Can vegan diet and HIIT workouts move the needle?

What percent of the core was Gleason 4? If that percentage is low than AS is the way I would go. If it was 40% type 4 vs. 40% of the core being cancer than I would be investigating focal therapy.

You have already done the best for your health by losing 20 pounds. There is no proof that a vegan diet or HIIT will stop progression of prostate cancer. However, HIIT is great for your heart health and that still kills 10x as many men as prostate cancer so that is a reason to keep that going. Now if in the years from 15 to 65 you had followed a vegan diet there is evidence of lower incidents of cancer. Not so much on quick fixes. I believe that I am stuck with the effect of those 99c Big Macs (it has been a while) I ate years ago. However, you have to do you. If you believe that going on a Kale and Brussel Sprouts diet helps, go for it. There are many on this board who believe that will give them control of their cancer. Prostate cancer has a 10-year survival rate exceeding 98% while many cancers have a 5-year mortality rate of about 80%. So do not get spooked by the word cancer.

@jim18 Thanks for your response! I have no other info from the biopsy report than what I wrote. 40% of the core was cancerous and I am pretty sure that means in the 40% a higher number of cells were Gleason 3 and less were Gleason 4. I hope that makes sense and I am reading it correctly. That would put it less than 20% Gleason 4. So active surveillance in your opinion is the way to go? I would like that for sure.
On the diet side, I was afraid that might be the case. The horse has left the barn. But i'll stick it out and see what the next PSA brings. Yes, I was also guilty of eating a less than stellar diet for many years and it might be a little too late to change that now` but i'm trying!

Exercise and the right diet can make a big difference. Chicken, Turkey and fish are not really a problem, It’s the red meat.

Here is something else that’s surprisingly useful

Running and prostate cancer
https://pmc.ncbi.nlm.nih.gov/articles/PMC12535562/
https://bioengineer.org/exercise-conditioned-serum-inhibits-prostate-cancer-growth/
You need to make sure your Exercising includes weight training.

As for whether active surveillance would make sense check out this video

Excellent Fred Hutch doctor video: Dr. Claire de la Calle

Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288

@sulatnasteve

You are doing great and you have the right attitude. 👍

No diet can completely cure the cancer BUT being fit and healthy and strong makes a MAJOR difference in how patients respond to PC treatments, how fast they recover after RT or surgery and exercise and diet lower ADT side effects if you ever need that in the future.

Your new lifestyle might slow progression of the cancer too and at least you know that you tried your best - that is how I look at all of it. There are many studies that show benefits of vegan diet in general, but not everybody is able to follow it. If you ever feel that it is unsustainable, some fish and chicken would be suitable addition. Try to avoid milk and egg products, some studies found them undesirable elements in PC diet, but there are many substitutes, as you know already.

Regarding your biopsy results, you just have to keep in mind that biopsy examines just 1% of the whole gland and that only prostatectomy can show the real picture. Studies showed that biopsy is correct in about 50% of the time, sometimes it shows gleason lower or higher than it actually is. Now, since you will have regular biopsies done in the future (every 1-2 years) , you might be safe in continuing AS. Just make sure to NEVER skip MRI and biopsy during AS.

Regarding your previous diet, in person of your age the biggest factor is -age. About 70% of man age 70 and above have some cancer cells in their prostate (post mortem examinations) so do not dwell on that - you are now going forward and doing all the right things to put yourself into best possible position to fight this beast and conquer it !

Wishing you all the best and may your gleason never change 🍀

@sulatnasteve You need to ask your doctors for more information on your biopsy. 40% of core means that if it was a 10mm then 4mm was cancerous. A 3+4 means over 50% was 3 but they usually give the percent of 4. A percentage of 45% type 4 is much worse than 5% type 4. Also want to know if there was large Cribriform or other condition noted in the biopsy. Both play into the AS vs. focal now (Nanoknife, Tulsa Pro, laser are most common; there is also an Aquablation trial active) if a good candidate. All of these can be followed by either surgery or radiation if there is a recurrence a few years down the line. You can get a second opinion on your biopsy if required.

Don't make the same mistake I made. When first diagnosed with Pca I went into stress mode trying to figure what the right things to do were. Like many here, I read everything I could find on the topic and of course found that a mostly vegetarian diet and exercise has some documented validity for slowing progression. I quickly transitioned to the vegetarian mindset eating beans, nuts, fruits, whole grains, and vegetables of all sorts, lots of tomatoes. Long story short, it was terrible! Felt constantly hungry. The weight flew off me. Within just a few months I had lost 30 lbs. From 180 down to 150. Too much for me. I'm 6'-1" and not only did everyone say I looked terrible, I felt like crap. I just could not continue this regimen. Anyhow, I started adding back in lean animal protien from fish, turkey, and chicken. I've managed to gain 20 lbs. back now at 170 lbs. feel much better. I believe the reduction in stress as I've become more comfortable with my journey has also helped. Oh yeah, I gave up a case of beer a week habit too. I now drink some zero alcohol beers occasionally. Not the same, but fills the void. As far as high intensity workouts, that's great if you can keep it up. At my age I choose a brisk 3 mile walk daily and some calisthenics. I'm convinced these measures are beneficial not only for Pca but for other maladies as we age.

As far as direct cancer control goes, it's highly speculative.

However, a healthy diet and regular exercise will definitely help counteract the metabolic side-effects of cancer treatment. When the metabolic side effects are more mild, your immune system is stronger and you can continue aggressive treatment for longer, so they can definitely help indirectly.

Note that it doesn't have to be vegan per se, just a healthy, well-balanced diet low in processed foods; likewise, staying active at all is more important than whether it's high intensity.

tl;dr: Eat well, move often 🙂

@jim18 You make a very valid point Jim. It seems that we are all focused on a ‘do nothing’ AS approach (which is not really doing nothing) or a cut, slash and burn method of treatment.
Focal therapy in this case makes so much sense: there’s definitely PCa but not a lot of it…so why wait?
TulsaPro stands out for me because they really seem to know when a patient’s particular cancer is treatable by their method - or not.
And as you point out, if necessary more conventional means - surgery/RT - can be used down the road. Great point,
Phil

@jeffmarc Wow! Thats an amazingly informative video! I am watching it again this morning. Thanks so much for your response and ill check out the running link as well. Sure appreciate it!

@surftohealth88 Thank you for your response. I sure don't look forward to a biopsy every one to two years but I do understand why thats so important. If this diet can have an effect on my Gleason score, it will be worth it. I'll get my 6 month check in September and see what happens. Appreciate your advice!