The Prostate Plan

When John Stone found out he had prostate cancer, he researched the conventional interventions, including surgery and radiation, and quickly learned the harsh truth--they don't always work, and can cause impotence and incontinence. After months of indecision, the 57-year-old real-estate developer from Groveland, Calif., heard about a research project being conducted by Dr. Dean Ornish in San Francisco. Now, two years after his diagnosis and a year after starting the Ornish program--which is based on dramatic diet and lifestyle changes--Stone has come to a startling conclusion. Speaking for himself and his wife, Sandy, he says: "Prostate cancer is the best thing that ever happened to us."

That extreme statement reflects the extreme changes required of Stone and other prostate-cancer patients taking part in Ornish's study, the first results of which were presented over the weekend at the Scientific Conference on Complementary, Alternative and Integrative Therapies at Harvard. Ornish's regimen is intense. It includes a vegan diet of fruits, vegetables, whole grains and beans (with soy products instead of dairy, and just 10 percent fat), no alcohol, three hours of aerobic exercise a week, an hour of meditation and other stress-management techniques each day, and weekly participation in a support group. Compliance is no cinch, even with cancer as the motivator.

The routine gets results, according to the study. After the first three months, Ornish reports, patients in the study showed an average 6.5 percent decrease in their PSA (prostate-specific antigen) level, a crucial blood marker for the disease. Ornish kept track of how well patients followed the guidelines and found PSA dropped an average of 9 percent among those who adhered closest to his regimen. His findings, he says, suggest diet and lifestyle changes may slow, stop or even reverse the progression of early prostate cancer. "Your body often has the ability to begin healing itself if you stop the behaviors contributing to the problem," says Ornish, a clinical professor of medicine at the University of California, San Francisco, best known for his equally unconventional work on heart disease. Ornish coauthored the study with Peter Carroll, chairman of urology at UCSF, and the late William Fair of New York's Memorial Sloan-Kettering Cancer Center.

For Stone, "a big meat-and-cheese man" who rarely exercised and once reached 300 pounds, the program has done more than lower his PSA (currently at 6.9 after peaking at nearly 10; anything above 4 is a red flag). It's changed his life. He's dropped about 50 pounds, to 195, and lowered his cholesterol from about 200 to 135. He says he's fitter than he's ever been and even enjoys meditation and support-group sessions, things he once considered a joke. And Sandy, who's followed the program with him, has dropped 40 pounds. Best of all, Stone says, he's lost his fear. "If I'm having my PSA checked every three months and I don't have some rapid increase, it's a very liberating feeling," he says.

Not everyone is impressed by Ornish's study, which compared two groups of 42 men who had not received conventional treatment for their biopsy-documented prostate cancer. The 6.5 percent decrease in PSA levels after three months is not significant, says Joseph Smith, president of the Society of Urologic Oncology and chairman of the department of urologic surgery at Vanderbilt University. "It doesn't impress me." Most oncologists consider anything less than a 50 percent decrease to be insignificant, he says. Ornish acknowledges the drop in PSA levels is "not that big a change," but says it is statistically significant. "You don't need it to go down," he says. "You just need it to not go up."

Ornish is hardly alone in recognizing the power of fruits and vegetables. "Even without direct evidence that a certain diet will lower your risk of cancer, it makes sense for so many other things," says Dr. Leslie Ford of the National Cancer Institute.

Prostate cancer is the second most common form of cancer among men, after skin cancer. This year, doctors will diagnose some 198,000 Americans with the disease, and more than 31,500 men are expected to die from it. Alan Jones, another of Ornish's patients, doesn't intend on being one of the latter statistics. The 62-year-old Episcopal dean of Grace Cathedral in San Francisco, Jones saw his PSA remain stable at 6.4 while taking part in Ornish's study. Like John Stone, he was reluctant to submit to surgery or radiation, with their side effects and recurrence rates (as high as 40 percent within two years of surgery). Jones also reports lower cholesterol. The irony of the situation is not lost on him. "I had to get cancer to get healthy."