Over the years, I have posted PCa studies on inflammation markers. The Systemic Inflammation Score [SIS] hasn't been used in a PCa study until now.
In essence, almost any marker of inflammation, or combination thereof, can be used to determine how bad one's subclinical inflammation is. PCa is an inflammatory condition & most of us would benefit from its reduction.
Many studies have used the markers to predict who would not do well on a particular treatment. The numbers are used to predict failure and there is no study showing that improving the numbers before treatment would be valuable, that is my belief.
Before surgery, my albumin was 3.9. My target for 17 years has been 4.5 and I use polyphenols (natural NF-kB inhibitors) to increase it. The SIS uses albumin too.
"The SIS was established by determining the serum Alb {albumin} level and LMR {lymphocyte-to-monocyte ratio}. The Alb level and LMR were analyzed as categorical variables and were dichotomized based on the median values of 40.3 g/L and 4.05, respectively. A SIS of 0 was defined as LMR ≥ 4.05 and Alb level ≥ 40.3 g/L, SIS of 1 as either Alb level ≥ 40.3 g/L or LMR ≥ 4.05, and SIS of 2 as Alb level < 40.3 g/L and LMR < 4.05 (Table 1). We divided the PCa patients according to the SIS into the low (score of 0 or 1) and high (score of 2) groups."
The simplistic 0-1-2 scoring is similar to the Modified Glasgow prognostic score, which also uses albumin & C-Reactive Protein [CRP].
"Our study showed that the SIS was associated with PSA, monocytes, neutrophils, NLR, PLR, lymphocytes, Alb, PNI, and LMR. The Kaplan–Meier analysis suggested that patients with a low SIS had better OS and PFS compared with those with a high SIS. Univariate and multivariate Cox analyses revealed that a high SIS was independently associated with a poorer OS in patients with PCa. To the best of our knowledge, this is the first study to determine that the SIS is a prognostic factor in patients with PCa.
"The SIS is based on the Alb level and LMR,19 which can be easily tested in any clinical laboratory. This scoring system could reflect the host’s nutritional and inflammatory conditions. The SIS has been regarded as a novel risk stratification biomarker in a variety of cancers."
This is another way to stratify systemic inflammation using white blood cell count ratios and serum albumin. But are these adequate and specific enough? Monocyte counts do tend to rise when acute inflammation becomes more chronic. And low albumin is indeed another good marker. However I think that adding high-sensitivity CRP (hsCRP) and fibrinogen levels to the albumin (or albumin/globulin ratio) and the various WBC and platelet rations provides a better profile.
And then we need to review strategies to reduce sources of inflammation: How are your teeth, gums and gut microbiome? And what adjuncts, dietary and medicinal can we deploy to reduce systemic inflammation? We are not just our cancer. We must protect our precious bodies as we continue to age and live.
Here is a good summary article on inflammation, how it can be assessed and what interventions can help reduce it. Paul / MB
"Many dietary and lifestyle changes may be helpful in removing inflammation triggers and reducing chronic inflammation as listed below. The most effective is weight loss. For example, in patients with psoriatic arthritis which is chronic inflammatory arthritis, weight loss alone has been shown to be independently associated with clinically significant improvement in disease activity and inflammation.
Low-glycemic diet: Diet with a high glycemic index is related to high risk of stroke, coronary heart disease, and type 2 diabetes mellitus. It is beneficial to limit the consumption of inflammation-promoting foods like sodas, refined carbohydrates, fructose corn syrup in a diet.
Reduce intake of total, saturated fat and trans fats: Some dietary saturated and synthetic trans-fats aggravate inflammation, while omega-3 polyunsaturated fats appear to be anti-inflammatory. Processed and packaged foods that contain trans fats such as processed seed and vegetable oils, baked goods (like soybean and corn oil) should be reduced from the diet.Fruits and vegetables: Blueberries, apples, Brussels sprouts, cabbage, broccoli, and cauliflower, that are high in natural antioxidants and polyphenols and other anti-inflammatory compounds, may protect against inflammation. Cherries and cherry juice consumption has been shown to be uricosuric and inhibitory for IL-1 in patients with gout.
Fiber: High intake of dietary soluble and insoluble fiber is associated with lowering levels of IL-6 and TNF-alpha. Nuts: such as almonds are associated with lowering the risk of cardiovascular disease and diabetes.
Green and black tea polyphenols: Tea polyphenols are associated with a reduction in CRP in human clinical studies.
Curcumin: a constituent of turmeric has been shown to be associated with significant improvement in several inflammatory diseases in animal models.
Fish Oil: The richest source of the omega-3 fatty acids. Higher intake of omega-3 fatty acids is associated with lowering levels of TNF-alpha, CRP, and IL-6.Mung bean: Rich in flavonoids (particularly vitexin and isovitexin). It is a traditional food and herbal medicine known for its anti-inflammatory effects.
Micronutrients: Magnesium, vitamin D, vitamin E, zinc and selenium). Magnesium is listed as one of the most anti-inflammatory dietary factors, and its intake is associated with the lowering of hsCRP, IL-6, and TNF-alpha activity. Vitamin D exerts its anti-inflammatory activity by suppressing inflammatory mediators such as prostaglandins and nuclear factor kappa-light-chain-enhancer of activated B cells. Vitamin E, zinc, and selenium act as antioxidants in the body.Sesame Lignans: Sesame oil consumption reduces the synthesis of prostaglandin, leukotrienes, and thromboxanes and is known for its potential hypotensive activity.
