SBRT and supplements : Starting SBRT... - Prostate Cancer N...

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SBRT and supplements

Sunfire
Sunfire

Starting SBRT 5 treatments next month. Are any supplements ok to take during treatment or should they be stopped prior to treatment and how soon can they be started post treatment. Currently take a vitamin pack, pomi t, saw Palmetto, and nettle. The supplements help with bph urine flow. Currently on Flomax 1x day. Told to start 2x day during treatments and AZO to avoid burning. Suggestions?

31 Replies

Yes, avoid ALL supplements for the 2 weeks of therapy, especially multivitamins. You want to avoid anything that is a powerful antioxidant. Exercise as much as possible. Saw palmetto and nettle may interfere with PSA tests - why risk it? Pomi-T does nothing, but it won't harm you. In addition to Flomax and pyridium (don't wear white underwear), you can take daily Cialis, and possibly naproxen. Did I mention exercise?

Sunfire
Sunfire in reply to Tall_Allen

Awesome good to know. As of yet haven't received info on stopping supplements. Yes exercise as often as possible. Only on the flomax now so will ask about pyridium and daily cialis. I haven't been offered that.

Tall_Allen
Tall_Allen in reply to Sunfire

azo=pyridium - it's available over the counter. Cialis protects erectile function.

What a screw-up that neither my urologist or oncologist suggested daily Cialis until I met with a nurse practitioner in that office in month 7 of ADT. Why wasn't it prescribed in month 1??

Fortunately, you know the story of what happened: that consistent-enough use of my device saved my potency and libido.

Congrats btw on not having to traverse the treacherous ADT waters, at least so far.

Thank you for what you do for all of us here, Tall_Allen!

cesces
cesces in reply to Tall_Allen

Exactly

I completed five SBRT treatments in August and completed my first post-treatment PSA test less than a week ago. I dropped from 4.77 in July to 1.48 this week. I was told to stop all supplements, especially antioxidants, two weeks before treatment. Although they said I could resume after treatments were over, I chose to discontinue most supplements and not eat anything with antioxidant properties. I haven't decided yet when to resume my multivitamin. I had minimal flow issues post-treatment and discontinued the prophylactic Flomax after a total of four weeks. I exercise 6-7 days per week (cardio 4 days per week) and didn't miss any exercise during or after treatment. Only side effect so far is reduced ejaculate.

Sunfire
Sunfire in reply to tnone

Congrats! It sounds successful and with little side effect so far. Hoping for the same. Exercising as often as possible. Good tips on supplements. All the best moving forward with Pca in the rear view mirror!

tnone
tnone in reply to Sunfire

Thanks for your support. I'll keep posting my results.

This post makes me wonder if there is any data on effects of using any supplements. My former urologist, who calls himself a "holistic urologist" and is one of the most well-known urologists in New York , had an extensive list of supplements to take. However, after seeing him for 10 years because I had very high PSAs and several negative biopsies, I realized that he probably recommended them because he owned a share of the supplement company. When I did get a diagnosis (PSA 42, Gleason 9) he falsified his records of consultations and told me that brachytherapy would not work in my case and that I should have a prostatectomy. When I got a second opinion from my current urologist I was told to avoid the surgery (which he said he no longer performs because he does not trust it), have brachytherapy, 5 weeks of radiation and 2 years of Luperon injections, the course I am now on. I completed the radiation in July and my PSA is now 0. My urologist also mentioned that my previous urologist probably did not recommend brachytherapy because it was not as profitable as surgery.

All that said, I am still taking fish oil, neem and vitamin D. Any ideas if any of them are effective?

cesces
cesces in reply to brooklynb

"This post makes me wonder if there is any data on effects of using any supplements. "

Very little

Tall_Allen
Tall_Allen in reply to brooklynb

Your current urologist is unusually enlightened.

Fish oil and Vitamin D have been proven to have no effect on cancer:

pcnrv.blogspot.com/2018/07/...

Neem oil:

ncbi.nlm.nih.gov/pubmed/249...

ajnr.org/content/31/7/E60

toxnet.nlm.nih.gov/cgi-bin/...

Lab studies usually do not translate to clinical effects in humans.

Hidden
Hidden in reply to brooklynb

“ falsified his records “ are you serious . Despicable ! Vit -d good , fish oil bad .. neem not sure . This web cite is split 50/ 50 about nutrients .

I had EBRT for 26 days summer 2018. Before it began I got expert nutritional and supplements advice from a functional medicine MD, with the idea of coming through the treatment in as good shape as possible. Then I asked my radiation oncologist about the supps list, which featured most of the herbs and compounds frequently discussed here. He is a seasoned prostate specialist at a national cancer center. He said he used to worry about antioxidants and whatever, but his experience with hundreds of patients had shown him that nothing we could take by mouth, following label dosages, would have any effect on radiation treatment. So don't worry about it, he said, take what makes sense to you and makes you feel good.

