Tag Archives: prostate cancer

Calcium and vitamin D supplements and prostate cancer; IOM and NIH reports

Use of calcium supplements has been already been associated with an increased risk of prostate cancer for men for many years in a National Institute of Health (NIH) an Institute of Medicine (IOM)report, (see page 6 and see excerpt later in this post)(and prostate cancer is also mentioned in a 1997 report on page 144, and from page 142 a summary statement about some groups of people who may be more at risk from excessive calcium intake:

Subpopulations known to be particularly susceptible to the toxic effects of calcium include individuals with renal failure, those using thiazide diuretics (Whiting and Wood, 1997), and those with low intakes of minerals that interact with calcium (for example, iron, magnesium, zinc).”)

from: Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, Jan 1, 1997 [http://iom.nationalacademies.org/Reports/1997/Dietary-Reference-Intakes-for-Calcium-Phosphorus-Magnesium-Vitamin-D-and-Fluoride.aspx]

If you are a person who is already seeing health professionals about prostate cancer risks and you haven’t been told that excess calcium has been associated with an increased risk of prostate cancer then maybe it’s time to ask why not? The following webpage does suggest men may be better to use calcium rich foods instead of supplements, however prostate cancer risk is not mentioned: MayoClinic.

While I was looking for the Institute of Medicine report I found a more recent National Institute of Health update on vitamin D levels and prostate cancer which shows on an apparent U-shaped trend for risk of prostate cancer and vitamin D levels.

Having low levels of vitamin D and having elevated levels of vitamin D was associated with risk of prostate cancer in men, however the trend was only apparent when patient’s data was grouped by quartiles rather than by the three currently accepted categories of vitamin D sufficiency. Quartiles divide the data into five groups. If the U-shaped trend was more apparent for the 20% of patients with the lowest levels of vitamin D and for the 20% with the most elevated levels of vitamin D then the lab values of those groups of patients must not have overlapped very closely with the range of lab values that are included in any of the three established categories of vitamin D sufficiency: “(concentrations less than 50 nmol/L being considered deficient, 50–75 nmol/L insufficient, and 75–125 nmol/L considered sufficient).” — which suggests to me that those currently accepted ranges of vitamin D sufficiency do not actually provide any information that is useful for assessing or counseling men about their risk of prostate cancer.

We would need to go to the original research study and see what the lab values were for the patients who fell in the lowest and highest quartiles — the 20% with the lowest values and the 20% with the highest lab values for vitamin D — in order to have some idea of how low or how elevated the lab values were for the men who had an increased risk of prostate cancer. The lowest 20% might have had values that were lower than 50 nmol/L (below 20-30 nmol/L is considered deficient) and the most elevated 20% may or may not have had values below or above 75 nmol/L — but we have no idea without going back to the original research article.

  • Excerpt from Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update).:
  • Prostate Cancer

    “In the current report, four new nested case-control studies (two rated A, two rated B) and one new prospective cohort study (rated B) found no association between baseline serum 25(OH)D concentrations and risk for prostate cancer. Two new nested case-control studies (both rated B) observed a trend between higher serum vitamin D concentrations and increasing risk for prostate cancer. In one study this increase was seen only among men whose sera were sampled in summer or autumn; in the other study, this trend was observed only when participants were divided by quartiles of 25(OH)D concentration, but not when they were divided by categories of vitamin D sufficiency (concentrations less than 50 nmol/L being considered deficient, 50–75 nmol/L insufficient, and 75–125 nmol/L considered sufficient).”

    “In the original report, 12 nested case-control studies (3 rated B, 9 C) evaluated the association of baseline serum 25(OH)D concentrations and prostate cancer risk. No eligible RCTs were identified. Eight of the nested case-control studies found no statistically significant dose-response relationship between serum 25(OH)D concentrations and the risk of prostate cancer. One C-rated study found a significant association between lower baseline serum 25(OH)D concentrations (<30 compared with >55 nmol/L) and higher risk of prostate cancer. Another C-rated study suggested the possibility of a U-shaped association between baseline serum 25(OH)D concentrations and the risk of prostate cancer (i.e., lower and higher serum 25(OH)D concentrations were associated with an increased risk of prostate cancer compared with that of the in between reference level).”

