Conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. Unfortunately statistics show this is rarely the case. Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy. Evidence based medicine suggests that the only reliable evidence for efficacy comes from properly run randomised controlled trials (RCTs). As mentioned below, none of the RCTs evaluating conventional intervention for prostate cancer have shown any clear benefit. Therefore the conventional cancer paradigm needs to be questioned.
The following is based on the conventional cancer paradigm.
The prostate gland makes fluid that forms part of the semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body).
As men age, the prostate may get bigger. A bigger prostate may block the flow of urine from the bladder and cause problems with sexual function. This condition is called benign prostatic hyperplasia (BPH). BPH is not cancer but surgery may be needed to correct it. The symptoms of BPH or of other problems in the prostate may be like symptoms of prostate cancer.
Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms.
Signs and Symptoms: Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions such as BPH.
Prostate cancer usually grows very slowly so it can take 10 to 30 years before a prostate tumour gets big enough to cause symptoms or for doctors to find it. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. (See overdiagnosis below.) Talk to your doctor about your risk of prostate cancer and whether you need tests. (National Cancer Institute)
Prostate cancer is the third most common cancer among men in Australia after lung cancer and colorectal cancer and the third highest cause of death among men.
The prostate needs male hormones (androgens) to work the way it should. Androgens originate in two places in the body. The main male sex hormone, testosterone, originates in the testes. Testosterone helps the body develop and maintain male sex characteristics. Certain other substances manufactured by the adrenal glands are processed by the prostate into a hormone called dihydrotestosterone (DHT). DHT is important for normal prostate growth but can also cause the prostate to get bigger and may play a part in the development of prostate cancer. The risk of prostate cancer is believed to increase with increased hormones such as the androgens.
The following dietary risk factors may also increase the risk of prostate cancer: Full cream milk, but not skim milk. The increased risks are not particularly significant: the risk of developing prostate cancer increased by 3 percent for a big glass of whole milk per day; 7 percent for almost a pound of dairy product that you have each day; and by 9 percent for two ounces of cheese a day ( Ralph Moss, Dairy and cancer: is there a link? Advances in Cancer Treatment, May 2015)
Treatment: Four types of standard treatment are used in conventional medicine for early prostate cancer:
- Active surveillance: Active surveillance is closely watching for any sign that the cancer may be growing or changing. You will have frequent doctor visits and tests such as DRE, PSA tests and biopsies. If these tests show that your cancer is growing or changing in any way, your doctor will offer you radiation therapy or surgery to treat the cancer. Active surveillance can be used for men with early-stage prostate cancer because the cancer often grows so slowly that it may not cause problems during a man’s lifetime. For some men, active surveillance may be a way to avoid the side effects and costs of treatment without shortening their life.
- Surgery: Surgery to remove the prostate is called prostatectomy. There are different types of surgery for prostate cancer. They include:
- Open prostatectomy, also called retropubic prostatectomy. In this surgery, your doctor removes the prostate through a single long cut made in your abdomen from a point below your navel to just above the pubic bone. He or she might also check nearby lymph nodes for cancer. This type of surgery can be used for nerve-sparing surgery. Nerve-sparing surgery lessens the chances that the nerves near your prostate will be harmed. These important nerves control erections and normal bladder function.
- Laparoscopic surgery. In this type of surgery, your doctor uses a laparoscope to see and remove the prostate. A laparoscope is a long slender tube with a light and camera on the end. This surgery is done through 4 to 6 small cuts in the navel and the abdomen instead of a single long cut in the abdomen. The laparoscope is inserted through one of the cuts, and surgery tools are inserted through the others. A robot can be used to do this type of surgery. This type of surgery can also be used for nerve sparing surgery.
- Perineal prostatectomy. In this type of surgery your doctor removes the prostate through an incision between your scrotum and anus. With this method, the surgeon is not able to check the lymph nodes for cancer and nerve-sparing surgery is more difficult to do. This type of surgery is not used very often.
