Lycopene & Saw Palmetto

JOURNAL OF UROLOGY Vol. 166, 613, Aug 2001 RESPONSE OF HORMONE REFRACTORY PROSTATE CANCER TO LYCOPENE BRIAN R. MATLAGA, M. CRAIG HALL,* DIANA STINDT AND FRANK M. TORTI From the Department of Urology and Comprehensive Cancer Center, Wake Forest University School of medicine, Winston-Salem, North Carolina Management of hormone refractory prostate cancer poses a significant challenge to the clinician. We report on a patient in whom multiple treatment regimens failed following the development of androgen independent disease. On referral to hospice care he began alternative treatment in the form of phytotherapy. Coincident with the initiation of this treatment, a durable major response occurred. CASE REPORT A 62-year-old white man was diagnosed with Gleason score 5 (2 + 3) organ confined prostate cancer in November 1989. He was initially treated elsewhere with monthly leuprolide therapy. Prostate specific antigen (PSA), first recorded as 1.0 ng./ml. in April 1991, increased to 27.0 ng./ml. in July 1996. Treatment was deferred as the patient was asymptomatic and the metastatic evaluation, including bone scan and computerized tomography of the abdomen and pelvis, was negative. In September 1996 gross hematuria developed and transurethral resection of the prostate was performed. Pathological examination revealed adenocarcinoma of the prostate (Gleason score 8 [4 + 4 ]). The patient was referred to us. PSA was 18.8 ng./mI., the metastatic evaluation remained negative and bicalutamide therapy was initiated. He did not respond to an antiandrogen and PSA increased to 43.6 ng./ml. in April 1997. He was placed on ketoconazole and hydrocortisone, and PSA increased to 73.15 ng./ml. in August. A regimen of doxorubicin, vinorelbine and prednisone was administered but PSA increased to 365.0 ng./ml. in March 1999. Computerized tomography of the abdomen and pelvis revealed extensive nodal disease. Bone scan showed skeletal metastases. The patient stopped all formal treatment regimens and transferred to hospice care. In March 1999 he began lycopene and saw palmetto supplements. PSA decreased to 139.6 ng./ml. in April and to 8.1 ng./ml. in May. PSA remained from 3 to 8 ng./ml. for 18 months. A repeat bone scan demonstrated improvement of bony metastases. He continues to take 10 mg. lycopene orally once daily and 300 mg' saw palmetto orally 3 times daily. At last followup he was asymptomatic. DISCUSSION Recent epidemiological reports and emerging experimental and clinical data suggest lycopene, the carotenoid largely responsible for the red color of tomatoes, may be associated with a decreased risk of prostate cancer and may have a role as an anticancer agent in this disease.1,2 Previous literature has primarily focused on chemopreventive benefits of lyco- pene but not on treatment of established disease. To our knowledge we report the first case to describe treatment of hormone refractory, chemotherapy refractory, metastatic prostate cancer with lycopene. Although the patient began saw palmetto concomitantly with lycopene, it is likely that PSA decrease is due to lycopene. In multiple trials saw palmetto has not been demonstrated to alter PSA.3 Our case report suggests that phytotherapy, specifically lycopene, may have a role in the treatment of androgen independent prostate cancer. Properly designed clinical trials will be necessary to define its potential use for this disease. REFERENCES 1. Giovannucei, E.: Tomatoes, tomato-based products, lycopene, and cancer: review of the epidemiologic literature. J Natl Can- cer Inst, 91: 317, 1999 2. Gann, P. H., Ma, J., Giovannucei, E. et al: Lower prostate cancer risk in men with elevated plasma lycopene levels: results of a prospective analysis. Cancer Res, 59: 1225, 1999 3. Marks, L. S., Partin, A. W., Epstein, J. L. et al: Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol, 163: 1451, 2000 RE: TOMATOE SAUCE Message: More on tomatoes in the news: Wednesday, March 06, 2002 - 12:12 a.m. Pacific Tomatoes lower risk of prostate cancer, study says WASHINGTON - A diet rich in tomato-based foods can lower the risk of prostate cancer, according to a new study that supports earlier research. Researchers analyzed the food choices and prostate-cancer histories of more than 47,000 men. Those who ate at least two meals a week containing tomato products lowered their risk of prostate cancer 24 to 36 percent. Dr. Edward Giovannucci of Brigham and Women's Hospital and the Harvard School of Public Health, the lead author of the study, said it supports previous research involving foods, particularly tomato products, that are high in lycopene, an anti-oxidant. Lycopene is thought to protect against cancer by absorbing oxygen free radicals, chemicals created during metabolism that can damage cells' genetic structure. The study is being published in today's Journal of the National Cancer Institute.

GUBI שלום רב אני מודה לך מאד על מה שהבאת כאן. אמנם קשה לבנות סטטיסטיקה ע"ס מקרים בודדים, אבל מנסיוני הדל נראה לי שאכן הליקופן מגן מפני סרטן הערמונית לפחות בשלביו הראשוניים. לי אישית היו 5 מטופלים שבביופסיה נמצא PIN HIGH GRADE- ממצא שתמיד יהפוך לסרטן, זה רק עיניין של זמן.החולים טופלו בפרוסייף .ב-4 חולים בביופסיות חוזרות ה- PIN נעלם. אצל חולה אחד הופיע סרטן הערמונית לאחר שנה. כאמור זה לא מחקר ולא ניתן לעשות סטטיסטיקה על 5 חולים , אבל זה בהחלט מעודד. כידוע לך נעשו נסיונות בחיות להם הוזרקו תאי סרטן מתחת לעור. בקבוצה שאכלה ליקופן הסרטן לא התפתח לעומת הקבוצה שלא אכלה ליקופן. אני מאד שמח שגם אתה "במחנה " של המאמינים בתכונות החיוביות של הליקופן. אני חושב שהפרוסייף פורטה החדש על מרכיביו מכיל בקפסולה אחת די הרבה יסודות חשובים מאד לערמונית. מבחינה קלינית יש בהחלט תוצאות. חסר מחקר מעבדתי יותר רציני, אבל בהחלט זה עובד.ד"ר אריאלי