  • Evidence Reports/Technology Assessments, No. 217.
    Newberry SJ, Chung M, Shekelle PG, et al.
    Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Sep. [http://www.ncbi.nlm.nih.gov/books/NBK253544/]
  • Dietary reference intakes for calcium and vitamin D / Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board ; A. Catharine Ross … [et al.], editors. Copyright 2011 by the National Academy of Sciences — ISBN 978-0-309-16395-8 (pdf) [http://www.nap.edu/read/13050/chapter/2#5] Excerpt, Box S-3: Potential Indicators of Adverse Outcomes for Excess Intake of Calcium and Vitamin D (page 6):

BOX S-3: Potential Indicators of Adverse Outcomes for Excess Intake of Calcium and Vitamin D (page 6)

Calcium

Vitamin D

  • Intoxication and related hypercalcemia and hypercalciuria

  • Serum calcium

  • Measures in infants: retarded growth, hypercalcemia

  • Emerging evidence for all-cause mortality, cancer, cardiovascular risk, falls and fractures

So excess calcium and excess vitamin D are both officially associated with increased risk of prostate cancer or with “emerging evidence for cancer” in general.

From some old notes, [8]: 12. [ncbi.nlm.nih] Carcinogenesis. 2011 Jun;32(6):822-8. Epub 2011 Mar 10. Enhanced formation of 5-oxo-6,8,11,14-eicosatetraenoic acid by cancer cells in response to oxidative stress, docosahexaenoic acid and neutrophil-derived 5-hydroxy-6,8,11,14-eicosatetraenoic acid. Grant GE, Rubino S, Gravel S, Wang X, Patel P, Rokach J, Powell WS.

“Stimulation of neutrophils with arachidonic acid and calcium ionophore in the presence of PC3 cells led to a large and selective increase in 5-oxo-ETE synthesis compared with controls in which PC3 cell 5-oxo-ETE synthesis was selectively blocked by pretreatment with NEM. The ability of prostate tumor cells to synthesize 5-oxo-ETE may contribute to tumor cell proliferation as well as the influx of inflammatory cells, which may further induce cell proliferation through the release of cytokines. 5-Oxo-ETE may be an attractive target in cancer therapy.”

***Did anyone besides me notice that they stimulated those cancer cells with calcium? Might simply not over stimulating cancer with excess calcium be an attractive target for cancer therapy? and cheap? – less calcium intake – more health output? /speculation/

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. Information is not a substitute for individual health guidance. Please see a health professional for individual health care purposes./

A research study proposal; for clarity

To clarify a point from my last post, the cancer research I would like to see completed would be on the use of a vegan diet with ginger as a preventative or as a cancer treatment. Adding fluoride or bromide to 6-shogaol was simply an example of how other natural products have been made into chemicals that could be patented in the past.

The difficulty with designing clinical research studies is the ethics involved with substituting an experimental treatment for a treatment that has evidence supporting its value. A person with cancer is more likely to be allowed into experimental trials only after they have already been through other anti-cancer treatments that were unsuccessful – but which likely left their bodies in a weakened condition. Trying an experimental treatment as a first attempt would have to be with the patient’s understanding of the possible risks of not using the standard of care treatment instead. Maybe the standard treatment for the patient’s type of cancer provides the 22.5 months of survival on average but the experimental treatment wouldn’t have any history of clinical trials to offer as a comparison. So frequently the experimental treatments are only offered to patients whose cancer has returned or that had failed to respond to standard treatments.

Prostate cancer is a very slow growing cancer that is frequently a benign problem compared to other types of cancer. It is said that more men die with prostate cancer than die from prostate cancer — and surgery in the area sometimes leaves men with worse problems so a watch and wait approach is being recommended more often. A diet based research study designed for patients in the watch and wait phase of prostate cancer treatment might be a reasonably ethical experimental design.