(Note: There is little evidence that surgery for prostate cancer has any benefit on increased percentage 5 year survival or reduced mortality but usually results in significant harm in the form of impotence (or erectile dysfunction) and/or incontinence. (The Efficacy of surgical treatment of cancer – 20 years later, DJ Benjamin) Screening for testicular cancer may reduce both morbidity and mortality, yet the effectiveness of any method is unknown. Equally, screening may also promote treatment procedures that are unwarranted or may adversely affect the health outcomes of the patient with no net benefit. Additionally, many organisations recommend against screening for testicular cancer due to the low incidence of testicular cancer and favourable outcomes in the absence of screening.. All of these comments come from peer-reviewed research. CISS)
- Radiation Therapy: This type of treatment uses high energy x-rays to kill cancer cells. Radiation therapy is an option for many men with early-stage prostate cancer. It is also a treatment for older men or those who have other health problems. There are different types of radiation therapy:
- External beam radiation. In this type of radiation therapy, a machine aims radiation at your cancer. The machine moves around your body, sending radiation from many directions. Before you start treatment, your doctor will map out the exact location of your prostate. Then you will have treatment once a day, 5 days a week for 6 to 9 weeks. Each treatment session usually lasts about 15 minutes. 3-D conformal radiation therapy is a type of external beam radiation that is often used to treat prostate cancer. It allows doctors to carefully plan the shape of the radiation beam so it targets the cancer more precisely while avoiding healthy tissues nearby.
- Brachytherapy is a type of internal radiation therapy in which a doctor places radioactive material inside the prostate. Brachytherapy is a choice for men with low-risk prostate cancer. There are two main types of brachytherapy used for prostate cancer, low-dose rate (also called LDR) and high-dose rate (also called HDR).
Risk from radiation treatment are similar to those from surgery, such as erectile dysfunction. You may develop bowel problems, such as diarrhea, trouble controlling bowel movements, and rectal bleeding. You may feel discomfort in the bladder or rectal area.
(Note: There is little evidence that radiation therapy for prostate cancer has any benefit on increased percentage 5 year survival or reduced mortality but usually results in significant harm as listed above. CISS)
- Hormone Therapy: This can play a role in treating early-stage prostate cancer. For men with high-risk early-stage prostate cancer it may be used along with radiation therapy. You can also receive it instead of surgery or radiation if:
- You are in your 70s or older or have other health problems
- Your cancer begins to change or grow while you are on active surveillance
There are different forms of hormone treatment. One is called Androgen Blockade Therapy (ABT) or Androgen Deprivation Therapy (ADT). Your doctor may suggest that you take hormone therapy for as little as 6 months or up to many years. Side effects may include loss of sex drive, erectile dysfunction (also called ED), hot flashes, osteoporosis and heart attack.
Flutamide (Eulexin®) is one of the first drugs approved by the FDA for the treatment of prostate cancer. It is generally used either with surgical or medical ablation of the testes (castration) or with another drug called leuprolide acetate. Some doctors consider it a treatment alternative by itself in patients with previously untreated advanced prostate cancer who wish to preserve sexual potency.
Unlike other forms of ADT Flutamide does not halt the production of these adrenal androgens. Rather it competes with DHT and blocks its uptake by the prostate tumour.
(Note: There is little evidence that hormone therapy such as ADT for prostate cancer has any significant benefit on increased percentage 5 year survival or reduced mortality but usually results in significant harm as listed above. (The Efficacy of surgical treatment of cancer – 20 years later, DJ Benjamin) CISS)
- Chemotherapy – the use of toxic drugs to kill the cancer cell or stop them from growing. Some men with advanced prostate cancer are given chemotherapy after standard treatment with radiation and hormone therapy. There is little evidence of any significant benefit. Research by Morgan et al concluded that chemotherapy for prostate cancer gives no increased percentage 5 year survival benefit.
The above therapies all come with risks and side effects which should be discussed in detail by your treating physician.
Early detection: Many doctors believe that one of the tests for the presence of prostate
cancer, the Prostate Specific Antigen (PSA) test, should also be used to screen men for early prostate cancer. This has resulted in the increasing promotion of PSA Screening before it was proven to be beneficial. Five subsequent randomised controlled clinical trials to evaluate the benefits of PSA screening evaluation found that there is little benefit from early detection, with the possible exception of men between the ages of 55 and 60 years in only one of the five trials. (Cochrane* database. Screening for prostate cancer, 2013.) A subsequent analysis of this trial found that confounding factors not corrected for (related to the harm from ADT) could explain the apparent benefit. (Haines and Gabor , Prostate-specific antigen screening trials and prostate cancer deaths: the androgen deprivation connection, 2013). This suggested that there was no benefit there either.
