Its doubtful whether supplements are sufficiently potent to drive down PSA enough to mask P.C. However, Finasteride formerly known as Proscar and I believe the generic is now called Avodart can significantly suppress PSA. Its used by some urologists to control the spread of aggressive prostate cancer. If a rise in PSA or PSA doubling time is suspicious enough to suggest the possibility of P.C. then it would seem a biopsy is the logical next step to establish a diagnosis.

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Hello Helopilot52,

I've interspersed my responses below in green, preceded by JJ. Jim

[QUOTE=Helopilot52;3555005]I have a number of questions regarding the use of supplements and their genuine effect on the prostate that someone may be able to answer….

1) Do supplements “mask” the PSA when cancer is present?

[COLOR="green"]JJ - I have never heard that this was a problem in the eight years I have been following nutrition and prostate cancer, though there were questions about saw palmetto at one time. On the contrary, there is a growing body of research that supports the effectiveness of some key supplements. Any of us can research what has been published at the Government website for the National Library of Medicine, [url]www.pubmed.gov;[/url] for example, search for " lycopene AND prostate cancer ". I always remind myself that promising results from many lab and animal research studies do not pan out when the research is taken to trials in humans. Still, sometimes that preliminary research, and research on populations who consume or don't consume as much of an item, are all we have to go on, and we have to place our bets.

As shs50 mentioned, there was a question if the fairly mild drug Proscar masked prostate cancer; actually, Proscar (now available generically as finasteride), decreases PSA by about half or more when acting on a healthy prostate by shrinking the prostate, which needs to be taken into account when evaluating PSA trends (set a new baseline, and take the trend from there). In fact, if the PSA does not decrease by about 50% or more after about six months of finasteride use, some doctors use that as a sign for extra monitoring, considering the weak response a sign of possible prostate cancer. Finasteride's sister drug (another drug in the 5-alpha reductase inhibitor class) is the widely advertised Avodart. Finasteride has been proven to reduce prostate cancer incidence by 25%, and to me the evidence is conclusive that it does it safely, without slightly increasing high grade (meaning higher Gleason) cancer. One analysis indicates that it actually decreases high grade cancer when compared to the placebo group, after taking finasteride's prostate shrinking effect and other impacts into consideration. This is not masking; rather, it is actually a favorable impact on the disease. It is clear that many doctors are not up-to-speed on finasteride and Avodart research and analysis.

2) Has anyone noted a reduction of their PSA as a result of using prostate supplements?

[COLOR="green"]JJ - I can't say for certain for my challenging case over the past eight years. I've done well, much better than my original prognosis of three good years and two declining years. I attribute most of that success to advanced intermittent triple hormonal blockade with maintenance during off therapy periods, but I believe the lifestyle program I follow has been an important part of my success. That program involves supplements, nutrition, diet, exercise and stress reduction. However, unlike some fellow survivors I have talked to who use many of the same supplements, and unlike many of the men in research studies, I have not seen a clear impact on my PSA trend from supplements.

3) What supplements are the most popular in ths Forum?

[COLOR="green"]JJ - Here are the ones I use:
- vitamin D3, from an organization whose manufacturer is Hoffman LaRoche. Quality is a major issue in vitamin D3 supplements, with many brands either lacking in vitamin D3 or providing it in a substance that is not well absorbed. My dose varies from 2,000 to 4,000, and I have periodic 25-hydroxyvitamin D tests to see how to adjust the dosage, shooting personally for a result between 50 and 100. I also get vitamin D from fish oil capsules and from herring at lunch every day. I live in Washington, DC area, and, though I'm nearly 65, I still seem to be able to make my own vitamin D from skin exposure during the months from April through September. I would take D3 even if I were not taking a bisphosphonate drug (now Boniva for me), which requires taking D3 and calcium supplements in order to work.

- calcium, 1,200 units daily. I would not be taking calcium if I were not on a bisphosphonate drug. There appears to be a mild increase in prostate cancer risk associated with calcium, but my impression is that the risk comes from inadequate vitamin D.

