Prostate Cancer information by Ray Sahelian, M.D. Supplements for prostate cancer
 

Cancer is when cells in the body grow out of control. Prostate cancer is a group of abnormal cells in the prostate. Prostate cancer can be aggressive, which means it grows quickly and spreads to other parts of the body. When cancer spreads, doctors say the cancer has "metastasized." Or it may be slow growing and stay in the prostate, causing few if any problems. Three out of four cases of prostate cancer are of the slow-growing type that is relatively harmless. Prostate cancer is the most common type of cancer found in American men, other than skin cancer. The American Cancer Society estimates that there are about 200,000 new cases of prostate cancer in the United States each year, and about 30,000 men will die of this disease.

Natural Options for Prostate Cancer
Exercise, maintaining normal body weight, eating fish, legumes, flaxseed, yellow-orange vegetables and cruciferous vegetables lower prostate cancer risk. Increasing the ratio of omega-3 to omega-6 fatty acids in the diet appears to slow the progression of prostate cancer. The so-called Western diet commonly consumed in the US contains mostly omega-6 fatty acids, derived from corn oil and other sources. Omega-3 fatty acids, by contrast, are abundant in cold-water fish, a food source missing in the diets of many Americans.
   Certain supplements have been found to have an influence on prostate cancer, particularly in laboratory tests. Long term, double blind human studies are not available to confirm these early laboratory findings, but it may be worthwhile to consider the following supplements with medical supervision:

Curcumin may help fight cancer, including prostate cancer. Researchers have found in the lab that curcumin can enhance the cancer-fighting power of treatment with TRAIL, a naturally occurring molecule that helps kill cancer cells. TRAIL stands for tumor necrosis factor-related apoptosis-inducing ligand. In an experiment with human prostate cancer cells in a laboratory dish, the combination treatment killed off two to three times more cells than either treatment alone.
Fish oils appear to be beneficial (see study below). Flax seed oil may also be helpful. Krill oil is another option.
Genistein levels are lower in patients with enlarged prostates or prostate cancer. Soy isoflavonoid supplements may help.
Indole 3 carbinol may be helpful as an anti prostate cancer supplement.
Resveratrol has been found helpful in mouse studies.
IP6 - inositol hexaphosphate
 Lycopene Adding lycopene to orchidectomy produces a more reliable and consistent decrease in serum PSA level; it not only shrinks the primary tumor but also diminishes the secondary tumors, providing better relief from bone pain and lower urinary tract symptoms, and improving survival compared with orchidectomy alone. However, lycopene supplements, alone, may not be enough.
 Milk thistle -- many compounds in mile thistle, including silymarin and silibinin, have shown potent anti-prostate cancer activity.
Quercetin is a flavonoid found widely in plants.
Saw palmetto -- one test tube study indicates saw palmetto slows the growth of prostate cancer cells. See Prostate Power Rx formulated by Ray Sahelian, M.D.
Stinging Nettle -- see study below
Reishi has anti-cancer activity in prostate cancer cells
 Vitamin E Natural Complex -- see study below. It is preferable to keep total vitamin E dosage a day to between 30 and 200 units. There is no proof that higher amounts of vitamin E are beneficial.

Effect of nutritional supplement challenge in patients with isolated high-grade prostatic intraepithelial neoplasia.
Urology. 2007 Jun;69(6):1102-6. Department of Urology, University Hospitals Katholieke Universiteit Leuven, Leuven, Belgium.
The researchers wanted to see the effects of selenium, vitamin E, and soy isoflavonoid supplements in men diagnosed with isolated prostate cancer on biopsy. The results showed that taking these supplements for a period of six months led to a decrease in the PSA level which could predict a lower risk of prostate cancer in future biopsies.   
   At the study endpoint, prostate cancer had been found in 24 men (33%), HGPIN in 34 (48%), and no HGPIN or carcinoma in 13 (18%). The prostate cancer risk throughout the study period was 25% in the group with a stable or decreasing PSA level and 52% in the group with an increasing PSA level.

 Prostate Power Rx - Physician Formulas
Formulated by Ray Sahelian, M.D.
 

With Saw Palmetto, Pygeum, Stinging Nettle, Gensitein, Quercetin, Phytoestrogens, & 9 Key Ingredients for support of normal prostate health and size.

Prostate Power Rx is carefully formulated with important herbs and nutrients to provide optimal prostate health.
 

Prostate Power Rx Supplement Facts
Saw Palmetto extract
Stinging Nettle extract
Quercetin
Rosemary extract
Beta Sitosterol
Pygeum extract
 Daidzein and Genistein (standardized to contain 40% isoflavones)
   (treatment with the isoflavones daidzein and genistein, the estrogen-like compounds found in soy, block prostate growth in rats)
Lycopene
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Subscribe to a FREE Supplement Research Update newsletter, Twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, including prostate cancer, and their practical interpretation by Ray Sahelian, M.D.

Prostate cancer symptom
Prostate cancer often doesn't produce any symptoms in its early stages. That's why many cases of prostate cancer aren't detected until they've spread beyond the prostate and become advanced prostate cancer.

Sign of prostate cancer
When signs and symptoms do occur, they may include the following: Dull pain in the lower pelvic area, urgency of urination, difficulty starting urination, pain during urination, weak urine flow and dribbling, intermittent urine flow, a sensation that your bladder isn't empty, frequent urination at night. As you may guess, many of these signs and symptoms could be due to benign prostate hypertrophy. However, when the following signs and symptoms occur, the risk becomes higher for prostate cancer: blood in your urine, painful ejaculation, general pain in your lower back, hips or upper thighs, loss of appetite and weight, persistent bone pain in its early stages.
     Many cases of prostate cancer aren't detected until they've spread beyond the prostate.

Prostate cancer cause
The cause of prostate cancer is not fully known, but hormonal, genetic, environmental, and dietary factors are thought to play roles. The following risk factors have been linked with development of this condition:
     Age: There is a strong correlation between increasing age and developing prostate cancer. More than 80% of prostate cancers are diagnosed in men older than 65 years. Autopsy records indicate that 70% of men older than 90 years have at least one region of cancer in their prostate.
     Race: African American men are 2 times more likely than white men to develop prostate cancer.
     Genetic factors: Men who have a history of prostate cancer in their family are at an increased risk.
     Diet: A diet high in fat and low in vegetables has been associated with an increased risk. Adding arachidonic acid, a common omega-6 polyunsaturated fatty acid, to culture media causes prostate cancer cells to grow twice as fast. Prostate cancer patients who are obese seem to have more aggressive tumors. Charred meat from barbeques can increase the risk for prostate cancer.
     Hormone use: Men who take testosterone or other androgen hormones may be at increased risk for prostate cancer. So does human growth hormone. HGH raises blood levels of another hormone, insulin-like growth factor, which preliminary evidence indicates may promote prostate cancer.
     Shift work - men who rotate shifts at work are more likely to get prostate cancer. This may be due to reduced release of melatonin and possibly additional factors.
     Sexually transmitted diseases are a cause of prostate cancer. Men with a history of the sexually transmitted disease gonorrhea may face a higher risk of prostate cancer. Chronic inflammation in the prostate gland, caused by infection, may over time promote tumor development.

Prostate Cancer and masturbation
Australian researchers questioned over 1,000 men who had developed prostate cancer and 1,250 who had not about their sexual habits. They found those who had ejaculated the most between the ages of 20 and 50 were the least likely to develop the cancer.

Prostate cancer prevention
Eat a variety of fruits and vegetables, reduce the intake of white bread, high intake of meats and saturated fat, reduce or eliminate smoking, reduce stress, sleep well, exercise, avoid unnecessary hormone use, particularly androgens, eat more flax and fish oil.
   Greater consumption of dark green and cruciferous vegetables, especially broccoli and cauliflower, is associated with a decreased risk of aggressive prostate cancer.

Standard Medical Prostate Cancer Treatment
Many prostate cancer patients — and their doctors — may be overreacting to the word “cancer.". Of the 234,000 American men expected to be diagnosed with prostate cancer in 2006, most will get surgery or radiation. But in many of those cases, the men might stay healthier without the aggressive treatment.

