IMPORTANT DIET AND SUPPLEMENT CONSIDERATIONS
IN OUR
FIGHT AGAINST
PROSTATE CANCER
DISCLAIMER: This information is not intended to replace the attention or advice of a physician or other health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a qualified health care professional. The following are just a few among many supplements recommended in literature and on Internet Websites as of possible help in combating prostate cancer. None of the suggested treatment regimens can guarantee a cure for disease.
Regarding Diet and Supplements:
Among the things learned from the 2006 International Conference on Prostate Cancer, reliable information found on the internet, and information saved to files from Stephen B. Strum, M.D., FACP, as well as the review of a paper from a January 2006 Man-to-Man meeting describing recommendations by Charles "Snuffy" Myers, M.D., both renown and highly respected Medical Oncologists who specialize in Prostate Cancer research and treatment:
DIET:
A "Mediterranean Diet" (Italian, Greek, Lebanese, Moroccan, Egyptian) is strongly recommended for all PC patients. No red meat, no dairy products (milk, egg yolk, cheese, etc.). Increase fish intake (decreases metastasis and PC recurrence), vegetables, tomatoes, olive oil (see URL below), almonds, pistachios, hazelnuts (monounsaturated fats). Increasing intake of monounsaturated fats causes progressive drop in PC. If your preference for fish oil is from supplements, then one should try to obtain "Nordic Naturals" on the internet www.nordicnaturals.com since, according to both Myers and Strum, it is important to have quality and this product provides that assurance.
Nordic Naturals is somewhat expense with a one month container with combination ingredients of just over 1,000mg costing around $30.00. On days that one of his choice fish products, King Oscar sardines, is consumed, Dr. Myers skips his Omega-3 supplement (Read more on Omega-3 below). Both see no reasonable reason to be consuming flaxseed in any form as a PC supplement.
Accolades for Olive Oil: http://www.realage.com/news_features/tip.aspx?v=1&cid=17764
SUPPLEMENTS:
Important among supplements has become VITAMIN D3 Cholecalciferol. 95% of men have been found to be deficient in this Vitamin, particularly those over age 70. This vitamin is essential for brain function, lung function, the immune system, lowers the risk for most common cancers as well as their recurrence, and lowers the risk for high blood pressure, diabetes and osteoporosis. Vitamin D3 converts into 25-hydroxy Vitamin D3 and is stored in fat. Optimum serum 25 hydroxy Vitamin D3 levels should be at least 65ng/ml. Most PC patients need 5,000 to 10,000 IU daily to reach these levels. Once reached a daily intake of 4000 IU will likely maintain. The pill form can be found available in 1,000 IU as well as 5,000 IU form for less than $10 in U.S. dollars from many manufacturers, and more from others. It is also available in lesser IU levels, but with higher levels you have fewer pills to consume. You should have your 25 hydroxy Vitamin D3 level determined, then, if deficient, have it measured again following a few months of increased Vitamin D3 intake to get to and maintain the recommended at least 65ng/ml level. Regular checks at maintaining within this level are then recommended. Dr. Myers notes that he has found that the IU level of Vitamin D3 provided by many suppliers fail to meet the IU specification noted on the label. If on a Vitamin D3 supplement for a few months and your 25-hydroxy Vitamin D3 levels are not increasing, he recommends the Vitamin D3 sold at www.lef.org has been tested and its IU level is as labeled. The most active form is 1,25 dihydroxy D3 or Calcitriol. For chemotherapy patients, the addition of Calcitriol nearly doubles the effectiveness of Taxotere.