Physical Exercise In human clinical trials, it is shown that energy expenditure through exercise lowers multiple pro-inflammatory molecules and cytokines independently of weight loss.
Conventional Drugs that Combat Chronic Inflammation
Metformin is commonly used in the treatment of type II diabetic patients with dyslipidemia and low-grade inflammation. The anti-inflammatory activity of metformin is evident by reductions in circulating TNF-alpha, IL-1beta, CRP, and fibrinogen in these patients.Statins are anti-inflammatory as they reduce multiple circulating and cellular biomediators of inflammation. This pleiotropic effect appears to contribute in part to the reduction in cardiovascular events.
Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen, ibuprofen, and aspirin acts by inhibiting an enzyme cyclooxygenase (COX) that contributes to inflammation and are mostly used to alleviate the pain caused by inflammation in patients with arthritis.
Corticosteroids also prevent several mechanisms involved in inflammation. Glucocorticoids are prescribed for several inflammatory conditions including inflammatory arthritis, systemic lupus, sarcoidosis, and asthma.
Herbal supplements like ginger, turmeric, cannabis, hyssop, and Harpagophytum procumbens are shown to have anti-inflammatory properties however one should always consult with a doctor before their use and caution should be taken for using some herbs like hyssop and cannabis."
Good response, MB. Just this morning, I was just skimming Keith Block's book, Life Over Cancer, and he mentions nearly the same labs, dietary mods, supplements, and pharma meds that you profile. (Not bad for a book published 14 years ago.)
Control of insulin resistance and inflammation seem the two areas we can most effectively use to slow down and kill off cancer - not as replacements for traditional treatments, but as major assists to them.
Thanks for the insights and link to what looks to be a superior resource on inflammation. Ciao - K9
I love this response, MB! I was thinking disordered energy generation due to IR/Metabolic Syndrome/etc had to fit in somewhere, either as a driver of inflammation or as a primary co-factor of its own.
If the inequality signs are as intended then the binary weights should be reversed in order a low total sum to represent a good state. Example: IF(LMR>4,0,1). But, with CRP the weights are in the right order.
Either Señor smurtaw or Justfor_ posted on N/L ratio (3.0), and P/L ratio (<100) some time back. Someone else, maybe you, also posted on the PIV (Pan-Immune Value) calculation. I added them all in four columns to my my master lab spreadsheet and monitor them with each new set of labs. Now I have one more column to add.
Note : The PIV is calculated as: (neutrophil count × platelet count × monocyte count)/lymphocyte count. I haven't yet seen a recommended PIV range for various stages of PCa.
The more ways of measuring systemic inflammation, the better, IMO.
Justfor, your numbers above are just numbers. How you feel, and your enjoyment of moments are key.
I am still Hormone Sensitive, but I lose sleep with numbers. They are good guides or baselines, but only numbers. I just met with a new Oncologist up in Raleigh, NC., with Duke. He has several patients who are 5 yrs+ after having rising PSA and Radiographic progression by using Provenge (Sipucel -T). PSA does not seem affected and can rise, yet these men are 5+ years since Hormone Failure. He believes the key is early like so many other treatments. He told me when PSA begins rising to get Provenge asap but before it reaches 5.0 if possible I will run my PIV numbers, but try to keep just as my baseline ALSO, work on my weight and lowering Glucose # Mike
Hi Mike, I have been a numbers person all my life, so this gives me confidence in dealing with PCa. And you know how much therapeutical confidence can become. The placebo effect is just this. I read your very long bio and got out of it another case in support to my post regarding "silly doctors and their parrots". Your PSA sequence looks ideal and in your shoes I would be very tempted to try an early Lu177 PSMA treatment like Tango65 did very long ago in TUM. Just a thought packaged along with my best wishes.
Thanks for your support Justfor. I hope LU 177 early, or LU J-591 like Mateo had are in my future. Early! First I am trying to take care of 3 lymph nodes positive on my Nov Pylarify Scan. UCLA has a trial that is working with Beta ray vs Gamma ray with radioactive die injected and 24 hours later usinng a geiger counter to locate and laproscopically remove the pos 3 lymph nodes. No trial proves extension of life (OS), from removing lymph nodes, but in my opinion removing larger metastasis allows ADT2 to work exclusively on the Micro metastisis in the blood stream. Not looking for cure, just extended remission. Mike
Sounds something similar to the radio-guided lymph node dissection surgery they are experimenting with in Germany. Check the second part with the interview of Dr Tobias Maurer, if you haven't done already:
I re read Dove Press article a 2nd time, and working thru my own numbers. On the PSA line item, I’m kind of assuming it is PSA at Dx? If I use it now after 2-1/2 yrs of ADT2, I guess it would skew the OS number too optimistically in my favor. Agreed?
My PNI seems independent from my PCa progression. As I haven't had an Albumin count with each an every blood lab test I don't put much credit to the interim values where the latest measured Albumin figure is carried forward (i.e. I don't use nominal values, say 4.55).
Latest 30 years PNI: Max = 60.8, Min = 51.2, Average = 54.7, N= 56
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