     Treatment depends on the prostate cancer stage. Prostate cancer surgery and prostate cancer radiation are most common options. A prostate cancer support group would be helpful for many men who do not have a good support system within the family.
     Treatment for prostate cancer depend in part on how big the tumor is or how it has spread - called advanced prostate cancer or if it has spread, metastatic prostate cancer. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and a prostate cancer surgery called radical prostatectomy are common treatment options. "Watchful waiting" is also a treatment option. In this approach, no treatment is given until the tumor gets bigger. Watchful waiting may be the best choice for an older man who has a higher risk of dying from something other than his prostate cancer. Generally, tumors that have grown beyond the edge of the prostate can't be cured with either radiation or surgery. They can be treated with hormones that slow the cancer's growth. Side effects of prostate cancer treatment, such as impotence and urinary incontinence, are far more common than most doctors admit. Treatment with anti-testosterone drugs lowers bone density and may lead to a high rate of broken bones. Prostate cancer cure can occur with the right medical and surgical treatment.
     When prostate cancer remains confined to the gland, it's safe to take a conservative approach to treatment. The death rate from localized prostate cancer does not increase sharply 15 years after diagnosis -- which probably makes intensive therapy unnecessary. In  a previous study reported in 2004, a substantial minority of early stage prostate cancers became more aggressive after 15 years of watchful waiting. The authors of that report said their results supported the idea of "early radical treatment for prostate cancer, notably among patients with an estimated life expectancy exceeding 15 years." By contrast, the findings published in May 2005 Journal of the American Medical Association do not show a long-term increase in mortality rates and, therefore, do not support the view of aggressive therapy for localized prostate cancer.
   Men with prostate cancer who are treated with cyproterone acetate face a higher risk of developing venous thromboembolism.
  
Prostate Cancer Hormone Therapy risks
Men who undergo hormone therapy for early prostate cancer may experience a modest, short-term decline in their mental capacities. Treatment aimed at suppressing testosterone levels, called LHRH-agonist therapy, in men with prostate cancer may cause subtle changes in cognition.
   Men with advanced prostate cancer may be given therapy to stop their production of testosterone, which may drive tumor growth. However, androgen deprivation therapy, or ADT, appears to trigger a rapid loss of bone mineral density (BMD) making it more likely for men to have osteoporosis and bone fractures. Anti androgen therapy can lead to gynecomastia.
   Men with recurrent or advanced prostate cancer may be put on hormone therapy to block testosterone production in an effort to halt or slow the growth of the tumor. However, this may put them at increased risk for developing insulin resistance and elevated blood sugar levels, which can affect heart health. These complications of what doctors call androgen-deprivation therapy or ADT may contribute to the high rate of heart disease in men with prostate cancer. Roughly half of men who develop prostate cancer die of other, unrelated causes. Heart disease is one of the most common causes of death in men with prostate cancer.
   The use of androgen deprivation therapy increases the risk of death from cardiovascular disease among men who undergo radical prostatectomy for localized prostate cancer.

Diabetes and Heart Disease Risk from Prostate Cancer Treatment
The main systemic treatment for prostate cancer involves blocking testosterone production. This is done either by removal of the testes (bilateral orchiectomy), or more commonly, by regular injections of a gonadotropin-releasing hormone (GnRH) agonist drug. GnRH agonists are the main treatment for metastatic prostate cancer and may improve survival for some men with locally-advanced cancers. However, little is known about the efficacy of GnRH agonists in treating men with less-advanced local or regional prostate cancer, many of whom receive this therapy. Earlier studies have found GnRH agonists to be associated with obesity and insulin resistance, a precursor to diabetes. "Our study found that men with local or regional prostate cancer receiving a GnRH agonist had a 44 percent higher risk of developing diabetes and a 16 percent higher risk of developing coronary heart disease than men who were not receiving hormone therapy," says Nancy Keating, M.D. who is a physician at Brigham and Women's Hospital. "Doctors should think twice about prescribing GnRH agonists in situations for which studies have not demonstrated improved survival until we better understand the risks of treatment," says co-author Matthew Smith, MD, PhD, associate professor of medicine at Harvard Medical School and a medical oncologist at Massachusetts General Hospital. "For men who do require this prostate cancer treatment, physicians may want to talk with their patients about strategies, such as exercise and weight loss, which may help to lower risk of diabetes and heart disease." Sept. 20, 2006, Journal of Clinical Oncology.

Prostate Cancer treatment is influenced on which type of doctor you consult
The type of prostate cancer treatment a man gets has a lot to do with the kind of specialist he sees first. Prostate cancer can be treated using radiation, radioactive seeds or surgical removal of the prostate. Surgery or drugs to stop production of testosterone, known as hormone therapy, may also be used in high-risk patients. Doctors often also advise close medical observation, also known as watchful waiting. Each treatment is associated with different benefits and side effects. Prostate surgery can cause urinary incontinence and erectile dysfunction; radiation therapy can cause diarrhea and erectile dysfunction; and hormone therapy can cause hot flashes and breast tenderness. Although the 5-year survival rate for men with localized prostate cancer is nearly 100 percent, it is the third most common cause of cancer death in men of all ages, and the most common cause of cancer death in men over 75. If a man's doctor happens to be a urologist, the recommendation for men under 70 most often will be surgery -- 70 percent of the time. For men over 75 who see only a urologist, the choice is watchful waiting or hormone therapy in 90 percent of the patients. But if they see both a urologist and a radiation oncologist, 78 percent of younger men and 85 percent of older men get radiation therapy.

Prostate Cancer Surgery
If under the age of 65, prostate cancer surgery by removing the prostate gland is a good option, particularly if a person is healthy otherwise. For those over the age of 65, particularly those with a chronic medical problem such as heart disease or diabetes, prostate cancer surgery may not be helpful.
     The time elapsed between a diagnosis of localized prostate cancer and surgery does not appear to have a large effect on the risk of cancer recurrence. There is no clear evidence that an increased time between biopsy and surgery is associated with a significantly poorer outcome. Any effect of a treatment delay is moderate, at least for a time period up to 6 to 12 months after diagnosis.

Prostate Cancer Radiation
For men with localized prostate cancer, waiting several months from the time of diagnosis before beginning treatment with external beam radiation therapy does not worsen their odds of survival or other outcomes -- even for high-risk patients.
     Adverse effects on the lower gastrointestinal (GI) tract after radiation therapy for prostate cancer may be more common than previously reported. Among men treated with radiation for prostate cancer a higher than expected rates of late GI toxicity persists even after several years after the radiation.

Complications of Prostate Cancer Treatment
For many men a diagnosis of prostate cancer can be frightening not only because of the threat to their lives, but because of the threat to their sexuality. In fact, the possible consequences of treatment — which include bladder control problems and erectile dysfunction or impotence — can be a great concern for some men.

Prostate specific antigen test - PSA
There is controversy regarding the use of the PSA test. It has not been proved that older men would benefit from getting a prostate specific antigen test since prostate cancer is such a slow growing tumor. A prostate exam using a finger can give a strong clue of a potential cancer when done by an experienced doctor.
     The standard PSA test produces many false positives and false negatives — meaning some men who think they do not have cancer actually do, while others may undergo uncomfortable biopsies only to learn there is no tumor after all.
     The time it takes for prostate-specific antigen (PSA) levels to double can help predict the clinical outcome of patients with prostate cancer who have been treated with combined radiation and hormone therapy, researchers report in the International Journal of Radiation Oncology, Biology, Physics. Brief PSA doubling time can predict apparent prostate cancer recurrence. Those who take finasteride, also known as Propecia and Proscar, need to have their PSA test number doubled to make the interpretation of the PSA number more accurate. See finasteride for more info.

Additional Prostate Cancer Tests
Low levels of a protein called AZGP1 (for zinc-alpha2-glycoprotein) in prostate cancer biopsy specimens indicate that the cancer is likely to spread to other sites in the body after removal of the prostate.

Prostate Cancer and Alternative Medicine
About one third of prostate cancer patients in the United States use some type of complementary or alternative medicine. Past studies have found that prostate cancer patients often begin taking alternative or complementary medicines after receiving their diagnosis. To investigate more specifically, researchers looked at use of more than 50 different types of complementary or alternative medicines in a group of 2,582 men in a registry of prostate cancer patients. One third reported using some type of alternative medicine, with 26% using mineral or vitamin supplements, 16% taking herbs, 13% taking antioxidants and 12% taking some type of alternative treatment for "prostate health," such as saw palmetto or lycopene. Men using alternative medicine tended to have higher incomes, more education, and more advanced cancer at diagnosis. Alternative medicine users also were more likely to have other illnesses. The men who used alternative treatments targeted to prostate health were younger and less likely to be obese. SOURCE: Urology, December 2005.

