To understand better the benefits of vitamin D, watch this video shared by the Prostate Cancer Research Institute where Dr. Charles Myers, a medical oncologist and prostate cancer patient himself, talks about the use of vitamin D, how patients can benefit from it and how its deficiency can worsen patients’ health condition. In this 2-minute video, Dr. Myers always monitors the 25-hydroxy vitamin D levels of his patients and supplements them as needed with up to 5000-7000 units (IU) /day to achieve an optimum Vitamin D range of 40-80 nanograms/mL. It should be noted that vitamin D is a fat-soluble vitamin and can be problematic if taken in large excess. It is best absorbed when taken with the highest fat-containing meal of the day. Supplementation and dosage should be discussed with your health care provider.
In an accompanying study, researchers at the Medical University of South Carolina presented a clinical study entitled “Vitamin D in the prevention and treatment of cancer.” In this study, Dr. Bruce Hollis shows that supplementation with vitamin D (2,000-4,000 IU daily) can have a significant impact on disease progression, with the ability to alter molecular and biochemical pathways, slowing or even decreasing the development of less aggressive, or low-grade, prostate tumors without undergoing surgery or radiation. It was concluded that vitamin D seems to be specifically targeting tumor inflammation occurring mainly in the prostate gland, arresting lower-grade prostate cancers from becoming aggressive.
Previously on this Godandprostate website, posts discussing the relationship of vitamin D to prostate cancer have been posted on July 14, 2016, May 5th, 2016, Jan 21, 2015 and July 17th, 2014.
If your doctor suspects you may have prostate cancer because of an elevated prostate-specific antigen (PSA) level, you might want to ask for a repeat PSA test to confirm the results, says a new Canadian study. It could save you from undergoing an unnecessary prostate biopsy that could entail serious complications. Of 1,268 men who underwent a second PSA test within three months of their first test showing elevated PSA levels, 315 (24.8%) had normal results the second time around. As a result of their findings, the researchers recommend that men with elevated PSA levels should repeat the test before undergoing a biopsy. Elevated PSA levels might result from infection, physical activity or sexual activity. The American Urological Association already recommends that the decision to undergo a biopsy shouldn’t be based on a single PSA test result. However, other studies reveal that only 16 to 56 percent of primary care physicians ordered a repeat test for patients with abnormal results. Most experts agree that PSA screening should be used with a digital rectal examination and additional information such as family history, race and age to assess the likelihood of prostate cancer being present. The PSA test should be performed following a discussion with the patient about its benefits and risks.
(The above was published in the Mayo Clinic Proceedings, 2015.)
In an article published in the journal Cancer Epidemiology, Biomarkers & Prevention (2016, Jan. 25), researchers at the National Cancer Institute (NCI) of the National Institutes of Health (NIH) document an association between higher serum levels of vitamin D and an increased chance of surviving prostate cancer. The current investigation included 1,000 participants in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study who were diagnosed with prostate cancer following enrollment. Just over 360 subjects died from their disease over 23 years of follow-up from the time of diagnosis. Serum 25-hydroxyvitamin D levels and other factors were measured upon enrollment and questionnaires concerning diet and medical history were completed by all participants. Among men whose vitamin D levels were among the top 20% of subjects, there was a 28% lower average adjusted risk of dying from prostate cancer compared to those whose levels were among the bottom 20%. The effect was stronger among those who survived more than 3.3 years. If these conclusions are validated, vitamin D supplementation could eventually be considered for men diagnosed with prostate cancer.
Prostate cancer patients who undergo radiation treatment, especially brachytherapy, are at increased relative risk of bladder cancer according to new study findings presented at the American Urological Association 2016 annual meeting by researchers from Albert Einstein College of Medicine in New York. This increased relative risk occurs predominantly after 10 years. Bladder tumors found in men following prostate radiotherapy are generally lower stage but higher grade than tumors found in patients without a history of prostate cancer the study showed. Compared with men without a history of prostate therapy, brachytherapy was associated with a 3.5-fold, 2.9-fold, and 5.5-fold increased risk of bladder cancer after 10 years in Caucasians, African Americans, and patients of other or unknown races, respectively. Albert Einstein researchers arrived at their conclusion by analyzing data from the 1973–2011 Surveillance, Epidemiology and End Results (SEER) database to ascertain the observed and expected number of bladder cancer cases after prostate cancer radiotherapy. Radiation cystitis, often manifested years later, is another potential undesirable side effect of radiotherapy. For further details, see the following link.
