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Prostate Cancer and Plant Based Nutrition
1. A presentation at NAVS
Summerfest 6/29/12
Stephan Esser MD
www.esserhealth.com
2. Prostate CA and Plant-Based
Nutrition
Stephan Esser MD
www.esserhealth.com
3. Goals
• Review definitions and tenets
• Overview of the Statistics
• Visit the classroom: anatomy,
physiology
• Brief review of Prostate cancer
• Engage Plant-based Nutrition
• Set Goals
4. NOT Goals
• Personal recommendations for
screening or treatment
• Updates on surgical techniques
• Intro to alternative treatments
5. By the end you will……
• Know more about cancer development
• Know what the prostate is and what it does
• Know signs and symptoms of cancer
• Be familiar with the evidence for plant-based
nutrition as it relates to PrCa
• Be equipped to make educated decisions
regarding your health
6. Definition
– Etymology: Middle English, from Latin, literally,
crab; akin to Greek karkinos crab
– a northern zodiacal constellation between Gemini and Leo b (1) :
the fourth sign of the zodiac in astrology
– A malignant tumor of potentially
unlimited growth that expands locally
by invasion and systematically by
metastasis
– Something evil or malignant that spreads destructively
7. “Cancer is a term used for diseases in
which abnormal cells divide
without control and are able to
invade other tissues.”
8. Levels of the Organism
• Atomic: Oxygen
• Molecular: DNA
• Organelle: Nucleus of the cell
• Cellular: Cell
• Tissue: Cells function together
• Organ: multiple Tissues work together
• Organ System: respiratory, circulatory etc.
• Organism: Human Being
9.
10. Cell Cycle
G1: Growth and
function
S: DNA Replication
G2: Preparation
M: Mitosis
12. Cell Cycle
G1: Growth and
function
S: DNA Replication
G2: Preparation
M: Mitosis
13. Cancer Operatives
• 1: Failure to slow/block abnormal growth
• 2: Acceleration of growth (ie: to an abnormal
level)
14.
15. Cancer Subtypes
• Carcinoma: skin or tissues that line/cover
internal organs
• Sarcoma: begin in bone, cartilage, fat, muscle
blood vessels or other connective tissues
• Leukemia: blood forming tissue. Eg: bone
marrow
• Lymphoma/Myeloma: cells of the immune
system
• Central Nervous System: in the brain and spinal
cord
16. Valuable Terminology
• Staging: evaluates the extent of a
persons cancer
• Grading: how abnormal a tumor looks
under a microscope
17. What we know!
• Cancer is an abnormal state of the cell
• It is often caused by dysfunction in the cell
cycle
• Overgrowth/inappropriate growth at the
cellular level = dysfunction at the
tissue/organ = dysfunction at the organism
level
22. In Review
• Cancer is the 2nd leading cause of death
• Prostate Cancer is the 2nd leading cause of
cancer death in men
• Cancer risk is quite significant
27. Development
• 11th-12th week of gestation
• Exponential growth during puberty
– 2ndary to androgens (testosterone and derivatives)
• Quiescent till 4th decade, then grows
28. Physiology
• Function:
– Exocrine gland which produces a milky white
slightly alkaline fluid
– Expelled into the urethra
– This comprises about 20-30% of ejaculate volume
– K, Zinc, Citric Acid, Fructose, free amino acids etc
– Also release Prostate Specific Antigen (PSA)
• Thins cervical mucus and allows sperm to swim more
freely
29. Prostate Cancer Symptoms
• Early: none
• Late: So does BPH
– Weak stream
– Increased frequency/hesitancy/urgency
– Blood in urine or semen
– Leg Swelling
30. To screen or not to screen
• Early: none
• Basic: Digital Rectal Exam
• Laboratory: 1980’s PSA, by 2001 75% of men
over 50 y/o were being screened
• USPTF:
– A shift……
31. Is screening always good?
Autopsy series suggest that 30%
• 1986 men older than 50 years of
of – 2005
– 1 million men received surgery, radiation therapy or both who
age and 70% of those older than test
would not have been treated without a P.S.A.
70 years of age have occult
– Of these 5,000 died soon after surgery and 10,000 to 70,000
suffered prostate cancer Most men more likely to
serious complications.
– 1/2 had persistent blood in their semen
die of other causes despite
– 200,000 to 300,000 suffered impotence, incontinence or both.
their diagnosis of PrCA
– Dr. Richard J. Ablin, founder of the PSA test has called its
widespread use a “public health disaster.”
34. Risk Factors
Non-Modifiable Modifiable
• Age >50/40 • # of Sexual partners
• Family History • Hx of STD’s
• Personal History • Vasectomy
• Race • Nutrition
AA>Hisp>White>Asian – Sat. Fat/Meat/Dairy
– Calcium
• Exercise: 10-30%
35. What we know
• Men who consume the highest amounts of
– Vegetables, fruits, beans, lentils etc risk
• 7th day Adventists/Less-Industrialized nations
– Meat, dairy, fiber-poor foods risk
• SAD
• Migration studies demonstrate ’d risk
– Asian men develop same risk for PrCA as white
men after 2-3 generations of migration to the US
37. Mechanisms for Development
• High blood androgen concentrations
• Increased blood levels of IGF-1 derived from
dairy
• Increased exposure to carcinogens released in
the heating of meats
• Low levels of ant-oxidant substances and fiber
38.
39.
