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Advanced Prostate Cancer
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Enzalutamide and Curcumin

I was diagnosed as Gleason 4+5 eighteen months ago with a PSA of 78. I was immediately put on three-monthly injections of Triptorilin (decapyptyl) and soon started a six infusion course of docetaxel. This brought my PSA down to a low of 0.55 twelve months ago. Since then my PSA has been creeping up and with it now at 2.28 I have just been prescribed Enzalutamide. I have been taking Vitamin D and Curcumin+piperine supplements but the Oncologist consulted the Pharmacist who suggested that I should stop the Curcumin as he was not familiar with Curcumin supplementation and was unsure of what, if any, inter-reaction their could be. He did say that he would look into it further but for me to stop in the mean-time.

Has anyone experience of the combination?

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I have been taking Tumeric Curcumin extract 500 mg and Pomegranate extract 250 mg daily since 2006 recurrence after prostatectomy in1999. I don't know if these have helped or hurt. This is in addition to oncologists recommended treatments listed in my profile. My doctors have not advised for or against these supplements. I started taking them on my own, based on a literature search I did 2006. I started Xtandi August 15, 2017. Only noticeable side effect of Xtandi so far has been a little more fatigued then before starting Xtandi.

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IMO, since Turmeric can be found in certain foods and spice blends, we commonly use, I would say it is safe to use. It is one of my top 10 supplements. I use Vitacost.com's ROOT2 Turmeric Extract, with Curcumin 3 complex---1160 mgs per serving. I also use Zyflamend, which is loaded with the Supercritical CO2 extract of Turmeric, along with extracts of 9 other herbs. I probably take about 16 different supplements directed against Pca. And none of my Doctors or Pharmacists or any Medico gives me an argument or discussion. That is because all my Doctors are integrative[believing in natural substances and drugs being synergistic].

I will not see a Doctor who is not Integrative. Might you Consider other Doctors??? Just a suggestion.

Nalakrats

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My radiation doctor told me I could take B17, I read about it and it has a very positive results. I did order the apricot kernals on ebay. and its loaded with B17 and its a natural part of the inside of the apricot seed, All natural too.

Robert

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Thumbs Up!

Nalakrats

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Turmeric - the source of curcumin - has been used in Ayurvedic medicine for many centuries. It is an important component - albeit small - of many Indian dishes, & has to be considered safe, since many consume it every day.

Could curcumin interact with Enzalutamide? Enzalutamide binds to the androgen receptor [AR]. Curcumin downregulates AR [6], so there should be synergy.

When I see "piperine" mentioned by someone on meds, I wonder about dose interference. The liver quickly metabolizes the greater portion of many drugs. A therapeutic dose might be a tenth of the prescribed dose, because the assumption is that the liver will destroy 90%. Piperine inhibits at least one of the enzymes that metabolyze many meds: CYP3A4, therefore it could increase the potency of many drugs, just as grapefruit juice does.

Ironically, Enzalutamide is more of a threat to other drugs than piperine, since:

"Enzalutamide is reported to be a strong inducer of the enzyme CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19, and can affect the circulating concentrations of drugs that are metabolized by these enzymes." [1]

& so piperine might actually be beneficial if other drugs are being used.

On the other hand, since your curcumin is not a bioavailable form (why else is it paired with piperine?), and the piperine will likely be trumped by the Enzalutamide, it may be pointless to use it. If you are nevertheless interested, consider LongVida [2], which is bioavailable without the help of piperine, and add piperine [3]. Even so, Enzalutamide-induced CYP3A4 might overwhelm the dose. In which case, liposomal curcumin [4] might be the answer.

-Patrick

[1] en.wikipedia.org/wiki/Enzal...

[2] swansonvitamins.com/now-foo...

[3] swansonvitamins.com/swanson...

[4] ncbi.nlm.nih.gov/pmc/articl...

[5] ncbi.nlm.nih.gov/pmc/articl...

[6] ncbi.nlm.nih.gov/pubmed/238...

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This list of supplements that can interact with Xtandi, & how strongly, was provided by an oncology pharmacist with a PharmD degree. (Each item says View Details, but I don't have them.)

The list doesn't include curcumin, so I'm still on that & Zyflamend after starting Xtandi a month ago. PSA declined after 4 weeks. Like 1 of the guys who posted before me, my side effect is fatigue. It hits hard after my 2nd meal of the day, & has forced more naps already than any of my previous decade of PCa meds.

Received: 8/1/2017 11:55 AM PDT

Enzalutamide <<interacts with>> TANSY RAGWORTView Details

Interaction Rating = Major Do not take this combination.

Enzalutamide <<interacts with>> ACTIVATED CHARCOALView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> AGARView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> AGRIMONYView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALCHEMILLAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALDER BUCKTHORNView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALGINView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALKANNAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALOEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ALPINE RAGWORTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> AMERICAN CHESTNUTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BARLEYView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BISTORTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BLACK TEAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BLACK WALNUTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BONESETView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BORAGEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BUTTERBURView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> BUTTERNUTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> CARRAGEENANView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> CASCARAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> COFFEE CHARCOALView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> COLTSFOOTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> COMFREYView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> DMSO (DIMETHYLSULFOXIDE)View Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> DUSTY MILLERView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> EASTERN HEMLOCKView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> EUROPEAN BUCKTHORNView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> EUROPEAN CHESTNUTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> EUROPEAN MANDRAKEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> EVODIAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> FLAXSEEDView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> GLUCOMANNANView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> GOLDEN RAGWORTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> GRAVEL ROOTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> GROUNDSELView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> HEMP AGRIMONYView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> HOUND'S TONGUEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> ICELAND MOSSView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> JALAPView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> KARAYA GUMView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> LIMONENEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> MARSHMALLOWView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> MEXICAN SCAMMONY ROOTView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> MORMON TEAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> PECTINView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> QUILLAIAView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> QUINCEView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> RHATANYView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> RHUBARBView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> RICE BRANView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> SLIPPERY ELMView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> TANNIC ACIDView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> TRAGACANTHView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> WATER AVENSView Details

Interaction Rating = Moderate Be cautious with this combination.

Enzalutamide <<interacts with>> CAFFEINEView Details

Interaction Rating = Minor Be watchful with this combination.

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Thanks a lot for taking the time to reply folks. It is exactly the information I was after. Thats my first week of Enzalutamide over with relatively minor side effects. My next appointment is in three weeks time, if they then OK the use of curcumin plus piperine I will report back on here.

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Why take the chance...Dr. Myers said to drop Curcumin when using Meformin because of gastro intestinal problems...IMO Curcumin is worthless because of its poor absorbtion and extremely short half life

Gus

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My father was also told to stop green tea supplements and turmeric while on Xtandi..

I have seen many posts on B17, did Dr. Myers recommend this to anyone? What supplements were recommended?

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