Matt Stampe

Cancer Care

2/16/2025

on What is going on with Men’s prostrate? Theory, Discipline, and Functionality.

The MSK Cancer Care videos (see notes at bottom of page) stated something quite important. The PSA exam men get only indicates if the prostate is having an issue and not positive for cancer. Biopsy or blood tests will be more valuable.

In the book, “Tao of Sexology”, by Dr. Stephen Chang, he proposed a theory that prostate issues could be linked to toxins in the colon. He advised men to be sure they are fully evacuating the colon on bowel movement, otherwise toxins in stool that is remaining can creep into the prostate. He advised men to be sure to clean fully.

Second he advised men should do prostate examinations on their own in the shower same way women need to do breast self exams. It might be hard to discuss this with male patients, but self digital-exam of the prostate is important. To find a baseline when the prostate is normal and when the prostate is swollen and tender.

I’ve found it difficult to talk to male patients about this, but I usually advise them on first intake when talking about urinary disorders, prostate history, low libido and erectile dysfunction.

Just my 2 cents. hope it helps prevent prostate cancer in men, because prostate cancer going unchecked can spread into the bones.

Post:

Another area of concern for male prostate is how much is actually ok to ejaculate. In Western medicine doctors think it is ok to ejaculate more often because it helps balance out the prostate. In Eastern medicine it is the storage of Jing (vital essence) that helps the Qi (vital energy) and the Shen (vital mind). I think we can use a middle way here with patients: Patients need to be advised “To not want to have too much sex nor too little” for the health of the prostate and testicles.

In his Book “Tao of Sexology” Dr. Stephen Chang had a chart based on what constitutes a healthy lifestyle by age and the ejaculation: for example in TCM we have acupuncture to prevent excess semen emission leakage. This is usually in young boys age 16 to 29 who are more in their prime, where it is actually more appropriate to ejaculate more. It is when men get into their 30’s, 40’s, 50’s and 60’s they have to be more conservative in semen emission.

Sun Ssu-mo’s advice on semen retention and control.:
age 30: not to be reckless with losing semen.
age 40- control the habit.
age 50- no more than every 20 days
age 60- every 30 days
age 70- every 100 days.


If I remember correctly, in his book Dr. Stephen chang says:
male age 15-29- once every other day is normal
30’s- every 2 to 3 days.
40’s- every 3 to 4 days
50’s- every 4 to 5 days
60’s- every 6 to 7 days
70’s- every 7 to 8 days.
(something like that, I no longer have the book)

A balance must be emphasized. “Not too much sex, nor too little”. There will be male patients that want to have acupuncture and herbs to increase libido and treat ED (erectile dysfunction).

This brings up the point of testosterone since low and high levels of testosterone can be a cause of prostate cancer. In Prostate cancer therapy, men are put on a castration cocktail of medications that lowers testosterone to prevent tumor growth.

So in my observation, it will be critical to balance hormones/Jing in male patients.

Question: Interesting information, I learned about this briefly in 5E school. I’ve actually had recent conversations with male friends in their late 30s/early 40s about too much sex and they were surprised. Did the book mention anything about holding in ejaculation…I’ve seen that discussed in podcasts- men talking about holding it in to preserve their essences, not with that exact wording but basically that’s what they were eluding to- any thoughts on this? Is it a good or bad thing?

Yes, the book did talk about semen retention methods like edging and using holds, even pressing the hui yin point, he called the “million dollar point”. I think again it should be a middle way, to not get to extreme with the holding. I had a Shaolin Kung fu teacher say to have normal sex and release sperm/semen, but in the next two sex encounters to hold it.

In yoga it is call Mula bandha “root lock”, these things should be done with an experienced teacher.

When I was 18 my Tai Chi teacher told me not to be excessive in sex and had me read the Mantak Chia books, “Cultivating Male sexual energy” , “Awaken healing with the Tao: Microcosmic Orbit”, and “Iron shirt chi kung”, and so that is basically what I do. The lifestyle of a monk and the common person is very different when it comes to celibacy practices and procreation.

Each individual is different and doing holds and celibacy can stagnate jing and Qi and may cause prostate swelling which is not normal.

Hope this helps.

