Lectures

Introduction: Nutrition as more than Diet

It is our choice of food that affects our risk of many cancers. Prostate cancer is associated with a typical Western diet. Such a diet centers around foods from animal sources, for instance hamburgers, beef, cheese, butter and full fat milk. This is high in saturated animal fats and is associated with a greatly (79%) increased risk of prostate cancer. (more info)

Another important aspect of healthy eating and cancer prevention involves the actual digestion and absorption of nutrients from the food chosen and eaten. Many of us eat too much, eat in haste and under stress and find that we have poor digestion as a result. This may lead to restrictive food choices avoiding those items that are nutritious and protective against cancer such as beans, whole grains, fruits and vegetables.

The main groups of nutrients that are important in protection from prostate cancer are summarised below:

• Primary prevention of metastasis (spread of an original tumor)
  Examples include lycopene from tomatoes, pink grapefruit and watermelon.
• Antipromotion strategies
  e.g. altering types of fat and quantity of fat consumed by increasing omega-3 fatty acids and reducing linoleic acid (red meat, processed soy bean oil, etc.). Oily fish are good sources of omega-3's. Other sources include walnuts, flaxseed and pumpkin seeds.
• Antiproliferative agents
  e.g. Vitamin D analogues. Prostate cancer is more evident in countries where there is less sunlight. Go outside daily.
• Antiangiogenetic agents
  e.g. soy protein. Isoflavones genistein and daidzein reduce the formation of new blood vessels that tumors need to provide them with nutrition. Bioflavonoids and bovine or shark cartilage are also antiangiogenic.

Modern Concepts of the Relationship of Micronutrients and Health: Botanical Factors or Phytonutrients

Plants cannot move like animals to escape danger hence they have powerful protecting chemicals that can be consumed by us and give us some of the benefits. Many of these plant based chemicals are colored orange or yellow and are called by the term bio ("life") flavonoids ("yellow"). The dark green color of chlorophyll may mask the orange or yellow colors and spinach, for example, is an excellent source of bioflavonoids. Many bioflavonoids are also anitoxidants, examples of which are pro-vitamin A (beta carotene) and other carotenoids, Vitamin C and Vitamin E. Dietary sources include dark green leafy vegetables, citrus fruits, cantaloupe, red wine/grape juice. These phytonutrients protect DNA from free radical damage that occurs as a result of natural metabolism, from environmental exposure to radiation, smog and tobacco smoke. They also help maintain the integrity of cell functions and cell division and protect from the mechanisms that lead to cancer cells dividing and thriving. Such action is described as anticarcinogic. Examples of anticarcinogens include ellagic acid (from berries and tomatoes), indoles from cruciferous vegetables (cabbage family), and the spices cumin and turmeric.

Advice for Prostate Cancer Patients: Chemotherapy Side Effects and Nutrition

• Nausea and vomiting:
  Try ginger ale (or natural ginger tea), saltine crackers, sucking ice
• Malabsorption and diarrhea:
  Digestive enzymes (papain from papaya, bromelain from pineapple), apples, brown rice
• Hot flashes:
  Avoid red wine, tobacco, caffeine, chocolate, colas
• Weight gain/fluid retention:
  Cut down on total calories, particularly foods from animal sources (red meat and dairy) and increase fruits and vegetables to at least five servings daily (eight or ten is even better). Avoid packaged and canned products that contain added sodium. Avoid salted snack foods such as corn chips and pretzels.
• Nutritional deficiencies at cellular level:
  Choose foods rich in nutrients such as beans, whole grains, dark green leafy vegetables and citrus fruits. Supplement with broad spectrum multivitamin and mineral containing 100% RDA (not megadoses). Use herbs and spices in food preparation as most contain valuable botanical factors. Particularly valuable are rosemary, thyme, cumin and turmeric.

• Enteritis and mucositis
  Aloe vera as a drink may be soothing. Avoid hot and spicy foods. Take care with oral hygiene.
• Lactose intolerance
  Avoid milk, ice cream and other lactose containing foods. Lactase enriched items like Lactaid milk may be tolerated in small quantities.

• Wise food choices - Lots of fruits, vegetables and legumes.
• Avoid excesses - Judicial use of supplements.
• Each time you choose more vegetarian foods you can feel confident that you doing something constructive and supportive to your health. This is especially important during "watchful waiting".

1. Emcyt (Estramustine; a combination of estradiol and nitrogen mustard)
   - milk, milk products and calcium rich foods may impair its absorption.
   - avoid salty foods to minimize fluid retention.
   - supplement with 200 micrograms of chromium GTF (glucose tolerance factor). Wheat germ is a good source of chromium.
2. Methotrexate (a folate antagonist; cytotoxic (cell killing) drug)
   - avoid supplements containing more than the RDA for folacin (400 micrograms) - a B vitamin found in leafy vegetables.
   - consume foods that produce an alkaline urine to aid in excretion (almonds, buttermilk, chestnuts, coconuts, fruits (except cranberries, prunes and plums) and all vegetables (except corn and lentils). Eat less foods that produce an acidic urine (nuts, meat, breads and pasta).
3. Mevacor (lovastatin; a cholesterol lowering agent; an inhibitor of HMG-CoA reductase).
   - to reduce the risk of cataract formation include carotenoids from dark green leafy vegetables and reduce simple sugars.
4. Proscar (finasteride; a 5-alpha reductase inhibitor)
   - none noted as significant in PDR. Dihydrotestosterone is the form that aggravates benign prostatic hyperplasia. Saw palmetto appears to act similarly.
5. Sandostatin (octreotide acetate; a growth hormone inhibitor)
   - note that gall stones may form after chronic use due to the slow contractility of the gall bladder. A diet containing only small quantities of cholesterol and phosphorus (from red meat, full fat dairy products and colas) will minimize this risk.
6. Velban (vinblastine sulfate; an antineoplastic agent from periwinkle)
   - avoid tryptophan supplements (now illegal in USA) as they may reduce the effectiveness of Velban.
   - avoid glutamic acid supplements for the same reason.
   - do not avoid sodium or salty foods.
   - to avoid constipation eat plenty of dietary fiber rich foods such as wheat bran and beans.
7. Zoladex (goserelin acetate implant; a LHRH antagonist)
   - none significant noted.

Tobacco use is associated with an increased mortality from prostate cancer. Don't smoke!!