I know that some patients take these supplements in spite of clinical data showing no effect for prostate cancer. I updated the article on curcumin with health warnings on hepatotoxicity. PLEASE, if you are taking either or both as supplements, at least tell your oncologist, and get liver enzyme tests every 3 months. It normally takes 4-6 months for liver enzymes to become elevated.
when I got diagnosed, I was sucked into the supplements world. I tired a lot of them, none of them worked for me to stop psa from rising or extending the psa doubling time. I realized at the end they are useless and STOPPED everthing. What a shame, some patients still believe in some, I don’t. Just waste of energy.
"sucked into the supplements world" - marvelous way to describe the phenomena. I do take calcium, magnesium, vitamin D, and methylphenidate (Ritalin). And one or two others. Maybe it doesn't have to be all or nothing, but for me it's mostly nothing.
Take for example the notorious curcumin. As Tall Allen points out it can be hepatotoxic. And it's bioavailability is notoriously low. And then there's the question of heavy metals contamination. And this is all beside the question of whether it works or not. There sure is a lot of propaganda for it.
Thanks for the heads up on tumeric/curcumin. Never took it for cancer, but only as a general anti-inflammatory. Study shows formulas with higher bioavailability may be the issue, and I was using those. Same with green tea. Oh well, I guess I save some and can put that $$ towards my BROQ.
Thanks TA. Every time I am about to get sucked into an expensive supplement/nutraceutical/vitamin-mineral program, I come here and find sound advice. Have not bought into anything yet and have saved a bunch of $$ and possible bodily harm. Keep the info flowing, it is appreciated.
I’m confused about this paragraph at the end of the study:
“In addition, this survey sample size was not adequate to detect hepatotoxic effects from botanicals or other adverse events since these arise in less than 1% of exposed individuals. Thus, our study was not designed to identify any causal relationship between consumption of the 6 botanicals of interest and the development of liver injury over time.”
I have been taking modified citrus pectin by EcoNugenics since my recurrence in 2010. Prostatectomy in 2007. My psa stopped rising at less than one some years ago. Would be interested in your point of view. PMSA scans show no lesions.
the supplements I have been taking for years are pharma-nord ubiqinol q10, modified citrus pectin, boswella for my osteoporosis, krill oil,pomi-t, magnesium, vit d3 with k2 mk-7, dr Chris woolams a bio chemist on canceractive is good. all my blood tests always come back ok.
Thanks for the response Tall Allen. Again I must say that you are a true blessing.
I take 9.6 grams of MCP per day. Double that for about first year after recurrence. Gleason score was originally 4+3=7. No lymph node involvement at time (2007) of robotic surgery. PSA started rising after 2 years. Started taking MCP in 2010. Declined radiation and chemotherapy recommendations from MSK for personal reasons and because their studies showed very limited longevity increase at that time. No lesions on PMSA scans thru last fall. Seems to have other benefits as well including strong immune profile at age 84.
While there are no control group studies that I am aware of , over 81 studies of varying quality suggest benefit of MCP in recurrence situations.
Question 1: Since the US is the largest consumer of Tumeric/Curcumin based supplements and food based products, is there a database for the number of people treated each year for liver toxicity issues caused by by Curcumin?
Question 2: Since Turkey is the largest consumer of green tea at nearly seven pounds per person, do they maintain a database on liver toxicity caused by green tea consumption?
I realize what they’re talking about, reread my questions. I know supplements are sometimes highly concentrated, but seven pounds of green tea would make a lot of tea and curcumin is consumed daily in the Indian diet, hence the reason for my question(s).
I read your question. You need to understand that curcumin and tea consumed by diet is not the same as taking concentrated supplements. Regardless of the amount consumed by diet, it's nowhere near.
Arrg. Here. 30 secs Google search. I'm sure there's more data, you need to find it.
Studies typically use doses of 500–2,000 mg of turmeric per day, often in the form of an extract with a curcumin concentration that is much higher than the amounts naturally occurring in foods.
For instance, the average Indian diet provides around 2,000–2,500 mg of turmeric per day, which only translates to around 60–100 mg of curcumin (14Trusted Source).
For reference, turmeric spices contain around 3% curcumin, compared to 95% curcumin in extracts (15Trusted Source).
