This new post is lifted from a previous post since Tal-Allen and myself were getting into an interesting discussion concerning this theme.
There many who would like to feel that Nutrition can play a role in the fight against PC, but the research in this area is complex - and it seems that Nutrition can have a stronger role in other cancers, but that PC is much less affected. Tal-Allen asked me to note any examples where invitro or mice/rat experiments show responses to Human PC.
There is a lot of reading to be done to find this information, and we should all expect that - if there was a miracle cure - then we would have found it by now. But it seems the process is complex and it seems probable to me that it is a combination of many nutrition sources which will have an effect. One molecule that has shown promise is Resveratrol - found in red grapes, blueberries, radish and more. Here is a link to one paper describing petridish experiments:
I myself believe that a healthy lifestyle, with a combination of many foods - mostly as raw as possible, is the best way to take advantage of this type of research until it brings us a better understanding of the whole PC process. We dont have standard GRADE A proof - largely because it is profoundly difficult to arrange for hundreds of people to eat exactly the same except for the difference between the intervention group and the placebo group - and to keep this going over 10 years or more. Its just not going to happen.
We have to eat something - and it seems sensible to include as many natural products as possible which have shown activity in attacking human cancer cells - by helping apoptosis, and/or repression of angiogenesis and inflammation.
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You never answered my question... You stated that a lab study may indicate a food is useful for prostate cancer, and I asked for an example.
As I said, lab studies are for other researchers - you are abusing them when you make treatment decisions based on them. Everything works in mice. Unfortunately, human physiology is not even close to that of mice. Lab studies are only properly used (1) as a screener to screen OUT drugs or (2) to provide plausible justification for an observed effect in humans. They are never used as an indicator of a diet regimen in human, as you would wish.
There are human tests, like the MEAL study which I have shown you. It is not THAT difficult to do and the results are MUCH more reliable than even the best mouse study.
Since you are fond of mice, why is it that you did not cite the following study, which shows that resveratrol worsens lethal prostate cancer in mice?
I have no idea why you favor raw foods - cooking often makes nutrients more bioavailable. Also, it makes food taste better, encouraging eating them. Also, I have no idea what you mean by "natural" foods. Do you mean unprocessed, made from scratch, or do you mean in the state found in nature? If the latter, there are no foods we eat that we haven't genetically modified.
If I were looking for certainty then this wouldnt do - because certainty needs a consistent result. But I do not expect certainty, only a probability. And of from the two studies you might say there is a 50% chance that resveratrol will be positive in PC supression. But there are many studies here - and the more important ones also examine toxicity - or dosage. A little of something may be good for you, but too much max produce the opposite effect.
I agree that mice are no substitute for humans, but when resveratrol attacks PC cells in a petridish - thats a good sign - but not proof. But since its easy to include resveratrol in the diet (a glass or two of red wine each day is to be recommended - even if it doesnt work on PC.) then there is nothing to lose.
I do not agree that we are abusing lab results - any scientific results can and could be used to weigh the balance of the evidence. Thats why most people on this site read and learn - and discuss with thier doctors. But they must be used in context.
Another food which is popularly cited as being beneficial is turmeric - or more precisely Curcumin. It has been widely researched in all manner of ways, and shows many indications that it may help against several cancers. Maybe thats why PC rate in india is so much lower than in the US? - who knows.
My thoughts on foods are that they should be as little processed as possible. Take white bread - which, to make the production process efficient has generally been robbed of a good deal of the nutrients it originally posessed at harvest. Cooking oils are another example - the production prosess doesnt appeal to the appetite. I eat both raw and cooked foods, but most vegetables I cook only lightly so they are still crunchy. But some spices need to be fried (soluble in fat, not in water) so how food is prepared is also an important factor.
But its not just about the good things you eat - but all the other stuff. If you live off McDonalds burgers then I doubt that the adittion of a little curcumin or resveratrol will be of much help
So you ignore the mouse research that says resveratrol makes it worse, fatally worse, and change your eating habits based on the mouse research that says resveratrol makes it better. Do you see a logical problem there? It is called "confirmation bias" - a very natural cognitive error that you may wish to educate yourself about. It may be bad for your health.
