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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Men in the United States get prostate cancer more than any other type of cancer except skin cancer. It is found mainly in older men. In the United States, about one out of five men will be diagnosed with prostate cancer. Most men diagnosed with prostate cancer do not die of it.
Complementary and alternative medicine (CAM) is a form of treatment used in addition to (complementary) or instead of (alternative) standard treatments. CAM treatments generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM.
CAM use among prostate cancer patients is reported to be common. CAM treatments used by prostate cancer patients include certain foods, dietary supplements, herbs, vitamins, and minerals.
This PDQ CAM summary gives general information about using foods and dietary supplements to lower the risk of developing prostate cancer or for treating prostate cancer, its symptoms, or side effects of disease treatment. In addition, this summary has sections for six specific foods or dietary supplements:
More topics will be added over time. These sections include the following information for each food or dietary supplement:
Studies of CAM use to treat prostate cancer have shown the following:
Studies of CAM use to lower the risk of developing prostate cancer or to prevent it from coming back have shown the following:
Studies of why prostate cancer patients do or don't decide to use CAM show that their choice is based on many factors, including their medical history, their beliefs about the safety and side effects of CAM compared to standard treatments, and their need to feel in control of their treatment.
Tea has been consumed in Asia since ancient times. Sailors first brought tea to England in the 17th century. Other than water, tea is the most widely consumed beverage in the world. All tea comes from the Camellia sinensis plant. The way the leaves of this plant are processed determines the type of tea produced.
To make green tea, the tea leaves are steamed and dried; this causes very little oxidation (a chemical reaction that takes place when a substance comes into contact with oxygen or another oxidizing substance). Black tea is made by crushing tea leaves to cause full oxidation. Oolong tea is made from partially oxidized leaves.
Some studies suggest that green tea may protect against cardiovascular disease and some types of cancer. Clinical trials designed to study whether green tea is useful in treating prostate cancer are in the early stages. There is not enough evidence to show whether green tea is effective in treating prostate cancer.
Many of the possible health benefits studied in tea are thought to be from compounds called polyphenols. Polyphenols are a large group of plant chemicals that include catechins (antioxidants that help protect cells from damage caused by free radicals).
The most active catechin in green tea is epigallocatechin-3-gallate (EGCG).
Green tea may be consumed as a beverage or taken in dietary supplements.
Laboratory and animal research has been done to study the effects of green tea in prostate cancer.
Studies of green tea in the laboratory have shown the following:
Studies of green tea in animal models of prostate cancer have shown the following:
Population studies and clinical trials have been done to find out if green tea may be useful in preventing or treating prostate cancer.
Population studies look for risk factors and ways to control disease in large groups of people.
A review of many population studies combined, mainly from Asia, suggested that green tea may help protect against prostate cancer in Asian populations. Black tea was not found to affect prostate cancer risk.
Clinical trials of preventing prostate cancer
A study assigned 60 men with high-grade prostatic intraepithelial neoplasia (HGPIN) to take green tea catechin capsules (600 mg / day) or a placebo. After 1 year, 9 men in the placebo group were diagnosed with prostate cancer compared to 1 man in the green tea catechin group. The findings suggest that green tea catechins may lower the risk of prostate cancer in patients at high risk for the disease. Two year follow-up showed that this effect was long-lasting. A larger, multicenter trial is underway.
Clinical trials of treating prostate cancer
Clinical trials designed to study whether green tea is useful in treating prostate cancer have shown the following:
Patients scheduled to undergo radical prostatectomy were assigned to drink green tea, black tea, or soda five times/ day for 5 days. Bioavailable tea polyphenols were found in prostate tissue samples of patients who drank either green tea or black tea. In addition, prostate cancer cells treated with blood taken from patients after they drank tea grew and divided more slowly than cells treated with blood taken from patients before they drank tea.
Fifty patients scheduled to undergo radical prostatectomy were assigned to take Polyphenon E (800 mg EGCG) or a placebo daily for 3 to 6 weeks. Patients treated with Polyphenon E had lower blood levels of prostate specific antigen (PSA) and insulin-like growth factor -1 (a protein linked with increased risk of prostate cancer) than patients treated with placebo, but these differences were not meaningful. The findings suggest that the possible anticancer effects of green tea polyphenols may need to be studied in longer treatment trials.
A small group of hormone-refractory prostate cancer patients were given capsules of green tea extract (375 mg of polyphenols/ day) for up to 5 months. The study showed that the green tea treatment was well tolerated by most of the patients. However, no patient had a meaningful decrease in PSA levels and all 19 patients had disease progression within 1 to 5 months.