It wasn’t a funny question. It was a legitimate question about whether the US or Turkey have a statistical database in relation to liver toxicity related to the consumption of green tea or curcumin.
My dad's cancer has recently spread to the liver. 8-10 lesions found. He takes these supplements all the time. Why in the world wouldn't the doctor say something knowing he takes it?
Here is my take on your question. Perhaps he is not aware of the damage these cause or he has tried and it has no impact on your dad’s thinking or at this stage the cancer is going to have more effect then the supplements and the placebo effect may actually help in some way. Just my guessing!
Many thanks for this info. Part of my strategy since RP in 2015 has been pomi t. I understand it can suppress psa readings, but if it reduces psa readings by a constant factor it should not hide a doubling time trend, correct? I feel I'm in too deep with it, and at psa of 0.1 I am monitoring for a defined DT before SRT.
There is only one potentially active ingredient in PomiT- sulforaphane. Curcumin interferes with the PSA test itself, not "reduces psa readings by a constant factor."
To minimize curcumin's potential interference with PSA test results, it would generally be recommended to discontinue curcumin several days to a couple of weeks before the test. However, the exact time frame isn't definitively established in scientific literature. Here’s a reasonable approach:
1. **7 to 14 Days Before the Test**: Stopping curcumin at least 1-2 weeks prior to your PSA test is often suggested. This allows sufficient time for curcumin to be metabolized and cleared from your system, reducing the chance that it will affect PSA readings.
2. **Consult Your Healthcare Provider**: Because individual factors like dosage, frequency of curcumin intake, and personal metabolism vary, it's important to discuss this with your healthcare provider. They can provide a more tailored recommendation based on your specific situation and any other medications or supplements you're taking.
Discontinuing curcumin ahead of the test as recommended by your healthcare provider should help in obtaining more accurate PSA test results.
The extent of curcumin's interference with PSA testing isn't well-documented with precise numbers, and studies on this specific issue are limited. However, curcumin's interference generally occurs due to its ability to bind with PSA or interfere with the assay used to measure PSA levels. This can result in lower PSA readings, but the exact degree of this interference likely varies depending on factors such as the dosage of curcumin, the individual's metabolism, and the specific PSA assay being used.
Since there's no clear range provided in clinical studies, it's difficult to quantify how much curcumin might lower PSA readings. If curcumin is being consumed regularly, it might be wise to inform your healthcare provider, as they may consider this potential interference when interpreting PSA test results. In some cases, discontinuing curcumin before a PSA test might be advised to ensure more accurate readings.
If you have a regular monitoring schedule for PSA levels and are taking curcumin, your healthcare provider might help adjust for this potential interference by comparing trends over time rather than relying on single PSA values.
Personally, I tested stopping for a month and restarting curcumin with NO change in PSA readings. But, I have the anti-BS gene that repulses red herrings.
Could you please clarify this in simple English so I can understand better what you actually did? My understanding is that you stopped Curcumin a month before the PSA test? And what was the effect?
Please go to my thread entitled: "An engineer's Bicalutamide maneuvers". The info you are seeking can be found therein, possibly in Greek to the reader English.
Reviewed your bio. The two 2024 time samples are to the 2nd decimal place while the previous ones where to the 3rd. Obviously different labs, so, not comparable. If you maintain such PSA readings without any medication you need do nothing for now.
As TA said, sulforaphane has gold standard study and other to back up its use. In US, product is BROQ. MCP study not quite gold standard study since no randomization but looks pretty good so cant hurt. Here is sulforaphane study.
It looks pretty good. I just don't like the fact that the supplement manufacturer was funding the study and there's a conflict of interest with 1 of the authors .
This might be redundant as it might have been answered already: should turmeric and green tea be avoided in their natural forms for apc patients? In juices and tea once a day? And what about pomegranate juice?
Here is a Phase II decent trial that says different. Anything that extends PSA doubling time that is simple, and dose that is easy, is worth using. This study showed average double time from 15 months to 54 months. Only problem with Pomegranate juice is shelf life is days.
