Modified Citrus Pectin - reply from Dr Eliaz

[Purple-Bike]

A member asked me to post the reply I was to get from Dr Isaac Eliaz on MCP, Modified Citrus Pectin / Pectasol and I do this.

Below is my communication with dr Eliaz, generously facilitated by AnnieAppleseed, followed by excerpts from two studies.

Dr. Eliaz writes that 80 % of patients with BRPC, biochemically recurrent prostate cancer, have shortening of PSADT, PSA doubling time, over time. This is contrary to the study provided by TA that I linked to him, which indicates lengthened PSADT. Both are contradictory to a second study, which indicates that most patients have no consistent shortening or lengthening of PSADT.

If the assumption is made that the second, to MCP more favorable study, is valid, the results from MCP use according to the phase II pilot study MCP trial are superior. His case would be stronger with a reference to the 80% statement, or if a placebo had been used in the trial.

My letter:

Dear Dr. Eliaz,

As a user of your Modified Citrus Pectin, Pectasol, may I ask a couple of questions?

The phase II pilot study shows a statistically significant and impressive increase in PSA doubling time when using Pectasol. However, I understand that PSA doubling time normally increases even in the absence of any intervention for men with biochemically recurrent prostate cancer, according to this study: ncbi.nlm.nih.gov/pmc/articl...

If possible, it would be great to get a comment from you!

The study states that ADT and other cancer treatmeants were discontinued at least six months before the start of the trial. Is it known whether any of the 59 patients may have started ADT or other cancer treatments during the trial? My high-risk cancer is currently senescent, but if my PSA was increasing, I doubt if I would dare trust MCP as my only treatment no matter how much I believe in it!

Reply from dr Isaac Eliaz

Quite the timing. We just presented our 18 months multi center follow up with 90% benefits.

Patients were not on ADT during the study.

They had no ADT for a few months before the beginning of the study. I assume that if we excluded anyone who had ADT we would have gotten even better results.

80% of patients with BRPC have increased PSA velocity/shortening of PSADT over time. We slowed it down in almost 90% of patients after 18 months, compared to baseline, as the only treatment.

What is interesting is results that we are getting from the community- real life cases. It will have a major impact when finally published.

There is no issue in combining MCP (Pectasol) with other supplements and therapies.

All the best,

Isaac

Excerpt from the study posted to dr Eliaz that indicates lengthened PSADT over time ncbi.nlm.nih.gov/pmc/articl...

Methods

In retrospective analyses of two BRPC cohorts: Johns Hopkins Hospital (JHH) patients who deferred therapy and placebo patients on a randomized clinical trial (RCT), we calculated changes in PSADT from early measurements to later measurements using subsets of available PSAs for patients with ≥6 and ≥9 PSAs. We simulated hypothetical single-arm trials using randomly selected, 50-patient subsets and simulated two-arm RCTs. (Note: “placebo patients”were prostate cancer patients who were randomized to the placebo arm of a phase II RCT of an experimental targeted non-hormonal agent conducted in 41 sites in the United States and Canada).

Results

JHH cohort (n=205) had median follow-up 58 months, median age 61 years, and median Gleason 7. PSA variability changed with duration of PSA measurement as median within-patient PSADT increases for men with >6 PSAs ranged from 1.0 to 1.4 months by PSA subset while increases for men with ≥9 PSAs ranged from 3.9 to 4.1 months. Frequency of measurement did not change PSA variability as PSADT increase was unchanged when odd values were used instead of all values. Approximately 30% of JHH men experienced >200% increases in PSADT. Up to 62% of 50-patient single-arm simulations detected significant PSADT change, whereas simulated RCTs did not. Results were supported in the RCT placebo cohort; 46% of patients experienced PSADT increases >200%.

