PROSTATE CANCER (also see CANCER)
Natural Support Strategies for the most common male cancer in the U.S.
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Prostate
carcinoma is the most common male cancer in the U.S. It accounts for
an estimated 32% of all newly diagnosed cancers. (Other forms of
prostate cancer, such as sarcoma, are rare). The incidence of disease
increases with each decade of life over age 50. Prostate cancer rates
have risen 108% since 1950, believed due in part to earlier detection.
Death rates from the disease have increased 23% in spite of widespread
use of surgery, radiation and chemotherapy.
There is great debate in the medical
community regarding the value of conventional treatment. Prostate
cancer is, in most cases, slow-growing. Increased survival rates
reported in some studies may be due to earlier detection, not
treatment. Many newly diagnosed and early stage cancers in older men
would never progress to morbidity or mortality. Considering the risk
of impotence (50-60% with surgery), incontinence (from surgery or
radiation) and other treatment side-effects, the value of conventional
therapy must be questioned in all cases of cancer in older men.
Prostate carcinoma is a
hormone-dependent cancer. Therefore, in addition to general immune
enhancing and anti-cancer therapies, hormonal manipulation has a role
to play in treatment of this disease. Herbal and nutritional treatment
for cancer can be considered an adjuvant therapy in all cases of
prostate carcinoma and the sole therapy in many cases. Even when
conventional treatment is deemed advisable, non-traditional uses of
conventional hormone-suppressive drugs (called "Androgen Deprivation
Therapy" or ADT), may be safer and more advantageous than standard
therapy alone. This is because, in it’s early stages, prostate cancer
is highly controllable with hormone-blocking therapy.
Laboratory Evaluation of Prostate
Cancer
In additional to generalized immune testing and basic cancer workup
(chemistry screen, CBC, TFT’s, etc.), several tests specific to
prostate disease allow the clinician to track progression
non-invasively and with greater accuracy. These tests include
prostatic-specific antigen (PSA), free PSA, prostatic acid phosphatase
(PAP), and prolactin.
PSA is now used as the preferred
screening test for both benign prostatic hypertrophy (BPH) and
prostate cancer. Because PSA may be elevated in both benign and
cancerous prostate disease, the test is not specific for prostate
cancer. Values in the "indeterminate" range (4-12) present a special
diagnostic dilemma. It is further estimated that 25% of men with
prostate cancer will have PSA’s less than 4. Taken together, the PSA
test poses a significant number of both false-negative and
false-positive results. The PSA is an accurate measure of cancer cell
activity once the diagnosis has been established.
Free-PSA is a more recent marker that
has not yet been universally embraced by conventional medicine.
Current research suggests that the free-PSA is a useful "next step"
for evaluating elevated PSA’s. In men with PSA’s ranging from 4.1-10,
higher levels of free-PSA (18.9 median value) correlated with benign
disease while lower levels of free-PSA (10.1 median) correlated with
cancer. It is estimated that 95% of "indeterminate" PSA reading could
be clarified non-invasively with the additional use of the free-PSA
test.
Prostatic acid phosphatase (PAP) was
the prostate cancer screening test that preceded use of the PSA. An
elevated PAP in a patient with known prostate cancer is indicative of
lymphatic spread of the disease.
Prolactin hormone is an additional
growth factor to the prostate gland, and rising prolactin levels
correlate with progression in advanced prostate cancer cases.
Prolactin receptors are found on prostate cancer cells, and it is
postulated that these receptors may facilitate the entry of
testosterone into the cell. Even with hormone ablation therapy,
detectable androgen remains in the blood from adrenal sources.
Blocking prolactin secretion may therefore be another method for
slowing progression of the disease. It is recommended that prolactin
levels be kept below 3 in all patients with hormone-responsive
cancers.
Specific Goals of Prostate Cancer
Therapy
Testosterone, prolactin, cortisol, insulin, glucose and arachidonic
acid-derived prostaglandins (especially PGE2) act as growth factors
for prostate cancer. Decreasing circulating levels of these hormones
and blocking inflammatory pathways should be undertaken in addition to
non-specific cancer therapies such as immune enhancement.
DIET AND LIFESTYLE RECOMMENDATIONS
Low saturated fat diets decrease the
body’s endogenous and exogenous hormone production. Conversely, diets
high in saturated fats decrease NK cell activity and increase
arachidonic acid, an inflammatory precursor. Rates of breast, colon,
prostate, uterine, ovarian and testicular cancers are significantly
higher in countries with high saturated fat intakes. Saturated fats
promote inflammatory prostaglandin synthesis while omega-3 fatty acids
are anti-inflammatory.
