Cranberry RCT study

The good thing is that you get to drink the cranberry juice regardless :-). There are no losers in that study, but it would be great if your PSA doesn't go up in February! My wife thinks tart cherry juice might help her sleep and I've been very happy to join her in that ritual. (It has salicylic acid, the ingredient in aspirin.)
One bottle happened to be cranberry juice (the label in this case is almost identical) so that was a surprise, but if you do get that 22% average reduction I can't wait to hear, maybe we can drink that in the mornings?!

@handera
As long promoted Cranberry juice has been associated with reducing UTIs. I had not heard about the association with PSA numbers but makes sense if also helps with UTIs.

When I was being treated at UFHPTI they took me off all my supplements but asked me to drink cranberry juice. They said their research was showing helpful preventing UTIs.

As you know UTIs are not uncommon when getting radiation treatments and/or going through RP.

UFHPTI is big on research and just got a 25 million dollar grant (I am in that research study) on photon and proton radiation treatments of PC. They provided me research on supplements and PC. Several studies showed that supplements help protect prostrate cells from oxidation and damage.

With that study they started following and were concerned with if supplements were protecting normal prostate cells from radiation they would also protect the cancer cells. The main radiation treatments for PC are to damage PC cells as prevents them from reproducing. Normal PC cells can recover from radiation and reproduce (all this per UFHPTI not me as not a medical professional) or reducing damage to them which is the goal of radiation.

One study showed possible relationship to protecting cancer cells and others showed they did not. So UFHPTI aired on and association of protecting cancer cells during treatments and asked me to stop taking any supplements. Funny they gave me a list of those supplements not to take and I was taking them all.

I had to stay off them two weeks prior to radiation, during radiation, and more 3 months after.

Their research mirrors your benefits of cranberry juice. I take the cranberry supplement even today 2.5 years after radiation.

Did you find (I did) the tart taste of the unsweetened one okay? I found it so strong got permission to take the supplemental. Was the type you drank sweetened with non sugar supplement? I like you would rather drink it so if you don't mind would like your feedback on my questions.

Interesting study.

The study summary indicated that the purpose of the study was to test “… an inverse association between cranberry supplementation and serum prostate specific antigen (PSA) in patients with negative biopsy for prostate cancer (PCa) and chronic nonbacterial prostatitis. This double blind placebo controlled study evaluates the effects of cranberry consumption on PSA values and other markers in men with PCa before radical prostatectomy.”

The conclusion was that “…Daily consumption of a powdered cranberry fruit lowered serum PSA in patients with prostate cancer.”

My question:
(1) Did the chronic prostatitis cause the elevated PSA?
(2) Does cranberry fruit simply help resolve prostatitis (which results in lower PSA)?
(3) Is this lower PSA indicative of improved PCa or simply relief from the prostatitis which caused the elevated PSA?
(4) Can this result be translated to men who don’t have prostatitis but only have positive biopsy for prostate cancer?

You’ll have to let us know your results.

@brianjarvis …and us the lowered PSA indicative if improved tumor markers? Initial studies said it was not, so it could be another Saw Palmetto rerun. Lower PSA, same old PCa..
Phil

@jc76

Regarding your UFHPTI comments, this study makes a similar observation, pointing out the concerning results of some "in vitro" studies:

"Findings from the above in vitro studies suggest that whole cranberry extract or at least 3 key types/categories of components, flavonols, proanthocyanidins or tri-terpenoids, are associated with biological alteration of cell targets and may be protective for PCa."

However, this randomized, double-blind, placebo control trial is much more pertinent to PCa men than "in vitro" studies and indicates:

"The down-regulation of serum PSA may be related to a trend to down-regulation of MSMB which has been reported to be androgen regulated. Unexpectedly, there was enhanced expression of PCA3 in the cranberry arm. The trend to downregulation of MSMB after cranberry supplementation is more reliable than upregulation of PCA3 due to the larger number of successful test results for both time points (19 for MSMB and only 8 PCA3 in the cranberry arm). Interestingly, 6/9 patients with downregulation of MSMB had also down-regulation of serum PSA. Furthermore, Martinez-Pinero et al. showed that urinary PCA3 is not a reliable marker of cancer stage or the response to androgen-deprivation therapy in advanced prostate cancer."

I believe this RCT was performed on men immediately before undergoing a RALP because of a previous study conducted on prostate cancer cells that were "androgen independent".

"Studies on the possible effects of cranberry and its components on prostate cancer were realized only in DU 145 human prostate cancer cells which are androgen independent. Treatment of cranberry proanthocyanidin- enriched fraction inhibited matrix metalloproteinase-2 and -9 (MMP) activity through the induction and/or inhibition of specific temporal MMP regulators. MMP activity is associated with tumor cell invasion and metastasis."

