Can Stress Make Prostate Cancer Worse? The Truth About Fear and Cancer

[00:00:00]The first thing somebody does when they get diagnosed with cancer is become stressed. But is that really bad? You know, if you're thinking about death, you're thinking about cancer, you're robbing your moment. The cancer is beating you twice. You do not want to die twice.

[00:00:20]All right, so we know stress is bad and it's bad if you have cancer.

[00:00:26]They tell you to relax and not to stress.

[00:00:30]How do you do that?

[00:00:31]The first thing somebody does when they get diagnosed with cancer is become stressed.

[00:00:37]But is that really bad? We're going to talk about that. Is there good stress, bad stress?

[00:00:43]How do we diminish it? Does it affect our immune system? And make cancer more likely to progress.

[00:00:49]So I'm going to break down some fallacies. First of all, stress is necessary, constructive, and helpful.

[00:00:56]It motivates action.

[00:00:59]If you are stressed because you have an exam in a week, that ain't bad.

[00:01:03]It's going to be helpful to make you study.

[00:01:07]If you don't study, then that is ignorance on your part and the stress will amplify.

[00:01:14]Take it to a job performance or a game or a future event.

[00:01:20]It's stressful to think about I don't know, a 50th class year reunion.

[00:01:26]Am I going to show up looking old and dumpy? Maybe it'll motivate. So stress can motivate. When you feel pressure, when you feel stress, think of it as a signal.

[00:01:37]The outside world is creating a stimulus that is creating internal stress.

[00:01:43]Remember, the stress is always an internal response to an external stimulus.

[00:01:50]So I never want you to point your finger and say, "Well, of course I'm stressed.

[00:01:54]Look at what my spouse did. Of course I'm stressed. My boss know. No.

[00:01:59]Those are stimuli.

[00:02:01]Okay, let's talk about how you respond to that.

[00:02:03]So, you've been told you have cancer.

[00:02:05]The stress hits you.

[00:02:07]Lesson number one, don't worry about being stressed. You're supposed to be stressed. You just told You were just told you had cancer.

[00:02:14]When faced with stress, the first thing you do is pause.

[00:02:18]Unless the stress is coming from a car barreling at you, then you move.

[00:02:23]But in general, particularly in regards specifically to prostate cancer, really almost any cancer, you have time. But prostate in particular, do not let a doctor, a urologist, or neighbor, a friend, an aunt, a relative tell you you have to make a decision fast. This thing can explode. Tick tick tick. It's not that way.

[00:02:49]The most important thing to do is make a good decision. The stress should help motivate you to ask questions, to seek answers, not to just go and do the first thing you're told.

[00:03:04]Look, you've all bought cars, I hope, at some point. It can be stressful. You go to a lot. They're pushing you to buy that car.

[00:03:12]How many of you would walk in the lot and drop top dollar day one?

[00:03:16]No. You'd shop around a little bit.

[00:03:18]Same thing with your prostate cancer.

[00:03:21]You pause and you shop a little bit. If somebody's giving you the big pressure, I'll never forget a patient of mine diagnosed with prostate cancer and the surgeon said, "We'll set you up for surgery. We've got to get you in right away before this spreads. Got to get it. Got to get it when it's early."

[00:03:37]Folks, that was over 30 years ago.

[00:03:41]My patient is still alive. His surgeon since passed away. Now, I find that ironic, although I don't wish harm to anybody.

[00:03:48]But let's talk about how you process this. First, when you stressed, don't worry that you're getting stressed.

[00:03:56]You're supposed to be. It's not going to collapse your immune system.

[00:04:00]In the acute phase, consider it a signal to action.

[00:04:04]Even if that action is contemplative, reflective, a little bit of research.

[00:04:11]Now you're through that window.

[00:04:13]Chronic stress in the absence of actionable events will wear you down. It'll make you no fun to be with. It will affect your immune system. And yes, it can be an amplifier of cancer.

[00:04:28]So you're through the first phase. My first recommendation, do your homework, study your options. There is no clear path of assured outcomes. None.

[00:04:40]So don't look for that ultimate I'm going to find the root cause, I'm going to find the thing that is going to zap this cancer and make it go away.

[00:04:50]That is not happening.

[00:04:51]You will choose a path of treatment.

[00:04:54]And once you make the choice, your stress level should go down.

[00:04:58]Because now you have a point of action.

