ANN ARBOR, Michigan--Prostate cancer patients are increasingly likely
to ask their physicians about alternative (or complementary)
therapies, and physicians need to know the evidence, or lack of
evidence, supporting their use.
"We need to get that information to the physician and to the
patient," said Mark A. Moyad, MPH, a clinical cancer researcher
and health educator at the University of Michigan Health System. He
spoke at a conference designed to do just that--the First
International Prostate Cancer Symposium for the Patient, sponsored by
the University of Michigan.
At a session on alternative therapies, William Fair, MD, of Memorial
Sloan-Kettering, emphasized the importance of reducing fat
consumption as a step toward reducing prostate cancer risk or the
progression of disease. He recommends that no more than 20% of total
daily calories should come from fat, a level supported by
experimental lab work.
Mr. Moyad, in his review of the use of various nutritional
supplements, highlighted three products that have shown promise in
preliminary studies: vitamin E, soy products, and green tea.
"Vitamin E studies from our laboratory and Dr. Fairs lab
show very promising results for prostate cancer patients. Were
doing work in animals right now with these supplements," he said
in an interview with Oncology News International.
These three supplements, along with reducing dietary fat, he said,
"show incredible promise, not just in prostate cancer but in
many other cancers and also in possibly reducing heart disease."
All Things in Moderation
When patients are interested in using supplements, Mr. Moyad
recommends moderate doses. "My work in supplements suggests
clearly that more is not better," he said. For vitamin E, he
recommends no more than 200 IU to 400 IU, taken with meals for better
absorption. Above 400 IU, he said, there is the possibility that the
vitamin will interact with the effects of aspirin and blood thinning
agents like coumadin and warfarin.
Another question that comes up with vitamin E is what type to buy
"because there are at least 8 or 10 different varieties
available," he said. Vitamin E is a general name for a series of
different compounds, he pointed out.
"Synthetic vitamin E has been used mainly in studies, but in our
lab, were using natural vitamin E, and were finding
results as good as those seen with the synthetic product," he
said. "So I think, right now, until we know which type is best,
patients can use any type."
Mr. Moyad said that green tea, which looks very promising as a cancer
preventive, is now often available in grocery stores as well as
health food stores, either as a tea or as a supplemental capsule.
"I suggest the decaffeinated variety," he said. Although
green tea contains less caffeine than coffee, it does contain enough
to possibly interfere with sleep.
He also advises patients to first try the natural product rather than
supplements. Green tea leaves contain at least four or five
compounds, called polyphenols, that may have an anticancer effect.
"You get all those compounds when you drink the product whereas
supplements generally contain significant quantities of only one or
two of the compounds," he said.
Mr. Moyad suggested caution in the use of other nutritional
supplements for which there is less information available. He
mentioned two supplements, recently touted as being very promising as
anticancer compounds, that may actually have the opposite effect,
according to early results.
One example is lycopene, an antioxidant found in tomatoes, that, when
studied in Dr. Fairs lab at Sloan-Kettering, was shown to
promote tumor growth rather than decrease it, as other work has suggested.
Results With Co-enzyme Q
Mr. Moyads group has recently looked at a supplement called
co-enzyme Q, which has been gaining popularity among patients as an
anticancer therapy. They found that it did not decrease prostate
cancer cell growth but, rather, increased it in a dose-dependent
manner. "The more we added, the more the tumor cells grew,"
Such conflicting studies confirm the importance of making sure that
physicians have the facts about supplements--both positive and
Two alternative techniques--acupuncture and meditation--may play a
supplemental role in prostate cancer treatment, not in reducing tumor
growth but "by possibly doing other things that can be helpful,
such as lowering blood pressure and reducing stress," Mr. Moyad said.
Meditation is being used in cancer support groups across the country
to help reduce the stress of living with cancer and its treatment.
Although there are as yet no studies of acupuncture in prostate
cancer, he noted that the NIH recently gave its seal of approval for
acupuncture as an adjunctive therapy in treating chemotherapy-related
nausea and cancer pain. "Prostate cancer patients often get
chemotherapy and often have significant pain," Mr. Moyad said,
"so it definitely looks like acupuncture is going to have a use
in the future with prostate cancer as a complementary therapy."