NEWSLETTER

No.7. November, 2002

1. REPORT OF THE MEETING HELD ON: Tuesday, 1 October

We were very pleased to welcome Ms Joanna Harnett to our October meeting and to hear her talk to us on Eating Well with Prostate Cancer - Diet and Nutrition. Joanna is trained in naturopathy, and works at the Northern Beaches Care Centre, Mona Vale with four General Practitioners specialising in natural health approaches. Her presentation was extremely interesting, informative and highly practical.The following points include notes taken at the meeting and also provided by Joanna subsequently:

Joanna introduced her topic by giving us a background to certain physiological and medical aspects of prostate disease. She made the

following five points:

1. Hormones play a role in the development of prostate cancer. Testosterone levels tend to fall after the age of 50 as prolactin, estradiol, sex hormones binding ligand, leutinizing hormone and FSH levels all increase. Prolactin increases the intake of testosterone by the prostate. The end result is an increased intra-prostatic concentration of dihydrotestosterone (DHT) due to its increased production and decreased removal. Increases in DHT are associated with increased risk of coronary heart disease, prostatic hyperplasia (BPH, or benign prostate enlargement) and prostate cancer. DHT is what is called a metabolite of testosterone. The enzyme 5-alpha-reductase converts testosterone to dihydrotestosterone. Testosterone enters the prostate cell and is converted to an active intermediate DHT which stimulates growth, protein synthesis and prostaglandin (PG) release in cells. As PGs compete for testosterone, binding sites in a feedback regulatory mechanism, a decline in the synthesis of the PGs with age may result in loss of inhibitory control. The only eicosanoid produced in significant amounts in BPH and prostate cancer is PGE2. Estrogen inhibits the hydroxylation of these active hormones (testosterone and DHT) which then activates the benign prostatic growth (BPH). A family history of BPH or prostate cancer or elevated PSA suggests increased 5-alpha-reductase activity and/or reduced DHT detoxification through phase 1 detoxification glucuronidation pathways.

2. Another initiator is exposure to cadmium from cigarette smoke, some batteries, and air pollution. Cadmium increases the activity of

5-alpha-reductase. Zinc helps the body remove cadmium as well as inhibiting 5-alpha-reductase.

3. Cholesterol metabolites (epoxy-cholesterols) as well as pesticides (dioxin, PCBs) accumulate in the hyperplastic (enlarged) or cancerous human prostate. Epoxy cholesterols initiate degeneration of prostate tissue. Decreasing cholesterol levels have been shown to improve this.

4. Infection and inflamation: It has been postulated that low-grade, non-invasive chronic or recurrent infection of the prostate with

E.Coli, with subsequent release of bacterial endotoxins, play a significant and contributive role in BPH. So, neutralising the endotoxins and reducing infection must play a role in treatment. The zinc ion is the prostate antibacterial factor, and its reduction in the prostate may potentiate this infection and inflamation with concomitant growth of prostate tissue.

Joanna then summarised some take-home practical implications based on the above five points.These are general cosiderations for prostate health, and Joanna emphasised that individual needs may vary. If you feel unwell or uncomfortable with any dietary changes you make, you should seek help from a qualified Health Care Practitioner.

A. Increase zinc-containing foods in your diet. BUT DO NOT TAKE SUPPLEMENTS OF ZINC UNLESS INSTRUCTED BY YOUR ONCOLOGIST OR DOCTOR. YOUR NEEDS ARE UNIQUE.

Foods that are good sources of zinc include: Beef, lamb and chicken (but eat no more that twice weekly as, unfortunately, the red meats and chicken can be high in cholesterol and possibly synthetic hormones; - and look for the organic registered NASAA/BFA chemical-free guarantee), oysters, pumpkin seeds (ground), sunflower seeds (also rich in vitamin E, but keep airtight in the frig as it can go rancid)

almonds, egg yolk (not fried, scrambled or baked, and no more than 2-3 per week due to cholesterol), ginger (grated over salads, or as a tea, or used in stir fries; but it should not be used with warfarin as it has a blood thinning effect), and wholegrains (especially rye and oats).

B. Increase Omega-3-containing fatty acids in the diet Good sources of Omega-3 oils include: Salmon, mackerel, herring, tuna (but this is a possible source of mercury), swordfish, sardines, pumpkin seeds (but make sure they taste fresh, not bitter or rancid). Aim for 3-4 fish meals per week. Pan fry, steam, bake in foil, or grill.

C. Eat foods that contain selenium Do not take supplements of selenium unless prescribed by your attending doctor. (It is potentially toxic.) Tuna, oysters, mushrooms, cottage cheese (low fat), cabbage and other cruciferous vegetables, zucchini, chicken, garlic (also a cholesterol reducer and blood thinner), fish, wholegrain cereals (especially oats and rye).

D. Eat a minimum of five different vegetables daily. People on plant-based diets appear to reduce risks of cancers in general. All vegetables are great steamed or raw. Root vegetables can be baked in olive oil or used in soups. Beetroot plays a specific role in helping the liver, so consume this vegetable regularly; grate it with lemon, carrot or coconut. Don't underestimate the importance of eating vegetables: try to eat at least five different veges a day.