[00:05:01]Yeah, but doc, what if it progresses?

[00:05:02]Yeah, but doc, what if I die? Okay, I get that piece of the equation.

[00:05:07]So you pick your path. What do you do next?

[00:05:10]You don't think about the next step. You go to the end of the road.

[00:05:14]This is called back engineering the etiology of your stress. Go to the end of the road. Yeah, I'm talking about death. You go to death.

[00:05:22]Cuz it's going to happen. Whether or not cancer or something else takes you away.

[00:05:28]From that perspective, you back engineer how you want to respond.

[00:05:34]I'm reminded of the movie The Candidate with Peter Boyle and Robert Redford. I love that movie. And if you know of what I'm speaking, then I guess we're classmates.

[00:05:43]In the movie, Peter Boyle plays an operative, a political operative. and his job is to find a candidate to run against a powerful incumbent who will absolutely win the election. Thus, this candidate is just there to stop the party from being embarrassed by not having a candidate. So, Peter Boyle's on one side of the table, he's talking to Robert Redford on the other, trying to convince him. Robert says, "I don't want to do it. I don't want to do it." And Peter Boyle takes a piece of paper, writes something on it, folds it in half, slides it across the table to Robert Redford.

[00:06:15]He opens it up, he looks at it, and the paper says, "You'll lose."

[00:06:19]>> [laughter] >> Think about that.

[00:06:22]With that paper, with the assured outcome of a loss, Robert Redford was liberated. I'm going to lose.

[00:06:30]Imagine you're sitting at that table, and imagine the Archangel, whomever your spiritual self, imagine it's you, your doppelganger, writes on that paper, folds it in half, slides it over to you, pick it up, you look at it, it says, "You die."

[00:06:46]Everything else pales in comparison to that moment. Every worry, every thought pales.

[00:06:54]So, because we're we know we're going to die, and when we back engineer that knowledge, here are some things that have helped others that are worth considering.

[00:07:04]Be prepared.

[00:07:05]Have a will.

[00:07:07]As much detail as you can execute. It's an actionable moment.

[00:07:12]Get a Get a plot. You remember Queequeg in uh Moby Dick? He had his uh his casket carved out. That's kind of creepy. I don't think I would do that.

[00:07:22]But, it kind of makes sense.

[00:07:24]You know, where you going to get buried?

[00:07:26]You going to get cremated? Details, details. Friend of mine's mother was dying of lung cancer, and in her last days, she planned her entire funeral, down to the napkins. It was constructive use of energy.

[00:07:38]Get rid of your junk if you're overloaded with it, because you can't get it away. Nobody wants it. So, now you're preparing the death phase.

[00:07:44]I rem- reminded of this, I was on a plane, it started bumping wildly, and I thought, well, this stinks. If this plane crashes, I mean, I die, that's not the worst thing in the world, I'm just a guy.

[00:07:55]But, how about the people that were counting on me to show up tomorrow? What will that be like? Then I got stressed.

[00:08:01]So, when the plane landed, needless to say, it didn't crash, and I didn't die in that moment, I started making plans.

[00:08:07]So, you get this back engineering. I'm not talking about a reckless, oh, I'm going to live like I have no tomorrow, right? No, you live like you have a tomorrow.

[00:08:17]Now, with death being certain, and everything else being relatively small in comparison, the thing that you can focus on is your vitality. It is the quality of the life you're living now, this week, tomorrow, next week.

[00:08:37]Without that focus, then you'll lose some of the joie de vivre, some of the joy of living.

[00:08:45]You know, if you're thinking about death, you're thinking about cancer, you're robbing your moment.

[00:08:50]The cancer's beating you twice. Now, my goal is to never die.

[00:08:55]All right. I do anti-aging medicine.

[00:08:58]Mm, immortality is unlikely.

[00:09:01]Because death seems likely, my real goal is to stay youthful and energized until my last breath. That's what I want for you all. That's achievable.

[00:09:14]Now, we're talking about actionable steps, as opposed to free-floating worry. Free-floating worry is useless.

[00:09:23]Worry that translates into action becomes energy to motivate change.

[00:09:29]Do not expect to wither. Do not expect to be tired. Do not expect, nor should you invite that kind of misery.

[00:09:38]If there's a treatment for your prostate cancer that promises negative effects, you really got to think hard.

