Surviving and thriving with and beyond prostate cancer
Whether your treatment has ended or you’re on long-term hormone or drug therapy, you may want to turn your attention to regaining your health, maintaining remission, and creating a body that is less supportive of cancer.
This may be a time when you feel anxiety around follow-up visits and testing, and perhaps fear that your cancer may recur. Taking charge of your health through blending anticancer healing practices and complementary therapies can empower you as you move in and through the challenges of living with cancer.
“A survivor is a person who lived through hardship or disaster. A thriver is more than that. It is someone who not only goes through an exceptionally positive or threatening life event, but shows subsequent growth because of the experience.”1Mangelsdorf J, Eid M. What makes a thriver? Unifying the concepts of posttraumatic and postecstatic growth. Frontiers in Psychology. 2015 Jun 23;6:813.
In addition to everything within At any time during your prostate cancer experience › you may consider the practices and therapies listed here. They promote both surviving and thriving, including reducing your risk of relapse or recurrence, as you live the rest of your life.
Top practices and therapies we have reviewed for reducing risk of recurrence and improving quality of life after treatment
These practices and therapies have at least modest evidence for the medical benefits listed. We add to this list as we complete new reviews of practices and therapies.
On this page
Recovering from treatment and maintaining remission
Balancing terrain
Several imbalances in your body terrainthe internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation, and more can make your body more susceptible to infection, slower to heal wounds, and/or more supportive of cancer. Chronic inflammation, high blood sugar and insulin resistance, obesity, and imbalanced stress chemistry may be particularly important to balance in relation to surgery, wound healing, and reducing recurrence risk.
Find health professionals who specialize in managing body terrain ›
Post-treatment monitoring
When you have finished treatment, discuss and develop a survivorship plan with your cancer treatment team. Your survivorship plan will include instructions and a schedule for follow-up visits and testing, but ideally it will go beyond that also to include guidance on lifestyle and other self-care practices to help you recover and prevent recurrence. The type of testing and monitoring done to assess your response to treatment and detect a recurrence depends on your specific cancer, treatment, and risk for recurrence.
If your plan doesn’t include guidance on lifestyle and other self-care practices, you can ask your team for this information and/or for a referral to programs, lifestyle coaches, and other supports specializing in people with cancer. You might also ask about a survivorship program and/or navigator who can help you with this part of the plan.
You need to find a balance in the type and frequency of monitoring for prostate cancer recurrence. Talk with your oncologist about your risk of recurrence and the type and frequency of monitoring best for you. Based on your risk, ask these questions:
- Have we done everything we know to do from a treatment standpoint to treat the cancer?
- What type and frequency of monitoring is best for me?
- What are the available monitoring tests and tools?
Helpful link
Reducing your risk of recurrence and improving quality of life after treatment
You can be active in creating a body that is less likely to support cancer recurrence. Both self-care practices and complementary therapies can provide benefit. Details of the evidence supporting the statements are in the pages available through the image links.
In addition to everything within At any time during your cancer experience ›, you may consider the practices and therapies listed here. They promote both surviving and thriving, including reducing your risk of relapse or recurrence, as you live the rest of your life.
Modest evidence of benefit of reducing your risk of recurrence and improving quality of life
Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) indicates confidence that the practice or therapy has an effect as noted. Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.
The evidence for these effects is described in the reviews available through the image links.
Moving More: good to weak evidence
Find strategies for moving more in this handbook.
Specific to prostate cancer:
- A lower risk of prostate cancer recurrence among men with the highest levels of physical activity (weak evidence)
- Better quality of life and ability to control urination after surgery among people participating in pelvic floor muscle training (modest evidence)
Cancer as a whole:
- Better strength, fitness, and quality of life among people participating in exercise after treatment (good evidence)
- Lower risk of recurrence among people participating in exercise (modest evidence)
Manage depression: good evidence
Find approaches for managing depression in this handbook.
Cancer as a whole:
- Higher risk of recurrence among people with depression (good evidence)
Guided imagery: modest evidence
Cancer as a whole:
- Better quality of life and function after completing cancer treatment among people treated with guided imagery, sometimes with other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body. (modest evidence)
Metformin: modest evidence
Specific to prostate cancer:
- Lower risk of recurrence among people with prostate cancer and diabetes treated with metformin (modest evidence)
- Lower risk of recurrence among people with prostate cancer (not specific to diabetes) treated with metformin (modest evidence)
Relaxation techniques: modest evidence
Cancer as a whole:
- Better quality of life after surgery among people with cancer treated with relaxation, sometimes with other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body. (modest evidence)
Preliminary or weak evidence of benefit for reducing risk of recurrence and improving quality of life
Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, although substantial uncertainty remains. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that a high degree of uncertainty remains about the links between the practice or therapy and the outcomes described.