Despite the fact that leading experts in the USA have argued against the continued use of PSA Screening (Boyle and Brawley, Prostate Cancer: Current Evidence Weighs Against Population Screening, 2009) most cancer authorities in Australia do not accept their arguments and continue to promote PSA screening. (Dr Otis Brawley is Chief Medical Officer at the American Cancer Society)
Overdiagnosis: Another problem relating to prostate cancer screening is overdiagnosis resulting in overtreatment. It is claimed that most prostate tumours found through PSA screening are not life-threatening. In fact the proportion of men with undiagnosed prostate cancer (ie in men without any health problem including cancer) found in men who had died in accidents, such as car accidents was 31% in men aged 30-39, 40% in men 40-49, 45% in men 50-59, 68% in men 60-69 and 82% in men aged 70-79. So if over half of older men have prostate cancer but only 3% will ever die of it the potential for overdiagnosis and overtreatment is enormous. (Welch HG. Overdiagnosed, 2011)
Before deciding on one of these treatments you would benefit from asking your physician three questions:
Question 1: What are my treatment options? – these should include doing nothing.
Question 2: What are the possible outcomes of those options? – including benefits and side effects.
Question 3: How likely is each of the outcomes to occur?
If you feel your doctor or other health practitioner is not able to answer these questions, or shows that he or she is not comfortable with you asking these questions, it raises the question as to whether they are practising evidence based medicine and you should consider getting another opinion.
These three questions can be expanded.
For a complete comprehensive overview of conventional treatments used for prostate cancer with up to date information on % effectiveness of each treatment on mortality and morbidity, please follow this link to The Ralph Moss Reports.
Alternative Cancer Therapies
As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer.
Another paradigm states that cancer is a systemic disease and the tumour is only a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:
- Treatment should cause no harm
- Treatment should be wholistic (ie consider the whole person – body, mind, emotions and spirit)
- The person with cancer needs to take control of their own health. This latter paradigm is supported by CISS (See Introduction to CISS)
Alternative cancer therapies are generally consistent with the above principles. In fact those believed to be the most effective in controlling cancer – psychotherapy and immunotherapy – also have strong supporting evidence from randomised controlled trials.
There are approximately 200 alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. The following are those with the most scientific evidence for benefit. What is important in any cancer treatment is to both understand and believe in your chosen therapy.
There are several alternative cancer therapies claimed to produce benefits with ovarian prostate cancer. Those claimed to have the most benefits in most types of cancer include psychotherapy and immunotherapy.
Although there were no patients with prostate cancers enrolled in the psychotherapy trials, psychotherapy was found to provide benefits in all types of cancers with solid tumours, so prostate cancer would not be expected to be an exception.
- Iscador (mistletoe extract)
Many clinical trials have shown benefits of Iscador therapy on people with different types of cancer. One analysis of 22 studies included 12 prospective studies, 5 randomised studies and 10 had a matched-pair design from which the authors identified 41 comparisons of Iscador vs no treatment. All but four showed a positive increased survival.
A random effect meta-analysis estimated the overall hazard ratio at HR = 0.59 (CI: 0.53 to 0.66, p < 0.0001). Simple meta-regression yielded a predicted HR = 0.74 (CI: 0.66 to 0.82, p < 0.0001). This means that Iscador was shown to produce about a 26-41% increase survival.
Randomised studies showed lower effects than non-randomised studies and matched-pair studies gave significantly better results than others.
References: Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer (Dec 18) 2009; 9: 451-.
- Issels Wholebody Therapy
Although not based on RCTs, the most successful therapy for late stage cancers including prostate cancer was Josef Issels’ Whole Body Therapy that focussed on restoring the body’s immune systems.
