Here is major news hot off the press, released at 6 PM this evening by the ASCO (American Society of Clinical Oncology) Genitourinary Cancer conference. They have published it as Abstract No. 11, and it was judged so important that it has been selected in the special group for oral presentation when the conference actually begins in a couple of days.
A group led by highly respected researcher Dr. Michael A. Carducci of Johns Hopkins' famed prostate cancer research group conducted a Phase II study using one of the most studied brands of pomegranate extract (POMx). Their goal was to see if results from the extremely encouraging Phase II trial led by Dr. Pantuck (UCLA) could be confirmed. That trial found that men with a rising PSA from recurrent cancer, who had an average PSA doubling time (PSADT) of 15 months at the start of the two year study, increased that doubling time to an average of 54 months. (A subgroup that continued on the regimen experienced a greater increase to 88 months! )
The Carducci team, led a multi-institutional study, randomized and double-blind (neither supplement administrator or patient knew whether the supplement was POMx or a placebo) involving 104 men (about double the size of the UCLA trial, as I recall it). The men as a group had higher risk disease features than the men in the UCLA trial.
They assessed results every three months up to eighteen months; 92% of the patients had at least six months of treatment; 70% had at least twelve months; and 36% had the full eighteen months. Thus, the patients did not get POMx for as long as the patients in the UCLA study, and the length of time makes a difference according to the data we now have. That suggests that longer exposure than in this trial to date would produce even better results.
The Carducci team's result was that the median (average) PSADT increased from an average of 11.9 months to an average of 18.5 months, which met the test for statistical significance. Moreover, 13 patients (13% of the whole group) were not counted in these figures because their PSAs actually declined! The final concluding sentence of the abstract states: "... This IND-conducted study confirms slowing of PSADT after treatment with POMx [the extract] as was found with POM [the juice], yet in a PCA patient population with greater high risk progression features."
This does not mean that pomegranate juice or extract are a substitute for therapy when therapy is needed. But it goes a long way toward proving that pomegranate can be an important element in our approaches to countering prostate cancer.
I'm delighted with this independent confirmation by a highly respected institution and principal investigator of a substantial impact of pomegranate on prostate cancer!
Words and icons are just not sufficient to convey the importance of this confirming study to the prostate cancer community or to relay the excitement in this wonderful news!
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I started on pomegranate juice the moment I read some other fellow Pc sufferers were on it.
Currently I am grappling with the statement that hormonal therapy will "almost, always become ineffective after usually 2 years" for metastatic cases like mine. And I am doing my darnest to ensure that my case will fall outside the 'almost' category.
Last edited by Administrator; 02-16-2011 at 10:21 AM.
I'm responding to your post #4. I am a fellow survivor who has had no enrolled medical education. Therefore, what I am relating below, is a capsule summary of the views I've heard experts express. In my opinion the best guide for advanced and metastatic patients is "Beating Prostate Cancer: Hormonal Therapy & Diet," by Dr. Charles "Snuffy" Myers.
Originally Posted by Lklklo
...Currently I am grappling with the statement that hormonal therapy will "almost, always become ineffective after usually 2 years" for metastatic cases like mine. And I am doing my darnest to ensure that my case will fall outside the 'almost' category.
Do you know where that quotation comes from? I believe the statement is close to the truth for patients treated in the past with obsolete hormonal blockade tactics, but I suspect that the statement is not true for many patients with well-done hormonal therapy plus countermeasures, perhaps supported by additional therapy, such as a short course of chemo.
I just refreshed my impressions with a look at www.pubmed.gov for cases like yours. I came away with these thoughts:
- There is not much research on the prognosis for metastatic patients on hormonal therapy.
- At least one study I looked at - I suspect most studies - look way backward for their data, back to the time when monotherapy (single drug or castration hormonal blockade) was the approach.
- It appears that countermeasures for side effects of blockade were not considered and were probably not used for patients whose results were tabulated in research studies. The most obvious countermeasure would be protection of bone density with a bisphosphonate drug plus associated calcium and vitamin D supplementation. This is one countermeasure that is very important to our welfare and survival!
- There appears to be no formally published research coverning combined blockade for men with metastases that also includes sound use of countermeasures. I'm certain there is no published research on triple blockade for such patients.
