An Interview with Dr. Bradley Hennenfent by Richard Steele.

Noted authority. Dr. Bradley Hennenfent, author of the book "Surviving Prostate Cancer Without Surgery," shares his thoughts on what he would do if he had prostate cancer.

1. I would put my cancer in mice.

" One of the biggest problems with prostate cancer," says Dr. Hennenfent, "is that doctors try to treat everyone with the same vaccine or the same hormone blockers or the same herbal medications. I think we need a more individualized approach. If I was going to agressively treat prostate cancer, I would put it in mice and let it grow. I would then use different treatment regimens on the mice to see what worked for my cancer."

" I would also want a vaccine made, just for my cancer," adds Dr. Hennenfent.

"But, these techniques are not available to many or most men with prostate cancer," he says.

2. "Watchful Waiting"

" Watchful waiting" means watching your prostate cancer until it causes symptoms - if it ever does - and then treating the symptoms. This is different from the practice of some doctors who advocate treatments that immediately decrease the quality of a man's life. Oftentimes, these doctors prescribe a treatment that is worse than the disease.

" Watchful waiting" is a viable option because most prostate cancer is small and slow-gathering. The fact is that a majority of men with prostate cancer will go on to live their lives without ever dying from prostate cancer. They will die with prostate cancer inside them, but not from it.

" Watchful waiting preserves your sexuality and urinary continence," says Dr. Hennenfent in his book. "The treatment itself does not harm you. You wait and see if your cancer becomes symptomatic and you start hormone blockade or have a TURP (transurethral resection of the prostate), only if you need it."

" Always remember that the least harmful treatment for prostate cancer, the one that interrupts your life the least, and is appropriate if your cancer is small and slow-growing, is watchful waiting," says Dr. Hennenfent.

3. Active Non-Invasive Therapy (ANIT)
The term "active non-invasive therapy" or ANIT was coined by prostate cancer survivor Sandy Goldman. Like many others, Sandy's physician recommended surgery after diagnosing Sandy's prostate cancer. But Sandy went the ANIT way: doing everything healthy and avoiding drastic and harmful measures, while still treating prostate cancer.

ANIT means following your prostate cancer with prostate specific antigen (PSA) tests and digital rectal exams (DREs).

ANIT means becoming an ardent student of prostate cancer by reading books, searching the internet and joining prostate cancer groups. It means trying to decide how to use the latest advances in predicting the course of prostate cancer.

ANIT also means reducing stress and living a healthier lifestyle, replete with a disciplined diet and regular exercise.

Dr. Hennenfent adds, "All men who can safely be put on Viagra, Levitra or Cialis and want to try one of these sex-enhancing drugs should be started on one as part of active non-invasive therapy. By seeing how good your sex life can be, you will think more carefully before undergoing prostate cancer treatments that will destroy your sexual function, and you might make better choices."

4. PC SPES (if it's available)

PC SPES is an over-the-counter combination of eight herbs: seven Chinese herbs along with the American herb saw palmetto. PC stands for prostate cancer and SPES is Latin for hope. Hence, PC SPES literally means prostate cancer hope.

The book "Surviving Prostate Cancer Without Surgery" tells of the case of Mario Mennelly, a 42-year-old utility company manager, whose prostate specific antigen (PSA, a protein secreted by normal and cancerous prostate cells, whose normal level is 0 or 4ug/L) rose from 100 to 122 within six months (September 1996 to March 1997) of being diagnosed for cancer.

After taking nine capsules of PC SPES every day for a month, Mario's PSA went from 122 to 11. Subsequently, he reduced his PC SPES dosage to six capsules a day and his PSA continued to fall to 1. By 2000, Mario's PSA was 0.2 and he intended to maintain it at that level.

However, in 2002, the United States Food & Drug Administration had issued a warning about taking PC SPES. The California Department of Health found that PC SPES contained sodium warfarin, a blood thinner. Shortly after that, BotanicLab, manufacturers of PC SPES, announced a voluntary recall. The company has since gone out of business.

For the sake of people like Mario and countless others out there, Dr. Hennenfent feels that the medical profession should not give up hope for PC SPES. He stresses a more thorough examination of the drug and perhaps adding low-dose estrogen with a blood thinner to the regimen.

" Apparently, there are natural substances in PC SPES that kill prostate cancer. We need to identify and study them," said Dr. Hennenfent. "We need to examine the entire Chinese way of medicine where several agents are given, which are thought to act synergistically, while in Western Medicine, typically one medicine is used."

5. Local Therapies

Dr. Hennenfent says that he would look carefully at local therapies such as cryoablation, radiation seed implants, 3-D conformal radiation, intensity modulated radiation therapy, and every other form of radiation therapy.

6. Hormone blockade

The testicles, adrenal glands and prostate all produce male hormones, and one strategy to fight prostate cancer is to block the male hormones. The treatment is called single, double or triple hormone blockade, depending on how many of the three organs are blocked.

In a sense, hormone blockade produces "chemical castration" as opposed to the old practice of "surgical castration" with a scalpel. Obviously, the main difference is that surgical castration cannot be reversed, while chemical castration can be stopped. It is a critical difference. It is no secret that men usually don't want to be castrated.

" I will always consider starting hormone blockade regardless of the stage and grade of prostate cancer that I have, and I will be hoping that triple hormone blockade followed by Proscar (finasteride) maintenance or intermittent hormone blockade, will have been proved to extend life by the time that I need them," said Dr. Hennenfelt.

" In fact, I will seriously consider bypassing PC SPES and/or estrogen and going straight to combined hormone blockade as my first treatment, depending on the results of studies now in progress - especially if such studies show that increased quality-of-life survival can be obtained by being on hormone blockade for a short time, intermittently, or by stopping all the blockade except Proscar maintenance."

Dr. Hennenfent ends with a cautionary note: "With so much happening with hormone blockage, radiation therapies, cryoblation and potential new therapies, it may be a terrible mistake to let your prostate and seminal vesicles be ripped out during radical surgery. Think of your quality of life as you pursue a cure for prostate cancer."

" However, you do not have to do what I do. People can look at the same facts and make different decisions, and more importantly, people can look at the same lack of facts and make different decisions."