A ketogenic (very low carbohydrate)
diet such as
The Super Fast Diet decreases
the availability of glucose and insulin. Insulin is a growth factor
for cancer and the primary metabolic pathway of cancer cells is
anaerobic glycolysis, meaning that cancer cells thrive with a high
glucose diet. In animal studies, even s slight change toward metabolic
acidosis resulted in tumor regression. A low carbohydrate diet which
induces ketosis (metabolic acidosis) may duplicate this effect.
Overweight patients can afford to lose weight on such a diet, to
further reduce their own hormone production. (Fat cells manufacture
estrogen, a growth-promoting hormone).
Foods of Special Benefit
Garlic, lemon peel (the peel contains limonene), fish, flax seed, soy
and soy products, fresh vegetables (especially non-starchy, dark leafy
greens), blueberries and other berries (high in flavonoids and low in
sugars), grains (whole grain only, to reduce insulin response and
increase fiber content).
Grains should be used sparingly. In
patients with more than twenty pounds to lose, they do not need to be
used at all until desired weight is achieved.
DIET AND LIFESTYLE RECOMMENDATIONS
- A ketogenic diet such as
The Super Fast Diet should be followed to lower insulin and glucose
levels.
- Achieve and maintain an optimal body weight and
BMI. (BMI 18-22).
-
Exercise regularly to improve
prostate circulation. Walking and running are the best for prostate
circulation because they use the major leg muscles. Cycling
restricts blood flow to the prostate and testicles and should not be
used as the primary form of exercise for men.
PRIMARY SUPPORT
-
Maxi Multi:
3 caps, 3 times per day with meals. Optimal (not minimal) doses of
vitamin A, carotenes, C, D and selenium appear particularly
important.
- Omega 3 fatty acids:
Flax seed meal,
2 teaspoons per day with food
OR
Max EPA
(Omega-3 rich fish oil): 1-2 caps, 3 times per day with meals
(target dose: 3-6 caps per day). (Or eat fish 3 times per week and
use 2 teaspoons of ground flax seed per day added to food).
-
Vitamin D:
1,000-5,000IU per day based on blood test results
-
Bromelain:
1-2 caps, 3-4 times per day between meals.
-
Melatonin
: 10-40mg before bed.
ADDITIONAL SUPPORT
(NOTE: These therapies should be undertaken with the guidance of
a physician who can order laboratory tests to determine hormone
levels and immune function, monitor the effectiveness of treatment,
assess possible toxicity and prescribe drugs when advisable). Please
strongly consider obtaining a
consultation
with Dr. Myatt.
To Decrease testosterone
- Saw palmetto: Serenoa repens, S.
serrulata (Palmaceae)
Saw palmetto blocks the conversion of testosterone to
dihydrotestosterone (DHT) and there is evidence that DHT may be five
times as potent as testosterone in stimulating prostate cancer cell
growth.
- Chaste berry: Vitex agnus-castus, V.
negundo (Verbenaceae)-
Vitex spp. decreases testosterone production in vivo and inhibits
prolactin synthesis and release in animal models. As the name
"chaste tree" implies, this herb was traditionally used by monks to
reduce libido.
- Rx: Casodex, Flutamide, Lupron, Zoladex
To Decrease prolactin
- Vitex spp.- Chaste tree
- Vegetarian diet
- Rx: Bromocriptine, Pergolide, Dostinex
Vitamin D3 (cholecalciferol): 1,000 I.U., 2-3 times per day
with meals.
Vitamin D3 induces prostate cancer cell death (apoptosis) by apparent
translocation of the cancer cell androgen receptor. This makes the
cell less susceptible to testosterone-induced cell-growth stimulation.
D3 encourages cancer cells to become more normal (induces
differentiation), inhibits a cancer cell from developing it’s own
blood supply (inhibits angiogenesis) and shows antitumor activity.
Because vitamin D has the potential to cause toxicity, doses over
1,000 I.U. should be monitored by a physician. Increased blood calcium
levels can result from toxicity. In clinical practice, D3 appears to
benefit metastatic bone disease in higher doses, perhaps because this
vitamin is needed for normal calcification of bone matrix.
Food sources of vitamin D include cold water fish (salmon, mackerel,
herring), butter, egg yolks and dark green leafy vegetables. Sunlight
acting on the skin will also create vitamin D. In areas of decreased
sunlight, increases of breast and colon cancer have been observed.
DR. MYATT’S COMMENTS
Prostate cancer, especially early and mid-stage cancers in older
patients, respond favorably to natural remedies. Whether as an
adjuvant to conventional therapy or as the sole therapy, such
treatment strategies should be considered.
Cancer, including prostate cancer, behaves differently depending on
the age of the patient, the extent of the disease, the patient’s basic
level of health, hormone status, etc., etc. For this reason,
cancer patients should seek qualified
holistic medical help when designing a natural (adjuvant or
primary) treatment protocol.
