The Annie Appleseed Project invites you to its conference on “Evidence-based Complementary and Alternative Cancer Therapies for Cancer Advocates” aka CAM for Cancer Advocates.
January 10-11, 2008 in West Palm Beach, FL

Results from a Phase 1 study of NEUVENGE, Dendreon’s candidate vaccine for breast cancer, appeared today in Journal of Clinical Oncology. Testing of Neuvenge in clinical trials runs several years behind Provenge, which is in an ongoing Phase 3 trial. Out of 18 patients with advanced breast cancer who received Neuvenge, 1 patient showed partial response for 6 months and 3 patients had stable disease lasting more than a year.

A California court has ordered PC Spes manufacturer Dr. Sophie Chen and International Medical Research, Incorporated (doing business as BotanicLab) to pay more than $24 million to consumers who bought PC Spes between 1998 and 2002. PC Spes, a purported herbal supplement targeted at prostate cancer patients, is no longer sold in the USA but reportedly is sold in Europe and the UK from the Netherlands.

The judgment was based on evidence of intent to defraud consumers and to loot company assets to avoid restitution.

“Contrary to the IMR Defendants representations, PC Spes was not all natural, was not all herbal, was not a dietary supplement, and was in fact a very dangerous product,” said Superior Court judge John S. Meyer, who presided over the case August 6-7 in San Diego.

In an exclusive report August 10, psa-rising.com published details of the judgment and a link to the full transcript (in .pdf).

As many as 3 out of 4 men with prostate cancer, according to Dean Ornish’s research and the current, July issue of Harvard Men’s Health Watch newsletter, take nonprescription supplements. Some of these men use diet, exercise, or both in the hope of improving their outcome. While most of them also receive conventional therapy, a minority relies on lifestyle changes during “active surveillance” before active primary therapy or after biochemical recurrence (rising PSA) following surgery or radiotherapy.

Do lifestyle changes actually work? “Experts don’t know,” the Harvard folks say, “though research raises hope that it may have a beneficial impact.”

Dean Ornish, who pioneered lifestyle change for heart patients, conducted a clinical study of similar changes for men with prostate cancer and reported results in 2005 (Intensive lifestyle changes may affect the progression of prostate cancer.) Harvard Health writes:

All of the 93 men who signed up for the trial had newly diagnosed low- to moderate-grade cancers that were localized to the prostate gland. Half were randomly assigned to a lifestyle program, and half got no advice on lifestyle changes. The program that researchers created included four elements: An ultra-low-fat vegan diet; supplements, including soy, fish oil, vitamins E and C, and selenium; an exercise program of walking 30 minutes six days a week; and stress reduction that included yoga-based stretching, breathing, and meditation for an hour a day.

At the end of a year, a small but significant difference was evident. The average PSA in the intensive lifestyle group fell, whereas the average PSA in the untreated men rose. The participants in the lifestyle group also showed favorable cancer-fighting changes in their blood.

Much more research is needed before lifestyle therapy can be recommended clinically. But, the Harvard Men’s Health Watch notes, men with prostate cancer may choose not to wait until science catches up with their disease. And since the lifestyle program studied is good for general health, its elements will make a reasonable addition to any prostate cancer program.

The results which Harvard Health is touting this month first appeared in print two years ago. Ornish updated them in a 2006 spin-off from the same study, which finds that men in the active surveillance arm who made lifestyle changes toward low-fat, vegan diet, exercise, and stress management improved their mental and physical health-related quality of life and sexual function.

