The Great Prostate Mistake

[groovedaddy]

EACH year some 30 million American men undergo testing for prostate-specific antigen, an enzyme made by the prostate. Approved by the Food and Drug Administration in 1994, the P.S.A. test is the most commonly used tool for detecting prostate cancer.

The test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with — I discovered P.S.A. in 1970. As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.

Americans spend an enormous amount testing for prostate cancer. The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.

Prostate cancer may get a lot of press, but consider the numbers: American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it. That’s because the majority of prostate cancers grow slowly. In other words, men lucky enough to reach old age are much more likely to die with prostate cancer than to die of it.

http://www.nytimes.com/2010/03/10/opinion/10Ablin.html?th&emc=th

[HysteryDiagnosis]

1. Maters.... I love sun dried maters

http://psa-rising.com/foodnews/2008/06/dehydrated-tomatoes-show-promise-for-preventing-prostate-cancer/


A positive anti-prostate cancer effect for tomato products has been suggested in many studies. This effect has often been attributed to lycopene. But it’s starting to look as though lycopene is only part of the story.
New cancer research from the University of Missouri, published in the June 1 issue of Cancer Research, suggests that dehydrating tomatoes and rehydrating the powder is key.
“Processing of many edible plants through heating, grinding, mixing or drying dramatically increases their nutrition value, including their cancer prevention potential. It appears that the greatest protective effect from tomatoes comes by rehydrating tomato powder into tomato paste,” said Valeri V. Mossine, Ph.D., research assistant professor of biochemistry at the University of Missouri.
Mossine and his colleagues found that FruHis – an organic carbohydrate or ketosamine present in dehydrated tomato products – exerts a strong protective effect against prostate cancer.

[groovedaddy]

2. My dad was diagnosed 5 or so years ago with prostate cancer. A friend told me about

lycopene and I told my dad. He really isn't a supplement kind of guy at all but he did order lycopene and has been taking it since. About 1 year after he was diagnosed, his physician told him that the tumor had shrunk. That news made my dad a firm believer in lycopene.

[HysteryDiagnosis]

3. Not only lycopene... please do read about the oncologist in your

garden as well as these.... I recently gave some Bio Greens and glyconutrients to a family member who was facing surgery for breast cancer. She started only a few weeks prior to surgery... tumor mass had shrunk by the day of the surgery.

In Vivo. 2008 Jul-Aug;22(4):441-5.
Review. Indole-3-carbinol as a chemoprotective agent in breast and prostate cancer.
Bradlow HL.
David and Alice Jurist Institute for Medical Research, Hackensack University Medical Center Hackensack, NJ 07601, USA. [e-mail]
Assessment of the oral use of indole-3-carbinol (I3C) as a chemoprotective compound has not sufficiently considered the chemical instability of I3C. This review addresses the question of whether I3C is directly active in its own right or only serves as a precursor, with all of the biological responses coming from reaction products arising in culture media and in the presence of stomach acid. Because of the rapid conversion of I3C into its dimer. diindolylmethane (DIM), and trimers very little circulating I3C is present following oral use to effect a biological response. Reports of toxicity associated with oral use of I3C relate to unfavorable enzyme induction, which can be attributed to non-DIM reaction products. Because DIM provides a predictable, safer response than the mélange of compounds derived from I3C DIM should be regarded as the chemoprotective compound of choice.
PMID: 18712169
Publication Types, MeSH Terms, Substances

