of Vitamin D3 + K2, 2000mg of Antarctic Krill Oil and Pomi-T, which I started 2 months ago.

I can definitely testify to the value of your Tier 1 and some of your Tier 2 evidence backed items.

Thanks again for documenting all this evidence based information...I just wish it had been so readily available when I first started my PCa journey....now it is!

@handera great data. Thanks for sharing. I’m really keen to build a database of people following similar protocols so we gather more evidence.