Prostate Cancer: When All Is Well Health Deteriorated – Severe Pains and Walking Difficulty – WHY?

CN (H878) is a 61-year-old male. For the past four or five years he suffered urine blockage.  The doctor prescribed Xatral, a medication to treat the symptoms of enlarged prostate (benign prostatic hyperplasia or BPH). No one bothered to check his PSA. Xatral apparently helped resolve his problem.

In October 2009, he started to have backpain in addition to urine blockage. On 25 March 2011 his PSA was at 991.90. This alarmed his doctor. The doctor told him that CN had prostate cancer.

A biopsy was done on 29 March 2011 but the result indicated no malignancy. A second biopsy was done on 5 April 2011. Again it was negative for malignancy although benign prostatic hyperplasia was indicated.

Due to the severe backpain, MRI was done and showed L4 vertebra was more sclerotic than the other vertebrae. A biopsy was done of the L4 and the result indicated metastatic carcinoma consistent with a primary from the prostate. His PSA then was at 1018.

1 Biopsy-reports

2 Bone-MRI

3 PSA-values

 

CN was subsequently treated with Lucrin injection (RM 1,300 per month per injection). He also took the oral drug, Casodex (RM 21 per tablet /day).  The treatment brought down his PSA level from the initial level of 991 to 0.2 within six months. Unfortunately, after six months, the PSA started to rise again from 0.2 to 25.1 in May 2012 (Table below).

CN was asked to undergo chemotherapy. He refused. CN came to seek our help on 11 May 2012.

 

 

Declined Chemotherapy and Radiotherapy

Chris: The doctor asked you to go for chemo and radiotherapy – you want that?

Patient: No, don’t want. No point.

C: Why no point?

Daughter: No meaning!

C: Why no meaning?

Daughter: He is taking these medications that the doctor gave and he already suffered.

C:  Do you have friends or relatives who had gone for chemo or radiotherapy – were they cured?

D: Cannot cure.

P:  I know of two friends. About two months ago one of them, aged 67, had colon cancer. After operation he did chemo for four times. The doctor asked him to go home – six months later, he died. There was another one, 51 years old. He had skin cancer. He received radiation but there was one more tumour which could not be treated. He had chemo – four times, he also died.

C: So two friends went for chemo – they all died. So you don’t want to follow them?

When CN came to see us on 11 May 2012, he presented with the following:

  1. He was unable to sleep – remaining awake till 4 to 5 a.m. each night.
  2. He had backache.
  3. He had no strength and found it difficult to even bend forward.
  4. He had difficulty moving his left arm.
  5. He suffered hot flushes and felt “heaty” in his body.

CA Care Therapy

CN was prescribed Capsule A, deTox tea, Prostate A, Prostate B, Bone and Pain Tea. He was also given Menopause Pill for his hot flushes.  He was told to abide by our recommended diet. After two weeks, he returned and told us that he was happy!  Look at the video – he could walk normally!

Chris:  When you came you said the doctor gave  you the injection and also the oral drug, Casodex. Because of that you said you could not sleep, had hot flushes. I gave you the Menopause Pill. After taking the Menopause Pill – still has problem?

Son: Much less now.

C: And you said you could not sleep at night – you were still awake until 4 a.m. or 5 a.m. Only then you could sleep. What happen now?

Patent: Can sleep. Better, very good.

C: You feel good already – so no need to take herbs!

P: No, no, cannot. I feel very happy.

(Note: Since patient could not speak / understand much English, our conversation was very limited).

He returned home with a month’s supply of herbs but he never came back after that.

Crash!

To our surprise, CN and his son and daughter turned up on 10 August 2012. He was in severe pain and could hardly walk into our centre. His son had to support him to slowly walk into our centre – watch the video to see how he suffered.  In short, his health had deteriorated – WHY?

 

 

Chris: I asked you to come back and see me in July – you did not come. Why?

Son: When taking the herbs, he was okay already.

C: So when you were on the herbs, everything was okay? No pain?

S: Just a bit of pain only.

C: So you were happy. Then now there is this pain – what did you eat wrong? Tell me what did you eat that I say you cannot eat?

Patient: Fish head curry!

C: Okay, very good. (Pointing to the daughter) You took care of him?