Winning Response! Sam Laffer:

The Memorial Sloan Kettering Fundamentals of Oncology Acupuncture did not spend much on prostate cancer. The PSI test only tells us about the organ and not cancer. At this point they said there is no way to effectively predict prostate cancer. If you an enlarged prostate take action to reduce it.
Self examination is one way but it is not exact way to predict cancer of the prostate.
Have a yearly exam and if you have family members whom have had prostate cancer have an exam more regularly.
Here are some preventative measures; Keep a normal to lean weight, do not smoke,
if you must drink alcohol only in moderation, eat a balanced diet. Do not eat processed foods. Stay away from farm raised fish (especially those that use coloring). Eat free range beef, chickens , eggs, etc. Eat as much organic foods as possible. Make sure to read the labels on foods. Exercise at least 30 minutes per day. The above mentioned is a good start to guide you to good health.

Kate Chung wrote: Prevention of Prostate Cancer :

1.Healthy Diet: Eating a balanced diet rich in fruits, vegetables, and whole grains may lower the risk. Limiting red meat and processed foods is also recommended.
2.Physical Activity: Regular exercise can help maintain a healthy weight, which may reduce the risk of prostate cancer.
3.Limit Alcohol and Tobacco Use: Reducing alcohol consumption and quitting smoking can improve overall health and reduce cancer risk.
4. Regular Screenings: While there is no guaranteed way to prevent prostate cancer, routine screenings for men over 50 (or earlier for those with a family history) can detect it early.

Diagnosis of Prostate Cancer :

1. Prostate-Specific Antigen (PSA) Test: A blood test measuring PSA levels, which may be elevated in men with prostate cancer.

2. Digital Rectal Exam (DRE): A physical exam where a doctor checks for abnormalities in the prostate.
Biopsy: If PSA levels are high or DRE finds abnormalities, a biopsy is often performed to confirm the presence of cancer.

3. Imaging Tests: MRI or ultrasound can help determine the extent of cancer and guide treatment decisions.

Early detection and lifestyle choices play key roles in managing prostate cancer risk. Regular check-ups with a healthcare provider are important for monitoring prostate health.

MSK video notes:

Prostate Cancer	Many men will get prostate cancer 14% of all new cancer cases in US
	A fraction of these men will die of the disease or suffer from it.
	It is the second leading cause of cancer related death in American Men.
	Minority men have a higher risk.
	Overtreatment- incompetence and erectile dysfunction
	PSA screening: PSA is not cancer specific, only prostate specific. Benign prostate issues occur, just not cancer.
	Specific overlap between BPH and cancer
natural biological PSA variations:	Patient age and prostate volume
	Prostate cancer
	Prostatic inflammation
	Race/ethnicity
Screening paradox	Increase detection rate but did not prevent deaths. 22% more cancer in the screening group.
	The family history of prostate cancer should be considered.
	Risk assessment: death from prostate cancer, death from other causes, Quality of life- over and under treatment
	Risk of disease are gauged by: stage, Gleason score, PSA.
Staging	T1
	T2
	T3
	T4- invading other structures
Bone disease	Is the central issue of treating metastatic prostate cancer
	Primary source of morbidity and mortality
	It is the most feared complication of cancer: cord compression, marrow failure, pain, fracture, death.
Gleason Score	Grade 1 to 5. Dominate and lesser population. Example 4+4 + 8.
Paradox of reasonable choices	surveillance- serial monitoring of cancer without treatment
	radiation therapy- external beam or seed placement
	Hormones or no hormones
	Surgery:  radical prostatectomy
High risk disease	Risk of treatment failure regardless of modality
	Risk of metastatic disease and risk of death.
	High Gleason score does not need surveillance, they need treatment to prevent spread.
Hormones	Testosterone and DHT are fuel for prostate cancer growth.
	Hypothalamus- LHRH – pituitary- ACTH to adrenals and FSH and LH to testes.
	Adrenals- androstenedione DHEAS, DHEA- testosterone, Estradiol
	Testes- androstenedione testosterone (T) and Estradiol.
	Adrenals and testes- SHBG, (T) 5 alpha reductase- DHT  – AR- Protein synthesis- Prostate cell.
	Flutamide Bicalutamide Nilutamide- inhibit testosterone and androgen receptors. Enzulutamide
	Ketoconazole- reduce testosterone in adrenal and testes and tumor. Arbiraterone.
	Orchiectomy Ketoconazole-
	Finasteride- reduces 5 alpha reductase.
	Leuprolide Goserelin- LHRH production reduce drug. GnRH atagnoists
Prostate Cancer Clinical states	Castration Sensitive-
	clinically localized disease -> Rising PSA: castration sensitive-> Clinical metastases or Rising Castrate Resistant
	Castration Resistant-
	Rising PSA: castrate resistant- > Castration sensitive metastatic _. Castration resistant 1st line -> mCRPC 2nd line.
Progressive prostate cancer	No Cancer-> Localized disease -> Rising PSA -> Castrate sensitive metastatic -> CRPC metastatic
	tx: lower testosterone agent at localized disease stage.
Early vs Deferred hormones	MRC- primary therapy for localized /met
	Messing- adjuvant, N1
	Bolla- adjuvant, high grade T3, 4
	85-31- adjuvant, T3 or N1
Early Hormones	Early bisphosphonates for bone wasting
	Early therapy for impotence
	Early SSRI’s for hot flash and depression
	Early Breast RT for gynecomastia
	Early cholesterol and glucose and weight management
Intermittent Hormonal therapy	PSA high 45_> lower to 0 with hormone therapy- > take a break -> if psa gets up like 20 range _> repeat hormone therapy.
	do chemo and radiation while on hormone T blockers if PSA is high again.
Castration resistant	resistant to testosterone lowering agents.
	It is still exquisitely sensitive to testosterone and DHT.
Androgen receptor (AR)	receives hormones that fuel the growth of cancer tumor by way of either AR mutations, AR overexpression,
	or copious androgens within the tumor. It might be androgen sensitive, or finding other sources of androgen in the body.
Reduce the androgen abiraterone	Cholesterol with Desmolase
	Pregnenolone-> progesterone-> deoxy-corticosterone -> Corticostero -> Aldosterone
	CYP 17a-hydroxylase for Pregnelone
	11b-hydroxylase for Deoxy-corticosterone
	17a-OH-pregnenolone -> 17a-OH-progesterone -> 11-Deoxy-cortisol ->Cortisol
	c17, 20-lyase to block 17a-OH-pregnenolone
	DHEA -> Androstenedione -> testosterone -> DHT or ESTRADIOL
	CYP19: armomaatse to stop DHT and Estradiol
Abiraterone and mCRPC	abiraterone 1000mg daily and prednisone 10 mg daily
	hormonal therapy could prolong survival in men with metastatic castration resistant disease by 35%
AR overexpression	Enzalutamide
	Enzalutamide is an oral investigation drug rationally designed as a new hormonal agent to target androgen receptor (AR) signaling,
	a key driver of prostate cancer growth.
	Enzalutamide- first in new class of AR signaling inhibitors that affect multiple steps in the androgen receptor signaling pathway.
Enzalutamide for mCRPC	mCRPC- Castration resistant prostate cancer
	mDV3100- 180 mg daily vs.
	Enzalutamide 160 mg daily. Overall survival was higher with this drug.
	good for both pre and post chemotherapy. Risk reduction for death.
Alliance A031201	Enzalutamide 160 mg, Abiraterone 1000mg, prednisone 5 mg
Hormones for prostate cancer	AR is active thought the natural history of the disease.
	“Hormonal therapy” covers a band swath of anti-AR approaches- survival data for both castration sensitive/resistant disease/
	Both ligand reduction and anti-AR approaches
	No other modality has had as broad an application or as clinically beneficial results for such a large group of patients.
Bone tumor	pain, fracture, disability, blood dyscrasias, neurologic compromise, death.
	deposited calcium and phosphate crystal on new bone, bone deposition, new layers of bone where the cancer is.
	new bone gets over deposited.
Radium-233 targets bone metastases	Radium 233 acts as a calcium mimic. It is a earthy element on the periodic table.
	Naturally targets new bone growth in and around bone metastases
	Radium 233 is excreted by small intestines.
	Low rate of damage to the bone and marrow increases quality of life with little or no side effects.
Immunotherapy	Sipuleucel-T: WBC from blood, collected and exposed to prostate proteins and injected into prostate.
	It is a kind of vaccine therapy.
Chemotherapy	Taxanes. Taxus baccatus.
	Cabazitaxel
	Docetaxel
	Many men will go right to chemo if disease is first found to be metastatic. Then hormone therapy is introduced.
Conclusion	Prostate cancer represents a wider spectrum of risk than most other cancers
	Good decision making relies on a adequate understanding of risk of disease, risk of therapy, and risk of patients other diseases.
	Substantial advances in what was previously an untreatable condition, mCRPC, now is substantially bending the
	survival curve of prostate cancer. Improving overall survival and quality of life.