Dr. Ornish emphasized a vegan diet high in soy proteins on the hypothesis that this would slow down prostate cancer prgression by reducing insulin-like growth factor levels and increasing levels of insulin-like growth factor binding proteins. He writes:

High levels of insulin-like growth factor 1 (IGF-1) are associated with increased risk of prostate cancer, whereas increased levels of some of its binding proteins (IGFBPs) seem to be protective. High intakes of dietary protein, especially animal and soy protein, appear to increase IGF-1. However, soy isoflavones have demonstrated anti-proliferative and apoptotic effects both in vitro and in vivo. We evaluated dietary intakes of total protein and soy isoflavones in relation to the IGF axis in prostate cancer patients making comprehensive lifestyle changes including a very low-fat vegan diet supplemented with soy protein (58 g/day). After one year, intervention group patients reported significantly higher intakes of dietary protein and soy isoflavones compared to usual-care controls (P < 0.001). IGF-1 increased significantly in both groups, whereas IGFBP-1 rose in the experimental group only (P < 0.01). Increases in vegetable protein over one year were associated with increases in IGFBP-1 among intervention group patients (P < 0.05). These results suggest that dietary protein and soy isoflavones, in the context of comprehensive lifestyle changes, may not significantly alter IGF-1. However, given the recent literature indicating that high intake of protein rich in essential amino acids (animal or soy protein) may increase IGF-1, it may be prudent for men with early stage prostate cancer not to exceed dietary protein recommendations.

Meanwhile another researcher, David Feldman at Stanford, has reported that 1) high dose vitamin D (calcitriol) has antiproliferative actions on LNCaP (metastatic, androgen-dependent) human prostate cancer cells ; 2) this action is “mediated mainly by induction of insulin-like growth factor binding protein 3 (IGFBP-3); 3) “androgens increase expression of IGFBP-3 and cause a major enhancement of IGFBP-3 stimulation by calcitriol.”

Further, Japanese researchers have found that insulin-like growth factor binding protein 6 boosts the action of artificial estrogen (DES) on both androgen-sensitive and androgen insensitive prostate cancer cells.

Arab men have low levels of prostate cancer. A recent study found that “As in Caucasians, serum IGF-1 and IGFBP-3 levels declined with age in Arab men” and that “Arab men with newly diagnosed prostate cancer had significantly higher serum IGF-1 level (P<0.01) and lower IGFBP-3 levels (P<0.01) compared to age-matched Arabs without the disease.”

Would it make sense just to take supplements or some kind of drug to bring about a better IGF-1 to IGFBP ratio or are lifestyle changes necessary or at least preferable (as Ornish believes)?  Last month (Int J Cancer. 2007 Jun 27) the Cancer Epidemiology and Genetics division at NCI/NIH reported that in their large population based study, no clear linkage between prostate cancer risk and IGF-1 and IGFBP-3 levels and ratios leaped out except in obese men:

There was no clear overall association between IGF-1, IGFBP-3 and IGF-1:IGFBP-3 molar ratio (IGFmr) and prostate cancer risk, however, IGFmr was associated with risk in obese men (BMI > 30, p-trend = 0.04), with a greater than 2-fold increased risk in the highest IGFmr quartile….

So, while the laboratory studies of cancer cells and tumors implanted in mice may lead to new pharmaceuticals down the line, for men today a reasonable goal is a leaner body achieved through a combination of diet, stress reduction, and exercise. Dean Ornish has mapped out one path to this goal, other paths are available and may be just as effective.

Coming up on this edition, an interview with the Director of the Office of Cancer Survivorship at the National Cancer Institute. We have a report on how urological diseases cost Americans $11 billion each year. And Bill Schmalfeldt shares a final report on his experience as a patient in a clinical trial. But first, Wally Akinso has a report about a blood test that might signal good news for folks suffering from throat cancer.

For those who have the appropriate software downloaded and would prefer to listen to this week’s podcast on your computer, here’s the link:

Date: 6/29/2007 | Time: 00:32:04 | Size: 29.3 MB
This podcast is updated every other Friday.

Danny Goldstein, a doctoral candidate in pharmacy in Israel, has developed a way of combining Taxol with Herceptin monoclonal antibody that overcomes the problem of the toxic emulsion normally required to make Taxol soluable. Goldstein’s nanoemulsion, used to create a Taxol-Herceptin combination and tested in mice, may allow superior, sustained delivery of this therapy to patients with advanced, mestatstic prostate cancer. Clinical trials will begin in about two years. Full story Nanotechnology Improves Chemotherapy-Antibody Combination, June 22.