S: No, me, me! I brought him to Kuala Lumpur the last two weeks.

C: Before that he was not in Kuala Lumpur? In your hometown, did he eat  anything he liked?

Daughter: A little bit la!  Went out to eat outside.

C:  But still okay?

D: Under control.

C: So the past two weeks he went to KL. And what did he eat?

S: Eat outside lor.

C: Everyday eat outside? Aya, you want to die la. Can die one you know!

S: Every night we went outside to eat – like pan mee.

C: You see I have told you before. One day eat, okay. Two days eat outside, okay. And one week, was he still okay?

S: One week still okay but after that he started to have pains.

C: Where is the pain?

P: From the stomach radiating to the back.

C: Before this bad food, do you ever have this problem?

S: No, no, never have this kind of problem.

C: This is my experience. Patients – when they eat bad food for a day, never die. Two days also never die but after two weeks they begin to see the bad effects. Only two days ago, I asked my wife why you did not come. I was wondering why – either you are already well or you are already dead. Now you are here.

S: (Everyone laughing).  Ya, now want to die already. The past few days he could not walk much and his condition became more serious.

Why did he suffer again? Two reasons:  He stopped taking our herbs for the past one month and on top of that started to eat any food he liked.

e-Therapy Restored Him

 

 

We immediately put CN on the e-Therapy. His condition improved after one session. And after four sessions of the e-therapy (i.e. four days)  CN felt he had recovered and did not feel it was necessary to travel (one and a half hours drive) to Penang to undergo more sessions of the e-therapy. When CN left he gave me a hug!  After that CN mysteriously disappeared (again!). Since then we did not get to see him again!

Comments

Since CN felt well with the herbs – no more pains and he could sleep well – he decide to forget taking the herbs. Since preparing herbs is indeed a chore and he is feeling great, CN decided not take the herbs for a while. So he did not take the herbs for a month. In addition, he went to stay with his youngest son in Kuala Lumpur for two weeks. His son is a bachelor and does not cook at home. Father and son went out for outside food every evening. After two weeks on bad food CN started to have pains. He had to return to his hometown and immediately drove to see us in Penang.  CN was in severe pains. His son had to support him to slowly walk into our centre. The video would be able to convey the agony he suffered. And this was on 10 August 2012. Compare this situation to what he was like some ten weeks ago, 25 May 2012.

To us at CA Care, things like this happen very often. When patients get well, they will not come and see anymore. When they get into trouble they will show up. Some patients do not take their herbs or they go out to eat anything they like once they feel well.  They want to believe they are cured!

For CN’s case, I really empathize with him. What happened is understandable – but NOT excusable because he cannot get away with what he did wrong. CN’s wife died in an accident some twenty two years ago, so CN lives alone in his home. His children are married and they live their separate lives while the youngest who is close to him, works in another town. My guess is that life to CN could be boring and probably meaningless as well. My favourite author, Harold Kushner  – a Jewish Rabbi, in Who Needs God wrote: More than any other human problem, loneliness, the absence of meaningful human connection, drains the joy and the sense of purpose from our lives … in my experience, more die of loneliness. There is perhaps nothing sadder than experiencing intense joy or intense grief and having no one to share it with.  At CA Care we understand this message. We try our best to treat patients like a human being.  As I have often said cancer is not only about a tumour in your breast, lung or liver. It is about you as a person.

Having seen CN in severe pain, we immediately put him on the e-Therapy. His condition improved after one session. And after four sessions, CN felt he had recovered enough and did not feel it necessary to undergo more sessions of the therapy. The sad part of the story is, up to this day we do not know what has happened to him. Since our last hug, we never get to see CN again. We are more than happy to help him or any other patients, in any way we can – that is, if the patient is willing or needs our help!

The following are the side effects of Lucrin and Casodex, as obtained from the internet.

Side effects of Lucrin: Approximately 52 percent of lucrin users report hot flashes and fluid retention under the skin occurs in at least 8 percent of users. More than 5 percent of patients experience dizziness, pain throughout the body, headache, nausea and vomiting. Some patients experience diarrhea, loss of appetite, anxiety, tingling in the extremities, forgetfulness, sour taste and insomnia. Fever and fatigue, breast tenderness and impotence in men are also possible.