Prostate Cancer Research Update
Prostate tissue and leukocyte levels of n-3 polyunsaturated fatty acids in men with benign prostate hyperplasia or prostate cancer.
 BJU Int. 2006 Feb;97(2):270-3.
Department of Nephrology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
To compare the levels of n-3 polyunsaturated fatty acids (PUFAs) in leukocytes and prostate tissue in men with prostate cancer or benign prostatic hyperplasia (BPH), as dietary intake of n-3 PUFAs has been linked to the risk of prostate cancer; the prostate-specific antigen (PSA) level was also compared to prostate tissue levels of n-3 PUFAs. Prostate tissue was obtained and leukocytes isolated from 20 men with prostate cancer and 35 with BPH. The n-3 PUFAs alpha-linolenic acid (ALA), eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA) were measured in prostate tissue and in peripheral blood leukocytes using gas chromatography. PSA levels were measured in all of the men. Conclusion: Dietary intake of the marine n-3 PUFAs reflected in EPA and DHA levels in leukocytes are also reflected in EPA and DHA levels in prostate tissue in men with and without prostate cancer. However, there is a discrepancy between the levels of ALA in leukocytes and in prostate tissue, with higher levels in men with prostate cancer. This is in accordance with the strong positive association between PSA and ALA levels in prostate tissue. This study therefore does not support the hypothesis that intake of marine n-3 PUFAs might protect against prostate cancer, but lends support to the deleterious role of ALA in the development of prostate cancer.

A compound formed when meat is charred at high temperatures -- as in barbecue -- encourages the growth of prostate cancer in rats. The compound, called PhIP, is formed when meat is cooked at very high temperatures. It appears to both initiate and promote the growth of prostate cancer in rats.

Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial.
 Int J Cancer. 2005 Mar 30
Randomized trials have shown, unexpectedly, that supplementation with selenium or vitamin E is associated with a reduction of prostate cancer risk. We assess whether a supplementation with low doses of antioxidant vitamins and minerals could reduce the occurrence of prostate cancer and influence biochemical markers. The SU.VI.MAX trial comprised 5,141 men randomized to take either a placebo or a supplementation with nutritional doses of vitamin C, vitamin E, beta-carotene, selenium and zinc daily for 8 years. Biochemical markers of prostate cancer risk such as prostate-specific antigen (PSA) and insulin-like growth factors (IGFs) were measured on plasma samples collected at enrollment and at the end of follow-up from 3,616 men. The supplementation had no effect on PSA or IGF levels. Our findings support the hypothesis that chemoprevention of prostate cancer can be achieved with nutritional doses of antioxidant vitamins and minerals.

Prostate cancer and inositol hexaphosphate: efficacy and mechanisms.
Anticancer Res. 2005 Jul-Aug;25(4):2891-903. Singh RP, Agarwal R.
Department of Pharmaceutical Sciences, School of Pharmacy, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
Inositol hexaphosphate ( IP6 ) is a major constituent of most cereals, legumes, nuts, oil seeds and soybean. Taken orally as an over-the-counter dietary/nutrient supplement, and is recognised as offering several health benefits without any known toxicity. In vitro anticancer efficacy of IP6 has been observed in many human, mouse and rat prostate cancer cells. Completed studies also show that oral feeding of IP6 inhibits human prostate cancer xenograft growth in nude mice without toxicity. In a recently completed pilot study, we observed similar preventive effects of IP6 on prostate tumorigenesis in the TRAMP model. Mechanistic studies indicate that IP6 targets mitogenic and survival signaling, as well as cell cycle progression, in prostate cancer cells. IP6 is also shown to target molecular events associated with angiogenesis. Moreover, IP6 has pleiotropic molecular targets for its overall efficacy against prostate cancer and, therefore, could be a suitable candidate agent for preventive intervention of this malignancy in humans.

In men with recurrent prostate cancer, drinking 8 ounces per day of pomegranate juice significantly increases the time it takes for an increase in levels of prostate specific antigen (PSA), an indicator of prostate cancer. Before the men in the study began consuming pomegranate juice, the average PSA doubling time, a measure of tumor activity, was 15 months. The average time after treatment was 37 months. So, there was almost a 2-year increase in the doubling time. Pomegranate juice contains a number of antioxidants thought to have anti-cancer effects, Pomegranate juice contains estrogen-like plant substances called phytoestrogens that could be useful in combating prostate cancer. Pomegranate juice therapy was well tolerated and no serious adverse effects were reported. In addition to the beneficial increase in PSA doubling time, in vitro testing showed decreased cancer cell division and proliferation and increased cancer cell death. Urine testing confirmed the presence of pomegranate antioxidants in all men. The study was funded by the Stewart and Lynda Resnick Trust, which own the POM Wonderful pomegranate juice company.

Men with nonaggressive prostate cancer who were treated with hormones or took no action at all are unlikely to die of the disease even 20 years later. Conversely, the disease is likely to be deadly for men with signs of more aggressive cancer treated with hormones or just observation. The new study, with an average follow-up of 24 years, suggests men with low-grade, localized cancers might do well with little or no treatment, avoiding the surgery or radiation that can cause impotence and incontinence. The findings are the latest to support a cautious approach in treating some prostate cancers, although there is still debate about how to define the riskiest cases. Prostate cancer is the most common major cancer, and a man's lifetime odds of getting it are 1 in 6.

Men who undergo radiation therapy for prostate cancer have nearly double the risk of developing rectal cancer when compared to men who opt to have surgery to treat prostate cancer.

Comparisons of percent equol producers between prostate cancer patients and controls: case-controlled studies of isoflavones in Japanese, Korean and American residents.
Jpn J Clin Oncol. 2004 Feb;34(2):86-9.
Our previous case-control study revealed that the Japanese residents in Japan could be divided into those who are able to degrade daidzein, a soybean isoflavone, to equol and those without this ability, and that the incidence of prostate cancer is higher in the latter group. METHODS: We recently conducted a similar case-control study involving not only Japanese residents in Japan but also Korean residents in Korea. The incidence of prostate cancer in Korean residents is known to be close to that of Japanese residents in Japan. On the other hand, American residents in the United States have a markedly higher incidence of prostate cancer as compared to Japanese residents in Japan. CONCLUSIONS: These results suggest that the ability of producing equol or equol itself is closely related to the lower incidence of prostate cancer. The results also suggest that a diet based on soybean isoflavones will be useful in preventing prostate cancer.

Compounds found in green tea may prevent the development of prostate cancer in men with a pre-cancerous condition called high-grade intraepithelial neoplasia (PIN). About 30,000 men die from prostate cancer in the United States every year. High-grade PIN progresses to invasive prostate cancer within a year in about 30 percent of men and no treatment is given to these men with high-grade PIN until prostate cancer is diagnosed. Green tea catechins may be one answer. A trial was performedinvolving men with high-grade PIN, who were given an inactive placebo preparation or one containing 600 milligrams of green tea catechins daily, "equivalent to 12-15 cups of green tea infusion, that is about two times the average intake in Asian countries. After a year, only 1 man among 32 in the green tea catechins group developed prostate cancer, a rate of only 3 percent. In contrast, 9 out of 30 men treated with placebo developed prostate cancer, for the expected rate of 30 percent.

High blood levels of alpha- and gamma-tocopherol, seem to cut the risk of prostate cancer by about 50 percent each. The findings are based on an analysis of 100 individuals with prostate cancer and 200 cancer-free "controls" participating in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which included nearly 30,000 Finnish men. Men with the highest levels of alpha-tocopherol in their blood at baseline were 51 percent less likely to develop prostate cancer than those with the lowest levels. Similarly, men with the highest levels of gamma-tocopherol were 43 percent less likely to develop the disease compared with men with the lowest levels. Further analysis showed that the link between high tocopherol levels and low cancer risk was stronger among subjects using alpha-tocopherol supplements than among non-users. This supports the original findings from the ATBC study, which showed that daily vitamin E supplementation reduced the risk of prostate cancer by 32 percent. SOURCE: Journal of the National Cancer Institute, March 2, 2005.

