In this episode, Dr. Geo is joined by Dr. Steven Freeland to discuss the powerful intersection of urologic oncology and metabolic health. Dr. Freeland shares groundbreaking research on how dietary interventions—specifically low-carbohydrate protocols—can slow prostate cancer progression and counteract the metabolic damage caused by standard treatments like Androgen Deprivation Therapy (ADT).

In This Episode, You’ll Learn:

The Metabolic Growth Signal: Why insulin and Insulin-like Growth Factor 1 (IGF-1) are considered "fuel" for prostate cancer cells and how reducing sugar can starve that signal.
The 20-Gram Protocol: Insights from Dr. Freeland’s study on ultra-low-carb diets, where participants saw a 20-pound weight loss and a significant slowing of PSA doubling time.
Combatting ADT Side Effects: How a metabolic approach can improve insulin resistance by 30% and surprisingly help preserve bone density during hormone therapy.
The "Slim-Fat" Reality: Why your BMI might be normal, but your visceral fat (adiposity) could still be driving inflammation and cancer growth.
Clinical Markers to Watch: Why patients should ask about HOMA-IR (Insulin Resistance) and Hemoglobin A1C rather than just focusing on PSA alone.

Key Quotes from the Episode:

"Lifestyle intervention isn't alternative medicine; it is metabolic medicine." — Dr. Steven Freeland

"Cancers need the same nutrients the body needs to grow. If we're reducing pro-growth stimuli to the whole body through weight loss and low carbs, it makes sense we're reducing it to the cancer." — Dr. Steven Freeland

Resources & Links Mentioned:

Dr. Steven Freeland: Cedars-Sinai Faculty Profile
Research Paper: Ultra-low carbohydrate diet and prostate cancer progression (referenced as the "20-gram study").
Recommended Diet Protocol: Induction Phase Atkins (as used in the clinical trials).
Clinical Markers: * HOMA-IR: (Fasting Insulin $\times$ Fasting Glucose) / 405 (or 22.5 in SI units).
Hemoglobin A1C: A 90-day average of blood sugar levels.
Wearables: Fitbit, Oura Ring, and Whoop (discussed in the context of tracking "active steps" and sleep quality).

Episode Breakdown by Timestamp:

[07:35] Breaking down the 20-gram carbohydrate trial and patient adherence.
[13:45] The impact of low-carb living on PSA doubling time (extending it by over a year).
[22:20] Using diet to shield the body from ADT-induced diabetes and bone loss.
[34:10] Why BMI is a "good enough" tool, but adiposity is the real target.
[41:00] Circadian eating: Why you are most insulin resistant at night.

👉 View complete episode show notes, resources, and transcript at DrGeo.com

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⚠️ Disclaimer

This podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

Lower PSA with Low-Carb Metabolic Science with Dr. Stephen Freedland