Biochem Pharmacol. 2006 Dec 15;72(12):1714-23. Epub 2006 Sep 12.
Indole-3-carbinol mediated cell cycle arrest of LNCaP human prostate cancer cells requires the induced production of activated p53 tumor suppressor protein.
Hsu JC, Dev A, Wing A, Brew CT, Bjeldanes LF, Firestone GL.
Department of Molecular and Cell Biology and The Cancer Research Laboratory, The University of California at Berkeley, Berkeley, CA 94720, USA.
Indole-3-carbinol (I3C), a dietary compound found naturally in cruciferous vegetables of the Brassica genus such as broccoli and brussels sprouts, induces a G1 growth arrest of human reproductive cancer cells. We previously reported that in LNCaP prostate cancer cells, I3C down-regulated cyclin-dependent kinase (CDK) 2 activity. In our current study, Western blotting and quantitative RT-PCR demonstrated that I3C treatment increased both the transcripts and protein levels of the CDK2 inhibitor p21(waf1/cip1) (p21). Transfection of luciferase reporter plasmids containing wild-type and mutated p21 promoter fragments revealed that I3C induced p21 gene transcription through a p53 DNA binding element. Oligonucleotide precipitation showed that I3C increased the level of activated p53 nuclear protein that is competent to bind its DNA target site on the p21 promoter. Ablation of p53 production using short interfering RNA (siRNA) prevented that the I3C induced G1 arrest and up-regulation of p21 expression. Western blots using p53 phospho-specific antibodies revealed that I3C treatment increased the levels of three phosphorylated forms of p53 (Ser15, Ser37, Ser392) that are known to contribute to p53 protein stability and greater transactivation potential. Taken together, our results establish that the I3C induced G1 arrest of human prostate cancer cells requires the induced production of the activated phosphorylated forms of p53, which stimulate transcription of the CDK2 inhibitor p21.
PMID: 16970927

[hedgehog]

5. There's also growing evidence about prostate cancer and Vitamin D deficiency

http://www.ncbi.nlm.nih.gov/pubmed/14580762

[HysteryDiagnosis]

6. You know.... if only it were true, what with the recent blowup about

vitamin D... lycopene... indole 3 carbinol or preferrably DIM, that surgeries and deaths due to cancer could be drastically reduced. No one can say for sure... it would be quackery for sure to tell a person to do anything less than standardized proven care... still one wonders if the body is capable of taking over when prodded appropriately.. look at the article on freezing breast cancer tissue... the immune system takes over. How cool is that?

[hedgehog]

7. Oh, I would never substitute Vitamins for conventional treatment.

What's important is growing evidence that some vitamins prevent some cancers. I can't find it now, but someone posted a link here a few months back to some fascinating power point slides from a scientific meeting. One set outlined a mechanism connecting Vitamin D to breast cancer. Another matched breast cancer rates to annual hours of sunshine on a map of the US. The exceptions to the rule were the agricultural counties of California and New Orleans, both areas with high pesticide/petrochemical exposure. The most amazing slide was one showing a linear relationship between Vitamin D blood serum levels and breast cancer rates.

[hedgehog]

4. The article is unclear on two points. First, is it worthwhile to test all men,

but base any further action on a change in PSA numbers? In other words, look for a trend, not a single reading.He does say that men with a family history of cancer should get checked regularly.

Second, it seems to be the treatment that is the problem, not the test. It's my understanding that young men tend to have aggressive, rapidly growing cancers while elderly men have indolent tumors. Clearly, younger men should be treated aggressively while the elderly can be treated with watchful waiting and if necessary chemo therapy (testosterone antagonist)to control metastasized tumors. I think anyone between say 60 and 70 falls into a gray area. Treat a healthy 70 year old, watch a sickly 60 year old?

I agree that aggressive treatment of someone in his 80's does more harm than good. The hard part would be to convince some men that they are better off living with the cancer than the treatment. The best course may be to stop testing at a certain age. The problem is to put that into a protocol without being accused of rationing care.

[EvolveOrConvolve]

8. It runs in my family

My great-grandfather, my grandfather, my dad, 3 uncles and a list of cousins have all had prostate cancer (and all survived it). I'm only in my late 30's, but I started getting a PSA test and a DRE every year. Everything looks good for now, but with my family history it could hit at any time. The age range of family members who have gotten the cancer ranges from the late 30's to the early 90's.

If insurance companies stop paying for the tests, I'll take care of it out of my own pocket.

