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How does one make treatment decisions when there are no large randomized clinical trials (RCTs)?

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Posted 8/20/2018 7:24 PM (GMT 0)
No- RCTs are not done to tic you off, although actual proof seems to get in the way of your firmly held opinion (confirmation bias).

Yes, the authors went into the study hoping that Vitamin E (of the type and amount that men were then buying it in droves) would have a benefit. So their bias, if any, was in support of Vitamin E. They proved that it actually increased the risk of PC.

Whether some other tocopherols or tocotrienols may be beneficial or harmful is yet to be determined. DL-alpha-tocopherol is what we all see in drug stores and in multi-vitamins, and 400 iu was the most prevalent amount sold.

The SELECT RCT had far-ranging implications. Most importantly, it demonstrated that observational studies are often wrong. It also led biochemists to search for the mechanisms by which Vitamin E caused prostate cancer. That led to the discovery that reactive oxygen species (ROS) are necessary to fight cancer, and that anti-oxidants like Vitamin E and Selenium get in the way.
Posted 8/20/2018 8:32 PM (GMT 0)
To those not named Allen.

Its only a question of time.
Emerging evidence supports that prostate cancer originates from a rare subpopulation of cells, namely prostate cancer stem cells (CSCs). Conventional therapies for prostate cancer are believed to mainly target the majority of differentiated tumor cells but spare CSCs, which may account for the subsequent disease relapse after treatment. Therefore, successful elimination of CSCs may be an effective strategy to achieve complete remission from this disease. Gamma-tocotrienols (γ-T3) is one of the vitamin-E constituents, which have been shown to have anticancer effects against a wide range of human cancers. Recently, we have reported that γ-T3 treatment not only inhibits prostate cancer cell invasion but also sensitizes the cells to docetaxel-induced apoptosis, suggesting that γ-T3 may be an effective therapeutic agent against advanced stage prostate cancer. Here, we demonstrate for the first time that γ-T3 can downregulate the expression of prostate CSC markers (CD133/CD44) in androgen-independent prostate cancer cell lines (PC-3 and DU145), as evident from Western blotting analysis. Meanwhile, the spheroid formation ability of the prostate cancer cells was significantly hampered by γ-T3 treatment. In addition, pretreatment of PC-3 cells with γ-T3 was found to suppress tumor initiation ability of the cells. More importantly, although CD133-enriched PC-3 cells were highly resistant to docetaxel treatment, these cells were as sensitive to γ-T3 treatment as the CD133-depleted population. Our data suggest that γ-T3 may be an effective agent in targeting prostate CSCs, which may account for its anticancer and chemosensitizing effects reported in previous studies.
Posted 8/20/2018 8:49 PM (GMT 0)
As I understand it, for those who have tried all available "standard of care" treatments without success, Clinical trials are used to try out unproven and as yet unapproved treatments. One can also see a doctor who applies his/her own treatment modalities based on his experience and knowledge but not peer reviewed.
Bob
Posted 8/20/2018 9:38 PM (GMT 0)
bubbatc

Quoting a lab study about gamma-tocotrienols is both irrelevant to the SELECT RCT and is exactly the kind of low-level evidence that SELECT showed may do harm.
Posted 8/20/2018 10:35 PM (GMT 0)
As a senior member you feel this statement should be ignored and buried? All studies were once low-level evidence. Is it more important to be right than to help people? Leave your ego at the door.

Gamma-tocotrienols (γ-T3) is one of the vitamin-E constituents, which have been shown to have anticancer effects against a wide range of human cancers. Recently, we have reported that γ-T3 treatment not only inhibits prostate cancer cell invasion but also sensitizes the cells to docetaxel-induced apoptosis, suggesting that γ-T3 may be an effective therapeutic agent against advanced stage prostate cancer.

I tried to create a poll but I couldn't make it work. If everyone feels that way then this really isn't the place for me.

I can tell you what I believe to be primarily responsible for all my numbers reductions on the previous page.

Post Edited (bubbatc) : 8/20/2018 6:15:08 PM (GMT-6)

Posted 8/20/2018 11:58 PM (GMT 0)
I'm not a mod...but I want to say to both of you...cut it out.
Posted 8/21/2018 12:03 AM (GMT 0)
i've been not so much reading this thread as spectating it ... like sitting midcourt at the wimbledon finals ... my head whipping back and forth ... back and forth ...
Posted 8/21/2018 12:21 AM (GMT 0)
Babbatc-

I guess you missed what I wrote earlier:

"Whether some other tocopherols or tocotrienols may be beneficial or harmful is yet to be determined. DL-alpha-tocopherol is what we all see in drug stores and in multi-vitamins, and 400 iu was the most prevalent amount sold."

I don't think that a lab study or a study in mice should be taken by patients as license to take any potentially harmful substance.