WARNING: Anyone with pre-existing kidney disease SHOULD NOT take higher doses of Vitamin D3. This highlights the importance of visiting with your physician to discuss Vitamin D3 deficiency as well as insure lab records rule out any kidney abnormalities. If none exist, then get tested to determine the 25 hydroxy Vitamin D3 serum blood level, and if deficient begin a higher daily Vitamin D3 intake to reach a desired 65-70ng/ml before leveling off at around 4,000 IU daily. (Note: See “Food for the Kidneys” further down in these suggestions)
Antioxidants that reduce the risk of PC as well as recurring PC include:
- Lycopene 15mg twice daily or 10mg three times daily
- Selenium 200mcg daily
- Vitamin E 200 IU daily (preferably gamma and not alpha)
- Soy isoflavones about 200 to 300 mg daily
- Omega-3 fish oil (both Myers and Strum advocate obtaining Omega-3 fish oils from "Nordic Naturals”\
- Red wine (4oz glass a week can reduce PC by 6%, so with 8 glasses a week you could reduce PC by 50%)
Pomegranate juice provides polyphenols with an 8oz glass containing 570mg - in trials, daily consumption of pomegranate juice changed PSA doubling time from 15 months, to 54 months -and it is important that the pomegranate juice is deeply red; if its appearance shows any browning, it will likely be less effective to ineffective. Pomegranate in extract form is much less expensive than juice as well as avoids the sugar content of juice and can be purchased from the Life Extension Foundation with one capsule of the extract providing the equivalent of 12.3oz of pomegranate juice. Dr. Myers has been prescribing two extract gelcaps be taken twice daily to several of his patients. Good for vascular health, has anti-PC properties, and some patients have noted that their otherwise high systolic blood pressure has dropped. http://www.lef.org/newshop/items/item00956.html
Calcium, as citrate only, 800mg/no more than 1000mg is considered sufficient (it seems we are getting sufficient calcium, and too much calcium reduces the effectiveness of Vitamin D3).
For info, neither Zinc nor Vitamin C have a role in prevention of PC though they do have a role in other areas.
Copper is to be avoided since new blood vessels appear to have a strong dependence on copper for growth, but low copper levels are unlikely to affect existing vessels. By depriving cancer tumors of the copper they need to form new blood vessels, vascularization is inhibited.
.
ADDITIONAL DESCRIPTION OF SUPPLEMENTS:
SELENIUM: Hydrogen Peroxide in the body is an end product of metabolism that causes genetic damage and triggers the development of a range of cancers. The role of Selenium in the body as a free-radical scavenger, is to convert that hydrogen peroxide to water, thus preventing the oxidative damage hydrogen peroxide does to the DNA in the prostate. Selenium is available over the counter in tablet form at 200mcg per tablet. Dr. Stephen B. Strum, M.D., a nationally recognized oncologist specializing in Prostate Cancer, recommends 400 mcg a day, and says Selenium works best in conjunction with Vitamin E, which enhances its activity.
VITAMIN E: Vitamin E is also a free-radical scavenger and also reduces oxidative damage to the prostate. In a recent study of 23,000 people, those taking Vitamin E over a six or seven year period had a 30% reduced death rate from Prostate Cancer over other participants not taking this Vitamin. And, with other factors, it was possible to prove that Vitamin E was affecting the evolution of pre-existing Prostate Cancer too. Vitamin E is available over the counter in softgel form, usually at 400 IU per softgel, though this is in an acetate form. Dr. Strum comments that Vitamin E succinate (VES), using the succinate salt of Vitamin E, is important. VES is likely available through health stores. Dr. Strum recommends 400 to 1000 IU a day as mixed tocopherols. Mixed tocopherols contain synthetic Vitamin E (d-alpha-tocopherol and di-alpha-tocopherol) (the kind usually sold over the counter) as well as natural Vitamin E. A study by Mark Moyad, a clinical prostate researcher and public health educator in the Urology/Oncology Department of the University of Michigan, et al. (in press, 1999) indicates gamma tocopherol has more anti-Prostate Cancer activity then conventional d-alpha-tocopherol. Dr. Myers recommends only 200 IU daily.
LYCOPENE: Lycopene – the red pigment in tomatoes. When you take lycopene from the test tube and add it to Prostate Cancer cells, it kills them because it initiates a suicide program within the cells. It is an antioxidant, a powerful one, but for some strange reason, its most powerful effect is in causing the Prostate Cancer cells to self-destruct. Lycopene is available over the counter in softgel form at 5 mg and 10 mg per softgel. Dr. Strum suggests 15 mg taken twice a day, Dr. Myers suggests 10mg three times a day. The FDA has recently announced that they have concluded that lycopene serves no purpose regarding prostate cancer; yet, if one searches the internet, there are also multiple studies that suggest that lycopene, in fact, does serve a very useful purpose – for example: http://highwire.stanford.edu:80/cgi/medline/pmid;15084515 or
http://www.healthcastle.com/lycopene-prostatecancer.shtml. Interestingly, the following URL also supports lycopene for prostate cancer patients but more so in a natural state than with supplements: http://www.mercola.com/2004/oct/16/synthetic_lycopene.htm .
