Phytotherapy in biochemically recurrent prostate cancer

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This paper is part of NMJ’s oncology special edition 2017. Read the newspaper or download the full edition here. Relation from the MD, Williams SG, Emery J, et al. A placebo-controlled, double-blind, randomized pilot study for combination phytotherapy in biochemically recurrent prostate cancer. Prostate. 2017; 77 (7): 765-775. Design double-blind, randomized, placebo-controlled 2-cohort parallel study; The participants were assessed at the beginning of the course and in week 12. Participants twenty -two Australian men between the ages of 56 and 84 with biochemically recurrent prostate cancer (BCR) were recruited from a cancer hospital in Melbourne, Australia. Medication and doses study the participants assigned to the test group took two capsules broccolis pross concentrate in a ratio of 20: 1 ...
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This paper is part of nmj ’s oncology special edition 2017. Read the newspaper or download the full edition here.

reference

van die Md, Williams SG, Emery J, et al. A placebo-controlled, double-blind, randomized pilot study for combination phytotherapy in biochemically recurrent prostate cancer. prostate . 2017; 77 (7): 765-775.

draft

double-blind, randomized, placebo-controlled 2-coorts parallel study; The participants were assessed at the beginning of the course and in week 12.

participant

Twenty -two Australian men between the ages of 56 and 84 with biochemically recurrent prostate cancer (BCR) were recruited from a cancer hospital in Melbourne, Australia.

medication and dosage study

The participants assigned to the test group took two capsules broccolis pross concentrate twice a day in a ratio of 20: 1 (each equivalent to fresh sprouts 2,000 mg [8 g/day]) and 2 capsules with 30 mg resveratrol (from polygonum cuspidatum extract 100: 1) and 100 mg catechine (from Green tire extract 25: 1) per capsule, twice a day. The placebo group took 2 capsules twice a day with microcrystalline cellulose, calcium hydrogen phosphate, magnesium stearate and hypromellosis and two 100 mg capsules with green oat powder twice a day.

target parameter

In order to estimate the PSA doubling time, 3 to 6 measurements of the prostate-specific antigen (PSA) were carried out at least 12 months before the admission. Clinical measurements that were levied at the beginning of the study were PSA, blood-urine nitrogen (BUN), electrolytes, liver function tests, estradiol, blood pressure, BMI and Karnofsky performance score. The quality of life was measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (Eortc QLA-C30) and prostate 25 (Eortc PR-25), at week 12, and the International Prostate Symptom Score (IPSS) and Hospital Anxiety and Depression Scale (Hads). The food intake of the test substances was recorded together with unwanted events in weekly diaries.

important knowledge

The study was not sufficiently Poverwert to demonstrate the effects of phytotherapeutic intervention on PSA doubling times from the Baseline for up to 12 weeks. There were no statistically significant differences in prostate symptoms, measured by the IPSS, fear and depression, measured by the HADs, or in the eortc QLA-C30 or Eortc PR-25. The phytotherapeutic combination was well tolerated. Few and easy side effects were reported, and compliance with the protocol was high.

The width of the confidence intervals of the PSA doubling times per group allowed the herbal group to achieve a better PSA result in a future study with a reasonable Power, which corresponds to other recently carried out, promising studies.

practice implications

Thirty percent of patients treated with prostate cancer with prostate or radiation therapy-and more than 50 % in cases with high risk-ultimately develop potentially life-threatening recurrences, 4 that are often recognized when their PSA values ​​start to rise after treatment. Standard treatment for recurring prostate cancer, whether biochemical or metastasis, is the intermittent or continuous androg -end privation therapy (ADT). As soon as the disease is "castration -resistant", the ADT is typically continued for life.

There is an urgent need for new, minimal toxic therapies for prostate cancer.

androgenic and androgen withdrawal have profound effects on the immune system, a knowledge that is increasingly valued at a time when researching immune -based cancer treatments. Preclinical studies indicate that androg-end privation could possibly have a positive or negative impact on the use of approved or testing immunotherapies for the treatment of prostate cancer. Initially, ADT is highly effective in the suppression of prostate cancer; However, the side effects are potentially significant and include fatigue; Weight gain; Muscle loss; Heat flashes; erectile dysfunction; Libido loss; Loss of strength, muscle mass and bone density; cognitive impairment; Depression; Osteoporotic fractures; Anemia; and increased risk of diabetes, metastases and cardiovascular events.

In connection with an otherwise asymptomatic person, such effects are particularly worrying, since the treatment is often used for many years. In addition, ADT is not healing. 8 Most tumors develop according to ADT in an average interval of 38 months to metastatic castration -resistant prostate. There is an urgent need for new, minimal toxic therapies for prostate cancer.

Despite some initial encouragement by cohort and small prospective studies, lycopine, saw palm or genistic extracts, which were evaluated in more scientifically sound analyzes, showed no use for prostate cancer. 9 On the other hand, preliminary clinical studies have the benefits of Sulforaph, Brokkoli, Green Tea, Kurkuma, Pomegranate juice and extract as well as white mushrooms shown. 10-15 Although the Australian study was not sufficiently meaningful in this review, it shows the feasibility of a randomized study with a combination of Sulforaphan, green tea, turmeric and resveratrol for the treatment of men with prostate cancer, which causes the The basis for the future is strengthened. In addition, the latter two polyphenols showed synergism in a preclinical bio -availability study, which supports their use in combination. 16 This expert is currently trying to approved and finance a clinical study with white mushrooms for treating prostate cancer.

The main restriction of this Australian study was the slow recruitment rate. The authors point out that the number of participants was limited by the advent of PET scans with prostate-specific membrane antigen (PSMA) in the recruitment hospital, which enabled the detection of micrometastases in many otherwise suitable patients with BCR, to whom salvage was then offered treatments. PSMA PET imaging is a great step forward in the detection of metastatic prostate cancer and uses a radioactive peptide, Gallium-68 to mark an antigen receptor (PSMA) that is located on the surface of every prostate cancer cell and provides valuable information that helps doctors carry out a more and more explanation and support in recruitment and monitoring Research topics.

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