Pygeum and PSA: Hello: I was Dx... - Advanced Prostate...

Advanced Prostate Cancer
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Pygeum and PSA

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Hello:

I was Dx Gleason 8 (4+4) 2015 at 70 years old; had IMRT (25 sessions) & seeds early 2016; shortly after PSA went to .44, but progressively increased to 1.95 by Jan 16 2018; then started dropping: Feb 26 was 1.3, Apr 2 was 1.18, then July 2 it dropped to 0.83. Around Feb was when I discovered Biotin, which I’d been supplementing for years past, could raise PSA so I stopped the supplement and sure enough my PSA dropped some (for me anyway). Coincidence that it was finally time for PSA to drop or biotin, I don’t know. For the April PSA test I stopped the multiple morning vitamin that had biotin in it and made sure no eggs 4 days before; down to 1.18…coincidence? Around May I started Pygeum BID & Turmeric once in the morning (I went from 2-3 nightly bathroom visits to 1, or none), then 10 days before the next PSA test (July) I stopped vitamins, wine at dinner, and gym 4 days before. About 10-12 days before the test I hurt my back and took Advil for 3 days, but this was stopped at least a week before the test...also I donated blood about 5 days before the July test because it was found I had very high, above normal, B6 levels. So finally now comes my question: does Pygeum have the same/equal affect on the prostate in regards to lowering PSA as finisteride, and if so to what affect? I read: ‘Unlike the drug finisteride, pygeum does not appear to work by affecting the conversion of testosterone to dihydrotestosterone; but rather, it is thought to reduce inflammation in the prostate and to inhibit prostate growth factors, substances implicated in inappropriate prostate enlargement…is believed to be a 5-alpha-reductase inhibitor’. I’ve read that if taking finisteride then your PSA shows only half of what it actually is, thus the question does finisteride mask PCa… anyway does pygeum produce the same PSA results as finisteride ie., a showing of 50% less than actual PSA; if not then to what extent? It is really exhilarating to have my PSA fall from 1.95 to 0.83 in about 6 months with only the use of 2 supplements and stopping vitamins for a week…or it’s just a coincidence and now is finally the time it took the PSA to fall after IMRT & seeds…and my prayers to GOD. Thank You.

23 Replies
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You should not be taking pygeum or anything else that artificially lowers your PSA. You need to have an accurate reading as to what is going on so that you can measure the effectiveness of your radiation therapy.

Hello: That's what I was questioning, does it artificially lower your PSA or the anti inflammation to the prostate is what is lowering the PSA...I've gone from 3 times a night (midnight to 7) to only once or none at all since the pygeum.

It is artificial in that it is not being lowered by the radiation. Try an alpha blocker like Flomax or Rapaflo.

Very allergic to Flomax...rash all over

He is not a lab rat Tall Allen, he wants relief from frequent bathroom trips. Your telling him the pygeum "artificially" lowers PSA. What is the difference between pygeum and casodex, xtandi, xytiga and any other ADT drugs. They don't cure prostate cancer they lower PSA and extend the life of the patient?

Treating PSA is very different from treating the cancer. There is no evidence that Pygeum reduces the cancer, only that he is artificially reducing his PSA. Other ADT drugs actually KILL prostate cancer cells, pygeum does not. If he is allergic to Flomax, he can try Rapaflo or any of about a dozen other alpha-blockers until he finds one that suits him.

Tall_Allen

in reply to larry_dammit

3 months ago

There is only one kind of drug that has been found to prevent prostate cancer - it's called a 5-α-reductase inhibitor (5ARi), and the best known brands are Proscar and Avodart. Proscar is available as a cheaper generic - finasteride. It will also shrink your prostate, reducing PSA, and re-grow lost hair… Avodart lowers PSA due to BPH, but does not lower the PSA due to prostate cancer.

So I ask what is the difference with pygeum, less side effects; how is it supposed to stop the radiation treatment I had 2 years ago that was supposed to kill the cancer? It does seem to help with my bph (urologist did a DRE a little while back and said it was enlarged, about 35Gm, but smooth and no nodules and suggested I take finasteride…I explained it really elevated my liver enzymes years ago; that’s why I looked up pygeum as an alternative…when taking finasteride it gives about a 50% less psa reading than actual; I was asking if anyone knew for a fact if pygeum acted in the same way.