WARNING FOR CONSIDERATION: Dr. Charles “Snuffy” Myers, M.D., another nationally recognized oncologist specializing in Prostate Cancer, had a word of warning in the use of these previous three antioxidants. If you are undergoing radiation therapy, you have to STOP using antioxidants until your radiation therapist tells you it is safe. He says this is important to remember! (The reasoning is that some studies indicate antioxidants inhibit the effectiveness of radiation. It should be noted, however, there are other studies that indicate antioxidants enhance the effectiveness of radiation as well as reduce side effects. Best to research, discuss with your radiation therapist, and draw your own conclusions).
FISH OIL/OMEGA-3 FATTY ACIDS: Not flaxseed oil, but Fish Oil. The evidence that the human brain requires Omega-3 is now considerable. It is being touted for dyslexia, schizophrenia, to prevent sudden death due to cardiac arrhythmia, to reduce the risk of hypertension, stroke, diabetes mellitus, multiple sclerosis, and the inflammation of arthritis. Dr. Myers says that the list goes on and on. In a study of patients who had a radical prostatectomy, it was determined that those who had three servings of ocean fish a week (and that means intake of Omega-3) had a 70% reduction in the risk of developing recurrent Prostate Cancer. A 70% reduction just by eating ocean fish! He said that though it is early, it looks like Fish Oil/Omega-3 Fatty Acids is a very powerful factor for your general health that can also have a major impact on the evolution of Prostate Cancer. Fish Oil/Omega-3 Fatty Acids is available over the counter in softgel form, usually at 1000 mg per softgel. Many patients are being prescribed 4000mg per day. Soon-to-be or currently breastfeeding moms need to be especially careful to avoid excess mercury. Still, most people can do their heart and body right by eating one or two servings a week of omega-3-rich fish that is relatively low in mercury. Unfortunately, most fish contain some mercury, thanks to industrial processing. But the less time fish spend simply living in a mercury-laden environment or eating other fish containing mercury, the lower the contamination levels will be. So for low-mercury fish, we're talking small fish that don't eat many other fish (or fish meal) and don't have a long life span. Here are five good choices:
1. |
Salmon (wild): 1 gram of omega-3 fatty acids per 2 ounces of fish;* 0.014 parts per million mercury concentration |
2. |
Herring: 1 gram of omega-3 fatty acids per 1 ounce of fish;* 0.044 parts per million mercury concentration |
3. |
Sardines: 1 gram of omega-3 fatty acids per 2-3 ounces of fish;* 0.016 parts per million mercury concentration |
4. |
Trout (freshwater): 1 gram of omega-3 fatty acids per 3-4 ounces of fish;* 0.072 parts per million mercury concentration |
5. |
Pollock: 1 gram of omega-3 fatty acids per 6.5 ounces of fish;* 0.041 parts per million mercury concentration |
*Oil content varies widely, depending on species, season, environment, diet, and packing and cooking methods. Cooking tip: Cook your seafood with garlic. Garlic has been shown to bind and reduce levels of mercury in the body, making it less toxic.
Here's the list of fish to AVOID:
• |
King mackerel: 0.73 parts per million mercury concentration |
• |
Shark: 0.99 parts per million mercury concentration |
• |
Swordfish: 0.98 parts per million mercury concentration |
• |
Tilefish (Gulf of Mexico): 1.45 parts per million mercury concentration |
So where does the beloved tuna fall? Pretty close to the middle of the road, actually, with mercury concentration ranging from 0.12 to 0.69 parts per million, depending on what kind of tuna you eat. And you'll need to eat anywhere from 3.5-12 ounces to get 1 gram of omega-3 fatty acids, depending on how you take your tuna: Fresh tuna has the most and canned chunk light tuna has the least. But chunk light tuna also has the least mercury.
