Geoff McLennan, MPA, Prostate Cancer Patient and Advocate – August 2023

One of my hardest days was when my urologist told me I had prostate cancer. For those of my generation, Boomers, the word “cancer” is the worst of all fears, as many before us have passed from it. But after the emotions abated, I rose to the challenge, got my life back on track, and began to understand that prostate cancer is rarely fatal during the first 15 years after diagnosis. So, gents and loved ones: what does living with prostate cancer (PCa) look like? Let me share my experience and point of view as a prostate cancer patient who has been on Active Surveillance for over 11 years.

Coping with a prostate cancer diagnosis

Living a full life with PCa is a choice. At Active Surveillance Patients International (ASPI), our motto is “Live, Learn, and Thrive with PCa”. We mean everything that motto represents. My choice of living with PCa is and was shutting off negative talk, either mine or from others. Even if your diagnosis is more complex than mine, medical research, advancing science, and technology just about have this thing beaten! Yes, you can get on with your life, choose to be with family, friends, and attend church and community meetings. When people express a grave concern for your PCa diagnosis, listen but realize you have a choice about your response. We all cope, but in different ways.

Coping when worries about cancer begin to overtake may mean changing how you think about your cancer, what you say, and your reaction. How can you thrive, seek support, and not ignore your cancer diagnosis? Don’t cancel events, ignore friends, and isolate yourself from life’s opportunities. Choose to make every day a winner. One of the ways I coped with my PCa diagnosis was to socialize. Have lunch with buddies, relatives, and siblings. I found out most people were not aware of prostate cancer, how it is diagnosed, treated, and the very real survival rate of about 98% after 15 years. While explaining to other people, I began to hear and understand their concerns for me. That helped, except I had to explain that I was not a lost cause. Very few men with PCa die from PCa, but from other causes. Doctors will often say, “men often die with this cancer rather than from it,” meaning another ailment may be more likely to cause death. Helping others understand the facts about PCa extinguishes the fuse from the fear of “cancer” lights.

Most men don’t want support that is like clinging to a buoy in the game of life. So in addition to socializing, another coping mechanism is to research the heck out of PCa instead of being afraid. Knowledge overcomes fear. Fiat Lux! Try these online resources to learn about genetic testing for prostate cancer and the many other new tools doctors use to keep you in the game based on your genetics. While you are learning, consider educating your friends and family about the benefits for genetic testing and understand that PCa is not typically a lethal cancer if you know the risks.

Finally, another coping mechanism is to just be honest about it. It is what it is. Accepting your diagnosis, even getting a second opinion by asking your urologist, is OK, but at the end of the day or week, you’ve got this, and you can handle it. The facts support your longevity if you live a healthy lifestyle. Move on, be strong and choose to live over fear.

When you do have a bad day or moment, and worries burden your day, consider seeing a therapist, as we are not rocks and have earnest feelings. Next time you see your general practitioner or urologist, be frank about your fears, and if you wish, ask for a mental health referral. Rather than going into a therapist’s office, you may choose online therapy and even attend group sessions online, such as ANCAN, ASPI and PCRI. A good tool for your mental health practitioner is the Myriad GeneSight test which provides your therapist information about what works best for you based on your genetics for depression and anxiety. We are learning so much about how genetics affect our medical treatment and advice.

Don’t go it alone and allow fear and rumors to drive you in overcoming this disease. Instead, ask yourself which coping mechanism you will try. Open yourself to others, including a therapist for support, and keep an open mind to what doctors, therapists, and friends might suggest. For a deeper dive on coping, check out this site by the Cleveland Clinic.

How does “lifestyle” relate to living with prostate cancer?

Lifestyle is broadly defined as how we behave during our day, including but not limited to exercise and weight, nutrition, sleep, stress, exposure to known carcinogens, socialization, and avoiding addictions, including alcohol and smoking. There are specialty medical practices that integrate many medical disciplines for an improved lifestyle, such as the Osher Integrative Health Center at UC San Francisco and the Stanford Lifestyle Medicine center, and many more integrative practices at mostly larger medical centers such as Langone in New York and Johns Hopkins in Maryland. When you can, avoid proven causes of cancer known as carcinogens or agents to which we may be exposed that are known to increase your risk of getting cancer. Some of these carcinogens you can control, such as alcohol, smoking, and deli meats, while others we might not, such as air pollution, sun exposure, water pollution, and accidental chemical discharges. As a lifestyle choice, chose to avoid carcinogenic exposures. Be aware that as a bonus, a healthy lifestyle protects you from many other diseases and chronic illnesses, including heart, liver, blood-carried (diabetes), and brain disorders. Knowing that PCa has a very low mortality or death rate, we realize the bonuses that a healthy lifestyle can bring to our entire body!

