In addition, total polyunsaturated fatty acids may slightly increase risk of cancer diagnosis and cancer death. This is from a meta-analysis of all randomized clinical trials and represents the highest level of evidence there is.
nature.com/articles/s41416-...
Be careful with supplements! Conclusions drawn from observational and lab studies (the kind you often find posted on this site and supplement-selling sites) are usually found to be wrong when tested in randomized clinical trials.
Have there been any negative reports about modified citrus pectin?
The last clinical trial I've seen is this interim, with only 6 months of follow-up that included no controls:
ascopubs.org/doi/10.1200/JC...
Among those 46 recurrent patients, 9 experienced gas and bloating as their only side effect. At 6 months, 27 did not have higher PSA, and 11 had higher PSA. Because there is no control group to compare it to, it's impossible to conclude it had any benefit for the 27 or if the 11 were worse off because of it.
Are there any supplements you recommend taking for those with prostate cancer?
Sulforaphane may be OK, but should not be taken by those having radiation. In general, balanced heart-healthy unprocessed foods (highly colored fruits and vegetables, green leafy and cruciferous vegetables, fats from vegetable sources, carbs from whole grains, variety of protein sources and in all things) are better than overloading your body with concentrated doses of "natural" drugs. Your body and its microbiome evolved to extract what it needs from the foods you eat and to discard the rest. Tricking your body to absorb some unnatural quantities of a "natural" substance may be unsafe.
Thanks for posting this. For many patients that last phrase “... offset by small protective effects on cardiovascular diseases.” could be equally important.
Thanks for posting.
Link to the full article:
sci-hub.tw/https://www.natu...
"Increasing LCn3 may slightly increase prostate cancer risk (low quality evidence), but effects on prostate cancer death were
unclear (the evidence was very low-quality, five deaths). Seven trials (38,525 men, mean duration 51 months, mean dose 1.2 g/d
LCn3) reported on 1021 prostate cancer diagnoses, finding higher
risk of prostate cancer in men with increased LCn3 (RR 1.10, 95%
CI 0.97–1.24, I2 0%, NNTH 334, Fig. 4). This slight increase in
prostate cancer risk was stable to all sensitivity analyses. However,
the suggestion of harm was contradicted by PSA data reported in
a single large trial (25% reduction, MD −0.13 ng/ml, 95% CI −0.25
to 0.01, 1622 participants). Raised PSA was reported in 12 of 62
participants in another trial (RR 0.47, 95% CI 0.16–1.40), also
contradicting the suggested LCn3 harms."
"The small harms resulting from increased LCn3, ALA and total
PUFAs need to be balanced against potential gains from the other
major cause of morbidity and mortality, cardiovascular disease
(Table 1). For example, this review suggests that increasing LCn3
intake may increase the risk of prostate cancer in men, such that
1000 men increasing their LCn3 intake would lead to three
additional men being diagnosed with prostate cancer. In a sister
review, meta-analysis including 25 RCTs and over 127,000
participants suggests that if 1000 people consume more LCn3
three will avoid death from coronary heart disease. Further
analyses suggest that of the 1000 six will avoid a CHD event and
one will avoid arrhythmia.55 The balance appears similar for ALA—
for every 1000 people increasing their ALA intake two will avoid a
CVD event, eleven will avoid arrhythmia but three will be
diagnosed with prostate cancer who would not otherwise have
been diagnosed (Fig. 5 represents the harms and benefits visually
as number of additional diagnoses incurred or avoided per 1000
people increasing their LCn3, ALA or total PUFA intake).55
Increasing total PUFA in 1000 people appears to prevent five
people dying from CHD, but two additional people will die from
cancer. Sixteen people will be protected from CVD events,
nineteen from CHD events, but eight more will be diagnosed
with cancer (Fig. 5).34 This suggests that small benefits and small
harms of increasing LCn3 intake are likely to be partially balanced
out across major sources of morbidity and mortality and indeed
increasing LCn3, ALA, omega-6 and total PUFA appear to have
little or no effect on all-cause mortality (Table 1).34,"
Thank you Tango for that expansion of the risk-benefit analysis.
What struck me was that the Confidence Intervals for their end points all crossed 1.0, meaning no additional risk. So the operative word is "may".
Could COQ10 be included as a risk?
yes - you are spot on!