The Food and Drug Administration (FDA) is advising consumers not to purchase or use “True Man” or “Energy Max” products promoted and sold as dietary supplements throughout the United States. Both products — touted as sexual enhancement products and as treatments for erectile dysfunction (ED) — contain potentially harmful, undeclared ingredients.The products contain substances called analogs that have similar structures to active ingredients in approved prescription drugs.

The undeclared analog ingredients in True Man and Energy Max may interact with nitrates found in some prescription drugs such as nitroglycerin and may lower blood pressure to dangerous levels. Men with diabetes, high blood pressure, high cholesterol or heart disease often take nitrates.

Tomatoes might be nutritious and tasty, say researchers based at the National Cancer Institute and Fred Hutchinson Cancer Research Center, but don’t count on them to prevent prostate cancer. Lycopene, an antioxidant predominately found in tomatoes, the researchers report in the May issue of Cancer Epidemiology, Biomarkers & Prevention, does not effectively prevent prostate cancer.

In fact, the researchers noted an association between beta-carotene, an antioxidant related to lycopene, and an increased risk for aggressive prostate cancer. In a preliminary report last year from the same study researchers noted that antioxidant supplements have weak, mixed results for prostate cancer.

No Magic Tomato? Study Breaks Link between Lycopene and Prostate Cancer Prevention … Full story

Recent studies have suggested that obese men have lower serum prostate specific antigen (PSA) concentrations relative to non-obese men. Researchers from centers across the USA hypothesized that the increased circulating plasma volume in men with higher body mass index (BMI) dilutes curculating PSA resulting in lower serum PSA concentrations on blood tests.

To test this they analyzed the relationship between serum PSA concentration, body mass index (BMI), plasma volume (calculated based upon age and estimated body surface area) and total PSA mass (PSA concentration multiplied by plasma volume) using a linear regression model adjusting for age at surgery, race, year of surgery, clinical stage, SEARCH site, pathological Gleason sum, extracapsular extension, surgical margins, seminal vesicle invasion and prostate specimen weight among 1304 men who underwent radical prostatectomy within the Shared Equal Access Regional Center Hospital (SEARCH) Database between 1991 and 2006.

Results: After controlling for clinical and pathological factors, higher BMI was significantly associated with higher plasma volume (p=0.005, see table) and lower PSA concentrations (p<0.001). There was no significant association between BMI and adjusted PSA mass (p=0.52).

Conclusions: In a cohort of men with prostate cancer, hemodilution due to greater plasma volume explained all of the lower serum PSA concentration observed among obese men. Future studies are needed to confirm these findings and to assess whether this phenomenon of tumor marker dilution occurs among obese people with other cancers as well. If confirmed, these findings may have broad implications for cancer screening in general among obese people.

Article title authorships:

CAN HEMODILUTION EXPLAIN THE LOWER PSA CONCENTRATIONS AMONG OBESE MEN?

Lionel L Baez, MD, Robert J Hamilton, MD, Robin T Vollmer, MD, Judd W Moul, MD, Christopher L Amling, MD, Christopher J Kane, MD, William J Aronson, MD, Matha K Terris, MD, Joseph C Presti, Jr, MD, Stephen J Freedland, MD. Duke University Medical Center, Durham, NC; Durham VAMC, Durham, NC; University of Alabama at Birmingham, Birmingham, AL; VAMC San Francisco, San Francisco, CA; VA Greater Los Angeles Healthcare System, Los Angeles, CA; VAMC Augusta, Augusta, GA; VAMC Palo Alto, Palo Alto, CA

One of the problems with photodynamic therapy is that patients may remain over-sensitive to light for weeks afterwards, or even suffer from burns in tissue close to the target area. Now, research scientists in Canada have taken a step forward by using an enzyme found in specific cancer cells to help light a “photodynamic molecular beacon” inside the cell. The method may make it easier to target tumors without damage to surrounding healthy tissue.
Full story:
Researchers Create New Photodynamic Molecular Beacon to Help Target Tumors and Minimize Side Effects