It was estimated in 1970 that a representative sample (252) of Issels’ patients with late stage cancers (of whom 3 had late stage prostate cancer) showed a 16.6% five-year survival following his treatment. This compared with less than 5% with standard treatment at the time. They also experienced a 15% 15-year survival compared with less than 2% for standard treatment. This long-term surviving group of 42 included 2 of the men with late stage prostate cancer.
References: (Issels, J. Immunotherapy in Progressive Metastatic Cancer – A Fifteen-Year Follow-up. Clinical Trials Journal, August 1970: 357-365 – editorial by Phillips S. Dr Joseph Issels and the Ringberg Klinik. Clinical Trials Journal. August 1970: 355-56.)
The above studies, that include RCTs, show that systemic therapies are much more successful than therapies based on the orthodox paradigm.
- Hydrazine sulphate
This is a common industrial chemical that was used as a component of rocket fuel during World War II. It was first proposed as a cancer treatment in the early 1970s by Joseph Gold MD, of the Syracuse Cancer research Institute, NY.
Gold drew on the work of Nobel laureate Otto Warburg, who theorised that cancer derived its energy from anaerobic glycolysis (fermenting sugar) rather than respiring in the normal way. Gold proposed using chemicals to control cancer’s growth by exploiting this process.
Gold suggested that by cutting off a tumour’s supply of new glucose, formed in the liver,
the drug could starve the tumour, in turn stopping the cancer from depleting the body’s energy pools and putting an end to cachexia, the terrible wasting process that appears in the final stages of the disease. It is this wasting process that often kills the cancer patient and is estimated to cause ~40% of all cancer deaths.
It has been reported that “Approximately half of the patients to whom the drug is properly administered in the early stages of the disease show an almost immediate weight gain and reversal of symptoms; in some instances, the tumor eventually disappears. The common types of cancer most frequently reported to benefit from hydrazine sulfate therapy are recto-colon cancer, ovarian cancer, prostatic cancer, lung (bronchogenic) cancer, Hodgkin’s disease and other lymphomas, thyroid cancer, melanoma, and breast cancer.”
Reference: Richard Walters, Cancer: Hydrazine Sulfate – http://www.healthy.net/Health/Article/Hydrazine_Sulfate/2011/4
In prostate cancer, Ralph Moss, Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention, reports the following alternative therapies have been shown to benefit.
- Vitamin A – Vitamin A was the first vitamin to be isolated and defined. It is a fat-soluble food factor that gives us the power of night vision. It also fortifies the mucous membranes that serve as a barrier against poisons, microbial invaders and carcinogens (cancer-causing substances). It protects the thymus gland (crucial for immunity) and is essential for protein synthesis and normal growth. Like other powerful food factors it is an antioxidant that destroys harmful chemicals called ‘free-radicals’. And it does much more.
In a large ‘prospective’ study’ of 2,500 men over the age of 50 followed for 10 years, 84 of them developed prostate cancer and their vitamin A levels were found to be significantly lower than those without prostate cancer.
In another NCI study blood was obtained in 1974 from over 25,000 people. Over 100 of these developed prostate cancer during the next 13 years. Once again the less vitamin A (retinol) they had in their blood the greater their odds of developing prostate cancer. (This represents a correlation or an association but does not necessarily mean there is a clear cause-and-effect relationship)
References Reichman M et al. Serum vitamin A and subsequent development of prostate cancer in the first national health and nutrition examination survey epidemiologic follow-up study. Cancer Research 1990; 50: 2311-2315.
Hsing A et al. Serologic precursors of cancer. Retinol, carotenoids and tocopherol and the risk of prostate cancer. J Natl Cancer Inst 1990; 82: 941-946.
- Zinc – Zinc is another mineral essential for health. Many studies have shown that the amount of this mineral naturally present in epithelial cells of the prostate is high: it is a “zinc-rich gland”. It has become a popular supplement, especially for the treatment of enlarged or infected prostates. Studies have shown a negative correlation between zinc intake and prostate cancer. (This again represents a correlation or an association but does not necessarily mean there is a clear cause-and-effect relationship)
In a Utah study of 358 cases of men with prostate cancer and 679 controls, dietary fat was found to be the strongest risk factor for prostate cancer. This and other studies suggest that dietary intake, especially fats, may increase the risk of aggressive prostate tumours in older men. (This again represents a correlation or an association but does not necessarily mean there is a clear cause-and-effect relationship)
References Larue JP et al. [Zinc in the human prostate]. J Urol (Paris) 1985; 91: 463-8.