"Anything that extends PSA doubling time that is simple, and dose that is easy, is worth using." That is just not true. Why do you suppose we rely on randomized clinical trials? In fact, when pomegranate was later tested in two randomized trials (one by the same group that did the single-arm trial you referenced), it was proven to have no effect:
Again, as an individual, for me there is enough chance of benefit for the cost, with little or no downside. How do we know the other two were not flawed? I think they are all biased and it is foolish to think they are not in some way in my view. With supplement studies, we rarely, if ever, will get the "Gold Standard" and I am not looking for that. Again, I am not a SOC medical provider. They are bound to Gold Standard for insurance purposes in the large institutions. I, nor you, am not so bound. We can actually use LOGIC, which as a professor at a large medical institution once admitted in a taped interview, his first job with all the science heavy 1st years, is to get them to forget logic when it comes to medicine. If one pill fixes someone 25%, logic says try 1 1/2 or 2. Institutions can only go to 1 1/2 pill after years of studies, and millions spent. I understand the institutional risk reduction strategy, but people are dying. Maybe that is why we have had hardly any progress in saving lives with regard to cancer for several decades. There are plenty of smart, progressive MDs out there today that realize this, and are not willing to let people keep dying, and are willing to try non-SOC treatments in the meantime, with informed consent. To me very similar to Trump's Right to Try Act for terminally ill patients. TA, I understand your position, which is the large institutional SOC only position. I dont agree with it, and you dont agree with mine. You and the large institutions are not right or wrong, you and they are just acting in your own best interest (although I am not sure of your interest other than just wholesale acceptance of the SOC position). I also am not saying you of SOC are wrong. I just like logic better. I appreciate your opinions, but they are not the only ones out there.
Some of us use science instead of our own faulty "logic" to make decisions about which drugs (supplements are drugs). The problem with "logic" is that, like opinions and ***holes, everyone's got their own. That's why medical researchers adhere to evidence-based medicine instead. In the end, science is better than your personal "logic."
I am sorry you have faulty logic. Mine has served me well in so many areas. However, not everyone has logic (so that analogy you used is faulty). You see, "evidence based' is based on logic. Science is never at an end point, so it is always based on logic of the "facts" they have access to, which of course can change at any time. We all know hundreds of "science based" items that turned out to false at a further point in time. Think of the whole T causes prostate cancer that every doc was taught, and is still taught. Science? No, a guess, maybe best guess at the time based on data they had, which we now know was WRONG. Why had they not found the saturation theory sooner? No funding. Institutional science goes where the funds are, and know their careers depend on making clients happy. Welcome to the real world. Nothing wrong with more studies to give us more information to come to logical conclusions with. You base everything on the "gold standard" studies. Thank God there are more and more science trained doctors today that understand that is a fool's errand, while people die and suffer. I see many major institutional docs these days that are willing to stray out of the Gold Standard and run with what is working based on all scientific information available at this time. I won't even go into the dozens and dozens of studies published in the acclaimed journals that are found to be fraudulent, lacking, biased, etc. Sad.
I don't refuse to accept the best evidence available. I always look at best evidence available. In the studies on sulforaphane, MCP, pomegranate juice, that is the "best evidence available" on those compounds. So, the fact that you grade the study as a B- or C+, is, in your own words, irrelevant since this is still the "best evidence available" as you espouse. There was empirical testing, with results. However, you put your spin on the "best evidence available", so who is not following the system you espouse? On the sulforaphane study, the best data available is the best data available per you, but then you add your preconceived prejudices (small study, someone farted, etc), so you are not following the scientific method, but adding logic into the equation. Pot meet kettle.
After Pantuck et al. did that trial that you are attached to, in which they wrote that it "warranted further testing in a placebo-controlled study" they actually did that larger placebo-controlled study. In the follow-up study, they found:"Compared with placebo, pomegranate extract did NOT significantly prolong PSADT in prostate cancer patients with rising PSA after primary therapy." This was backed up by that Swiss trial that I referenced. When a patient holds onto cherished beliefs in spite of the best evidence to the contrary, the patient is deluding himself.
The rules of medical evidence and how that evidence is evaluated is not up to you or me. There is scientific consensus on this. Otherwise, you are adhering to your own faulty logic. You are free to do whatever you please with your own body, but please, keep it to yourself.
