Prostate Cancer Prevention
New Study Reveals Four Nutrients that Lower PSA and Slow Cancer Progression
Prostate cancer is a leading cause of cancer death among men. Yet, only about 15% of new prostate cancer diagnoses require immediate and aggressive treatment (Bastian 2012; CDC 2013b).
The majority of newly diagnosed prostate cancer cases have low- or intermediate-risk malignancies. For men with low risk malignancies, oncologists sometimes practice “watchful waiting” or “active surveillance,” monitoring parameters such as prostate-specific antigen (PSA) to evaluate tumor progression (Loeb, Berglund 2013; Bul 2012). This approach can delay the need for aggressive treatment, and in many cases is turning out to reduce or eliminate the need for surgery, chemo-, or radiation therapy (Loeb, Berglund 2013).
During this period of watchful waiting, there is an additional option that has been shown to lower PSA. A landmark study from the United Kingdom has demonstrated that a combination of four foods—a fruit (pomegranate), an herb (green tea), a spice (turmeric), and a vegetable (broccoli)—concentrated into a pill, dramatically slowed markers of prostate cancer growth by a median of nearly 64% (Thomas 2013).
Working closely with the National Cancer Research Network, this formula was developed based on extensive documentation showing how certain foods function to slow prostate cancer growth. We begin this report with a critical review of this groundbreaking study conducted on human prostate cancer patients.
Landmark UK Study: Food Pill Slows Evidence Of Prostate Cancer Growth
In June of 2013, the American Society of Clinical Oncology included in its program a report on a “food pill” that had a dramatic impact on men with prostate cancer (Thomas 2013). For those who don’t know, the annual conference of the American Society of Clinical Oncology (ASCO) is where many cancer treatment breakthroughs are announced to the world.
The study reported at the ASCO conference was an exploration of the role of four polyphenol-rich foods with known anti-cancer properties (Thomas 2013). The trial development team worked in partnership with the UK government’s National Cancer Research Network, which ensured the highest scientific credibility and quality assurance. They extensively scrutinized the clinical and laboratory data for foods that have a high chance of an anti-cancer effect. They came up with a specific blend of four cancer-fighting foods concentrated into a capsule designed to be taken twice daily. They then set out to test its effect in the most rigorous of scientific trials—a double-blind placebo-controlled randomized trial within which they examined its effect on prostate-specific antigen, or PSA.
The researchers recruited 203 men aged 53 to 89 years (average age 74 years) with prostate cancer proven by biopsy (Thomas 2013). Fifty-nine percent of the men had not yet undergone any treatment and were being followed closely with periodic PSA measurements, while 41% had already had a radical intervention (surgery, chemotherapy, or radiation) but had relapsed with climbing PSA levels.
The subjects were then randomly assigned to receive either a twice-daily oral capsule containing a blend of pomegranate seed, green tea, turmeric, and broccoli, or an identical placebo for 6 months. At baseline, there were no significant differences between the two groups, except that the placebo group was on average 4 years older than the treatment group. Neither the doctors supervising the trial nor the men knew whether they were taking a placebo or the test product.
The men in the study had their PSA levels measured at baseline, at 3 months, and at 6 months, to determine the rate of rise. The results were remarkable.
In the placebo group, PSA levels rose by a median of 78.5% over the 6-month period, while in the supplemented group, PSA rose by a median of only 14.7%, a statistically significant 63.8% difference (Thomas 2013).
In addition, and importantly, 46% of men in the supplemented group had a stable or lower PSA by the end of the study, compared with just 14% of the placebo group; again, this was a significant difference, and suggested that in nearly half of the treated men, their cancers had stopped growing or had even regressed.
In another remarkable measure, just 7.4% of supplemented men being monitored by active surveillance or watchful waiting required a change in management plan, while 26% of those in the placebo group required a change in their management plan (Thomas 2013). In other words, the supplement directly supported the decision to defer care and avoid painful, costly, and invasive procedures in this group of men.
Following the success of this trial, the research team is designing a range of new scientific trials involving this unique fruit and vegetable blend collaborating with academic cancer centers across the world. These include men already taking androgen deprivation therapies, or those in PSA remission following successful primary treatments such as surgery, brachytherapy, or radiotherapy. They are also partnering with clinicians outside the urology cancer field to determine its effect on osteoarthritis, chronic breast pain, hot flushes, and even tinnitus, and hopefully the results of these trials will be available by early 2015.
Let’s now look more closely at each of the ingredients in this new prostate-cancer-fighting food pill, to see what each one brings uniquely to the formula and how each reinforces the other to reduce the risk of prostate cancer progression.
