OK back to the issue of substances that reduce PSA. Let's say hypothetically one is taking a supplement, like aspirin such as I posted recently, or whatever that could suppress expression of PSA artificially, let's say by 50% yet NOT affecting the cancer.
I am wondering whether there is a simple way to test for this, such as: stop taking it for several days (washout) and get PSA. If the effect is artificial, then the PSA jumps to the 50% higher or correct value. However IF the substance (say broccoli extracts, boron, whatever) were having a real effect on the cancer via AR effects, arresting growth, apoptosis, or whatever, then am I correct in thinking the PSA would not immediately jump significantly in a short period because real PCa growth that had been inhibited by the substance would take significantly longer to recur?
TIA
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Spaceman210
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It depends on its pharmacodynamics: the elimination half-life of the substance, its ability to accumulate, and the steady-state concentration. Finasteride, for example, has an elimination half life on a single dose of 5-7 hours, but rises to a much higher steady-state level with multiple dosing. (It affects PSA from BPH, but not PSA from PCa). Curcumin has an elimination half life of a half-hour, but does not accumulate with multiple dosing, and doesn't reach a higher steady state concentration (which explains its lack of effectiveness).
I must admit it hadn't occurred to me that supplements might lower the PSA 'artificially' while actually not affecting the cancer cells at all. If so, this is a real concern.
After reading many posts on this forum and doing further research, I selected a small number of supplements to take. These are: Ca / Mg / D3, Broccomax, Vit E - tocotrienols, melatonin, MCP and Boswellia Serrata extract (Lox inhibitor). From what I read, they all seemed to demonstrate potential anti-cancer properties which could negatively affect cancer cells and decrease my PSA. But is this in fact so, or does a decrease in PSA not actually indicate this at all?
Any further insight into this would be appreciated.
My Ca level has been decreasing for the last 6 months, 10.2->9.8->9.2 mg/dL, and I am considering starting Ca citrate. No idea if this is a good idea or a horrible idea. Normal is said to be 8.8-10.6, so getting towards the low end. Already taking prolia for bone density.
Thanks Tall_Allen for your advice. Truthfully I find the issue of Ca supplements somewhat confusing. I thought I had read that as long as the Ca was balanced by appropriate levels of Mg that it was OK to take the supplement and presumably good for bones with metastases. Also my supplement has Vit D3 with it which I also understand is good. Any further ideas on this? I do appreciate your sharing your knowledge. Thanks.
That said, it's important to maintain adequate levels when taking Prolia or other bone preserving agents. I think your body is the best guide. If your blood levels are low, then supplement to bring it up to normal levels. The way your body uses minerals and Vitamin D is individual and complex. If you are a white man, supplementing Mg accomplishes nothing:
Try to get all your vitamins, minerals, and micronutrients from food. Your body knows how to absorb and balance them from foods better than if overloaded by supplements. Blood tests are the best way to monitor.
A thought to ponder--suppose you stopped taking the supplements that suppress your PSA and inhibit cancer cells from clustering and metastasizing to get a relevant PSA reading to satisfy someone's curiosity, even your own. You then get a more accurate PSA result but may have provided an opportunity for cancer cells to metastasize. Your body is your own little chemistry lab! Things going on inside all the time!
A true story. My school bus driver had a small farm. He and his very pregnant wife were harvesting the hay. Rain was threatening which would might cause the hay to go moldy if it soaked it. The hay would be much of the winter feed for their livestock. His wife's water broke. She went into the house and gave birth. She put herself together and told her young daughter, "Take care of the baby. I have to help you father finish getting the hay in". Back to the field she went to hoist bales of hay!
The baby---NOT--born under a "Maternity Ward" sign! That was in 1955?? five years before I became a passenger on the bus. Quite the story around town!
Her husband, a good man, died of a heart attack. Guess who became our bus driver? She did! Well! She was rarely if ever late despite our little white knuckles! Man could she drive that bus!
One thing to consider is that some supplements may halt cell cycle progression, rather than induce cell death. In this case, the PSA doubling time time will lengthen. When the supplement is withdrawn, PSA will surge & the PSADT will shorten.
Another thing to consider is that advanced PCa cells might not produce PSA. PSA might seem to be under control but the cancer might be growing larger.
Frankly, I don't see how a supplement can lower PSA without affecting cancer growth.
It is interesting that we are being warned off supplements because of PSA masking continued growth, while researchers rely on it as a measure of success.
1] Apalutamide (Erleada, ARN-509) - Phase II trial:
"Overall, 89% of patients had ≥50% PSA decline at 12 wk."
2] Enzalutamide (Xtandi) - Phase II trial:
"67 men were enrolled into the study. 62 patients ... had a decline in PSA of 80% or greater at week 25."
3] Abiraterone (Zytiga) - Phase II trial:
"The primary outcome was > or = 50% prostate-specific antigen (PSA) decline ..."
...
In fact, a 50% or more PSA reduction is a common measure of the success of a treatment. Do researchers worry that they might simply be masking cancer growth?
Patrick - thank you! What you have said is exactly what I was thinking. If PSA decreases, whether from medications or supplements, it has to be a measure of success.
After posting my concerns earlier I went again and reviewed why we had selected the supplements we had. In each case they clearly seemed to demonstrate anti-cancer properties that could inhibit progression by one means or another (which I assume might also lower PSA) although my main objective was the former. I even came across a double-blind randomised clinical trial that is underway studying the possible benefits of Broccomax. So someone thinks it's worth studying in depth.
So I will continue on my supplement program as is, and maybe even add a few more along the way : )
Further, I guess the other thing to do is to check for radiographic progression in case of mutation to NE cells. Any suggestions as to how often that should be done?
Once again thank you for your great contributions to this forum. We do appreciate them.
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