So much to cover. This newer study you cite concludes that pomegranate extract did not SIGNIFICANTLY prolong PSADT, which means it DID prolong PSADT!! Thanks for adding another study that shows it is to some benefit, with little cost and no downside. It is the studies that show it does slow PSADT, not someone's "cherished beliefs". And only one cup a day of juice. You just won't see your own bias and flaws in your arguments.
I don't mind relying on the scientific consensus (by the way, is it 51% that forms the consensus, or higher like 95%?) And again, I'm not the one with the faulty logic on this as shown above.
Consensus at conferences is usually 95+%, but for "levels of evidence" and GRADE it has to be 100% among researchers because they will not get published if they don't follow that. It would be like flat-earthers trying to be published in an aerospace journal.
I sometimes forget how much jargon is used in journals and how easily it can be misunderstood by patients who have no knowledge of statistics. The word "significantly" refers to statistical significance. Whenever there is a placebo-controlled trial, the experimental group has to improve the results of the placebo group by an amount greater than random variation would allow -this is called a significance test. It does not mean "meaningful." For example, in a trial of 10,000 people, an improvement of .1% can be significant, but not meaningful. But in a trial of 10 people, an improvement of 50% can be statistically insignificant because of the small sample size.
It's because you'd probably have to drink a couple of gallons of it to get enough of it's chief phytocompound, ellagic acid. And in doing so, you'd be fueling the cancer cells with so much of the juice's abundant sugar that they'd proliferate far faster than the ellagic acid could inhibit them.
In general, fruit juices, as well as many other foods, are more suitable for the prevention of cancer by providing the body with antioxidant, anti-inflammatory, detoxifying, immune-boosting, DNA repair, etc. support.
But once the disease manifests, they're not, in and of themselves, effective as treatment options for it, though they still could be part of a healthy diet for it.
I don’t understand the confusion or doubt about the concentrations found in supplements vs naturally present in foods, teas etc. Very easily found info if you look. Lightning vs lightning bug, and it’s a major selling point for supplement manufacturers. Caveat Emptor indeed.
Also, we should all keep in mind that doctors generally do not look too carefully at many of the supplements their patients are taking, since there is such a glut of them, mostly with no reliable data on their efficacy or even their purity, consistency of dose etc. If doctors tried to keep up on it they would have time for little else.
It would be a more intelligent approach to medicine if they did though given that some supplements can impede the efficacy of conventional treatments. Perfect example: Radiation treatment destroys cancer cells by creating enormous oxidative stress in them. Someone taking huge amounts of Antioxidants at the same time, depending on the type and level, could impede the treatment by countering the oxidative stress on the cancer cells (to destroy them) from the radiation.
My radiologist wanted to rush me right into appointments for treatment without giving this an ounce of thought until I introduced the subject. He then slowed his pace and said, "Certainly, we wouldn't want you taking lots of antioxidants while doing the treatments as they might interfere to some degree. But doing regular amounts shouldn't be a problem."
So basically, he's saying that normal dietary levels of antioxidants are okay during radiation treatment, but "therapeutic or interventional levels are not. So doctors, if they're being responsible practitioners, should not assume that all patients are consuming a diet that's perfectly "treatment-compatible."
There have been studies in the past that show high-dosage supplements can have a negative impact. It is much better to have these tyoe of things in the regular food preparation in levels that are appropriate for cooking and just use them more frequently than taking high dosage supplements. The argument that "some is good, so more is better" is flawed.
Sorry, the thread has spread to all kinds of supplements, so was not sure what you were referring . With Curcumin, I agree. I am stopping but dont worry about spices, etc in food since the levels will be very low. but hopefully there will be some benefit. Thanks.
I looked at the links and am genuinely interested in natural products, alternative treatments and supplements, as they relate to PCa treatment, or prevention. There are a lot of claims made, but are they legitimate, both pro and con? When looking at studies I always want to know the statistical significance of the findings.
For the Curcumin portion of the study referenced there is no presentation of P factors, study power or CI confidence intervals; just conclusions.
For Green Tea the study does provide some statistical backup and a positive finding for a subset of men with PCa.
