Charles “Snuffy” Myers
American Institute for Prostatic Disease
In every discussion of every cancer there comes a moment when somebody will discuss the entire subject of DIET and how it affects the cancer under discussion. Prostate cancer is no exception to this generalization.
Michael Milken, the former “Junk-Bond-Champion” of the world and a prostate cancer survivor who has single handedly put up more money for PC research than any other individual in history, became a firm believer in the importance of diet in prostate cancer development, evolution, and ultimate management. Dr. Myers is another dedicated believer in the impact of diet on PC from inception to finale’.
Both men, Milken and Myers, have gone so far as to publish special cookbooks detailing recipes containing the right ingredients prepared in the correct ways to either promote a cancer-free lifestyle or to help mitigate the effects of prostate cancer once a man has it. Dr. Myers cookbook is available from his Foundation at a cost of $30 and Mr. Milken’s cookbook is available through his Prostate Cancer Foundation at a nominal charge.
At the very least, one can enjoy the great recipes in each of these books secure in the knowledge that although you many not get cured of your PC by what you eat, at least you wont be promoting the growth of your cancer through bad eating habits.
Dr. Myers reviewed some of the basic objectives of a cancer-healthy diet. He suggested a healthy dose of COMMON SENSE when dealing with this subject. Some diet “gurus” adamantly oppose all fats and all animal products. Others urge abstinence from any and all sugars. Others urge avoiding all “acid containing” foods.
After looking at all the ‘no-nos’ in cancer linked diets, Dr. Myers concluded that saw dust (from organic trees), ice cubes (from distilled water), and bio-degradable Styrofoam mixed with soy ink covered old newsprint might make the “ideal” cancer diet.
By adding COMMON SENSE to this line of reasoning he summarized the few basic guidelines to be followed:
1. Any diet should also be good for one’s GENERAL HEALTH.
2. It should not employ expensive or exotic foods.
Should provide a menu that is attractive to eat.
And 4., food preparation should “not take too much time”. These principles are followed in his Cook Book.
He then reviewed some existing diets that have been promoted as contributing to male longevity. And assuming that prostate cancer does reduce overall male longevity, he selected these diets around which to build his own.
The diets he referred to as contributing to overall longevity included the “OKINAWAN” which is heavy on Tofu, fish, rice, and vegetables. Another one is the Seventh Day Adventist diet that is purely vegetarian. The third, and perhaps most influential in his choice is the so-called Mediterranean Diet. This is heavy in fish, legumes, grains, nuts, fruits, wine and olive oil.
Running through these diets is the common theme of very limited red meat intake, high intake of grains and legumes, and high vegetable components.
As a generalization, Dr. Myers stated that prostate cancer is “much less common in those countries than in the USA”.
[Ed Note: Whenever generalizations are made relative to differences in PC rates between American men and those from other cultures, e.g. Okinawa, we have to recognize that a major component of the difference might simply be the difference in the amount of prostate cancer screening done in these non-USA cultures! Intuitively, it’s hard to believe that Okinawan men are screened by PSA with anything like the frequency done for American men.]
Dr. Myers came down heavily in favor of the so-called Mediterranean diet for male longevity. Here he cited the long life expectancy for Sardinian men. A curious fact is that up to some 40% of calories in this diet are from FAT. Conventional wisdom would shake its head at this fact. But oil rich foods like olives, olive oil, almonds, pistachio and hazel nuts are major components. Red wine is an important component of this diet as is pomegranate juice.
[Ed. Note: Do you Sardinian men have lower stress lives than Americans? Do Sardinian men have genetic structures that inherently favor longevity? In other words, how valid is a single food generalization? Don’t Sardinians eat hard salamis with hard cheeses?]
He then went on to discuss a major advantage of this diet in that it is easily followed when dining out. California, with its Mediterranean like climate, is a major source in America for the components of a Mediterranean diet. Myers cited a large study done by the Harvard School of Public Health involving 47,882 men who were followed for 12 years. Out of that group 2,482 cases of PCa occurred. Of those men, the ones who ate fish 3X /week had a 44% decrease in metastatic cancer. They estimated that each 0.5 g of fish oil consumed led to a 24% decrease in metastatic disease among these men.
