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Prostate Cancer- Treat or Active Surveillance?

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Evidence-based, Non-toxic Prostate Cancer Therapies Is Both Treatment And Active Surveillance

A diagnosis of prostate cancer doesn’t really give you actionable information these days. It is the stage at diagnosis and prognosis that results from your diagnosis of prostate cancer that really matters to you.

On the one hand you could live with slow-growing prostate cancer in your prostate for the rest of your life and die peacefully in your sleep in your nineties. Conversely, you could be diagnosed with prostate cancer and it could grow, spread to other parts of your body and you could die a young man.

So what is a newly diagnosed man with prostate cancer supposed to do? The challenge you face is that active treatment of prostate cancer will cause side effects- potentially serious side effects.

If you have prostate cancer that is low risk meaning that you have little risk of developing real health problems from your prostate cancer, you might want to utilize evidence-based but non-conventional therapies shown to reduce your risks further.


  • Nutrition
  • Supplementation
  • Lifestyle therapies 

I am both a long-term cancer survivor and cancer coach. I work with cancer patients and survivors to provide the most effective of both conventional (FDA approved) and evidence-based but non-conventional therapies.

Click the links below to learn more about low-risk Prostate Cancer-

For more information on prostate cancer supplementation, lifestyle therapies and nutrition, please scroll down the page, post a question or a comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Clinically significant and non significant prostate cancer an ongoing question.

“One of the most important problems in urological practice is how to differentiate clinically significant and non significant prostate cancer (Pca) i.e. how to avoid over treatment of tumors with low malignant potential in one hand, and inappropriate less aggressive treatment of significant tumors, on the other hand…

Transrectal ultrasoundguided prostate biopsy id the golden standard, but there are few dilemmas concerning prostate biopsy: the number of biopsy cores, inter and intra-observer variations in the grading, the significance of PIN, multifocal character of PCa etc.”

Prostate Cancer Blood Test May Avert Biopsies

“The Prostate Health Index (phi), a blood test that combines 3 PSA measurements into a single score, improves detection of clinically significant prostate cancer (PCa) and could help decrease the number of unnecessary prostate biopsies, researchers reported…

The researchers used the Epstein definition of clinically significant PCa (Gleason score 7 or higher, 3 or more positive cores, and more than 50% involvement of any core)

The test measures total, free, and [-2]proPSA (p2PSA), the latter being an isoform of free PSA identified as the most PCa-specific form found in tumor extracts…

“Phi is a simple blood test that we recommend for use as part of a multivariable approach to reduce unnecessary biopsies and over diagnosis,” the authors concluded…

Dr. Loeb’s group acknowledged some study limitations, including the use of biopsy criteria to define clinical significance. “Although biopsy criteria are frequently used, these end points are not perfect and other factors such as life expectancy also have a key role in defining over diagnosis,” they wrote…”

Understanding Your Genomic Prostate Score

“…The result provided by the Oncotype DX prostate test is called your Genomic Prostate Score (GPS). Your GPS provides important information about how aggressive your cancer is based on the biology of your individual tumor. Used along with other test results, your GPS can help to personalize your treatment plan and give you and your doctor greater confidence in choosing your course of care….”

Time Trends and Variation in the Use of Active Surveillance for Management of Low-risk Prostate Cancer in the US

“What are the recent trends and ongoing variation in the use of active surveillance for patients diagnosed with low-risk PCa…

In a cohort study of more than 20 000 men treated at nearly 350 urology practices across the US, with data drawn directly from electronic health record systems, rates of active surveillance increased sharply from 26.5% in 2014 to 59.6% in 2021…

Participants  This retrospective analysis of a prospective cohort study included men with low-risk prostate cancer,

  • defined as prostate-specific antigen (PSA) less than 10 ng/mL,
  • Gleason grade group 1, and
  • clinical stage T1c or T2a,

newly diagnosed between January 1, 2014, and June 1, 2021..

Results  A total of 20 809 patients in AQUA were diagnosed with low-risk PCa and had known primary treatment. The median age was 65 (IQR, 59-70) years; 31 (0.1%) were American Indian or Alaska Native; 148 (0.7%) were Asian or Pacific Islander; 1855 (8.9%) were Black; 8351 (40.1%) were White; 169 (0.8%) were of other race or ethnicity; and 10 255 (49.3%) were missing information on race or ethnicity.

