Flaxseed to fight prostate cancer

[SYLVESTER1592]

I just came across this report:

http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=16353

and a similar report here:

http://www.newscientist.com/article.ns?id=dn11981&feedId=online-news_rss20

It says flaxseeds are effective against prostate cancer. Herbs and other substances have been used against prostate cancer. As far as I know none of them work well.

It was presented at the American Society of Clinical Oncology Meeting in Chicago, June 1-5, 2007 and seems to be a controlled study funded by the National Institutes of Health. To what extent it was blinded, I don’t know.

Doesn’t look like Woo… but does seem to lean towards alternative medicine and sounds promising, but past experiences make me curious if this is for real.
Any opinions on this one?

SYL :)

[Zep]

If it works, and can be proven to work, what makes it "alternate"?

Remember: There's no such thing as "alternate medicine". It's either medicine that works, or it's not medicine.

[fls]

Here is the abstract (http://www.asco.org/portal/site/ASCO/menuitem.34d60f5624ba07fd506fe310ee37a01d/?vgnextoid=76f8201eb61a7010VgnVCM100000ed730ad1RCR D&vmview=abst_detail_view&confID=47&abstractID=36219).

Like most preliminary results, further study will tell whether it's reproducible and provides any real benefit, or whether it fizzles like most of these things seem to do.

Linda

[SYLVESTER1592]

They can't tell you how it works except for a hypothesis based on the contents of flaxseed being Omega 3. I honestly don't know if this is for real or to what extent it is based on fundamental research. It does seem very credible...

There doesn't seem to be a reason not to give it and I'm wondering if this is a good advice for patients. I have to admit I'm very tempted, even though I don't have all the details yet.

SYL :)

[JJM]

Here is some discussion:

http://scienceblogs.com/terrasig/2007/06/shark_cartilage_tanks.php#more

[fls]

They can't tell you how it works except for a hypothesis based on the contents of flaxseed being Omega 3. I honestly don't know if this is for real or to what extent it is based on fundamental research. It does seem very credible...

There doesn't seem to be a reason not to give it and I'm wondering if this is a good advice for patients. I have to admit I'm very tempted, even though I don't have all the details yet.

SYL :)

Are you a physician?

I know you could make a case for suggesting anything that has a chance of helping and that doesn't seem to have direct harm. The things that give me pause are the harm from information overload, the substitution of a maybe/possibly/perhaps intervention for a known to be helpful intervention (people would rather pop pills (especially because they're not "pills" if they're "natural") than exercise and eat a balanced diet), the possibility of unknown harm, the generation of distrust and confusion as recommendations end up getting reversed, and that it counteracts attempts to promote critical thinking when the distinction between various levels of evidence is blurred or eliminated.

Linda

[SYLVESTER1592]

Are you a physician?



Actually, MD, PhD :wackycute:

But as soon as I state that, I feel I need to put a disclaimer on this comment since I’m still checking these reports and this forum is not a medical office.

“<snip> distrust and confusion as recommendations end up getting reversed, and that it counteracts attempts to promote critical thinking when the distinction between various levels of evidence is blurred or eliminated. <snip>”


This is exactly what worries me too… :wackyyes:

That’s exactly why I was so hesitant. It’s still only phase II, and only just out. Most of these herbal remedies did not work in the past. But I’m pretty sure that one of these days a patient will show up with this and ask if this is a good idea. I’m still checking. :wackyunsure:

Most of these things can be dismissed quite easily for obvious reasons when you look at experimental design, follow up studies etcetera, but this one looked like a good candidate for a working medical treatment. Of course it’s a preliminary report phase II, but a patient with prostate cancer does not need a prescription for this and would probably try it anyway. :wackyfrown:

It’s the non-harming part with demonstrated effects in a controlled clinical trial that throws me off from the normal skeptical attitude. I feel I have to be honest about this:” I think there might be a possible effect, we are not completely sure at this time, but the studies seem promising and as long as it’s part of your normal diet and you have it once in a while… I see no problem, but don’t overdo it! It’s not an alternative or replacement for treatment and the side effects are not completely clear.”
(Obvious disclaimer: no part of these comments can replace clinical evaluation by your physician. No part of this comment should be interpreted as medical advice or can be judged as an alternative for professional medical counsel) :wackySLEEP:

It would seem the only obvious, frequent problem (when used in moderation, supplemented as part of a normal diet with variation) would be the laxative effect of this product. When you look at the patient population (often elderly), a laxative is often part of their daily medication. So no harm there… A healthier more balanced diet would maybe even be helped out by flaxseed as long as at is added to a normal diet with good variation and … you don’t overdo it.