Dietary lycopene and other carotenoids may protect against prostate cancer, Australian and Chinese researchers report. The findings confirm those of other studies that have identified lycopene as a protective agent against some types of cancers. Lee, of Curtin University of Technology, Perth, and colleagues conducted a study in southeast China involving 130 patients with prostate cancer, and a comparison group of 274 cancer-free "controls." The participants were interviewed about food consumption and a variety of other matters. After factoring in age, total fat and caloric intake, as well as family history, diet appeared to have an influence on the odds of developing prostate cancer. The risk of prostate cancer declined with increasing consumption of lycopene, alpha-carotene, beta-carotene and other carotenoids the investigators report in the International Journal of Cancer. Consumption of foods including tomatoes, spinach and citrus fruits was also associated with a reduced cancer risk. The researchers conclude that "carotenoids in vegetables and fruits may be inversely related to prostate carcinogenesis among Chinese men." SOURCE: International Journal of Cancer, March 1, 2005.

Men with more advanced prostate cancer often undergo treatment to reduce levels of testosterone, which drives tumor growth. Now, a new study shows that this so-called androgen deprivation therapy can affect mental performance.

The mortality rates for most men diagnosed with prostate cancer in the United States are no higher than those in the general population, a new analysis shows. "The bottom line is that most men diagnosed with the disease today can expect to live as long as, or longer than, men their age without the disease," two editorialists comment. The value of prostate specific antigen (PSA) screening in reducing prostate cancer mortality is still in question, Dr. Hermann Brenner and Dr. Volker Arndt of the German Center for Research on Aging in Heidelberg report in the Journal of Clinical Oncology. Widespread use of the PSA test in the US since the late 1980s means many more men are living with a diagnosis of prostate cancer, the physicians point out. They used "the recently introduced period analysis methodology" to evaluate 5- and 10-year survival rates for 183,484 men diagnosed with prostate cancer between 1990 and 2000 included in the Surveillance, Epidemiology and End Results Program (SEER), a large US database. Overall, relative 5-year survival rates for prostate cancer patients were 99 percent, and 10-year survival rates were 95 percent, Drs. Brenner and Arndt found. "That is, excess mortality compared with the general population was as low as 1 percent and 5 percent within 5 and 10 years following diagnosis, respectively," they explain.  For the two thirds of men with well or moderately differentiated localized or regional prostate cancer, there was no excess mortality at all. The researchers note that it is possible that earlier diagnosis might not in itself mean longer survival. The question of whether PSA screening does in fact reduce mortality from prostate cancer must be answered by large-scale clinical trials, which are currently underway.

A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a biomarker for prostate cancer progression in some men. The study of 37 men with the disease found that 6 weeks on the supplements generally lowered patients' levels of male sex hormones, which fuel prostate cancer growth, and, in some patients, put the brakes on rising levels of prostate-specific antigen (PSA).] PSA is a protein produced by the prostate gland; rising PSA levels in a man's blood can signal cancer or, in men already diagnosed with the disease, cancer progression. However, the PSA effects seen in this study do not necessarily mean the supplement was hindering the men's tumors from growing, according to the study authors. The question of whether the change in patients' PSA rise translates into a change in tumor size "remains unresolved," they report in the International Journal of Cancer. But more "thought-provoking" is the possibility that diet changes could help lower a man's risk of developing prostate cancer, said lead study author Dr. Ries Kranse, of Erasmus Medical Center Rotterdam in the Netherlands. The supplement mixture he and his colleagues studied included a powder-based drink that contained green tea extract, a soy extract supplying estrogen-like compounds called phytoestrogens, and antioxidants such as lycopene. Patients also used margarine spiked with cholesterol-fighting plant sterols and the antioxidants vitamin E and selenium. The men in the study, all of whom had prostate cancer and rising PSA levels, used the supplements for 6 weeks; each also used inactive, or placebo, supplements for another 6 weeks. Kranse and his colleagues found that the patients' male hormone levels were lower when they were on the supplement compared with when they were taking the placebo. In the 21 men who showed a dip in a hormone measure called the free androgen index, the supplement also appeared to slow rising PSA levels. When these men were on the placebo, it took an average of 36 weeks for their PSA levels to double, versus 115 weeks with the supplement. This finding, according to Kranse, suggests that if the supplement proves capable of slowing or stopping tumor growth, it would be through the hormonal effects of the estrogen-like compounds. If this is the case, he said, a "dietary intervention" could eventually serve as an alternative to certain hormone-suppressing drugs used in prostate cancer treatment.
The current findings are in line with studies of the general population that suggest diets rich in antioxidants and phytoestrogens may lower the risk of prostate cancer. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed. SOURCE: International Journal of Cancer, February 20, 2005.

 Do dietary lycopene and other carotenoids protect against prostate cancer?
Int J Cancer. 2004 Oct 28
To determine whether dietary intake of lycopene and other carotenoids has an association with prostate cancer, a case-control study was conducted in Hangzhou, southeast China during 2001-2002. The cases were 130 incident patients with histologically confirmed adenocarcinoma of the prostate. The controls were 274 hospital inpatients without prostate cancer or any other malignant diseases. Information on usual food consumption, including vegetables and fruits, was collected by face-to-face interviews using a structured food frequency questionnaire. The risks of prostate cancer for the intake of carotenoids and selected vegetables and fruits rich in carotenoids were assessed. The prostate cancer risk declined with increasing consumption of lycopene, alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin. Intake of tomatoes, pumpkin, spinach, watermelon and citrus fruits were also inversely associated with the prostate cancer risk. The results suggest that vegetables and fruits rich in lycopene and other carotenoids may be protective against prostate cancer.

Consumption of red wine may reduce the risk of prostate cancer in middle-aged men. Dr. Janet L. Stanford, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues studied data from 753 newly diagnosed prostate cancer patients between 40 and 64 years of age, and from a comparison group of 703 matched "controls" to assess the association between alcohol consumption and prostate cancer. The men with and without prostate cancer completed in-person interviews about lifetime alcohol consumption and other risk factors for prostate cancer. No clear associations were observed between the risk of prostate cancer and overall alcohol consumption, the team reports in published in the International Journal of Cancer. However, "each additional glass of red wine consumed per week showed a statistically significant 6% decrease in relative risk" of prostate cancer, they report.

New research shows that it's possible to identify men with slowly progressive or latent prostate cancer, reflected by prostate specific antigen (PSA) levels that remain stable or fall over time. These men are good candidates for a "watchful waiting" approach to managing their prostate cancer. In other words, such patients can be monitored regularly and only treated if their prostate cancer progresses.

Phytoestrogens in common herbs regulate prostate cancer cell growth in vitro.
Nutr Cancer. 2004;49(2):200-8. Shenouda NS, Zhou C
Missouri University Center for Phytonutrient and Phytochemical Studies, University of Missouri, Columbia
Prostate cancer is an important public health problem in the United States. Seven phytoestrogens found in common herbal products were screened for estrogen receptor binding and growth inhibition of androgen-insensitive (PC-3) and androgen-sensitive (LNCaP) human prostate tumor cells. In a competitive 3H-estradiol ligand binding assay using mouse uterine cytosol, 2.5 M quercetin, baicalein, genistein, epigallocatechin gallate (EGCG), and curcumin displaced > 85% of estradiol binding, whereas apigenin and resveratrol displaced > 40%. From growth inhibition studies in LNCaP cells, apigenin and curcumin were the most potent inhibitors of cell growth, and EGCG and baicalein were the least potent. In PC-3 cells, curcumin was the most potent inhibitor of cell growth, and EGCG was the least potent. In both cell lines, significant arrest of the cell cycle in S phase was induced by resveratrol and EGCG and in G2M phase by quercetin, baicalein, apigenin, genistein, and curcumin. Induction of apoptosis was induced by all of the 7 compounds in the 2 cell lines as shown by TUNEL and DNA fragmentation assays. Androgen responsiveness of the cell lines did not correlate with cellular response to the phytoestrogens. In conclusion, these 7 phytoestrogens, through different mechanisms, are effective inhibitors of prostate tumor cell growth.