Still another large cohort study published in the journal Cancer showed that the risk of colorectal cancer (CRC) is increased following a diagnosis of prostate cancer. This suggests CRC screening should be considered following a prostate cancer diagnosis, especially among those undergoing radiotherapy.
An April 4th, 2011 website post described two studies from Johns Hopkins and UCLA which concluded that pomegranate extract increased PSA doubling time (PSADT) in men with prostate cancer. Recently, the National Cancer Institute (NCI) has updated its information from human studies of pomegranate extract. In a study reported in 2006, researchers observed the effects of pomegranate juice (PJ) on PSA values in prostate cancer patients who had rising PSA levels following treatment with surgery or radiation. The study participants drank 8 ounces of juice daily (570 mg/day total polyphenol gallic acid equivalents) for up to 33 months. Drinking PJ was associated with statistically significant increases in PSA doubling time (PSADT). After 33 months of follow-up, the median PSADT increased from 11.5 months to 28.7 months (P < .001).
A phase II study evaluated 1-g and 3-g doses of pomegranate extract in 104 men with rising PSA values following initial therapy for localized prostate cancer. The study reported that pomegranate extract was associated with an increase of at least 6 months in PSADT in both treatment arms, without adverse effects. However, a phase III placebo-controlled trial of 183 patients who were randomly assigned to the pomegranate juice, pomegranate extract, or placebo did not significantly prolong PSADT in prostate cancer patients with rising PSA after primary therapy. Some data from this study suggest that a subgroup analysis should be done to further investigate a potential unique sensitivity.
Personally, I had taken pomegranate extract daily supplied by POM Wonderful for years. I was recently informed that the makers of POM Wonderful are no longer providing the extract capsules. I cannot say for sure whether the extract is helping me but I have no averse effects to my knowledge. However, if you are considering taking pomegranate in any form, you should share this information in discussions with your physician. The National Cancer Institute (NCI) publishes extensive information on studies of the effects of various supplements and vitamins on prostate cancer. See the following link.
In a very informative seven minute video clip recently posted on Prostate Cancer News Today, Dr. Alicia K. Morgans, an Assistant Professor of Medicine in the subject of hematology and oncology, at the Vanderbilt-Ingram Cancer Center discusses prostate cancer and bone metastasis. She discusses what these diseases entail, how they spread, where in the body they spread, how they are detected and treated and how patients are affected.
Prostate Cancer News Today is a weekly e mail from Bayer Healthcare that contains 3-4 articles referencing various aspects of prostate cancer. An e mail received May 16th, 2016 contained an article called “Finding Out About Prostate Cancer Clinical Trials.” The article was one of the best references I have seen to provide information about the benefits of clinical trials and how to find institutions sponsoring them including the U.S. government National Institutes of Health / National Cancer Institute at https://clinicaltrials.gov. The article also discussed what a patient should ask his physician about trials as well as an article describing reasons to participate and benefits received in trials. Lastly, the weekly e mail also contained details about a specific clinical trial involving a cutting-edge therapy called stereotactic body radiotherapy (SBRT) as a means of delivering radiation to the exact area affected by prostate cancer instead of irradiating the entire gland.
In addition, the May 30th e mail from Prostate Cancer News Today contained an excellent review entitled “How Prostate Cancer Clinical Trials Work, from Research & Development to Human Trials.” Please check out this brief but informative link.
I also strongly suggest that you subscribe directly to this valuable e mail service.