Here is the pull quote from the study;
NIHMSID: NIHMS682273 - No differences in the number of PCa cases were observed: 5/49 (PolyE, or Polyphenon E® (PolyE), a proprietary mixture of GTCs, green tea catechins) versus 9/48 (placebo), P=0.25. A secondary endpoint comparing the cumulative rate of PCa plus ASAP (Atypical Small Acinar Proliferation) among men with HGPIN (High-Grade Prostatic Intraepithelial Neoplasia) without ASAP at baseline, revealed a decrease in this composite endpoint: 3/26 (PolyE) versus 10/25 (placebo) [70% drop], P<0.024 [2.4% probability that the result was random]. This finding was driven by a decrease in ASAP diagnoses on the Poly E (0/26) compared to the placebo arm (5/25). A decrease in serum prostate specific antigen (PSA) was observed on the PolyE arm [−0.87 ng/ml (95%CI: −1.66, −0.09)]
So, for the green tea portion of the study, the 'P' factor for concluding that there was no difference in the number of PCa cases between control and placebo was 0.25, meaning that the chance that the result, or null hypothesis, is wrong is 25% (i.e., that green tea reduces PCa); this is too high for a good study. P factors of 0.05 are the standards normally required (see ahajournals.org/doi/10.1161.... I have seen many studies with P factors at or below 0.005; those really get my attention. Then the confidence interval (CI) is also important when considering a P factor; a wide interval allows for a lower P factor, thus reducing confidence in the conclusion. There is no CI reported for this finding, that I can find. Without a CI we cannot determine what “value” a P of 0.25 even has.
Next, the study is underpowered as well with only 97 patients total. Studies should have at least 100 patients in each study arm so as to no to be considered underpowered; this study had half that many in the control and placebo groups. See this reference; (see ncbi.nlm.nih.gov/pmc/articl.... Notwithstanding, this study could have been accepted had it stated the ‘power level,’ at which it operated. 80% is the normal standard required, but none is reported (see nephjc.com/news/2018/7/18/u....
Nonetheless, the secondary end point is very interesting for a subset of men. It had a finding that green tea had a reduction in cumulative rate of PCa plus ASAP among men with HGPIN without ASAP at baseline. ASAP is a term used in pathology to describe a finding in prostate biopsy samples where small acinar structures appear suspicious for malignancy but do not meet the full criteria for a definitive cancer diagnosis. HGPIN, unlike low-grade PIN (prostatic intraepithelial neoplasia), is associated with a higher risk of developing into prostate cancer over time. This study reported a 70% drop (from 10 to 3 men) in PCa rates for men who lacked ASAP at baseline but had HGPIN and took PolyE. Approximately 30-40% of patients with ASAP may develop prostate cancer within a five-year period (pubmed.ncbi.nlm.nih.gov/268.... This result is reported at a 95% CI, with a P of 0.024 (2.4% chance of the result being false). This research also showed a drop of PSA of 0.87 on average with a maximum drop of 1.66 reported. So, for this exclusive group of men the secondary endpoint, use of green tea PolyE, shows promise and the P factor and CI are more acceptable. However, this part of the study is also underpowered with less than 30 patients in each group (control vs placebo). Make your own conclusions and understand that the study group has a very restrictive pathology.
In conclusion, we need to look under the hood of publications to see if the study warrants the findings and if the headlines merit the publicity. This goes both ways, for studies that purport to show and negate the effects of natural product and alternative remedies. P factors that are high dont provide the basis to wave off use of supplements, or alternative treatments. P factors that are reported without CI’s are almost pointless. Studies that have less than 100 patients in each group are generally underpowered and may not be large enough to avoid inconclusive results. Results, both negative and positive, may apply to very restricted sub sets of men with unique pathologies and be of little use to the general PCa population. TNX Rick
Like all drugs, supplements must prove their efficacy and safety. The burden of proof is with the drug. Since most drugs have no efficacy, there is an agreed upon sorting process. If a drug does not show efficacy in a small early study, development work is discontinued. Considering that most drugs that show efficacy in smaller studies do not show efficacy in larger trials, this policy seems prudent.
There is no proof from a randomised trial that circumin has any efficacy, and a suggestion from a trial that all it does is render the PSA test invalid.