To be clear... I'm not saying that one mouse study is better than the other. I'm saying that they BOTH are useless for making treatment decisions.
You (I don't know why you say "we" - do you purport to speak for others? Have you taken a survey that enables you to claim "most people on this site"?) , you are certainly abusing those studies. That's why the authors of those studies do NOT make treatment recommendations based on them. The studies are scientific, but your abuse of them is pure voodoo. The authors of those studies understand the science, and the "levels of evidence" that you continue to ignore at your peril.
As for curcumin... you are making another claim with no real evidence. What if it masks PSA? If you want to understand why it may be a bad idea, read this:
No No - TA - I dont ignore the evidence - on the contrary I look at the probabilities as I have said. We cant judge just from one example. You asked for an example - but there is much more evidence from results that shows potential benefits of for example curcumin in the fight against PC than there is against. There is much too much for me to read everything so its good to look at recent reviews to get a valid picture. See for example this :
Overall, the available in vitro studies have shown that curcumin is able to inhibit viability, proliferation, survival, migration/invasion, and adhesion of various human prostate cancer cells. Curcumin inhibited both androgen-sensitive and -insensitive prostate cancer cells by targeting a number of signaling cascades responsible for regulating cellular function
and
The available in vivo studies have shown that curcumin administration is able to inhibit the growth/volume, formation, development, proliferation, and angiogenesis of prostate cancer tumors while promoting apoptosis
These authors do not make claims without evidence as you suggest.
What we dont know yet is dosage considerations, bioavailability and interactions with other molecules, and how/if these processes are also active in human biology. We dont know this because clinical trials are difficult and the subject is complex - too many variables.
So on balance, and particularly because it is not a drug or a supplement, and also because I am rather fond of the taste, I normally use tumeric in my cooking. I am aware that it may influence PSA to some degree, but a constant use will not be expected to hide a consistent rise or decline.
Quantity does NOT overrule quality. 1000 times zero is still zero. There aren't any real scientists who believe such a thing.
As if anticipating your comment the authors rightly write:
“The authors of ‘Curcumin May Defy Medicinal Chemists’ state that ‘even if 1% of the papers published make sense, it would still be a sizable number to warrant against passing a negative verdict on the whole field.’ This seems to equate the number of manuscripts with scientific fact. If the fundamental foundation of curcumin bioactivity was based on 100 papers that did not take into account its Assay Interference Compound potentials (e.g., aggregation, fluorescence, and reactivity interference, etc.), or did not consider the difference between curcumin and Curcuma, the amount of confounding variables would make the following work inconclusive at best, regardless of the number of manuscripts.”
I think you fall into the trap of using mouse models to infer clinical (human) efficacy. Everything works in those lucky mice!
The randomized clinical trial discussed in the article (Level 1 evidence) showed that in 35/39 men taking curcumin (and 30/43 taking placebo), PSA did not progress during the first 6 months after they ended their first cycle of ADT (while they took the drug or placebo). But their PSA more than caught up in the following 10 months.
They also found that curcumin doesn’t extend the testosterone-blocking effect of ADT. However, it may be suppressing the amount of PSA that is detected from the cancer, but it does not seem to delay progression of the cancer. In fact, progression occurred 2 months earlier among those taking curcumin (which was not statistically significant in this small sample size). So it may be affecting the use of PSA as a biomarker of progression. We have to be careful about “treating PSA” without treating the cancer. This PSA-masking effect deserves further study. Patients often depend on PSA monitoring to give early clues about clinical progression. If curcumin masks PSA, it should be avoided.
The reason you believe this stuff is confirmation bias, not science. It is dangerous, but if you want to do it for yourself - go ahead.
The authors of those studies do not make claims for patients at all, which is my point. You are just seeing things that aren't there.
That said, dietary intake of turmeric is probably innocuous. It is overloading the body with supplements that I object to.
