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Old 03-06-2008, 10:39 AM   #1
IADT3since2000 IADT3since2000 is offline
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Nutrition & lifestyle tactics - books, resources and quick summary

Shortly after I was diagnosed with a challenging case of prostate cancer in December 1999, I was glad to learn there were some tactics I could employ on my own that would probably help me battle the cancer. The tactics involve nutrition, diet, certain supplements, exercise and stress reduction. Though none of the evidence is completely conclusive at this point, it is still reasonably strong for some of the tactics. I continue to follow developments closely, but I am just a fellow survivor with no enrolled medical education, so use the following for leads and information but not as authoritative medical recommendations.

There is an over abundance of information about such tactics available electronically, much of it good, much of it not. I'm convinced the leading expert in nutrition and lifestyle to aid our battle against prostate cancer is Dr. Charles "Snuffy" Myers, MD, a medical oncologist specializing in prostate cancer who has battled his own challenging case of PC. Dr. Myers has authored or co-authored two books for laymen on this subject: "Beating Prostate Cancer - Hormonal Therapy & Diet," 2006, and, with his wife, a PhD, and sister-in-law, "Eating Your Way to Better Health -
The Prostate Forum Nutrition Guide," 2000. The former book has updated information, including a long discussion of vitamin D and its important role against prostate cancer, as well as information on exercise and stress reduction.

Another good but now somewhat dated book is Dr. Bob Arnot's (MD) "The
Prostate Cancer Protection Plan," 2000 (to which Dr. Myers contributed). While it is now eight years old, most of the information is still worthwhile.

Another helpful book is by Dr. Daniel W. Nixon, MD and Max Gomez, PhD, "The Prostate Health Program - A Guide to Preventing and Controlling Prostate Cancer," 2004.

Dr. Mark Moyad, MD, also has published on nutrition, lifestyle and prostate cancer, but he is quite conservative in his recommendations, wanting to see very solid evidence before recommending something, though sometimes surprisingly taking a flyer without good evidence at all, such as when he recommended flaxseed oil a few years ago, a recommendation he has since reversed. Dr. Moyad is like a conventional doctor who is very knowledgable on nutrition but not at the leading edge. In that sense, what he recommends gives you an idea of where conventional doctors should be if they were to invest the time and devote the attention needed to follow developments.

You can do your own review of scientific research by going to the US
Government web site _www.pubmed.gov_ ([url]http://www.pubmed.gov[/url]) and searching for topics like " lycopene AND prostate cancer ". You'll see evidence for and against each, though my impression is that the trend of evidence is usually fairly clear as you read through the abstracts.

A recent intensive study of the world's medical literature concluded that there were no nutritional elements that conclusively either acted against or promoted prostate cancer, though there were several that "probably" were involved or "possibly" were involved, based on two lesser categories of evidence. That 517 page report is the "World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007." Their expert panel was clearly taking a conservative view, basically setting up a "Good Housekeeping Seal of Approval" type service for nutrition and cancer. The panel found probable benefit from lycopene and selenium foods and selenium supplements as well as possible benefits from legumes, vitamin E foods, and vitamin E supplements. The panel found probable increased risk from high calcium diets and possible increased risk from processed meat and from milk and dairy products. The panel found an unlikely effect on risk from beta carotene food and supplements.

Here's a brief rundown of the most mentioned nutritional items.

Vitamin D3 - most PC patients are deficient in vitamin D, and accumulating evidence suggests vitamin D is very important for success against prostate cancer. The level can be measured with a simple blood test known as 25-hydroxy vitamin D, and the doctors I follow recommend a level between 50 and 80 ng/ml. I gave some detail about this on 02-05-2008, 11:27 AM under the thread "Should we be concerned?" This is particularly important for African Americans because dark skin is so effective in filtering sunlight, which is unfortunately not a good thing regarding vitamin D. Dose recommendations vary, with most doctors I follow recommending between 1,000 to 4,000 units per day, adjusted according to test results, but some recommending up to 8,000 IU per day in order to achieve better test levels. For those who are severly deficient, there is an approved FDA medication that provides 50,000 units. It is possible to overdose, but it is difficult for most of us to do that, and tests to monitor your level ensure that you are in the good range. Before research published in 1999 by Dr. Reinhold Vieth of the University of Toronto, there was a lot of concern about overdosing and a lack of appreciation for the importance of vitamin D, but that has changed a lot over the past decade.

Selenium - 200 mcg per day is the usually recommended dose of this inexpensive supplement. That dose appears quite safe, though there is some preliminary evidence that those with diabetes, insulin resistance or a higher risk of those conditions might be increasing their risk by taking selenium. The recent thread "Cracking the selenium out of Brazil nuts and a safety issue" has further information.

Lycopene - about 30 mg per day is recommended, broken up into several portions a day, and easy sources are tomato or V8 juice and tomato paste (such as in cocktail sauce), and generally stewed or cooked tomatoes.

Vitamin E, especially vitamin E including some gamma tocopherol - 200 IU per day is now recommended. Vitamin E and selenium appear to work together.

Pomegranate juice or extract - a clinical trial by a prestigious team from UCLA demonstrated some remarkable benefits involving patients with recurring prostate cancer patients, who drank high quality pomegranate juice, in clinical trial results published in July 2006. Now an extract is available in capsule form made from the same mix of pomegranate elements that the team researched in the juice. This is exciting research, but the study was funded by the manufacturer of the juice, and it would be reassuring to have a confirming study.

Fish (particularly fatty fish like salmon, herring and sardines) three to four times a week and fish oil, especially for omega 3 fatty acids.

Green tea, especially with a little lemon juice or other source of acid to preserve the potency of green tea's beneficial elements. Two to four cups per day is recommended.

Eating a variety of fruits and vegetables. I'm particularly impressed with claimed benefits from eating broccoli and broccoli sprouts.

Avoiding red meat (including pork), mainly because of a high level of arachidonic acid, which fuels prostate cancer.

Avoid egg yolks.

Avoiding dairy food - milk, cheese, butter, apparently because of the main milk proteing casein, which appears to be a problem for cancer generally and specifically for prostate cancer.

Avoiding flaxseed oil and canola oil, both of which are potent sources of alpha linolenic acid, which aids the growth of prostate cancer cells. Younger women have no problem with these oils, and they appear to help protect against breast cancer and foster cardiovascular health, but they are not a good idea for men, who do not metabolize them well. Olive oil is fine instead of vegetable oil.

Getting aerobic and strength exercise are beneficial, especially 30 - 40 minutes at least three times a week.

Reducing stress, even going as far as meditation, appears helpful.

Taking mild medications like finasteride or Avodart and a statin drug also appears beneficial.

These are most of the main elements. While some of it may seem like the usual pablum - "Take two aspirin, drink plenty of fluids, and stay in bed." - there is good research supporting each of the recommendations.

Jim