I agree with that - any normal amounts of antioxidants one can take by mouth are probably completely overwhelmed by the pro-oxidant radiation. Then why take the supplement? Why risk any diminution of its effectiveness?

Hidden
Hidden in reply to Johnkelsey

I agree.. 🤙🏽

Hey Sunfire!

A few links and excerpts:

integrativeoncology-essenti......

"A recent study found that patients who took 1500 mg per day (500 mg, three times per day) of a more bioavailable oral form of curcumin (Meriva) had significantly fewer symptoms while undergoing chemotherapy or radiation therapy compared with placebo."

ncbi.nlm.nih.gov/pmc/articl...

"CONCLUSION

Overall, our review shows that curcumin can kill a wide variety of tumor cell types through diverse mechanisms. Because of numerous mechanisms of cell death employed by curcumin, it is possible that cells may not develop resistance to curcumin-induced cell death."

ncbi.nlm.nih.gov/pmc/articl...

From the study's conclusion.

"A substantial volume of evidence exists that curcumin is a radiosensitizer of multiple cancers as well as a radioprotector of several normal tissues."

"Further research is greatly needed to strengthen curcumin’s major weakness - poor gastrointestinal absorption leading to low oral bioavailability."

Talk with your doctors. I hope you have a forward thinking "crew" that has some experience in how certain supplements can lessen the side effects of radiation and even make it more effective.

Your Pomi-T is a proprietary blend---It took a few clicks to find a list of the ingredients. Proprietary--secret!

Amount Per Serving:

Pomi-T Super Proprietary Blend 480 mg

-Broccoli (florets, stalks) powder, turmeric (root) powder, pomegranate (whole fruit) powder, green tea (leaf) extract 5:1

Broccoli stalks are low in sulforaphanes. Food wise-broccoli "sprouts' have been show to be the most effective cancer killer.

Turmeric root powder. The turmeric root only consists of about 3% curcumin which is the active ingredient.

I take a pomegranate supplement that is derived from the fruit, flower and SEED. Seeds are the powerhouse of a plant, a germinating food that can grow another plant.

Pomi-T is effective and receives good reviews from reputable sources. I prefer more potency and the addition of some other supplements as the study ended for lack of funding at the four supplements that Pomi-T contains. It would be interesting to have the study resumed and add some supplements such as resveratrol, quercetin, garlic, Turkey Tail mushroom and a blend of some other mushrooms. Maybe a little zinc and boron too.

Copy that which is between the lines. Again the link came up as server error after I posted.

________________________________________________________________________________________________

Polyphenol-rich Pomi-T highly effective against PSA in ...

canceractive.com/article/po......

_________________________________________________________________________________________________

If you have a team that allows curcumin use the best brand and also take piperine and bromelain, with it to enhance absorption.

Something interesting about vitamin C. Copy the entire script below. It will bring you to some interesting reading.

High-dose vitamin C proves safe and well-- copy that which is between the lines.

_______________________________________________________________________________________________

Iowa Nownow.uiowa.edu/2017/03/high-......

________________________________________________________________________________________________

My best to you.

Currumpaw

Tall_Allen
Tall_Allen in reply to Currumpaw

Turmeric has been shown to interfere with PSA tests- not something you want with radiation. It has never been shown to have any clinical effectiveness:

pcnrv.blogspot.com/2019/04/...

Currumpaw
Currumpaw in reply to Tall_Allen

Hey T_A!

I know about your feelings regarding curcumin.

This might be why one should take it--from my earlier post--note that I capitalized the IS and AS WELL AS --rather definitive words used in the study's conclusion.

ncbi.nlm.nih.gov/pmc/articl...

From the study's conclusion.

"A substantial volume of evidence exists that curcumin IS a radiosensitizer of multiple cancers AS WELL AS a radioprotector of several normal tissues."

From the link you supplied--SEEMS, POSSIBLE, UNLIKELY and PLAUSIBLE--words used when speculating a reason why something occurs without a factual basis. The could just be the author's reluctance to put his name on it. Reputation you know!

"It SEEMS that curcumin suppressed PSA. Although it is POSSIBLE that 30 days of curcumin reversed the prostate cancer, that is UNLIKELY. It is more PLAUSIBLE that curcumin affected the PSA assay.

Radiation can cause secondary cancers. Does PSA matter for a patient undergoing radiation? If they feel that it affects a PSA reading they can stop curcumin supplementation after the radiation is done. At the same time that study showed that curcumin is a radiosensitizer making cancer cells more vulnerable to radiation and making the treatment more effective.