TA – I fully respect your need not to stray from established medical fact, and, using the criteria of Grade A evidence I can agree with most of what you say (maybe with the exception of the remarks on confirmation bias).
But for metastasic Prostate Cancer I myself am on the standard ADT of Zoladex. It was patented in 1976 and approved for medical use in 1987 – so it is the result of our science as it was nearly 50 years ago. There has been a lot of focus in the intervening time, and our problems with pinning down just what is beneficial and what is not in cancer treatment are probably due to the complexity of the problem. I suspect that when we eventually understand the effect of diet on cancer in the human body there will emerge a pattern of interdependence on many factors simultaneously.
Take for example the oft quoted finding that indian males report cancer at just 30% of those in USA. WOW – maybe they eat better?? – but you cant conclude that until you have researched in a scientific way – because maybe cancer rates in India are 70% unreported due to the rural nature of the country. So – using your criteria these facts are nonsense and should not be considered - I would conclude the same. But when I find a similar pattern in Nigeria and Japan then I allow myself to conclude:
There is a strong possibility that diet or other lifestyle considerations are an important factor in the cancer process. But due the complex nature of diet and the near impossibility of making standard clinical trials in humans where all aspects of diet are controlled, we cannot conclude – or recommend a particular path through diet to help in containing cancer.
But I work on probabilities when I am trying to understand what we have learned in the 50 years of ADT, and as long as I don’t take supplements thinking that they will help (there we agree) I am happy to bias my diet to things which are normal foods where evidence in vitro and in vivo (animals) is reasonably supportive that specific foodstuffs are better or worse. We have lived in an era where eating fat was taboo because of cholesterol – but today we have a much more balanced view of this. So I would like to step beyond your Grade A certainty arena and into uncertainty and probabilities, and allow that a preponderance of indications can point to a useful path to the future. I like the views expressed here:
"While a cautionary approach is welcome, summary dismissal of an entire area of research is like throwing the baby out with bath water."
So I relate to such articles as: mdpi.com/2218-273X/10/11/15... (which I have referred to before) and the conclusions given specific to Curcumin (but indicative of many other potential foods which may influence the development of cancer):
"The downregulation of cell proliferation, paired with the enhanced activity of programmed cell death both in vitro and in vivo, render curcumin an ideal candidate for the development of novel anticancer pharmaceutical agents providing fewer detrimental effects due to its low toxicity. Future in vitro studies should focus on utilizing cell culture conditions such as different oxygen levels and glucose concentrations for the purpose of obtaining data that represent better the tumor microenvironment seen in vivo. Additionally, further studies utilizing normal prostate epithelium are required to examine whether curcumin can discriminate between cancerous and healthy tissue when interfering with certain signaling pathways. In vivo animal experiments utilizing different prostate cancer models are imperative to accurately determine curcumin dosage and investigate whether curcumin has potent effects against prostate cancer in vivo. Finally, clinical studies are required to examine the effectiveness of curcumin against human prostate cancer."
I can only repeat. There are good reasons why the studies you love should be ignored. They are almost always wrong. That's why there are levels of evidence. You ignore them at your own peril. Good luck.
This is an excellent discussion. While you both have different points of view I respect that you keep the discussion civil. Too many back and forth online quickly devolve to name calling. So thanks to both of you.
I often chime in on posts and will do so again. I won't cite studies though I've read most of them. I first became aware of food and diet in the early 70's. My dad had a heart attack and in his recovery became a follower of DR Kenneth Cooper, an Air Force Colonel and physicians who worked with the space program and was an early proponent of aerobics. Dad had a clunky period stationary bike and was a fan for a decade. The dietary science back then said avoid cholesterol and avoid saturated fats so margarine it was occasionally eaten by the spoonful. Dad lived a good life, not without heart challenges, and lived to 85.
