Prostate cancer diets and the use of supplements have continued to be an issue faced by men fighting advanced prostate cancer. Different products seem to fall in and out of vogue; unfortunately we usually have little actual hard data on the real value of any of these products.
The use of pomegranate with the goal of extending PSA doubling time (PSADT) (the amount of time it takes for the PSA score to double in size…. 2 to 4; 4 to 8 etc.) is one of these issues that has been debated over the last four to five years. The initial, small study of the use of pomegranate was performed at UCLA. This study confirmed that pomegranate did extend the PSADT, but many individuals discounted the study because of its very small size and because it was funded by POM Wonderful, one of the major manufactures of pomegranate juice and extract.
At today’s Genitourinary Cancers Symposium, Carducci et al. will report data from a randomized, multi-center, double-blind, Phase II clinical trial that compared two different doses of POMx capsules in men with a rising PSA after primary treatment who wished to delay starting androgen deprivation therapy (ADT).
The trial randomized men who had a rising PSA but no metastases. The men received either high-dose (3 mg/d) or low-dose (1 mg/d) of POMx. The men were stratified based on their baseline PSADT values and their Gleason scores; however, there were no restrictions on PSADT and no upper limit PSA scores. The end points were until disease progression or for 18 months. PSA scores were recorded every 3 months. This study was designed to detect a 6-month increase in PSADT from baseline.
The results of the study, as presented in the study abstract, are as follows:
• 104 men were enrolled and treated for up to 6, 12, and 18 months (92, 70, and 36 percent of men respectively).
• The men were 96 percent white, had a median age of 74.5 years, and a median Gleason score of 7.
• The average (median) PSADT was 11.9 months at baseline with a range of 1.6 to 54.6 months compared to 18.5 months
with a range of 2 to 1,523 months after treatment (p < 0.001).• There was no significant treatment difference in effect on PSADT between the two dose groups (p = 0.920).• Declining PSA levels were observed in 13/104 men (13 percent) during the study.• There were no significant changes in serum testosterone levels in either group.• Mild to moderate diarrhea was seen in 8/104 men (7.7 percent).Carducci and his colleagues conclude that, “POMx treatment significantly increased the PSADT by over 6 months in both treatment arms, with no effect on testosterone.”This study concludes that pomegranate extract has some clinically positive effect on the PSADT. It also shows that the lower dosage of POMx is equally as effective as the higher dosagePOM Wonderful recently was prevented by the FDA from promoting the supposed positive effects of POMx on PSADT because of the lack of clinical evidence. This trial will not change the FDA’s perspective.The only supplement that I have personally used and continue to use is POMx. This study does support my non-scientific belief that POMx does extend PSADT, at least in men with a rising PSA but no indication of bone metastasis.I also wish to add that I still remain concerned that not all supplements are created equal. The FDA does not regulate the manufacturing process of supplements and often there is little or no quality control by the manufacturer. I do believe that POMx does make a legitimate product and does have reasonable quality controls in place.Joel T. Nowak, M.A., M.S.W.
My father was dx with PC in 2004 and had radical prostatectomy he had radiation and hormon therapy up until 2009 in September 2009 till December 2009 he had chemo and than again another chemo in July till September 2010, his PSA dropped with the last infusion. But than it started rising every month as follows:11/22/10 psa 0.7;12/20/10 psa 1.6;01/24/11 psa 3.2;
02/13/11 psa 4.6; 03/11/11 psa 8.8, than I read that Pomegranate might me a good supplement, since he was not getting any treatment for his PC because he had other infection that needed to be treated, we were expecting a very high PSA however surprisingly the last reading of his PSA test that was done 05/03/2011 was 6.8.
He was eating fresh pomegranate for almost a month from end of march until 23rd of April one pomegranate per day.
Could this pomegranate consumption be the result of the PSA drop?! it is a significant drop of 2 points for month and a half (8.8 to 6.8) with no other treatment!
The doctor is not for the pomegranate consumption since the last study showed that 30-40% of man had their PC worsened.
Can you please comment on this so we can decide if my father should continue to consume pomegranate (fresh), extract pills are not available in europe.
Bianca – I am an advocate for taking pomegranate. I am not familiar with the research you cited about 30-40% of men had there PC made worse. Will you please send me a link to this study.
We asked for a second opinion from a urological oncologist from US Dr.Nordquist in March since we had to decide on my fathers treatment and were very anxious since his PSA was doubling every month, i asked about the pomegranate during our consult about the second opinion and he also mentioned it in his review – second opinion.
With the recent developments of PSA decrease from 8.8 to 6.8 we asked for an additional comment since my father was not getting any treatment for his PC except the fresh pomegranate for a period of about 4 weeks in between the PSA tests.
The comment that we got from Dr. Nordquist was that pomegranate might affected the decrease but we need to be careful since the last study showed a significant portion of men had their PC worsened – or maybe he thought PSADT shortened also he referred to the presentation of the study results presented by Dr. Michael Carducci at the ASCO GU 2011 meeting.
So I googled the event and this is the link: http://www.medpagetoday.com/MeetingCoverage/ASCOGU/24941
Towards the end of the article there is a discussion that might be concerning.
Thanks for the study, I had missed that one. I am going to spend some time with it, maybe follow up with the researchers. At first read it was clear that some men do have a longer PSA doubling time and are probably also getting a benefit (at least in the slowing down of the PSA which as the article pointed out might not be at all related to survival). Quick response is that he needs to closely monitor PSA scores in this in-between time. If his numbers stay down then he might well be having a positive response to the pomegranate. If that changes, then he will need to stop it. Pomegranate is not usually know to lower PSA, but to slow downing the doubling rate. So, is it responsible for his PSA decline? Who knows.
I am sending you by email an invitation to join the advanced prostate cancer on-line support group where we have over 600 caregivers and survivors sharing information, ideas and experiences about this disease. Feel free to join us.
We have decided to wait additional 4 weeks before we get on with a treatment, my father has given blood today for another PSA check so we are anxious to see the results on Wednesday.
Please revert back with the additional info on this study!
my father’s new PSA from Monday 05/09 was 6.1
Do you know if anything else would be trigger to lower psa?
Have you had a chance to review the study.
Possibly collard green consumption might be looked at as a way of slowing down prostate cancer. I have no clinical proof but have read several articles online that speak of it seeming to ward off or slow down PC. During many years when our diet was heavy in collard greens, my significant other’s prostate cancer was pretty well controlled [which I know is not evidence and does not prove anything but i is the truth.] However I do no know if collards lower PSA. But his PSA was lower than. Could just be a co-incidence. He has now started consuming these greens again hoping there MIGHT be some benefit even in his current very advanced situation. If anyone has information about collard greens and other members of the cabbage family in this regard, we would like to know.
Mr. Nowak, my significant other and I would like to join the on-line support group for advanced prostate cancer. He has advanced metastatic disease and is having quite a rough time.
If you write me at my e-mail address I will give you the patient’s e-mail and name. We would both like to join if that is possible. He has had this for 22+ years. Until 2 years ago he was able to control it with diet and supplements but at that point the original tumor died and it was replaced by a new, much more aggressive tumor which is large & inoperable.
Thanks for any insights you may have.Ann