Pomegranate compounds suppress enzymes in the intestine and liver that convert certain molecules (procarcinogens) into cancer-causing agents (Faria 2007; Saruwatari 2008). As it relates to those with prostate cancer, the active constituents in pomegranate have proven to be potent inducers of malignant cell death through apoptosis (Vicinanza 2013; Sineh Sepehr 2012; Lee ST 2012; Gasmi 2010; Adhami 2009; Pantuck 2006; Malik 2006; Malik 2005; Albrecht 2004).
During the development of androgen independence, prostate cancer cells are known to increase testosterone synthesis inside their own cells, which maintains cancer cell growth in the absence of significant amounts of circulating testosterone. Overexpression of the androgen receptor occurs in androgen-independent prostate cancer and has been proposed as another mechanism promoting the development of androgen independence. Pomegranate has been shown to inhibit expression of the androgen receptor and androgen synthesizing genes in prostate cells, which helps block an important survival mechanism utilized by prostate cancer cells to escape eradication (Hong 2008).
Multiple basic laboratory and human studies have demonstrated that pomegranate treatment, specifically various active compounds, slows PSA doubling time and reduces production of PSA in malignant prostate cells (Adhami 2009; Malik 2006; Paller 2013; Seeram 2007).
In one recent study, pomegranate juice treatment in men with rising PSA after surgery or radiotherapy resulted in a significant delay in PSA doubling time (the time it takes PSA levels to rise) from a mean of 15 months before treatment to 54 months following supplementation (Malik 2006). Another study found a more modest, but still significant delay in doubling time, from 11.9 months to 18.8 months (Paller 2013).
Animal studies demonstrate additional anti-cancer activity in pomegranates. In a specialized mouse model of prostate cancer, 100% of untreated mice developed palpable tumors within 20 weeks, compared to as low as 20% in the group treated with pomegranate extract; the treated animals lived for up to a median of 92 weeks, more than twice as long as the 43 weeks survived by untreated mice (Adhami 2012).
These remarkable results are observed in part because naturally occurring pomegranate polyphenols are concentrated in prostate tissue, facilitating their protective effects (Seeram 2007). Once in the prostate, these polyphenols selectively inhibit cancer cell proliferation, leaving healthy prostate tissue relatively unaffected (Sineh Sepehr 2012; Hong 2008). This is a potential “epigenetic” effect: pomegranate polyphenols decrease the expression of proteins that cancer cells use to support their rapid rate of replication (Gasmi 2010; Malik 2005; Albrecht 2004; Selvi 2010).
Added prostate cancer-fighting benefits of pomegranate include reduction of the inflammation that drives cancer progression, suppression of new blood vessel growth within a forming prostate tumor, and increased expression of genes that keep cells clumped together normally, thereby inhibiting the invasive potential of prostate cancer (Pantuck 2006; Sartippour 2008; Wang 2012; Pitchakarn 2013).
Green tea makes a unique contribution to the prostate-cancer-fighting pill as a result of a special combination of naturally occurring polyphenols called catechins (Connors 2012; McCarthy 2007; O’Sullivan 2008; Pezzato 2004).
Studies show that one of green tea’s catechins, EGCG, accumulates specifically in prostate tissue, where it selectively kills cancer cells (leaving healthy cells unaffected) and reduces serum PSA levels (Henning 2006; Bettuzzi 2006; Pandey 2009; McLarty 2009; Siddiqui 2006; Chuu 2009).
In a further demonstration of the cancer-suppressing role of green tea, when researchers studied men with a pre-cancerous condition called prostate intraepithelial neoplasia, they found only one tumor after one year in the 30 men given green tea polyphenols, while the 30 placebo recipients developed nine cancers (Bettuzzi 2006). The treatment was safe, and as an extra bonus was found to reduce other lower urinary tract symptoms as well.
Green tea is already acknowledged as a cancer preventive in Japan because of epidemiological studies documenting prostate cancer risk reduction of up to 86% in men who drink the most green tea (Pandey 2009; Fujiki 2012; Jian 2007; Kurahashi 2008).
Laboratory studies point to still other anti-cancer effects from green tea. Its components reduce genetic expression and activity of androgen receptors that most prostate cancers need to survive (Chuu 2009; Harper 2007; Siddiqui IA 2011; Lee YH 2012). Green tea also induces human cancer cell death by apoptosis through a variety of epigenetic mechanisms (Pitchakarn 2013; Gupta 2012; Hagen 2013). And recent studies reveal polyphenols in brewed green tea shut off new blood vessel growth, important in slowing cancer development (McCarthy 2007).
