One of the more interesting abstracts at ASCO last week involved patients taking capsules with a mixture of plant extracts that contain polyphenols. I can pretty much guarantee that at least one of my patients this week will arrive with some sort of news article and ask my opinion. So in the spirit of pre-emption, here are my thoughts.
Polyphenols are some of several natural chemicals that seem to slow prostate growth in the test tube. That said, it makes sense that some of them might work in people. We, ourselves, looked at silibin, one of the more active polyphenols in a human clinical trial. Unfortunately, even taking 13 grams/day of the highly absorbed silibin phytosome preparation, did not seem to have any effect on PSA, possibly because the chemical is rapidly metabolized by humans (unlike mice). Other investigators have published positive results using pomegranate juice or extracts. I have previously reviewed some of these findings here and here. We also completed a trial recently using acai juice that is unpublished, but does show some mild activity.
When the abstract noted above on Pomi-T was presented, there was a great deal of skepticism from experts in the audience who went to the microphones to question the presenter. I think this was well-founded. In the past, patients have spent millions of dollars (literally) on PC-Spes. That story turned out to be actual fraud, with the activity almost certainly related to the manufacturers adulterating the herbal mixture with DES. So before you run to your computer and order Pomi-T from a company you have never heard of, be sure you read this article which tells the PC-SPES story. We all hope for simple, non-toxic solutions to cancer problems. Unfortunately, cancer is more complex than that and while I have personally seen some patients respond with drops (temporarily in all cases) in PSA when they start taking some new supplement and are brave enough to tell me about it, this is clearly a small minority. An interesting question remains: If it can’t hurt, why not? The PC-SPES story answers that – because you don’t know what you are taking! Furthermore, for every carefully studied herbal remedy, there must be 100 or so that are nothing but “hope in a bottle” for which charlatans are eager to charge willing and well-meaning patients. It will be interesting to see what further studies tell us about Pomi-T…
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