Patients with androgen-independent prostate cancer that had spread to other places in the body consumed green tea (6 grams / day). Of the forty-two participants, one had a meaningful decrease in blood PSA levels which did not last longer than 2 months. Green tea was well tolerated by most of the study patients. However, there were 6 reports of serious side effects, including insomnia, confusion, and fatigue. The findings suggest that green tea may have limited benefits in patients with advanced prostate cancer.
Green tea has been well tolerated in clinical studies of patients with prostate cancer. One study found that the most commonly reported side effects of green tea were gastrointestinal symptoms. These were mild except for two reports of severe anorexia and moderate breathing problems. There is evidence that consuming 10 or more cups of green tea/ day for long periods of time does not cause ill effects and that any side effects that do occur are due to caffeine content in the tea.
The U.S. Food and Drug Administration has not approved the use of green tea as a treatment for cancer or any other medical condition.
Green tea is available in the United States in food products and dietary supplements. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made.
Current Clinical Trials
Check NCI's list of cancer clinical trials for CAM clinical trials on green tea for prostate cancer and green tea extract for prostate cancer that are actively enrolling patients.
General information about clinical trials is also available from the NCI Web site.
Lycopene is a carotenoid (a natural pigment made by plants). Lycopene protects plants from stress and helps them use the energy of the sun to make nutrients. Lycopene is found in fruits and vegetables like tomatoes, apricots, guavas, and watermelons.
The main source of lycopene in the American diet is tomato-based products. Lycopene is more bioavailable (easier for the body to use) in processed tomato products like tomato paste and tomato puree than in raw tomatoes.
Eating carotenoids, including lycopene, along with dietary fat may help the body absorb them. For example, one study showed that more lycopene was absorbed from diced tomatoes cooked with olive oil than diced tomatoes cooked without olive oil.
Lycopene in the diet may affect antioxidant activity and communication between cells. Laboratory and animal studies have shown that lycopene may help lower the risk of prostate, skin, breast, lung, and liver cancers. However, clinical trials of whether lycopene lowers cancer risk have shown mixed results.
Lycopene may be consumed in the diet or taken in dietary supplements.
Laboratory research and animal studies have been done to find out if lycopene may be useful in preventing or treating prostate cancer.
Studies of lycopene in the laboratory have shown the following:
Studies of animal models of prostate cancer treated with lycopene have shown the following:
Several population studies and clinical trials have been done to find out if lycopene may be useful in preventing or treating prostate cancer.
Population studies look for risk factors and ways to control disease in large groups of people. Population studies of prostate cancer risk have shown the following mixed results:
Clinical trials designed to study whether lycopene is useful in preventing prostate cancer have shown the following:
Clinical trials designed to study whether lycopene is useful in treating prostate cancer have shown the following:
Lycopene has been consumed by prostate cancer patients with very few side effects in many clinical trials. Doses ranging from 10 to 120 mg/ day have caused only occasional gastrointestinal symptoms (e.g. diarrhea, nausea and vomiting, bloating, gassiness and stomach irritation). In one study, symptoms went away when lycopene was taken with meals.
The U.S. Food and Drug Administration has not approved the use of lycopene as a treatment for cancer or any other medical condition.
Lycopene is available in the United States in food products and dietary supplements. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made. An FDA review in 2007 found that there was not enough evidence to allow a claim that lycopene helps lower cancer risk.
Check NCI's list of cancer clinical trials for CAM clinical trials on lycopene for prostate cancer that are actively enrolling patients.
Pectin is a type of polysaccharide (a carbohydrate with many small sugar molecules that are chemically linked). Pectin is found in the cell walls of most plants and has gel-like qualities that are useful in making many types of food and medicine.
Citrus pectin is found in the peel and pulp of citrus fruits such as oranges, grapefruit, lemons, and limes. Citrus pectin can be modified with high pH and heat to break its molecules into smaller pieces. Modified citrus pectin (also called MCP) can be digested and absorbed by the body.
MCP may be taken by mouth in powder or capsule form.
A study in prostate cancer cells compared 3 different kinds of pectin: citrus pectin, PectaSol (a dietary supplement with MCP), and fractionated pectin powder. Prostate cancer cells treated with the pectin powder had more damage than those treated with citrus pectin or PectaSol. However, when citrus pectin was modified by heating it, it caused the same amount of damage to prostate cancer cells as the pectin powder.
Only a few studies have reported the effects of MCP in animal models of cancer, including one prostate cancer study. Rats injected with prostate cancer cells and treated with MCP showed less spread of the cancer to the lungs but no effect on tumor growth at the original cancer site.
