Testosterone & Prostate Health

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How I Think About Prostate Cancer Prevention

I recently read an article in The Epoch Times titled “I’m an Oncologist—Here’s How I Protect Myself From Prostate Cancer” by Dr. Manuj Agarwal. As someone who cares deeply about helping men stay fit to fight into their later years, I wanted to share my thoughts with a few minor critiques.

But first, here’s a quick breakdown of what Dr. Agarwal recommends:

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Dr. Agarwal’s Prostate Cancer Prevention Strategy

Proactive Habits:

• Annual PSA testing starting at age 40 ❌
• Prioritizing sleep with wearable tracking ✅
• Regular intake of cooked tomatoes for lycopene ❌
• Daily matcha for EGCG and stress modulation ✅
• 300+ minutes of weekly movement, including resistance training, cardio, and rucking ✅
• Natural testosterone support via sleep, strength, micronutrients, and lean body composition ✅
• Zinc supplementation ✅
• Blood sugar control using a CGM ✅
• Stress management and recovery routines (like qigong!) ✅
• Morning sunlight exposure to anchor circadian rhythm ✅

Avoidance Strategies:

• Endocrine disruptors (e.g., BPA, phthalates, parabens) ✅
• High-dose anti-oxidents (vitamin E, selenium, choline) ✅
• Processed and red meats ❌
• Smoking ✅

Caution Note:

• Warns that finasteride/dutasteride can artificially lower PSA readings, possibly delaying detection. ✅
  IMO, these are evil drugs anyway. Finasteride was originally developed for enlarged prostates, then repurposed as a hair loss drug. But its side effects are far from benign. Users report everything from erectile dysfunction, low libido, and emotional blunting to anxiety, insomnia, and brain fog. Some of these effects persist even after stopping the drug—a condition now called Post-Finasteride Syndrome (PFS). It works by suppressing DHT, but DHT isn’t just about hair—it plays a key role in hormone balance, brain health, and sexual function. If you’re considering it, weigh the short-term cosmetic gains against the potential long-term cost.

Philosophy:

• Focuses on “pre-habilitation”—building physical and mental resilience in advance of illness, not just reacting after the fact.✅

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My Take

Overall, this is a solid article. Dr. Agarwal lays out a good framework for proactive health, but there’s one glaring undercurrent: he underplays the role of testosterone.

Yes, supporting natural T production is critical—and it’s good to see he lifts, sleeps, and watches his diet. But zinc alone isn’t enough. Magnesium is essential too—it’s a key cofactor in converting pregnenolone into testosterone, and preventing Test from being inactivated by SHBG (sex hormone binding globulin). I also recommend botanicals like ashwagandha and tongkat ali. I use a supplement called Sigma Male by Gorilla Mind to help keep my T levels dialed in.

That said, supplements and lifestyle tweaks aren’t always enough. With the sheer volume of endocrine disruptors in modern life, some men are going to need TRT. And in many cases, it’s more cost-effective than throwing money at marginal gains from over-the-counter products. (Remember, there is a difference between something being “statistically significant” in a research setting and being clinically significant in the real world. Even if a supplement doubles your T levels from 300 to 600, 600 is still low from a functional perspective.)

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Cutting processed food is smart—but the red meat–cancer link, much like the “climate crisis,” is junk science. It’s based on flawed observational studies riddled with reporting errors, confounders, and researcher bias. The same level of evidence supports lycopene from tomatoes, which are nightshades that can trigger inflammation in sensitive individuals.

Instead of obsessing over annual PSA checks, most men would be better served by regularly testing their testosterone and aiming to keep levels as close to our ancestral levels of 1200 ng/dL as possible. Prostate cancer is often framed as a disease of aging—but that’s correlated with declining T. As I discussed in Declining Testosterone Levels, today’s 40-year-old has lower testosterone than his grandfather did at 60. That’s a problem.

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Another concern: routine PSA screening followed by a 12-needle biopsy can do more harm than good. Biopsies puncture the basal cell layer—your natural containment barrier—and that can enable cancer to spread. In humans, basal cells form a continuous layer of cells resting on the basement membrane, and upon which rests a layer of luminal cells. Elevated PSA often prompts doctors to push T blockers, which tank your health and quality of life, and ironically, have the opposite of the intended effect.

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If you want a more nuanced, up-to-date view on prostate health, check out the work of Dr. Victoria Bird. Her approach is grounded in current research, not fear-driven, and arguably anti-manliness, if not anti-male protocol.

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