[00:09:46]Now we're giving up the moment for some pie-in-the-sky, maybe I won't die as quickly, deal.

[00:09:55]That, folks, is a rotten deal.

[00:09:58]So, I say no.

[00:10:01]I say vitality, live the moment. That is encompassing of stress reduction. Are you going to die if you live in the moment and you don't pursue conventional treatment for prostate cancer?

[00:10:15]Yeah, you're going to die. You're going to die either way. Maybe not of cancer, but someday out there.

[00:10:21]You do not want to die twice.

[00:10:24]You don't want your masculine vitality to die and then your body follows it some years later.

[00:10:31]No, that's that's that's double jeopardy. That's death times two. It's a living death followed by a mortal death.

[00:10:38]Do not do that.

[00:10:40]So, active stress reduction, we talk about actionable steps.

[00:10:44]How about meditation? How about yoga?

[00:10:46]How about how about how what things can you do?

[00:10:50]Depends on your personality.

[00:10:53]Do I meditate? I do, but I do it briefly. I in the gym, when I'm lifting weights, I'll sometimes just close my eyes.

[00:10:59]I know where the weight is. I know where I am. I don't need to see anything.

[00:11:03]Especially, I don't need to see that person in the corner of the gym doing some dorky maneuver that is just annoying me. It shouldn't It should not annoy me, but it does.

[00:11:14]I don't know why they do it. Would you stop that already? That's dumb looking.

[00:11:17]Or some doofus they're wearing.

[00:11:20]Or worse yet, worse yet, they're sitting on the machine texting on their phone.

[00:11:26]>> [sighs] >> Meditative moment. So, so you can do this if it appeals to you, right? The deep breath, depart yourself.

[00:11:34]Sometimes I've been told, you know, you really ought to stress reduce. You really ought to relax. Friends of mine are retired out playing golf.

[00:11:43]You know, every day Saturday to them.

[00:11:45]They love it.

[00:11:47]That would drive me nuts.

[00:11:50]Getting up without having a purpose, getting up without the need, the desire to chat with you guys, to have an effect on the planet because of what I do as a physician. Whoa.

[00:12:00]That thought stresses me.

[00:12:02]So, when they tell me to relax, retire, and go play golf, I get heart palpitations. My point being, it's different for different people.

[00:12:10]You have to know what makes you happy. You have to know what makes you feel satisfied. The idea that there is some type of prescribed activity necessary for us to reduce our sense of anxiety is false thinking.

[00:12:25]I've seen these wellness places you can go away to. They stress me out. The day is chock-full of stuff. You know, stretching, sunrise, sunset.

[00:12:36]Too much for me. Now, for some people, they love it.

[00:12:41]So, knowing your DNA, knowing what motivates you, this is the place you want to go.

[00:12:48]There's something called hedonistic deprivation. It's a chronic form of stress that eats away at your vitality.

[00:12:57]And it goes like this.

[00:12:59]Absence of joyful interlude begets misery.

[00:13:03]Now, you take a child and you don't let him play, they become a demented loser pulling the wings off of flies, right?

[00:13:09]That's horrible.

[00:13:10]Flip it around. The child does nothing but play, they become like, you know, like a a donkey in Pinocchio. A kind of a life loser. There's a balance here, folks. As a grown-up, as an adult, we play.

[00:13:23]We don't think of it that way, but in my world, going out to dinner, playtime.

[00:13:28]Having a margarita, playtime.

[00:13:31]Playing kickball, playtime.

[00:13:34]You got to have some of that. You have to know, it's your job to plan that.

[00:13:39]Extended deprivation begets a deprivation rebound. So, in other words, if you think I have to fight cancer by wearing a hair shirt, I have to fight cancer by never having another glass of wine, I have to fight cancer by eating nothing but tofu, you know, three times just stop.

[00:13:59]You're creating stress.

[00:14:01]You're You're eliminating hedonistic outlet.

[00:14:05]Can you have occasional foods that are in a vacuum not good for you?

[00:14:10]Yeah.

[00:14:11]The The emphasis is on the occasion.

[00:14:14]The emphasis is on hedonistic reinforcement of vitality.

[00:14:20]Knowing Yeah, you ever plan a vacation?

[00:14:22]Of course you have.

[00:14:24]And then you get what I like to call anticipatory hedonism.

[00:14:27]You're looking forward to that vacation.