A few studies in prostate cancer patients suggest that MCP may have some anticancer benefits.
In a study of patients with advanced solid tumors, including prostate cancers, MCP powder in water was given 3 times/ day for at least 8 weeks. The study showed some quality of life improvements in physical functioning, overall health, fatigue, pain, and insomnia. About one-fourth of patients showed stable disease after 8 weeks of treatment and a smaller number had stable disease for more than 24 weeks. Since the study did not include a group of patients who did not receive MCP for comparison, it was not designed to be able to tell if any of these changes were due to the addition of MCP. The primary goal of the study was to determine if MCP would be well tolerated by cancer patients, and it was.
In a study of the effect of MCP on prostate-specific antigen (PSA) doubling time (how long it takes PSA levels in the blood to increase by 100 percent), prostate cancer patients who had rising PSA levels were given 6 PectaSol capsules 3 times/ day for 12 months. After treatment, 7 out of 10 patients showed a slowing of PSA doubling time.
Two studies of MCP showed that most patients had very few side effects. Itching, stomach upset, and gassiness were reported in one study. In another study, 3 patients had abdominal cramps and diarrhea that went away when their treatment was stopped.
The U.S. Food and Drug Administration has not approved the use of MCP as a treatment for cancer or any other medical condition.
MCP is available in the United States in food products and dietary supplements. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made.
Check NCI's list of cancer clinical trials for CAM clinical trials on modified citrus pectin for prostate cancer that are actively enrolling patients.
The pomegranate fruit (Punica granatum L.) is native to Asia and grown throughout the Mediterranean, Southeast Asia, East Indies, Africa, and the United States. Pomegranate has been used for medicinal purposes since ancient times.
Different parts of the pomegranate fruit have bioactive compounds (chemicals found in small amounts that have actions in the body that may promote good health). These include:
Pomegranate may be consumed in the diet or taken in dietary supplements.
Laboratory studies of pomegranate in cancer cell lines include the following:
Studies of animal models of prostate cancer in which the animals were given pomegranate have shown the following:
Two clinical trials that studied pomegranate in prostate cancer patients have been fully reported.
In a study of patients with rising prostate-specific antigen (PSA) levels after surgery or radiation therapy, patients were given 8 ounces of pomegranate juice daily for up to 33 months. Drinking pomegranate juice was related to a slowing of PSA doubling time (how long it takes PSA levels in the blood to increase by 100 percent). In addition, when prostate cancer cells (LNCaP) in the lab were treated with study patients' blood before and after the study, there was a decrease in cell growth and increase in cell death following pomegranate treatment.
In a study of patients with rising PSA levels after therapy for localized prostate cancer, patients were given 1 gram or 3 gram doses of pomegranate extract. Both doses of pomegranate extract were related to a slowing of PSA doubling time.
Two studies of pomegranate juice in either prostate cancer patients or patients with erectile dysfunction reported no serious side effects.
Some pomegranate products may contain added sugar. Certain groups, such as the American Institute for Cancer Research (AICR), recommend avoiding sugary drinks. For more information, see the AICR website.
The U.S. Food and Drug Administration has not approved the use of pomegranate as a treatment for cancer or any other medical condition.
Pomegranate is available in the United States in food products and dietary supplements. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made.
Check NCI's list of cancer clinical trials for CAM clinical trials on pomegranate-extract pill for prostate cancer, pomegranate juice for prostate cancer, and pomegranate liquid extract for prostate cancer that are actively enrolling patients.
The soybean plant has been grown in Asia for food since ancient times. Soy first arrived in Europe and North America in the 18th century. The soybean can be processed into a wide variety of products including soy milk, miso, tofu, soy flour, and oil.
Soy foods contain many phytochemicals that may have health benefits. Isoflavones are the most widely researched compounds in soy. Major isoflavones in the soybean include genistein (which may be the most bioactive isoflavone), daidzein, and glycitein. Isoflavones protect the soybean plant from stress and have antioxidant, antimicrobial, and antifungal actions.
Isoflavones are phytoestrogens (estrogen -like substances found in plants) that attach to estrogen receptors in cells. Genistein has been shown to affect many pathways in prostate cancer cells involved in the growth and spread of cancer.
Soy may be consumed in the diet or taken in dietary supplements.
Laboratory research and animal studies have been done to find out if soy may be useful in preventing or treating prostate cancer.
Studies of soy in the laboratory have shown the following:
Studies of animal models of prostate cancer treated with soy have shown the following mixed results:
Many population studies and clinical trials have been done to find out if soy may be useful in preventing or treating prostate cancer. Soy products studied include dietary supplements, drinks, and bread.