Keep in mind that oil content estimates can be fairly rough, despite the best research efforts. A fish-oil supplement is a surefire way to get the omega-3 fatty acids you want and need. But talk to your doctor first. Fish-oil supplements are dangerous for certain people. Dr. Myers recommends a daily total Omega-3 intake of 4000mg. Here is some additional information regarding the importance of fish oil:
Food Fit for Your Kidneys
What heart helper can also keep your kidneys feeling fine? It's fish.
That's right. The omega-3s in fatty fish (like salmon) not only help your heart stay healthy, but they seem to keep kidney cancer away, too. Women in a study who ate fatty fish on a fairly regular basis lowered their risk of kidney cancer by 44 percent.
Mega Omegas
It's no fish tale! Almost 15 years of data show that when salmon and other fatty fish (like sardines and herring) regularly show up on your dinner plate, you could be giving kidney cancer the big kiss-off.
Researchers suspect that certain omega-3 fats in the fish may change the immune response of cancer cells in a way that thwarts their invasive process. But it's got to be fatty fish; slim swimmers (like cod) can have 20 to 30 times less omega-3s.
Fatty fish are also chock-full of vitamin D, which may play a protective role as well. (Look up more D sources with this online tool.)
Fishing for Smarts
Did you know? Fish -- as well as these five other foods -- can help keep your mind young, too.
BETA-CAROTENE WARNING! Dr. Myers warned that there is a growing body of evidence that Beta-Carotene, as a supplement, is actually DANGEROUS for Prostate Cancer patients. In a trial in which patients were given Vitamin E and Beta-Carotene, or Beta-Carotene alone, there was an increase in the death rate of those patients by 30%. We would suggest if any of you are supplementing your diet with Beta-Carotene, that you look further into these findings.
VITAMIN C: Vitamin E works best in association with Vitamin C. Dr. Strum recommends 1000 mg of Vitamin C be taken after each meal to prevent fatty acid peroxide generation.
COENZYME Q10 (CoQ10): Coenzyme Q10 is known to work best when given with Vitamins E and C. Since you are likely taking both these vitamins, it is then advantageous to take CoQ10 since is has been shown to prevent oxidation of LDL cholesterol. In fact, the prevention of fatty acid oxidation may be just as important as decreasing fat consumption. Dr. Strum suggests Coenzyme Q10 be taken at a dose of 200 mg a day. An added benefit of CoQ10 is the improvement in heart function and diabetic control as well as the treatment of periodontal disease. Dr. Myers lists CoQ10 as a supplement he doesn’t recommend but doesn’t explain why. Yet, take note of the ninth paragraph in the following URL calling COQ10 “A Gentle Cancer Killer:”
http://www6.miami.edu/ummedicine-magazine/fall2005/fstory4.html.
The second paragraph in the following URL describes the effect of COQ10 on prostate tumors: http://www.med.miami.edu/news/view.asp?id=519 and gives a more descriptive explanation of the research.
CALCIUM (as a Citrate) with Vitamin D3: Calcium is much better absorbed in citrate form than carbonate. It is best taken at bedtime to lower excessive bone resorption by 20%, and should be taken in conjunction with Vitamin D to lower urinary calcium excretion. Over-the-counter Citracal contains 630 mg Calcium (as Ultradense calcium citrate) and 400 IU Vitamin D3 (as cholecalciferol) comes in caplet form. 2 caplets at bedtime are recommended.by the manufacturer. This same combination of Calcium as citrate/Vitamin D3 is often found at lower cost at outlets like Sam’s Club or Costco but you should check the label because some contain a calcium combination of citrate and carbonate, and you only want the citrate. Your physician may recommend other dosages and other forms of calcium and/or Vitamin D.