[PHYSICIAN NOTE #1: Digestive enzymes (multi
enzymes), whether from animal sources (pancreatin, etc.) or
botanical (bromelain, papain),
have been shown to increase survival time, inhibit metastasis, and
stimulate immune cells. Enzymes induce differentiation and inhibit
angiogenesis, possibly through antifibrinolytic mechanisms. It has
also been postulated that enzymes may help unmask tumor cells and make
them more accessible to the immune system.]
PHYSICIAN NOTE #2:
Melatonin
is a hormone produced by the pituitary gland. It regulates circadian
rhythms and plays a role in sleep regulation. It is also a more potent
antioxidant than glutathione or vitamin E. In vitro, melatonin
demonstrates anti-estrogen activity and immune stimulation. Recent
research shows that melatonin inhibits cell proliferation profoundly
in vivo but only weakly in vitro. It is synergistic with IL-2 and
increases the effectiveness of IL-2 treatment. Dosages used are much
higher in cancer treatment than for insomnia or longevity protocols.]
Prostate Cancer: Case Studies
The following case studies are meant to highlight for the reader or
physician the effects of diet, hormone deprivation therapy, and
adjuvant therapy on prostate cancer. Information about new prostate
cancer blood tests, as well as new ways to interpret older tests, are
also given. Anyone with a diagnosis of cancer should be working with a
knowledgeable physician. Cancer can often be controlled through
non-invasive measures but regular blood tests are important to verify
the success of treatment. The interpretation of such tests is best
done in conjunction with a physician.
I am
available for consultation.
Case # 1: An otherwise healthy 65 year old male was found on
routine physical exam to have a PSA of 19.7. Digital rectal exam (DRE)
was unremarkable; Gleason score 2 + 3 on biopsy. Other relevant data:
weight 208 pounds, height 5’11", blood sugar 110, cholesterol 211,
triglyceride 244.
The patient had originally declined conventional treatment offered
him at the time of diagnosis. He began a self-prescribed regimen of
CoQ10, vitamin A,C,E, N-acetyl cystein and MGN3 (mushroom
preparation). In four months, his PSA was 14.0, other vitals remained
relatively unchanged.
At this point, the patient consulted me. I performed a PAP which
was 1.1, normal. I put the patient on a ketogenic diet (The Super Fast Diet), substituted
Maxi Muli
formula for his separate vitamins, added
Maxi Greens and vitamin D3. One month later, his PSA was 10.2,
weight 189, blood sugar 83, cholesterol 167 and triglycerides 43.
Dr. Myatt’s comments
PSA is an accurate marker of prostate cancer activity after the
diagnosis of cancer has been established. Any significant decreases of
PSA represent a slowing of the disease process, so this number can be
used in early and mid-stage prostate cancer to assess efficacy of
treatment. The patient’s initial decrease of PSA was due entirely to
his supplement regimen since no diet changes were made at that time.
After beginning
The Super Fast Diet,
the patient had a further decline in PSA, accompanied by significant
improvements in blood sugar, weight, cholesterol, and triglycerides.
After two months and four months, the patient’s PSA’s remain at 10.2.
A continuing decline is desirable, but this "holding pattern" is still
good.
The ketogenic diet made the most dramatic improvement in this case.
Not only did it result in further control of the cancer, but the
patient is now at lower risk for cardiac and other weight-related
problems as well. It is important to remember that a disease such as
prostate cancer rarely appears in isolation. Overall improvement of
the patient’s health is necessary to gain control of the disease and
minimize risk of other diseases. What good is it
to save a person from prostate cancer only to have them die of a heart
attack?
Case # 2: An obese (250 pounds+) 56 year old male with a
history of asthma was found on routine physical exam to have a PSA of
4.4 and a free PSA of 5.9, suggesting cancer. Biopsy confirmed the
diagnosis. During the first four weeks after diagnosis, the patient’s
PSA rose from 4.4 to 6.2, a rapid increase suggesting a possibly
aggressive cancer. The PAP was within normal limits, indicating no
lymphatic or extra-capsular spread.
The patient was advised to follow a
The Super Fast Diet (a ketogenic
diet), which would be expected to benefit both the cancer and asthma.
(Obesity is associated with an increased likelihood of asthma and
contributes a large hormone burden to the body because fat cells
manufacture estrogen. Estrogen is a growth factor for hormone-related
cancers including prostate cancer). The patient has thus far failed to
follow a ketogenic diet. Hormone deprivation therapy was initiated,
and this dropped the PSA to less the 0.1 in one month, indicating
current control of the disease. Since cancer cells eventually "escape"
hormone suppression, this treatment will not be expected to work
indefinitely. During this time, the patient will be encouraged to lose
weight, preferably on a ketogenic diet. I will continue to encourage
him to either have surgery or become more dedicated to a non-surgical
cancer control program. Prostate cancer is one form of cancer that is
highly amenable to diet and lifestyle modification if the individual
is willing to make some modest positive changes.