A Northwestern University study of 190 men of median age 64 having their prostate removed found those with low vitamin D levels were more likely to have rapidly growing tumors than those with normal levels of the “sunshine” vitamin. The study was published on-line in the Journal of Clinical Oncology. The researchers found that nearly 46 percent of the men had aggressive cancer, and these men had vitamin D levels about 16 percent lower than men with slower-growing tumors. Racial distinctions were also noted in this study with black men having more aggressive tumors and lower vitamin D levels than white men. After accounting for age, PSA levels and abnormal rectal exams, researchers found that blood vitamin D levels below 30 nanograms per milliliter (ng/mL) were linked to higher odds of aggressive prostate cancer. The study however does not necessarily prove that vitamin D deficiency causes aggressive prostate cancer, only that the two are associated. Experts quoted herein state that while these results are important enough to spur further study into the vitamin D – prostate cancer potential biomarker connection, there is not sufficient evidence at this time to recommend vitamin D supplements to prevent prostate cancer or to make it less aggressive. It should be noted however that most Americans in general have lower than normal vitamin D levels which seem to be implicated in several medical conditions. It is recommended that men and women be blood-tested routinely for vitamin D levels using the 25-hydroxy vitamin D assay. Optimum levels should be at least 30 ng/mL. (One can get too much vitamin D so consult your physician to discuss test results and supplement recommendations if needed.) It was also suggested that perhaps men should be tested for Vitamin D when they are diagnosed with prostate cancer and subsequently supplemented with vitamin D if they are deficient. For further information, see the link to this study published in the National Institutes of Health Medline. For an additional summary of this study see the following link from Cancer Therapy Advisor.
Prostate Cancer News Today recently sent an e mail summarizing the twelve currently-approved drug treatments for prostate cancer. Rather than reproducing the list here, I am providing a link to the article.
A large study (see the Cancer Network Oncology link) from Harvard Medical School and Brigham and Women’s Hospital in Boston suggests that men receiving testosterone-suppressing (hormone) therapy (ADT) for prostate cancer may be at increased risk of developing depression. The findings, published online April 11th in the Journal of Clinical Oncology, are based on Medicare records for over 78,000 U.S. men treated for prostate cancer between 1992 and 2006. Overall, 43 percent underwent hormone therapy. Once other factors were taken into account, the study found a 23% increased risk of depression compared to men receiving other cancer treatments and a 29% increased risk of inpatient psychiatric treatment. The investigators also concluded that the longer men were on hormone therapy, the greater the risk of depression. Longer exposure to hormone therapy (ADT) resulted in an increased risk of depression from 12% with less than 6 months of therapy to 26% with 7-11 months of therapy and up to 37% among patients treated for 12 months or longer. While the increased risk of depression may be a direct result of reduced testosterone levels, there could also be indirect effects such as sexual dysfunction, hot flashes and weight gain. Hormone therapy (ADT) can also be accompanied by metabolic, cardiovascular, bone and cognitive adverse events. Several prior studies have found a similar significant association between depression and ADT yet smaller studies have also shown no link. There is currently no consensus on whether ADT is associated with depression noted the authors. The study authors also stated that while hormone therapy may not be a good choice for men with “low-risk” cancers, but for “higher-risk” cancers treated by surgery or radiation, adding hormone therapy might be a good choice. For men with “intermediate-risk” prostate cancer, the benefits of hormone therapy are less clear, and would have to be weighed against the risks. Pertinent commentary from Dr. Mayer Fishman of the Moffitt Cancer Center in Tampa, FL (not Miami) was also provided in the following linked Medline article.
On a personal level, I have been on intermittent ADT for over nine years and thankfully I am asymptomatic. In light of the above, I have at times experienced very short periods of mild depression which could be due to any one of a number of causes not just ADT. More importantly however, as I approach 75 years of age, my personal relationship with God through His Son Jesus Christ and the in-dwelling Holy Spirit, allows me to retain my joy of this earthly life and the anticipation of my eternal life to come in a new heaven and a new earth with a new disease-free body. Over the years, I may have asked God the same questions as did the authors of Psalm 42. They wrote in verse 11, “Why my soul are you downcast? Why so disturbed within me? Put your hope in God, for I will yet praise Him, my Savior and my God.” I can echo the words of the Old Testament prophet Nehemiah 8:10 who states “do not be grieved, for the joy of the Lord is your strength.” Hopefully, these brief thoughts could serve as an antidote for any disease-induced depression.