Pygeum is not finasteride. Pygeum is known to artificially lower PSA. Because you need an accurate PSA reading to monitor the effectiveness of the radiation therapy you had, you should not be taking it.

Also, radiation reduces prostate size and BPH. 35 cc is very normal, and is not enlarged. Just give it time and track your PSA without artificially changing it. You are trying to cure your cancer, not "treat" PSA.

Pygeum is being used in Europe and other places to treat Pca and is being studied here in the US. So I assume your objection is based purely on FDA and AMA recommendations.

You can't just make stuff up - the facts have to support your beliefs. Pygeum is NOT part of the EUA recommendations for treating PCa. Please show me a citation were ANY professional organization anywhere has recommended its use for prostate cancer. Clinicaltrials.org lists NO studies on pygeum for prostate cancer.

clinicaltrials.gov/ct2/resu...

My objection is based purely on the fact that pygeum may obscure the PSA testing that is used to determine whether radiation therapy has been effective.

Hidden
Hidden
in reply to Tall_Allen

I am not "making stuff up". Pygeum is being used for PCa in Europe. Sorry if that does not meet your standards of being FDA approved. I hate to sound like a paranoid but the FDA with it's revolving door of Drug execs serving as its commissioner, the FDA protects the profits of the large drugs companies, not consumers.

Tall_Allen
Tall_Allen
in reply to Hidden

Then show me one professional organization in Europe or anywhere that endorses pygeum for PCa. It is not in clinical trials in the US.

Hidden
Hidden
in reply to Tall_Allen

If you believe your own government:

ncbi.nlm.nih.gov/pubmed/177...

Phytosterol Pygeum africanum regulates prostate cancer in vitro and in vivo.

Shenouda NS1, Sakla MS, Newton LG, Besch-Williford C, Greenberg NM, MacDonald RS, Lubahn DB.

Author information

Abstract

BACKGROUND:

Prostate cancer is an important public health problem. It is an excellent candidate disease for chemoprevention because prostate cancer is typically slow growing and is usually diagnosed in elderly males. Pygeum africanum (Prunus africana or Rosaceae) is an African prune (plum) tree found in tropical Africa. An extract from the bark of Pygeum africanum has been used in Europe as a prevention and treatment of prostate disorders including benign prostatic hypertrophy (BPH). More recently in the USA, the phytotherapeutic preparations of Pygeum africanum and Saw palmetto have been marketed for prostate health including prostate cancer prevention and treatment.

METHODS:

The anti-cancer potential of Pygeum africanum has been tested both in vitro (PC-3 and LNCaP cells) and in vivo (TRAMP mouse model).

RESULTS:

In tissue culture, ethanolic extracts (30%) of Pygeum africanum inhibited the growth of PC-3 and LNCaP cells; induced apoptosis and altered cell kinetics; down regulated ERalpha and PKC-alpha protein, and demonstrated good binding ability to both mouse uterine estrogen receptors and LNCaP human androgen receptors. TRAMP mice fed Pygeum africanum showed a significant reduction (P = 0.034) in prostate cancer incidence (35%) compared to casein fed mice (62.5%).

CONCLUSION: Pygeum africanum, which is widely used in Europe and USA for treatment of BPH, has a significant role in regulation of prostate cancer both in vitro and in vivo and therefore may be a useful supplement for people at high risk for developing prostate cancer.

Tall_Allen
Tall_Allen
in reply to Hidden

Mouse studies aren't worth anything. Until there is a clinical trial, there is no proof whatever. The guys on this site already have PCa. And the OP is taking it while trying to see if his radiation worked - a big no-no.

Hidden
Hidden
in reply to Tall_Allen

The important line here is the pygeum is already being used in Europe. As with many treatments the FDA is the last to approve anything. I suspect this drug will end up in the trash bin because it cannot be patented for profit.