Source: Lucrin Side Effects | eHow.com http://www.ehow.com/about_5306460_lucrin-side-effects.html#ixzz24XoOrKCa

Side effects of Casodex:  The very common side effects are: dizziness, hot flushes, feeling sick, abdominal pain, constipation, blood in the urine, abnormal enlargement of the breasts, breast tenderness, chest pain, weakness or loss of strength, fluid retention. the less common side effects are: sleepiness, decreased sex drive, impotence, depression, loss of appetite, weight gain, anaemia, indigestion, wind (flatulence), hair loss (alopecia), excessive hair growth, dry skin, itching (pruritis), rash and liver problems.

Sourcehttp://www.netdoctor.co.uk/cancer/medicines/casodex.html

 

Prostate cancer surgery ‘has little or no benefit’ in extending life of patients

The study compared surgically removing prostate gland with ‘watchful waiting’

Some experts now questioning whether disease should even be called cancer

New research into prostate cancer has revealed that surgery has little or no benefit in extending the life of a patient.

Dr Kate Holmes, head of research at the The Prostate Cancer Charity, said: ‘Early data from the Pivot trial certainly suggests that surgery to remove the prostate does not provide any significant survival benefit for men with low to medium risk of prostate cancer.
Read more: http://www.dailymail.co.uk/health/article-2136512/Prostate-cancer-surgery-little-benefit-extending-life-patients.html

Prostate Cancer: PSA Declined With Herbs, PSA Increased Without Herbs

LES (H608) is a 60-year-old man. He had the following underlying medical problems:

  1. Hypertension.
  2. Depression.
  3. Ischaemic heart disease (reduced blood supply of the heart muscle to coronary artery disease).
  4. Childhood asthma.

In 2004 he was diagnosed with a benign prostatic hyperplasia  —  a non-cancerous enlargement of the prostate gland. This makes urination difficult and uncomfortable. He has been taking Hytrin (Terzosin) ever since.

In May 2011, his PSA reading was at 9.2. A biopsy was done and indicated cancer of the prostate, Gleason score 3 + 3. The doctor suggested that LES undergo chemotherapy or TURP (transurethral resection of the prostate). LES declined both procedures. Instead, he came to seek our help on 15 May 2011.

LES was prescribed Capsue A, deTox tea and Prostate A tea. After a week on the herbs, LES reported that he felt “heaty”. Four days on the herbs he did not have any more pain when urinating. But if he stopped taking the herbs, the pain recurred.

We did not get to see LES again until the end of March 2012.

 

 

When LES came in March 2012 – i.e. ten months later, he said that:

  • He was not committed enough – As you said, I must be faithful in taking your herbs. When I became well I did not take your herbs!
  • When he first came his PSA was 9.4. After taking the herbs it dropped to 7.5, then to 5.5. He decided to stop taking the herbs – I was too lazy to cook the herbs!  His PSA went up to 9.2.
  • His doctor suggested medical intervention – surgery and radiation –  but he declined. He decided to come back to us and start with the herbs again!
  • He told his doctor that he was taking our herbs.
  • Chris: Okay, that is fine. Don’t worry, you don’t have to die with PSA 9.4!

Comments

 

Prostate Cancer: PSA Dropping and He Preferred CA Care Herbs to Casodex and Zoladex

ML is a 69-year-old male from Indonesia. He was diagnosed with prostate cancer on 6 September 2011. Before this diagnosis ML already had problems with his prostate since April 2008. His PSA on 1 April 2008 was 9.31 and this kept rising over the years.

On 8 December 2011, we received an e-mail from ML.

Dear Dr. Chris,

I’m ML from Jakarta who went to meet you on 21 October 2011. After taking Prostate A tea and Mountain Guava deTox tea and capsule A, my PSA went down to 0.37 from  4.67.

Before that my doctor advised me to change my diet and gave me Casodex + Zoladex. These helped my PSA to go down to 4.67. Then I stop these drugs and took your herbs. My PSA went down to 0. 37. What must I do? Do I still have to take the herbs and for how long?

Thanks for your help.

On 16 December 2011, ML sent another e-mail.

Dr. Chris,

Congratulation, Praise The Lord from ML, Jakarta. I checked my PSA on 14 December. My PSA = 0.19.

