Consequences of Prostate Cancer Treatment

A cancer diagnosis is seen as a teachable moment in medicine where we can try to get people to eat healthier, but “research has suggested that male cancer patients may be reluctant to introduce dietary modification…This has been attributed to dietary modifications often being viewed as mimicking “feminine” eating behaviours, such as emphasizing an increase in fruit and vegetables.” 

As I discuss in my video Changing a Man’s Diet After a Prostate Cancer Diagnosis, “[a]lthough healthy eating might enhance long-term survival, few men with prostate cancer make diet changes to advance their well-being.” Many of the cancer survival trials require adherence to strict plant-based diets, and though researchers tried providing extensive nutrition education and counseling programs, dietary adherence was still a challenge.

Apparently the way Dean Ornish was able to reverse the progression of prostate cancer with a plant-based diet was by home-delivering prepared meals to the subjects’ doors, figuring men are so lazy they’ll just eat whatever’s put in front of them. After all, male culture tends to encourage men to drink beer and eat convenience food and meat.

Take Men’s Health magazine, for example. Included in the list of things men should never apologize for were liking McDonald’s, not offering a vegetarian alternative, and laughing at people who eat trail mix. The magazine features articles with such titles as “Vegetables Are for Girls” and sections like “Men and Meat: There’s Only One Kind of Flesh We Like Better and Even Then She’d Better Know How to Grill.”

To appeal to male sensibilities, doctors are advised to use ‘body as machine’ metaphors, framing “men’s health in terms of mechanical objects, such as cars, requiring tuning.” But if men are so concerned about their masculinity and manhood, maybe we instead should share a bit about what prostate cancer treatment entails. The prostate is situated at the base of the penis, so when you core it out with a radical prostatectomy, you lose about an inch off your penis, if it gets erect at all. Only 16 percent of men undergoing the procedure will regain their pre-surgery level of erectile functioning.

Patients are typically quoted erectile dysfunction rates around 60 to 70 percent, but studies have generally considered erectile function recovery “as the ability to maintain an erection hard enough for penetration about 50% of the time…” So, occasionally being able to get an erection is considered recovery, but when a surgeon tells patients they will recover function, the patients probably assume that means the kind of function they had prior to surgery, which only happens 16 percent of the time and only 4 percent of the time in men over 60. Only 1 in 25 gets his baseline sexual function back.

Erections aren’t the only issue. Patients experience other problems like orgasm-associated pain even years later and urinary incontinence during foreplay, stimulation, or orgasm. The vast majority of couples overestimate how much function they’re going to recover. Couples reported feeling loss and grief. Having cancer is bad enough without the additional losses. You’d think that would be enough to motivate men to improve their diets, but almost a fourth of the men newly diagnosed with prostate cancer state they would prefer to have their lives cut short rather than live with a diet that prohibits beef and pork. More men would rather be impotent than improve their diet. It appears pleasures of the flesh may sometimes even trump pleasures of the flesh.


Did I say reverse the progression of cancer? See Cancer Reversal Through Diet? and my overview video How Not to Die from Cancer.

For more on prostate cancer prevention and survival, check out:

Interested in more information on maintaining male sexual function? See:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Concerns About Bone Broth

There are toxicological issues associated with production and processing of meat, such as the presence of various toxic contaminants—from dioxins and PCBs to cooked meat carcinogens. Carcinogenesis, the development of cancer, may be the main concern, but there are a number of other toxic responses connected with the consumption of meat products. Lead, for example, can be toxic to the nerves, gastrointestinal tract, bone marrow, and kidneys.

Where is lead found in the food supply? In general terms, the highest levels of lead, as well as arsenic and mercury, are found in fish. Sardines have the most arsenic, but tuna may have sardines beat when it comes to mercury and lead.

The problem is that “fish-consumption advisories related to human health protection do not consider the fish by-products fed to farmed animals,” like farmed fish. If some tilapia are fed tuna by-products, they could bioaccumulate heavy metals and pass them onto us when we eat them. Researchers found the highest levels in frozen sole fillets, averaging above the legal limit for lead.