Population studies look for risk factors and ways to control disease in large groups of people. Population studies of soy intake and prostate cancer risk have shown the following:
Clinical trials of preventing prostate cancer
Soy products and isoflavones have been consumed by prostate cancer patients with very few side effects in many clinical trials. The most commonly reported side effects were minor gastrointestinal symptoms.
The U.S. Food and Drug Administration has not approved the use of soy as a treatment for cancer or any other medical condition.
Soy is available in the United States in food products and dietary supplements. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made.
Check NCI's list of cancer clinical trials for CAM clinical trials on soy isoflavones for prostate cancer and soy protein isolate for prostate cancer that are actively enrolling patients.
Zyflamend is a dietary supplement that contains 10 different herbs. Zyflamend contains extracts of rosemary, turmeric, ginger, holy basil, green tea, hu zhang (Polygonum cuspidatum, a source of resveratrol), Chinese goldthread, barberry, oregano, and Baikal skullcap.
The extracts found in Zyflamend have anti-inflammatory activity and possible anticancer benefits. There is limited evidence about how Zyflamend may act against tumor growth. Zyflamend has been shown to interfere with the activity of COX-1 and COX-2 enzymes, which are involved in the development of inflammation and possibly cancer. Zyflamend may also act against the NF-kappa B and lipoxygenase (LOX) families of proteins that stimulate tumor growth.
Zyflamend is taken as a dietary supplement in capsule form.
Laboratory and animal research has recently been done to study the effects of Zyflamend in cancer.
Studies of Zyflamend in the laboratory have shown the following:
Studies of Zyflamend in animal models of cancer have shown the following:
A report of one patient with high-grade prostatic intraepithelial neoplasia (HGPIN) who received Zyflamend 3 times/ day for 18 months showed that PSA levels were not affected. However, at the end of 18 months of treatment, repeat biopsies of the prostate did not show HGPIN or cancer.
In a phase I safety study of Zyflamend, patients with HGPIN took Zyflamend (780 mg) 3 times/ day for 18 months with additional dietary supplements (probiotic supplement, multivitamin, green and white tea extract, Baikal skullcap, docosahexaenoic acid, holy basil, and turmeric). Zyflamend and the added dietary supplements were well tolerated and there were no serious side effects. At the end of 18 months of treatment, more than half of patients had benign biopsy results, about one-fourth had HGPIN, and about one in 8 had prostate cancer.
A phase I safety study of Zyflamend (described above) reported no toxicity or serious side effects. Some of the patients had mild heartburn that went away when Zyflamend was taken with food.
The U.S. Food and Drug Administration has not approved the use of Zyflamend as a treatment for cancer or any other medical condition.
Zyflamend is available in the United States as a dietary supplement. Because dietary supplements are regulated as foods, not as drugs, FDA approval is not required unless specific claims about disease prevention or treatment are made.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes were made to this summary to match those made to the health professional version.
Complementary and alternative medicine (CAM)—also referred to as integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.
Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.
Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.
It is important that the same rigorous scientific evaluation used to assess conventional approaches be used to evaluate CAM therapies. The National Cancer Institute (NCI) and the National Center for Complementary and Alternative Medicine (NCCAM) are sponsoring a number of clinical trials (research studies) at medical centers to evaluate CAM therapies for cancer.
Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have undergone rigorous evaluation. A small number of CAM therapies originally considered to be purely alternative approaches are finding a place in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) Consensus Conference in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful.
The NCI Best Case Series Program, which was started in 1991, is one way CAM approaches that are being used in practice are being investigated. The program is overseen by the NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients' medical records and related materials to OCCAM. OCCAM conducts a critical review of the materials and develops follow-up research strategies for approaches deemed to warrant NCI-initiated research.
When considering complementary and alternative therapies, patients should ask their health care provider the following questions:
National Center for Complementary and Alternative Medicine (NCCAM)
The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.
CAM on PubMed
NCCAM and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the Web sites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.) CAM on PubMed is available through the NCCAM Web site. It can also be accessed through NLM PubMed bibliographic database by selecting the "Limits" tab and choosing "Complementary Medicine" as a subset.
Office of Cancer Complementary and Alternative Medicine
The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI Web site.
National Cancer Institute (NCI) Cancer Information Service
U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.
Food and Drug Administration
The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.
Federal Trade Commission
The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
Images in the PDQ summaries are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in the PDQ summaries, along with many other cancer-related images, are available in Visuals Online, a collection of over 2,000 scientific images.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2013-01-10
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
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