Do you consider the PSA test to be reliable? I feel that it can only be a somewhat valuable reference point if taken at specific intervals recording a history of movement.

The PSA test isn't a radiosensitizer nor is it a radioprotector of other tissues. Stop the curcumin after radiation therapy and then get the PSA test if it is felt to be important. If other testing more sensitive and reliable is being done then the PSA becomes somewhat irrelevant at that point in time.

Thanks for your input.

Currumpaw

Sunfire
Sunfire in reply to Currumpaw

Interesting discussion. Have not yet discussed supplements during treatment with RO. The Pomi T does help flow for me. I see a difference without taking it. Placebo effect? Not sure. I planned on stopping GNC Megan Man multivitamin pack. It includes several supplements. Wondering if I should start the Curcumin into treatment. Otherwise if I can continue Pomi T I will. Alot to consider maybe just stop it all for 2 weeks of treatment. Thanks for input all!

Tall_Allen
Tall_Allen in reply to Sunfire

Pomi_T has one ingredient - sulforaphane - that may be beneficial in slowing progression:

cancerpreventionresearch.aa...

However, it may interfere with the abscopal effect, thought to be important for a complete cure from radiation:

sciencedirect.com/science/a...

You may want to give it, and all supplements, a pass until after you are cooked.

Sunfire
Sunfire in reply to Tall_Allen

Excellent finding I would agree on supplement elimination during treatment. Plan is to eliminate and keep PCa where it belongs..in the past! As a patient advocate how soon after treatment do you find patients reintroduce supplements multi vitamins etc. without effect on treatment?

Tall_Allen
Tall_Allen in reply to Sunfire

Multivitamins have fallen into disrepute in the US, where most people are able to meet vitamin and mineral needs from their foods. With the discovery of the harm of Vitamin E on prostate cancer (not to mention its suspicion of culpability in illness and deaths due to vaping), the science showing no benefit to Vitamin D supplementation, the suspicion of folates for prostate cancer, and the known interference of biotin with PSA tests, it's difficult to make a case for taking them at all. I do think that intravenous Vitamin C (where it acts as a pro-oxidant) is interesting, but oral Vitamin C (where it acts as an antioxidant) is counterproductive to apoptosis, and immune killing of cancer cells. Vitamin Bs are ubiquitous in our foods and need no supplementing. Vitamin K is best obtained from green, leafy vegetables. Calcium may promote prostate cancer progression.

Hidden
Hidden in reply to Currumpaw

🤙🏽😂

Tall_Allen
Tall_Allen in reply to Currumpaw

Hey Currumpaw! What you call "evidence" and what I call evidence are two different things. I am much more careful about statements I make (my name is on all my articles). Until there is a large, well-done RCT, the "evidence" is merely suggestive. If you want to make wild claims unsupported by fact, that's your prerogative.

You will note that in the study you decided was such clear evidence, that (1) none of the people were treated for prostate cancer, and (2) all of the people received radiation after surgical removal of their tumors as clean up (none were detectably metastatic). They received much less radiation than one would for primary prostate RT, and the technique used (3D-CRT) is no longer used for prostate RT because IMRT has lower toxicity.

"The total dose of radiation applied ranged from 30 to 50 Gy with conventional fractionation (1.8‐2.0 Gy/day) administered with Linear Accelerator machine, 6‐10 MV photon beam energy and with conformal three‐dimensional techniques (3D‐CRT)."

The danger of self-treatment is that, while side effects may be less, it may interfere with the therapy. That study did not look at how effective the salvage RT may or may not have been, only the side effects. What would be the point of lowering side effects, if it means the cancer will come back because of it?

The authors of the study (to their credit) are much more cautious than you are:

"This study is clearly limited by the heterogeneous nature of the patient cohort investigated in terms of age, sex, type of malignancy, and medication, by the generality of the side effects considered, and by the lack of a dose adjustment in relation to the treatment. It does not, obviously, provide any indication that curcumin can have a positive effect on the course of the disease, as claimed by anecdotal information popular within the cancer patients community, nor disprove the risk that curcumin, as an antioxidant, might interfere with cancer treatment. "

onlinelibrary.wiley.com/doi...

PSA is a very different test post-treatment than it is pre-treatment. It is much more useful for determining biochemical recurrence than for initial biopsy.

I'm certainly open to the fact that certain re-formulations of the curcumin molecule (notably ASC-J9) may be found to be a good companion to radiation. Much research has to be done before safety is assured.

In fact, when nano-curcumin was tried in a randomized, double‐blind, placebo‐controlled phase II trial of nanocurcumin in prostate cancer patients undergoing radiotherapy, it was found to have no effect on toxicity, nor did it affect tumor response:

onlinelibrary.wiley.com/doi...