Antitumor activity of herbal supplements in human prostate cancer xenografts implanted in immunodeficient mice.
Anticancer Res. 2003 Sep-Oct;23(5A):3585-90. Ng SS, Figg WD.
Molecular Pharmacology Section, Cancer Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institute of Health, 9000 Rockville Pike, Bethesda, MD
Prostate cancer is the second leading cause of cancer death in American men. Therapeutic options for metastatic prostate cancer are limited. The use of herbal therapies in the treatment of this malignancy remains controversial. MATERIALS AND METHODS: We tested five herbal supplements which contain different combinations of various natural herbs such as licorice, black cohosh, Dong Quai, false unicorn and vitex berry root extracts, fennel seed extract, red clover blossoms extract as well as genistein and gamma oryzanol, for antitumor activity in severely combined immunodeficient mice bearing CWR22R and PC3 prostate cancer xenografts. CONCLUSION: Our results demonstrated that herbal supplements containing the aforementioned extracts inhibit the growth of prostate tumor xenografts, possibly in part by antiangiogenic mechanisms. The potential use of these herbal supplements as preventive and therapeutic agents in prostate cancer warrants further investigation.

Tomato phytochemicals and prostate cancer risk.
J Nutr. 2004 Dec;134(12):3486S-92S.
Mounting evidence over the past decade suggests that the consumption of fresh and processed tomato products is associated with reduced risk of prostate cancer. The emerging hypothesis is that lycopene, the primary red carotenoid in tomatoes, may be the principle phytochemical responsible for this reduction in risk. A number of potential mechanisms by which lycopene may act have emerged, including serving as an important in vivo antioxidant, enhancing cell-to-cell communication via increasing gap junctions between cells, and modulating cell-cycle progression. Although the effect of lycopene is biologically relevant, the tomato is also an excellent source of nutrients, including folate, vitamin C, and various other carotenoids and phytochemicals, such as polyphenols, which also may be associated with lower cancer risk. Tomatoes also contain significant quantities of potassium, as well as some vitamin A and vitamin E. Our laboratory has been interested in identifying specific components or combination of components in tomatoes that are responsible for reducing prostate cancer risk. We carried out cell culture trials to evaluate the effects of tomato carotenoids and tomato polyphenols on growth of prostate cancer cells. We also evaluated the ability of freeze-dried whole-tomato powder or lycopene alone to reduce growth of prostate tumors in rats. This paper reviews the epidemiological evidence, evaluating the relationship between prostate cancer risk and tomato consumption, and presents experimental data from this and other laboratories that support the hypothesis that whole tomato and its phytochemical components reduce the risk of prostate cancer.

Aqueous Extract of Urtica Dioica (stinging nettle) Makes Significant Inhibition on Adenosine Deaminase Activity in Prostate Tissue from Patients with Prostate Cancer.
Ankara University, Turkey.
Cancer Biol Ther. 2004 Sep 18;3(9).
Aim: Investigation of possible effects of aqueous extract of Urtica dioica (stinging nettle) leaves on adenosine deaminase activity in prostate tissue from patients with prostate cancer. Methods: Ten prostate tissues from patients with pathologically proven localized prostate cancer (Gleason scores 4 to 7) were used in the study. In the tissues, ADA activities with and without preincubation with different amounts of stinging nettle extracts were performed. Results: Aqueous extract of stinging nettle results in significant inhibition on adenosine deaminase (ADA) activity of prostate tissue. Conclusion: ADA inhibition by stinging nettle extract might be one of the mechanisms in the observed beneficial effect of stinging nettle in prostate cancer.

 For many men, a routine PSA blood test to screen for prostate cancer has become an annual ritual. Now the developer of the test says it can't be relied on for this purpose, and has led to overly zealous treatment of men with prostate enlargement. Dr. Thomas A. Stamey at Stanford University first reported in 1987 that levels of PSA in the blood could be used as a marker of prostate cancer. "What we didn't know in the early years is that benign growth of the prostate is the most common cause of a PSA level between 1 and 10 ng/mL," Stamey notes in a university press release. Standard units of measurement of PSA are nanograms per milliliter (ng/mL) of blood. Stamey's group found that the average size and invasiveness of prostate cancers have been dropping over the past two decades, to the point that the cancers being discovered may not be clinically meaningful.

Phytoestrogen tissue levels in benign prostate hyperplasia and prostate cancer and their association with prostate diseases.
 Urology. 2004 Oct;64(4):707-11.
To compare phytoestrogen tissue levels in men with small-volume benign prostate hyperplasia (prostate enlargement), large-volume prostate enlargement, and prostate cancer. METHODS: Prostate tissue samples of men consuming a Western diet who underwent surgery for prostate enlargement (n = 63) or prostate cancer (n = 31) were collected and frozen. In the tissue samples, the enterolactone and genistein levels were determined. We subsequently compared the tissue levels in patients with prostate enlargement and prostate cancer and studied the impact of enterolactone and genistein on prostate volume. RESULTS: The enterolactone tissue levels were comparable in patients with prostate enlargement and prostate cancer and revealed no correlation to prostate volume. The genistein tissue levels tended to be lower in patients with prostate cancer compared with the entire prostate enlargement group. In addition, the genistein tissue levels were significantly greater in men with small-volume prostate enlargement compared with those with large-volume prostate enlargement. CONCLUSIONS: Our data suggest an involvement of genistein in the pathogenesis of prostate enlargement and, possibly, of prostate cancer. The impact of enterolactone is currently unknown.

Phytoestrogens in common herbs regulate prostate cancer cell growth in vitro.
 Nutr Cancer. 2004;49(2):200-8.
Prostate cancer is an important public health problem in the United States. Seven phytoestrogens found in common herbal products were screened for estrogen receptor binding and growth inhibition of androgen-insensitive (PC-3) and androgen-sensitive (LNCaP) human prostate tumor cells. In a competitive 3H-estradiol ligand binding assay using mouse uterine cytosol, 2.5 M quercetin, baicalein, genistein, epigallocatechin gallate (EGCG), and curcumin displaced > 85% of estradiol binding, whereas apigenin and resveratrol displaced > 40%. From growth inhibition studies in LNCaP cells, apigenin and curcumin were the most potent inhibitors of cell growth, and EGCG and baicalein were the least potent. In PC-3 cells, curcumin was the most potent inhibitor of cell growth, and EGCG was the least potent. In both cell lines, significant arrest of the cell cycle in S phase was induced by resveratrol and EGCG and in G2M phase by quercetin, baicalein, apigenin, genistein, and curcumin. Induction of apoptosis was induced by all of the 7 compounds in the 2 cell lines as shown by TUNEL and DNA fragmentation assays. Androgen responsiveness of the cell lines did not correlate with cellular response to the phytoestrogens. In conclusion, these 7 phytoestrogens, through different mechanisms, are effective inhibitors of prostate tumor cell growth.

Obese men who undergo surgery for prostate cancer are more likely than their non-obese peers to experience a rise in prostate-specific antigen (PSA) levels, a sign that their disease is returning

Lycopene: modes of action to promote prostate health.
 Arch Biochem Biophys. 2004 Oct 1;430(1):127-34.
Epidemiological evidence strongly suggests that lycopene consumption contributes to prostate cancer risk reduction. Preclinical studies show that lycopene acts via different mechanisms, which have the potential to cooperate in reducing the proliferation of normal and cancerous prostate epithelial cells, in reducing DNA damage, and in improving oxidative stress defense. The mechanisms include inhibition of prostate IGF-I signaling, IL-6 expression, and androgen signaling. Moreover, lycopene improves gap-junctional communication and induces phase II drug metabolizing enzymes as well as oxidative defense genes. These findings provide plausible explanations for the epidemiological findings how lycopene can contribute to reduced prostate cancer risk. The novel finding that lycopene reduces local androgen signaling in the prostate suggests also efficacy in prevention of benign prostate hyperplasia. Intervention trials in humans are required to finally prove clinical efficacy of the lycopene molecule in prostate health.

Lycopene and prostate cancer.
Prostate Cancer Prostatic Dis. 2002;5(1):6-12.
The role of diet and dietary supplements in the development and progression of prostate cancer represents an increasingly frequent topic of discussion in the urologist's office. As access to information becomes forever easier, patients are more aware and educated about this subject than ever before. The role of antioxidants including carotenoids in all this has been the subject of great interest for some time. Lycopene, the carotenoid that gives tomatoes and other fruits and vegetables their red colour, has been of particular interest recently as regards its role in prostate cancer. The aim of this review is to briefly outline the biology and chemistry of lycopene, the scientific basis for its proposed anticancer properties and evaluate what conclusions the practicing urologist may draw from the data thus far. The media and industry have raced to encourage not only diets high in lycopene but also dietary lycopene supplements but there is probably only sufficient evidence to recommend to patients a diet rich in all vegetables and fruits of which tomatoes and tomato based products should certainly be a part.

