Let food be thy medicine …

One of the easiest yet hardest things you can do to improve your health is to change your diet. 

This seemingly innocuous statement deals a harsh blow on Thanksgiving Day.

“No, sh**”, I thought to myself as Jodie served me a plate of Tofurky alongside a tiny slice of pumpkin pie.

Sigh. 

For the longest time I strongly believed that diet didn’t matter. This sage advice was given to me during my first year of college by a senior who, from the perspective of a lowly freshman, was the wisest person in the world. 

“Trust me, Scott…”, he said while tearing chunks out of a McDonald’s Big Mac, “…it doesn’t matter what you eat as long as you burn the calories.”

“You can eat a dozen of these things,” he said while waving the burger at me, “and as long as you exercise you’ll be fine!”

big-mac

Blessed with a fast metabolism ( and an exercise routine ) this advice carried me for a very long time. I stayed away from fast food, but for the most part I ate pretty much whatever I wanted. After being diagnosed with Prostatitis I did some research on the web and began to realize that some foods that I was eating might be making the inflammation and subsequent urinary problems worse. I started a rudimentary “elimination diet”, and cut out spicy foods, red meat, caffeine, alcohol,  and an assortment of other foods from my diet.

While I was experimenting with my elimination diet, my wife, a real estate agent, discovered a book titled, “How Not to Die” on the bedroom nightstand of a house she was showing to some clients. After laughing at the morbid title, she did a quick search on Amazon and realized that the book was a cleverly named and highly rated guide on how to prevent disease through a plant-based diet. She bought a copy and quickly read it from cover-to-cover. Since finishing “How Not to Die” Jodie has also read “Anti-Cancer: A New Way of Life”, “Radical Remissions”, “The China Study”, and watched the documentary “Forks Over Knives”.

Thoroughly convinced and armed with the empirical evidence that a plant-based diet is a possible treatment against cancer, my wife volunteered to be my own personal nutritionist and chef in my battle against prostate cancer. 

In addition to feeding me more fruits, vegetables, and whole grains she also wanted to :

  • Greatly reduce my refined sugar consumption to starve my cancer cells.
  • Eliminate processed grains due to their high sugar content.
  • Only buy organic foods to eliminate pesticides.
  • Eliminate dairy entirely as it has been shown to increase prostate cancer risk.
  • Eliminate meat, red meat in particular, due to the hormones and antibiotics used in its production.

My wife isn’t alone. Since being diagnosed with prostate cancer I have talked to a handful of other prostate cancer patients and all of them highly recommended a vegetarian or vegan diet to me. It’s not just a “cancer thing”, either. I have several friends who have changed their diets as well in an effort to reduce inflammation and they have had a lot of success as well.  

The odd thing is, when I talk to medical doctors, or even nurses, the majority of the time they are undecided. It turns out there just isn’t enough quantifiable large scale studies on how a plant-based diet affects cancer. Doctors work on facts – not theory. It’s not that they don’t believe that such a diet doesn’t work, there just isn’t enough evidence to back it up. 

Convincing studies would be huge, long term, expensive projects. They would be complicated, too, as there are so many meals a day and so many variations and levels of commitment.  Some people are strictly vegan, some are pescatarian, others are vegetarian or flexitarian. The results could be devastating to a wide variety of food producers, too. Can you imagine the impact on the dairy and meat industries if such a study determined, without a doubt, that their products cause cancer? I hate being a conspiracy theorist but I feel it would be highly unlikely that the government would ever spearhead such a study and risk the fallout. As diet is likely not patentable I doubt any private industries would pony up the cash, either.

I am not a vegetarian or vegan in the strictest sense. I love animals. They taste delicious. I just choose not to eat them for health reasons. 

