Nutritional Approaches in Prostate Cancer

Nutritional Approaches in Prostate Cancer

The Enlarged Prostate

Benign prostatic hypertrophy (BPH) With various degrees of bladder obstruction affects around 55% of men between the ages of 40 and 60. Symptoms commonly include difficulty in beginning to urinate with intermittency of urinary flow, chronic nocturia, increased urgency and a decreased force of urinary stream together with terminal dribbling and a feeling that the bladder has never completely emptied.

Other findings may include chronic prostatitis induced by infection, haematuria due to rupture of the superficial veins of the prostatic urethra and trigone brought on by straining to void. When prolonged obstruction of the urethra occurs, calculus formation is not uncommon.

Diagnosis usually involves a rectal examination which reveals an enlarged prostate gland with loss of the gland's median furrow and having a rubbery consistency. If the prostate is tender and slightly hardened, prostatitis is likely.

Benign prostatic hyperplasia usually responds well to orally administered zinc (25mg elemental zinc bd), cold pressed linseed oil (1-2tablespoons daily), vitamin E 250mg daily and the liposterolic extract of Seronoa repens (saw palmetto) which contains sterols (betasitosterol and its glycoside), fatty acids (caproic, caprylic, lauric, palmitic and oleic) and carotenes.

The cause of this condition is thought to be related to the conversion of testosterone to the more active form called dihydrotestosterone (DHT) which stimulates cell multiplication and consequently prostate enlargement. The serenoa extract in particular is thought to prevent the conversion of testosterone into DHT and also to inhibit the binding of DHT to cellular and nuclear receptor sites.

Prostatic Cancer

If on palpation the prostate gland appears stony hard and nodular then prostate cancer is a possibility. This is usually confirmed by CT and bone scans, intravenous pyelogram (IVP) and may include a lymphangiogram, magnetic resonance imaging (MRI) or transrectal ultrasonography and blood tests for prostate specific antigen (PSA), a marker for prostatic cancer and other prostatic diseases or prostatic acid phosphatase (PAP) which rises in patients where prostatic cancer has spread to surrounding tissues. A prostate biopsy may also be used to determine the presence of cancer cells and later, at surgery lymphadenectomy may help to identify the stage of prostatic cancer.

Four main stages have been delineated. A Stage A tumor is still located entirely in the prostate gland, causes no symptoms and is too small to be felt during a rectal examination. Intervention is frequently not suggested at this stage. At Stage B the tumor is still symptomless and located entirely within the prostate but is large enough to be felt during a rectal examination. Treatment choices are usually surgery or radiation. By Stage C the tumor has spread to nearby parts of the body and urination is frequently difficult. Hormone therapy may be suggested with surgery, radiation or both. A Stage D tumor has spread to other parts of the body, most commonly the bones, and there is difficulty in urination, bone pain, weight loss and tiredness. Treatment commonly involves chemotherapy and/or hormone therapy.

Removal of the prostate is usually only effective if performed in the early stages (Stage A+B). Surgical removal of the testicles (orchidectomy) removes some of the body's potential to produce testosterone (and hence DHT) but the adrenal glands are also known to produce androgens, hence orchidectomy does not cure prostate cancer. Another method of reducing testosterone levels is by administering the female hormone estrogen. While estrogen does successfully reduce the production of testosterone by the testicles and thus the initial growth rate of the cancer, remissions brought about by orchidectomy and estrogen are usually of short duration and do not tend to improve overall survival. Alternatives to this approach include chemotherapy and antiandrogen therapy. The latter involves the use of drugs that block the activity of male hormones and these are sometimes given in combination with an LHRH analogue (A drug called a luteinizing hormone-releasing hormone which is as effective a s surgery but does not require the removal of the testicles.

It appears that the main problem of limited effectiveness in trying to treat prostate cancer either by surgery or inhibition of androgens made by the testes is that the testes produce only about 50% of the androgens produced by man - the rest are produced by the adrenal glands. Realizing this fact Professor F. Labrice and his group at Laval University Hospital in Quebec City, Canada have begun using LHRH analogues (to prevent the testes from producing androgens) together with the drug, flutamide (to stop the adrenals from making androgens). This approach has proved to be most successful as long as the patient has not had previous treatment to inhibit androgens made by the testes only. In such cases the cancer will frequently convert to being non-hormone dependent rendering hormone manipulation ineffective.

