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Posted 8/5/2011 3:08 PM (GMT 0)
www.slate.com/id/2300578/
Posted 8/5/2011 3:25 PM (GMT 0)
The author of the article counts Pomegranate as just another anti-oxidant, lumps it in with all the others and labels them as worthless...

Never mentioned is the Johns-Hopkins controlled study and trial that proved pomegranate juice and extract could and did dramatically slow down the PSA doubling time in a large group of men with advanced PC...

Perhaps the benefit of Pomegranate in treating PC has NOTHING to do with anti-oxidant properties....
Posted 8/5/2011 4:53 PM (GMT 0)
Fairwind, you are correct. Let him refute the fact that POM increased PSADT (maybe by other than antioxidant activity) or that a regimen of D3 such as the trial by Vieth did the same nearly doubling PSADT. These supplements are never intended as cures. They are intended to slow down progression and give patients time to benefit from any future treatment that comes along. In the case of these two, cost is modest and not a factor.

RalphV
Posted 8/5/2011 5:08 PM (GMT 0)
Oh boy, our favourite subject, again. I will repeat what 3 different Oncology Dieticians have told me about POM juice in general, to present the other side. The most experienced of the 3, more than 25 years in the field, said she has not seen any hard evidence of POM aiding in PC cases, she said the hard facts aren't there, and she considers the current interest in POM as the current fad that men are doing. Of course, she said, if you like the taste, drink it.

David in SC
Posted 8/5/2011 5:22 PM (GMT 0)
I'm also skeptical about many of these food product claims, but I figure that it can't hurt so I have little to loose by adding them to my diet. To be honest the price of POM juice does hurt a little bit, so I try not to guzzle the stuff. Aside from that I've added lots of tomato juice, soy, cruciferous vegetables (broccoli, cauliflower, cabbage), asparagus, turmeric (I"m starting to sweat out curry), green tea with a few pinches of saffron and generally lots of other intensely colored fruits and vegetables. I've seen some positive results with my weight and digestive system but I have no clue if it is impeding my cancer development.
Posted 8/5/2011 5:31 PM (GMT 0)
Dreamerboy, Use the pomegranate in pill form. Cheaper and sugarfree

RalphV
Posted 8/5/2011 6:01 PM (GMT 0)
Hi David,
This is very recent research and maybe your dieticians are not aware of the results of this double- blind study reported at the ASCO 2011 meeting. This research supports a previous result. I consider this researcher a well known medical oncologist experienced in PCa.

"In a phase 2 double-blind study led by Michael A. Carducci, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, researchers found that treatment with the pomegranate extract (POMx) was associated with a greater than six-month median increase in PSA doubling time (PSADT). Previous research had shown that pomegranate extract, which is rich in antioxidants and vitamin C, has antitumor effects."

Source:
tinyurl.com/3lqpuyb

Or from the ASCO site:
tinyurl.com/3qaxd6r

RalphV
Posted 8/5/2011 6:13 PM (GMT 0)
Carducci's study was a confirmation of a smaller UCLA study that showed the same thing. So we have two double blind studies that confirm that POM increases PSADT and no studies to disprove it. This is another example of our beliefs creating bias. those that believe that POM works will take these studies as evidence and those who do not believe will find fault with a hundred studies that show the same.
JT
Posted 8/5/2011 6:16 PM (GMT 0)
ralf,

i would never openly dispute your level of knowledge on all things pc, but the head oncology dietician i have access too, is very up to date in her field, she says she reads and studies every single report/study on nutrician, vitamins, supplements, etc.

given her field of expertise, and considering she has spent 25 years of her life assisting only oncology patients, i think her opinions have strong merit. there would be no reason for her to say differently. i never told her i agreed or disagreed about POM, just wanted to know her professional opinion.

she said she has seen every fad that has come along during her years, and most all of them don't pan out to reality.

she is also the one that feels strongly that people picking and choosing supplements/vitamins on their own is a dangerous course of action - when not being assisted by sound medical advice.

on diet, she is all about heart healthy diets, she is totally against people eliminating entire groups of food, she said there is no hard evidence that it helps to do so, and you can mess up the proper balance that a body needs to be healthy.

she is not against vegeterian or vegan lifestyles, but in her experience, she sees just as many cancer patietns on those diets as she does people that eat terrible.  and she said if someone is dx at age 60 for example, you aren't going to change the damage from a lifetime of bad eating.  as far as the special things that each of enjoy, i.e. my love of good quality chocolate, she said not to eliminate them from your life, but to eat such things in moderation.