Although I try to stick to a plant-based diet, I still eat fish about once a week. Sushi is Jodie and my comfort food ( Kaylee is no slouch, either ). In an odd twist, while we were staying in Mission Beach during the summer we had a craving for it and found a nearby restaurant called, “Now Sushi”. While looking through the menu Jodie noticed that all of the seafood was listed in quotation marks and quickly realized that the restaurant only served Vegan Sushi! We didn’t mention it to the kids, and they didn’t notice. And the food? It was great!

It’s getting easier and easier to find restaurants that serve delicious plant-based meals. A couple of weeks ago my mom and stepfather took Jodie, my daughters, my brother, Todd, and I to a vegan restaurant ( yes, on purpose this time ) called “Peace Pies”. It was an eccentric little hole-in-the-wall off of Voltaire Street in Point Loma. The front counter was overloaded with stacks upon stacks of little plastic containers with clever names inked on them. Each container held what we thought looked like marijuana? We ordered a variety of dishes: wraps, pasta, and quesadillas . After our meal, everyone agreed that the food, although entirely plant-based, was very good. And the marijuana? It turned out to be Kale Chips, and delicious at that!

While the girls and I were trying to decide on a vegan dessert ( Chocolate, it turns out, can be vegan, too, if not low-sugar ) my brother and Jodie had a short conversation.

“So, did you like it?”, Jodie asked.

“Yeah, it was okay. But, once Scott gets better he can go back to his old diet.”, my brother replied.

“He could, but I don’t think he will want to.”, Jodie told him.

Jodie is right. Following a whole food, plant-based diet is not as bad as you would think. The food is actually quite delicious. There are a lot of good recipes out there, and fortunately, Jodie is really good at making them. And, if the diet helps keep my cancer in check, why would I ever risk stopping?

Sometimes you miss certain meals though – even the simple sandwich. 

You can imagine how excited I was when Jodie messaged this picture to me at work the other day :

sandwich

Our conversation went like this …

“I’m perfecting the Vegan Sandwich. This one is on organic sprouted grain bread. It has hummus, avocado, micro-greens, lentils, spinach, cucumber, tomato, and red onion”, she wrote.

“That looks delicious! Can you take some better pictures so I can share it on my blog?”, I replied.

“…I ate it.”

“You seriously ate my blog post?”

“It was my lunch…”

Fortunately, she’s since gathered more ingredients and made me my own sandwich. And yes, it tastes delicious. 

Last but not least, my hormone therapy appears to be working, although I won’t know for sure until I get the results back from my monthly PSA test. From a symptomatic perspective using the bathroom has become easier. Urination is no longer restricted or painful, and I can actually stand at the urinal again ( ladies, this is BIG, trust me ). Admittedly, I wouldn’t impress the smallest of fire departments with my flow, but it’s a huge relief to me. In retrospect it’s a little unnerving how slowly and stealthily the prostate cancer symptoms crept up over time. Like a lobster in a pot of boiling water, sometimes I feel like I never knew the temperature was ratcheting upward. So far the only downsides are a lack of energy in the evenings and, yes, hot flashes. But both are a small price to pay for the benefits. I have an upcoming appointment with my oncologist, Dr. Tyler Stewart in the next couple of weeks. I’ll be sure to keep everyone updated with the latest on my privates.

In the meantime, as we roll into the holidays I’d like to wish everyone a Merry Christmas and a Happy Hanukkah! Thank you for all of your support. It helps a lot!

– Scott

P.S. If you want Jodie to start sharing some of her recipes, so do I. Send me a message and I’ll see if I can twist her arm.

Previous : A Research Study

#prostatecancer #cancer #prostatitis #psa #prostate #urology #oncology #drawnandcoded #iwillbeatthis #vegan #vegetarian #plantbaseddiet #forksoverknives #radicalremission #hownottodie

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A Research Study

ClinicalStudy.png
My oncologist, Dr. Stewart, encouraged me to enroll in a research study to learn how to improve MRIs ( Magnetic Resonance Imaging ) for the detection of metastatic cancer without using an injected contrast dye. The study is funded by the Department of Defense (DoD) and the Prostate Cancer Foundation (PCF).

