A Patient's Guide to Managing Hormone-Refractory Prostate Cancer  

Chapter 9. Take Care of Your General Health
 

You are going through a difficult battle, true of any cancer. So the message of this chapter is simple. Take care of yourself, in every way possible. Most of these messages you’ve heard your entire life, so we won’t belabor them.

Nutrition

Don’t expect to defeat advanced metastatic prostate cancer by what you eat, but don’t help the cancer along either. Eat a low-fat diet. Prostate cancer thrives on certain fat. The only good fats are found in olive oil and cold-sea fish; the rest of them are to be minimized, if not avoided altogether.

Veggies are good. The dark-colored vegetables especially are good—broccoli, spinach, and so on. Lycopene is good; it is found in tomatoes; so everything with tomatoes is good, especially when they are cooked, as in sauces.

Tea is good for drinking, especially green tea. Soy foods are good. Three helpings a week of ocean (not farm) fish are good for your cardiac health.

The books by Dr. Dean Ornish address low-fat diets, even though they are focused on cardiac health. Dr. Charles Myers has a nutrition/cookbook for prostate patients (Eating Your Way to Better Health), available through his web site www.prostateforum.org.

As a rule of thumb in following a low-fat diet, avoid all red meats; avoid egg yolks in any form; as nearly as possible, avoid all milk fats, in any form—stay with low-fat milk, cheese, etc.; and try to avoid, as much as possible, fats and oils in the form of salad dressings, oleomargarine, and cooking oils—with one exception—olive oil.

Food supplements and vitamins

All of us take some combination of food supplements and vitamins. See the list in Chapter 6 for one example. The purpose for taking the following supplements is explained in that table.

As basic daily food supplements, you might consider taking vitamin E (400 i.u.), selenium (200 micrograms, not milligrams), vitamin B-12 (100 mcg), vitamin C (500 mg, except when on chemo), vitamin B mixture, calcium (1 g), 500 mg magnesium with zinc, Coenzyme Q-10 (100 mg twice a day), GLA and DHA fatty acids (500 mg DHA 2-3 times a day), lycopene (30 mg). You will want to work out your own list.

UCSF has a webpage that summarizes a lot of information on nutrition and prostate cancer.

The following table may also be useful to you in selecting vitamins to supplement. You don’t necessarily need to supplement every vitamin; however, cancer is insidious in that it depletes many of the body’s resources. This table will, however, give you a list for discussing with your doctor. The table focuses on the health problems that result when you are deficient in a particular vitamin. However, you must exercise caution because some of these vitamins should not be taken during chemo (e.g., your own doctor should have a say in which of these vitamins you supplement. Further, the fat-soluble vitamins have toxicity limits, as well as effects on your blood coagulation.
 

Vitamins and Associated Symptoms of Deficiency
Vitamin	Deficiency Symptoms
Water-Soluble Vitamins
Ascorbic acid (vitamin C)	Bleeding gums, bruising
Thiamin (vitamin B1)	Fatigue, depression
Riboflavin (vitamin B2)	Cracked lips, scaly skin
Pyridoxine (vitamin B6)	Anemia, irritability
Niacin	Dermatitis, dementia
Folic acid (vitamin M or B9)	Megaloblastic anemia (production of dysfunctional red blood cells)  (check with your doctor to see if ok to take with HRPCa)
Vitamin B12	Megaloblastic anemia, neurodegeneration
Pantothenic acid	Weight loss, irritability
Biotin (vitamin H)	Dermatitis, anorexia, depression
Fat-soluble Vitamins
Vitamin A	Night blindness
Vitamin D	Rickets, osteomalacia (loss of bone calcium)
Vitamin E	Hemolysis of red blood cells (breakdown of red blood cells and release of hemoglobin)
Vitamin K	Hemorrhage, delayed blood clotting
McMurry, John, Organic Chemistry, 5th ed., Brooks/Cole:  Thomson Learning, Pacific Grove, CA, 2000, p. 1103.

Exercise

Stress can be ferocious in fighting this disease because your life is on the line. Exercise is good for everything you can think of. It increases your appetite, improves your digestion, enhances your attitude, allows you to sleep. There will be times that exercise is difficult, for example, when you are undergoing chemo. Do what you can as regularly as you can.

An exercise program three times a week that includes aerobic exercise (walking, swimming, biking) is great. Also try to add some resistance exercise to keep your muscle mass. Once you stop off the flow of testosterone to your body, your muscle mass begins to deteriorate. You may also wish to take daily creatine (the weightlifter’s supplement) to enhance muscle mass. However, stay away from anything like DHEA that contains hormones to feed the prostate cancer.

Rest

Rest is important to fight stress. It is also one of the best pain relievers. Get all the rest your body can take while you are in this battle.

If you have a difficult time sleeping, Ambien® is one effective sleeping pill if used infrequently. It can cause a dependency. Benadryl ® also works well as an aid in sleeping. Of course, the best sleep aid is exercise.

Your psychological well-being

It is difficult to over-emphasize the stress caused by a chronic disease. You are being forced to make life-impacting decisions at a time you may not feel up to it.

When one person gets cancer, the whole family gets it. You also need to keep in mind that your wife (and children) is suffering stress of at least the same magnitude as you. Completely open communication seems to be the best way to deal with the family’s stress.

You can choose to close yourself off from the world or open yourself to all the help available. Those of us on the support list have chosen the latter course and believe it is more successful. Clinical studies have also shown that asking for help and reaching out are healthy tactics.

A local support group is good for contacts and talks. There are also many on-line support groups, such as ours, for prostate cancer. Our experience is that both are good for whatever help they provide.

This is also the time for prayer. Turn to your church and your God for support. If you need convincing, clinical trials have even shown that prayer works in improving disease outcomes. Certainly the support of fellow church members is beneficial.

After fighting this disease for a long-time, it is possible to suffer the effects known as “post-traumatic stress syndrome.” Typically, the result is depression, which is dangerous to your life. It suppresses the immune system, destroys the quality of your life, and puts you at risk for suicide. Take your situation seriously, and be good to yourself and others around you.

When you feel that this disease and the battle are driving you crazy, one of the best counter-tactics is to go out and help someone else. What you see in this book, our support list and web site are serious efforts to help ourselves by helping others.
 

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