The experimental dietary treatment that I would propose would be based on a vegan diet, possibly with fish, and which is low in arachidonic acid rich foods and is not excessive in total calcium foods or supplements and which provides adequate amounts of CLA fats, [8, 12, 13] and with ginger powder daily, approximately a half teaspoon per day or equivalent ginger root cooked in food — or with an appropriate amount of the purified active compound, 6-shogaol. However, use of the whole root or ginger powder or mixed extract might provide other beneficial phytochemicals, from a summary I wrote years ago:

  • In humans, mice, and in petri dish studies, ginger has been found to inhibit the action of 5-LO from converting as much arachidonic acid into 5-HETE and slowing prostate cancer cell growth. [13]
  • *The cancer cells replicate human enzymes  that increase membrane breakdown and release of arachidonic acid which is then converted into a form the cancer cells can use as an energy source. The ginger extract stopped the step that would have converted the arachidonic acid into the form, 5-HETE, that could be used as a food source for the cancer cells. [13]  So adding ginger to the diet might make avoiding arachidonic acid containing foods less of an issue – but moderation is usually still a good idea. Arachidonic acid is an omega 6 fatty acid found in egg yolks,chicken, liver and animal fats. [14, 15] Arachidonic acid can also be formed out of linoleic acid which is found in seeds and nuts and most vegetable oils. [15]

Approximately a half teaspoon of ginger powder was the amount found helpful for reducing pain for arthritis patients, but I still haven’t found the exact reference link, sorry. A different study on muscle pain due to exercise found that two milligrams of ginger powder given daily prior to the episode of strenuous exercise (approximately 3/4 teaspoon, which was given in capsules) helped reduce the exercise induced muscle pain by 25%. [9, 10] Heat treatment of the ginger powder was not found to give any further reduction in muscle pain in that study however for cancer prevention heat treatment might be increasing the amount of the chemical that is active against cancer, 6-shogaol.

Clinical results that showed benefit for the men with prostate cancer in the watch-and-wait phase might than be preliminary evidence to support trying the treatment plan for men with more advanced stages of prostate cancer or for women with breast cancer — with their understanding of the potential risks of using an alternative treatment instead of the standard of care treatment.

As a nutrition focused member of a multi-disciplinary team I would count on other specialists to work out the details related to stages of cancer and assessment, etc.                  — no one works alone these days.

/Tangent: 6-shogaol and two other phytochemicals found in ginger have also been found to help promote bronchodilation in asthma patients.  [11]/

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. Information is not a substitute for individual health guidance. Please see a health professional for individual health care purposes./

Evidence based medicine: is the evidence to support the use of patent medicine?

The underlying problem with a for-profit health care industry is that a primary focus has to be on finding medicines and surgical devices that can be patented and sold for a profit rather than focusing exclusively on finding out how to prevent disease or restore healthy function. Finding out how the body works during health and sickness and finding out how to restore health using natural strategies is not as profitable because natural strategies are usually not something that can be patented and sold at a steep mark-up.

Natural processes of the body are studied in health and sickness with the stated goal of learning how to restore health but too often there is also an underlying and unspoken goal to restore health but only with a product that can be patented and sold at a markup. Foods and vitamins and natural hormones can not be patented and therefore it is less profitable to use them as treatments — there is less of a price mark-up.

As most people involved with primary prevention in public health know all too well, prevention is often under-resourced in public agency budgets and virtually non-existent in the private for-profit sector.

The President of the Institute of Medicine, Dr. Harvey Fineberg, addressed this in a 2006 lecture at the UCLA School of Public Health entitled “Why Prevention is a Hard Sell.”146 He listed some of the reasons as follows: “There is no drama in prevention; non-events are not counted; statistical lives don’t have immediacy; prevention is not profitable; prevention often runs against commercial interests; it may conflict with personal preferences or religious beliefs; and there is declining trust in leaders and institutions, challenging people’s willingness to follow guidelines.”

A Forbes magazine story in 2004 quoted a clinician at a cancer treatment center in New York as saying that ten years earlier, he could extend the life of one of his patients by 11.5 months on average with a drug that cost $500; in 2004, he could extend the life of a patient with the same diagnosis 22.5 months, at a cost of $250,000. The goal of many current cancer treatment protocols is to repeat this experience with more and more types of cancer. [1 

Vegetarian and vegan diets have also been associated with fighting cancer — but by reducing the amount of cancer promoting chemicals (IGF-1) in the person’s blood. Vegans had less of the cancer promoting chemical than vegetarian diners, who had less than people eating a meat based diet.