Below is his brief medical history:

  1. 1 April 2008, PSA 9.31. Took prostate glands pills (Kai Kit Wan)
  2. 23 Jan 2009, PSA 11.83. Still on prostate glands pills
  3. 19 Jan 2010, PSA 23.7  Still on prostate glands pills
  4. 26 May 2010, PSA 19.83 Still on prostate glands pills
  5. 15 June 2011, PSA 33.23 Conprosta capsule (Qian Lie Kang capsule)
  6. 1 Aug 2011, PSA 32.8
  7. 6 September 2011, Biopsy:  confirmed adenocarcinoma of the prostate .Gleason score 4+3=7. USG:  prostate size twice the normal size. Bone scan was normal, no metastasis.
  8. 17 Sept 2011, Infection of the prostate, pain. Doctor prescribed  Levoproxacine & Ratinidine tablets.
  9. 20 Sept 2011, PSA 47.67 Medical treatment with Casodex & Zoladex. Vegetarian diet.
  10. 15 Oct 2011, PSA 4.67  On Casodex.
  11. Stopped Casodex on 30 October 2011.
  12. 21 Oct 2011, Visited CA Care Penang. Spoke with Chris Teo.
  13. 25 Oct 2011, Singapore General Hospital. Urology Department. MRI : no metastasis, prostate cancer (organ confine ). Advised to undergo surgery / radiation. Surgery, robot – assisted radical prostatectomy. Radiation : IMRT technique ( 37 session ). Declined medical treatment as suggested by SGH doctor.
  14. 1 Nov 2011, Start on CA Care’s herbs: Capsule A ,Prostate A & Mt.Guava Tea for two weeks.
  15. 15 Nov 2011, PSA 0.37 Continue with CA Care’s herbs.
  16. 14 December 2011, PSA 0.19.

This is indeed an interesting case. However, there are many things that need clarification. We requested Pak Teddy in Jakarta to meet up with ML and get some answers from him.

Below is Pak Teddy’s e-mail.

Hello Prof. Chris,

These are the answers from him. He came yesterday. He visited for about 45 minutes and had to go to another place after that.

 Questions 1. When and why did he come and see you?
He came to see me on 27 Sept 2011. He wanted to know about the herbal therapy from CA Care.

2. Who asked him to come?
A friend in the church inform him of my address.

3. When he came — did he believe what you told him? 
At that time I don’t know he believed me or not. But he bought some herbs that I suggested. And he came again the second time. During this second visit, he explained that after he had met me, he opened his Bible while at home. He read the page that he opened and there was this information about the Diet which I have explained to him earlier. So he followed the Diet that I suggested. He also informed me that he checked in the net about the ingredients of Capsule A. He learned that Typhonium flageliforme has the ability to fight the cancer cell. He had more confidence on our herbs.

4. He came to Penang … after he saw you — but he did not take the herbs yet. Why — he was not sure? After he came to Penang he started to take the herbs? 
Yes, he did not take the herbs immediately after see me. This was because he was not sure of it. At that time he was on Casodex. He wanted to know how far the Casodex works. He started Casodex + Zoladex Injection (first injection ) on 23 September 2011. He stopped taking Casodex on 30 October 2011.

On 21 October 2011 he visited you in Penang. After meeting you and after reading the book he bought (Prostate Cancer Healed Natually), he became more confident that he was on the right track.

On 25 Oct 2011 he went to Singapore General Hospital, Urology Department. He was advised to undergo surgery/ radiation. Surgery is robot-assisted radical prostatectomy. Radiation is IMRT technique  (37 session ). He refused the suggested medical treatments.

5.  Besides the PSA going down,  did he feel better after taking the herbs?

Yes he felt that his body  was more comfortable.
6. He was taking Casodex and Zoladex injection, for only one month and the PSA went down from 47.65 to 4.67 — that means the medication is working. Why did he give these up and go for herbs? 
Because he is afraid of the side effects of the drugs.

7. With less than a month on Casodex and Zoladex…what did he expect the PSA to be? — I think PSA dropping to 4.67 is very good indeed.
Yes he knows that. If he continues with the Hormone therapy he can get the PSA to go down but on the other hand he did not want to take the risk of the side effects  …bone destruction , etc.. He doesn’t want to have additional disease or problems. He better take the herbs. He believes herbs do not have side effects.