A few things also worth considering as regards diet and supplements:
1) agents that may work (or not) for cancer prevention may differ from those that may work (or not) for cancer treatment, and
2) agents that exist naturally in the matrix of "real food" may OR may not have very different implications for the organism than agents that are isolated in "supplement" form.
For about a month this past fall I was consuming large amounts of soy milk and toasted flax. Next PSA test was NOT good, so I aborted that experiment. But I of course have no idea if the PSA spike was related to fatty acids, to phytoestrogens, to high protein... or to none of these, or some combo.
Trying to link cause and effect is pretty hard to do with any certainty in an n=1 scenario with so many seen and unseen variables.
Do you know of any other data about soy milk and flax seed? I drink about 400 ml of soy milk and about 30 mg of flax seed daily as I am vegan.
I do not take any supplements except D3K2 and Calcium as I am still on ADT.
I know Dr. Bob Leibowitz recommends against them, but otherwise there seem to be contradictory reports and studies. Seems more agreed upon that they help PREVENT getting PC, but less agreement on their use when treating. Might be worth starting a new post, to get more feedback?
A resource that I think is great for exploring questions such as these is a phone app called "About Herbs" created by Memorial Sloan-Kettering Cancer Center. It's free, and is basically a dictionary of herbs and supplements and what we know/don't know about them and various cancers.
Avacado and pumpkin seeds /flax seeds are O.K. I love my Guakamoli.
Hey T_A!!
intermountainhealthcare.org...
ncbi.nlm.nih.gov/pubmed/236...
Smoking and salting, the old preservation techniques, changed the nature of the food. Makes sense right? Like a diet of bacon, ham, cold cuts and sausage? That would be beneficial!
High quality and in moderation are important facts to remember.
This from a vegan of two plus years.
Currumpaw
I noticed that using omega-3 is better than using WD-40..... No more sticking windows, doors. joints and etc....
google.com/search?q=slip+sl...
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 03/07/2020 1:26 PM EST
You say be careful with supplements but omega 3 and ALA are found in many foods.
Foods are very different from supplements. Your body evolved to process foods and can compensate for a little over and under. Supplements overwhelm the body's control mechanisms. They are drugs, not foods.
"Supplements" can be known interchangeably as "foods." A supplement is not always am isolated substance.
Omega 3 supplement is usually just algae oil or fish oil. Is olive oil also a drug then?
Supplements are not foods. Foods are foods. When you eat fish, you are eating a lot more than a concentrate of omega-3's - there are dozens of oils, proteins, enzymes, micronutrients and many other substances. Your microbiome has coevolved to extract what is useful to your body and excrete the rest. You can overwhelm your microbiome, your liver, and other biochemical control systems by ingesting concentrates in amounts never found in foods we eat. Get your nutrients from real food and stop trying to outsmart your body. Millions of years of evolution has made your body a lot smarter than you are.
The term "supplement" can absolutely be used to refer to foods. When I take a flaxseed powder supplement, alma berry supplement or a maca supplement, all of those are foods ground into powders and sometimes capsulized. The term supplement has become an umbrella term that encompasses many different products, including foods. Anything that is an extra supplemental element with intended benefits.
If supplements are drugs and you are against them, you recommend men forgo all drugs for prostate cancer then? Pharmaceuticals are highly doctored substances and are not beneficial for the liver or the microbiome either. Most of them cause dangerous side effects, and many lack efficacy and are taken off the market. If liver health is your concern, all drugs are potentially harmful, right?
Like I've said before, a well rounded approach is key. These extremes of foregoing all conventional or foregoing all holistic, are not helpful or beneficial to men's care. It sets the stage for inferior care.
Supplements are extracts, isolates or concentrates. They are never found in nature that way. Unless one is a fisherman, one would never consume those quantities of omega-3s everyday. For the danger in doing that, read these:
"This study confirms previous reports of increased prostate cancer risk among men with high blood concentrations of LCω-3PUFA. The consistency of these findings suggests that these fatty acids are involved in prostate tumorigenesis. Recommendations to increase LCω-3PUFA intake should consider its potential risks."
academic.oup.com/jnci/artic...
"Docosahexaenoic acid was positively associated with high-grade disease."
ncbi.nlm.nih.gov/pmc/articl...