The EGCG trial reported:
"The primary endpoint of this study was not met as significant differences in PCa rates were not observed between the two study arms: 5/49 (10.2%) Poly E versus 9/48 (18.8 %%) placebo, P=0.25"
The P value is the probability of that data (or even more extreme) if the null hypothesis is true. The null hypothesis is that the intervention had no effect. Because the P value is well above 0.05, the null hypothesis (no effect) is accepted.
Since you like details:
While you claimed, "Notwithstanding, this study could have been accepted had it stated the ‘power level,’ at which it operated. 80% is the normal standard required, but none is reported." The trial said, "This study had 79% power (2-sided) to detect a change from 30% to 9% with 50 patients per arm (derived from PASS 2008); with a power of 98% if the true rate of progression were .03 in the better group and .30 in the inferior group. "
I understand P values differently and the higher the P the less confidence you have on the outcome. The reported outcome is that these supplements dont work. In any event, without a CI the P value is of less/ no use as you dont know the interval its applies to. Personally, I would not follow any study with a P value of 0.25.
So, a small study, of any size, done without statistical rigor, can negate the effects of supplements. Interesting. Have not heard that one. Makes it easy to knock them down in that case.
I could not find the study's power. Regardless you need 100 minimum in each group for sufficient power, from my sources. This study makes the claim curcumin does not work with a study group of less than 100 patients, of which 49 were in the control group, 5 of which had a reaction! If it were reversed and the study said curcumin did work, I would not take the supplement based on this study and its sample size. So, I dont know why we reject categorically that this supplement does not work on such thin evidence.
I dont mean to get into a table-tennis match via reply. We simply disagree on this study, its sampling, size, power and efficacy. I would not accept its results. You may have a different opinion. But I would not conclude, based on this study, that these supplements dont work. As always; 'we need more research.' But, if small, statistically-challenged studies scan knock down supplements, then these larger, better studies will never come. QED. Rick
That is a misunderstanding of P values. Many misunderstand them. It's not a matter of personal opinion - it has a defined meaning. Here's an article that may help you better understand:
Most of us should know by now and factor in your irrational hatred of supplements. Go ahead and beat me over the head with your "science". I'll keep taking vitamins and supplements.
It's good to be reminded that plant derived chemicals can have toxic or complex off target effects. Perhaps for those who choose to take curcumin because of ongoing interest in its' anti Pca activity, ncbi.nlm.nih.gov/pmc/articl... should consider also taking milk thistle or sylmarin,onlinelibrary.wiley.com/doi... .
There is no evidence that curcumin is clinically effective. 1000 x 0 = 0
Silymarin may interact with drugs that have an effect on cytochrome p-450, which is most drugs. Men who are taking drugs for prostate cancer should be wary.
Really bad advice "to continue evaluating treatments based on your personal response, especially with something as critical as prostate cancer management." The only way anyone can be sure that a treatment is safe and effective is to know what would have happened had you not taken it. The only way to know that is from a randomized clinical trial among similar patients.
You're absolutely right. Personal observations can be valuable for understanding how you feel or react to a particular treatment, but they don't provide definitive evidence of safety or efficacy, especially for serious conditions like prostate cancer. Randomized clinical trials (RCTs) are the gold standard for determining the true effectiveness and safety of treatments, as they control for variables and reduce biases that can affect outcomes.
Thank you for pointing that out—it's crucial to rely on robust scientific evidence, especially in critical health situations.
I initially emphasized personal observation because it's common for people to monitor their own responses to treatments as part of managing chronic conditions. However, I should have more clearly highlighted that while personal experience is important, it doesn't replace the need for evidence-based approaches like RCTs, especially in serious medical conditions like prostate cancer.
I appreciate your correction, as it reinforces the importance of relying on scientifically validated information for critical health decisions. I'll make sure to be more precise in the future.
Hello Tall Allen Iam taking green tea with tumeric/curcumin tea with black pepper in the AM and soursop tea in the afternoon. Apricot seeds (4) , liver dose shot, aloe vera shot in the AM. I also take Vit K, D3, B complex Vit C, calcium zinc and magnesium. I am currently on Xtandi 160 mg and Eligard injection every 3 months.
There is no known benefit to any of those for prostate cancer, and there is known harm, especially your slow poisoning with apricot seeds. People with cancer may not have the repair mechanisms intact to get rid of all the toxins, and need to be careful about what they put in their bodies.
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