Mocht u kanker-actueel de moeite waard vinden en ons willen ondersteunen om kanker-actueel online te houden dan kunt u ons machtigen voor een periodieke donatie via donaties: https://kanker-actueel.nl/NL/donaties.html of doneer al of niet anoniem op - rekeningnummer NL79 RABO 0372931138 t.n.v. Stichting Gezondheid Actueel in Amersfoort. Onze IBANcode is NL79 RABO 0372 9311 38   
Elk bedrag is welkom. En we zijn een ANBI instelling dus uw donatie of gift is in principe aftrekbaar voor de belasting.

En als donateur kunt u ook korting krijgen bij verschillende bedrijven waaronder bij MEDpro op prostasol of prostectan voor prostaatkanker welke goed te combineren is met granaatappelsap: 

https://kanker-actueel.nl/NL/voordelen-van-ops-lidmaatschap-op-een-rijtje-gezet-inclusief-hoe-het-kookboek-en-de-recepten-op-basis-van-uitgangspunten-van-houtsmullerdieet-te-downloaden-enof-in-te-zien.html

2 november 2015:

Granaatappelsap aanvullend op eerstelijnsbehandeling verlengt bij prostaatkankerpatiënten met het MnSOD AA genotype het tijdstip tot zich een PSA stijging voordoet met gemiddeld een jaar 13,6 tot 25,6 maanden, in vergelijking met een placebo naast een standaard behandeling. Het verschil tussen een placebo en een extract van granaatappelsap was minder en niet statistisch significant, maar wel nog beter. Bij alle deelnemende patiënten werd er wel een verschil gevonden van enkele maanden maar dit was niet statistisch significant. Interessant overigens dat zowel een placebo als een extract een positief effect had op de snelheid van de PSA stijging. Maar het granaatsap zelf gaf de beste resultaten bij vooral patiënten (bij 22% werd dit type gevonden uit alle deelnemende patiënten) met het MnSOD AA genotype.

granaatappelsap grafiek

Dit is een gedegen opgezette studie zover ik dat als leek kan beoordelen. Maar oordeelt u zelf maar, het volledige studierapport: A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer is gratis in te zien. Zie ook toegevoegde referentielijst.

Het voilledige studierapport van een eerdere fase II studie, zie hieronder artikel daarover: Phase II Study of Pomegranate Juice for Men with Rising Prostate-Specific Antigen following Surgery or Radiation for Prostate Cancer is ook gratis in te zien en toont de waarde van granaatappelsap om PSA stijging te remmen. 

Het abstract van de recente studie staat onderaan artikel. Hieronder grafiek van deelnemende patienten uit deze studie verdeeld over de groepen.

granaatappelsap deelnemersgrafiek

2 juni: bron: Reuters

8 ons granaatappelsap = ca. twee glazen per dag - lijkt een sterk remmend effect te hebben op prostaatkankergroei geassocieerd met PSA stijging na operatie of bestraling van de prostaatkanker. Op ASCO 2005 presenteerden onderzoekers een fase II studie waarbij 48 mannen met recideif van prostaatkanker zijn gevolgd die of een operatie hadden gehad of waren bestraald voor hun prostaatkanker na stijgende PSA waarden. Na de behandeling kregen de mannen elke dag 8 ounces = ca. 225 ml. is een longdrinkglas granaatappelsap te drinken en niets anders. Ten opzichte van statistische gegevens waarin een gemiddelde tijd tot nieuwe PSA stijging ligt op 15 maanden tot nieuwe PSA stijging werd nu deze tijd met het granaatappelsap verlengt tot maar liefst 37 maanden, een winst dus van bijna twee jaar. De onderzoekers gaan nu een fase III studie hiermee opzetten. Het is al langer bekend dat granaatappels veel anti-oxidanten bevatten, maar lijkt nu ook effect te hebben door de phyto-oestrogene capaciteiten. Met dank aan Peter die ons vertelde dat bij sommige Turkse winkels dit granaatsap is te verkrijgen. Er zit wel suiker in, maar zonder suiker lijkt het niet te drinken zo zuur, althans dat vertelde Peter ons. Met dank aan Gert die ons het abstract stuurde van de studie en daaronder artikel van Reuters