“Women placed on plant-based diets for just two weeks, for example, were found to suppress the growth of three different types of breast cancer (see images of the cancer clearance).” “Similar results were found for men against prostate cancer (as well as against prostate enlargement).” [2]

Fighting cancer by preventing it from happening in the first place could extend a person’s lifespan far more than 22.5 months and without causing severe vomiting or hair loss, and at a much lower price than $250,000, and without potentially causing cognitive decline. The bad news is that cognitive decline is common among breast cancer survivors and the good news is that the decline tends to improve somewhat between 18 months and 36 months after treatment, (less of an improvement was seen in survivors with multiple diagnoses). [3]

However news that a vegan diet stops production of a cancer causing chemical from forming in a person’s blood would probably not be good news for the person who would rather be told that their cancer was a complete mystery which probably had nothing to do with the person’s lifestyle or their food preferences and that some medication, or surgery, or radiation, or a combination of all three, would take care of the problem without the person having to change a thing about themselves — except that that isn’t really true. Some of the treatments might make all food taste metallic, and some may cause severe vomiting which might leave the person not wanting to eat anything at all and may leave them with some lasting food aversions depending on what they were eating before the severe vomiting stage was reached — the dietary recommendation is to plan ahead for the nauseous stage and to eat something anyway because nutrients are still important but choose nutritious foods that aren’t also favorite nutritious foods for meals that are likely to be coming back up again in a short while. A vegan diet, on second thought, probably tastes better than having a metallic taste in the mouth, or worse.

And it doesn’t even have to be a vegan diet — vegetarian diets that include fish have also been found to reduce cancer risk, [7] — but the information about either study wasn’t in mainstream news outlets. I found the information on virtual news websites — so this is basically top secret news — the cure for cancer has been in the grocery store this whole time — just avoid the meat aisle and maybe the egg and dairy cases and spend more time in the produce section.

It can be a career risk to write about less profitable health treatments. The paragraph about cancer treatments and the 50,000 percent increase in price that occurred over ten years, that was excerpted earlier in this post, concludes with the following statement: “Those who seek to prevent or reduce the magnitude of these profits risk being swept aside by industry representatives and their political and scientific spokespeople.” [1]

Ginger has over 400 active phytochemicals and humans have been enjoying it for thousands of years — the long term evidence is in on ginger – people keep growing it because they like it — either they like its flavor or its effects or both. [4] Some of the active phytochemicals in ginger have been found to help reduce arthritis pain as much as the anti-inflammatory pain-killing medication ibuprofen (approximately a 1/2 teaspoon dried ginger powder per day). And even better pain control was found when ginger was used in combination with ibuprofen. Ginger also helps protect against ulcers while long term ibuprofen use can be damaging to the GI tract. And more recently another phytochemical found in ginger, 6-shogaol, has been found to help kill breast cancer cells while at the same time not being harmful to surrounding healthy cells. This is early research rather than clinical trials. [4, 5] The negative side effects from most cancer treatments are usually because the treatments are harmful to both cancer cells and to health cells that grow rapidly.

Ginger has few negative side effects compared to chemotherapy or even ibuprofen. The two risks that I am familiar with: 1) Eating large amounts on a daily basis may increase risk of bruising and  bleeding too easily as ginger has blood thinning activity. A half teaspoon of dry powdered ginger per day was the dose found helpful for reducing arthritis pain. I have experienced easy bruising when I was using more than the half teaspoon of powdered ginger on foods, I was also eating chunks of candied ginger regularly and was also using raw ginger in cooked dishes in large amounts. I haven’t had problems with easy bruising when eating only the half teaspoon per day dose.   2) Small amounts of ginger during pregnancy is probably fine and active phytochemicals in the root vegetable may be helpful for reducing nausea, (Folk wisdom example: Gingerale for nausea), but very large quantities of ginger on a regular basis during pregnancy  may increase risk of miscarriage.