GENISTEIN: Cancer cells use the enzyme tyrosine kinase as a growth factor. Soy genistein is a potent inhibitor of tyrosine kinase activity. Its use is suggested to decrease cell adhesion, slow proliferation and decrease metastatic potential. Dr. Strum recommends Mega Soy Extract. Each 700-mg capsule of Mega Soy Extract contains 134 mg of genistein, 122m mg of daidzein, and 24 mg of glycetein, and he advises two of these capsules a day. Mega Soy Extract can be purchased from Life Extension telephone 1-800-544-4440. A little side note regarding Genistein and Broccoli: Eating foods like broccoli and soy has been linked to lower cancer rates, and California researchers say that they may have discovered what underlies this protective effect. Using cells in a lab dish, a team led by Erin Hsu, a graduate student in molecular toxicology at the University of California, Los Angeles has found that genistein, an isoflavone in soy, and diindolymethane (DIM), a compound made in the gut during digestion of broccoli, cabbage, kale and other cruciferous vegetables, reduce the production of two proteins needed for cancers to spread. Previous research has suggested that risk of prostate cancer may be reduced by dietary intake of DIM from broccoli and genistein from soy but this is the first study to find a clued to the value of dishes in which broccoli or other cruciferous vegetables are served with soy foods like tofu and edamame beans. To read more:
http://psa-rising.com/nutri/index.php/?p=50
SAW PALMETTO? NO! This URL explains that purchasing saw-palmetto as a 5AR inhibitor is a waste of money:
http://www.youngagain.org/tnpc_chapter5.htm
Among the remarks:
"A typical analysis of saw palmetto shows that it contains a variety of fatty acids (capric, lauric, myristic, palmitic, palmitoleic, stearic, oleic, linoleic, linolenic, arachic, and eicosenoic), and minute traces of sterols and other plant chemicals that are biologically insignificant. Obviously, these herbal formulas just do not contain any effective amounts of active ingredients. That means you would have to eat about a pound of saw palmetto berries to get a basic dose of 330 mg of beta-sitosterol. Even with the most expensive “10x” (ten times) extracts of these herbs, one would still have to eat about two-hundred 500 mg capsules to get the 330 mg of beta-sitosterol! So, it is obvious that these herbs are ineffective, despite their continual promotion by the so-called natural health industry. Please understand that saw palmetto, Pygeum africanum, and other herbs and their extracts are simply biologically irrelevant, because they do not contain enough active ingredient. Even when the label says “85 percent fatty acids and sterols,” you can be sure that it really means “nearly all fatty acids and almost no sterols.” The saw palmetto products sold in America simply have no value, no matter how much advertising you have read. You won’t see any saw palmetto or other herbal prostate product with any significant amount of beta-sitosterol in it."
BORON: Promotes healthy bone density. Shrinks prostate tumor size. Lowers PSA. May help prevent Prostate Cancer. Alleviates joint discomfort. In an Email to a patient, Dr. Strum recommended 9 to 12 mg daily
MODIFIED CITRUS PECTIN (MCP): Also known as fractionated pectin, is a complex sugar (polysaccharide) obtained from the peel and pulp of citrus fruits. MCP is rich in short, non-branched, galactose-rich carbohydrate chains. These shorter chains dissolve more readily in water and are better absorbed and utilized by the body than ordinary long-chain pectins. MCP appears to reduce the risk of metastasis – the spread of cancerous cells from one tumor to other sites n the body. For metastasis to occur, cancer cells must first clump together. Protein molecules called galectins appear on the surface of cancer cells. The more galectins present, the easier it is for the cancer cells to clump together and metastasize. According to preliminary research, MCP binds to the galectins. By doing so, it blocks the cancer cell’s ability to clump and spread. Although MCP has no significant direct anticancer effect, it is felt that it can be an important natural anticancer strategy. Studies suggest that MCP is best used in preventing the metastasis of breast cancer, prostate cancer, lung cancer, and melanoma. There is not a lot of human data available yet. In one of the few human studies, MCP was shown to decrease the cancer growth rate in 4 of 7 men with prostate cancer as measured by a reduced rate of increase in PSA levels. The typical dosage recommended for adults ranges between 6 and 30g daily in divided doses (e.g., 6g one to five times daily). Dr. Strum recommends 5g three times daily. The MCP powder is usually dissolved by blending in water or juice.
Interesting supplement remarks in a post to a patient by renown Medical
Oncologist specializing in prostate cancer research and treatment Stephen
B. Strum:
Vitamin D. at a dosage of 800 international units per day is almost never
sufficient to obtain optimal blood levels of 25 hydroxy D-3. The average
dose required to achieve this is 8000 international units of vitamin D-3 per
day. It is important to confirm this by obtaining 25 hydroxy D-3 levels as
a dose of vitamin D is adjusted. This is called titration. It is also
important to realize that the use of other supplements such as genistein
will increase the production of 25 hydroxy D-3 by stimulating the
hydroxylase enzyme that converts vitamin D3 to 25 hydroxy D-3.