Publishing #: 831
Presentation Title: Phase II Study of Pomegranate Juice for Men with Rising PSA following Surgery or Radiation for Prostate Cancer
Category: 44 Advanced
Author Block: Allan J Pantuck*, John T. Leppert, Nazy Zomorodian, Navindra Seeram, Daniel Seiler, Harley Liker, He-jing Wang, Robert Elashoff, David Heber, Arie Belldegrun, Los Angeles, CA

Introduction and Objective: Phytochemicals in edible plants can have cancer preventive benefits through antioxidation and via gene-nutrient interactions. Pomegranate juice has been shown to be a rich source of polyphenolic flavonoids. Pre-clinical data suggested the ability of pomegranate juice to modulate the growth and progression of prostate cancer. To determine the clinical effects of pomegranate juice on patients with prostate cancer, a clinical trial was performed. Methods: A 2 year, single center, phase II, Simon two stage clinical trial for men with rising PSA after surgery or radiotherapy was designed based on a 20% response rate, an alpha of 5%, and 90% power. Eligible patients had a detectable PSA greater than 0.2 ng/ml and less than 5 ng/ml, and a Gleason score of 7 or less. Serial PSA measurements determined a baseline PSA doubling time. Patients were treated with 8 ounces of pomegranate juice by mouth daily (wonderful variety, equivalent to 1.5 mmol of total polyphenols per day) until disease progression. Clinical endpoints included safety, effect on serum PSA, and exploratory laboratory studies. Patients were followed in 3 month intervals for serum PSA, and blood and urine were collected for laboratory studies. Results: The study was fully accrued to 48 participants in two stages after efficacy criteria were met. There were no serious adverse events reported and the treatment was well tolerated. No patients developed metatsatic disease on study. Mean PSA doubling time significantly increased with treatment, from a mean of 14 to 26 months (p< 0.048). The slope of the mean log PSA decreased from 0.08 to 0.04 on treatment (p< 0.019). In vitro assays using pre and post treatment patient serum on the growth of LNCaP showed decreased cell proliferation and increased apoptosis (p<0.07). Pomegranate polyphenols were detected in the urine of all participants by LC-MS. Conclusions: We report the first clinical trial of pomegranate juice in patients with recurrent prostate cancer. The positive and significant beneficial effects on PSA parameters achieved, coupled with corresponding laboratory effects on prostate cancer in vitro cell growth and apoptosis warrent further testing in a randomized, placebo controlled phase III study. Keywords: Prostate cancer,Antineoplastic agents,Antioxidants
,br> American Urological Association Annual Meeting
May 21 - 26, 2005
San Antonio, Texas, USA

Monday, May 23, 2005

NEW YORK (Reuters Health) - In men with recurrent prostate cancer, drinking 8 ounces per day of pomegranate juice significantly increases the time it takes for prostate specific antigen (PSA) levels to rise, according to research presented Monday at the annual meeting of the American Urological Association in San Antonio.

Before the men in the study began consuming pomegranate juice, the average PSA doubling time, a measure of tumor activity, was 15 months, lead author Dr. Allan J. Pantuck, from the University of California at Los Angeles, told Reuters Health. "The average time after treatment was 37 months. So, there was almost a 2-year increase in the doubling time."

Pomegranate juice contains a number of antioxidants thought to have anti-cancer effects, Pantuck noted. In addition, the juice contains estrogen-like plant substances called phytoestrogens that could be useful in combatting prostate cancer, in particular.

Based on encouraging results in cell culture and in animal models of prostate cancer, Pantuck said his team decided to conduct a clinical trial of pomegranate juice in 48 men with rising PSA levels after surgery or radiation therapy for their malignancy. As noted, the subjects were instructed to consume 8 ounces of pomegranate juice daily.

Pomegranate juice therapy was well tolerated and no serious adverse effects were reported. In addition to the beneficial increase in PSA doubling time, in vitro testing showed decreased cancer cell division and proliferation and increased cancer cell death. Urine testing confirmed the presence of pomegranate antioxidants in all men.