Nutritional Approaches

Over the last ten years many patients with prostatic cancer have sought my advice on nutritional and dietary matters relating to weight loss and digestive disorders. After visiting an wholistic health care clinic in Arosa, Switzerland in September, 1989 I became especially impressed with the effectiveness of raw food diets and natural remedies used during the treatment of patients with disorders ranging from cancer and mental health problems to multiple sclerosis. On returning to Sydney I started to incorporate some of these approaches into my dietary programs. Of particular interest were three case studies of men with prostatic cancer who, as part of their total treatment program, included the following dietary and nutritional advice:

Predominantly Raw foods with adequate primary protein and essential fatty acids with particular emphasis placed on the consumption of a minimum of 250g beetroot either cooked, raw or juiced each day.
Zell Oxygen is a German manufactured high nutrient density yeast supplement grown under high pressure oxygen (40-60mls daily) and
Kyolic (aged garlic) liquid extract taken in a dose range varying from 5-15mls daily.
Case Study No. 1

Ray, 67 years of age, had a history of prostate operations during 1984 after a biopsy revealed precancerous cells. Following surgery (and radiation during the first weeks of 1985) the PSA (prostate specific antigen) remained below 10ng/ml until April 4, 1990 when a routine check revealed an elevated PSA of 75ng/ml. A whole body bone scan, taken on June 8 indicated "extensive metastatic involvement of the bone, this is largely confined to the axial skeleton although there is one area of metastatic disease involving the right femoral trochanter."

After a lecture I had given several months previously, Ray had noted that I suggested that raw foods, Zell Oxygen, Kyolic garlic and beetroot may be beneficial foods for cancer patients wishing to improve their nutritional status. As he was dropping weight he incorporated these foods into his diet (June 14, 1990). One week later he had an orchidectomy followed by a nine day course of estrogen while still maintaining a raw fruit and vegetable diet.

On July 13 his PSA had dropped to 3.1ng/ml at which stage he stayed at a health farm in Queensland for several weeks while still maintaining a diet of raw fruit and vegetables. In addition he drank wheatgrass juice, had enemas and noted that his weight had dropped from 71 kg to 61 kg and that there was also a noticeable loss of muscle strength.

When Ray came to my consulting rooms on August 8, I modified his daily nutritional support in the following manner:

- Beetroot 250g (juiced and mixed with equal parts of carrot juice and some celery juice)

- Zell Oxygen 15ml tds in juice

- Calcium Orotate 400mg qds (to help calcify bone metastases)

- Kyolic garlic liquid extract 5ml tds (detoxification and immune support)

- Pancreatic enzymes (Bioglan Panazyme) 2 tablets after each meal (digestive support)

- The addition of egg and fish to prevent negative nitrogen balance. He ate these raw in addition to the Hippocrates raw fruit and vegetable diet and still maintained the wheatgrass juice 150ml per day.

The PSA had dropped to 0.1ng/ml by September 12, 1990 and zero by December 7, 1990 and has remained at zero ever since.

During a nutritional check-up at my clinic in May 1991 he had gained weight and muscle strength. PSA was still zero and PAP (prostatic acid phosphatase) 1.5ng/ml also well within the normal range of up to 3.5ng/ml. The report accompanying the total body bone scan May 29, 1991 was as follows: "There is some irregularity in the uptake inferiorly in the right sacro-iliac joint but on review of his previous three bone scans this has never changed and is presumably not due to degenerative change. Apart from this, the study is normal. There is no scan evidence of metastatic disease." An excellent result in view of the June 8, 1990 scan which indicated "extensive metastatic involvement of bone."

A detailed breakdown of Ray's diet is shown in Table 1. His personal notes and observations are also included for interest. Following the successful outcome with Ray's program I started two other individuals on a similar program but they maintained a less rigid diet. The results are as follows:

Case Study No. 2

Hans, a 66 year-old man was diagnosed as having Stage C prostatic cancer. Following a TUR (transurethral resection) performed on May 22, 1991, a CT scan of the abdomen and pelvis indicated local invasion of the carcinoma at the left posterior aspect of the gland with spread to left internal iliac lymph node and left paraaortic chain to the level of the mid-abdomen. Several discrete lesions in the liver also suggested multiple metastases. Abone scan was clear and prostate specific antigen (PSA) was 7.9. Treatment consisted of surgery and Androcur (cyproterone acetate) 50mg per day.

Hans came to me for dietary advice and nutritional support on June 4, 1991. His nutritional regime consisted of Zell Oxygen 15ml tds, Kyolic liquid extract 3ml tds and an antioxidant vitamin supplement containing vitamins A, C, E and the B complex.

Breakfast consisted of whole grain cereal or eggs and mushrooms. Lunch and dinner comprised mainly cruciferous vegetables such as cabbage, cauliflower and broccoli with the addition of carrots and at least half a container of canned beetroot twice daily. Protein was derived from moderate daily portions of veal, chicken or fish including sashimi and liver once a week. His condition is now normalized with a PSA 0.6ng/ml.