Nutrition and prostate cancer

Studies show better nutrition may reduce the risk of getting PCa and prevent it from becoming metastatic. A cancer-fighting diet includes: lycopene from cooked tomato products, cruciferous vegetables, avoiding deli processed meats, and reducing dairy products such as butter. Instead of red meats substitute fish and vegetable proteins such as beans and processed bean products like soy milk. More on how your diet may protect you from chronic diseases and cancer can be found here.

Dr. Stacey Loeb and Dr. Justin Gregg recently hosted a webinar discussing diet research on prostate cancer indicating nutrition can help reduce the severity of PCa and help men recover from treatments. Almost 20 carefully controlled (quality) studies on PCa conclude that low fat/plant diet + exercise+ weight control + sleep result in lower progression of PCa regardless of your diagnosis. Watch the full webinar here. The key takeaway is adherence to a healthy lifestyle. Repeat: exercise, sleep, and eat well, and you live longer!

What lifestyle changes can you make now?

The kind of lifestyle we should aim for should be realistic for us city and town dwellers with diet, sleep, and exercise that still allows for some fun, such as staying out late for a movie and eating a bucket of buttered popcorn. The key is moderation, unless you have known risks factors such as family history of cancer, prior diseases, or have an early work schedule. Based on the research referenced above, lifestyle behaviors you can control to avoid serious PCa and other diseases might include:

• Reasonable dietary changes. If you have PCa, you don’t have to feel deprived and think you can’t enjoy a milkshake. Try substituting lower fat, reduced sugar ice creams and don’t drink milkshakes every day.
• Consult your doctor and urologist for referral to a dietician. Attend online programs or read articles about nutrition.
• Start with gradual exercise. Most health research has proven that 150 minutes per week of moderate to intense exercise with increased heartbeat helps reduce cancer growth or reduce risk for cancer, but also extends your life. Even 10 minutes a day is beneficial.
• When re-starting exercise, pay attention to your body. Work gradually into an exercise program.
• Develop a regular sleep schedule, but don’t refuse intimacy or a good late-night movie.
• Dress up your vegetables but don’t drown them in fatty dressings.
• Learn to read food product labels and limit saturated fat intake. To avoid overloading on fats, don’t order the mega-size French fries unless sharing.
• Do not smoke, period.
• If you drink, don’t drink as if setting a fraternity record. Then skip days and be alcohol-free.
• Make time for stress free activities such as yoga, meditation, and sleep.

When I graduated from high school my older brother gave me a plaque that reads: “Education is going from cocksure ignorance to thoughtful uncertainty”. It has been 52 years since high school, and this gift hangs on my wall and is embedded in my thoughts. The point I want you to think about is that however much we know today, we will know more soon. Advances in medical science will positively influence our lives and longevity. As for today, take the next step and adhere to a lifestyle of reasonable diet, moderate to challenging exercise, sleeping well and thinking positively. Avoid stressing and seek camaraderie.

Until we meet again on these pages: eat, exercise and be happy!

Read more like this: Patient Prostate Cancer Journey Part 1: A Urology Exam Reveals Unexpected Results

Geoff McLennan, MPA, Prostate Cancer Patient and Advocate

Author Bio:

Geoff is dedicated to helping families and friends support a prostate cancer patient. He joined the board of Active Surveillance Patients International (ASPI) in 2018 and is an 11-year PCa patient. As a PCa patient advocate, he envisions providing a broad understanding of how patients can collaborate with clinicians for realistic medical care. He enjoys meeting and learning from his clinicians, cancer researchers, providing free online programs for patients, and reminds us that “to live, learn and thrive with PCa” is the motto of ASPI. He is glad he took science courses for understanding a healthy lifestyle that includes exercise and diet.

Geoff also volunteers as a board member and past chairman of the Placer County Mental Health Advisory Board where his interest includes therapy and resources for AS men, and a broad oversight of community mental health programs and innovations. He is married to Constance McLennan, a fine artist, has a grown son, and lives in Northern California.

*Disclaimer: The views expressed in this blog are solely those of the author, and do not represent the views or opinions of Myriad Genetics or its affiliates. It is important to consult with your healthcare provider.