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Prostate Cancer Bone Metastasis: Why Standard Treatment Fails Men and What to Do Instead · Intellectual Medicine

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  The message is live life, don't anticipate death, maintained
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  vitality. Nobody can guarantee us
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  tomorrow. And I do not want to pay the
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  price of today's misery for some false hope that it'll make me
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  live longer. Do you really want that piece?
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  I want both. I want both for you.
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  So there is a desperate need for alternative approaches, even in
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  the setting of metastatic spread.
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  So we know the first thing you do when there's a suspicion of
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  prostate cancer being present based on an elevated PSA,
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  abnormal MRI of the prostate is you do not get a biopsy.
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  It stirs things up, can spread disease.
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  But suppose you go to the doc and the cancer has already gone
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  to the bone your first time in, you're feeling pretty good and
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  you're having some back pain, and lo and behold, it's prostate
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  cancer in the bone. Now, first back pain is common,
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  but back pain caused by metastatic cancer is pretty
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  darned uncommon. So do not get a bunch of imaging
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  studies. Wait a few weeks.
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  If you strained your back, it's going to get better.
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  If not, the cancer will still be there.
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  It's not going to make a difference in your outcome.
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  So you present to the doctor, now you've got it in the bone.
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  What next? I still do not advocate
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  conventional approaches. The problem, they're going to
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  damage your health. You are going to suffer a
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  negative consequence because the approach of conventional
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  medicine toward metastatic cancer to the bone, prostate
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  cancer to the bone, is testosterone annihilation.
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  You take testosterone out of your body, you're going to get
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  tired, weak, develop breast. In all likelihood your sex drive
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  goes away, you get depressed. It is a horrible way to live.
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  It's a terrible thing to do to a man.
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  And all that misery and the cancer will eventually progress.
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  Not maybe 100% of the time that cancer is going to progress.
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  You got to have honest information, men.
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  That's called castration resistant cancer.
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  OK, A lot of things bad in that sentence #1 castration.
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  Are you kidding me? Going to cut your testicles out
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  of you, whack your testosterone for what?
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  So you feel like a like a jellyfish and the cancer
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  progresses. Anyhow, this is O for two guys.
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  In fact, there's a better way. We'll talk about that, an
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  alternative approach that I advocate.
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  First, more about prostate cancer and how it moves.
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  If you don't have it in the bone currently, that's a fear.
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  You think about that, it's out there.
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  Suppose it goes to the bone. What can I do to make it not go
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  to the bone? That's what the protocol focuses
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  on. Conventional medicine aspires to
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  achieve that goal. The way they do it, however, is
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  not worth the price of admission.
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  They do it by causing irreparable harm.
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  And Despite that irreparable harm, the cancer can still
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  progress. Take the prostate out.
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  You would think that'd be the end of the story, right?
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  No prostate, no problem. False studies now have
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  demonstrated. After 20 years of following men,
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  we know that you can still get metastatic disease to the bone.
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  Horrible but true. You suffer the consequence of a
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  surgery, radiation is even worse, and now here it comes
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  back again. So do not let them scare you.
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  And you're doing something irreparable, certainly not
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  without contemplation. My advocacy is for honest
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  information. Forgive men choices.
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  Not the same treatment offered by 8 different docs.
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  That's what's out there currently.
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  I've developed my protocol to give men another path forward
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  should they choose it, and that's what we're talking about.
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  Suppose it's in the bone. Is this repurposed drug therapy
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  pathway still viable? I believe it is.
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  Now, when or if it's in the bone, men, you've got years to
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  live. In all likelihood, the average
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  survival is measured in years 5 to 7, even with conventional
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  treatment, even with its progression now, yeah, there are
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  cases where it's like a House of fire.
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  They're uncommon. Every now and then there's a
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  variant of the prostate cancer that causes rapid progression
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  that is a bit random. It's sad if it happens, but
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  there is no way to determine whether or not that's your fate
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  by virtue of doing biopsies. You don't stick needles in a
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  prostate gland, ever, but especially not when you already
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  know there's cancer there. You're just stirring the pot.
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  How do I know that? Well, common sense tells us
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  that. Case study reports of metastatic
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  spread tell us that, and an interesting detail regarding
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  survival points toward that. Men who present with cancer
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  already in the bone as their first symptom versus men who
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  first presented with early stage cancer and later it went to the
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  bone. The men who didn't have any
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  treatment prior to it going to the bone have a longer survival
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  from that point forward. Then the men who first had
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  treatment, then it went to the bone.
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  If you measure it from the timing of bone metastatic
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  presentation. Now I'm not advocating that
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  we're rooting for bone metastatic disease, not at all.
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  We're doing things to prevent that from happening.
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  But most importantly, you don't want to sacrifice vitality.
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  So what happens? Conventional medicine, they're
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  going to say, well, your, your PSA is going up.
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  In some cases you feel pretty good, feel pretty good.
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  The evidence shows maybe it's metastatic.
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  Maybe it's starting to creep into the bone a little bit.
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  Sometimes your studies are equivocal.
