Prostate Cancer: it’s Greek to me!

Horizontal axis: 0 refers to year 2000; the graph represents 15 years of my PSA
levels. At 5.24, biopsy was done which was negative.  Since then, there have
been two small peaks with the most recent decline over the past four
values spanning the most recent 13 months.

From 2000 to the present, I have had 27 PSA determinations spanning 15 years from age 53 to 68.  While I started this controversial laboratory-screening test with relatively low levels measured on an annual basis, the frequency of the testing has increased to more closely follow my rising PSA level to 6.34.  This prompted a biopsy that was thankfully negative and two seesaw fluctuations in PSA levels that currently is on the downswing.  My latest value of 3.61 just arriving on my doorstep as a welcomed gift from God - the lowest value in 5 years….following a sequence of three other declining values!

Indeed, if I had only stopped following my PSA level so closely, I could have possibly avoided all of the medical hoopla…..the biopsy, the MR scans, the PCA3 level, my pitiful interactions with my kind and wonderful local urologist, Charles Kim,  the disastrous consult at Mt Sinai (New York), the consult at Sloan Kettering (New York), the consult at UCSD (San Diego), and the sleepless nights agonizing over cancer, my health, my life and my death.

And it isn’t by any means that I believe that I’m now home free and don’t have to worry about prostate cancer (PC) in the future.  I’m not delusional (at least in this instance) and I realize full well that this current period of declining PSA (over the last 4 determinations) maybe part of the precancerous period of waning and waxing prostate tissue oncogenesis.  The aging process doesn’t help this a bit!

Indeed, I have read TOO many accounts of men experiencing these types of fluctuations over years and even decades with large swings in their PSA’s leading to more testing, multiple biopsies, MR scans, diagnoses of prostatitis, antibiotic courses, and eventually to the diagnosis of PC.  I can only imagine how much MORE suffering that these folks have experienced as compared to myself, although I’m quite an expert, maybe the world’s expert at paining myself with worry that is wildly out of proportion to the reality of the situation. 

But the reason for this essay is not for me, but rather for those at risk men who might read this writing for the POSSIBILITY that there might be some valuable insight and suggested course of action that is worthy of adapting.  Its really not that I believe that folks take to good advice…. assuming I’m giving any…..by following suit. I remember that I preached colonoscopies for a time to anyone that would listen when my gastroenterologist found a few adenomas in my colon that were threatening to grow out of control.  Few if any heeded my advice; the one person who I saved from cancer never even thanked me for pushing him to get the test done.  No, I have no delusions about giving advice, but I will do so anyway, just in case there are one or two folks out somewhere in cyberspace that are listening intently. 

Who knows whether PSA, or any other blood or urine tests are worthy of doing screening for PC.  So much controversy exits for such a test that lacks sensitivity and specificity.  But we do it anyway, having started testing; it’s hard to stop.  And there is probably some worth in following serial measurements of PSA looking for alarming or reassuring trends.

Reading about what can reduce your chances of PC it is clear that what is healthy for your heart and brain, and every other organ in your body is also healthy for your prostate gland.  Exercise, weight control, avoiding fat, red meat, not smoking, avoiding too much alcohol, etc is all good. 

But there are specific foods that are more likely to reduce your risk of PC by as much as 20%.  Broccoli, cauliflower, peanuts, tofu, green tea, tomatoes and tomato sauce, are high on the list.  And the more I read, the more convinced I am that dietary modifications are a worthwhile low risk maneuver that MIGHT reduce my chances of PC.  To be sure, I wanted to avoid the use of drugs, since at least some of them decrease the risk of PC but for those who finally succumb, the PC is more aggressive.

For the last two years, I have reduced my coffee intake to a trickle, substituting green tea for my morning coffee and trying to add one more cup in the afternoon.  Some of the research says that to get the maximum effect, you need four or five cups of green tea, but I have not reached this level of consumption as of yet.  The suggestion to drink some chilled green tea may add another opportunity to drink more during the day as a refreshing liquid filler.  To me, SUGAR should not be added to the green tea, otherwise, you are just adding to your risk of Type II diabetes, especially if you end up drinking more than a few cups.  There are many green teas that I cannot stomach, but there are several that I tolerate and even like.  The one I am currently using comes under the Tazo brand, which is flavored with a little spearmint to liven it up.

Tomatoes are the second food item I have chosen to exploit.  I probably eat on average three tomatoes a day, usually raw, during lunch, in conjunction with a little feta cheese and Mediterranean olives which constitutes my lunch.  Research suggests that its better to consume cooked tomatoes for they release their lycopenes more efficiently…… I do eat a considerable amount of tomato sauced Italian pastas when possible. But the daily routine of consuming at least three moderate size tomatoes for lunch each day also serves to reduce intake by avoiding high caloric fatty lunches. 

Parenthetically, the combination of tomato, feta cheese and olives reminds me that these are three components of most Greek salads.  The REAL Greek salad also included cucumber, but modern day renditions substitute lettuce.   The Greeks eat a lot of salads and so I wondered whether their incidence of PC was lower than in other European countries and or the US. My suspicion was confirmed at least in one handy study that showed a lower autopsy prevalence of PC in Greece, which for example was 2 ½ times less than in the US.  Mortality rates in Greece in men with PC were also lower.  Other medical articles suggest that the Mediterranean diet may indeed reduce the risk of PC.

I eat other PC averting foods like peanuts, broccoli, and cauliflower but those items are consumed haphazardly.   I need to do better to increase my consumption of these foods, since there are other health benefits that they offer as well.

Time will tell whether my newfound approach will continue to pay dividends.  Even if I’m destined to develop PC…which I dearly hope I’m not,……..protecting my prostate gland with green tea and tomatoes may delay the cancer from appearing, limit its aggressiveness, and improve my chances of survival.

Again, time will tell…..who knows what tomorrow brings…..the objects of our many obsessions may not be what causes us harm…..it is the unknown, the unexpected, the serendipitous that is waiting for us to let our guard down….