This led to this RCT's interesting conclusion:

"These data suggest that further studies to evaluate cranberry consumption as a prophylactic against the bio-chemical recurrence of prostate cancer in patients after surgery is warranted."

It may be that cranberry consumption could help reduce a RALP man's tendency toward bio-chemical reoccurrence!

Regarding taste, 100% Ocean Spray unsweetened cranberry juice it is very tart (only 60 calories/8 oz, 9 grams of natural sugar and a good source of potassium)...the first couple times takes some getting use to....by day 3 I was looking forward to my 8 ounces of "fine wine"! I sip it like one would sip an excellent single malt scotch 🙂

All the best!

@brianjarvis

Actually, the purpose of "This double blind placebo controlled study" was ONLY to evaluate "the effects of cranberry consumption on PSA values and other markers in men with PCa before radical prostatectomy.

The authors indicate that their PREVIOUS study's purpose was related to "negative biopsy for prostate cancer (PCa) and chronic nonbacterial prostatitis"...this was not included in the purpose of this RCT.

It is not stated whether the 64 PCa men, who were part of this RCT, had chronic prostatitis. My guess is the most did not, although a certain level of BHP is likely to have been present in these men...but it was clearly not the purpose of this RCT to determine the prostatitis or BHP status of these men. Therefore, your questions (which are interesting questions) cannot be answered by this RCT.

We all know that EVERY natural AND active treatment means of attempting to controlling PCa spread is not guaranteed to work. In fact, as many as 20-40% of men who undergo RALP will experience BCR....so is that a reason not to undergo RALP....maybe....every man must decide and be convinced in his own mind what he is willing to do as a long term, sustainable set of actions toward dealing with his PCa.

@handera There are a number of studies looking at natural products for controlling PCa progression:
> fiber: https://clinicaltrials.gov/study/NCT06661044

> MCP: https://clinicaltrials.gov/study/NCT06661044

> (various dietary supplements): https://www.cancer.gov/about-cancer/treatment/cam/hp/prostate-supplements-pdq

Hopefully one of them will prove to be beneficial.

@brianjarvis @handera
I am learning a lot of cranberry juice and studies from you guys, thanks. I think I am going to change to drinking the juice versus the supplement I am taking. Thanks! It really added to me knowledge of cranberry supplements during radiation treatments.

Just to clarify UFHPTI asked me to drink cranberry juice to help prevent urinary tract infections (UTIs). It was not briefed for me to do to help prevent or treat the prostate cancer. The studies you mentioned really added to my understanding of possible benefits of cranberry juice.

UFHPTI provided me with research on the cranberry juice helping prevent UTIs. UTIs are one of the common side affects I could experience and studies had shown cranberry juice could help prevent UTIs. I had heard that before just from the day to day world of living not having PC radiation side affects . I just found the juice itself so tart asked if could take supplement and was told yes.

I thank you for information on cranberry juice and possible other factors on prostate cancer itself.

The studies and research shown to me about supplements helping to protect normal prostate cells in some studies could also help protect prostate cancer cells as well. They did not mention cranberry juice to me just as a possible reduction in chances of UTIs.

UFHPTI R/Os stated that UFHPTI moved to go with research and studies that were some pro and some saying negative side affects of taking certain supplements protecting PC cells as wells as normal cells to move to that they help protect prostate cancer cells as well and asked me to come off certain supplements.

This information was personal experience with being treated with proton radiation for PC and where that recommendation came from for me. I have not done any research myself on this so cannot reference and pro/con personally.

@brianjarvis

Thank you for these links! I will review them more thoroughly.

Being on AS, I’m always on the hunt for credible evidence regarding exercise and dietary protocols that have shown, via some level of scientific evidence (RCT’s being the best) to show a statistically significant lowering of known PCa progression related biomarkers.

I fully understand (and expect) that “natural methods” will never be absolutely conclusive for beneficial effect in PCa progression reduction,

However, when one runs into a favorable double blinded, placebo controlled RCT’s that shows clear PCa biomarker related beneficial effect, whether (as in this study) the PSA reduction was related to the elimination of chronic prostatitis, prostate size reduction (BHP), inflammation reduction, UTI elimination or a true slowing of PCa progression, I say “sign me up”.

@handera Those are all important efforts to look into.

I’m just personally cautious not to chase after every study - realizing that many things can cause PSA to fluctuate without having any impact on the PCa at all. Otherwise, I’d be desperately pumping myself full of supplements - some legitimate, some snake oil.

Just be cautious.