I am NOT against drugs - I never said such an absurd thing. I am against using drugs that are untested in clinical trials for safety and efficacy. Unlike pharmaceuticals, supplements are unregulated. They are drugs, where you have no idea if they are effective, safe, what drug interactions there may be, or what is actually in the bottle. For pharmaceuticals, the risks are known - the patient knows which side effects to expect, and if needed, liver function is monitored. Very few are taken off the market. The few that are should give you confidence that their effects continue to be monitored. No such monitoring goes on for supplements.
Purveyors of supplements as drugs always try to make it seem reasonable to take substances of unknown toxicity and efficacy into the body's of people who are already compromised by cancer. It is not reasonable - it is dangerous. People and companies who do this are preying on the desperation of sick people.
BTW- "holistic" does not mean taking supplements. It means this (from my dictionary):
• Medicine: characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease.
I am all for treating patients holistically - not just their bodies, but also their minds and social interactions. Giving patients another pill is not holistic treatment and is not "well-rounded," as you claim.
I'm not an expert, but I never said holistic meant supplements. However, supplements are an important part of holistic treatment. Holistic is the opposite of the conventional & mainstream route which has a very limited focus. Balance and a well-rounded approach are key. There is absolutely no reason to stigmatize supplements as a whole. Many are approved for cancer use, have clinical trials, and there are many trusted brands which are GMP certified. Many are well-researched and the side effects, interactions, and contraindications are clear and well-documented.
Furthermore, FDA approved drugs are taken off the market all the time. Vioxx is one example. It was FDA approved as a pain reliever NSAID. On the market for 5 years. Linked to 27,000 deaths before it was taken off the market. Baycol is another. FDA approved and on the market for 3 years causing 52 deaths kidney failure. How exactly did these get approved and how exactly did clinical trials not spot such simple reactions as heart and kidney issues?
Common sense and research are key.
Broccoli isn't FDA regulated but frankly, I'll take my chances on that. An extract from broccoli...even better, especially for cancer. Even better:BOTH.
Supplements are certainly extracts, isolates and concentrates, but supplements can also be from whole food sources. In fact, I need to take my mushroom supplement right now (ground and powdered whole reishi). Supplement is an umbrella term. And there is absolutely nothing wrong with extracts, isolates and concentrates, per se. Individually we may find some problematic for certain people, but as a whole many can be therapeutic and helpful for tackling certain illnesses.
The way in which you lump all supplements together is irresponsible. Your initial post did not cite efficacy and clinical trials as a concern. Rather it was microbiome, liver and overwhelming the body. All of these certainly are a concern for pharmaceuticals, and often even worse.
The research with omega 3s and prostate cancer tested fish oil predominantly. Perhaps the issue is with fish rather than omega 3s. However, recent research says omega 3s are safe for prostate cancer: swdcmi.com/news/cancer/pros...
It's difficult to know what to believe. Personally, I wouldn't take my chances with fish.
Wordss have meanings. It is silly to just make them mean whatever your whim is. No communication is possible unless you use the shared meaning. Your statement that "Holistic is the opposite of the conventional & mainstream route which has a very limited focus" is not what holistic means, as I showed you in my previous post.
You make unfounded statements: "Many are approved for cancer use" Really? Name one that is FDA-approved for prostate cancer. "Many are well-researched and the side effects, interactions, and contraindications are clear and well-documented." In fact, none of them are, and there has never been a Phase 3 randomized clinical trial showing any of them to be safe or effective for prostate cancer. The biggest Phase 3 study on a supplement - Selenium and Vitamin E - proved that Vitamin E in the type and amounts most men were taking actually caused prostate cancer.
You made an outrageous statement that FDA-approved rugs are taken off the market "all the time." The fact that you can only name two (I could probably name a few more) out of the thousands of FDA-approved drugs, should give anyone comfort that they are doing a good job. Certainly, drug researchers have learned from those mistakes - drug screening and research methods have improved because of them.
I have no problem with foods. If you want to eat your mushrooms and broccoli, go ahead - I ate them both. But if you use mushroom pills to eat quantities you would never be able to eat, you are taking a drug - which should be tested for safety and efficacy. Sulforaphane looks pretty good, but should not be taken with any kind of radiotherapy or immunotherapy. Fish is fine if not eaten exclusively. We evolved as omnivores and do best with a variety of foods.
"as a whole many [supplements] can be therapeutic and helpful for tackling certain illnesses." Where is the proof of that? Where is your proof that any are safe and effective for prostate cancer? Medical science requires evidence. You just make up these statements. There are widely accepted standards as to what constitutes proof. You have none. Your citation of a commercial website proves you have no understanding of these things. I hope you will take the time to learn instead of harming others with your profound ignorance of medical science.