Some men with prostate cancer that hasn't spread may not need to undergo treatment, as long as a watchful eye is kept on their condition. They can do as well as similar men who undergo radiation therapy. "Observation is an option for men with nonaggressive prostate cancer who are older or have other medical co-morbidities," Dr. Eric M. Horwitz from the Fox Chase Cancer Center in Philadelphia, Pennsylvania, told Reuters Health. Horwitz and colleagues compared outcomes in two matched groups of men with localized prostate cancer: 69 who were just watched (because their disease was indolent, or they had other significant medical conditions, or they refused treatment), and 69 who were treated with radiation. Survival rates after eight years were estimated to be 73 percent in the observation group and 75 percent in the radiation group. After eight years, 93 percent of patients who were watched showed no sign of disease spread, as did 95 percent of the radiation patients. SOURCE: BJU International, July 2004.

Effect of permixon (saw palmetto extract) on human prostate cell growth: Lack of apoptotic action.
 Prostate. 2004 Sep 15;61(1):73-80.
Hill B, Kyprianou N. Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland.
Permixon, a phytotherapeutic agent derived from the saw palmetto extract or Serenoa repens plant, is a lipid/sterol extract that is believed to interfere with 5alpha-reductase activity, thus inhibiting prostate growth. In this study, we investigated the magnitude and specificity of the effect of saw palmetto extract on cell proliferation and apoptosis in human prostate cancer cells. METHODS: The effect of saw palmetto extract was examined in androgen-independent PC-3 prostate cancer cells, androgen-sensitive LNCaP prostate cancer cells, and MCF-7 breast cancer cells in vitro. Cell growth, apoptosis induction, and cell proliferation was studied after exposure to saw palmetto extract at two concentrations (10 and 100 microg/ml). Cell proliferation and cell cycle progression were determined after 24 hr on the basis of (3)[H]-thymidine incorporation assay and flowcytometric analysis, respectively. Apoptosis induction was evaluated in treated and untreated cultures using the Hoescht staining and caspase-3 activation. RESULTS: Exposure of prostate and breast cancer cells to a high dose of saw palmetto extract (100 microg/ml) resulted in a significant decrease in the rate of cell growth; an effect that was not time-dependent and was not associated with cell cycle arrest. saw palmetto extract treatment (at either high or low dose) had no effect on apoptosis induction in prostate cancer cell lines (P > 0.6). Furthermore, in vitro saw palmetto extract was a weak inhibitor of 5alpha-reductase activity type 2 in prostatic homogenates. CONCLUSIONS: The results indicate the ability of saw palmetto extract to affect prostate cancer cell growth without inducing apoptosis or cell cycle arrest. This effect was not prostate-specific and was only manifested at high concentrations of saw palmetto extract. Furthermore our findings indicate that saw palmetto extract is weak inhibitor of 5alpha-reductase compared to finasteride. This study challenges previous evidence on the anti-growth effect of saw palmetto extract in the prostate and its ability to inhibit 5alpha-reductase activity, while questioning apoptosis as a mechanism of action of this phytotherapeutic against prostate growth, a concept that may have therapeutic significance.

Staying active through moderate walking may help prevent fatigue in men undergoing radiation therapy for prostate cancer,

The relationship between dietary carotenoids and prostate cancer risk in Southeast Chinese men.
 Asia Pac J Clin Nutr. 2004;13(Suppl):S117.
To investigate whether dietary intake of lycopene and other carotenoids has an etiological association with prostate cancer, a case-control study was conducted in Hangzhou, southeast China during 2001-2002. The cases were 130 incident patients with histologically confirmed adenocarcinoma of the prostate. The controls were 274 hospital inpatients without prostate cancer or any other malignant diseases, who were matched to the age of cases. Information on usual food consumption, including all vegetables and fruits, was collected by face-to-face interview using a structured food frequency questionnaire. The risk of prostate cancer for the intake of carotenoids and selected vegetables and fruits rich in carotenoids was assessed using multivariate logistic regression, adjusting for age, locality, education, income, body mass index, marital status, number of children, family history of prostate cancer, tea drinking, total fat and caloric intake. The prostate cancer risk declined with increasing consumption of lycopene, alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin. Tomatoes, pumpkin, spinach, watermelon and citrus intake were also inversely related to the risk of prostate cancer. The dose response relationships were also significant, suggesting that intake of lycopene and other carotenoid rich vegetables and fruits may associate with a reduced risk of prostate cancer.

The fatty acids found in fish may slightly lower a man's risk of prostate cancer, but another type of fatty acid found in a range of foods may raise the risk, a large study suggests. Researchers found that among nearly 48,000 U.S. men followed for 14 years, those with the highest intakes of two fatty acids found in oily fish were 26 percent less likely than men with the lowest intakes to develop advanced prostate cancer. The opposite was true, however, when it came to alpha-linolenic acid, or ALA. Like the two fish-oil fats, ALA is an omega-3 unsaturated fatty acid that is thought to promote heart health; it is found in vegetable sources such as soybeans, canola oil, walnuts and flaxseed, and to a lesser extent in meat and dairy products. In this study, men with the highest intake of ALA were about twice as likely as those with the lowest intakes to develop advanced prostate cancer. And the risk was increased regardless of whether the ALA came from vegetable or animal sources, according to findings published in the American Journal of Clinical Nutrition.

Aqueous Extract of Urtica Dioica (stinging nettle) Makes Significant Inhibition on Adenosine Deaminase Activity in Prostate Tissue from Patients with Prostate Cancer.
 Cancer Biol Ther. 2004 Sep 18;3(9).
Ankara University, Turkey.
Aim: Investigation of possible effects of aqueous extract of Urtica dioica (stinging nettle) leaves on adenosine deaminase activity in prostate tissue from patients with prostate cancer. Methods: Ten prostate tissues from patients with pathologically proven localized prostate cancer (Gleason scores 4 to 7) were used in the study. In the tissues, ADA activities with and without preincubation with different amounts of stinging nettle extracts were performed. Results: Aqueous extract of stinging nettle results in significant inhibition on adenosine deaminase (ADA) activity of prostate tissue. Conclusion: ADA inhibition by stinging nettle extract might be one of the mechanisms in the observed beneficial effect of stinging nettle in prostate cancer.

Eating broccoli and tomatoes together may offer better protection against prostate cancer than eating either vegetable alone. Tomatoes are especially hailed as protective against prostate cancer, and scientists believe the lycopene that makes them red may be responsible. But lycopene supplements did little to prevent cancer in rats. Broccoli is also believed to help prevent cancer, because it contains compounds called glucosinolates and perhaps other healthful molecules. For the latest study the researchers fed rats dried, powdered tomato, dried broccoli, or a combination of both. A fourth group of rats was fed finasteride, a drug shown to reduce the benign growth of the prostate and also being tested for its potential to prevent prostate cancer. The rats were all injected with human prostate tumors. This mimics human cancer to a certain degree, although not perfectly. The rats developed tumors, but in those given the food supplements the tumors grew more slowly and stayed smaller than in those given finasteride. The rats given both broccoli and tomato had the smallest tumors.

Dietary intake of n-3 (fish oils) and n-6 fatty acids and the risk of prostate cancer.
 Am J Clin Nutr. 2004 Jul;80(1):204-16.
Laboratory studies have shown that n-3 fatty acids (mostly in fish oils) inhibit and n-6 fatty acids stimulate prostate cancer growth, but whether the dietary intake of these fatty acids affects prostate cancer risk in humans remains unclear. We prospectively evaluated the association between intakes of alpha-linolenic (ALA; 18:3n-3), eicosapentaenoic (EPA; 20:5n-3), docosahexaenoic (DHA; 22:6n-3), linoleic (LA; 18:2n-6), and arachidonic (AA; 20:4n-6) acids and prostate cancer risk. A cohort of 47 866 US men aged 40-75 y with no prostate cancer history in 1986 was followed for 14 y. RESULTS: During follow-up, 2965 new cases of total prostate cancer were ascertained, 448 of which were advanced prostate cancer. ALA intake was unrelated to the risk of total prostate cancer. In contrast, the multivariate relative risks (RRs) of advanced prostate cancer from comparisons of extreme quintiles of ALA from nonanimal sources and ALA from meat and dairy sources were 2.02 (95% CI: 1.35, 3.03) and 1.53 (0.88, 2.66), respectively. EPA and DHA intakes (fish oils) were related to lower prostate cancer risk.  CONCLUSIONS: Increased dietary intakes of ALA may increase the risk of advanced prostate cancer. In contrast, EPA and DHA (fish oils) intakes may reduce the risk of total and advanced prostate cancer.

