Dear Patients& Colleagues,< p>< span style="font-family: Times New Roman; font…" /> Rondschrijven van Dr. Strum - origineel | Prostaatkanker

Rondschrijven van Dr. Strum - origineel

Dear Patients & Colleagues,

I receive so many emails from patients about supplements they should use to treat PC. I have seen an undo focus on this topic at so many PC conferences over the last 20 years, while other topics, far more important, involving KEY CONCEPTS are ignored. If you were to read through all the PCRI Insights issues published over the last 10 years during times when I was closely involved with the PCRI, you would see little in the way of human studies showing efficacy of supplements in reducing the prostate cancer tumor cell population. Yes, there are some articles, but these are in the minority compared to the rest of what has been published.

Here is my opinion on this issue. 

Of the supplements available that seem to have the most bearing on PC treatment and overall internal medicine health, there are two I would select:

1. Vitamin D-3

2. Omega-3-fatty acids (fish oil or algae-based)

There are many peer-reviewed publications (PRP) about these two supplements to the extent that I regard them as fundamental or foundational products in the total health care of all human beings. What is missing, however, in the use of these two agents is the assessment of BIOLOGICAL ENDPOINTS based on serum values of:

1. (25-OH)-D3 for monitoring Vitamin D-3 dose

2. Essential Fatty Acid (EFA) profile or Comprehensive Fatty Acid (CFA) profile  for monitoring diet and use of omega-3 fatty acids. See http://216.245.161.151/TestView.aspx?testID=7754&searchfor=82426 

After the above,  the additional supplements of value to include requires considerable thought.  If a person is on a bisphosphonate compound such as Zometa, Aredia, Fosamax, Actonel or Boniva, then they need to be on a

3. Comprehensive bone supplement but NOT one containing an excess of calcium. I suggest 800mg to maximum of 1,000 mg and again monitor the Biological End Point (BEP) of serum calcium, & ideally intact PTH if any real concern about adequacy of calcium intake & Vitamin D-3. For me, the ideal comprehensive bone supplement has still not been formulated but the closest to this would be Jarrow's Bone Up or Ultra Bone Up or LEF's Bone Assure.  Remember that this product contains not just an absorbable calcium but also magnesium, boron, & MK-7 at biologically significant doses.   

After these top 3, using the patient's context would enable fine tuning recommendations for adding other supplements.  Here are my thoughts on this:  

4. PomX for those with active PC who are hoping to prolong PSA doubling time (PSADT).  

5. MK-7 for those with bone loss and/or vascular calcifications. MK7 functions to carboxylate osteocalcin & deposit calcium in bones rather then in vascular tissue & elsewhere where it does not belong.   

6. Boron for bone density increase, understanding that the boron dose of 3mg is probably modest and that boron can be used in doses up to 27mg per day without significant toxicity.  

7. Strontium citrate for bone density via stimulation of bone formation. Silica as well.  

8. CoQ10 & ALC (acetyl L-carnitine) for those with CVD (cardiovascular disease) or diabetes mellitus or both and to enhance ATP and energy utilization.  

9. Melatonin to enhance sleep, possibly to dR (down-regulate) the androgen receptor. 

10. Folic acid, B12 & TMG (trimethylglycine) to reduce homocysteine (Hcy) levels.

Now I may have missed something, and am open to hearing from you, but what I have indicated above would be the major products that seem to consistently benefit living patients as opposed to cell lines, hamsters, rats, mice and other non-human test systems.

There is no doubt that many other supplements have some degree of biologic activity when PC is the issue at hand, but nothing that compares to the degree of efficacy that is easily evidenced when using current traditional forms of hormonal, radiation, surgical or chemo therapies. That's just the way it is. I would love it if some non-toxic supplement would make PC disappear.  It just ain't happening so far despite the many claims you see on the internet. Caveat emptor--"Let the buyer beware".  

Lastly, let me say that I eat a healthy diet, I exercise 3 or more times a week, do not smoke and do not drink significant amounts of alcohol.  And...my desktop is cluttered with bottles of vitamins and supplements, of which I take intermittently, hoping that they will do something of significance to alter the course of my life. But I still affirm that much too much attention is being paid to supplements and not enough to the key issues and fundamentals about that which is known to be effective against PC.  

Again I make mention of The Anti-inflammation Zone by Barry Sears where the major focus is on CRD (Carbohydrate-restricted diet) and the use of Fish Oil to modulate the eicosanoid pathways to regulate inflammation. If Americans were to seriously follow Sears' advice we would resolve the epidemic of obesity, diabetes mellitus and CVD (cardiovascular disease) that has occurred over the last 30 years. This is not solely a health issue but an economic issue that will topple this country and result in catastrophic consequences for future generations.  We are not only destroying our external environment but also are internal one. The focus of the peoples of planet Earth should be on milieu factors; and the focus should be now before further destruction occurs.  But I digress...

I expect many of you to ask why I have not included in my list: 

Vitamin C, E, beta carotene, selenium, lycopene, GLA, CLA, saw palmetto, flower pollen, DIM, red yeast rice, alpha lipoic acid, iodine, boswellia, xyflamend, glucosinolates, resveratrol, ellagic acid, curcumin, garlic, ginger, ginkgo, glutathione, glucosamine, green tea (EGCG), magnesium, NAC (N-acetyl cysteine), quercetin, SAMe, silymarin or silibinin, SOD, taurine, theanine, urtica, zinc, etc.  

I do recommend many of the above in the context of a person's specific biologic profile but with the realization that I have not had confirmation of efficacy as I do with the so-called conventional therapies. For example, I would love to treat men with PC without having to use ADT.  But androgen deprivation (AD) is clearly effective and does so in a clear-cut fashion, without a degree of subtlety that would take a huge randomized controlled trial to show efficacy.  The same is true of the other "conventional therapies".  I have not seen this to be the case with vitamins and/or supplements. 

So, please, do not spend so much time and effort in finding more and more supplements to take.  Instead, make sure that the foundational supplements you are taking are in the right dose per the blood levels you should be using by applying the fundamental concept of BEPs (Biological End Points).  

It is OK to use other supplements but know that essentially 95% of the literature, involving tens of thousands of papers, have involved studies in cell lines and non-humans and that they POSSIBLY could help, and appear to do no harm. I frequently use such supplements to AUGMENT conventional therapies but I rarely use them as stand alone treatments.  If, and when we see studies of supplements involving human tissues and with BEPs such as PSA, PSA kinetics, tumor volume, CTC (circulating tumor cells), etc showing an anti-cancer effect from a particular supplement or combination of supplements, then we should take major notice and consider employing such products.  In the meantime, use your common sense and ask for the evidence. The facts, ma'am, just the facts.  

My best regards to all,

Stephen    

Stephen B. Strum, MD, FACP Medical Oncologist specializing in PC     

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