I didn’t find the ginger powder/ibuprofen study citation when I looked for it, but while looking I did find a more recent study done on cell cultures that found ginger extract effective for reducing cytokine production in Rheumatoid Arthritis (RA) and Osteoarthritis (OA). [6]

In a for-profit industry too often the goal of research is to find a chemical that is effective for some health condition, like 6-shogaol, and then to find a way to chemically make it unique and therefore able to be patented and sold at a larger markup than would be possible for a produce item like ginger root, but without ruining the original chemical’s effectiveness and without making the new chemical too toxic. That can be a risk when fluoride or bromide is added to a medication; the heavy metal can help the medication enter cells — which can make it a more effective or a faster acting medication — but then the atom of fluoride or bromide is not easy for the body to remove from the cell and the heavy metals may be increasing long term health risks. [8]

My goal in sharing health information is twofold —

— For the general reader who is interested in science and alternative health information: writing easy to read summaries of health information for the individual reader is where I have training and experience. As a patient I am looking for health guidance for my own conditions but as a dietitian I also am interested in learning more about all aspects of health and illness. The entire body needs balanced nutrition in order to function and therefore a dietitian specializes in understanding all of the body’s systems and how they interact.

— For the open-minded science reader: some people read summaries and other people read reference lists. Frequently cited papers or books would be immediately recognized by some readers and they might be interested in clicking on other links that they hadn’t seen yet, or hadn’t seen in relation to the rest of the list. Some readers might read the summary in seconds and skim through the links in a few minutes — and gain ideas for their own research — that is my hope. In some places there may be more funding, and more academic freedom, and more interest in preventative health care, and more interest in the use of natural products for restoring natural function, — I can dream and read and share. Some comments that I’ve received do suggest that at least a few people appreciate my posts for providing research ideas.

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. Information is not a substitute for individual health guidance. Please see a health professional for individual health care purposes./

  1. Richard W. Clapp, DSc, MPH, Molly M. Jacobs, MPH, and Edward L Loechler, PhD, Environmental and Occupational Causes of Cancer New Evidence, 2005–2007, Rev Environ Health. Author manuscript; available in PMC 2009 Dec 10., [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791455/]
  2. Kathy Freston,  A Vegan Diet (Hugely) Helpful Against Cancer, 12/09/2012 [http://www.huffingtonpost.com/kathy-freston/vegan-diet-cancer_b_2250052.html]
  3. Zheng Y, et. al., Long-term cognitive function change among breast cancer survivors., Breast Cancer Res Treat. 2014 Aug;146(3):599-609. doi: 10.1007/s10549-014-3044-1. Epub 2014 Jul 9. [http://www.ncbi.nlm.nih.gov/pubmed/25005574]
  4. Ginger: 10,000x Stronger Than Chemo (Taxol) In Cancer Research Model, Nov. 7, 2015, [http://healthimpactnews.com/2015/ginger-10000x-stronger-than-chemo-taxol-in-cancer-research-model/]
  5. Anasuya Ray, Smreti Vasudevan, Suparna Sengupta, 6-Shogaol Inhibits Breast Cancer Cells and Stem Cell-Like Spheroids by Modulation of Notch Signaling Pathway and Induction of Autophagic Cell Death., PLOS One, September 10, 2015, DOI: 10.1371/journal.pone.0137614 [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137614]
  6. Søren Ribel-Madsen, et al., A Synoviocyte Model for Osteoarthritis and Rheumatoid Arthritis: Response to Ibuprofen, Betamethasone, and Ginger Extract—A Cross-Sectional In Vitro Study., Arthritis. 2012; 2012: 505842. 2012 Dec 31, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546442/]
  7. Jennifer Lea Reynolds, Vegetarian diet reduces cancer risk by up to 43% in new study., Nov. 6, 2015,   [http://www.naturalnews.com/051856_vegetarian_diet_colorectal_cancer_fish.html#]
  8. by me, “Private: Eicosanoids are made from eCBs from the membrane,” *This is one of my older posts with more excerpted material and a messier format so I have it closed to public view. The post does include more information on the health benefits of ginger for preventing colorectal cancer and prostate cancer. Ginger extract seems to help prevent cell membrane/endogenous cannabinoid breakdown and reduce the release of metabolites of endogenous cannabinoids (eCBs) — which include eicosanoids and arachidonic acid. The pharmaceutical industry charges $2,945 for 1 mg of eicosanoids which we would be able to make for ourselves in the amounts that we need if we are healthy and well nourished. Eicosanoids are also a natural chemical so I’m not sure why it can be sold or how the patent process works in the pharmaceutical industry.
    [http://transcendingsquare.com/2011/10/04/eicosanoids-are-made-from-ecbs-from-the-membrane/]