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  Guys is not a study in medicine. Very, very few of them that are
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  absolute. Even a PET scan of prostate
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  specific membrane antigen, PET scan is considered to be pretty
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  darn accurate determining if there's cancer in tissue, bones
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  and other places. But even that kind of a false
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  positive. So you've got to be very
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  cautious, particularly if you're feeling pretty good about doing
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  a treatment like castration or what they call testosterone
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  annihilation. So if the cancer goes to the
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  bone and if it's causing pain or other symptoms, a cycle of
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  androgen deprivation therapy can take away the bone pain, can
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  shrink the prostate cancer sufficiently to allow for better
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  urine flow. In other words, it can have
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  merit at this point. But here's where we part waves
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  with our friends in conventional medicine.
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  They believe in testosterone annihilation.
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  We're going to bang that testosterone level as low as it
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  can go, and we're going to follow your PSA and we're going
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  to treat you until your PSA level becomes negligible below
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  10 lower, preferably non appearing.
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  I don't support that approach. Treating APSA is different than
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  treating symptomatic cancer. You run the risk of being
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  overtreated. You run the risk of having
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  extended testosterone deprivation, causing fatigue,
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  weakness, osteoporosis, man boobs, gynecomastia and Med
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  speak depression, mood alteration, loss of sex drive,
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  loss of erections, loss of muscle mass.
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  Good Lord, how horrible you watch yourself go from a stout
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  man into a doughy jellyfish, depressed and sad.
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  Oh, by the way. And then it progresses.
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  Anyhow, yeah, don't sign me up for that path.
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  What I like to see happen instead, it's bipolar
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  testosterone mitigation. This is not standard of care.
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  That's precisely the point. The standard of care, in my
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  opinion, is awful. First they make you feel crappy,
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  then it progresses. Anyhow, no mitigation therapy
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  means a cycle of androgen deprivation to lower symptoms.
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  Take the bone pain away, make urine flow again, and the PSA
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  will go down. But the goal is not contingent
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  on the PSA. That gives us more liberty after
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  a cycle of androgen deprivation. Here's the kicker.
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  You do a cycle of testosterone therapy now.
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  Wait wait, I thought testosterone was pouring gas on
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  the fire. Doctor Huggins in the 1940s won
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  a Nobel Prize by by developing that theory.
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  That theory has been pretty well put to rest.
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  Newer studies and new scrutiny of his original studies
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  disconnect those two phenomenon. Now it is true that some of the
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  prostate cancer is sensitive and responds to lowering
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  testosterone, but not all of it. And eventually the cancer comes
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  back. What you've done in that
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  setting, it's felt, is you've damaged the cancer cells that
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  are vulnerable to lowering testosterone, But there's a
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  cluster of them that are resilient to that and they then
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  take over, start to grow, and you become what they call
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  castration resistant. The testosterone blocking
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  therapy no longer works. Now from the time they block
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  your testosterone to the time you become castration resistant
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  can happen as quickly as one year.
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  That's a bad place to be because they don't have a lot of other
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  treatments left. Your survival is still measured
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  in years, even with awful treatments.
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  You can go another five years beyond that.
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  So the message is live life, don't anticipate death, maintain
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  vitality, and by all means, in my humbled opinion, don't let
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  them put you on chemotherapy. Chemotherapy is awful for
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  prostate cancer patients. Prostate cancer is slowly
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  dividing. Chemotherapy works best on
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  rapidly dividing malignancies. It does not have, in my view, a
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  role to play in prostate cancer in the approach that I advocate
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  now. Conventional medicine loves, not
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  loves, but they support its use. You're going to feel rotten.
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  It's going to be side effects, and the cancer is going to
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  progress. You may get a reprieve, but we
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  don't know if that reprieve is improved very much by the by the
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  chemotherapy. The studies are hard to
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  interpret. Not everybody has metastatic
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  disease at the same level. Some have a little bit in the
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  bone, some have devastating extension.
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  The fear for many men is a fear of infirmity, pain, suffering.
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  This is not 1980s terminal care management guys.
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  If your destiny is this cancer is for the cancer to take your
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  life at the end, they got plenty of meds available.
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  That window of time between misery and death is really short
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  and can be well managed. I know it's scary to
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  contemplate. I don't like to think about me
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  dying. I like to think about me being,
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  well, immortal, right? We know the reality we're going
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  to die. We.
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  I like Woody Allen's quote, he said.
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  I don't mind dying. I just want to be there when it
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  happens. We don't want the extended
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  suffering. And I feel that's what happens
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  with this castration therapy. Yeah, you may not be withering
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  in pain, but you're you're a lump.
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  You'll lose your joae de verve. Now, the approach that I'm
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  advocating is research based. It is not proven to make you
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  live longer, but by golly we're going to aspire to make you live
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  better. And yes, we're going to go after
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  longevity. If we know for a fact, and it's
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  a fact, man, it's not debated that when you start castration
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  therapy, 100% of the time the cancer will progress and if you
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  don't die of something else first, it'll take your life.
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  If that's a known consequence of current treatment, doesn't it
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  beg an alternative? And we know from preliminary
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  studies that the bipolar testosterone that is spiking
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  high levels of testosterone and then crashing it seems to be
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  rather unpleasant toward cancer cells.