From what I've read of your personal PSA history, you've had some prostatitis.

halbert- chill. People can disagree on this site.
Posted 8/21/2018 12:31 AM (GMT 0)
TA - absolutely correct. The problem is not the fact that we disagree, sometimes it’s the tone with which we disagree. I’ve been guilty of it myself, (now that I’m a mod I try to be a model citizen, but it’s hard 😂 ). I am IN NO WAY IMPLYING THAT YOURE GUILTY OF IT - or not. I think multiple members are guilty of it, and just pointing it out.

To everyone - Sarcastic tone by itself is not a violation of the forum rules. But it can easily degenerate and thus lead to a violation. We are all very passionate about what we discuss here and that’s a good thing.
This is a great discussion, and hopefully that won’t happen here, so the thread doesn’t need to be locked.

May I respectfully suggest that EVERYONE read their post before hitting submit. Especially when they are disagreeing. Ok, ok, I’ll start doing it to0. 😄 there. I just did.
Posted 8/21/2018 12:43 AM (GMT 0)

Pratoman said...
TA - absolutely correct. The problem is not the fact that we disagree, sometimes it’s the tone with which we disagree. I’ve been guilty of it myself, (now that I’m a mod I try to be a model citizen, but it’s hard 😂 ). I am IN NO WAY IMPLYING THAT YOURE GUILTY OF IT - or not. I think multiple members are guilty of it, and just pointing it out.

To everyone - Sarcastic tone by itself is not a violation of the forum rules. But it can easily degenerate and thus lead to a violation. We are all very passionate about what we discuss here and that’s a good thing.
This is a great discussion, and hopefully that won’t happen here, so the thread doesn’t need to be locked.

May I respectfully suggest that EVERYONE read their post before hitting submit. Especially when they are disagreeing. Ok, ok, I’ll start doing it to0. 😄 there. I just did.

I am amazed at how consistently testy we can get with each other, when I'm betting every one posting here wants nothing more than to be helpful to his PC brother. It is particularly surprising considering how many of us are low on testosterone, which seemingly should make it more difficult to be testy. Well, at least I can never be accused of getting testy. Right?
Posted 8/21/2018 12:46 AM (GMT 0)
In a week, after my first shot, I’m guessing I will be consistently testy...less..
Ok, back on topic.
Posted 8/21/2018 1:13 AM (GMT 0)
Prat - ummm, not sure how much I really need to know about your testies ...

Just say'n. ;)

not trying to be testy
Posted 8/21/2018 1:39 AM (GMT 0)

InTheShop said...
Prat - ummm, not sure how much I really need to know about your testies ...

Just say'n. ;)

not trying to be testy

Your right Andrew/ I changed the wording, thanks for making me tighten it up. But I gotta make jokes it’s my way of coping. Like you make poetry.
Posted 8/21/2018 1:48 AM (GMT 0)
Jokes are good, you didn't need to change it.
Posted 8/21/2018 2:31 PM (GMT 0)
"From what I've read of your personal PSA history, you've had some prostatitis."
-
Wow, So to recap -
You're vehemently against a handful of walnuts, ignoring research from one of the top ranked hospitals in the nation for cancer care.
You continue treat a 10 year old proven flawed study with junk vitamin E as gospel.
But you have zero problem dishing out potentially harmful and false medical advice.

I feel bad for the people here, I won’t be one of them.

But I'll call my doc and tell him Allen said I don’t need the biopsy or mri, so he should repay all that wasted money to Johns Hopkins.
Posted 8/21/2018 3:16 PM (GMT 0)
Bubba,

Calling your doctor if you have concerns is always a good idea. Feel free to tell him that some random guy on the Internet told you you probably just have prostatitis. See how impressed you doctor is with that news. And your doctor will be right. Nothing anybody says here on this forum is medical advice. The most anyone can hope to get here is suggestions for topics to discuss with their medical team, and maybe some help holding up their side of the conversation.

you said...
I feel bad for the people here, I won’t be one of them.

Yeah, I suspect that most of us feel bad for you too. Good luck.
Posted 8/21/2018 10:07 PM (GMT 0)

Pratoman said...

To everyone - Sarcastic tone by itself is not a violation of the forum rules.

Thank the Lord..... blush
Posted 8/22/2018 12:10 AM (GMT 0)

PeterDisAbelard. said...

Calling your doctor if you have concerns is always a good idea. Feel free to tell him that some random guy on the Internet told you you probably just have prostatitis. See how impressed you doctor is with that news. And your doctor will be right. Nothing anybody says here on this forum is medical advice. The most anyone can hope to get here is suggestions for topics to discuss with their medical team, and maybe some help holding up their side of the conversation.

A good reminder, Peter.
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