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References
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Foods of Special Benefit
Garlic
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arterial occlusive disease. Clin Investig 71:383-86, 1993.
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macrophage and T-lymphocyte function. Mol Biother 3:103-107, 1991.
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disease. Prev Med 19:346-61, 1990.
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natural killer cells. Fed Proc 46:441, 1987.
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cancer risk. J Natl Cancer Inst 2000;92(1):61–8.
5.) Kune GA. Eating fish protects against some cancers: epidemiological and
experimental evidence for a hypothesis. J Nutr Med 1990;1:139–44 [review].
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Pharmacol Ther 1999;83:217–44.
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and histopathologic features. Urology2001;58:47–52.
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human-patient BPH and prostate cancer in histoculture. Prostate 1998;34:75–9.
Body Weight (BMI) and Prostate Cancer
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Exercise and Prostate Cancer
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bone disease. J Clin Endocrinol Metab. 2008 Jan;93(1):2-7.
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how regular exercise might reduce the risk for clinical prostate cancer. Eur J
Cancer Prev. 2007 Oct;16(5):415-21.
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different measures of adiposity, and cancer mortality in men. Obesity (Silver
Spring). 2007 Dec;15(12):3140-9.
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reverse adverse effects of androgen suppression treatment in men with prostate
cancer. Prostate Cancer Prostatic Dis. 2007;10(4):340-6. Epub 2007 May 8.
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Multiple Vitamins and Cancer / Prostate Cancer
1.) Simone CB 2nd, Simone NL, Simone V, Simone CB. Antioxidants
and other nutrients do not interfere with chemotherapy or radiation therapy and
can increase kill and increase survival,
part 1. Altern Ther Health Med. 2007 Jan-Feb;13(1):22-8.
2.) Simone CB 2nd, Simone NL, Simone V, Simone CB. Antioxidants and other
nutrients do not interfere with chemotherapy or radiation therapy and can
increase kill and increase survival,
Part 2. Altern Ther Health Med. 2007 Mar-Apr;13(2):40-7.
3.) Moss RW. Should patients undergoing chemotherapy and radiotherapy be
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5.) Kristal AR, Stanford JL, Cohen JH, Wicklund K, Patterson RE.Vitamin and
mineral supplement use is associated with reduced risk of prostate cancer.
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Antioxidants (General) and Prostate Cancer
1.) Simone CB 2nd, Simone NL, Simone V, Simone CB. Antioxidants
and other nutrients do not interfere with chemotherapy or radiation therapy and
can increase kill and increase survival, part 1. Altern Ther Health Med. 2007
Jan-Feb;13(1):22-8.
2.) Simone CB 2nd, Simone NL, Simone V, Simone CB. Antioxidants and other
nutrients do not interfere with chemotherapy or radiation therapy and can
increase kill and increase survival, Part 2. Altern Ther Health Med. 2007
Mar-Apr;13(2):40-7.
3.) Kirsh VA, Hayes RB, Mayne ST, Chatterjee N, Subar AF, Dixon LB, Albanes D,
Andriole GL, Urban DA, Peters U; PLCO Trial. Supplemental and dietary vitamin E,
beta-carotene, and vitamin C intakes and prostate cancer risk.J Natl Cancer
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and experimental cancer therapies and decrease their toxicity. Integr Cancer
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systematic review of trace elements and vitamins in the critically ill patient.
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chemotherapy. Gynecol Oncol. 2003 Mar;88(3):434-9.
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high-dose multiple micronutrients as an adjunct to standard and experimental
cancer therapies. J Am Coll Nutr. 2001 Oct;20(5Suppl):450S-463S; discussion
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Vitamin A , Carotenes and Prostate Cancer
1.) Wu K, Erdman JW Jr, Schwartz SJ, Platz EA, Leitzmann M,
Clinton SK, DeGroff V, Willett WC, Giovannucci E.Plasma and dietary carotenoids,
and the risk of prostate cancer: a nested case-control study. Cancer Epidemiol
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Lower prostate cancer risk in men with elevated plasma lycopene levels: results
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of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer
Inst. 1995 Dec 6;87(23):1767-76.
4.) Majewski S, Szmurlo A, Marczak M, Jablonska S, Bollag W.: Synergistic effect
of retinoids and interferon alpha on tumor-induced angiogenesis: anti-angiogenic
effect on HPV-harboring
tumor-cell lines.Int J Cancer. 1994 Apr 1;57(1):81-5.
Vitamin C and Cancer / Prostate cancer
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[review].
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Vitamin D and Prostate Cancer
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Saw Palmetto (Actions)
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Chaste Berry (Vitex) Actions
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