Interestingly and importantly, genistein also inhibits the enzyme that
breaks down the most potent form of vitamin D known as 1, 25 dihydroxy
cholecalciferol. Therefore, the combination of vitamin D3 and genistein
may be a potent combination to use in the prevention of prostate cancer as
well as in the active therapeutic approach to prostate cancer; or for that
matter any disorder in which vitamin D appears to be a crucial element, e.g.
breast cancer, colon cancer, multiple sclerosis, Alzheimer's disease, colon
polyps, psoriasis and others.
Statin compounds deplete the body of CoQ10. If you are prescribed statins
you need to take a CoQ10 supplement in the order of 200 mg per day
minimally. CoQ10 may also have anti-prostate cancer activity.
Persaud I, Narain NR, Woan KV, et al: Coenzyme Q10 induces apoptosis in
human prostate and osteosarcoma cells.
Prostate cancer is the second leading cause of cancer deaths in men in the
United States and often metastasizes to bone. Androgen-independent prostate
cancer is highly resistant to the current standard of care and presents a
challenge to quality of life. We have discovered a novel in vitro protocol
that facilitates the solubilization of the lipophilic molecule Coenzyme Q10
(Q10). Q10 is naturally resident in mitochondria and has been described as
a potent antioxidant and crucial in the production of ATP. We previously
demonstrated a pharmacologic dose of Q10 (50uM) selectively induces
apoptosis in human melanoma, while being supportive to normal keratinocytes
and fibroblasts in vitro. In the present study, we tested the effect of Q10
on an androgen-independent prostate cancer model, PC3 and osteosarcoma 143b
cells using proliferation assays. In addition, the effect of Q10 on
mitochondrial polarity was investigated using JC-1 stain in the presence of
Q10. At 200 ?M Q10, results show a reduction of 69.57% ± 7.56 and 74.51% ±
4.51 in PC-3 and 143b cells, respectively. Moreover, uptake and aggregation
level of JC-1 in PC-3 mitochondria analyzed by flow cytometry revealed a
significant increase in green fluorescence in Q10 treated cells, indicating
mitochondrial depolarization, a hallmark of apoptosis. Taken together, the
data suggest that Coenzyme Q10 is a viable anti-tumor agent with minimal
normal tissue toxicity and may be useful in controlling disease progression
of prostate cancer.
Pomegranate in the form of POM Wonderful juice at 8 ounces per day per the
UCLA study.
Pantuck AJ, Leppert JT, Zomorodian N, et al: Phase II study of pomegranate
juice for men with rising PSA following surgery or radiation for prostate
cancer. J Urol 173:225A, 2005.
PMID
Abstract 831
INTRODUCTION AND OBJECTIVE: Phytochemicals in edible plants can have cancer
preventive benefits through antioxidation and via gene-nutrient
interactions. Pomegranate juice has been shown to be a rich source of
polyphenolic flavonoids. Pre-clinical data suggested the ability of
pomegranate juice to modulate the growth and progression of prostate cancer.
To determine the clinical effects of pomegranate juice on patients with
prostate cancer, a clinical trial was performed.
METHODS: A 2 year, single center, phase II, Simon two stage clinical trial
for men with rising PSA after surgery or radiotherapy was designed based on
a 20% response rate, an alpha of 5%, and 90% power. Eligible patients had a
detectable PSA greater than 0.2 ng/ml and less than 5 ng/ml, and a Gleason
score of 7 or less. Serial PSA measurements determined a baseline PSA
doubling time. Patients were treated with 8 ounces of pomegranate juice by
mouth daily (wonderful variety, equivalent to 1.5 mmol of total polyphenols
per day) until disease progression. Clinical endpoints included safety,
effect on serum PSA, and exploratory laboratory studies. Patients were
followed in 3 month intervals for serum PSA, and blood and urine were
collected for laboratory studies.