Currumpaw
Currumpaw in reply to Tall_Allen

Hey T_A!

Got your response.

Wow!

I'm pointing out that there are screens of studies that show that curcumin is a radiosensitizer and also radioprotective. Not my claim, it is the claim of the studies. Not my evidence, I didn't perform the studies. There isn't a whole lot of money in curcumin. I worked in pharmaceutical manufacturing for over 14 years. That which makes the $$ takes priority. Many of the drugs that get FDA approval and marketed then get pulled. Unanticipated side effects and a few deaths.

The CDC lists ionizing radiation as a carcinogen. The dental ex-rays, which that are now a part of the yearly check up and use a very low level of radiation are now under scrutiny. There is screen after screen of studies and articles about thyroid cancer and dental ex-rays. Glands are sensitive. The curcumin studies "claim" it was also found to be radioprotective. Dental ex-rays. Two former co-workers with very nice teeth, aged mid thirties to early forties had thyroid cancer. The ratio was just under 2% of the workforce but their youth certainly makes one take notice. All ionizing radiation, regardless of the level is a carcinogen even the low level used in to obtain dental ex-rays. The radioprotective aspect of curcumin for normal tissue but not for cancerous cells that study after study mentions --I am not a doctor or scientist that came to these conclusions. They are just online for anyone to access. When one is given choices of treatment I imagine that their doctor mentions that radiation comes with the possibility of future cancers from the radiation. The radioprotective aspect could be important. Preventing a future cancer resulting from RT was my thought. Who wants more cancer!

I didn't act as a loose cannon. In my post to the member I initially responded to this advice was included.

"Talk with your doctors. I hope you have a forward thinking "crew" that has some experience in how certain supplements can lessen the side effects of radiation and even make it more effective."

Thanks for the link T_A showing the percentage of side effects for those on Meriva and those not. It was 120 mg daily dosage wasn't it? Better quality product, better absorption? Some of the studies on line used as much as 3 grams per day. A new, more absorbable curcumin is on the market at least once a year now it seems.

I realize I am not a doctor and I don't prescribe or dictate. His doctors will need to know what he is taking. If he isn't happy with them then he has the option of finding a new team--it takes quite a few working together. As is said in one of the links you supplied, supplementation by patients is unreported. That is so true.

Yep! PSA. Once the gland is gone, factors affecting PSA are gone--size, inflammation, injury, sex and maybe an infection! But--my thought--when having the radiation therapy, why not take curcumin as long as --again--the patient needs to be open and honest and confer with their doctors. Again, as in my original post---

"Talk with your doctors. I hope you have a forward thinking "crew" that has some experience in how certain supplements can lessen the side effects of radiation and even make it more effective."

The doctors have to informed and in agreement. The amount of things that some take almost composes their diet.

When the therapy is over, stop the curcumin. Give it time to clear out and then a PSA test. That link you supplied showing the reduced side effects--Nice!

I have seen radiation damage to skin. If radiation damage can be limited and the discomfort from it why not?

The link you posted below. There is much going on in efforts to find ways to make curcumin more bio-available.

Even when you get a little "hot" you make some good points. Thanks.

Currumpaw

Hidden
Hidden in reply to Currumpaw

I’ve taken the Meriva throughout RT continually over four years now. No visible signs of pc during this nutrient laden voyage . That’s just my story . Good luck .

I agree about stopping all the anti-oxidants (multi-vitamins etc).

When I underwent my rad treatments, they specifically told me to stop completely.

That logic also follows about what you eat. The two are linked.

About curcumin / turmeric - I recall reading about taking EXTRA curcumin during treatment. It appeared to multiply the effectiveness of the healing potential.

I know it is controversial to a point, but I'd take it again when faced with the same situation.

I continue to take high quality curcumin daily - I believe it has helped me a lot .....

IMHO, this is the best potential supplement on the planet - but you need to address the bio-availability.

Then what do you make of this?

onlinelibrary.wiley.com/doi...

They used a nanocized preparation to address the bioavailability. As you see, when they actually tried it on men with prostate cancer receiving radiotherapy, it had no effect on toxicity or on tumor response.

Yes, maybe the turmeric/curcumin debate also has to do with the absorption and bioavailability. There are forms that are also not researched related to prostate cancer, so there may be a lot of unknown. There are all types of forms of turmeric some which have BioPerine, and others that are hydro-soluble for better absorption. This could affect research if this was not taken into account.

Tall_Allen
Tall_Allen in reply to kcc9993

The issue is not so much absorption as it is first pass metabolism. You can’t change that without changing the molecule.

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