Cancer Prevention
High Marks for Nutritional Supplement in Patients with Localized Prostate Cancer By Alice Goodman
Berlin, Germany—A food supplement containing pomegranate seeds, green tea, broccoli, and turmeric— called Pomi-T (natureMedical)— taken twice daily significantly lowered prostate-specific antigen (PSA) levels versus placebo in men with localized prostate cancer, according to the results of a double-blind, placebo-controlled clinical trial. Use of the supplement allowed more men to remain on observation alone, according to results of a new study presented at the 2013 meeting of the Multinational Association of Supportive Care in Cancer. Phase 2 clinical studies have demonstrated that polyphenol-rich foods, such as those found in Pomi-T, have anticancer effects. This new, independent study (ie, not funded by the manufacturers of Pomi-T) is the first adequately powered, randomized, placebo-controlled phase 3 clinical trial of Pomi-T in men with localized prostate cancer.
The investigators enrolled 203 men (average age, 74 years) whose PSA levels were rising after radiotherapy or surgery for localized prostate can-
group, a significant 63.8% difference. PSA levels were stable or lower than baseline in 46% of men using the supplement versus 14% of men taking
“These results are awesome. We didn’t expect such a big response. This can change practice, because men and their doctors look at their PSA as a deciding factor in whether to continue on active management.” —Robert J. Thomas, MD, Mb, Chb
cer. They were managed with active surveillance (59%) or watchful waiting (41%) and were randomized to 2 capsules of Pomi-T daily or to placebo for 6 months. At 6 months, the median rise in PSA levels was 14.7% in the Pomi-T group compared with 78.5% in the placebo
placebo, a significant (P = .001) 32% difference. At follow-up, 7.4% of the men taking Pomi-T required treatment with radiation, surgery, or androgen-deprivation therapy compared with 26% of the men in the placebo group (P = .01). No differences were found between
the 2 groups in laboratory measurements of cholesterol, blood pressure, serum glucose, C-reactive protein, or adverse events. Taking the supplement allowed the majority (92%) of the men to remain on active surveillance compared with 74% of those receiving placebo. “These results are awesome. We didn’t expect such a big response. This can change practice, because men and their doctors look at their PSA as a deciding factor in whether to continue on active management,” stated lead investigator Robert J. Thomas, MD, Mb, Chb, Consultant Oncologist, Bedford Hospital National Health Service Trust, Cambridge, United Kingdom. Of note, this supplement is well tolerated and may improve digestion and urinary symptoms, Dr Thomas said. Men are more amenable to taking a nutritional supplement than to receiving active drugs, especially hormone therapy. This agent does not appear to act on hormones. n
Survivorship
Including Caregivers in the Care of Patients with Cancer Improves Quality of Life Washington, DC—Real-life experience translated into a research interest for Fedricker D. Barber, RN, MSN, of the M.D. Anderson Cancer Center, Houston, TX. At the 38th Annual Congress of the Oncology Nursing Society, Ms Barber presented a poster about the relationships between adult cancer survivors’ and caregivers’ social support, self-efficacy for physical activity, and quality-of-life (QOL) issues. The sample included 101 cancer survivors and caregivers with a median age of 62 years. Physical QOL was significantly higher for caregivers than for cancer survivors at baseline, but after 1 month of caregivers exercising with their patients, no differences were seen in this parameter between the 2 groups. Social support from caregivers or friends in performing physical activity improved participation in physical activity. “We found that cancer survivors and their caregivers rely on social
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support to encourage and motivate them to participate in physical activity. These findings suggest that priority should be given to strategies that encourage physical activity for both cancer survivors and their caregivers,” she said. Approximately 10 years ago, her husband was diagnosed with prostate cancer and had received 6 months of antiandrogen hormone therapy. During that relatively short course of treatment, he gained a lot of weight and was very tired. Ms Barber was concerned, because her husband was a young man in his late 40s, and she knew that lack of exercise and weight gain were associated with the risk of developing heart disease, diabetes, a second primary cancer, and cancer recurrence. So she sprang into action, so to speak. “When I saw what was happening to my husband, I decided to become part of the solution. I helped him by buying exercise videos and doing
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the exercises with him,” Ms Barber explained. “I emphasized to him that exercise would improve his immune
“Cancer survivors and their caregivers rely on social support to encourage and motivate them to participate in physical activity.” —Fedricker D. Barber, RN, MSN
system, reduce his fatigue, and prevent muscle wasting.” She found that her participation encouraged him to exercise, and soon he was losing weight and gaining energy. This experience led to the incorporation of caregivers and spouses of patients with cancer into an exercise plan in her practice. “I give all patients an education sheet on physical activity, even if they are advanced cancer patients. Exercise helps fatigue, mood, function, and sleep. Some patients think that if they have fatigue, they should stay in bed, but the opposite is true. If you exercise, the fatigue is reduced,” Ms Barber said. Exercise has been found to prevent the recurrence of cancers of the gastrointestinal tract, ovaries, esophagus, and breast. It also helps reduce some of the late effects of cancer treatment, such as poor wound healing, bowel urgency, and outlet obstruction, and it helps build up immune function, she said.—AG n
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No. 7