If there would be a real harmful side-effect or a reason to say no to this, I would. If you have any, I like to know. At this moment in time I don’t see one, that’s why I was interested in your thoughts on this. A normal intake of flaxseed/ linseed is not harmful as far as I know and it’s not a “new” product either. I think people have been eating this for quite a while, so I would expect some report of harmful effects. As long as it is an added substance used with moderation in the form of flaxseed rather then some concentrated form. High intake may turn out to promote cancer growth or is transformed to a high amount of phytal oestrogen which could have other effects as well. So this is something that may harm, and I think people need to be aware of that possibility before they start taking this and to avoid the risk that they will take it in high amounts as a kind of alternative treatment.

However, the abstract says it’s safe!... That’s a fine statement for a medical researcher doing a phase II trial to communicate to other researchers, but patients interpret this a little bit different… That worries me. You are right that on the level of the patient (and even doctors for that matter) the level of evidence is blurred and labeling something as safe in a phase II trial is a bit premature for my taste. :wackysad:

I know this product has been advocated by the alternative/complementary medicine branch for some time and I always thought it could do no real harm, but would not help you much either. For flaxseed there seems to be more and more reports of the contrary… :wackyskeptical:

I find it disturbing that other sites (http://www.wellnessletter.com/html/ds/dsFlaxseed.php) and even the alternative medicine sites (alternative medicine.com (http://www.alternativemedicine.com/common/adam/DisplayMonograph.asp?storeID=02AD61F001A74B5887D3B D11F6C28169&name=ConsHerbs_Flaxseedch)) are more conservative then the real medical organizations in this and a clear message should have been part of the abstract. I hope they put it in the article and publish it as an open source document so it’s available for everyone.

I’m very curious what others think of this. Am I wrong here? We are normally very critical towards homeopaths and alternative medicine and the obvious “Woo”, we can debunk in 5 seconds. But being critical should also mean that we are critical towards our colleagues. This is normally done by research and in discussions and papers, but patients read websites, not papers. If the papers have flaws or are less then completely accurate this has nasty effects. We’ve seen such problems with highly sponsored research such as the Xigris trials by Eli Lilly in the recent past and I feel that critical thinking should be exactly that, critical, not just picking off the easy targets. :wackyskeptical:

What do you think?

SYL :wackysmile:

[fuelair]

As a prostate cancer survivor, with primary care MD and urologist both cautious but quick on the trigger, thus making me a cancer survivor, I say fine on flaxseed or other O3. But don't stop having the test as often as needed and don't put off decisions waiting for more on this!!!
And(I am NOT a doctor BUT) if you are a good candidate for the DaVinci surgery (minimally invasive) go for it!!

[fls]

I’m very curious what others think of this. Am I wrong here? We are normally very critical towards homeopaths and alternative medicine and the obvious “Woo”, we can debunk in 5 seconds. But being critical should also mean that we are critical towards our colleagues. This is normally done by research and in discussions and papers, but patients read websites, not papers. If the papers have flaws or are less then completely accurate this has nasty effects. We’ve seen such problems with highly sponsored research such as the Xigris trials by Eli Lilly in the recent past and I feel that critical thinking should be exactly that, critical, not just picking off the easy targets. :wackyskeptical:

What do you think?

SYL :wackysmile:

I'm not sure what you are getting at. Are you thinking that if the source of the drug was not natural that we'd be jumping on the bandwagon?

Linda

[SYLVESTER1592]

I'm not sure what you are getting at. Are you thinking that if the source of the drug was not natural that we'd be jumping on the bandwagon?

Linda

No, what I mean is that clinical trials for “Woo”are mostly absent or at best very badly designed or executed and are therefore easy to debunk and reject. Regular medicine is conducted by stringent rules and evidence is provided by peer –reviewed clinical trials, which also means we are initially less likely to be critical towards it.