Phytoestrogens and prostatic growth.
 All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Natl Med J India. 2004 Jan-Feb;17(1):22-6.
The incidence of and mortality from prostate cancer in the West is higher than that in Asian countries. Migrants from Asia to western countries, who maintain their traditional diet, do not have an increased risk of prostate cancer. This has been attributed in part to 'phytoestrogens in vegetarian Asian diets. Prostate cancer is a hormone-dependent disease and estrogens retard the growth of prostatic tumors by interfering with the action of testosterone. Estrogen increases the level of sex hormone-binding globulin that binds testosterone, resulting in lower free testosterone levels, thereby decreasing androgenic stimulation of the prostate. Estrogens used to retard the growth of prostate cancer are associated with certain undesirable side-effects. Phytoestrogens have weak estrogenic potency and anticancer effects. Thus, these phytochemicals have a possible role in the prevention of hormone-dependent diseases such as prostate cancer. Although the relative potencies of various phytoestrogens compared with estradiol are low, the estrogen receptor (ER) complexes formed by estradiol and isoflavones have functional similarities. Also, phytoestrogens have a higher affinity to bind to ER-beta than ER-alpha. They are anti-proliferative and inhibit tyrosine and other protein kinases which play a key role in tumorigenesis, and also inhibit the production of the potent androgen 5alpha dihydrotestosterone in the prostate. Since prostate cancer cells usually multiply slowly and the development of this cancer can take many years before symptoms appear, the latent period provides a chemopreventive opportunity for natural therapy with phytoestrogens. Although phytoestrogens have not yet been used in long-term trials to evaluate their ability to reduce the risk of prostate cancer, the evidence thus far suggests that they have a protective effect against the growth of prostate tumors.

Inhibition of telomerase activity and secretion of prostate specific antigen by silibinin in prostate cancer cells. CONCLUSIONS: The down-regulation of PSA by silibinin and its counteraction on DHT effects indicate that this compound can interact with the expression of genes that are regulated through the androgen receptor. Silibinin can also inhibit the telomerase activity that mediates cell immortality and carcinogenesis. The 2 effects underline the possible therapeutic use of silibinin as an antiproliferative agent in intervention for prostate cancer. J Urol. 2004 May;171(5):1934-8.

Comparisons of percent equol producers between prostate cancer patients and controls: case-controlled studies of isoflavones in Japanese, Korean and American residents.
 Jpn J Clin Oncol. 2004 Feb;34(2):86-9.
Our previous case-control study revealed that the Japanese residents in Japan could be divided into those who are able to degrade daidzein, a soybean isoflavone, to equol and those without this ability, and that the incidence of prostate cancer is higher in the latter group. METHODS: We recently conducted a similar case-control study involving not only Japanese residents in Japan but also Korean residents in Korea. The incidence of prostate cancer in Korean residents is known to be close to that of Japanese residents in Japan. On the other hand, American residents in the United States have a markedly higher incidence of prostate cancer as compared to Japanese residents in Japan. RESULTS: The number of subjects was 295 in Japan (133 patients and 162 controls), 122 in Korea (61 patients and 61 controls) and 45 in the United States (24 patients and 21 controls). The percentage of equol producers among patients and controls was 29% and 46% in Japan (P = 0.004) and 30% and 59% in Korea (P = 0.001), respectively. The active isoflavone level was markedly lower and the percentage of equol producers was also lower (17% for patients and 14% for controls) for Americans as compared to the Japanese and Koreans. CONCLUSIONS: These results suggest that the ability of producing equol or equol itself is closely related to the lower incidence of prostate cancer. The results also suggest that a diet based on soybean isoflavones will be useful in preventing prostate cancer.

Ganoderma lucidum (Reishi) in cancer treatment.
 Sliva D. Cancer Research Laboratory, Methodist Research Institute, Indianapolis, IN
Integr Cancer Ther. 2003 Dec;2(4):358-64.
The popular edible mushroom Ganoderma lucidum (Reishi) has been widely used for the general promotion of health and longevity in Asian countries. The dried powder of reishi was popular as a cancer chemotherapy agent in ancient China. Thus, reishi clearly demonstrates anticancer activity in experiments with cancer cells and has possible therapeutic potential as a dietary supplement for an alternative therapy for breast and prostate cancer.

Ejaculation frequency is not related to increased risk for prostate cancer.

Prostate cancer patients underwent an operation called a bilateral nerve-sparing retropubic radical prostatectomy. More than 90 percent of these men who had the operation suffered from erectile dysfunction afterwards.

Use of supplements containing selenium may reduce the risk of advanced prostate cancer. The fact that no effect was seen against early prostate cancer suggests that selenium works by slowing cancer progression rather than by preventing it all together. A recent study links the consumption of the essential mineral selenium with a lower risk of prostate cancer. There are now seven population studies in the past six years that examined the possible connection between selenium and prostate cancer. All but one of them have found selenium protective. Yet, since scientists are still uncertain how prostate cancer starts or can be prevented, it is too early to say that selenium definitely protects the prostate.
Findings from a new animal study suggest that selenium use may decrease age-related DNA damage in the prostate and increase epithelial cell apoptosis. Therefore, dietary supplementation with the mineral could be useful in preventing prostate cancer. Dr. David J. Waters, from Purdue University in Lafayette, Indiana, and colleagues evaluated the prostate glands of 49 elderly male dogs that were randomized to receive a regular diet or a diet supplemented with selenium for 7 months. Prostate cells and lymphocytes from selenium-treated dogs demonstrated significantly less DNA damage than cells from control animals. Although the exact mechanism was unclear, it did not appear to involve the plasma antioxidant enzyme glutathione peroxidase. Animals treated with selenium also demonstrated significantly greater epithelial cell apoptotic activity than control animals. The authors state. "Further study of the process of carcinogenesis within the prostate of animal species vulnerable to spontaneous cancer development may provide important insights into the putative anticancer mechanisms of selenium and identify biomarkers that predict the prostate's response to selenium." Source: J Natl Cancer Inst 2003;95:237-241.

Men over 50 who have higher levels of testosterone have a higher risk of prostate cancer. The findings may mean that men should be cautious about testosterone replacement therapy, being tested in older men who see a decline in general health and vigor.
       
Men over 50 who have higher levels of testosterone have a higher risk of prostate cancer. The findings may mean that men should be cautious about testosterone replacement therapy, being tested in older men who see a decline in general health and vigor.

Ejaculation frequency is not related to increased risk for prostate cancer.

Effects of a mushroom mycelium extract on the treatment of prostate cancer.
 Urology. 2002 Oct;60(4):640-4.
To determine whether supplemental amounts of a polysaccharide/oligosaccharide complex obtained from a shiitake mushroom extract would lower the prostate-specific antigen (PSA) level in patients with prostate cancer. CONCLUSIONS: shiitake mushroom extract alone is ineffective in the treatment of clinical prostate cancer.

A flavonoid antioxidant, silymarin, inhibits activation of erbB1 signaling and induces cyclin-dependent kinase inhibitors, G1 arrest, and anticarcinogenic effects in human prostate carcinoma DU145 cells.
Cancer Res. 1998 May 1;58(9):1920-9.
Prostate cancer is the most common nonskin malignancy and the second leading cause of cancer deaths in United States males. One practical and translational approach to control Prostate cancer is to define a mechanism-based anti-carcinogenic agent(s). Recently, we showed that silymarin, a flavonoid antioxidant isolated from milk thistle, possesses exceptionally high to complete protective effects against experimentally induced tumorigenesis. Because the epidermal growth factor receptor (erbB1) and other members of the erbB family have been shown to play important roles in human PCA, efforts should be directed to identify inhibitors of this pathway for Prostate cancer intervention. Taken together, these results suggest that silymarin may exert a strong anticarcinogenic effect against Prostate cancer.