[Ed. Note: without reviewing the original article one might conclude that simply swallowing lots of fish oil is a cheap and effective way of preventing metastatic prostate cancer from developing. Common sense tells us that there has to be much more involved. The original reference cited by Dr. Myers is :” Augustsson, et. al., Cancer Epidemiology Biomarkers Prev., 12-64, 2003. In another Harvard study cited by Myers, of 1202 men with PCa, 392 progressed in the period 1986 – 1996. When stratified by fish consumption, there was a difference of 27% in recurrence risk between the highest and lowest levels of fish consumption. Original reference cited for this one was Chan. Et. al. Cancer Causes Control 17: 199, 2006). Major conclusion is that consuming lots of fish is an effective These data argue in favor of lots of fish in our diet.
Myers continued analyzing the other principal components of the Mediterranean diet including red wine. The intake of red wine has been linked to improved health benefits for several years. He also reviewed the fat content of the Med. Diet and concluded that the mono-unsaturated oils found in olives, almonds, pistachios, etc. are beneficial in reducing incidence of PCa. He also argued for the benefits of tomatoes (lycopene component, especially), and pomegranate juice. But the anti-oxidants contained in pomegranate juice (very expensive) are also contained in Welch’s Grape Juice, far cheaper and more conveniently obtained.
To support the arguments in favor of tomatoes in the Med diet, he cited again the Harvard Study of 1,202 men who had been treated for PCa with surgery and/or radiation. Those in the group who had consumed the largest amounts of tomatoes had a “44% reduction in recurrence” when compared to the lowest consuming group. He cited another small study, Ansari et. al. BJU 92, 375, 2002. In this study, 54 pts with metastatic disease underwent orchiectomies with the group stratified into with and without lycopene in their pre-orchiectomy diets. A “complete psa response” was found in 78% of those taking the lycopene vs. 40% complete response in the control cohort. Bone scans were 15% vis 30% with and without lycopene.
Deaths occurred in 13% with lycopene diets vs 22% w/o. This was a very small sample so its statistical significance is probably limited.
Myers cited another small study of 26 men newly diagnosed. The study separated the men into two groups: placebo vs 15 mg of lycopene twice daily for three weeks prior to radical surgery. Kucuk, et. al reported that in this study, 73% of the men on lycopene had cancer free surgical margins vs 18% in the control group. (Kucuk, et.al Cancer Epidemiology Biomarkers 10, 861, 2001).
What can one conclude about lycopene? Add it to your diet if you’re a young man concerned about PCa later in life. Add it to your diet if you’re an older man already dealing with PCa.
[Ed. Note: When a researcher sets out to test a hypothesis that he believes to be correct, chances are that his results will support the hypothesis. Unless the true standard of good science is followed, to wit: a prospective, double blind, carefully controlled clinical trial with a large sample is performed, all other results have to be treated with some skepticism.]
He concluded his talk by discussing the data supporting the importance of Vitamin D, especially Vitamin D3 and the form known as “Calcitriol”. He reported on a study that showed how Vit D3 positively affected the results of chemotherapy with Taxotere. He cited another small study of 15 pts who were experiencing post primary tx rising PSA. In this study (Woo, et. al. Nutr.Cancer 51: 32.2005) reported that 9 out of the 15 had their PSA stop rising or actually begin to drop. Woo reported that 2,000 IU per day of Vitamin D3 caused the median PSA doubling time to go from 14.3 months to 25 months.
Again, the same criticism of this study that was discussed in the preceding Ed. Note applies. Too small a study that does not meet the criteria for establishing the truth or falsity of the hypothesis.
[Ed Note: In the final analysis, none of the results claimed for these substances have been shown to extend survival, which in the final analysis, is the only result that really matters. Surrogate end points are created to demonstrate some kind of support for the hypothesis being presented for testing. Think in terms of the great general oncology fable: “ your tumor has shrunk x % so the chemotherapy is working!” But has overall survival been changed? Unfortunately, the answer too often has been no.]
Intl Prostate Cancer Conference, October 2006, Reston, VA
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