- selenium 200 mcg per day. I used to take 400 mcg daily because of my challenging case, but doctors I follow, especially Dr. Charles Myers, have cautioned there is some evidence of a small increased risk of diabetes or insulin resistance associated with selenium. That's based on follow-on analysis of the very trial that highlighted selenium's possible role in helping prevent prostate cancer, the Clark trial.

- vitamin E, including gamma tocopherol, 200 IU. I used to take 400 IU, but research indicated a possible small risk of complications at doses above 200 IU and substantial effectiveness at 200 IU.

- fish oil capsules, 4,000 IU daily, for omega 3 fatty acids in a form men can absorb well (contrast to flaxseed oil).

- soy, 200 mcg average per day. Dr. Maha Hussain's team demonstrated a benefit from soy a couple of years ago in an impressive (though fairly small) randomized trial. However, one recent research indicated there may be an unfavorable tradeoff of benefit when both soy and lycopene are consumed. I've learned that results from single studies are frequently misleading, but that is something I'm keeping an eye on; the study also involved highly respected researcher M. Hussain.
(Nutr Cancer. 2007;59(1):1-7.Lycopene and soy isoflavones in the treatment of prostate cancer.Vaishampayan U, Hussain M, Banerjee M, Seren S, Sarkar FH, Fontana J, Forman JD, Cher ML, Powell I, Pontes JE, Kucuk O.)

- Pomegranate extract capsules, 2 per day. I use a source that manufactures its capsules from pomegranate extract supplied by Pomella, whose extract is based on research performed by the UCLA team that demonstrated effectiveness of pomegranate juice (limited to 8 ounces to avoid too much sugar in the diet) in a trial in greatly extending PSA doubling times for men with recurring prostate cancer.

- glucosamine, 1,500 mg daily. I'm convinced this helps keep my knees and joints in good shape, which helps me exercise. (My knees creak when I don't use it and don't creak when I do.) To me, research is persuasive that exercise does a lot to help our cause in combatting prostate cancer, and it certainly helps in maintaining bone density, a likely issue for those of us on hormonal blockade therapy. Chondroitin is often supplied with glucosamine, but there is evidence that chondroitin increases risk for prostate cancer patients, while glucosamine is safe.

- Co Q10 - 50 mg. I started this within the last year because I'm taking a statin drug, and there is persuasive evidence that those of us on statins should be taking some Co Q10. Dr. Myers recommends it for statin users, but is opposed to it for those prostate cancer patients not on statins. There is controversy here, with other leading doctors favoring Co Q10. However, one of the areas of Dr. Myers's extraordinary expertise is nutrition, diet, and supplements for prostate cancer, so I usually lean toward what he advises when there is controversy.

- green tea - I take a capsule daily, though research in humans hasn't shown much of an impact on prostate cancer, in contrast to an impressive impact in lab and animal research involving prostate cancer. However, it appears safe. This is in addition to the green tea I drink (with lemon drops to preserve potency).

- aspirin, 81 mg, basically for heart health, and also essential temporarily while I'm on thalidomide to help prevent blood clots.

I don't take several supplements often advised for prostate cancer, basically based on Dr. Myers's advice. Chief among them is curcumin, which I used to take. I'm hoping research will clear the story on curcumin, as a lot of lab and animal research suggests that it should be helpful. Saw palmetto has real quality problems in available supplements, and it's effect on prostate cancer looks doubtful to me. There is at least one saw palmetto supplement that delivers the goods, Permixon.

Supplements should not be the whole story for any of us, as we should be getting many key nutrients from our diet. I consume a lot of seafood, cooked broccoli daily, lycopene from V8 and cocktail sauce daily, green tea (4 to 10 bags), lots of fruit and vegetables, virtually no red meat, no high alpha lenolenic acid foods (like flaxseed oil and canola oil), virtually no dairy food, etc.



Thanks

[COLOR="green"]JJ - Hope this helps. Jim