Sciences changes. We've learned that transfats are probably worse then olive oil. For a time we thought a glass of red wine was good now the thinking seems to be the risk of alcohol outweigh the benefit especially to excess. Dietitians favor a heart healthy Mediterranean diet which is also a prostate friendly diet. My dad told me 20 years ago to reduce my belly or visceral fat as he was sensitive to the hereditary nature of heart issues. I half listened. Had I lost more would I have avoided prostate cancer? Perhaps. Or perhaps it would have emerged more slowly and arrived at an age where I was less healthy in dealing with it.
My point here is that the science changes and the dietary recommendations changes. It is not a big secret what is considered healthy eating and to go looking for studies which tell you what you want to hear might make one feel like they have a magic bullet but they probably don't. Maintain a healthy diet and get a variety of exercise. Get your check ups. Be prepared for the fact you are eventually going to catch something. Live a good life.
Thank you Allen. This "raw food" thing is accepted as scientific fact by huge numbers of persons!! Long ago, I read some certainly imperfect studies demolishing that theory...but hardly anyone will believe me on this!! I eat many green veggies that I would avoid raw!!
Broccoli contains high amounts of of sulforaphane where an essential enzyme for its digestion (myrosinase) is destroyed by even the slightest heating. The nice thing about enzymes, though, is that they are not used up in catalyzing chemical reactions. So eating just a single raw broccoli floret along with a plateful of cooked broccoli will provide a lot of bioavailable sulforaphane.
On the other hand, raw tomatoes contain lots of lycopene, but none of it is absorbed unless the tomatoes are cooked and processed. One tablespoon of tomato paste has more bioavailable lycopene than a dozen tomatoes and MUCH more than lycopene pills. (Most of you may not remember that lycopene was all the rage for prostate cancer (based on mouse studies) until it was discredited by higher level evidence).
Some of the popular food fads, like circumin, do not make it past the gut (yes, I know about bioperene), but even if injected into a vein, first-pass metabolism renders it useless, and it is rapidly excreted.
Some foods (like beans) contain enzymes that inhibit digestion. If those enzymes are not destroyed by cooking, it will be indigestible. Other foods (milk and animal proteins) can be dangerous if eaten raw. I know a young man who died of e. coli sepsis from eating raw chopped beef. Pork and fish (non sushi grade) can contain worms. I am amazed that stores can sell raw milk - that is a disaster waiting to happen. Heat begins the process of protein breakdown that is necessary for humans to absorb essential amino acids.
Heating makes food more palatable, so we consume more. That's important for cancer patients who may suffer from cachexia. Overcooked meat, however, can create carcinogens.
Only some of the water soluble vitamins (most B and C) are leached out or destroyed by boiling. (I microwave, roast or stir fry my vegetables). Fortunately, B vitamins are abundant so even if cooking reduces the amount, it would be difficult to not get enough. Citrus juices can provide all the Vitamin C needed. All the other vitamins (A, D, E, and K) are not destroyed by cooking. Minerals are not destroyed by cooking.
appaently all my purchases of brocolli over many years have been wasted....microwave in water to near boiling....thus geting little vitamin C?
Are all these mechanisms you mention lab-derived? Human studies? or strictly chemist theoretical conclusions? at least i'm not eating raw beans, but getting little benefit from raw tomato every day?
How the heck do we expect the average person to be aware of all this....is there some Bible?
evryone should spend countless hours Googling and trying to make sense of evrything they read.....when most have very little or no education re biochem or statistical analysis?
Well, I do, and you can believe me, or you can look up everything I say- your choice. I never say things that can't be substantiated. If you're skeptical (which is a good thing), look it up for yourself.
Allen - I was not challenging your comments. I was speaking about the general public and obtaining sound nutritional guidance....without having your education and dedicating huge time to unearthing the truth. Yes personally, if I want to have a second opinion re anything you or anyone ese might offer I will try to find something apparently well-sourced using Google,etc. I think you have done an excellent job of reminding all of us to tread cautiously when it comes to conclusions about values of anything medical or nutritional.
No one says this but eating is bad for you, I'm serious! No one talks about quantity. Also we were not designed nor our we built to handle 3 meals a day.
Periodic fasting is probably way healthier then eating a piece of raw broccoli or and steamed tomato. Just saying...
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