Web edition: August 10, 2006
Prostate cancer will claim the lives of an estimated 30,000 men in the United States this year. The second leading cause of cancer death in men, its incidence climbs with age. In Western countries, the disease is reaching nearly epidemic proportions among the elderly. However, the cancer can grow so slowly that many men with prostate cancer will die of something else first.
A mystery has always been what factors might improve a man's odds of having a slow-growing malignancy. A new study suggests that drinking pomegranate juice might be one of them.
Several studies have associated diets high in plant-derived polyphenolsprincipally, the deeply pigmented antioxidants in many fruits and vegetableswith lower risks of malignancies including prostate cancer. Because the blood-red juice of pomegranates is especially rich in such compounds, Allan J. Pantuck of the David Geffen School of Medicine at the University of California, Los Angeles and his colleagues decided to test it against metastatic prostate cancer. These are malignancies that have spread beyond the gland, which in these men had been removed or destroyed, along with tumors, by radiation.
Over time, the presence of these residual cancer cells was confirmed by rising concentrations of a protein in the men's blood: prostate-specific antigen (PSA). Because PSA is made by prostate cellsusually cancerous onesand because these men no longer had intact prostates, the presence of the substance indicated that cancerous prostate cells continued to exist in the men's' bodies, Pantuck explains.
The researchers calculated that the men's average doubling time in PSA concentrationsa rough gauge of cancer growthwas 15 months. After men drank a glass of juice a day, their average doubling time more than tripled. In nearly one-third of men, Pantuck notes, PSA values actually fellin a few cases, dramatically.
Although this is just one study and the juice showed no sign of curing the disease, Pantuck says it shows that pomegranate juice might be a beneficial adjunct to other therapies in men with this potentially lethal disease.
A glass a day
Last fall, researchers at the University of WisconsinMadison reported related laboratory data. They incubated cells from an aggressive form of prostate cancer with pomegranate-fruit extract. The higher the concentration of the extract the greater the inhibition of the cancer cells' growth, notes team leader Hasan Mukhtar.
The team also injected humanprostate-cancer cells into lab mice. The cells grew into tumors, but the rate was reduced in animals fed pomegranate extract, his team reported in the Oct. 11 Proceedings of the National Academy of Sciences. The team confirmed the juice's effect by measuring PSA concentrations in the animals' blood.
The new study extends these trials into people. Pantuck's group recruited 46 men who, despite having undergone prostate-cancer surgery, were exhibiting rising PSA values, as measured over a 6-month period. Concentrations of the protein at the start of the study ranged from 0.2 to 5 nanograms per liter of blood, indicative of small residues of cancer cells. These men had no medical sign of metastatic disease except for the PSA concentrations and were on no anticancer drugs or other therapies.
All recruits were then assigned to drink an 8-ounce bottle of pomegranate juice daily. PSA and other cancer indicators were measured every 3 months, and men were removed from the trial if they showed signs that their disease was advancing rapidly. By 33 months into the trial, PSA values had changed measurably in enough men to allow the researchers to calculate the concentration's new doubling time. On average, that figure was then about 54 months.
Overall, "more than 80 percent [of recruits] had a prolongation in their PSA doubling time," says Pantuck. "This means [that] for the majority of patients, their cancer's growth slowed."
PSA concentrations decreased in about a third of the study participants, the team reports in the July 1 Clinical Cancer Research. Most such decreases were small, but four men exhibited declines in the cancer indicator of more than 50 percent while taking the juice. One man's PSA concentration dropped a whopping 85 percent, Pantuck says. Once PSA becomes detectable, the urologist explains, it tends to rise inexorably"you don't expect it to spontaneously decrease."
The researchers also conducted a few biochemical tests. For instance, they grew standard cultures of human-prostate cells in test tubes and fed the cells blood serum taken from the recruits at the beginning and end of the trial. The procedure was intended to reveal whether something changed in the men's blood that might affect cancer growth. Pantuck's group found that the cells' growth rate was 12 percent slower when the lab cultures were fed serum from the men after they had been drinking the juice.