Tall_Allen
Tall_Allen
in reply to Hidden

Pygeum is being used in the US too- you can get it on Amazon. The important thing is that no urological association, North American or European, approves its use for prostate cancer (regardless of the FDA or pharmaceutical mfrs).

I'm going to suggest a different view of the problem from Tall_Allen's. He knows much more about cancer than I do and I think his point about wanting to know how well the radiation is working is well taken, but here's another way to look at it.

Doing a Google search on pygeum and prostate cancer I see that there is some evidence that pygeum acts against prostate cancer cells in vitro, i.e., in a test tube it kills off some cancer cells. If that is also true in vivo, i.e. in real human patients (and I don't think any studies have been done so no one knows if it's true), then taking it won't hurt you and might help. It looks possible that, if your reduction in PSA is due to pygeum, it may not be because the pygeum is masking the cancer but because it's killing some of it. That sounds to me like a good thing. Maybe you won't know how much of your response to treatment is due to radiation and how much to pygeum but, isn't it better to kill more cancer cells than less?

In addition, we know that radiation does not kill most cancer cells immediately. It weakens them and damages their ability to replicate. When they are weak, they are more likely to be killed by androgen deprivation therapy and it turns out that combining ADT with radiation produces longer remissions and a higher rate of apparent cures than radiation alone. Maybe the pygeum will do the same for you.

I am no kind of expert. All of the above is a layman's speculation. It might be totally wrong but, for whatever it's worth, there it is.

Alan

I think it's a really poor idea to take a mouse study in vitro as evidence that pygeum kills prostate cancer cells.

Finasteride is recommended by LifeExtension as a way to keep a man's PSA lower. Finasteride is taken by men to prevent hair loss. It is also known as Propecia. My oncologist has said not to use Propecia. If the day comes when I need to use hormone drugs the drugs are usually only effective for so long. Using finasteride now might shorten the time that drugs such as Lupron would be helpful. Web Md lists natural, plant derived supplements and foods for BPH, among them, pygeum.

There is a YouTube video where Dr. Klotz of Toronto is speaking at a urologist's conference about a patient with hormone resistant prostate cancer. Dr. Klotz has a graph showing the patient's PSA history. The patient's family manufactures hot sauce. The patient said he and his family know that hot sauce has medicinal qualities so he figured why not try it? The patient began dosing himself 3X a day with hot sauce. His PSA stabilized while he was "on the sauce"--sorry, I couldn't help but do that!--. the patient's internist felt that the daily dosing of hot sauce was interfering with his blood pressure medication and the patient "got off the sauce" --oops! sorry! The patient's PSA began to rise again as it had before it leveled off when he began dosing the hot sauce. The hot sauce controlled his PSA and likely his cancer progression but did not cure it. It masked the fact that his cancer was still there and active but put it in a sort of a holding pattern.

The point is, as Tall_Allen said, taking supplements to reduce PSA will give untrue results needed to assess the effectiveness of the treatment if that is what you are looking for. If you want to do whatever you can to keep your PSA down then go for it. The natural foods and substances mostly seem to control, not cure, otherwise we wouldn't be on this site.

As Alan Meyer wrote hormone therapy is often combined with radiation. It is important to keep your doctor informed about what you are taking and why and if you should be on a hormone reducing drug such as finasteride. If you're not satisfied with your doctor you know what to do.

My feeling is that one's primary concern is the cancer - not a doctor who might be monitoring PSA as though your radiation treatment were monotherapy.

Is it possible to reduce PSA without having a positive effect on the cells that produce PSA? I don't believe so. If you took pygeum & your PSA dropped, I view that as a good thing.

Pygeum has been widely used for BPH. It is thought likely that β-sitosterol is the chief agent. It is a 5α-reductase inhibitor. If that is what you are aiming for, you might consider Avodart as a more reliable alternative. Have you had your DHT tested?

But there are some papers on pygeum having anti-PCa properties. It may act as an anti-androgen. A German study found that a pygeum compound (N-butylbenzene-sulfonamide) could stop the androgen receptor from moving to the nucleus. [1].

