Throwing the Kitchen Sink at [Prostate] Cancer

 

The morning after my initial diagnosis, I remember waking up early with this thought in my head that I had to make some bold changes in my lifestyle in order to gain control of my situation. There were more tests ahead and I was still weeks away from a medical game plan. But I had this intense need to get the ball rolling now! My initial thoughts were around how can I "starve" cancer and reverse the trend. I have absolutely no medical or science background, but maybe I recalled some studies I had heard about years ago about tumor shrinkage in mice after calorie restriction. So, I got to work googling everything I could. Ultimately, I would "throw the kitchen sink at this" using a multi-part strategy:

- Nutrition - What to eat and when to eat
- Exercise Routine - I already had a solid approach to exercise, but it was time to go a little harder
- Sleep - I had noticed the quality of my sleep had declined over the previous months. Sleep is important!
- Mindfulness/Meditation - I knew nothing about this. Time to learn.
- Alcohol - I had to (mostly) give this up due to a slightly elevated liver enzyme

My medical treatment plan firmed up at the end of December. I discussed some of these ideas with my doctor(s) and got the reassurance that nothing I was doing would mess with my treatment which mainly involved ADT, a common prostate cancer hormone therapy, and may even help with the side-effects.

Though I'm presenting this as a strategy that I'm employing to help me overcome prostate cancer, I honestly believe that these strategies are good for overall health regardless of anyone's specific situation.

Disclaimer: I'm not a doctor, so please, run this by your doctor to make sure it will complement other treatments you may be on.

Nutrition

When I googled "how to starve cancer", a book came up on the top of the list, interestingly titled How to Starve Cancer. I ordered it a couple of days later, just after my diagnosis. This became the first of a series of books I would buy on the subject. I won't go into a lot of details, but the book is written by an amazing woman named Jane McLelland who also happens to be a stage 4 cancer survivor. It turns out that "starving" cancer is not as far-fetched as it sounds and Jane McLelland lays out a brilliant strategy on how to attack different types of cancer using combinations of diet, supplements and a handful of old, forgotten, low-toxicity drugs. I recommend reading the book, however, my takeaways were more on the diet side and less on the supplement/off-cycle drug side as I wanted to make sure all of my actions perfectly complemented my primary treatment plan. This book, combined with other research I was doing, formed the basis of my approach - that I'm still following 3 months later.

I'll break down my approach toward nutrition into 2 sections, "what to eat" and "when to eat", each with reference links behind them to learn more.

What to Eat (from zero cancer.org)

Guidelines for a Healthy Diet

• Your diet should be:
  • Primarily plant-based
  • Include plenty of fruits and vegetables
  • High in fiber
  • Low in fat
  • Limited in the amount of simple sugars

What I do

• Breakfast - I skip most mornings, see below. I love my coffee and will usually take my first 2 cups black, and then add in some unsweetened vanilla almond milk for my subsequent cups.

• Lunch - Typically a big salad with a good mix of veggies (lettuce, cruciferous, carrots, tomatoes and a low-calorie, low-fat dressing

• Dinner - My wife is a great cook! But she has different dietary interests than me, so we'll usually do Purple Carrot every other week. For the non-Purple Carrot weeks, we'll do healthy soups, salads (again, 2-a-day is typical), pasta with meatless meatballs, and occasional grilled fish. I'll finish with fruit (some combo of watermelon, cantaloupe, raspberries, strawberries, grapes)

• Snacks - I need to limit my snacking! But my go-to's are fruits, healthy granola, Skinny Pop, vegan chocolate chip cookies

When to Eat (great article by Monique Tello, MD, MPH)

Avoid sugars and refined grains. Instead, eat fruits, vegetables, beans, lentils, whole grains, lean proteins, and healthy fats (a sensible, plant-based, Mediterranean-style diet).

Let your body burn fat between meals. Don’t snack. Be active throughout your day. Build muscle tone.

Consider a simple form of intermittent fasting. Limit the hours of the day when you eat, and for best effect, make it earlier in the day (between 7 am to 3 pm, or even 10 am to 6 pm, but definitely not in the evening before bed).

Avoid snacking or eating at nighttime, all the time.

What I do

I do a modified version of time-restricted, intermittent fasting. 

During the week, Monday through Friday, I limit my eating to Noon to 8pm, so this means lunch and dinner (see above).

In the morning I'll have 2 cups of black coffee and 2 cups of coffee with unsweetened vanilla almond milk.

On the weekends, I mix it up a little and allow myself a healthy breakfast. This usually consists of:

• My favorite cereal, Uncle Sam (Whole Wheat Kernels, Whole Flaxseed, Salt) that I combine with  with strawberries, blueberries and a banana -or-

• A banana/strawberry Acai bowl from my favorite joint in town (it costs over 10 bucks!, so only a couple of those a month😉)

Exercise

I had a decent approach to exercise before the diagnosis. But my new situation caused me to add a little more structure and discipline to my routine. I aim to work out 6 days a week, with a full day off. 
A few years ago, I discovered the sport of triathlon. I got totally hooked. There is something really cool about showing up early to an event on a beautiful sunny morning and seeing all of these cars pull up with really cool, high-tech bikes on the roofs. It gets the adrenaline going. But I learned that the real benefit to this sport isn't just the racing, it's the training! By definition, triathlon training turns out to be an ideal cross-training training regimen. This is great for everyone, but becomes really important for people as they get older. 

At some point in the future, I'll try to do a separate breakout post on each component, but for now, here's an overview of my routine and setup.