Given these promising findings, Pantuck noted that a multicenter phase III randomized trial is now in the works.

The study was funded by the Stewart and Lynda Resnick Trust, which own the POM Wonderful pomegranate juice company.

A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer

Prostate Cancer Prostatic Dis. 2015 Sep;18(3):242-8. doi: 10.1038/pcan.2015.32. Epub 2015 Jul 14.

A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer.

Abstract

BACKGROUND:

The primary objective of this study was to compare the effects of pomegranate juice on PSA doubling times (PSADT) in subjects with rising PSA levels after primary therapy for prostate cancer.

METHODS:

Double-blind, placebo-controlled multi-institutional study, evaluated the effects of pomegranate liquid extract on serum PSA levels. The primary end point of this study was change in serum PSADT. Additional secondary and exploratory objectives were to evaluate the safety of pomegranate juice and to determine the interaction of manganese superoxide dismutase (MnSOD) AA genotype and pomegranate treatment on PSADT.

RESULTS:

One-hundred eighty-three eligible subjects were randomly assigned to the active and placebo groups with a ratio of 2:1 (extract N=102; placebo N=64; juice N=17). The majority of adverse events were of moderate or mild grade. Median PSADT increased from 11.1 months at baseline to 15.6 months in the placebo group (P<0.001) compared with an increase from 12.9 months at baseline to 14.5 months in the extract group (P=0.13) and an increase from 12.7 at baseline to 20.3 in the juice group (P=0.004). However, none of these changes were statistically significant between the three groups (P>0.05). Placebo AA patients experienced a 1.8 month change in median PSADT from 10.9 months at baseline to 12.7 months (P=0.22), while extract patients experienced a 12 month change in median PSADT from 13.6 at baseline to 25.6 months (P=0.03).

CONCLUSIONS:

Compared with placebo, pomegranate extract did not significantly prolong PSADT in prostate cancer patients with rising PSA after primary therapy. A significant prolongation in PSADT was observed in both the treatment and placebo arms. Men with the MnSOD AA genotype may represent a group that is more sensitive to the antiproliferative effects of pomegranate on PSADT; however, this finding requires prospective hypothesis testing and validation.

PMID:
26169045
[PubMed - in process]

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Acknowledgements

Study funding, pomegranate products and placebos provided by Pom Wonderful. Manuscript co-author AJP has received research funding from and DH has received research funding and is a paid consultant to Pom Wonderful. Study Principal Investigators include: RD (Taussig Cancer Center Cleveland Clinic), AK (Winthrop Medical Center), AJP (UCLA Institute of Urologic Oncology), JC (Virginia Mason Medical Center), CAP (University of Texas MD Anderson Cancer Center), Sheldon Freedman, Gary Karlin (AdvanceMed Research), WA (UCLA, West LA VAMC), Giribala Patel (St Jude Heritage Medical Group), Andre Liem (Pacific Shores Medical Group), Frederic Kass (Santa Barbara Hematology Oncology Group), Robert Dichman (Central Coast Medical Oncology Corporation), Brad Bauer (Alabama Clinical Research Institute), WC (Alaska Clinical Research Center), GS (Five Valleys Urology), Ron Israeli (Staten Island Urologic Research), Joseph Kuntze (Coastal Medical Research Group), Robert Kratzke (University of Minnesota). Contract Research Organization (CRO) clinical trial support services provided by Radiant Clinical Research, Chicago, IL, USA. Data management and statistical analysis performed by Daniela Markovic and Jeffrey Gornbein, PhD, from the UCLA Department of Biomathematics.


Plaats een reactie ...

1 Reactie op "Granaatappelsap onderdrukt PSA stijging bij prostaatkanker van 15 maanden naar 37 maanden dus verlenging van PSA stabiliteit met circa twee jaar"

  • willem :
    Voor mij blijft de vraag of de psa onderdrukt wordt of dat de oorzaak van de PSA, de kanker, onderdrukt wordt

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