The men's blood also tended to be less vulnerable to oxidationa chemical reaction that can damage cellsonce pomegranate-juice supplementation began.
In this trial, no one was treated with a placebo instead of pomegranate juice. Such a study design is the gold standard for medical trials, because it rules out the possibility that just the idea of treatmentor some other factormight be responsible for any effect that emerges from the study.
That's why Pantuck's group and others at institutions around the nation recently began just such a placebo-controlled, follow-up trial of pomegranate juice. The researchers' goal is to recruit some 350 patients with prostate cancer. Some men will receive pomegranate juice containing 570 milligrams of polyphenols per 8 ounces. Others will get juice with twice that quantity of polyphenols, and some men will receive a pomegranate substitute with no polyphenols.
Even if it turns out that the juice doesn't affect prostate growth in the new trial, there are plenty of reasons to enjoy this fruit. A growing library of published studies show that its antioxidant-rich flesh and juice inhibit cholesterol oxidation in human blood, lower blood pressure, retard the development of atherosclerosis, and even slow progression of Alzheimer's disease.
People in sunny climes may derive yet another unexpected benefit from pomegranate consumption: skin protection from the sun's harmful ultraviolet rays. Earlier this year, Mukhtar's group showed that treating cultured skin cells with a pomegranate extract minimized the development of precancerous changes when those cells were later irradiated with ultraviolet light. The scientists reported their findings in the March Photochemistry and Photobiology.
You say you don't like pomegranates? There may still be ways to fight prostate cancer naturally, via the dietsuch as by drinking tea.
At a meeting 2 years ago, Suzanne Henning of the University of California, Los Angeles and her colleagues reported that polyphenols in tea appear to make men's blood less nourishing to prostate cancer cells. Moreover, drinking tea prior to prostate cancer surgery made noticeable changes in the tissue's cells. Those cells were less susceptible to runaway growth, a hallmark of cancer, in men who drank tea than in those who didn't (see Tea Yields Prostate Benefits). Her team's findings have now been formally published, in the July Journal of Nutrition.
Other evidence suggests that soy and aged garlic inhibit prostate cancer, as might foods rich in selenium (such as certain grains)or boron (such as grapes and red wine). Indeed, Mukhtar argues, the best approach is always to strive for diversity in the diet, especially plenty of products made from different fruits and vegetables.
Cut eggplant into 1/4-inch slices, and place them on paper towels. Sprinkle slices with salt, and weight them down with heavy plates or a board for 30 minutes. Then pat them dry with paper towels.
Prepare pomegranate syrup by cutting 2 or 3 pomegranates in half and juice using a citrus reamer or juicer until you have 1 cup of liquid, or use 1 cup of commercial pomegranate juice. Combine juice and 3/4 cup of sugar in a small saucepan; bring to a boil. Reduce heat and simmer about 20 minutes until reduced to 1/2 cup, stirring frequently.
Lightly brush eggplant slices with olive oil, and place them on grill. Grill them for 3 minutes on each side, or until they are lightly browned on both sides. Remove from grill. Arrange the eggplant by overlapping the slices on a serving dish.
In a mortar, crush garlic cloves with 2 tsps salt to a paste. In a non-metallic bowl, combine the garlic paste and pomegranate syrup. Spread a little of the mixture on each eggplant slice. Sprinkle the slices with minced parley and pomegranate seeds for garnish and chill covered.
Nutritional Analysis: Calories 239, Protein 1g, Fat 2g, Calories from Fat 27%, Cholesterol 0mg, Carbohydrate 55g, Fiber 2g, Sodium 397mg.
Credit: Pomegranate Council
11444 W. Olympic Boulevard
Los Angeles, CA 90064-1544
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Department of Dermatology
Medical Sciences Centre
University of Wisconsin, Madison
1300 University Avenue
Madison, WI 53706
Allan J. Pantuck
Department of Urology
David Geffen School of Medicine
University of California, Los Angeles
66-118 Center for Health Sciences
Los Angeles, CA 90095-1738
19 Sherwood Court
San Francisco, CA 94127
Web site: [Go to]
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