[00:14:29]You know, right now in the moment things a little dicey, but by golly in August I'm going to be fill in the blank on a cruise, whatever it is you like.

[00:14:38]Apply that principle to your life right now with your prostate cancer, with your uncertainty about what happens next week, next month, or next year.

[00:14:48]Live fully.

[00:14:50]Take actionable steps.

[00:14:52]Plan hedonistic interludes.

[00:14:55]Whatever they may be for you, they're not optional.

[00:14:58]They have to fit your life, they have to fit your likes, they have to fit your budget.

[00:15:04]But do not deprive yourself of that outlet. It's part of your cancer treatment.

[00:15:11]Yeah, I could write a prescription for that, right? Go on a 7-day cruise. Hmm, would that make it tax deductible?

[00:15:16]I don't know, we're stretching the envelope a little there, folks, but the point here make sure you weave that into your life on a regular basis.

[00:15:24]Don't let the cancer be your shadow.

[00:15:26]So, stress, look at that as an opportunity to reflect and take an action.

[00:15:33]When your mind circles back, circles back, circles back, break the chain.

[00:15:37]Move it away. There's a time to think about your cancer, and that's in a moment maybe like this where we're talking about it.

[00:15:44]Maybe when you're with your doctor.

[00:15:46]Then, there's a time not to talk about it.

[00:15:50]When I was in high school, a classmate of mine injured his leg in a car accident.

[00:15:55]And for the next 3 years, everything circled back to his leg.

[00:16:00]You couldn't talk to the man without him talking about his leg.

[00:16:04]Ah, it's a nice day out today, isn't it?

[00:16:06]Yeah, you know, on days like this, my leg doesn't hurt so much.

[00:16:09]Where did that come from? Yeah, I saw the the football game last night. Yeah, I wish I could play football, but you know, I can't walk cuz my leg hurts.

[00:16:15]Don't be that person.

[00:16:17]People ask how you are. Say, "I'm fine."

[00:16:20]They want to talk about your cancer?

[00:16:21]Yeah, maybe, maybe not. There are people that are confidants, but you do not want to wear out folks with the theme of your cancer, right?

[00:16:31]You're more than the cancer, especially with prostate cancer.

[00:16:35]You do the right thing, you take an action, you live with the consequence.

[00:16:41]My wife once asked me if I knew I were dying, would I regret anything. You know, I I do a lot of anti-aging. I do supplements. I'm on some peptides, some hormone.

[00:16:50]All based on research, all guided by my physician.

[00:16:55]Why do I do that? Because I like vitality.

[00:16:57]Will I die? Yes. Will those interventions have helped me live longer? Who knows? I like to believe they will, but that's less important to me than the vitality moment.

[00:17:07]And ultimately, if I'm clutching my chest, I'm going to the ground, I'm not going to be thinking to myself, "Ah, I should have quit smoking." Or, "Oh, I wish I exercised more." Or, fill in the blank. That's how I want you to live.

[00:17:20]Without regret regarding your health, your vitality. You do all the things that make the most sense.

[00:17:27]And then you don't have to worry.

[00:17:28]Because if you die, that fate was out of your hands.

[00:17:33]You don't have to second-guess what you chose to do.

[00:17:37]Even though the path remains uncertain.

[00:17:40]So, I don't know. I hope this has been helpful to you guys.

[00:17:43]Um it's a practice, it's an art, it's a skill that has to be repeated. This is not new. You can go back thousands of years. The ancient philosophers talk about stress. It's not the result of modern living. It's not because of cell phones. It's not because of the space age, jets, cars.

[00:18:00]It was here during Aesop's fables. It was here when Socrates was tromping the earth.

[00:18:07]It is the state of mankind.

[00:18:09]It's one of the things that the great philosophers and religious mystics sought to eliminate. Whether it's Buddha, or Christ, Muhammad, it was stress reduction.

[00:18:21]Peace is what they wanted us to have.

[00:18:25]Well, if we had it, they didn't need to give it to us. Fact is, we more often default to being stressed.

[00:18:31]So, take a deep breath, move to the light, find the things that quicken your pulse, make you smile.

[00:18:39]Therein lies your stress reduction.

[00:18:41]And it helps fight cancer.

[00:18:43]And it makes life more fun.

[00:18:45]Well, thanks for spending some time with me. I hope it wasn't too stressful. Talk to you next time. Bye now.