Conclusion

These data suggest that calculated PSADT in BRPC may naturally increase over time in the absence of therapy and may be influenced by duration of PSA follow-up. As a result, single arm trials could show false significant increases despite the lack of active treatment of these patients. Placebo-controlled RCTs including clinical endpoints are recommended to screen novel agents in men with BRPC to mitigate bias because of natural PSADT variability.

Excerpt from the one other relevant study, from 2021, that I could find in a quick search, which indicates no consistent pattern in change of PSADT.

auajournals.org/doi/10.1097...

INTRODUCTION AND OBJECTIVE:

Among men with hormone naïve biochemically recurrent (BCR) prostate cancer (PCa) after primary therapy, a shorter prostate specific antigen (PSA) doubling time (PSADT) predicts a greater risk of PCa specific mortality (PCSM). However, whether PSADT values stay consistent over time and the corresponding impact on prognostication for PCSM is currently unknown.

METHODS:

There were 1,652 patients treated with radical prostatectomy (RP) between 1982 and 2019 at 8 Veterans Affairs hospitals who had a biochemical recurrence included. For all patients, PSADT values were calculated using all the PSA values within each 12-month block after BCR up to 3 years. All patients had PSADT values for year one, 705 patients had PSADT values for year two, and 379 patients had PSADT values for year three. All PSA values were prior to adjuvant therapy and therefore had no impact on PSADT calculation. Statistical analyses included a Wilcoxon signed-rank test to evaluate changes in PSADT between years and univariable and multivariable cox regression models to evaluate associations with PCSM.

RESULTS:

There was no significant change in PSADT between years 1 and 2 or between years 2 and 3 (both p<0.05). Of the 379 patients with year three PSADT data available, 289 (76%) of them showed no consistent pattern of shortening or lengthening of the PSADT over the first 3 years after BCR (Figure 1). Change in PSADT was not associated with PCSM in univariable or multivariable analysis (both p<0.05), whereas the year 2 PSADT [HR (95%CI)=0.62 (0.48-0.82), p<0.001] and year 3 PSADT [HR (95%CI)=0.61 (0.46-0.82), p<0.001] significantly predicted PCSM after adjusting for pathological Gleason sum, seminal vesicle invasion, and lymph node metastasis.

CONCLUSIONS:

For the majority of patients having BCR after RP, PSADT did not change over time. However, while PSADT does not change consistently over time, the PSADT in year 2 and year 3 were strongly predictive of PCSM. This information may serve to guide patients and physicians regarding timing of adjuvant treatment among those at higher risk for PCSM following BCR after RP.

[Purple-Bike]

Oops, the flow diagram from the second study landed on the top of the post.

[Soumen79]

Thank you for this!But i am getting confused with the adt caveat - anyone please try to explain this? I am on adt and uses mcp maintainance dose.

[Purple-Bike in reply to Soumen79]

The adt caveat means that the results are valid in the absence of any intervention including adt. In the presence of adt I belive MCP can be considered beneficial if Dr Eliaz is correct or if the second study is valid. If the first study is correct, any benefit is uncertain.

[Soumen79 in reply to Purple-Bike]

Thank you!! You made it simple.

[Purple-Bike in reply to Soumen79]

But it's confusing with the differing trial results. Maybe good, maybe not. Adding it to a cocktail of might-be good supplements can improve the odds of success in this battle.

[Rolphs]

I use the maximum dose for MCP and have for more than a year. There is also a maintenance dose. What do you take?

[Soumen79 in reply to Rolphs]

Six capsules per day is what i am taking.

[Hidden]

I mixed up and choked down the pectin for about a yr per a Nat doc . After I went into remission he told me to stop it . I happily did so .. I think it helped out what was a terrible urology in me ? Good luck!

[dhccpa]

What daily dosage does Dr. Eliza recommend?

[Purple-Bike]

As I recall, but not fully certain, six a day of his Pectasol.

[Purple-Bike]

Yes, please post!. As forTherepeutic Apheresis, I have been doing a similar treatment, Therapeutic Plasma Exchange / Plasmapheresis.

