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Hello from a difficult patient in London

Prostate Cancer | Last Active: May 21 3:11pm | Replies (45)

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@paulsweeney

Dear, Paul

I read your amazing website with great interest.

I've already followed some of its recommendations. But I have a question for you. Have you stopped taking ADT and have been taking supplements all this time?

I have Gleason 9, a severe variant. Should I buy Pomi-T? Will it be effective?

I'm currently taking ADT and Erleada and am worried about resistance. Thank you, and God bless you!

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Replies to "@paulsweeney Dear, Paul I read your amazing website with great interest. I've already followed some of..."

@denis76 Thank you for the kind words, and I'm glad the site has been useful.

I want to be upfront with you — my situation is very different from yours. I have Gleason 3+4, which is intermediate risk. I've never been on ADT. Evidence.zone is primarily built for men on active surveillance with low-to-intermediate risk disease, and the studies I reference are mostly in that population.

Gleason 9 is a different disease with different treatment priorities, and I don't want to give you the impression that what works for someone like me is automatically relevant for you.

That said, to answer your specific question about Pomi-T — the original trial involved men with low-risk prostate cancer, not men on ADT. Professor Thomas's newer trial (YourPhyto + YourGutPlus, published in European Urology Oncology 2025) also studied men not taking ADT. So we don't have direct evidence for these supplements in your situation.

What I would say is that the general principles of eating well, exercising, managing stress, and supporting your overall health are important at every stage of the disease. Some of the dietary interventions on evidence.zone — lycopene from cooked tomatoes, omega-3, plant diversity, reducing dairy — are low-cost, low-risk, and unlikely to interfere with your treatment.

But please talk to your oncologist before adding any supplements, because some can interact with ADT or Erleada. Berberine and green tea extract in particular have CYP enzyme interactions that could affect drug metabolism.

I really hope things go well for you. Keep asking questions — that's the most important thing any of us can do.

Paul