Based on these observations, I'm convinced that no one has published research showing what happens to metastatic patients on hormonal therapy where a sound approach and countermeasures for side effects were used. I'm convinced that triple blockade is the approach that should be used for such men. Based on the opinions of the experts, backed by their clinical practice, the dose of the antiandrogen, bicalutamide, should be 150 mg, not 50 mg. Monitoring should include PSA (ultrasensitive PSA when the level falls below .1), testosterone (less than 20), DHT (less than 5), and at least initially a liver function test to make sure the bicalutamide is not injuring the liver (rare). Monitoring CEA, PAP, NSE, and CGA should be considered, especially if the cancer underproduces PSA. A bisphosphonate should be used in support; if bone metastases exist, the drug of choice would be Zometa. It would be administered fairly frequently, but not more frequently than every three months, unless the doctor thought it was worth an increased risk of osteonecrosis of the jaw in order to combat bone mets. All the other applicable countermeasures recommended by the experts would be used, to the extent the patient could comply, including lifestyle tactics (diet, nutrition, supplements, aerobic and strength exercise, and stress reduction). As part of the cardiovascular countermeasures, the patient would be on a statin drug, and would take 30 to 50 mg of Co-Q-10 to offset a side effect. If the patient does not achieve a PSA of 0.05, then stronger measures need to be used, such as ketoconazole with high-dose hydrocortisone, instead of the bicalutamide or equivalent, or transdermal estrogen, with Leukine, possibly Provenge, or other promising drugs in support.
It would be so useful to have research on outcomes for patients following such an approach, but, to date, it does not exist, and probably will not for years to come. I'm convinced that patients on that approach would do much better than the two year limit you have in mind.
Why can't Canadians get Pomx. There are various websites that sell it (not just the company that makes it). I would have guessed some of these would ship to Canada. But maybe I am wrong about that...
I'm confident your right. There is at least one other well regarded brand (based on testing) that would also ship to Canada.
One question I have: what about the risk that Pom might keep psa in check but not do anything to reduce cancer, thus potentially masking a growing cancer. Any thoughts on that?
That would be contrary to any other suppression of PSA that I know about. It is true, of course, that the higher Gleason grade cells typically underproduce PSA, but there is nothing to suggest that pomegranate's effect is due to upping the Gleason grades. Also, there have been a number of laboratory studies of pomegranate juice or extract to see what is causing the effect, including studies of gene arrays. It turns out that the pomegranate has components that switch off a number of unfavorable genes and switch favorable ones on. In other words, the effect is at least partially understood and is real.
When I called the company itself, they said that you can't get Pomx in Canada.... and that's a very good question you asked, Medved.
I tried to get off them too by email and phone. But they do not ship outside the US.
However, my daughter-in-law managed to get via < edited > with free shipping to any location. The prices are competituve too. Try it.
Last edited by hb-mod; 02-17-2011 at 04:49 AM.
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The quote is taken from the American Cancer Society's ' Complete Guide to Prostate Cancer' pg 285. 2005c.
I do concur with you that the statistical data used is probably outdated and has not factored in the latest treatment advances and new drugs. As such the prognosis is likely to be less pessimistic. I have run past the little I have learnt about PC( certainly not by choice) in this short space of time with some of the GPs in my neighbourhood and I am appalled by how little they know about this desease and the treatments available.
Fortunately the specialist I am seeing seems well experienced and I will be raising some of your suggestions at the appropriate time. I have learnt alot from this board and see great value in the empowerment of the patient in seeking his cure.
Someone said the golden rule in treating PC is there are no rules. Each case seems to stand on its own. My specialist commented that alot depends on the host's response to the treatment. My gut feel take that to mean much will depend on the individual's attitude to diet, exercise and possibly drastic change in lifestyle. My past life was one where I virtually eat what I like with little regard to what it does to my body, kept late nights usually with little sleep, work like a mad dog most of the time with exercise as last in the priority list of things to do. All this has now changed. I am on the Plant programme and my body other than God comes first! It may be too little too late. But to me it's better late than never. I will not succumb to this beast without a fight!
Thanks Rhonda for pointing out the shipping issue, and John for a solution. I could not find out why POMx could not ship to Canada. I understand that there may be an added tarriff for shipment of a supplement to Canada depending on Canadian law.
It's my impression that both of these brands are highly regarded and have been well tested. I also have seen information on two other well regarded brands, but I don't recall the names.
I've been using pomegranite powder concentrate. It has a 70% ellagic acid content. I believe that ellagic acid is the active ingredient? I use this powder in a smoothie every morning (tastes terrible). googling on 'pomegranite powder' will find this product