8. Did he stop the Caxodex and Zoladex totally when he took our herbs?  
Yes he totally stopped  Casodex on 30 October 2011. Then he start with our Herbs on 1 Nov 2011(only herbs).

9. Now his PSA is 0.37  — how sure is he that it is the herbs that make the PSA go down? It can be due to the effect of the Casodex/Zoladex. 
He knows that. May be the Zoladex effect is still at work ( 3 months effectiveness ) but once again he doesn’t want to continue because of the possible side effects. Now he is happy and explained to me that he only wants to continue with the herbs.

His doctor friends were surprised. You have a prostate cancer problem, but you keep smiling and  you seems to be  easy going ( because they know that prostate cancer can kill  him). He explained to me that all his doctor friends were worried about him.

He always replied them: I don’t have to go for surgery. But my PSA is now almost zero. Bye , bye  surgery  ( with a smile on his face ).


10. Is he going to stop taking the herbs — or when is he planning to continue taking the herbs?

No, he wants to continue with the Herbs.

Comments

 There are a few lessons we can learn from this case after you have listened to our conversation in this video.

1.  About being a stubborn person

ML’s PSA reading was elevated since April 2008. It was then at 9.31. ML took herbs (not from CA Care). The PSA kept increasing inspite of this herbal treatment. It was not until September 2011 that ML had a biopsy toconfirm what was wrong with him. A biopsy indicated prostate cancer with Gleason score of 7 – take note the maximum score possible is 10. So medically this was a rather serious cancer.

I asked ML this question: You were taking the herbs from April 2008 – the more and longer you took the herbs the higher the PSA went up. Why did you continue taking the herbs – increasing PSA means the herbs were useless – why continue taking the herbs or doing the same thing?  His wife replied that he (husband) was stubborn. Being stubborn can be either bad or good. Stubborn combined with “foolishness or stupidity” can lead of disaster.  If things do not work out the way it should for you, why hang on to it? At CA Care we tell our patients this: “Take the herbs of two or three weeks – a month at most. Ask yourself if the herbs help you or not. If you don’t benefit from the herbs within this time frame, stop taking them. Go and find someone else to help you.”  Hanging on to our herbs for months without any benefit is not only a waste of money but more importantly risking your life.

The good side of being stubborn (or having a mind of your own) is that you are not like a cow to be led by the nose! Just because the expert said something, you must follow. ML went to the experts in Singapore and he was offered robotic surgery or radiotherapy.  How do you like that? Better to be stubborn?

Dr. James Watson is a Nobel Prize winner in Medicine. This honor was in recognition of his discovery of the DNA double helix structure. He also was the first director of the National Institutes of Health’s Human Genome Project from 1988 to 1992. Now 83 and the chancellor emeritus at Cold Spring Harbor Laboratory, Dr. Watson was diagnosed with prostate cancer. After looking into radiation treatments and surgery, he decided on a course of “watchful waiting.” He said, “I was 80 and probably won’t live to be 90. So I will probably die of something other than prostate cancer.”  He takes ibuprofen (pain killer) every morning as well as a diabetes drug.  He also gets “hard exercise” in the form of vigorous tennis matches.  Being famous as he is, he could get the best medical treatment for prostate cancer in the world but he did not want to go for medical treatment. Why? Sometimes it is good to be stubborn!

2.  Side effects of Casodex and Zoladex

ML did not wish to continue with Casodex and Zoladex (even though they seemed to help) because of the risk of side effects.  I came to know that both ML and his wife were “medically trained”. So they know what “scientific medicine” is – they believe herbs are safer. Each of us has our preference – some would say herbs are not scientific or proven and liken them to snake oils, while others like ML thinks otherwise.

Let me remind you this – do not make choices solely on your preference, personal liking or belief. Make your decision based on research data available to you. Read and learn for yourself – research the facts and write these down and then use your head and heart to make sense of what you know.  That is a better  way  to make a wise decision. Before that, read and know the facts first. So here are the facts about the side effects of Casodex and Zoladex.