An increasingly popular prostate cancer treatment also makes bones brittle and may be responsible for over 3,000 fractures each year in the United States, researchers reported on Wednesday. Hormonal ablation treatment for prostate cancer blocks the effects of the male hormone testosterone, either with drugs or by castration. Until now, doctors have regarded the treatment as relatively harmless, Vahakn Shahinian, said chief author of the new research. He said that given the new findings, doctors and patients should be aware of the risks of the prostate cancer therapy, which seems to slow the growth of prostate tumors but may not always help patients live longer. The findings add another layer of complexity to the already-difficult question of how best to treat prostate cancer, which strikes 220,000 U.S. men each year. Sometimes a tumor is growing so slowly it's hard to know whether treatment is necessary. Neutralizing testosterone is one option. More than 88,000 men a year get the drug treatment. But the Shahinian team, which studied the records of nearly 51,000 cancer patients, found 19.4 percent of prostate cancer men who survived at least five years after anti-testosterone therapy broke a bone. In other patients, the rate was 12.6 percent. "Our findings, along with those of smaller clinical series, underscore that such treatment for prostate cancer is not benign" and there is no hard evidence it helps patients live longer, the researchers warned.

Soy protein isolates of varying isoflavone content exert minor effects on serum reproductive hormones in healthy young men.
 J Nutr. 2005 Mar;135(3):584-91.
Inverse associations between soy and prostate cancer and the contribution of hormones to prostate cancer prompted the current study to determine whether soy protein could alter serum hormones in men. In conclusion, soy protein, regardless of isoflavone content, decreased DHT and DHT/testosterone with minor effects on other hormones, providing evidence for some effects of soy protein on hormones. The relevance of the magnitude of these effects to future prostate cancer risk requires further investigation.

Inhibition of spontaneous metastasis in a rat prostate cancer model by oral administration of modified citrus pectin.
 J Natl Cancer Inst. 1995 Mar 1;87(5):331-2.
Prostate cancer is the most common cancer diagnosed in U.S. men and remains incurable once it has metastasized. Many stages of the metastatic cascade involve cellular interactions mediated by cell surface components, such as carbohydrate-binding proteins, including galactoside-binding lectins (galectins). Modified citrus pectin (pH-modified), a soluble component of plant fiber derived from citrus fruit, has been shown to interfere with cell-cell interactions mediated by cell surface carbohydrate-binding galectin-3 molecules. CONCLUSIONS: We present a novel therapy in which oral intake of modified citrus pectin acts as a potent inhibitor of spontaneous prostate carcinoma metastasis in the Copenhagen rat.

Can Prostate Cancer Risk be Reduced with Supplements?
I have no doubt that cancer is influenced by diet, perhaps more so than most doctors are willing to admit. But can supplements influence prostate cancer risk?
     Several trials over the past few years have shown that supplementation with selenium or vitamin E is associated with a reduction of prostate cancer risk. In a new study published recently, researchers wanted to find out whether supplementation with low doses of several antioxidant vitamins and minerals could reduce the occurrence of prostate cancer. The trial comprised 5,141 men randomized to take either a placebo or a supplementation with nutritional doses of vitamin C, vitamin E, beta-carotene, selenium and zinc daily for 8 years. Biochemical markers of prostate cancer risk such as prostate-specific antigen (PSA) and insulin-like growth factors (IGFs) were measured. During the follow-up, 103 cases of prostate cancer were diagnosed. Overall, there was a moderate reduction in prostate cancer rate associated with the supplementation. However, the effect differed significantly between men with normal baseline PSA and those with elevated PSA. Among those with normal PSA, there was a significant reduction in the rate of prostate cancer for men receiving the supplements. The researchers say, "Our findings support the hypothesis that chemoprevention of prostate cancer can be achieved with nutritional doses of antioxidant vitamins and minerals."
     My comments: There are a number of other supplements that have been studied in relation to prostate cancer prevention or treatment, at least in the laboratory or in mice. These include curcumin (from turmeric), lycopene (found in tomatoes), silymarin (in milk thistle), genistein (in soy), and many others.

Nutrients that may have positive benefits in Prostate Cancer
 A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a PSA, a marker for prostate cancer progression. The study of 37 men with the disease found that 6 weeks on the supplements generally lowered patients' levels of androgens such as testosterone, which stimulates prostate cancer growth. PSA is a protein produced by the prostate gland; rising PSA levels in a man's blood often signals cancer or, in men already diagnosed with the disease, cancer progression. The supplement mixture included a powder-based drink that contained green tea extract, a soy extract supplying estrogen-like compounds called phytoestrogens, and carotenoids such as lycopene. The men in the study, all of whom had prostate cancer and rising PSA levels, used the supplements for 6 weeks; each also used inactive, or placebo, supplements for another 6 weeks. The patients' androgen levels were lower when they were on the supplement compared with when they were taking the placebo. The current findings are in line with studies of the general population that suggest diets rich in antioxidants and phytoestrogens may lower the risk of prostate cancer. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed. Many phytoestogens found as supplements include beta sitosterol, genistein, and daidzein.
     Two interesting notes: 1. Mortality rates for most men diagnosed with prostate cancer in the United States are not much higher than those in the general population. Most men diagnosed with prostate cancer can expect to live as long as men their age without the disease. 2. The value of prostate specific antigen (PSA) screening tests in reducing prostate cancer mortality is still in question.

Prostate Cancer emails
Q. I had radical surgery in November 2005, and since then, I have never had any erection. I've tried caverject (intracavernosal alprostadil), pump and all have not worked. I am 58 yrs old and worried.

Q. I have prostate cancer at least for the last four years. I am on watchful waiting. I did take Proscar and Prostasol last year before sep 2005 then I got struck with west Nile virus. When I was diagnosed with prostate cancer my psa was 5 and progressed to 15, then started to fall back to .5 before west Nile virus. After that PSA started to up slowly in one year to 24. of course I did start Prostasol two months even then PSA go on rising. I have also added Proscar of 5 mg in the morning with breakfast. and early in the morning 2 caps of Prostasol. during lunch dinner 2 caps of Prostate Power Rx formula. Luckily my prostate cancer seems to confined as per MRI and CT scans. I wish to speak and discuss with Dr.Sahelian to give more detail if he would like to give any other suggestions. My urologist do not want me to wait any more and to take aggressive procedures like radiation or Lupron shots. I will appreciate if I can discuss with Dr. Sahelian.
   A. Thank you very much for your email, however we are not in a position to offer individual advice. We can only offer general information on the website. We wish you an optimal outcome.

Q. I have had prostate cancer and the prostate removed by radical surgical procedure. I am 59 years old and in good health, want to have sex but cannot get hard enough to do it.
   A. There are a number of herbs and combinations used as sexual enhancers. It is impossible to predict in any person which one or which combination will work.

Q. For many years before my prostate cancer was diagnosed at age 74, I used DHEA, pregnenolone, avena sativa, etc.. Following radical prostatectomy, my urologist told me to cut out all supplements that stimulated the production of testosterone or caused it to be retained in my body -- in order to prevent a possible recurrence of the cancer. Is this something physicians agree on, or is there room for debate? I sure miss my testosterone-boosting supplements.
   A. There is scientific agreement that excess testosterone promotes prostate cancer, and it is our opinion that androgen supplements such as DHEA and pregnenolone could also promote prostate cancer.

Q. A lot of older men may feel they have prostate cancer and know that increasing testosterone means increasing rate of cancer. Would you please list herbs, vitamins, supplements that increase the risk for testosterone stimulation?
   A. The two over the counter supplements that we definitely do not suggest for those who have prostate cancer or at a higher risk for prostate cancer are the hormones DHEA and pregnenolone. There are some herbs that may stimulate testosterone release, at least in the short term, but many herbs also have anti-cancer benefits. Even if some of these herbs stimulate testosterone release, their effects may be short lived and may not be clinically relevant in the long run. No easy answers are available as to which herbs are not recommend for prostate cancer since long term human studies are lacking. Two herbs that are thought to stimulate testosterone, at least initially, are tribulus terrestris and tongkat ali.

Q. Which supplement or combination of can be used to successfully inhibit DHT and excess estrogen resulting in elevated PSA after prostate removal. Have made diet and life style changes; any other suggestions?
   A. You may wish to review the supplements mentioned towards the top of the page and have your doctor read this info and together come up with a plan.

Q. What kind of natural supplement regimen would I need to help deal with a prostate cancer issue?
   A. There is no accepted prostate cancer supplement regimen since research in this field is too early. Your doctor may consider some of the herbs, vitamins, and nutrients listed at the top of the page.

Additional links
 Graviola herb
Mangosteen herb
Capsaicin, which makes peppers hot, can cause prostate cancer cells to kill themselves. 


 

prostate cancer