Vitamin And Mineral Supplements
Multiple U.S. cancer organizations do not recommend the usage of single supplements for prevention of cancer or cancer progression. Observational evidence suggests that some supplements may do more harm than good . Still, certain groups, such as individuals with vitamin D deficiency, may benefit from supplementation. The Physicians Health Study II found no prostate cancer mortality benefit among healthy men with the use of multivitamins, vitamin C, or vitamin E.
Localized prostate cancer.
Selenium may downregulate genes involved in tumorigenesis. However, one RCT did not report an improvement in PSA velocity in active surveillance patients assigned to take a daily selenium supplement. In fact, those taking the highest dose of selenium and had the highest baseline selenium had a statistically significant increase in PSA velocity compared the placebo group .
Advanced prostate cancer.
One non-randomized trial among men with mCRPC reported that after 12 weeks of weekly 60g intravenous ascorbic acid infusion, PSA actually increased by a median of 17ng/ml. There was also a high frequency of adverse events.
A future direction for supplement studies includes exploring their interaction with conventional therapies. For example, one study is investigating PSA changes among mCRPC patients treated with docetaxel with or without vitamin C .
Evaluation Of Cam Therapies
It is important that the same scientific methods used to test conventional therapies are used to test CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health are sponsoring a number of clinical trials at medical centers to test CAM therapies for use in cancer.
Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a 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 been tested using demanding scientific methods. A small number of CAM therapies that were thought to be purely alternative approaches are now being used in cancer treatmentnot 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 meeting in November 1997, acupuncture has been found to help control nausea and vomiting caused by chemotherapy and pain related to surgery. However, some approaches, such as the use of laetrile, have been studied and found not to work and to possibly cause harm.
What Are The Side Effects Of External Beam Radiotherapy
Like all treatments for prostate cancer, radiotherapy can cause side effects. These will affect each man differently, and you might not get all the possible side effects. Sometimes bowel, urinary and sexual problems after radiotherapy treatment are called pelvic radiation disease.
Side effects happen when the healthy tissue near the prostate is damaged by radiotherapy. Most healthy cells recover so side effects may only last a few weeks or months. But some side effects can start months or years after treatment. These can sometimes become long-term problems. Before you start treatment, talk to your doctor, nurse or radiographer about the side effects. Knowing what to expect can help you deal with them.
If you have hormone therapy as well as radiotherapy, you may also get side effects from the hormone therapy. Read more about the side effects of hormone therapy and how you can manage them.
If youre having radiotherapy as a second treatment, and you still have side effects from your first treatment, then radiotherapy can make those side effects worse or last longer. It may also cause other side effects. The most common side effects of radiotherapy are described here.
Short-term side effects of radiotherapy
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Radiopharmaceuticals That Target Psma
Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.
Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.
This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.
This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.
Possible side effects
Some of the more common side effects of this drug include:
This drug can lower blood cell counts:
- A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
- A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
- A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.
This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.
Should I Use Supplements Or Herbal Remedies
Some people like to use dietary supplements or herbal remedies, but theres little evidence theyre helpful for men with prostate cancer. Some may even be harmful.
Theres little evidence that supplements are helpful for men with prostate cancer. Some supplements may interfere with your treatment for prostate cancer, so let your doctor or nurse know if youre taking any.
Most people should be able to get all the nutrients they need by eating a balanced diet, without taking supplements. If you do choose to take supplements, dont take more than the recommended daily allowance for each nutrient because large doses could be bad for your health.
Some men may need to take specific supplements. For example,
- Vitamin D. Between October and March, try to take 10 micrograms of vitamin D supplements every day. This is because during these months, there is not enough sunlight in the UK for your body to produce enough vitamin D.
- Calcium. If youre on hormone therapy, your doctor might recommend calcium supplements.
Some men like to take herbal medicines to help manage their prostate cancer or the side effects of treatment. For example, some men drink sage tea to help with hot flushes. But there is very little evidence that herbal remedies can help to treat prostate cancer or reduce side effects.
Herbal supplements being tested
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The Initial Causes Diet During Radiation Therapy For Prostate Cancer
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
Include Fiber In Your Diet
Fiber is an important part of your diet because it:
- Helps regulate bowel movements and prevent constipation.
- Provides a feeling of fullness.
- Helps with weight loss.
- Can lower the risk for diabetes, heart disease, and obesity.
Plant foods are the best sources of fiber. In addition to fruits and vegetables, eating a variety of whole grains, cereals, legumes , nuts, and seeds can provide the fiber you need.
Read your food labels carefully to find out if the foods you choose have whole grains. Food labels must have the word whole right before the name of the grain. For example, when choosing a wheat bread or pasta, the label must read whole wheat, not enriched wheat flour.
Here are some tips to get more fiber and whole grains in your diet:
- Eat foods such as whole-wheat bread, brown rice, barley, whole oats, oatmeal, bran cereals, and popcorn.
- Try pancakes, muffins, or bread mixes made with whole-wheat or buckwheat flour.
- Choose a whole grain like barley and add a small amount of dried fruit or toasted nuts.
- Add beans to rice, pasta, salad, and soups.
- Choose fresh fruits and vegetables instead of juices.
Slowly increase how much fiber you eat and drink at least 8 glasses of liquids each day.
For more information on how to include fiber in your diet, read Food Sources of Fiber.
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Intensity Modulated Radiation Therapy
IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.
Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.
A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.
Limit Salt And Sodium
Eating foods with a lot of salt may raise your blood pressure and increase your risk for stroke, heart failure, and kidney disease. Eat less than 2,300 milligrams of sodium per day. Fresh food that isnt processed is usually lower in sodium.
Read food labels to find out the amount of sodium in the product. Choose foods that are labeled low sodium, very low sodium, or sodium-free.
Here are some tips to reduce how much sodium you eat:
- Dont add salt to food at the table.
- Pay attention to the ingredients. Sometimes the name of a food can be misleading. Lemon pepper, spice rubs, and adobo may contain large amounts of salt or other sources of salt, such as MSG .
- When cooking, flavor foods with fresh herbs and spices instead of salt.
- Limit canned foods.
- Limit packaged, processed, pickled, and cured foods.
- Be aware that both fast food and regular restaurant food can contain large amounts of salt.
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Be Prepared Stock Up On Healthy Foods
Another ingredient to a healthy diet during radiation therapy is to plan ahead.
- Stock up your pantry with diverse and healthy foods.
- Prepare and store healthy meals in your refrigerator and freezer before you begin therapy.
- Always have your favorite snacks available at work or on the go.
A small amount of pre-planning and preparation will make it easy to eat well even if you are not feeling your best.
How To Read Food Labels
The label below lists the nutritional content of a serving of macaroni and cheese. The arrows point to the boxes on the right, which explain what each line means.
Figure 3. How to read food labels
This food label shows that macaroni and cheese is high in total fat and saturated fat. Due to its high fat content, this food wouldnt be considered a healthy choice.
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Stereotactic Body Radiation Therapy
This technique uses advanced image guided techniques to deliver large doses of radiation to a precise area, such as the prostate. Because there are large doses of radiation in each dose, the entire course of treatment is given over just a few days.
SBRT is often known by the names of the machines that deliver the radiation, such as Gamma Knife, X-Knife, CyberKnife, and Clinac.
The main advantage of SBRT over IMRT is that the treatment takes less time . The side effects, though, are not better. In fact, some research has shown that some side effects might actually be worse with SBRT than with IMRT.
Tips For Nutrition During Cancer Treatment
- Maintain a healthy weight. For many men, this means avoiding weight loss by getting enough calories on a daily basis. For men who are overweight and are obese, this may mean losing some weight. If you are trying to lose weight, it should be moderate, meaning only about a pound a week.
- Get essential nutrients the body needs, such as protein, carbohydrates, fiber, vitamins, minerals, phytonutrients, such as carotenoids, and water. Not only will your body function better, you will feel better.
- Be as active as you can, such as taking a daily walk. If you sit or sleep too much, you may lose muscle mass and increase your body fat, even if you are not gaining weight.
If you are struggling to eat enough or are eating too much, nutrition counseling may help you get essential nutrients, such as protein, vitamins, and minerals into your diet and maintain a healthy body weight. Ask your health care team for a referral to a registered dietitian or nutritionist. Dietitians and other members of the health care team work with people to meet their nutritional needs.
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Strategies For Good Nutrition During Treatment
While dietary fat or added sugars are generally not restricted during treatment, there are many nutritious ways of increasing calories to prevent excess weight loss.
Eat small, frequent meals:
- Instead of three large meals a day, eat small amounts frequently throughout the day.
- Carry food with you at all times, so you can snack in the car, while waiting for treatment or to see your doctor, and at other opportunities.
Eat calorie-dense foods:
- Pick foods that pack a lot of nutrition into every bite, and include protein several times a day.
- Eat a variety of foods with many colors, textures and flavors. It’s important to include fruits and vegetables in addition to high-calorie and high-protein foods.
Avoid plain food:
- Before you eat or drink anything, ask yourself, “What can I add to give this more calories or protein?” Make each bite count.
Concentrate on soft and liquid foods:
- Soft and liquid foods are easier and less time-consuming to eat. For example, stirring in one tablespoon of creamy almond or peanut butter into hot cereal an add 90 calories to your meal.
Use supplemental nutrition drinks:
- Liquid supplements can increase your calorie and protein intake. They require no preparation and are easy to carry with you. You can also make your own shakes at home.
Weigh yourself regularly:
- Keep a weight log. If your weight goes down, increase your calorie and protein intake. For accuracy, always use the same scale.
Have a good attitude:
Moffitts Approach To Prostate Cancer
Nutritional guidance from experienced dietitians is just one component of prostate cancer care at Moffitt Cancer Center. The multispecialty team in our Urologic Oncology Program provides a full spectrum of supportive care and specialized clinical treatment in one location, eliminating the need for patients to travel to multiple clinics for the services they need. Our prostate cancer treatment team collaborates to develop individualized plans for each patient, then refines plans as necessary to ensure the best possible outcomes and improved quality of life.
If you would like to consult with a Moffitt oncologist about your prostate cancer treatment options or receive a second opinion, call or fill out a new patient registration form online. Our team prioritizes prompt response times and will contact you within 24 hours. We also offer comprehensive prostate cancer screening servicescontact Moffitt for more information.
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Proton Beam Radiation Therapy
Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.
Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.
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How Can Your Diet Help Manage Cancer Treatment Side Effects
Some dietary changes can help you manage side effects after your treatment begins. These side effects include:
- Appetite loss. Eat small meals or nutritious snacks throughout the day, rather than three large meals.
- Constipation. Drink plenty of water, consider a fiber supplement, and add veggies and beans to your meals.
- Diarrhea. Choose foods or drinks with sodium and potassium .
- Loss of taste. Knowing what to eat when you cant taste can be difficult. Consider trying new foods with different spices or marinades. You can also add strong flavors, such as lemon or lime juice.
- Nausea. Anti-nausea foods include citrus, ginger and peppermint oil. You can suck on a slice of lemon, drink ginger tea or eat ginger chews.
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