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  It appears to disrupt their DNA in a way that can kill off some
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  of them. That's kind of cool because now
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  you're getting the updraft of testosterone, all of its
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  wonderful benefits, energy, brain function, libido, muscle,
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  you feel like yourself. And potentially, and this is an
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  unproven part, we're tracking these outcomes.
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  We have patients in this pathway currently.
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  Is it possible that by doing this type of an approach, we can
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  extend the survival because we're not subjecting those
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  prostate cancer cells to an unrelenting barrage of androgen
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  deprivation such that they adapt to it and overcome it?
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  Is it possible that this stuttering, intermittent cycle
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  is going to extend the utility of treatment and help men live
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  longer? I think it may.
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  The thing that makes me advocate it, even in the absence of clear
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  knowledge about its potential for longevity, is that you're
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  going to get vitality. You're going to feel better.
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  And we're not abandoning hope for extending lifespan.
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  This is the part of the journey, then, where you can see the
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  finish line. You can feel it.
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  It may be five years out there, but it's different for you.
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  Like, we all know we're going to die in an abstract sense of the
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  word. The older we get, the more it
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  creeps into our brain. While I wake up tomorrow.
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  They didn't think that way when you're 25.
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  Most of us didn't. Now it starts to creep if you're
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  70, if you're 80, if you're 90, when you have prostate cancer,
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  it feels like there's a terminal event out there waiting for you.
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  Well, in fact, there is. We don't know if it's prostate
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  cancer, though, and we do not want the terminal event to be
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  preceded by a living death, Dementia, fatigue, all bad.
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  So vitality, always. My message to you is do not give
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  up hope. Do not quit your optimistic
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  pursuit of a high quality of life.
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  That's all we have, isn't it? We have today, we have the
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  moment, we have vitality. Nobody can guarantee us
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  tomorrow. And I do not want to pay the
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  price of today's misery for some false hope that it'll make me
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  live longer. Do you really want that piece?
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  I want both. I want both for you.
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  So there's a desperate need for alternative approaches, even in
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  the setting of metastatic spread.
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  Fear drives men to do things they otherwise would never
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  consider fear. And that fear I, I'm afraid,
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  sometimes gets amplified by well, meaning, but a little bit
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  histrionic. Clinicians.
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  Oh, my God. You must go on androgen
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  deprivation. You have to have chemotherapy.
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  You have to have radiation. Otherwise it's going to
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  metastasize. Question, doc.
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  If I do all that, will it not spread?
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  If I do all that, will I not die?
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  No. No.
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  It's going to progress anyhow. That is what it means to fight
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  cancer like a man. It means staring the potential
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  for death in the face and saying I choose life.
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  I choose vitality. In the abstract.
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  It's always easy to say I want to die with my boots on.
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  I'm going to go out like a man. I'm going to go strong forward.
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  Now is the time to live those words.
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  Not abandoning hope, not saying oh the heck with it.
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  I do not advocate, by the way, abandoning any treatment with
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  this nihilistic sense that I'm going to die anyhow.
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  Oh, the heck with it. Let me just get it over with.
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  Oh, if you did nothing, you'd probably have years to live.
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  You know, there was a movie John Wayne starred in.
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  And in the movie, he gets diagnosed with prostate cancer
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  by virtue of a digital rectal exam, we presume They don't show
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  that in the movie, but you get the picture.
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  And he then goes out and lives in a reckless manner that ends
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  with him getting killed. And I get it, you know, he's
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  thinking, let me go out with guns blazing.
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  But shoot, if he had done nothing, he might have had
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  another 15 years. Anyhow, that's movies.
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  That's why we don't use them to guide real life.
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  So if you're listening to this, and if you have bone metastatic
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  disease, live life. Do not sit idly waiting for
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  death. You have options.
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  You do not have to pursue conventional treatment.
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  You have alternative pathways forward.
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  Focus on vitality. If you're listening to this and
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  you have prostate cancer but it has not metastasized, fantastic.
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  Your likelihood of living a good long healthy life is pretty darn
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  strong. Therefore you're going to avoid
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  things that are conventionally recommended.
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  No biopsies? Nope, you track that non
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  invasively. I wish they had a magical
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  treatment that would solve our problem and it's not out there.
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  We need to learn to live with our prostates, even if they
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  harbour cancer cells. We need to learn to live with
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  prostate cancer even if it goes to our bone.
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  We need to put vitality first. We need to step up away from
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  conventional treatment if we ever hope to change these
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  outcomes. So the new treatments aren't new
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  at all. They're really more of the same,
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  except for this brave initiative that some of you are embracing.
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  All right, well, that's a quick synopsis.
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  Prostate cancer. What if it goes to the bone?
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  Fear. Do not let it dominate you.
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  Do not let prostate cancer kill you twice, once in the spirit
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  and then again in the body. Well, guys, today's a good day.
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  Let's live great together. Grab vitality, celebrate life.
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  We're not here very long. Let's make the best of it.
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  Talk to you next time. Thanks.