Common side effects of Casodex: Back, pelvic, stomach, or general body pain; constipation; decreased sexual ability; diarrhea; dizziness; frequent urination, especially at night; gas; headache; hot flashes; nausea; stomach upset; sweating; trouble sleeping; weakness.

SEVERE side effects of Casodex: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; difficulty swallowing; unusual hoarseness); black or bloody stools; blurred vision or other vision changes; bone pain; breast growth or pain; changes in the amount of urine produced; chest pain; dark or bloody urine; fainting; fever, chills, or persistent sore throat; flu-like symptoms; increased hunger, thirst, or urination; joint pain, stiffness, or swelling; loss of appetite; mental or mood changes (e.g, anxiety, depression); muscle aches or weakness; numbness or tingling of the skin; pale stools; severe or persistent cough; severe or persistent dizziness, drowsiness, or headache; severe or persistent nausea or stomach pain; shortness of breath; swelling of the ankles, legs, or feet; unusual bruising or bleeding; unusual tiredness or weakness; vomiting; weight change; yellowing of the skin or eyes.

Less serious side effects of Zoladex:  hot flashes, sweating, headache, dizziness; mood changes, increased or decreased interest in sex; vaginal dryness, itching, or discharge; impotence, fewer erections than normal; breast swelling or tenderness; bone pain; diarrhea, constipation; sleep problems (insomnia); or acne, mild skin rash or itching.

Serious side effect of Zoladex:  back pain, severe numbness or tingling in your legs or feet; muscle weakness, problems with balance or coordination; loss of bladder or bowel control; urinating less than usual or not at all; pain or burning when you urinate; blood in your urine or stools; feeling like you might pass out; trouble breathing; pale skin, easy bruising; nausea, loss of appetite, increased thirst, muscle weakness, confusion, and feeling tired or restless; high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss); sudden numbness or weakness, sudden severe headache, confusion, problems with vision or speech; or chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.

(The list on side effects is obtained from the website, http://www.drugs.com/zoladex.html)

In our question to ML we asked: Besides the PSA going down, did he feel better after taking the herbs?

His answer was:  “Yes he felt that his body was more comfortable”. This is important. Do you learn anything from this  often repeated statement –  “The operation is a success but the patient died of complication.” What is the point of having an operation if this is the outcome? It is most shocking to read what Dr. James Forsythe wrote in his book, The Compassionate Oncologist, According to Big Pharma and the cancer industry, death from chemotherapy is acceptable as long as standard chemo protocol has been adhered to” (page 91).  Can you believe that?

3.   Diet for your cancer

This is the most frustrating point of all. Over the years working with cancer patients, we have this uphill task of telling patients to take care of their diet. Diet is important for your cancer. But it is a hard battle. Dr. James Forsythe (in The Compassionate Oncologist) wrote, “I know from firsthand experience that oncologists and physicians aren’t allowed to talk about supplements or diet as part of cancer treatment.”

  • Patients were being told that they can eat anything they like. Diet has nothing to do with their cancer – eat anything and be happy! Eat well so that you can come back for more chemo or radiation! Unfortunately many cancer patients don’t like the idea of not being able to eat what they like. They say: “I am already dying and now you tell me not to eat what I like. I better eat now before it is too late.” Others would say: “Go and see this Chris Teo and you die because you cannot eat many things you like.”  I remember one classical case of a medical doctor who came to ask for help. He had undergone chemos after chemos but the treatment did not cure him. After I told him to take care of his diet he said, “No, I don’t believe you. I cannot follow what you advised me.” To that I replied, “No, my therapy is not for people like you. If you are not prepared to take care of your diet, go somewhere else for help.”
  • Lately, I learnt that there is a bit of progress. A patient came to us after being told by his doctor that he should go home and just wait, but at the same time to take care of his diet. His liver cancer is too advanced and no medical treatment is indicated. I asked the patient what did his doctor say that he cannot eat – what does “taking care of your diet” mean? To my surprise the answer was, “No he did not tell us what to eat or not to eat. He just said, take care of your diet!” It is indeed amazing such a thing does happen! How do you expect the patient to know how to follow your advice if you don’t provide more information?  At CA Care we have our books, Food & Cancer, to tell you exactly what you need to know. Then, to guide you in your kitchen there is Healthy Cooking. There is no reason now why cancer patients do not know how to take care of their diet. Even more, there is no reason why cancer patients cannot eat healthy, good tasting food.
  • In this case, ML is really lucky to find a medical doctor who encouraged him to take care of his diet.  Cheers to this doctor! Dr. Dean Ornish is a medical doctor and president of Preventive Medicine Research Institute and Clinical Professor of Medicine at the University of California, San Francisco.  Dr. Ornish has directed randomized controlled trials demonstrating that comprehensive lifestyle changes may stop or reverse the progression of early-stage prostate cancer and even reverse severe coronary heart disease, without drugs or surgery. Go to his website, http://www.pmri.org/dean_ornish.html and learn for yourself what diet can do for your cancer.