40. Benefits of Plant-Based Foods
• ’d blood androgen concentrations
• ’d blood levels of IGF-1
• ’d exposure to carcinogens released in the
heating of meats
• ’d levels of ant-oxidant substances
• ’d fiber consumption
43. Prostate CA and Diet
• Dean Ornish et al Journal of Urology 2005
– Men with low-mod level of biopsy proven PCA
– 1 year on Ornish program or regular
– PSA 4% and 6% in controls
– Serum inhibited Prostate CA cell growth by 70% in
diet group and only by 9% in controls
44. Diet Changes Gene Expression
• Ornish et al PNAS 2008
– 31 men with biopsy proven PrCA
– 3 months of Ornish program
– Repeat biopsy
– 48 up-regulated and 453 down-regulated genes
– These genes shown to relate to cancer growth
and development
47. By the end you will……
• Know more about cancer development
• Know what the prostate is and what it does
• Know signs and symptoms of cancer
• Be familiar with the evidence for plant-based
nutrition as it relates to PrCa
• Be equipped to make educated decisions
regarding your health
48. What we know
• Prostate CA is a problem
• Plant-Based nutrition has minimal risk
• Plant-Based nutrition appears to reduce risk of
development and slow progression if present
Eat More Plants!
http://www.merriam-webster.com/dictionary/cancer I put the word cancer into google as a search and received 229,000,000 results.
http://www.cancer.gov/cancertopics/what-is-cancer
Tissue --> a bunch of cells working together on one job Organ --> lots of tissues working together Organ system --> a group of organs working together for a particular function Organism --> many organ systems working together
So here is our prototipical cell……..this illustration shows well the basic structural components of a cell. And it is at this level that I want to briefly discuss cancer. Trillions of cells = the body
G1: cell is synthesizing its structural proteins and enzymes to perform its functions. Notice the checkpoints on the cell and it’s function. These are moments when the cell is evaluated by RNA/DNA Check points: are proteins in the cytoplasm which making the key decision of whether the cell should divide, delay division, or enter a resting stage
Road Rage example…one hit…late for work…..two hits someone cuts us off….someone stressing us from home…etc….then we snap
G1: cell is synthesizing its structural proteins and enzymes to perform its functions. Notice the checkpoints on the cell and it’s function. These are moments when the cell is evaluated by RNA/DNA Check points: are proteins in the cytoplasm which making the key decision of whether the cell should divide, delay division, or enter a resting stage
The real cell cycle……likely even more complex than this….this is where the influence of a multitude of outside and internal factors can influence the health of the cell cycle. Alter any of these cell processes…those that limit the rate of cell multiplication or alter the self-checking potential or potential for apoptosis and the result will be abnormal growth
What is staging? Staging describes the extent or severity of an individual’s cancer based on the extent of the original (primary) tumor and the extent of spread in the body. Staging is important:Staging helps the doctor plan a person’s treatment.The stage can be used to estimate the person’s prognosis (likely outcome or course of the disease). Cancer cells divide and grow without control or order to form a mass of tissue, called a growth or tumor. As the tumor grows, it can invade nearby organs and tissues. Cancer cells can also break away from the tumor and enter the bloodstream or lymphatic system. By moving through the bloodstream or lymphatic system, cancer can spread from the primary site to form new tumors in other organs. The spread of cancer is called metastasis Tumor (T) TX Primary tumor cannot be evaluated T0 No evidence of primary tumor Tis Carcinoma in situ (early cancer that has not spread to neighboring tissue) T1, T2, T3, T4 Size and/or extent of the primary tumor Regional Lymph Nodes (N) NX Regional lymph nodes cannot be evaluated N0 No regional lymph node involvement (no cancer found in the lymph nodes) N1, N2, N3 Involvement of regional lymph nodes (number and/or extent of spread) Distant Metastasis (M) MX Distant metastasis cannot be evaluated M0 No distant metastasis (cancer has not spread to other parts of the body) M1 Distant metastasis (cancer has spread to distant parts of the body)
Dysfunction may be excess stimulus of growth, failure to slow growth or the like.
Approx. 1,300,000 new cases per year www.cdc.gov/.../mmwrhtml/ figures/m846qsf.gif www.ncbi.nlm.nih.gov/ bookshelf/picrender.fcgi.. http://www.ctahr.hawaii.edu/CS/blogs/sustainable_agriculture/cdc_logo(2).jpg
Unfortunately 1 million plus American’s die from cancer every year as well. And of these you can see the break down on the side. Notice the distribution. Although breast cancer was far more common than Lung cancer, lung cancer tends to be much more aggressive cancer and causes greater mortality as a result.
Knobil and Neill's Physiology of Reproduction, Volume 1 By Ernst Knobil, Jimmy D. Neil
Autopsy series suggest that 30% of men older than 50 years of age and 70% of those older than 70 years of age have occult prostate cancer
Autopsy series suggest that 30% of men older than 50 years of age and 70% of those older than 70 years of age have occult prostate cancer
Brother with PRCa doubles your risk Age >50 in whites and 40 in blacks Exercise may decrease risk of more aggressive PCA…. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476014/ http://ukpmc.ac.uk/abstract/MED/7621474 http://www.annals.org/content/118/10/793.short http://www.ncbi.nlm.nih.gov/pubmed/15157121 http://www.ncbi.nlm.nih.gov/pubmed/15668508 http://jjco.oxfordjournals.org/content/35/11/690.full The biological reasons for this association are unclear, but hypotheses include the effects of meat on hormone profiles, the paucity of anticarcinogenic phytochemicals in high-meat diets, and the potentially carcinogenic effects of compounds generated during hightemperature meat cooking.
http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(19890801)64:3%3C598::AID-CNCR2820640306%3E3.0.CO;2-6/abstract Dairy and PR CA Risk: http://www.nature.com/bjc/journal/v98/n9/abs/6604331a.html Risk post migration: http://ukpmc.ac.uk/abstract/MED/9858325
Road Rage example…one hit…late for work…..two hits someone cuts us off….someone stressing us from home…etc….then we snap