Does Finasteride mask PCa? Finasteride is used to treat BPH. As such, it reduces PSA due to BPH. 80% of prostatic biopsies are unnecessary & occur because of the PSA noise of BPH. So while Finasteride for BPH will lower PSA, it can actually unmask PCa. It is easier to spot an upward trend due to cancer.

But what about PSA produced by PCa cells? Finasteride is not approved for treatment of PCa. It isn't expected to be beneficial and I would not expect a PSA decrease. But a reduction of DHT might well increase PSA doubling time [2].

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/197...

[2] ncbi.nlm.nih.gov/pubmed/?te...

As the above discussion shows, there are different points of view on all this and reasonable arguments that can be made on both sides. It makes sense to alert your radiation oncologist about what you're doing. He may have an opinion.

I think you should also ask him about your rising PSA. Has it risen steadily, i.e., one rise, then another, then another, then another? Or did it go up and down even before you started the pygeum? Did you have hormone therapy alongside your radiation? Has your doctor discussed a plan for what PSA values you're looking for and what values will trigger additional treatment? Those are all things that should be discussed.

Alan

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in reply to AlanMeyer

Let me try to explain. I was treated for prostate cancer 2 years ago: imrt & seeds. My Gleason score was 7 (4+3) 1 core 20%, 1 core 10%, and 8 (4+4) 1 core @< 5%. My psa went to 0.44, and from then on steadily increased to 1.95 by Jan 2018. There was no up/down bounce just a steady increase. My RO said she got the other doctors together in a conference about my case and they concluded there was failure/recurrence and her answer was if psa continues to rise have another biopsy and go from there, like hormones; then by the grace of God my psa began to fall...I’ve read that it could take 2-3 years after seeds for psa to finally start to drop; hopefully that is what’s happening here. In the mean time I still have a prostate, and that makes psa. Also since treatment I have to go to the bathroom about every 45 waking minutes or so, I’m sure most who’ve had radiation know the feeling; it’s not that I can’t go, that’s no problem…stream seems ok, it’s the constant have to go. Allergic to flomax and also has too many side effects “for me”…congestion, light headed, and large rash; like I said, no problem going, just the constant going and feeling of not completely emptying. I heard about finisteride from years past and was Rx 1Mg for hair loss but even that small dosage kicked my liver enzymes up to almost 100 (ast). Last checked a couple months ago urologist/DRI prostate was 35g, but smooth, no nodules and Dr. suggested finisteride, but liver problems with that, so I researched for an alternative to finisteride for BPH and came upon pygeum and turmeric and began to take them: night bathroom trips went from 2-3 to 1 or none. In the meantime I was due for another psa test; remember it had already begun to drop. One thing before I go further it was suggested to let the radiation do its work, I don’t understand that statement; I’ve already had the radiation and seeds, there’s nothing I can do to stop their working; remember the Dr’s have already concluded it failed so taking a few supplements that are purported to be somewhat an alternative to a drug for bph. So my last psa dropped to .83 and I was elated, but then wondered if it was a false drop like finisteride does and that’s why I asked on this forum, thinking possibly out of the millions who have PCa and read this forum maybe someone went the same route I did with the supplements…I was asking if anyone knew, ‘for sure’, if the pygeum dropped psa, (50% difference), like finisteride does…pygeum is supposed to act on the prostate differently than finisteride and I was hoping the drop was due to the treatment finally kicking in. I’m not “chasing” psa so to speak, but tell me how else you’ll know if the cancer is coming back if you don’t monitor psa, tell me if anyone here isn’t concerned about raising psa, and isn’t happy to see it drop.

Thank You

So, how will you know if you had recurrence if you've artificially lowered your PSA? A biochemical recurrence is defined as nadir+2. It took me 4 years to reach nadir. But if you're blocking the cancer cells from putting out PSA, you may never hit that nadir+2 level (even though cancer may still be growing and spreading). It's important to know because salvage therapies can be initiated if a clinical recurrence is biopsy-confirmed.

Urinary symptoms of radiation can persist but usually go away on their own as inflammation subsides and the prostate shrinks and atrophies. You should see if your PSA is still low without the pygeum and see if you still have urinary symptoms. You may be able to eliminate one more unnecessary drug.

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