A presentation at NAVS Summerfest 6/29/12                 Stephan Esser MD                www.esserhealth.com
Prostate CA and Plant-Based          Nutrition                    Stephan Esser MD                   www.esserhealth.com
Goals• Review definitions and tenets• Overview of the Statistics• Visit the classroom: anatomy,  physiology• Brief review ...
NOT Goals• Personal recommendations for  screening or treatment• Updates on surgical techniques• Intro to alternative trea...
By the end you will……• Know more about cancer development• Know what the prostate is and what it does• Know signs and symp...
Definition– Etymology: Middle English, from Latin, literally,  crab; akin to Greek karkinos crab– a northern zodiacal cons...
“Cancer is a term used for diseases in     which abnormal cells divide   without control and are able to        invade oth...
Levels of the Organism•   Atomic: Oxygen•   Molecular: DNA•   Organelle: Nucleus of the cell•   Cellular: Cell•   Tissue: ...
Cell Cycle             G1: Growth and             function             S: DNA Replication             G2: Preparation     ...
Cancer Growth
Cell Cycle             G1: Growth and             function             S: DNA Replication             G2: Preparation     ...
Cancer Operatives• 1: Failure to slow/block abnormal growth• 2: Acceleration of growth (ie: to an abnormal  level)
Cancer Subtypes• Carcinoma: skin or tissues that line/cover  internal organs• Sarcoma: begin in bone, cartilage, fat, musc...
Valuable Terminology• Staging: evaluates the extent of a  persons cancer• Grading: how abnormal a tumor looks  under a mic...
What we know!• Cancer is an abnormal state of the cell• It is often caused by dysfunction in the cell  cycle• Overgrowth/i...
Basic Epidemiology
Mortality Statistics 2006-2007
Cancer deaths per year
Cancer RiskTotal 1:6
In Review• Cancer is the 2nd leading cause of death• Prostate Cancer is the 2nd leading cause of  cancer death in men• Can...
Mini- Med School
Anatomyhttp://healthinessbox.files.wordpress.com/2012/04/prostrate-health.jpghttp://www.cancer.gov/PublishedContent/Images...
Anatomy Cont’d http://healthinessbox.files.wordpress.com/2012/04/prostrate-health.jpg http://www.cancer.gov/PublishedConte...
Dysfunction• Prostatitis• Benign Prostatic Hypertrophy• Prostate Cancer
Development• 11th-12th week of gestation• Exponential growth during puberty  – 2ndary to androgens (testosterone and deriv...
Physiology• Function:  – Exocrine gland which produces a milky white    slightly alkaline fluid  – Expelled into the ureth...
Prostate Cancer Symptoms• Early: none• Late:   So does BPH  – Weak stream  – Increased frequency/hesitancy/urgency  – Bloo...
To screen or not to screen• Early: none• Basic: Digital Rectal Exam• Laboratory: 1980’s PSA, by 2001 75% of men  over 50 y...
Is screening always good?  Autopsy series suggest that 30%• 1986 men older than 50 years of    of – 2005   – 1 million men...
What Causes Prostate Cancer?
What causes any Cancer?• Loss of normal cell division
Risk Factors      Non-Modifiable               Modifiable•   Age >50/40            •    # of Sexual partners•   Family Hi...
What we know• Men who consume the highest amounts of  – Vegetables, fruits, beans, lentils etc  risk     • 7th day Advent...
Cancer Growth
Mechanisms for Development• High blood androgen concentrations• Increased blood levels of IGF-1 derived from  dairy• Incre...
Benefits of Plant-Based Foods• ’d blood androgen concentrations• ’d blood levels of IGF-1• ’d exposure to carcinogens r...
A few Studies
Prostate CA and Diet• Dean Ornish et al Journal of Urology 2005  – Men with low-mod level of biopsy proven PCA  – 1 year o...
Diet Changes Gene Expression• Ornish et al PNAS 2008  – 31 men with biopsy proven PrCA  – 3 months of Ornish program  – Re...
Now What
By the end you will……• Know more about cancer development• Know what the prostate is and what it does• Know signs and symp...
What we know• Prostate CA is a problem• Plant-Based nutrition has minimal risk• Plant-Based nutrition appears to reduce ri...
Thank You!
Enjoy more powerpoints and   educational resources at    www.esserhealth.com
Prostate Cancer and Plant Based Nutrition
Prostate Cancer and Plant Based Nutrition
Prostate Cancer and Plant Based Nutrition
Prostate Cancer and Plant Based Nutrition
Prostate Cancer and Plant Based Nutrition
Prostate Cancer and Plant Based Nutrition
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Prostate Cancer and Plant Based Nutrition

