Over the last 15 years, I have seen an increasing number of patients with prostate cancer, and by using a comprehensive and collaborative approach, I have seen some truly amazing results.
Cancer is the disease of our time, and it persists as one of our greatest medical challenges.
Why Cancer is Hard to Treat
Two major factors that contribute to the unique challenges of treating cancer:
1. Cancer’s ability to adapt. Just like all living systems, when confronted with a strong environmental challenge, cancer evolves, it mutates, and it takes advantage of any natural system that is available in order to survive.
2. Uncontrolled growth. Once a 2 millimeter malignant lump or bump is discovered, there are already millions of cancer cells present in the tumor, and the disease has generated significant momentum.
On the positive side, most prostate cancers develop slowly, giving us an opportunity to alter the internal biological terrain to curtail its growth.
I have found that a treatment protocol that combines botanical medicine, nutrition, diet, and lifestyle, and sometimes a low dose of a pharmaceutical agent called Avodart has shown positive and durable results in many of my patients.
The Role of Avodart
One of the primary fuel sources driving the progression of most prostate cancers is a hormone metabolite called dihydrotestosterone, or DHT.
DHT is a product of the breakdown of testosterone by an enzyme called 5 alpha reductase. This enzyme is the target of several of the key nutrients and botanical compounds that I work with, and is also the target of the drug Avodart (Dutasteride). In some cases, I will recommend that a patient speak with their urologist or primary care doctor about getting a prescription for Avodart as a part of an integrative protocol.
Although often prescribed to eliminate DHT entirely, I have found that by suppressing DHT to just below normal levels, patients achieve good disease control, with minimal side effects.
Similarities Between BPH and Prostate Cancer
The prostate gland gets larger in most men as they age, and most men if they live long enough, will experience some form of prostate disorder.
Benign prostatic hyperplasia (BPH) and prostate cancer share similar etiologies in that both are often characterized by dysfunction of key enzyme pathways. These include the 5 alpha reductase enzyme system, which leads to elevation of dihydrotestosterone, along with reduction of free testosterone; and the aromatase system which converts testosterone into estrogen, leading to elevated estrogen levels in the blood.
Many pathophysiological mechanisms contribute to these and other changes associated with prostate cancer and BPH, including:
- Oxidative damage;
- Elevated homocysteine and methylation defects;
- Lipid imbalances;
- Vitamin and mineral deficiencies; and
- Enzyme system dysfunction leading to hormonal imbalance.
Prostate cancer further involves many growth pathways associated with proliferation, tumor progression, and angiogenesis.
Treatment Plan Basics
Whether for BPH or prostate cancer, a thorough prostate health protocol should aim to:
- Address relevant constitutional factors;
- Supply key nutrition;
- Reduce oxidative damage and inflammation;
- Modulate important enzyme systems;
- Improve hormone efficiency; and
- Inhibit proliferation and tumorigenesis.
In my clinic, treatment also includes a tailored combination of botanical formulas to balance the endocrine system as a whole, while simultaneously targeting the known pathway disruptions associated with prostate cancer and/or BPH.
The Role of Botanical Medicine in Oncological Therapy
Chemotherapy and “targeted agents” (TKI or MAB) have specific “targets.”
What often happens is that because cancer cell populations are not homogenous (that is, there are cells bearing different genetics within a given tumor), the oncological therapy destroys the cell population that is susceptible to its action, but some other population(s) within the tumor survive and grow – unaffected by the intervention. Simultaneously, the unaffected cell population(s) are unhindered by competing cell lines that were destroyed by the chemotherapy.
This new population is often resistant to the original therapy, and has less internal competition from other cell lines, which makes finding effective oncological treatments more difficult.
Medicinal plants and plant compounds are extremely valuable in this context because they do not target a single pathway, or receptor – rather, they affect many pathways simultaneously, modulating cellular activity and altering the biological terrain of the body to inhibit cancer.
Traditional Chinese Medicine and Cancer Care
Traditional Chinese Medicine (TCM) doctors have been treating cancer for as long as the disease has been around (earliest inscriptions depicting tumors were on tortoise shells from the 16th-11th centuries B.C.).1Li X, Yang G, Li X, Zhang Y, Yang J, Chang J, et al. (2013) Correction: Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese. PLoS ONE8(6): 10.1371
TCM treatments include the use of specific botanical formulas, nutrition, dietary and lifestyle interventions, and additional TCM therapeutics such as acupuncture, moxibustion and manual therapy. This whole medicine approach addresses the whole person and supports the endocrine and neuroendocrine systems, balances the organ networks and resolves pathological factors by utilizing all relevant information and applying therapeutics based on individual presentation.
In the modern oncological setting, cancer treatment is based on biomedical assessment with lab work, scans, pathology reports, and genetic testing. The treatment generally consists of surgery, chemotherapy, radiation, immunotherapy, and/or targeted agents.
In many cases, a collaborative approach is the most beneficial one, where TCM and modern biomedicine assessments and treatments are interwoven into a well-orchestrated, comprehensive protocol. In this setting, TCM therapeutics are often utilized for the prevention of drug side effects, the maintenance of the healthy cells in the body, and for helping to make biomedical treatments more effective through herb/drug synergy.
Fortunately, we are seeing increasing demand for holistic care within the conventional medical model: the top 10 Cancer Centers in the U.S. provide Integrative Medicine Service or Integrative Therapies Programs, which include acupuncture.
An Unconventional Perspective on Cancer
As someone who has developed an intimate relationship with cancer, what I call “the disease of our time,” I have dedicated a great deal of my life to evaluating the potential for a holistic, collaborative approach to managing this disease.
The greatest inroads we can achieve at this time come in the form of preventive strategies that improve health and well-being. The old adage, “an ounce of prevention is worth a pound of cure,” takes on a different importance in the field of oncology, and my own adaptation in this context is, “an ounce of prevention, is worth a TON of cure.” The process of going through modern oncological treatment for cancer can be severely debilitating and can have lifelong negative effects on our bodies.
The process of “fighting cancer” is a much more difficult and disturbing place to confront this disease, and unfortunately this is where most of our effort is spent. Although almost every one of us has been touched by it, “the race for the cure” is somewhat of a futile endeavor. Unfortunately, there just isn’t a magic bullet to kill cancer… It takes a concerted effort directed at the individual and their unique set of circumstances. If we don’t direct our efforts and intention at the prevention of this debilitating disease, we may find ourselves deep in a war we cannot win.
My first goal in managing cancer and chronic disease is to slow the progression of the disease, then stabilize the disease process while strengthening the person, then reverse the disease process, which could take weeks, months, or years, and eventually find a long term, managed solution, or in some cases a “cure.”
However, the practice of good medicine is not all about cure. It’s first about helping people: helping them face the many choices and decisions that a cancer diagnosis brings by deepening their understanding of what is happening in their bodies, and what potential treatments are available. It’s also about supporting them through the process, and providing them with a comprehensive review and interpretation of the current literature surrounding their condition, and an assessment of the outcomes associated with specific treatment regimens.
One of my primary goals for every cancer patient is to help them become as healthy as they possibly can be. By addressing imbalances with botanical and nutritional medicine, and supporting people’s bodies with positive dietary and life style choices, no matter what treatment direction a patient ultimately chooses, they will be well prepared to face it.
This writing is adapted in part from my article, Combining Traditional Chinese Medicine and Modern Medicine in the Treatment of Cancer published in Cancer Strategies Journal, 2013.