Case Study No. 3

William, a 70 year-old man also presented on June 4, 1991 with prostatic cancer Stage C with lower lymph node involvement. He requested nutritional and dietary advice before undergoing radiation therapy from June 18 to July 29. I started him on a nutritional regime which consisted of as much raw food as possible, Zell Oxygen 15ml tds, Kyolic powder 2 capsules bd together with beta carotene 20mg, vitamin E 500mg, vitamin C 2g, vitamin A 5000i.u., a B-complex vitamin and the juice from 250g beetroot daily in divided doses. Since a myocardial infarct in 1973 he also took Adalat, Betaloc, Midamor and quinine bisulphate.

While undergoing the above regime his PSA dropped from an initial 12.6 to 6.2ng/ml (26 August, 1991) and after another 6 weeks to 2.8ng/ml (October 17, 1991). By November 26 the tumor mass had gone. Palpation revealed the prostate as soft, normal in size (not hard and rubbery as before) and the prostate flow rate has returned to normal. The impotency experienced in June has now been replaced with normal sexual function.

These three cases are interesting because the dietary modifications in association with more orthodox treatment appears to have helped swing the balance towards a favorable outcome in all three (and I might add, consecutive) patients.

As men age, the prostate gland seems to be particularly susceptible to metabolic irregularities. By 70 years of age very few men are not affected by enlargement of the prostate gland with some interference with function and those less fortunate end up with cancer of the prostate. However both of these conditions may be amenable to nutritional and dietary support.

Correspondence:

Robert Buist, Ph.D.

Editor-in-Chief

International Clinical Nutrition Review

Suite 4, 21 Sydney Rd.

P.O. Box 370

Manly, NSW 2095

Australia

The Diet

1. Breakfast:

Watermelon (one large dinner plate piled high)

Cantaloupe (rock melon)

Honeydew melon

2. Lunch:

Two Bananas

One Orange One Mango

One Peach

One Apple

One Pear

(Varies with the season)

A soup plate of fruit salad containing pineapple, kiwi fruit, strawberries, passion fruit. (Varies with the season)

3. Dinner:

One heaped plate of salad, consisting of

Tomatoes

Mixed vegetables (cabbage, cauliflower,

Cucumber

corn, onion, garlic, etc.) in a marinade

Green peppers Pumpkin, grated

Snowpeas

Carrots, grated

Lettuce

Celery

Spinach

Sprouts, home grown (alfalfa, mung beans, fenugreek)

Nut sauces Tabbouleh, homemade

Avocado sauce Kelp powder

To this salad he later added the following cooked items: Lightly steamed potatoes and asparagus, cooked beetroot in cider vinegar, lavash flat bread (unleavened), spread with tahini. After nine months steamed fish in lemon juice and poached eggs. Cooked food eaten after raw food.

4. Wheatgrass juice from homegrown wheat. 150ml taken over the day.

Extras between meals. In addition to the three main meals

Boiled brown rice

Mixture of barley, rice, millet flakes and buckwheat kernels soaked in water overnight and eaten an hour after breakfast with orange juice

Acidophilus yogurt

Organic eggs eaten raw in orange juice. Two per week.

Fish fillets, eaten raw after soaking in lemon juice. Two per week.

One teaspoon of black molasses per day (because he felt like it)

Peppermint tea and wheatgrass juice.

Personal Notes

Using the Mind

Affirmation. Believe to the point of certainty that you are getting well. "I have everything to live for and have no intention of dying. Many others have beaten cancer and so have I."
Visualization. I concentrate my mind on the cancer areas so that I feel them being attacked, eaten, wiped out, carried away by the white blood cells...or their more easily visualized equivalents. I imagine Pacmen eating the cancer cells or a high pressure jet blasting the cancer cells away. However my preference is to visualize cancer-eating ants crawling over the cancer and attacking it fiercely. I concentrate on the prostate site then on virtually each individual vertebra in turn. This produces a highly localized feeling which is so strong that it reaches the threshold of pain. It is a mixture of ache, tingle and pressure. It takes enormous concentration (which often lapses) and it takes at least thirty minutes to "do" my prostate and spine. My control is such that I can focus first on the front and then on the back of each vertebra. I do this twice a day: first on waking and then following a short rest after lunch. I need to lie on my back in a quiet darkened room.
I also practice Meditation and Relaxation but tend to fall asleep. I also avoid, as far as possible, any mental stress - no deadlines, no frustrations, jobs can wait.
Possible Causative Factors

The loss of a son in Vietnam in 1971.
The tensions and frustrations associated with my job.
Early exposure to many chemicals during University days and, later, in teaching Science.
We ran a part time cattle property from 1971 to 1986 and were exposed to herbicides, pesticides and diesel exhaust gases.
Side Effects of the New Lifestyle

Dilatations are no longer necessary. The flow remains excellent. This might be coincidental.
I seem to need less sleep and I am fully alert on waking.
Bowel movements are always easy and complete.
I no longer wear glasses when driving and a chronic tinea problem has disappeared. These changes might also be coincidental.

Townsend Letter for Doctors & Patients.

~~~~~~~~

By Robert Buist

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