LE Magazine June 2003
Reducing Prostate Cancer Deaths
Through Prevention and Early Diagnosis
by Stephen B. Strum, M.D.
Medical Oncologist Specializing in Prostate Cancer
Co-Founder and First Medical Director of the Prostate Cancer Research Institute
When AA is formed or ingested (e.g. red meat and egg yolk) it undergoes metabolism by the cyclo-oxygenase (COX) and lipo-oxygenase (LOX) enzymes. A vast part of the biotech industry has been dedicated to the development of COX inhibitors ranging from non-specific drugs like aspirin to ibuprofen to more selective COX 2 inhibitors like Celebrex and Vioxx. We can naturally shift the eicosanoid pathways away from AA production by dietary maneuvers that avoid excessive carbohydrate intake and the resulting insulin stimulation. This is the basis of the Zone diet and the Atkins diet. Referring to Figure 2 and focusing on the pathway between DGLA and AA (shown in green), we can direct our attention to dietary and pharmacologic approaches that prevent overproduction of AA or inhibit AA production. If we neglect this pathway, overproduction of AA occurs. AA is an omega-6 fatty acid that generateds free radicals that cause cell injury. Specific metabolic products of AA such as PGE2 and 5-HETE are created through the actions of the enzymes COX-2 (cyclo-oxygenase 2), 5-LOX (5-Lipoxygenase), 12-LOX, and 15-LOX. These metabolites are examples of bad eicosanoids and have been implicated in PC growth and metastasis.27,28 In a study of human PC where 5-LOX and its metabolite 5-HETE were evaluated in malignant versus benign prostate tissue within the same patient, both 5-LOX and 5-HETE were significantly over-expressed in the PC tissue.29 In other words, specific eicosanoids are modulators of tumor cell interactions with certain host components within the context of cancer growth, invasion and spread. What the layperson can do to inhibit AA is to reduce insulin-stimulating carbohydrate ingestion and to use a high quality of EPA/DHA to inhibit the AA pathway. These approaches are the basis for Barry Sears' latest book called The Omega Rx Zone.30
Figure 2. The Eicosanoid Pathways
The pathways to good versus bad eicosanoids are dictated by whether DGLA metabolism favors arachidonic acid (AA) production and the generation of bad eicosanoids, or instead is shunted preferentially toward favorable eicosanoids of the PG1 series (PGA1 and PGA2).
Other products that appear to play a potentially significant role in prevention and treatment of PC include soy isoflavones such as genistein and daidzein, the grape anti-oxidant known as reserveratrol,31-35 the curcuminoids found in the spice turmeric (curcumin),36-39 and a substance in various teas such as green tea called EGCG (epigallocatechin gallate).40-44 Future issues of Life Extension magazine will address these areas.
There have been tens of thousands of articles written about PC. The number of medical journals keep increasing and with it an exponential increase in information about this disease, as well as its relation to other illnesses. The monumental task of the physician, especially in today's bizarre world of medical economics, is to keep up with this literature as best as possible and whenever applicable to translate what is being learned to the patient's active care. This is the heart and soul of translational medicine: applying what we are learning by taking the research findings to the "bedside" of the patient.
I would make a plea, to all men and their loved ones, based on 40 years of watching the evolution of medicine and the outcomes of thousands of men with this disease, that active participation of the patient and his partner is critical to an optimal outcome. In the best of all worlds, this should involve co-partnership with the physician but this is not occurring. Instead, the physician is becoming increasingly distant from the patient and his partner as he is overwhelmed with the constraints of managed (mangled) care, huge overhead costs, and an increasingly complex life bureaucracy. Given such a setting, the empowerment of the patient and his partner(s) must become a common phenomenon. Access to the Internet and to other sources of information geared to the patient and his partner may enable the concept of translational medicine to survive and hopefully be brought to its rightful place in the lives of many men and their families. This was the reason that Donna Pogliano and I spent years creating A Primer on Prostate Cancer, The Empowered Patient's Guide.
The efforts of many thousands of physicians and researchers throughout the world have provided us with the opportunity to significantly reduce death and morbidity caused by PC. What is most critical for you is to initiate the actions needed to bring these efforts to fruition and have them become a life-long lifestyle change. You owe it to yourself and your family to initiate such steps if you have not already done so. This can save your life.
Stephen B. Strum, M.D.
Ashland, Oregon 2003
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