[Purple-Bike]

Rereading up on this: One serving is 4.8 g for six caps and for some reason 5 g for the powder; perhaps the difference is because of binders. The 10-15 grams of powder must be for the recommended humungous starting dose, which for caps is 18 per day. Maintenance dose is six caps, which is what I used. There are limits.....

If one chooses to take MCP, three bottles of 270 caps each, with six caps per day lasting 4.5 months comes to 52 dollars per month. Three large packets of powder 454 g each, with 4.8 g per day, lasting nine months comes to 36 dollars per month. Excluding freight, and for non-U.S. customs.

Swansons and others have less expensive MCP, which the Eliaz site says are not to be trusted because they do not have the "correct molecular formulations", have toxins/additives and have no research to back up.

There is a large number of studies indicating benefits in an impressive range of areas including PCa for MCP, probably mostly connected to dr Eliaz, but all are preclinical, except this one released study on PSA (showing up as three in the list) and one or two old studies on release of toxins.

Right, the not-finally-published study is bothersome, as is Dr Eliaz not giving any reference to his statement that most have reduced PSADT over time when he is reacting to a qualified study indicating the opposite.

I wish there was a way to judge which of the two posted studies that are most valid; to me both appear to be of high quality but I am not a good judge on this. Or if a third study can be found. To get a handle on what the normal range of PSADT change in the absence of interventions actually is.

To include or not include this in the list of just-maybe-good supplements to gulp down........?

[Purple-Bike]

If there is (micro)metastasis, is the Galactin-3 protein there, which is not removable, more important than that which is removed from the blood plasma?

[Purple-Bike]

All my plasma is reduced, replaced by albumin and a saline solution, for possible anti-aging effects. What I don´t know is if it will have an anti-PCa effect. Circulating tumour cells will certainly be removed, but will they soon be replenished from my micrometastasis? What is the relative role of future spread of cancer from the plasma vs micrometastasis? Remains to figure out.

Looking forward to getting your post when you have time to put all together!

[Purple-Bike]

I understand! Am trying to get comments on the first study from the lead author of the second study, no answer yet.

What are your favourite tests for kidney/liver stress? I use ASAT/ALAT and creatinine. So far no stress indicated, although I take close to 15 supps.

[Purple-Bike]

Do you make all five kidney tests at the same time? I thought a combination of two - creatinine plus either eGFR or BUN - is enough to rule out kidney stress (from supplements) in the great bulk of cases. That is what I find from an admittedly fast search.

[Polaris1]

Thanks for the information you have posted. Since you have contact with Dr. Eliaz, could you please ask him to clarify the confusing statement he sent to you?

"80% of patients with BRPC have increased PSA velocity/shortening of PSADT over time. We slowed it down in almost 90% of patients after 18 months, compared to baseline, as the only treatment."

I can think of several possible interpretations of the statement, but I don't wish to speculate.

Thanks in advance!

[Purple-Bike in reply to Polaris1]

You are right, the statement is ambiguous. What bothers me most is the 80% statement without any reference to where he gets this data from, after he has received a well designed study showing the opposite. It verges on arrogance, or is it just something he has taken out of nowhere?

I have no direct contact with Eliaz, it has been via email with AnnieAppleseed. I don´t feel comfortable asking her again to facilitate contact with him, but if you want you can message her and ask if she is up for this.

[GeorgeGlass in reply to Polaris1]

youtu.be/IKiSPUc2Jck(Not working as expected?)

[Purple-Bike]

We will have to wait for the not yet published study....

[GeorgeGlass]

Thanks for the post PB. Sex Panther - 60% of the time, it works every time, from the movie Anchorman. I take this stuff in the middle of the night when I get up to pee. I am skeptical though, because this forum has a lot of guys taking it, and I haven't heard a peep from anyone that their psadt has slowed. If it worked, wouldn't guys be clamoring about the doubling time being increased?