Turmeric’s unique contribution to the prostate-cancer-fighting pill is its extraordinary anti-inflammatory properties, provided chiefly by its natural primary component, curcumin (Dorai 2001; Gupta SC 2013). Reducing inflammation with curcumin reduces the metastases that ultimately kill prostate cancer patients (Rao 2012; Cheng 2013; Killian 2012; Sundram 2012). Curcumin also down-regulates genes involved in adhesion, motility, and invasiveness that prostate cancer cells need to invade and spread (Herman 2009).
Curcumin specifically inhibits prostate cancer cell production of PSA by blocking its genetic expression (Yang 2005; Chung 2011). At the same time, it also reduces activation of the androgen receptors on cancer cells that trigger increased production of PSA (Tsui 2008; Choi 2010).
But the whole turmeric root also contains important oils and other substances that enhance curcumin’s absorption and have health benefits of their own, including anti-cancer actions (Aggarwal 2013).
Turmeric’s components also inhibit cancer cell proliferation, restore cancer cells’ ability to die normally by apoptosis, and decrease the density of blood vessels needed for tumor expansion (Dorai 2001). By modulating cell signaling mechanisms, curcumin arrests the out-of-control cell replication cycle typical in cancer (Teiten 2011; Guo 2013).
Curcumin also sensitizes cancer cells to chemo- and radiation therapy, as well as to the intrinsic “death factor” called TRAIL (TNF-related apoptosis-inducing ligand), one of the body’s natural cancer-suppressing mechanisms (Shankar 2008; Chendil 2004; Goel 2010). Remarkably, these sensitizing effects are not found on normal, healthy cells, so they remain protected during treatment (Goel 2010).
The compound has also been found to block growth factors and androgen receptors used by cancer cells to support themselves (Hung 2012; Shah 2012; Teiten 2012).
Broccoli’s unique contribution to the prostate-cancer-fighting pill is its ability to up-regulate phase II detoxifying enzymes in gut and liver tissue, enabling the body to render harmless thousands of potentially carcinogenic molecules in our diet (Clarke 2011; Rogan 2006; Joseph 2004; Abdul Razis 2013). In addition, the naturally occurring sulfur-rich broccoli constituents sulforaphane, indole-3-carbinol (I3C), and others have now been identified as potent epigenetic regulators (Clarke 2011; Dashwood 2007; Myzak 2007; Myzak 2006).
These broccoli compounds control enzymes called histone deacetylases (HDAC) that regulate the genes encoded in DNA—including those responsible for promoting or suppressing cancer formation (Clarke 2011; Dashwood 2007; Myzak 2007; Myzak 2006). Known collectively as histone deacetylase (HDAC) inhibitors, such molecules are prime objectives of Big Pharma (Gryder 2013; Stettner 2012).
Men with high consumption of broccoli and other cruciferous vegetables have a 40% lower risk of invasive prostate cancer (Kirsh 2007). And in animal studies, broccoli feeding reduced prostate tumor weight by 42% in prostate cancer-prone mice and suppressed growth of implanted human prostate cancer cells by 40% (Myzak 2007; Canene-Adams 2007).
Broccoli compounds reduce PSA production as a result of slowing prostate cancer cell replication in laboratory cell culture models (Zhang 2003; Chiao 2002; Han 2007). They appear to inhibit expression of the androgen receptors that prostate cancer needs to survive (Chiao 2002).
Broccoli’s other prostate cancer-fighting properties include inhibition of growth and transcription factors that are activated in malignancies, restoration of normal tumor suppressor genes, and increased production of apoptosis-inducing proteins (Traka 2010; Melchini 2013; Hahm 2010; Choi 2005; Ho 2009; Traka 2008).
Prostate cancer is a paradox: Its typically slow growth rate makes it possible to treat if discovered early, but once it has metastasized, it is often lethal.
The combination of four widely-recognized cancer-fighting foods, pomegranate, green tea, turmeric, and broccoli, in a single twice-daily pill has now been shown to significantly reduce the rate of rise of PSA, the tumor marker that indicates progression and invasion of prostate cancer (Thomas 2013).
This new pill appears to work by providing cancer-suppressing actions at a wide variety of targets. All of this pill’s components have the capacity to cause favorable epigenetic changes, reversing the gene damage that leads to cancer development and restoring normal cancer suppression mechanisms (Gasmi 2010; Malik 2005; Albrecht 2004; Connors 2012; Gupta 2012; Hagen 2013; Herman 2009; Clarke 2011; Dashwood 2007; Myzak 2007; Myzak 2006).
In a tightly controlled clinical trial, putting them together in a single pill was shown to be effective at slowing the growth of existing prostate cancers and preventing surgical and other side effect-prone procedures.
If you or someone you know suffers from prostate cancer, or is interested in preventing it, this new functional food pill, or its individual constituents, should be part of their daily program.