E. Eat fruits or vegetables high in lycopene.Tomatoes (cooked tomatoes appear to have higher concentrations of lycopene), tomato sauce/paste/concentrate/juice, watermelon.

F. Limit or, ideally, avoid alcohol.

G. Reduce saturated fat intake and transfatty acid intake. Use tahini, avocado, almond nut butter, or homos as spreads, and avoid margarines. If using butter, use it sparingly and only occasionally. Use olive oil in cooking. Obtain good oils from fish, raw nuts and seed sources (as in the omega 3 section).

In conclusion, the approach to diet should be prevention rather than cure. Look for balance and variety. Finally, try to do it right, but do it

well if you do it wrong - and be happy!

2. CORRECTION

There are two errors that require correction in the report in the October Newsletter of Dr Michael Lowy's talk on 3 September. In the second last paragraph on page 3 it is stated that it is not possible for Dr Lowy to receive referrals at St Luke's. On the contrary, he is very happy to receive referrals.The phone number for the Australian Centre for Sexual Health at St Luke's Hospital is 9357 2111.The second error is the phone number: 9280 0084.This number relates to the consumer help line: Impotence Australia. It is not connected to the St Luke's Clinic, and is for phone advice only. Our apologies to Dr Lowy for these errors.

3. NORTHERN BEACHES RELAY FOR LIFE

The NSW Cancer Council's Relay for Life is probably well know to many of you. It began in Sydney in 2000, and this year is being staged in 25 communities around the State. It will come to the Northern Beaches at Brookvale Oval on Saturday, 9 November, starting at 10.00am and finishing at 10.00am on Sunday, 10 November.

The Relay for Life is a 24 hour outdoor event where teams of 10 to 15 people take turns walking (or running) around the Oval to raise funds for cancer research. A festival-style atmosphere is created around the event, enabling the entire community to become involved, support the participants, raise money, and have fun. The Survivors Walk andThe Candlelight Ceremony of Hope are two definite highlights of any Relay for Life.

The first lap of every Relay for Life is set aside especially for the Survivors Walk. This is a ceremonial lap of honour for cancer survivors and their carers (who do not need to be members of a team). The Candlelight Ceremony of Hope is held on dusk at each event. Messages to loved ones are written on paper bags with candles placed inside. The glowing bags are then placed around the track and glow through the night. The setting sun, a minute's silence, and beautiful music combine to make this ceremony a very memorable experience.

An 11 minute video on the Relay for Life will be shown at our November Meeting. Members of the Northern Beaches Prostate Cancer Support Group are invited to attend the Opening Ceremony and Morning Tea on Saturday, 9 November, from 9.30am to 10.45am at the Brookvale Oval. This is a worthy cause, and it is hoped that as many of you as possible will attend (not necessarily as part of a team) and give your support to the event. We are intending to have a Prostate Cancer Information Booth at the Oval. You might even inspire your friends, family and carers to form a team!!

4. RESEARCH: SURVEY OF PROSTATE CANCER SUPPORT GROUPS

A survey of members of prostate cancer support groups across the country is currently underway. The aim of the survey is to help understand who attends support groups, and how these groups are helpful - or even unhelpful, and how they can best meet the needs of men with prostate cancer.The project is being conducted jointly by the Australian Prostate Cancer Collaboration Education Committee and the Prostate Cancer Foundation of Australia.

A Survey Form is included with this month's Newsletter and you are strongly encouraged to fill in the form and return it in the enclosed

stamped, addressed envelope. It will take about 35 minutes of your time. Participation is entirely voluntary and the information you provide will be treated with complete confidentiality. If you want further information about the Survey, you will find in the material the telephone numbers of persons concerned with the Project whom you can contact.

5. PCFA LAPEL BADGES

The Prostate Cancer Foundation of Australia has produced a small and smart lapel badge bearing the words Finding the Answers Together and the Foundation's sunflower logo. The cost is only $4.00 and badges can be obtained at the sign-in desk at each meeting. Proceeds go towards the work of the Foundation.

6. WEBSITES

Professor Bruce Barraclough of the Royal North Shore Hospital is in the process of preparing a website to provide information for men with prostate cancer. He is interested to gain as much input as possible as to the kind of information that would be helpful. If you have any ideas or suggestions, please ring the RNSH on 9926 7111 and ask for Professor Barraclough or his secretary, or pass on your ideas to me (J.C.).

7. REMINDERS: Dates of coming meetings (All meetings are held in the Palliative Care Cottage, Mona Vale Hospital)

i). November Meeting (6.30pm, Tues., 5 November): Treatment Side effects - Incontinence and Soiling. The speaker will be Sr Judy

Tarlington, Special Registered Nurse, Mona Vale Hospital. Also Relay for Life video.

ii) December Meeting (6.30 pm, Tues., 3 December): Christmas Barbecue and Open Discussion.

All friends, partners, carers, and family are welcome at all our meetings. (Refreshments served.)

YOUR CONTACT NUMBERS

Program Co-ordinator Dr Peter Moore Northern Beaches Palliative Care 9997 3555	Group Leader John Conroy 9918 9358 conroyjs@bigpond.com
NSW Cancer Council Cancer Support Helpline 13 11 20	Prostate Cancer Foundation of Australia 1800 220 099