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    A Diet for Cancer?

    The Dean Ornish solution.

    What's the Evidence? continued...

    It's hard to find a prostate cancer expert who will criticize the notion of a lifestyle-induced remission. Consensus seems to hold that the epidemiological evidence amounts to a good reason to test this hypothesis, and that Ornish and his colleagues, by setting up a randomized, controlled trial, are taking the right course to validate the theory.

    Still, not all urologists are as enthusiastic as Moul and Carroll. Some take issue with watchful waiting itself. William Catalona, MD, professor of surgery at Washington University in St. Louis and a leading prostate cancer expert, believes that this approach is really nothing more than a delaying tactic based on outdated information. "About five years ago there was data coming out of Sweden suggesting that watchful waiting was as good as surgery, particularly in older men with early-stage cancer," he says. But, Catalona adds, "We haven't seen any follow-up since then. I think watchful waiting causes some men to postpone effective therapy so long as to miss their window of opportunity for successful treatment."

    Too Drastic?

    But the major criticism is the same one as for Ornish's anti-heart-disease regimen: that the program is too draconian. "The dietary change is much too difficult for all but the most committed person to stick to," says Catalona. Both Ornish and Moul, not surprisingly, disagree. When threatened with cancer, they say, people become motivated to make changes that might otherwise have seemed unthinkable.

    That was the case for Dennis Simkin, a San Francisco Bay area resident who learned three years ago, at 51, that his PSA measurement of 6.8 was in the borderline danger range. A biopsy ordered by his doctor, Carroll, confirmed that he had early-stage prostate cancer. Simkin opted to try the Ornish program in hopes of avoiding the need for treatment that might make him impotent, incontinent, or both.

    "We had always eaten fairly healthy," Simkin says, "But this was drastic. It did take time to adjust. Eliminating all added oil from our diet, for instance, was hard."

    Still, soon after making the changes, Simkin noticed that he felt better. "That made the transition much easier," he says. What's more, his PSA quickly dropped below 4.

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