Lead exposure has been shown to have adverse effects on nearly every organ system in the body. Symptoms of chronic exposure range from memory loss and constipation to impotence and depression. These symptoms present after pretty hefty exposure, though. However, we now know that “[b]lood lead levels in the range currently considered acceptable are associated with increased prevalence of gout and hyperuricemia” (elevated levels of uric acid in the blood). According to the Centers for Disease Control and the World Health Organization, a blood lead level needs to be less than 25 micrograms per deciliter to be “non-elevated.” You’d assume that at values under 25, there’d be no relationship with health outcomes, but even throughout this “acceptable” range, lower lead means lower uric acid levels and lower gout risk. So, even blood lead levels 20 times below the acceptable level can be associated with increased prevalence of gout. “These data suggest that there is no such thing as a ‘safe’ level of exposure to lead.” 

Once lead gets into the body, it tends to stay in the body. It builds up in the bones such that it may take 30 years just to get rid of half. The best strategy? Don’t get exposed in the first place.

If lead builds up in bones, though, what about boiling bones for broth? As I discuss in my video Lead Contamination in Bone Broth, we know bones sequester lead, which can then leach from the bones. So, researchers suggested that “the bones of farmyard animals will sequester lead, some of which will then be released into broth during its preparation.” Who eats bone broth? Bone broth consumption is encouraged by many advocates of the paleo diet. Online, you can learn all about purported “benefits” of bone broth, but what they don’t tend to mention is the theoretical risk of lead contamination—or at least it was theoretical until now. Broth made from chicken bones was to have markedly high lead concentrations, up to a ten-fold increase in lead. Researchers concluded, “In view of the dangers of lead consumption to the human body, we recommend that doctors and nutritionists take the risk of lead contamination into consideration when advising patients about bone broth diets.”

But what if you only use bones from organic, free-range chickens? They did use only bones from organic, free-range chickens.


For more on the paleo diet, see:

Other products contaminated with lead include Ayurvedic supplements, protein powders, wild animals shot with lead ammunition, dairy products, and tea from China:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Foods that Affect Testosterone Levels

A number of studies suggest that exposure to industrial pollutants may affect sexual function, for example, loss of libido, sexual dysfunction, and impotence. This may be due to effects on testosterone levels. In a study of men who ate a lot of contaminated fish, an elevation in PCB levels in the blood was associated with a lower concentration of testosterone levels. These pollutants are found predominantly in fish, but also meat and dairy. The lowest levels are found in plants (see Dietary Pollutants May Affect Testosterone Levels).

Testosterone doesn’t just play a role in the determination of secondary sex characteristics like facial hair at puberty. It also regulates normal sexual functioning and the overall physical and psychological well-being of adult men. Abnormally low levels of testosterone can lead to decreased physical endurance and memory capacity, loss of libido, drop in sperm count, loss of bone density, obesity, and depression.

Endocrine-disrupting compounds that build up in fish may be able to mimic or block hormone receptors, or alter rates of synthesis or breakdown of sex steroid hormones. In children, these pollutants may actually impair sexual development. Boys who are exposed may grow up with smaller penises (although only by about two-thirds of an inch shorter at most). Researchers have tried exposing cells from aborted fetal human penises to these kinds of dietary pollutants, and gene expression related to genital development is indeed affected at real-life exposure levels. We’re not sure if the effects on penis length are due to the pro-estrogenic effects of the toxins, though, or the anti-testosterone effects.

You’ve heard of save the whales? Well, male reproductive organs may be at risk from environmental hazards as well.

I previously addressed how we discovered the endocrine disruptor phenomenon in Alkylphenol Endocrine Disruptors and Allergies, as well as where they’re found (Dietary Sources of Alkylphenol Endocrine Disruptors).

For more on sustaining male virility, see Male Fertility and Diet, The Role of Diet in Declining Sperm Counts, and Dairy Estrogen and Male Fertility.

I’ve talked about the role a plastics chemical may play in male sexual functioning (BPA Plastic and Male Sexual Dysfunction). But it’s not just toxins, it’s the total diet (Survival of the Firmest: Erectile Dysfunction and Death), and not only in men (Cholesterol and Female Sexual Dysfunction).  My latest on the topic is Best Foods to Improve Sexual Function

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. Image has been modified.