she said weight watchers was as good as any consumer weight loss program, because its all about controlling intake in general. she said everyone wants some easy answer, but it comes down to eating less, exercising more.

david

Post Edited (Purgatory) : 8/5/2011 12:20:37 PM (GMT-6)

Posted 8/5/2011 6:31 PM (GMT 0)
ahhhh .... more fuel for fatalistic.  who is this doctor anyway?  not that i care cool .

ed

 

Posted 8/5/2011 6:37 PM (GMT 0)

actually weight loss comes down to burning more calories than you consume. that's exactly what weigh watchers preaches.  but they also offer peer support as well as ideas on how not to treat your body like a garbage can.  garbage in garbage out. 

ed

Posted 8/5/2011 6:57 PM (GMT 0)
David,
I am not disputing her qualifications. Did you discuss this particular study and asked for her opinion? This supplement is not intended as a cure. It is cheap and for someone experiencing a short PSADT it is something to consider. I am here to pass on information and not to argue about my doctor is better than yours or my opinion is better than yours. This is not what I do. I pass on information that I consider beneficial. It is for the patient to decide. It is that simple.

RalphV
Posted 8/5/2011 7:11 PM (GMT 0)
David:

It seems there are a few supplements that are endorsed by some of the top doctors who base their claims on really good studies.

Your dietician may not be right. For example, I think there is a LOT of evidence that a Vegan diet does make a significant difference regarding PSADT. The reality is that most of us (well, speaking for myself anyway) would find it impossible to stick with such a restrictive diet. My hat is off to those that can. We are slowly considering doing the next best diet, theMedit. Diet. We have looked at a couple of books and we are about ready to pick out a few recipes and just do it.

No doubt a heart healthy diet makes good sense -- for your heart and for PC.

I am starting to do a few of the supplements.

David, why don't you just buy the POM pills and do it. It is not cheap (at least the POM-Wonderful brand that they recommend), but it is worth a shot. Also, fish oil with Omega 3 only (not Omega 6) IS quite inexpensive.. Don't you already do the D3.

Just to do nothing in terms of diet, supplements, and even tx. does not seem like the right thing to do.

I might add that I am also skeptical, probably influenced by the fact that every tx. and test I've done has failed.

Mel

 

Posted 8/5/2011 8:16 PM (GMT 0)

ralfinaz said...
Did you discuss this particular study and asked for her opinion?

 

 

This point was further emphasized in a recent discussion I heard on "Doctor Radio" (a show on XM/Sirius satellite radio).  The doctors from NYU/Langone Medical Center on this show highlighted how nutrition and supplements are only now showing up in the typical medical school syllabus.  To a large degree, today's extent of the molecular-level understanding of how foods impact cancer is only about a decade old.  As a result, the NYU doctors commented, is that in fact many of the older doctors and medical professionals end up learning a lot from their patients. 

Oncology is a very broad field, and most of the dietiticans' work is focused on helping patients hold down their food.  However, the textbooks being taught to today's dietitican students includes many more specifics on smart lifestyle choices.

Posted 8/5/2011 8:34 PM (GMT 0)
I guess I'm a bit of a trouble maker, by posting this link and stirring things up. However, Slate is one of my daily reads, and I wasn't sure that others here read it.

In past discussions, I presented arguments that the PSADT studies discussed in this thread are not as strong as some posters think. If they were, you'd be seeing guidelines for physician practice that included POMs. Unfortunately, I don't have time to look them up until the weekend, so when I do post, it will stir up a whole new hornet's nest.
Posted 8/5/2011 9:00 PM (GMT 0)

Postop said...
If they were, you'd be seeing guidelines for physician practice...

Most of us aren't holding our breaths until this shows up on the NCCN Clinical Practice Guidelines in Oncology for Prostate Cancer (maybe some are), but it is notable that all of the gurus who specialize narrowly in treating the challenging PC cases all have lifestyle choices as part of their "prescription."  POM pills aren't a cure, but they are an "ounce of prevention" choice to help stack the odds in your favor.

In another thread, Raddad recently quoted some pomegranate info from I link I provided him:

Raddad said...
Wow this is pretty interesting - its is from the Link that Casey59 provided in his response to me.