Holistic IS the opposite of conventional care. Conventional care is limited, doesn't treat the whole body and is largely focused on the symptoms and drugs. Holistic focuses on the whole person.
I never said FDA approved. I said "approved" meaning oncologists approve of their use for prostate cancer. In fact, here's a discussion of some: cancer.gov/about-cancer/tre...
There are plenty of supplements that have gone to phase III and plenty more that have had randomized phases, perhaps not "phase III randomized" for prostate cancer, but so? The clinical trials phases have shown efficacy and safety. Resources for later-stage randomized clinical trials are usually reserved for pharmaceuticals for obvious reasons.
Prevention is key anyhow. "At present, finasteride remains the only intervention shown in long-term prospective phase III clinical trials to reduce the incidence of prostate cancer." Might as well take turmeric.
Do you really want me to list all the pharmaceuticals taken off the market? 4,500 drugs and devices are removed from shelves every single year, AFTER they received FDA approval. How could the FDA approve 4,500 products every year that are so unsafe that they need to subsequently be taken off the market? That's concerning and hardly conjures up much trust for the FDA approval process.
"But if you use mushroom pills to eat quantities you would never be able to eat.." Have you looked at the size of most capsules and tablets? I could easily eat the recommended dosage a day (3 pills) in a 1/5 of a meal. Many supplements are just powdered herb, food, berry, or whatever stuffed into a veggie or gelatin capsule for convenience. Not all, but many are. Sure, food is great, but would you treat your cancer with food alone? Heck no. Common sense and research prevail.
"Where is the proof of that? Where is your proof that any are safe and effective for prostate cancer?"
Research and clinical trials.
The "commercial" website I linked doesn't sell omega 3. You're supposed to use it as a jumping board and go look up the study that they referenced to. Here it is: ahajournals.org/doi/abs/10....
Obviously more research has to be done.
You take your drugs and I'll take my supplements. In fact, I cured my pericarditis with them. No pharmaceuticals needed.
I showed you the dictionary definition of holistic - it means body, mind and social - you don't get to make up your own definitions.
You are quite wrong about what your link shows. It only shows the research (mostly low level of evidence lab studies) that has occured. It does NOT show that oncologists are using any of it. ASCO does not endorse the use of any supplements. Again - you are the purveyor of false info.
You make unfounded statements like "there are plenty of supplements that have gone to phase III and plenty more that have had randomized phases." I guess you don't know that Phase 3 means randomized. Can you cite one that has proven safety and efficacy for prostate cancer?
"4,500 drugs and devices are removed from shelves every single year, AFTER they received FDA approval." I don't doubt that. That's because the FDA has strict quality requirements. There are no such requirements for supplements. FDA assures safety and efficacy and monitors quality of pharmaceuticals on an ongoing basis. Many supplements have been pulled off shelves for mislabeling - but the FDA does not monitor them as it does pharmaceuticals.
If you enjoy freeze-dried food, that's fine. Astronauts on the space station get their food that way. But that is NOT what anyone on this planet means by supplements. Again, you are making up definitions.
I have seen the "research and clinical trials" you imagine prove the safety and efficacy of supplements. None have proven safety and efficacy for any supplements. You appparently have not seen any either, or else you would cite at least one. I'll allow sulforaphane, even though it was quite small (Phase II). You are posting on a prostate cancer site- so keep it relevant.
Did you actually read that study of omega-3s? It does NOT say there is any benefit. It says there was no association found with risk of PCa in those 87 men. The two studies I cited were across 1658 men and 1393 men, respectively. Which would you believe?
Your profile has no info. Why are you on a prostate cancer website?
Hi Allen, You talked about supplements being the culprits for increasing PCa risk and deaths. How about those natural seeds, like chia seeds and flaxseeds? Do these seeds pose the same risks as the supplements you were describing?
Thanks from Taiwan
No. Foods are fine. Your body can easily handle foods. It is only when you overload your body with some substance that it can cause problems.
Newly dx with high risk locally advanced prostate cancer..bewildered 
Addition of an ARSI to standard ADT significantly increases the risk of fractures and falls in men with prostate cancerMediterranean diet may decrease risk of prostate cancer progression for men on active surveillance
Is Real-World Evidence a Complement to Randomized Clinical Trials?Covid-19 may increase PSA in men with prostates