Waalkes MP et al. Cadmium carcinogenesis in male Wistar [Crl:(WI)BR] rats: dose-response analysis of effects of zinc on tumour induction in the prostate, in the testes, and at the injection site. Cancer Res. 1989; 49: 4282-8.
West DW et al. Adult dietary intake and prostate cancer risk in Utah: a case-control study with special emphasis on aggressive tumors. Cancer Causes Control 1991; 2: 85-94.
- Hyperthermia (Heat therapy) – Hyperthermia is increasingly used in conjunction with other conventional treatments because it has been found to enhance their effects. For example at Stanford University six prostate cancer patients underwent radiotherapy after tumour recurrence. Four also received hyperthermia from an electromagnetic system. Three of the six were later found to be free of tumours, two had recurrences and one had died.
References Kaplan I et al. Secondary external beam radiotherapy and hyperthermia for local recurrence after 125-iodine implantation in adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1991; 20: 551-4.
(NOTE: In the last 25 years since Moss’ book was published there have been many developments in the hyperthermia area with more evidence of benefit of hyperthermia in the treatment of prostate cancer – CISS)
- Indoles – Indole glycosinate is the scientific name for the protective chemical found in cabbage, broccoli, cauliflower and brussels sprouts. The presence of cabbage and related vegetable in the diet has been definitively shown to enhance a particular system of enzymes that detoxifies cancer-causing substances. It also has a protective effect against radiation.
In the same way that estrogen has been linked to an increase in the incidence of breast cancer, there is some suggestion that hormones might be involved in than increase in incidence of prostate cancer. (Hence the use of Androgen Deprivation Therapy mentioned above to reduce the level of hormones) German scientists have modified indoles to make them into anticancer drugs. Because these substances are anti-estrogens they might find particular application in the treatment of hormone dependent tumours such as those of the prostate. Eating raw or lightly cooked cabbage converts the hormone estrogen into its inactive form.
References. Albert PM. Physiological effects of cabbage with reference to its potential as a dietary cancer–inhibitor and its use in ancient medicine. J Ethnopharmacol. 1983; 9: 261-72.
Schneider MR et al. Antitumor activity of antiestrogenic phenylindoles on experimental prostate tumors. Eur J Cancer Clin Oncol. 1987; 23: 1005-15.
- Selenium – In addition to the above four alternative therapies there are several supplements believed to have anti-cancer properties that are not confined to specific types of cancer. Selenium is one of them. Selenium is believed to reduce the incidence of cancer by stopping carcinogens corrupting the genetic material of the cell; slowing the spread of cancer cells; and enhancing the body’s normal anticancer immunity. Researchers believe this might explain why people who have a relatively abundant supply of selenium in their diets experience less cancer. This includes prostate cancer. For this reason selenium supplements are used. The National Academy of Sciences (NAS) advises that no more than 150 micrograms of selenium be taken orally daily. However in the treatment of cancer the dosage is generally about 10,000 micrograms (or 10 milligrams), nearly 100 times the NAS’ recommended dose.
References. Schrauzer G. Selenium and cancer. A review. Bioinorganic Chemistry 1975; 5: 275-81.
Schrauzer GN et al. Cancer mortality correlation studies.III. Staistical associations with dietary selenium intakes. Bioinorganic Chemistry 1977; 7: 23-24.
Ladas HS. The potenytala of selenium in the treatment of cancer. Holistic Medicine 1989; 4: 145-156.
(NOTE: In many Western countries the soil is claimed to be depleted in selenium as a result of several factors. As a result less selenium is present in locally produced foods. This suggests supplementing the diet with selenium-rich foods or with selenium supplements in forms such as selenomethionine. CISS)
If you or someone close to you has just been diagnosed with prostate cancer it is important that you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical , mental, emotional / psychological and spiritual treatment.
For more information on some more common evidenced based alternative treatments please go to the alternative treatment tab. If you don’t know where to begin in your journey to wellness then we suggest you read Where to start.