Kathryn Borg’s feature entitled ‘Fitness, meditation and prostate cancer’ (The Sunday Times of Malta, December 4) touched on a number of useful factors affecting disease expression and longevity.

Britain’s Queen Elizabeth and her sister Margaret would be expected to have similar genetic make-up but they experienced very different longevity due to different diets and lifestyles. Good or bad genes can in fact be ‘switched on or off’ by dietary and lifestyle changes – this is now called epigenetics.

Prof. Dean Ornish, an American cardiologist, has been among the first to demonstrate how dietary modification, regular exercise and stress management can reverse coronary heart disease without surgical intervention. In conjunction with urologists, he has also scientifically demonstrated how his programme can halt and, to some extent, reverse low grade prostate cancer.

This and other studies led to simple monitoring management of prostate cancer instead of active therapy with hormonal manipulation, radiotherapy and chemotherapy. However, simple monitoring is only safe with very low grade prostate cancers and not with more aggressive types.

A friend of mine contacted me about his prostate cancer 10 years ago, saying he wanted simple monitoring and nutritional medicine rather than the hormonal therapy and the radiotherapy he had been recommended. I said I would have to review his cancer pathology slides before recommending simple monitoring.

Fortunately for him, his cancer pathology had been over-diagnosed at St Elsewhere and his tumour was an uncommonly very low grade one. He happened to be very knowledgeable about improving his general health and anti-tumour immunity with diet, nutritional supplements and regular exercise. He has remained well with very low PSA blood test results.

Of course, we’re all heading one way but, in what condition and how fast you get there, is important.