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  • 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.
  • http://seer.cancer.gov/statfacts/html/prost.html#incidence-mortality
  • http://healthinessbox.files.wordpress.com/2012/04/prostrate-health.jpg http://www.cancer.gov/PublishedContent/Images/cancertopics/treatment/prostate/understanding-prostate-cancer-treatment/prostate-booklet-5.jpg http://www.jeffersonhospital.org/images/staywell/142104.jpg http://lafeverchestnuts.webstarts.com/uploads/chestnut.jpg
  • 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
  • Testosterone./ dihydroepiandosterone/
  • http://www.ornishspectrum.com/
  • http://www.ornishspectrum.com/wp-content/uploads/Intensive_Lifestyle_Changes_and_Prostate_Cancer.pdf
  • http://www.ornishspectrum.com/wp-content/uploads/8369.full_.pdf
  • Prostate Cancer and Plant Based Nutrition

    1. 1. A presentation at NAVS Summerfest 6/29/12 Stephan Esser MD www.esserhealth.com
    2. 2. Prostate CA and Plant-Based Nutrition Stephan Esser MD www.esserhealth.com
    3. 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. 4. NOT Goals• Personal recommendations for screening or treatment• Updates on surgical techniques• Intro to alternative treatments
    5. 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. 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. 7. “Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.”
    8. 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. 9. Cell Cycle G1: Growth and function S: DNA Replication G2: Preparation M: Mitosis
    10. 10. Cancer Growth
    11. 11. Cell Cycle G1: Growth and function S: DNA Replication G2: Preparation M: Mitosis
    12. 12. Cancer Operatives• 1: Failure to slow/block abnormal growth• 2: Acceleration of growth (ie: to an abnormal level)
    13. 13. 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
    14. 14. Valuable Terminology• Staging: evaluates the extent of a persons cancer• Grading: how abnormal a tumor looks under a microscope
    15. 15. 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
    16. 16. Basic Epidemiology
    17. 17. Mortality Statistics 2006-2007
    18. 18. Cancer deaths per year
    19. 19. Cancer RiskTotal 1:6
    20. 20. 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
    21. 21. Mini- Med School
    22. 22. Anatomyhttp://healthinessbox.files.wordpress.com/2012/04/prostrate-health.jpghttp://www.cancer.gov/PublishedContent/Images/cancertopics/treatment/prostate/understanding-prostate-cancer-treatment/prostate-booklet-5.jpghttp://www.jeffersonhospital.org/images/staywell/142104.jpghttp://lafeverchestnuts.webstarts.com/uploads/chestnut.jpg
    23. 23. Anatomy Cont’d http://healthinessbox.files.wordpress.com/2012/04/prostrate-health.jpg http://www.cancer.gov/PublishedContent/Images/cancertopics/treatment/prostate/understanding-prostate-cancer-treatment/prostate-booklet-5.jpg http://www.jeffersonhospital.org/images/staywell/142104.jpg http://lafeverchestnuts.webstarts.com/uploads/chestnut.jpg
    24. 24. Dysfunction• Prostatitis• Benign Prostatic Hypertrophy• Prostate Cancer
    25. 25. Development• 11th-12th week of gestation• Exponential growth during puberty – 2ndary to androgens (testosterone and derivatives)• Quiescent till 4th decade, then grows
    26. 26. 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
    27. 27. Prostate Cancer Symptoms• Early: none• Late: So does BPH – Weak stream – Increased frequency/hesitancy/urgency – Blood in urine or semen – Leg Swelling
    28. 28. 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……
    29. 29. 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.”
    30. 30. What Causes Prostate Cancer?
    31. 31. What causes any Cancer?• Loss of normal cell division
    32. 32. 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%
    33. 33. 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
    34. 34. Cancer Growth
    35. 35. 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
    36. 36. 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
    37. 37. A few Studies
    38. 38. 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
    39. 39. 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
    40. 40. Now What
    41. 41. 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
    42. 42. 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!
    43. 43. Thank You!
    44. 44. Enjoy more powerpoints and educational resources at www.esserhealth.com

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