RESULTS: The study was fully accrued to 48 participants in two stages after
efficacy criteria were met. There were no serious adverse events reported
and the treatment was well tolerated. No patients developed metatsatic
disease on study. Mean PSA doubling time significantly increased with
treatment, from a mean of 14 to 26 months (p< 0.048). The slope of the mean
log PSA decreased from 0.08 to 0.04 on treatment (p< 0.019). In vitro assays
using pre and post treatment patient serum on the growth of LNCaP showed
decreased cell proliferation and increased apoptosis (p<0.07). Pomegranate
polyphenols were detected in the urine of all participants by LC-MS.
CONCLUSIONS: We report the first clinical trial of pomegranate juice in
patients with recurrent prostate cancer. The positive and significant
beneficial effects on PSA parameters achieved, coupled with corresponding
laboratory effects on prostate cancer in vitro cell growth and apoptosis
warrant further testing in a randomized, placebo controlled phase III study.
Pantuck AJ, Zomorodian N, Belldegrun AS: Phase-II study of pomegranate juice
for men with prostate cancer and increasing PSA. Curr Urol Rep 7:7, 2006.
[PMID:16480662]
Introduction: There have been a number of reports recently on the
preclinical, in vitro, and in vivo antiproliferative and apoptotic
activities of pomegranate polyphenols in prostate cancer, including
demonstration of a dose-dependent inhibition of cell growth/cell viability
and induction of apoptosis in human prostate cancer PC3 cells associated
with induction of Bax and Bak (proapoptotic); downregulation of Bcl-X(L) and
Bcl-2 (antiapoptotic); induction of WAFl/p21 and KIPl/p27; a decrease in
cyclins Dl, 02, and E; and a decrease in cyclin-dependent kinase (cdk) 2,
cdk4, and cdk6 expression [I]. Aims: To determine the clinical and
laboratory effects of pomegranate juice on patients with prostate cancer.
Methods: An open-label, single-arm, 2-year, phase-2, Simon two-stage
clinical trial for men with increasing prostate-specific antigen (PSA) after
surgery or radiotherapy was performed. Eligible patients had a detectable
PSA greater than 0.2 ng/mL and less than 5 ng/mL that was documented as
increasing, enough pre-treatment PSA time points to calculate a baseline PSA
doubling time, no hormonal therapy prior to entering the study, no evidence
of metastatic disease, and a Gleason score of 7 or less. Patients were
treated with 8 oz of pomegranate juice by mouth daily until meeting disease
progression endpoints. Patients were followed in 3-month intervals for serum
PSA and blood and urine were collected for laboratory studies.
Results: The
study was fully accrued after efficacy criteria were met. There were no
serious adverse events reported. None of the patients developed metastatic
disease on study. Mean PSA doubling time significantly increased with
treatment, from a mean of 15 to 37 months (P < 0.048). In vitro assays using
pre- and post-treatment patient serum on the growth of LNCaP showed a 12%
decrease in cell proliferation and a 17% increase in apoptosis (P = 0.0048
and 0.0004, respectively).
POM wonderful is the pomegranate product used in the above studies. Many
patients (myself included) have decided to use various pomegranate extracts
but I cannot in good faith say the extracts are as effective until studies are
done to confirm their efficacy in regard to prostate cancer. Shown below is
the URL for Pom wonderful:
www.pomwonderful.com
http://www.pomwonderful.com/100_percent_juice.html
Supposedly available at
7-Eleven
Albertsons
QFC
Safeway
WinCo
Pomegranate as an extract can be purchased from Life Extension Foundation at much less expense than in juice form. 1 capsule contains the equivalent of 12.3oz of pomegranate juice. Info: http://www.lef.org/newshop/items/item00956.html
WHEN IT COMES TO CONSIDERING DIET AND SUPPLEMENTS, here is startling information about the IMPORTANCE of diet and, particularly, supplement use:
Supplement use could save U.S. $24 billion
A report released this month by the Dietary Supplement Education Alliance (DSEA) concluded that the use of dietary supplements by specific American populations could result in a savings of at least 24 billion in health care costs over a five year period. The current report updates a similar report commissioned by DSEA in 2005 which estimated 5.6 billion dollars in savings over five years.