Previous : Doubling Down on Hormone Therapy

Next : Let food be they medicine …

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Doubling Down on Hormone Therapy

So, I finally admitted defeat and bought one of these beauties. 

IMG_3391

Sexy, right? Amazon sells a model with a larger pill capacity but this one screams “minimalist and sleek” to me. Why a pill box? Because my medications keep increasing in number and complexity. As food can have a big effect on how a medication is absorbed in your body, it’s important to take some medications based around meals. The most logical way to do this is to organize pills by mealtime in cute, colorful, OCD-inducing plastic boxes.

This week is Thanksgiving. 

Thanksgiving, as everyone knows, is a time to reconnect with family and friends by filling your plate with food and then sitting down at the dinner table to compare illnesses. 

Up until this year I’ve been the underdog in these conversations. However, this year is different! This year I get to slap my new pill box down and insert myself into the conversation with gusto! Maybe I’ll even raise the ante a bit and sneak a couple of placebo pills in as well!

Honestly, it’s a little disconcerting. In less than 6 months I’ve gone from no medications at all to enough to require, well, a pill organizer. My friend, Missy pointed out that it’s not forever. Retired from the Navy she used deployments as an analogy. She told me, “Deployments take two years. They suck, but in the end you get to come home and return to your normal life.” Coincidentally, my friend Pat who also has prostate cancer just ended his “deployment” and is doing great after concluding two years of treatments. 

So, what goes into my pillbox? 

The latest medication is Zytiga. Zytiga is used to treat aggressive prostate cancer, like mine. It along with Prednisone and the Firmagon shots that I started last week, complete the hormone therapy cocktail prescribed to me by my oncologist, Dr. Stewart. Dr. Stewart told me that Zytiga stops my adrenal glands from producing testosterone. If you remember from my prior post, testosterone feeds prostate cancer. Without testosterone the cancer should stop metastasizing and shrink. Zytiga is just another way of crimping the fuel line. One of the side effects of Zytiga is that it lowers the amount of cortisol produced by the adrenal glands. Cortisol, known as the “stress hormone” helps regulate blood pressure, metabolism, and stress levels. Sounds important, right? The Prednisone is a synthetic cortisol to replace what is lost when taking Zytiga. I also need to take vitamin supplements such as calcium to maintain bone density and prevent muscle loss. Zytiga can also cause high blood pressure and liver problems. While taking it I will need to monitor my blood pressure daily and have blood drawn every two weeks to check my liver function. 

Oh, and Zytiga costs $10,000 per month.

Yes, the zeros are in the right place. That’s roughly $160 per pill. I take two pills per night. My prostate cancer cells apparently have very very exquisite tastes. In retrospect maybe I should have bought a pill box with a padlock…

Zytiga isn’t even a cure for prostate cancer – it’s a treatment

I wish I could peg the blame solely on some greedy pharmaceutical executive somewhere pricing these things. In reality, I know that the truth is a lot more complicated than that. Zytiga, being approved in 2011, is a relatively new medication. Newer medications can take up to a decade and well over a billion dollars to get approved. Of all potential candidates only 10% are ever approved by the Food and Drug Administration ( FDA ) for the market. That’s a lot of money and a lot of risk. 

Thankfully, my health insurance helps a lot with the costs. I now understand why insurance rates increase annually as treatments like this skyrocket in price. No, it’s not okay and it’s definitely not sustainable but I’m at a loss how to fix the problem. 

Fortunately, there are people smarter than me working on solutions.

Last night after I choked down my jagged little pills Jodie showed me a study that she had found with an innovative solution for cutting costs.  Earlier I mentioned how some medications are absorbed differently based upon what they are taken with. Zytiga, for this reason, is taken on an empty stomach. The study found that if Zytiga were instead taken with food, the dosage could be halved and have the same overall effect. At $160 per pill the study estimated that the savings per patient were in the hundreds of thousands of dollars. Although the study hasn’t been clinically approved it is refreshing and a step in the right direction.

That’s all for now. Happy Thanksgiving everyone!

Previous : Manopause

Next : A Research Study

#prostatecancer #cancer #prostatitis #psa #prostate #urology #oncology #drawnandcoded #iwillbeatthis

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Manopause

“Hormone therapy generally makes everything shrink”, the radiation oncologist told me.

“Like, everything?”,I asked.

“Yes.”, she replied.

( Cough, Cough )

Everything everything?”

“Yes, it’s a potential side effect.”

“Can I, uh, quote you on that?”, I replied.

“Sure!”, she said with a smile. 

And then she explained to me how shrinkage was a good thing – at least for future treatments. Smaller tumors mean less invasive surgery. Smaller tumors also mean less radiation when undergoing radiation treatment. You’ve heard it here first.

Shrinkage is good.

She explained that hormone therapy also starves “free floating” cancer cells that have broken away from the main tumor. By starving and killing these vagrant cells the hope is to stave off metastasis to other organs. 

Next she told me that cancer is treated based upon where it originated.

If cancer cells break off from the main tumor and spread somewhere else, the new tumor is still the same type of cancer. Prostate cancer that has spread to the bones is still very much prostate cancer and as such can be treated with similar therapies, such as hormone therapy. Cancer that originated in the bones is a different type of cancer altogether and as such must be treated differently. 

The upside of all this, at least for prostate cancer, is that the PSA score is a systemic indicator of prostate cancer in the entire body – not just within the prostate. If the prostate is removed for example, and the PSA score keeps going up, chances are good that the prostate cancer has found a new home elsewhere. That’s the bad news. The good news is that the same arsenal of treatments are effective against it no matter where it is. Well, as long as the treatments can reach it.

I’ve been on the hormone therapy medication, Degarelix, for almost a week now. 

After being told of the side effects and reading one too many reviews online I thought I was in for pure hormonal hell. So far my fears have been exaggerated.

The injection sites are painful.

I now have large painful bumps to the left and right of my belly button. Sneezing of course, hurts. So does sitting up from a prone position. When laying down I’ve opted to flop around like a beached seal instead of twisting. I wake up a lot, too, but I seem to fall back asleep easily enough. I can only assume that this is a result of the other side effects of the medication. The worst pain so far? The removal of the band-aids that were covering the injection site from my unshorn belly.

It makes me a little lethargic. 

Everything takes just a little more effort. I’m more tired, a little spacey, and forgetful. I was told to lift weights to counteract the muscle mass and bone density that is lost as a result of the hormone therapy. I’ve managed, but I get winded faster and everything feels just a little heavier. I’m lucky in that I have a sedentary job where the heaviest thing I need to lift is a computer mouse. If I were moving furniture however, I’m pretty sure I’d be well, screwed.

I’ve kept my anxiety under control.

This is what I was worried about most. Just thinking about anxiety makes me anxious. If you remember the 80’s movie Beetlejuice, when the titular characters’ name is said aloud too many times he jumps out and terrorizes everyone. Well, anxiety for me is kind of like that. I have an entire bandoleer of Ativan at the ready if necessary, but so far I haven’t had to use it. Staying in the moment has helped the most. As there is no clear path for my treatment yet, worrying about it is probably the worst thing I can do.

And then, of course, there’s the occasional hot flashes.

They’re not bad and they are rare, but they happen. I can best describe the sensation by flip-flopping the typical advice given to someone for public speaking: Picture yourself naked on stage talking to a large clothed audience. That, to me, is what a hot flash feels like.

A couple of days after my first treatment our neighbors invited us on a hike. While we were getting ready my oldest daughter, Ashley shoved one of those battery-powered handheld fans into my hands. This one in particular even had a water reservoir. 

“Here, dad!”, she said excitedly.

“Uh, thanks… um, why?”, I replied.

“In case you have hot flashes on our hike!”, she said proudly.

So, yes. My daughters have my back. It’s reassuring to know that when menopause hits the Vandervort household someday that I can take at least some credit in grooming my girls to take care of their mom, too.

Last but not least, I bought Jodie and the girls necklaces to wear to mark the start of my cancer treatment. The necklaces are simple silver chains, each adorned with three heart pendants. One heart for each girl. To me the necklaces are a symbol of solidarity. It seemed an appropriate gift for the three people who are going to be on the front lines with me throughout this fight. 

KayleeHeartNecklace-COLLAGE
My daughters, Kaylee and Ashley wearing their necklaces.

Take care of yourselves, stay healthy, and live life.

Previous : Let the games begin…

Next : Manopause

#prostatecancer #cancer #prostatitis #psa #prostate #urology #oncology #drawnandcoded #iwillbeatthis

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Let the games begin…

Today, Jodie and I drove to UCSD for my first hormone therapy treatment. As I mentioned in my previous post I was to be given Degarelix, more comically known as “Firmagon”, to reduce my testosterone levels. My nurse reiterated the side effects before describing how the medication would be administered.

“The shots will be given using a really small needle…”, my nurse said.

“Wait…shots? Plural?”, I responded.

“…to your belly…”, she resumed.

“Uh….”, I replied.

“…and it requires a loading dose of two shots. One on each side…”, she continued.

“…”

“…and together the shots will contain roughly three times the serum as a normal dose.”

“You’re not really selling this that well, you know.”, I told her.

“I have some ice packs for you to use afterwards. You will likely have some pain at the injection site for a couple days on up to a week. There will also be some swelling and redness.”, she responded.

“Swelling? Can you at least distribute the shots to look like I have abs?”, I requested.

At this point Jodie offered some Tylenol capsules which she had brought along for the occasion. The nurse quickly had me take them before preparing the shots.

“If I scream like a little girl don’t take it personally. You look like a nice person.”, I told the nurse before laying down on my back and pulling back my shirt.

“Oh, you don’t have much of  belly. That’s going to make this a little more tricky…”, the nurse said before starting the first injection.

Fortunately,  Jodie was able to capture the entire procedure on film for posterity. It went down something like this …

1
My nurse explaining what to expect as far as pain and side effects.
2
The shots being administered.

Okay, I might be exaggerating a little.

The administering  of the shots didn’t hurt much more than a flu shot. My nurse did an incredible job. The jury is still out on residual pain but I’ll be sure to post on that in the future if it is an issue.

A couple of band-aids later Jodie and I headed back to the parking garage. As I started backing out of the parking spot Jodie told me, “I have a special song for the occasion!”

“Uh, okay”, I said smiling.

She then started playing Stone Temple Pilots, “Creep” which ironically, was one of my favorite songs from high school. I didn’t quite understand the relevance until the chorus. When it played we sang aloud and had a good laugh. My wife has an odd  sense of humor as I do…

Forward yesterday makes me wanna stay
What they said was real makes me wanna steal
Living under house guess I’m living I’m a mouse
All’s I gots is time got no meaning just a rhyme

Take time with a wounded hand ’cause it likes to heal
Take time with a wounded hand ’cause I like to steal
Take time with a wounded hand ’cause it likes to heal,
I like to steal

I’m half the man I used to be (this feeling as the dawn it fades to gray)
Well, I’m half the man I used to be (this feeling as the dawn it fades to gray)
Well, I’m half the man I used to be (this feeling as the dawn it fades to gray)
Well, I’m half the man I used to be
Half the man I used to be

…okay, maybe not exactly half the man.

Jodie pointed out later that the Firmagon marketing material advertises an 88% drop in testosterone on the first day. “So, you’re effectively 12% the man you used to be!”, she said smiling at me.

“Thanks, honey.”

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Next : Manopause

#prostatecancer #cancer #prostatitis #psa #prostate #urology #oncology #drawnandcoded #iwillbeatthis

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