Pomegranate (Punica granatum; Punicaceae)
• Research suggests that pomegranate exhibits strong anti-inflammatory and antioxidant* effects
[73].
• Pomegranate seed oil and fermented juice block the cancer cells’ oxygen supply, slow cell growth,
and promote cell death [74].
• Pomegranate extract, rich in ellagitannins, can inhibit tumor-associated angiogenesis as one
of several potential mechanisms for slowing the growth of prostate cancer in chemopreventive
applications [75].
• Pomegranate extract inhibits both androgen-dependent and androgen-independent prostate cancer
cell growth [76].
• Pomegranate extract inhibited nuclear factor-kappaB (NF-kappaB) activation in androgen
independent prostate cancer cells [77].
• Animal data suggest that pomegranate fruit extract significantly inhibits tumor growth while also
significantly decreasing PSA levels [73].
6
• Prostate cancer patients significantly increased PSA doubling time (mean of 54 months compared
to 15 months) by consuming 8 oz pomegranate juice daily [78].
• Note that pomegranate interacts with some medications; please discuss with your healthcare
provider if you use pomegranate products regularly.

Bud comment - Pomegranate juice is actually very tasty!

The link I sent him was a document written by the author of the 2010 dietitican's textbook titled, "Clinical Nutrition for Oncology Patients."  [Actually, that subject covering all of oncology is way too broad for any one specialist to write an entire textbook.  The linked document quoted above was authored by the person who wrote the chapter in that textbook which focused solely on Prostate Cancer.]

 

Posted 8/5/2011 10:30 PM (GMT 0)
Trader Joes sells 32 Oz of pomegranate for about $4.50.

That works out to about $1.13 a 8 Oz glass.

I have no idea how that compares to the POM pricing
Posted 8/6/2011 12:34 AM (GMT 0)
Purgatory:
Ralf has provided ASCO reports from JHU researchers. You dietician has her own personal comments. Whom do you believe represents the best science? I think I know what you are gong to say.
Posted 8/6/2011 12:52 AM (GMT 0)
pomx costs me less than a buck a day.  the capsules are delivered to my house every 90 days and the cost is automatically deducted from my Visa card. Pomx is vegan and calorie free and probably the only sure way i'd get my dose every day.

ed

 

Posted 8/6/2011 2:03 AM (GMT 0)
Ed:

As I said, it's not cheap.

Mel

Posted 8/6/2011 2:31 AM (GMT 0)
tar, thanks for deciding in advance how i will answer, lol.

whenever these topics come up here, its the same circle. pity anyone that has an opposing view. its fairer to say, that there is no agreement on the experts on this subject.

ed, you say it's a fatalistic view? i think that's way off base, some would say its a realistic view, not depending on false hope in products of questionable value. i don't think wishful thinking and "stacking the odds" is ever going to change anyone's ultimate cancer outcome.

ralf - you presented one view on this study, and i counter with what i feel is a qualified answer from a real life oncology dietician expert, i don't think either view is completely right or wrong. we still ultimately will do what we feel is right in our own cases.

david
Posted 8/6/2011 2:31 AM (GMT 0)
Here is the past thread on the POM PSADT study:

www.healingwell.com/community/default.aspx?f=35&m=2031322


Here is my prior comment on the Carducci study:

this is not a controlled study, because there was no control group. The two groups are two different doses, and the doubling time is compared to that in a baseline period prior to starting the drug. They seem to be looking for a dose-response--with most drugs, as you increase the dose, the effect increases. There was no difference between the two doses (1 gm/day vs 3 gm/day), but both had a difference from the baseline. So this study is randomized, but not controlled. So this is not level 1 evidence.

Here is the review of the data on POM from the NIH

www.nlm.nih.gov/medlineplus/druginfo/natural/392.html

This rates the evidence for POM slowing prostate cancer as insufficient to judge.
Posted 8/6/2011 2:38 AM (GMT 0)
Postop:

your last link from the NIH has a lot of good info I think, and it backs up some views that my oncologist holds on the subject.

My GP of some 17-18 years has a more pestimstic view about POM, but I don't feel he's up to day on a lot of things, but he said the whole current POM craze was a designed effect by the POM grower's associations to push a produce that had limited use prior to tying it into possible medical cures. I think that is a bit harsh, but would be interesting to see if there is any hard truth to it.

The only time in my life, that I ever saw pomegrantes being widely sold and used, was when I lived in Morocco as a kid.

david
Posted 8/6/2011 3:38 AM (GMT 0)
David,

You nailed my experience with Pom - it is considered in Mediterranean culture as an important fruit, so often on the table.

We used it a lot as a fruit on the table and juice. If it was magical, why do I now have aggressive PCa?

Posted 8/6/2011 3:48 AM (GMT 0)
142, when I lived in Rabat, Morocco, we had a pom tree in the back yard, the servants would take the fruit and were eager for it. As kids, they were fun to throw at each other, and I always thought all those seeds looked neat. We had kumquat trees too, but never acquired a taste for them either.

david
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