Phytotherapeutic interventions in the management of biochemically recurrent prostate cancer: a systematic review of randomised trials

Abstract

ObjectiveTo evaluate the evidence from randomised trials for the efficacy and safety of phytotherapeutic interventions in the management of biochemically recurrent (BCR) prostate cancer, indicated by prostate-specific antigen (PSA) progression, numbers progressing to/time to initiation of androgen-deprivation therapy or salvage therapy. Patients and MethodsMEDLINE (Ovid), EMBASE (Ovid), AMED (Ovid), CINAHL (EBSCO) and the Cochrane Library databases were searched. Clinical trials investigating phytotherapeutic interventions as dietary supplements or dietary components, including multicomponent herbal formulations, in men with BCR prostate cancer were located. Eight of nine authors contacted for further information responded. Methodological quality was assessed using the Cochrane Collaboration's risk of bias assessment tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews was followed. ResultsOf 23 full-text articles assessed for eligibility, five met the criteria for inclusion. Two studies were placebo controlled; two were active control trials; and one a high-/low-dose trial. The interventions were administered as isolated phytochemicals (sulphoraphane), phytotherapeutic extracts [Pomi-T (pomegranate, turmeric, green tea and broccoli sprout extract), soy, lycopene, and POMx (pomegranate extract)], or plant-derived dietary items (soy and lycopene). All studies found serum PSA levels to stabilise, decrease or rise more slowly in a significant number of men, and three studies reported stabilising or lengthening of PSA-doubling time. Studies were generally of good quality, but sample sizes were predominantly small, and durations short. ConclusionsHigh-quality studies in this area are lacking. Sulphoraphane, lycopene, soy isoflavones, POMx, and Pomi-T are safe and well tolerated. There is limited evidence that they can affect PSA dynamics. No recommendation can be made for the use of these agents in managing prostate cancer morbidity and mortality until high-quality, fully powered studies are available. Recommendations are made for improving reproducibility and translation of findings with regard to study population, study endpoints, design, and the reporting of phytotherapeutic interventions.

Effect of lycopene supplementation on cardiovascular parameters and markers of inflammation and oxidation in patients with coronary vascular disease

“…There are a number of recently published clinical trials and metaanalysis data revealing beneficial health effects of lycopene (Cicero & Colletti, 2015;Mahmoodnia, Mohammadi, & Masumi, 2017;Singh & Bagewadi, 2017;van Die et al, 2016). However, only few of them (Graff et al, 2017;Zhu, Gertz, Cai, & Burri, 2016) adequately address the issue of lycopene bioavailability in volunteers.…”

Use of Complementary and Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-Boomers

“…Integrative care includes complementary and alternative methods, alongside traditional medical approaches. The effectiveness of this approach is being studied in addressing pain management and treating PTSD among veterans (35,37), symptom management among cancer patients (38), and supporting healthy behaviors such as smoking cessation (39) and weight loss (40). Given our finding that baby boomers are more likely than pre-boomers to try CAM modalities such as energy healing, herbal therapies, massage, and relaxation or meditation techniques, a continuing focus on integrative care is important.…”

Food-based natural products for cancer management: Is the whole greater than the sum of the parts?

“…Overall there is a dearth of high quality studies that can provide guidance regarding the anti-cancer use of the isolated compounds/parental extracts/combination of compounds. A recent review of the literature for clinical trials that investigated phytochemical intervention in biochemically recurrent prostate cancer identified 23 full-length articles of which only 2 studies that were identified as having placebo-controlled, 2 were active control studies and one was a dose-response study [131]. Using the US Food and Drug Administration model these compounds must be evaluated for anti-cancer surrogate markers (identified and validated from cell culture models) or endpoints to establish risk reduction.…”