A Prostate Cancer Case Study: Part 4

Jim Flood discovered he had an aggressive form of prostate cancer in 2008. In his series, "You’re Only As Good As Your Last PSA," he details his journey from being diagnosed to receiving treatment to coping with side effects. Read A Prostate Cancer Case Study: Part 1, Part 2, and Part 3.

Life changes amid prostate cancer

Plant-based diet

As Hippocrates also said, "Make food your medicine, and medicine your food." Over the last 10 years, my diet has evolved from omnivorous to dairy-free to full vegan. Everything I eat is plant-based and usually organic. It is broadly what is called the Mediterranean diet, less the animal protein.

We get most of our fresh food from organic box suppliers. Happily, my reading menu has returned to something nearer normal, but I keep up-to-date with the diet/nutrition/cancer scene through a small number of excellent websites. There is rarely anything random in what I eat or drink.

It may be, as much of the literature suggests, that such a diet is essentially preventative rather than curative, in which case the stable door is swinging in the wind. On the other hand, it must be good for my aging microbiome and therefore for my immune system in general.

Regular exercise

"Walking is man’s best medicine," said good old Hippocrates again. All the authorities emphasize the importance of regular exercise along with diet. My running career ended about 15 years ago when arthritis in my left knee put a stop to it. Walking, dancing, and cycling stepped up to the plate.

Cycling bit the dust literally about 3 years ago, when twice in 18 months I blacked out on the bike, crashed, and hurt myself (and the bike) quite badly. The hospital investigated but could find no satisfactory explanation, although they did let slip that I was not the first such case.

Now the COVID-19 lockdown has stopped all dancing, and a long walk is difficult to fit in every day. So I have developed a 10-minute fitness routine consisting of running up and down the stairs from the cellar to the attic 4 times, followed by a few exercises like press-ups and abdominals, and stretching with therabands. Twice a day is the aim – not very ambitious really but requiring a surprising amount of self-discipline.

Trying meditation

Meditation leading to serenity is what much of the literature regards as the third pillar of the DIY approach to cancer. I can’t claim to have had much success in this department, despite serious attempts at yoga and pilates. I’m ambivalent: part of me quite fancies a bit of serenity, part of me equates it with inactivity. I seem to need movement to generate thoughtful thoughts.

In my youth, my best ideas often came during cross-country runs. Each to their own. Obviously, I am not against meditation, just not very good at it. My thoughts are in fact mostly centered on my 3 lads. They have been wonderfully supportive over these 12 years, and in my old age, we exchange wit, wisdom, and practical help. I suppose you could call it applied meditation.

PSA rollercoaster

My cancer has settled into a kind of volatile stability: the PSA rises steeply until it reaches the mid-teens, a hormone injection fells it like a stone to near 1, it slowly recovers, and the cycle begins again.

I am grateful to the consultant for 2, to me, very important things: firstly, he is of the school that believes in "intermittent" treatment, whereby hormone injections are given only when the PSA rises above a certain level instead of automatically every quarter; and secondly, he has delegated the whole management process to my GP.

The 3-month injections have turned out to be effective for 12 to 15 months at a time. Nobody seems to know why or how common this is. I like to think that it lulls the famously crafty cancer into complacency: why bother creating your own alternative blood vessel support system when you only get knocked on the head once a year?

The injection always has a dramatic effect on the PSA. Whether my diet and exercise regime makes any contribution to that depends on whom you ask.

An uncertain future

How long have I got? No doctor will say, because no two cancer cases are the same. Perhaps it is better not to know; in this instance, ignorance may be bliss. That's especially if one of these days the hormone treatment begins to fail, as I am assured it will, and I am urged on to the next step: the dreaded chemotherapy.

The fact is that in 12 years, the cancer has yet to cause me any pain or even inconvenience, whereas the treatments have given me significant disabilities. On the other hand, without them I would not have discovered what I now regard as healthy eating; it’s a silver lining of sorts.

Improving my chances of survival

It is also true, of course, that if I had not had the treatments and the cancer had continued to grow and probably spread, I would have tormented myself with eternal "if onlys." Anyway, alongside the orthodox medics, I now use a qualified herbalist, who understands diet and dispenses personally tailored brews and tinctures.

I have to believe I have improved my chances of survival with a diet immeasurably better than it used to be, but then it started from a low base. I also think it helps to have purposeful things to do, and I persuade myself I have plenty of them.

A regular reminder

The quarterly PSA test is a regular reminder of mortality, a check on hubris. Until 2008 I had assumed I would go on more or less forever. Now I know you’re only as good as your last PSA.

I am happy to share my experience and the lessons learned along the way with anyone who is interested or maybe in a similar situation, but I am all too aware of the danger of becoming a medical bore.