The report re-emphasizes that supplementing select groups with calcium and vitamin D, folic acid, omega-3 essential fatty acids (EFAs), and lutein with zeaxanthin could have a tremendous impact on health care expenditure. In the summary of the findings, the report states that the use of calcium and vitamin D by postmenopausal women could potentially avoid approximately 776,000 hospitalizations for hip fractures and a significant number of extended nursing facility stays for this group, resulting in a savings of 16.1 billion dollars.
If folic acid were used by the 44 million American women of childbearing age, 600 fewer infants would be born with neural tube defects, resulting in a savings of 1.4 billion dollars over five years. Omega-3 fatty acid supplementation in the amount of 1800 milligrams per day among those over the age of 65 would result in a 3.2 billion dollar savings, and avoidance of 374,301 hospitalizations over the next five years. And just 6 to 10 milligrams lutein with zeaxanthin per day is estimated to save $3.6 billion by preventing 190,927 individuals from losing their independence due to loss of central vision resulting from macular degeneration.
“Rapidly escalating health care costs in the U.S. have severe implications for our society as a whole,” DSEA president Jon Benninger stated. “This study provides valuable data that may lead to preventative health care solutions and address the budgetary problems facing federal and state health insurance programs, corporate health cost managers and individual families.”
According to the US Department of Health and Human Services and Department of Agriculture, “The Nutrition and Your Health: Dietary Guidelines for Americans acknowledges that some Americans may need a vitamin and/or mineral supplement to meet specific nutrient needs.” In view of the potential savings for an overburdened health care system alone, not to mention the prevention of a significant amount of suffering and disability, the consistent use of nutritional supplements by at-risk groups could greatly benefit these populations, as well as our society as a whole.
MORE TO EXPLAIN VITAMIN D:
Understanding 1,25 dihydroxy Vitamin D and 25-hydroxy Vitamin D.
1,25 dihydroxy Vitamin D (range 15.9-55.6pg/mL) is increased in sarcoidosis and hyperparathyroidism. It may be elevated in cases of hypercalcemia associated with malignant lymphoma. It is decreased in rickets, type I vitamin D-resistant rickets, hypoparathyroidism, pseudohypoparathyroidism, and renal osteodystrophy and psoriasis. Because of the complex, multifactorial control of calcium balance, it is often useful to measure parathyroid hormone in conjunction with vitamin D. This is NOT the assay to determine vitamin D deficiency. The 1,25-dihydroxy Vitamin D assay should never be used for detecting Vitamin D deficiency because levels will be normal or even elevated as a result of secondary hyperparathyroidism. Rather, 25-hydroxy Vitamin D is the appropriate assay.
25-hydroxy Vitamin D (range 32-100ng/ml) deficiency leads to the mobilization of calcium from bone. Individuals with more severe vitamin D deficiency can develop osteomalacia and/or osteoporosis. Osteomalacia in children, also referred to as rickets, results in well described skeletal malformations since their bones are actively growing. Recent clinical and edpidemological studies suggest that vitamin D deficiency may play a role in several conditions related to bone including prostate cancer, breast cancer, colon cancer, heart disease, hypertension, multiple sclerosis, and type 1 diabetes. A number of studies have shown that vitamin D deficiency is very common, especially in certain high-risk populations. This situation has occurred, in part, because the foods in the typical American diet are very low in vitamin D. Fatty fish, such as mackeral and salmon and fish liver oils, are some of the few natural dietary sources of vitamin D. Most people do not eat enough of these foods to maintain adequate vitamin D levels. In the United States, vitamin D is added to milk in order to prevent the occurrence of rickets in the pediatric population. Unfortunately, too many children do not drink enough milk to raise their vitamin D levels to the optimum range. Also, recent studies have shown that the level of vitamin D in fortified milk is frequently much lower than that recommended by the FDA. Human milk contains very little vitamin D because many mothers are deficient, so children of mothers who choose to breast-feed are at risk of developing rickets if they are not given supplemental vitamin D. The American Academy of Pediatrics recommends that infants who are exclusively breast-feeding should be given a supplement of vitamin D. Several factors are associated with an increased risk of developing vitamin D deficiency. At risk populations include:
