Home Success Story & Hard Truth Prostate Cancer Prostate Cancer - My Story

This saga starts with a PSA check in April 2007 at Bumrungrad Hospital in Bangkok, Thailand, which returned a high score of 19.6 ng/ml (“normal” range is zero to 4.0 ng/ml). A digital rectal examination did not find any physical abnormalities but a urine analysis found a high white and red blood cell count indicating an infection. An ultrasound showed an enlarged prostate (Benign Prostatic Hyperplasia or BPH) estimated as 93 cl, compared to the normal range of 20~30 cl. The urologist prescribed a course of antibiotics to rule out the possibility of an infection of the prostate (Prostatitis).

Prostate Cancer - My Story

by Stephen Taylor, Bangkok, Thailand.

This saga starts with a PSA check in April 2007 at Bumrungrad Hospital in Bangkok, Thailand, which returned a high score of 19.6 ng/ml (“normal” range is zero to 4.0 ng/ml). A digital rectal examination did not find any physical abnormalities but a urine analysis found a high white and red blood cell count indicating an infection. An ultrasound showed an enlarged prostate (Benign Prostatic Hyperplasia or BPH) estimated as 93 cl, compared to the normal range of 20~30 cl. The urologist prescribed a course of antibiotics to rule out the possibility of an infection of the prostate (Prostatitis).

I realized the possibility of prostate cancer (PCa) so I started a fast-track self education program, ordering several books and scouring the Internet for information. I started taking Beta Sitosterol and Ashitaba (a Japanese plant extract reputed to improve the immune system) to try to reduce the size of the prostate and hopefully reduce the PSA.

By June 2007, after several more consultations with the urologist, and despite a slight drop in PSA to 17.6 in May, the PSA had increased to 19.6 ng/ml while the urine analysis was normal, so I was advised to have a biopsy since the chance of PCa was 50%. I then had more pre-surgery checks such as a Chest X-Ray, EKG, and further blood tests. I had a biopsy using an 18-core sample which a later learnt was quite a high number, but thankfully I was under general anaesthetic for the procedure. PCa was diagnosed in both prostate lobes with a Gleason Score of 2 + 2 = 4, with less than 5% affected in one lobe, and only a small focus on the other lobe. At the time I was 61 years old.

The urologist recommended an MRI and Bone Scan to see if the PCa had metastasized, but when I expressed reluctance to rush into any further procedures before thinking about it some more, the doctor became quite irate about it and said something like “You are trying to get me to agree to things I do not agree with.” It seems that in Thailand at least, doctors are not used to patients questioning their decisions. At the time I felt I had no choice but to go along with the doctor’s advice (I learnt later that I was probably correct - see below) so I had the MRI and Bone Scan which did not show any abnormalities.

With these test results the urologist recommended surgery, either a Radical Prostatectomy or robotic Da Vinci Surgery. When I asked if there were other alternatives he referred me to a radiation oncologist who recommended High Dose Brachytherapy (temporarily inserting radiation tipped probes into the prostate) with external radiation and hormone therapy, according to a German protocol. The oncologist considered the cancer Stage as T2c [cancer in both lobes] and “High Risk” [defined as 2 out of the 3 factors: PSA > 10, Gleason Score >= 7, Stage >= T2c]. I obtained a slide show demonstration of the protocol from the doctor to study at home which stated the 8-year disease specific survival was 93%, but the biochemical failure (PSA rising) was 27%.

Meanwhile, I had been investigating other options and came across the web site of Dr. Bob Leibowitz at www.compassionateoncology.org, which has several interesting case studies and reports which can be downloaded. I contacted Dr. Leibowitz’s office but they referred me to Dr. Steven Tucker, a colleague of Leibowitz who was practicing in Singapore. I then learnt about so-called Intermittent Triple Androgen Blockade Therapy from a 2005 ASCO presentation by Leibowitz and Tucker available at www.asco.org which had excellent long term results. The survival rate for the protocol over 75-months was 99.4%, with only one man out of 183 dying of metastatic prostate cancer. These results were later extended to eight years.

I contacted Dr. Tucker by email and he strongly recommended a second opinion on the biopsy slides by a known expert in the field, and so I sent the biopsy slides to Professor Jonathan Epstein at Johns Hopkins University in the USA, who kindly offered to review them gratis. He also reported PCa in both prostate lobes but with a higher Gleason Score of 3 + 3 = 6, although I believe this is the lowest grade he gives. In a subsequent phone conversation with Prof. Epstein, I asked him what I should do about it and he said I should have a Radical Prostatectomy. I said I didn’t like that option and he said I could do external radiation plus hormone therapy.

In July 2007 I travelled to Singapore to see Dr. Steven Tucker and I had a long consultation with him which lasted for well over one hour, during which we discussed the treatment options and the pros and cons of hormone therapy. I was impressed that this was the first time that any doctor had spent so much time with me discussing the issues. Normally, I had the impression they wanted me out of the door as soon as possible! Dr. Tucker also agreed my case was “High Risk” because my PSA was nearly 20, but considered the clinical Grade as T1c [confined to the prostate]. I decided then and there to go for a 1-year course of Intermittent Hormone Therapy using 3-monthly Zoladex injections, 150 mg / day of Casodex, and Avodart, and after the first injection returned to Bangkok the same day.

Dr. Tucker did query why I had the MRI so soon after the biopsy, because the haemorrhaging from the biopsy does not produce a clear image inside the prostate capsule. My doubts about this procedure seem to have been vindicated. I later learned from the book Beating Prostate Cancer: Hormonal Therapy & Diet by oncologist Dr. Charles “Snuffy” Myers that MRI and CT scans only identify 15-30% of known metastases. In other words the tests are very insensitive and it seems strange to base important treatment decisions on such tests. Later I showed Dr. Myers’ book to the oncologist in Bangkok as something worth reading, but he waved it away saying it was “not a medical textbook.”

After my return to Bangkok I went to see the radiation oncologist for a Bone Density Scan as requested by Dr. Tucker. Hormone therapy can lead to bone loss and osteoporosis. The oncologist’s first remark when I told him I wanted to do the hormone therapy rather than his High Dose Brachytherapy was “You are too young!” a remark that does not make sense to me even now. However, he did schedule a Bone Density Scan for me and offered to assist with the routine checks requested by Dr. Tucker. The bone scan showed some signs of osteoporosis in the lumbar spine but nothing very serious.

Over the next year until July 2008 while I was on Intermittent Hormone Therapy I had monthly PSA/Testosterone, Blood, and Liver Function checks at a local hospital and sent the results to Dr. Tucker in Singapore. From the beginning I was not aware how expensive the medications would be, and while my insurance companies would pay for most of the doctors’ fees and three-monthly Zoladex injections, they would not pay for the take-home medications Casodex and Avodart. A three month supply of medications, including the Zoladex, costs about US$3,600. Fortunately, I found an online supplier of cheaper generic equivalents to Casodex and Avodart at www.alldaychemist.com and they have proved to be reliable. Dr. Tucker agreed that I could use the generic replacements which proved to be effective. The insurance cover from one company ran out in one year, and the cover from a second policy has a high deductable and low payout, so I’m basically on my own from now on.

I had originally agreed with Dr. Tucker to see him every 3-months in Singapore, but after the second visit it became clear that I could do all the required tests in Bangkok, have the Zoladex injection locally, and buy the generic medications online. If required, I could have a phone consultation with Dr. Tucker and communicate by email, so there was no need for me to go to Singapore again, up to the present time.

While on the hormone therapy the side effects were somewhat worse than I had anticipated. I felt very fatigued with a constant muzzy head so I could not think clearly. My breasts began to get larger and I lost hair on my arms and legs, had muscle loss, and I had loss of libido (loss of sexual desire) and erectile dysfunction (or ED, difficulty having an erection). I only continued the therapy because I knew that all those men in the Leibowitz-Tucker study had completed the therapy. Then in December 2007 I had some sort of mental breakdown whilst on holiday with my family in Thailand. I was sobbing and crying most of the night, comforted by my wife. This is most unusual and scary because I normally have a placid personality and think of myself as well balanced emotionally, or so I thought. Fortunately, this episode only lasted one night.

From the start I had been avidly reading several books about prostate cancer and alternative remedies but the more I read the more I realized the lack of scientific data or clinical studies to support any of the usual treatments like surgery or radiation. I’m a retired engineer with a degree in Physics so I’m used to the idea of theories and experimental data, but with prostate cancer it all looked most unscientific to me. One description of the state of affairs concerning prostate issues caught my eye, when the writer described it as “A wastebasket of clinical ignorance.” Too true, I agreed. So I turned to alternative treatments to see what they might offer, but the difficulty there is that there are disagreements even amongst the holistic practitioners, and many of the pills and potions sold on the internet are likely to be modern “snake oil” scams.

The most significant discovery was the work of Johanna Budwig (1908-2003), a German scientist and Nobel prize nominee, who considered that the problem of cancer is one of consuming the wrong type of fats, and the corresponding healing properties of highly unsaturated fatty acids, especially from flax seed oil. In brief, the Budwig Protocol involves consuming flax seed oil thoroughly dissolved in quark, a German cheese (nearest equivalent is cottage cheese), following a vegetarian diet, having sun baths, and living a stress-free life. For more information see the three books by Budwig available in English, and at www.healingcancernaturally.com/budwig_protocol.html. Budwig claimed to cure cancer in 90% of cases, even from advanced cases, and several others follow the protocol or variations on the same idea, including Bill Henderson at www.beating-cancer-gently.com.

I started following a much watered down version of the Budwig Protocol from July 2007 and continued to January 2009, with using the flax seed oil and cottage cheese mixture once a day (Budwig advised twice a day) and a mainly vegetarian diet, although I did consume some tuna fish (not allowed in Budwig) and my wife cooked fried Thai food using virgin coconut oil (Budwig advises steaming or boiling vegetables).

During the one year of hormone therapy (while also following the above diet) my PSA dropped to a low of 0.02, and after completing the therapy in July 2008 the PSA continued to drop to a low (nadir) of 0.01 in October 2008. I considered this an excellent result, and so did Dr. Tucker, but after I stopped the intermittent hormone therapy while maintaining the diet, the PSA started to go up. In January 2009 it was 0.22, in April 1.96, and in June 4.10. The following graph show the rise in PSA seemed to be going up exponentially, and if I did not do anything about it, in another six weeks it would most likely have doubled again, possibly to about 8.

When I went to see my local oncologist for the routine checks, he suddenly turned from being friendly and talkative to being unresponsive and refusing to give any opinion, saying I should talk to Dr. Tucker about it.

In January 2009 I had tried to tighten up on the Budwig Protocol and for about three months consumed two helpings of flax seed oil with cottage cheese a day (as per the Budwig Protocol), but the PSA continued to rise during this period.

I asked Dr. Tucker about supplements and diet and he advised against taking Beta Sitosterol which can adversely affect the PSA as can “natural” progesterone products. He also advised not taking zinc, red clover, quercetin (an antioxidant), isoflavones (e.g. Novasoy, derived from soy), green tea extract, and proprietary blend products, and flax seed oil, although he did recommend using ground flax seed. Dr. Tucker also recommended a number of books about diet.

By June 2009, when the PSA reached 4.10 I asked Dr. Tucker where we should go from here if the PSA keeps on going up. He replied saying that although we didn’t need to take any action yet, “if the PSA keeps going up AND we agree on re-starting ADT2 [triple hormone therapy] then, yes I would strongly consider/advise that you undergo radiation therapy as part of overall treatment.” I asked what type of radiation therapy Dr. Tucker would recommend, and he replied saying either (a) TomoTherapy, or (b) IMRT with High Dose Brachytherapy or (c) 3D Conformal RT (modern but still an older version, least expensive), with (a) or (b) being the preferred choice.

I asked Dr Tucker at what rising PSA level we should consider these options, and although reluctant to give a specific figure (because it depends on other factors), he suggested a PSA of 10 plus or minus 2, or in other words in the range of 8 to 12. This corresponds to other information I have been able to find which suggests that hormone therapy should be initiated again at a PSA level of half the original pre-treatment level. In my case that would be a PSA of 10.

I found out that TomoTherapy was unavailable in Thailand, so tried to contact three medical centers in India, Singapore, and Hong Kong, to find out how much it would cost. The hospital in India did not respond, the one in Singapore would not give an estimate, and the Hong Kong hospital said it depends on the exact treatment but as a guide it would cost the equivalent of US$50,000 as an upper estimate. I believe the travel, logistics, and cost of being treated outside of Thailand make this option prohibitive, so I would probably have to be treated in Thailand under option (b) above.

However, I did find the following statement in a recent New York Times article about PCa treatment:

"Some doctors swear by one treatment, others by another. But no one really knows which is best. Rigorous research has been scant. Above all, no serious study has found that the high-technology treatments do better at keeping men healthy and alive. Most die of something else before prostate cancer becomes a problem."

I sent the quotation to Dr. Tucker and asked him to comment, but he said this was a matter for a phone consultation or face to face meeting. I have not followed this up.

From the list of books on diet recommended by Dr. Tucker I read a most illuminating and convincing book by Dr. T. Colin Campbell called The China Study, which contains scientific evidence that protein from animal sources, including casein from milk, causes cancer. I later read the book Prostate Cancer by Professor Jane Plant [not on Dr. Tucker’s list], who cured her breast cancer using a strict vegetarian diet. These books and other online resources clearly indicated that a strict Vegan diet is required. Dr. Johanna Budwig may well be correct but I felt I could not afford to continue consuming high quantities of cottage cheese, mixed with the flax seed oil. I theorized that the quark cheese used by Budwig may have been more wholesome years ago than today’s mass produced cottage cheese produced from factory farmed milk containing growth hormones. Certainly there were other aspects of the Budwig Protocol which I found concerning, including the lack of scientific data to back up Budwig’s claims, the whereabouts of Budwig’s own case records, and the somewhat unconvincing anecdotal evidence to support the theory, although undoubtedly some cancer patients are helped by it, and there are aspects of the protocol which are even considered mainstream these days, including sun exposure for generation of Vitamin D and reduction of stress.

Some months before, in around October 2008, I had become aware from one of my correspondents of the CA Care web site and clinic of Dr. Chris Teo in Malaysia at www.cacare.com. I found Dr. Teo’s eBooks Food & Cancer and Understanding Cancer War & Cure and his general approach to fighting cancer to be sensible, pragmatic, and in-line with my own thoughts. Some of his online videos of cancer patients were also quite impressive. I decided to contact Dr. Teo by email and in May 2009 decided to try his protocol of a strict Vegan diet (vegetarian diet with no meat, chicken, fish, eggs, milk, processed or junk food, canned foods, cooking oil even using virgin coconut oil, butter, margarine, sugar or sugar substitutes, soft drinks, alcohol, refined salt except a small quantity of natural sea salt) together with taking his herbs for a limited period, to see if there was any positive result. In my case Dr. Teo recommended two types of herbal tea and some herbal capsules. Later, I met Chris Teo twice in Bangkok and we had long discussions about cancer issues and my particular case.

In July 2009 after five weeks on Dr. Teo’s regimen I went for a PSA and testosterone check and to my delight found the PSA had dropped from 4.10 to 3.85, and it had not followed the exponential curve upwards to a probable PSA of around 8. The testosterone had continued to recover to normal levels after I stopped the hormone therapy. The last PSA check in August 2009 showed a very slight and statistically insignificant rise in PSA from 3.85 to 3.96, but it does appear the PSA has reached some kind of plateau.

The following enlarged portion of the previous PSA graph shows more clearly the rapid exponential rise in PSA values, and how this has apparently been halted by the diet and herbs protocol.

I should make clear that during the rise of my PSA to 4.10 I stopped taking Beta Sitosterol and Multi-Vitamin supplements, but continued taking 1,200 IU / day of Vitamin D3. I had checked my “25-OH Vitamin D3” (Vitamin D3) level in March 2008 and the result of 33.18 ng/ml was lower than the optimal range of 65-90 ng/ml for cancer patients, so had started taking the Vitamin D3 supplement. A second check in July 2008 showed an increased level of 66.53 ng/ml and I’ve continued with the Vitamin D3 supplement and also try to have sun baths for a few minutes on most days. I also do moderate walking exercise for at least 30-minutes a day.

When I saw the local oncologist to get the test result when my PSA went down to 3.85, and even before I had sat down in his office, he exclaimed excitedly “Your PSA’s gone down!” and followed it up by asking “Have you been taking anything?” I said I had been on a strict diet and taking Chinese herbal teas. His response was “There must be hormones in the herbs” to which I replied I very much doubt that is the case (and note my testosterone level had actually increased). Dr. Teo and I had a good laugh about it when I told him the story. On the last visit to the same oncologist he said, without any justification at all, “I’m sure it’s due to the strict diet and nothing to do with the herbs” and tried to tell me (like talking to a complete idiot --- maybe I am, as a Chartered Engineer with a Physics degree!!) about how unscientific the herbal remedy was and how the medical profession requires clinical trials. I told him that he must know very well that the drug companies will not finance any trials if there is no money to be made from it. Just look at the exorbitant cost of the hormone medications.

My own thoughts about the current situation with the diet and herbs is that the results look very promising indeed, but despite the enthusiasm and kindness of Dr. Chris Teo who tells me I would be his first failure, I think that prostate cancer (and life) is too uncertain to say definitively that I have managed to overcome the PCa using the diet and herbs. It does give me great encouragement to carry on with the same protocol.

I have no regrets at all about doing the one year of Intermittent Hormone Therapy, which had successfully reduced my PSA from 19.6 to a very low 0.01 (before rising again), thanks to Dr. Steven Tucker. I’m also grateful that the doctors at local hospitals in Bangkok were prepared to carry out the routine checks and procedures as recommended by Dr. Tucker when they obviously did not agree with the therapy. During this time I sought advice from other urologists and two of them recommended (seriously) an orchiectomy (removal of the testicles) as an effective and cheap (!) treatment option. I politely but firmly declined the offers, and wondered if the same urologists would still recommend a lobotomy to cure psychological problems!

As part of the Intermittent Hormone Therapy I took Avodart, and after I completed the one year on hormones I have continued taking Avodart (later Proscar) as so called “Finasteride Maintenance” according to the Leibowitz-Tucker protocol. In August 2009 I have decided to discontinue the Proscar. This medication is known to reduce PSA values, so under normal circumstances I might expect my PSA to rise somewhat after stopping taking Proscar. We shall see.

(To be continued).

Comments by Chris

It is a privilege to be able to help Steve in some way. And I am glad that the fear of his PSA shooting up high is, for the moment, dispelled. But from the very start, I have made it clear that I would not be able to guarantee the herbs will work, though in my heart, I did not see any reason why it should not work since the teas had helped so many others. But knowing that life is never certain and that not all people are the same, it would be presumptous on my part to guarantee anyone of positive outcome. Our philosophy at CA Care is we do our best and leave the rest to the Almighty God.

However, take note of what I said – we do our best. Don’t expect to find the magic bullet from CA Care. We have none. Our best to also mean patients must do their part. Steve told me that he would abide by the dietary advice and would not cheat. It is on this basis alone that I was happy and ready to accept failure, if I have to fail. This is because I too wish to know and learn from his experience.

So, I have a great patient with a great spirit – not a kiasu (only want to win type).

I have told Steve: So far I have not failed in such a case and if ever I fail, this will be my first case of failure (this refers to early-stage not medically written off cases). And I am ready to admit and accept it if it comes to that.  Eleven weeks on the herbs and with no cheating on the diet (but Steve admitted: except for some minor transgressions), I have not failed yet. Since one swallow does make a summer, we shall wait for another three months to see where the PSA is heading. We don’t know what the future is, but there is room for optimism.

I wrote Steve and request him to share this story with others. Most people would not want to share. When they come to see me, they expect and demand all the information in the world about their cancer from me. But, when the time comes for them to say something about their success, they would not want to share or let others know. Steve is willing to share. And not only that, he is not going to camouflage himself. He would not want me to cover his face in the video clips. Thanks Steve for your contribution. I hope CA Care has many more people like Steve in the future, and much less of the kiasu.

You will note that Steve has declared that he derives no financial benefits in writing this story. There is no bribery here. Let there be no mistake, there are a lot of corruption and prostitution in the writing of research papers, even in established medical journals. Drug companies paid ghost writers to write papers for doctors who then are paid handsomely by lending their names as authors for the work they never did. Richard Smith, editor for the prestigious British Medical Journal for twenty-five years said: Medical journals are an immoral marketing tool for drug companies. I’d always known medical journalism wasn’t about the truth. Richard Horton, editor of the Lancet, wrote in March 2004: Journals have devolved into information laundering operations for the pharmaceutical industry.

UPDATE by Stephen Taylor on 24 February 2010