Have RT coming up and am trying to investigate radio sensitizers.
I don't want to take anything that is still under controversy. Looking for things that basically could/will help, but pretty much won't do any harm in making the RT less effective.
In my research, it seems that in the past, people were advised not to take anything that may be an anti-oxident, as the PCa is killed by oxidation (or direct oxidation is one of the modes that kills the PCa? ).
When I pull up the current literature, I am seeing that several of the supplements are getting reviews that are pretty much that it's a positive thing to do.
The three that I have found so far that seem to have positive reviews are
-Curcumin
-Melatonin
-Resveratrol
What do you think about these three? Any other to add to the list?
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groundhogy
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You didn't say what is being irradiated- metastases, lymph nodes, or the prostate.
The problem with radiosensitizers is that they may also sensitize healthy tissue to radiation, causing toxicity. What we want is something that radiosensitizes the cancer but radioprotects healthy tissue - a tall order. There is one thing I know of that does that -- exercise.
Unless you have some reason to believe that the radiation needs your assistance, it is a bad idea to take anything that has not been used in a prospective clinical trial. You have no idea what the unanticipated biochemical effects might be.
With my RO's permission, when I had prostate radiation, I took low dose Viagra to protect penile vasculature. I also started early on my alpha-blocker and took NSAIDs to prevent excess inflammation.
Here is a comprehensive review of radio-sensitizers which includes summaries and links to clinical trials where present. Note under the section discussing compounds from Chinese herbals they specifically mention curcumin and reaveratrol.
And here is another review of mechanisms of radio sensitization with emphasis on ROS related mechanisms. Quercetin, Genestein and Curcumin are specifically identified as being beneficial.
We briefly described here the behavior of cancer stem cells and radioresistance therapies in cancer treatment. To overcome radioresistance in treatment of cancer, strategies like fractionation modification, treatment in combination, inflammation modification, and overcoming hypoxic tumor have been practiced. Natural radiosensitizers, for example, curcumin, genistein, and quercetin, are more beneficial than synthetic compounds
None of that qualifies as evidence patients should use. You have to look at clinical evidence, not lab studies, as I did above. Unfortunately, all the clinical evidence there is, and there isn't much, is retrospective. Patients may be endangering their therapy by taking those supplements.
Thanks for your reply. Expected that and am happy that you anchor the hard evidence end of our APC considerations. That is essential. You know that someone facing a treatment decision now cannot wait for prospective randomized clinical trials to be completed, pier reviewed and presented. As regards to grey areas or adjuncts that do not yet have such top level evidence. So then it comes down to possibilities and risk vs reward estimations.
You mention yourself an early start to an alpha blocker and NSAIDS around your own RT. It is not different. We take our best shot with incomplete information when the main treatment modality )RT to our identified sites or suspected fields is not 100%.
My treating radioligand oncologist last
Month for Lu-J591 suggested I stay on my high testosterone cycle through the treatments and not stop quercetin and curcumin supplements.
We take our best shot and accept what may come. Those two have no toxicity so the risks are very low even though any benefit is uncertain.
I certainly know the urgency. But I also know the danger of jumping to unwarranted conclusions, and taking things that may interfere with therapies.
My NSAIDs, ED meds,alpha blockers actually do have RCTs saying they are safe and effective, so it is very different.
The best reason for taking meds like quercetin and curcumin (that can have no effect because bioavailability is minimal) is that it has a placebo effect when patients take it.
The interesting drug being tested as a radiosensitizer with Pluvicto is called Veyonda (idronoxil). A phase I/II trial found it was safe, with only anal inflammation attributable to the suppository. Results were no better than trials without the radiosensitizer; however, unlike those other trials, almost all (91%) patients had already received Jevtana.
If you want to try it,it is FDA-approved for other purposes, so it can be prescribed off-label.
For a completely different reason, curcumin should be avoided if you are taking Lu-177-J591, as should several other foods and supplements. Please read the section "Beware of MSG and other supplements" in the article below:
You may want to especially email the following to your oncologist before taking curcumin. If it chelates iron, it probably also chelates lutetium and gallium. Its bioavailability is so low that it probably won't do much harm, but why risk it?
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damage control of Radio therapy 
Meeting with RO - responses
Experience, thus far with Lupron and Abiraterone
High risk and ADT duration since PSMA 
Why not use Chemo early?