Bicycling (Indoor or Outdoor)

I'm a bike geek! I actually have 3 bikes: a Trek Emonda road bike, a Trek Farley fat-bike and a Cervelo P3 triathlon racing bike. The Cervelo doubles as my indoor bike (since I don't compete all that often and especially not in the offseason). It sits on top of a Wahoo Kickr Snap bluetooth smart-trainer which sends and receives data from the Zwift indoor bicycling app. Depending on the weather, I'll usually get in 3 rides a week, either on the roads, trails or in my basement.

Running

I was a competitive runner in high school and college but was always plagued by injuries. In fact, I had all but given up running for decades until I turned 55 and decided to give it another try. By using slow ramp-ups in distance, new footwear and lots of PT, I've managed some limited periods of success. I'm currently running injury-free for up to an hour every other day. Some of my running beliefs:

• Always follow the 10% distance increase rule. Quite simply if you're doing 2 miles a day, or every other day, stick with that for at least a week, before upping the distance to 2 1/4 miles. 

• Mix up the distances. In the example above, when you get to 2 1/4 miles, don't do the same thing every time out. Mix it up, so that you average out to that target distance. Maybe do 1 1/2 one day and 3 the next, etc

• Shoes - Yikes, I've tried everything from minimalist, maximalist, Hoka, Brooks, Addidas, Nike you name it. The "go-to" shoe for me, has turned out to be the appropriately named Brooks Adrenaline GTS (yeah, it turns out that GTS actually does stand for Go To Shoe 😀)

• Learn what types of injuries you can run through and which ones you need to completely stop running. When in doubt, stop running and bike instead

• A rigid night splint, if you can tolerate it, can work wonders for many lower leg issues like Achilles tendonitis and plantar fasciitis. I've had some good luck with these reducing morning pain.

• Run on soft surfaces whenever possible. Trail running is fun!

• Use treadmills when you need to, but try not to use them exclusively since they can lock you into repetitive foot strike patterns without the varied terrain that you get outside

Swimming (with Covid - it's Seasonal/Open Water Swimming Only for Me)

Not much to say here, except to say that I suck at swimming. My only wisdom to offer, is that if I can swim 2.4 miles in an Ironman, anyone can. How do you get to a point where you can swim 2.4 miles? Easy, you start in a controlled environment like a pool at the gym and you start with 10-15 minutes. That doesn't have to be continuous either. Do a few laps and rest. Once you are doing 10-15 minutes regularly, try increasing it to 20-25 minutes. Don't get hung up on laps. Just swim using your watch or wall clock at the end of most pools.

Weight Training

I think I've got a good, easy-to-follow approach here. The time commitment of integrating weight training into a cardio program (biking, running, swimming) can be tough. But I've got 2 flavors of weight routines I do depending on the amount of time I have. The long one can take 40-60 minutes and the short one I can do in as little as 20 minutes.

For equipment, I use: dumbbells, bench, physio ball and a pull-up bar

I track all of this in a Google sheet which I can easily update from my iPhone when I work out. Here's a glimpse of that (there are more columns not shown to the right):

It might be hard to read here, but it actually renders fine on my phone. It's a simple matrix with the dates as rows and all exercises as columns. The first exercises I consider mandatory, and I'll do them every time, regardless of whether this is a short or long routine. They are:

• Pull-Ups, Push-Ups, Ball situps, ball backups and bench leg-raises

If I'm doing a short routine, I'll add one more exercise which is a modified full-body burpee with 25 lb weights.

If I'm doing the full routine, I'll replace the burpees with 3 sets of traditional dumbbell exercises such benchpresses, fly's, squats etc

Sleep

My Garmin 935 smartwatch keeps track of time spent sleeping and all stages of sleep. Not sure how accurate it is, but I've noticed a drop off in the amount of deep sleep I get every night over the last few months. Deep sleep is important for cell recovery. I've tried a bunch of prescriptions and over-the-counter drugs to help with this, with no significant improvements. Two things that seem to be helping the most currently are:

SleepyTime Tea

Blue Light Blocking Glasses

I realize that both of these may sound gimmicky and my apparent success may be more in my head, but so far, they seem to be the only things helping. 

Warning TMI Alert - Having to get up to go to the bathroom is another thing that obviously doesn't help sleep. I'm currently researching some things here with regard to diuretics that I take and salt intake in my diet. More to come if anything pans out.

This is a work in progress, more to come in the future.

Meditation

I know this is important, but know very little about it. I have downloaded one of the popular iPhone apps called HeadSpace, but honestly haven't used it enough aside from specific content aimed at improving sleep. More to come here also. 

Alcohol

I used to be a nightly drinker. Typically, 2 or 3 glasses of red wine or an occasional beer. Since starting my clinical trial, I've had to maintain good blood values in my monthly evaluations. One of my blood values called AST was slightly elevated. In order to stay in good standing in the study, I chose to give up most (not all) alcohol 😞. I'll still allow a drink or 2 on Friday and Saturday nights. So far this is working out well. I really look forward to Friday evenings now! I will post something in the future on my view toward alcohol, but in short, I question a lot of the conventional information out there on the health benefits of various types of alcohol. I don't believe any of it. For all of the advocates, there is also evidence that its adverse effects on health far outweigh any perceived benefits. But I love a glass of wine once in a while. So that's my approach for now, limit it to the weekends, let my system clear it out during the week.

A long post today! I hope to some deep-dives into many of these topics in future posts. That's all I've got for now. Cheers.