Updated:

Dear Dr. Chris Teo,
Lama tidak ada kabar dari saya, tapi masih tetap berhubungan dengan Pak Teddy. I’m doing well,  my PSA  is 0.3 in mid-February, and I’m still taking your Herbs as usually, I want to ask you is there a minimal dose to mantain my psa level, or should I take the usual dose. Thanks beforehand.  Greetings from all of us and Happy Easter.

 Update 2:

I would like to inform you, I’ve check my blood on 24 May 2012, My PSA is 0.52.

PSA down to 0.3 – Bye, Bye Radiotherapy

Sam (not real name, H328) is 61 years old. He had been enduring urination problems for the past one year plus. Then in March 2010, there was a blockage, prompting him to seek doctor’s help. A tube was inserted and over a liter of urine was removed from his bladder.

A CT scan on 31 March 2010 indicated an irregular shaped prostate, 4.8 x 3.7 x 3.6 cm in size. Few calcification were noted in the prostate gland. The prostatic urethra appeared dilated. The bladder wall was thickened. A right iliac node was about 1.9 x 1.6 cm – indicating lymhphadenopathy.

A TURP (transurethral resection of the prostate) was performed.  This is a common surgical procedure to treat the enlargement of the prostate gland.  The histopathology report of the prostatic tissues indicated a poorly differentiated adenocarcinoma, Gleason grade 4, Total Gleason score: 4+4, Stage T2c. The perineural lymphatics were infiltrated.

His PSA on 31 March 2010 was 47.07.

Sam was prescribed hormonal pill which he took for about a week or two and then stopped. He decided to see another doctor in another hospital.  MRI on 3 April 2010 showed no evidence of bony or intracranial metastasis.

Sam was given two options: One, to receive hormonal injection every three months. Or two, to undergo an orchidectomy – i.e. to remove the testes. On the advice of his doctor friend, he opted for the latter, i.e. removal of both his testes.  After the surgery, his doctor asked him to undergo 35 times of  radiation treatment. This would cost RM 23,000 (the same treatment would cost RM 28,000 in Kuala Lumpur).

The PSA on 5 April 2010 was 33.18.

Sam declined radiotherapy. He came to seek our help on 28 May 2010. He was started on herbs and was asked to take care of his diet.  On 5 November 2010, Sam came back to see us again. His PSA on 20 September 2010 returned a reading of 0.3. He went to see his doctor and was told that there is no further need to do radiotherapy. Another PSA test needs to be done in two months time.

Comments: There are two issues involved in this case study.  One, let us look at the PSA readings again.

Date PSA
31 March 2010 47.07
5 April 2010 33.18
28 May 2010 Started on herbs + diet
20 September 2010 0.3

The question to ask: Is the drastic drop of the PSA due to the removal of his testes or due to the herbs? I went into the net to search for answers.

A paper written by doctors in Brazil said the following:

Most prostate cancers are hormone-dependent; this means that they need testosterone for disease progression. Ninety percent of testosterone is produced by Leydig cells of the testis, whereas adrenal glands account for 5% of this production. The simplest way to get a hormonal blockade is bilateral orchidectomy.

Between January 2001 and December 2001, 32 patients with advanced prostate cancer underwent bilateral orchidectomy at our Hospital. They had the following results:

  • 4 patients required anti-androgens after surgery to control rising PSA.
  • 27 patients had decreased PSA level. The lowest nadir obtained was 0.08 ng/mL.
  • 4 patients showed no PSA decrease 30 days after orchidectomy.