No evidence of an effect on reducing risk of recurrence and improving quality of life
Artesunate and other artemisinin-based drugs ›
Specific to prostate cancer:
- No evidence of an effect on risk of prostate cancer recurrence in a case study treated with artesunate
No evidence of lower risk of recurrence of cancer as a whole among people treated with mistletoe in a combined analysis of studies
Specific to prostate cancer:
- No evidence of an effect on quality of life during intermittent androgen deprivation among men with prostate cancer treated with curcumin in a preliminary study
Further therapies that may reduce risk of recurrence
These therapies are reported to reduce risk of recurrence. We have not fully assessed the evidence, although we provide preliminary reviews as linked.
Improving quality of life
Good or modest evidence of benefit for improving quality of life after treatment
Moving More: good evidence
Find strategies for moving more in this handbook.
Cancer as a whole:
- Better strength, fitness, and quality of life among people participating in exercise after treatment (good evidence)
Guided imagery: modest and preliminary evidence
Cancer as a whole:
- Better quality of life and function after completing cancer treatment among people treated with guided imagery, sometimes with other mind-body therapies (modest evidence)
- Less cognitive dysfunction after completing cancer treatment among people with breast cancer participating in an imagery-based group intervention (preliminary evidence)
Relaxation techniques: modest evidence
Cancer as a whole:
- Better quality of life after surgery among people with cancer treated with relaxation, sometimes with other mind-body therapies (modest evidence)
Preliminary or weak evidence of benefit for improving quality of life after treatment
How integrative experts approach survivorship
Clinical practice guidelines
Physical activity, including aerobic exercise, is recommended to improve health-related quality of life and physical function; aerobic exercise is also recommended to reduce side effects:
Anxiety
Depressive symptoms
Fatigue
Sleep disruption
For bone health, combined moderate-vigorous intensity resistance plus high-impact training is recommended.
NCCN Guidelines for Patients®: Survivorship Care for Healthy Living, 2020 ›
Recommendations for healthy living in general:
Get enough sleep
See your primary care provider on a regular basis
Follow health guidelines as appropriate
Do not take supplements unless your health provider prescribes them.
Do not stop eating healthful foods because you take supplements
These guidelines make recommendations regarding side effects and symptoms common among people with cancer. Specific recommendations are listed in handbooks: Managing Symptoms and Side Effects ›
Published programs and approaches
Lise Alschuler, ND, FABNO, and Karolyn Gazella
Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer: A Five-Step Integrative Plan to Reduce the Risk of Recurrence and Build Lifelong Health. Berkeley, California: Ten Speed Press. 2013.
Chapters 1-5 list five key body pathways to target to make your body inhospitable to cancer.
Keith Block, MD
Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.
Dr. Block describes his remission maintenance program. You can learn more about Dr. Block’s integrative program to address these terrain factors:
- Chapter 15, Inflammation: Overcoming cancer’s fiery side
- Chapter 16, Immune Surveillance: Mounting the immune barricades
- Chapter 18, Glycemia: Breaking cancer’s sugar addiction
Dr. Geo Espinosa
Dr. Geo Espinosa presented a webinar hosted by the Academy of Integrative Health & Medicine.
Posttreatment prostate cancer protocol
Dr. Espinosa describes his protocol for posttreatment prostate cancer, beginning at 33:37 and continuing until 46:42 minutes into the recording (13 minutes 5 seconds total).
Play videoJeremy Geffen, MD
Geffen J. The Seven Levels of Healing. Audio CD – 2002
Geffen J. The Journey Through Cancer: An Oncologist’s Seven-Level Program for Healing and Transforming the Whole Person. New York, New York: Three Rivers Press. 2006.
Geffen J. The Seven Levels of Healing. Presented at Cancer as a Turning Point Conference in Seattle, Washington in 2006.
The late, renowned integrative oncologist Jeremy Geffen, MD, developed a healing program based on what he calls The Seven Levels of Healing. It is a program of body, mind, heart, and spirit for healing and transforming the whole person.
Gerald M. Lemole, MD; Pallav K. Mehta, MD; and Dwight L. McKee, MD
Lemole GM, Mehta PK, McKee DL. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
These doctors present easy-to-incorporate lifestyle changes to help you “turn on” hundreds of genes that fight cancer, and “turn off” the ones that encourage cancer, while recommending lifestyle approaches to address each type.
Recurrence
This handbook provides guidance if you have been diagnosed with a cancer recurrence.
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References