[unc70]

9. Ablin also thought that AIDS was not caused by HIV

While Ablin might have discovered the antigen itself, I am not impressed with his ongoing research in the forty years since. He seems determined to be the contrarian on many issues, and he should have learned a bit of humility from being wrong so often, famously disputing research showing the HIV virus causes AIDS:


"As an alternative to the hypothesis that AIDS is solely an infectious disease I suggest that the opportunistic infections and tumors such as Kaposi?s Sarcoma seen in AIDS patients result from a combination of lifestyle hazard and immunodeficiency, whereas patients with hemophilia the infections are a consequence of immunosuppression resulting from infusion of anti-hemophiliac factor."

Dr. Richard Ablin, PhD, State University of New York

Lancet, April 1985


I should see if anyone has posted this at the NYT. When I read his articles about the PSA since that Lancet HIV/AIDS article, they all start seeming the same. He is not just a contraian, he appears to have some issue with who is getting research money and with who will profit from testing and treatment. I need to do find out a lot more about Ablin to be sure, but I wonder if the financial failure of some of his companies could be a factor -- but that is pure speculation.

What I know is that he has no credibility with me.

This subject is very dear to me. Last year, after more than a dozen years of watchful waiting following my first negative biopsy, my wait was over and I had surgery that confirmed Stage 3 prostate cancer that had started to grow outside the prostate itself. Just barely in time, my surgeon was able to get clear margins though he had to go a long way to get them. A year later, everything looks good.

Yes, the PSA test is really inadequate and the biopsy of the prostate is only a little better with roughly 30% false negatives and nearly as many underestimating the prevalence of tumors. But it is all we have at the moment, and none of us wants to endure late stage prostate cancer.

I have previously discussed the limitations of the studies he cites and many other things related to prostate cancer. Just search on "unc70 prostate" for posts here and other sites.

The research that I am most conflicted about involves folic acid. Many studies had shown that insufficent folic acid during pregnancy was the cause of many birth defects. (Prematurity, birth defects, and infant mortality is another focus of mine.) After failed attempts increase consumption of foods or supplements high in folic acid amonth women likely to become pregnant, I supported efforts to deliver the folic acid by enriching flour, and these efforts worked and greatly reduced the number of cleft palates and other defects.

Unfortunately for me, a study published last year shows taking folic acid supplements greatly increased the risk of prostate cancer. I could not find significant flaws in that study, so I am now left with sorting out a problem, that enriching everyone's flour eliminates a lot of birth defects, but it could also be the cause of increases in prostate cancer.

So how to we bet the folic acid to the younger women who need it and not to the older men who do not?

[trident1996]

10. One small problem re: HIV

I need to correct you on one point. Ablin did NOT say that HIV did not cause AIDS. What he said was that HIV <b>by itself</b> was not enough to cause AIDS, that you need a 2nd thing or a 'cofactor' in order for the virus to cause AIDS. The virus by itself is not enough, but the virus PLUS a chemical that shuts down the local immune response would be enough to allow the virus to 'set up shop' and cause the problems known as AIDS. Ever wonder why some people can be HIV-positive and not be considered to have AIDS? It may be that the virus WAS in the persons body, but it was not able to set-up and replicate and thus become a full-blown infection. It may be that those who DO get AIDS also had a cofactor called transglutaminase. Transglutaminase shuts-down the immune response, and it is found in 1) blood and 2) semen. Think about it. It's not as wacky as you might think.

Ablin may or may not be right about PSA, and he may or may not be right about AIDS. I just found a March 2010 (non-Ablin) journal article - 15 years after that Lancet article you mentioned - and it says "TGs may be a novel area of enquire for the development of anti-HIV agents. Several lines of evidence have demonstrated the involvement of TG in HIV pathogenesis"

I just wanted to clarify the statement regarding the Lancet AIDS/HIV article, regardless of how you feel about his PSA NYT article.

[phylny]

11. Routine PSA test saved my husband's life

He had NO symptoms - not a one. Yet, his PSA had risen. Post surgery, his physician said that if they hadn't found it when they did, he'd be dead in two years. It was an aggressive cancer.

He was 54 at the time of diagnosis. He had a radical prostatectomy, and needed no further treatment, other than routine blood tests that show he remains free of prostate cancer for now.