A paper written by doctors in India said:

  • Orchidectomy over the decade has been the most effective tool for lowering the circulating testosterone.
  • Prostate tumor may respond in a variety of ways to castration therapy (orchidectomy).
  • There is no definitive way to predict which patient will respond to orchidectomy.
  • PSA has been used as the clinical marker to monitor the disease.
  • In the present study, we recorded changes in PSA level after orchidectomy and it was evident that maximum percentage changes in PSA are seen in the first three months after orchidectomy.

In another research paper was this information.

  • A bilateral orchidectomy was performed.  In all 3 cases PSA and testosterone levels were reduced following castration, although PSA levels again began to increase within two weeks of orchidectomy in 2 of the 3 patients.

Further reading led me to what patients wrote in the chat rooms. The following are some examples.

One reader wrote:

My father has been recently diagnosed with Prostate Cancer. He underwent orchidectomny a month ago (by a local general surgeon). He is on Zometa on a monthly basis. The PSA before surgery was 160. Few days ago, the blood tests were done and his PSA was about the same, 160. I was wondering how quickly PSA will fall after orchidectomy? If it does not fall, what does it mean to the treatment?

A reader asked this question:

I’ve had an orchidectomy, so my testes don’t produce testosterone. My PSA is rising and my doctor has suggested that I get an injection of Lupron (or Zoladex). Why?

What are the after effects of an orchidectomy?

Orchidectomy causes sudden hormone changes in the body. Side effects from hormone changes include: Sterility, Loss of sexual interest, Erection problems, Hot flashes, Larger breasts (gynecomastia), Weight gain, Loss of muscle mass, Thin or brittle bones (osteoporosis).

Another reader wrote:

Besides the list of side effects that JCR gave you there are also upwards of 20 more. Some of these side effects are loss or reduction of short term memory, loss of strength, loss of body hair, possibility of having pain in joints and back, mood swings–some of which can be anger and/or increased sensitivity to situations that can result in crying.

What to think about.

Removing the testicles is one way to cut down on testosterone and other male hormones. Taking medicine is another way to reduce androgen levels in your body. Some men may prefer surgery over taking pills or having injections. But if you choose to take medicine, you can stop taking the hormone drugs. And the side effects from taking medicine may go away. An orchidectomy is permanent. Some men choose to have reconstructive surgery after an orchidectomy, in which the surgeon replaces the testicles with artificial testicles.

From the above information and discussion, it appears that undergoing orchidectomy makes sense to some people, because removal of the testes deprives the prostate of the hormone it requires. That is provided the patient can come to term with the idea that he is being castrated. As the doctor friend of this patient said – you are already old! But think again, is 61 years old a bit too young to do such a thing?

Another point to note is that not all orchidectomy leads to a drastic drop in the PSA. And also, a drop of PSA does not mean the disease is cured.

The second comment I wish to raise about Sam’s case is the idea of opportunity cost. This is something that I learned   in my economics class in the 1960s. The dictionary definition of opportunity cost is: The cost of an alternative that must be forgone in order to pursue a certain action. Put another way, the benefits you could have received by taking an alternative action.

Opportunity cost is one of the most important and fundamental concepts in decision making. We have to look at what sacrifices we make when we have to make a choice. Cost here implies something is being sacrificed or involves having to give up something.

So, opportunity cost is the process of choosing one good or service over another.  Even though you might not realize it, you use opportunity cost every single day – to make choices about what you do every day.

In Sam’s case, after surgery he was asked to undergo 35 times of radiation treatment at a  cost of RM 23,000. What could have happened if he were to follow his doctor’s advice? The material effect is, he would have to spend RM 23,000 for the treatment. With the treatment comes the various side effects which could be devastating or otherwise. His quality of life would be adversely affected in one way or another.  Then look at another direction. Sam turned to herbs. His PSA dropped to 0.3 and the doctor said Sam need not do radiotherapy anymore. How much good is the advice of doing radiotherapy then?

There is one danger that I can foresee.  Now that the PSA has gone down to 0.3, patient appears to be out of danger! It is hard to convince him that this is not a cure. The cancer might recur. After some months, most patients go back to their old ways again.