Rates of AS increased sharply and consistently from 26.5% in 2014 to 59.6% in 2021. However, use of AS varied from 4.0% to 78.0% at the urology practice level and from 0% to 100% at the practitioner level. On multivariable analysis, year of diagnosis was the variable most strongly associated with AS; age, race, and PSA value at diagnosis were all also associated with odds of surveillance.

Conclusions and Relevance  This cohort study of AS rates in the AQUA Registry found that national, community-based rates of AS have increased but remain suboptimal, and wide variation persists across practices and practitioners. Continued progress on this critical quality indicator is essential to minimize overtreatment of low-risk PCa and by extension to improve the benefit-to-harm ratio of national prostate cancer early detection efforts…




Leave a Comment:

John says 7 years ago

Hello David – I will try and be brief.
jan, 2015: first ever PSA test @ age 52 – PSA of 6
July, 2015: 2nd test: PSA score of 8
Oct, 2015: biopsy, gleason 3/3 in 8 of 12 cores, high of 30%

Doctors recommend the “gold standard” (their words) of prostatectomy.

I have gone cold turkey and stopped coffee, sugar, meat, oils, and dairy. Basically a McDougall diet. then I read about Budwig, and for the last 7 days I have been taking FO/CC mixture twice a day – not very McDougall-ish. I also started exercising and have lost 12 pounds.

What are your thought on all of this? I told the doctors in October I will make a decision in Jan. or Feb.

I have no symtoms and overall I feel great. I still can’t believe I actually have cancer.

    David Emerson says 7 years ago

    Hi John-

    I am sorry to read of your prostate cancer diagnosis. I have to say however, that you are doing a great job of pursuing lifestyle therapies that may already be lowering your PSA.

    To answer your questions:

    1) If you are interested I will link evidence-based research citing the citotoxic properties of antioxidant supplements such as curcumin, green tea extract, etc. This form of therapy is a good idea regardless of what additional therapies you choose at a later date.

    2) A prostatectomy can and usually does lead to serious collateral damage such as incontinence and erectile disfunction. I will link info that calls into question the need for this aggressive therapy for your stage.

    3) If, after reading the HIFU info linked below you are interested in learning more about that therapy I can do further research for you- studies, specialists, that kind of thing.

    Please read the study conducted by Dr. Dean Ornish regarding gene expression of men diagnosed with low grade prostate cancer (you).

    Prostate Cancer Genes Altered By Intensive Diet And Lifestyle Changes

    This is the HIFU info-

    High-intensity focused ultrasound (HIFU) for prostate cancer- low side-effect curative approach ?

    John- after reading the above you may still decide to have a prostatectomy. This is up to you. My goal is to provide a spectrum of information for you so that you can have choices.

    This is a link to Gleason info that relates to you-

    Let me know if you have questions about the above info.


    David Emerson

Jian Yuan says 7 years ago

My dad has a PSA >1500? is there still chance to be treat? He is 69 and was very healthy before… feeling sick for about 4 month…

    David Emerson says 7 years ago

    Hi Jian-
    A very high PSA can be misleading. Please read the link below. Please consider having another psa test done as well as a biopsy. Please have a biopsy, get more information and we can discuss your/your dad’s treatment options. Contact me again and I can recommend both conventional and non-conventional therapies. Hang in there. David Emerson

    How High Can the PSA Go?
    “It is possible for the PSA to go to very high levels. There is no absolute maximum value. In fact, I have seen PSA values over 2000 ng/mL. As a rule of thumb, the higher the serum PSA, the more extensive the tumor, but this is not an absolute rule or a direct relationship. It varies from individual to individual. For example, a man with a PSA of 40 ng/mL does not have twice as much tumor as a man with a PSA of 20 ng/mL. It IS generally true, however, that a man’s PSA will go from 20 to 40 when the tumor roughly doubles in size. Each person’s tumor makes and leaks PSA at its own rate. Similarly, I have patients with PSAs over 300, yet who are alive without tumor 10 years after receiving radiation and hormones. Having said that, a smaller fraction of that group is alive than out of the group of men with PSAs of 10….” read more…

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