That doesn’t mean they are always right and when regular medicine makes a mistake there are serious consequences to it. Our medication generally does not come with the warranty of “No side-effects”. So even a well-designed clinical trial needs some critical thought to see if it’s conducted well, and if the methods, result, discussion and conclusions are right.

We usually wait for the researchers to solve this question and in most cases have time to wait until they pass the phase III trial. In this particular case the “medication” is not prescribed, but readily available. That’s why I’m critical to a treatment advice based on preliminary research results and especially to the labeling of this treatment as safe after a phase II trial. The phase II trial evaluates efficacy and toxicity, but only in a small group, so only very common toxicity is noted. When they say “Further controlled analyses and additional studies are needed to confirm findings.”, I don’t think they should give it a conclusive label as safe, but rather draw the conclusion that no toxicity during the trial was noted and further research into the safety and efficacy is required in a phase III trial.

I think critical thought shouldn't only be applied to "Woo", don't you agree?

SYL :)

[fls]

No, what I mean is that clinical trials for “Woo”are mostly absent or at best very badly designed or executed and are therefore easy to debunk and reject. Regular medicine is conducted by stringent rules and evidence is provided by peer –reviewed clinical trials, which also means we are initially less likely to be critical towards it.

That doesn’t mean they are always right and when regular medicine makes a mistake there are serious consequences to it. Our medication generally does not come with the warranty of “No side-effects”. So even a well-designed clinical trial needs some critical thought to see if it’s conducted well, and if the methods, result, discussion and conclusions are right.

We usually wait for the researchers to solve this question and in most cases have time to wait until they pass the phase III trial. In this particular case the “medication” is not prescribed, but readily available. That’s why I’m critical to a treatment advice based on preliminary research results and especially to the labeling of this treatment as safe after a phase II trial. The phase II trial evaluates efficacy and toxicity, but only in a small group, so only very common toxicity is noted. When they say “Further controlled analyses and additional studies are needed to confirm findings.”, I don’t think they should give it a conclusive label as safe, but rather draw the conclusion that no toxicity during the trial was noted and further research into the safety and efficacy is required in a phase III trial.

I think critical thought shouldn't only be applied to "Woo", don't you agree?

SYL :)

Why do you have the impression that the researchers or I think otherwise?

Linda

[SYLVESTER1592]

Why do you have the impression that the researchers or I think otherwise?

Linda

I don’t. :wackycool:

When it becomes complicated most people back off. I think there are a lot of smart people in this forum and like to see their thoughts to see what criticism they have and what flaws they can find. Positive comments are also welcome. I’m still checking this out since I only saw this yesterday. I would like to see what other criticisms there are to form a definite opinion.

SYL :wackysmile:

[cbish]

All I know is Flaxseed makes you fart like a friggin' horse! That's the real reason why people hate Barry Bonds.

[Ivor the Engineer]

My mother eats linseed and I can confirm the protective effect since she has not yet contracted prostate cancer;)

[Zep]

I don’t. :wackycool:

When it becomes complicated most people back off. I think there are a lot of smart people in this forum and like to see their thoughts to see what criticism they have and what flaws they can find. Positive comments are also welcome. I’m still checking this out since I only saw this yesterday. I would like to see what other criticisms there are to form a definite opinion.

SYL :wackysmile:The answer is probably absurdly simple: Is it being subject to proper trialling such that we can have confidence in the test results?

If so, then it's hardly woo, is it. Maybe it will prove efficacious, maybe not. But we will know with confidence.

[Beady]

I just came across this report: <snip>
It was presented at the American Society of Clinical Oncology Meeting in Chicago, June 1-5, 2007 and seems to be a controlled study funded by the National Institutes of Health.

The answer is probably absurdly simple: Is it being subject to proper trialling such that we can have confidence in the test results?

If so, then it's hardly woo, is it. Maybe it will prove efficacious, maybe not. But we will know with confidence.

I thought one of the hallmarks of woo-ish science was a complete avoidance of controlled studies, academic presentations and peer judgement, in favor of dashing straight to the media. Besides, if pomegranates are supposed to have some effect against prostate cancer, why, in principle, couldn't flaxseed?

If the only complaint is that the idea is unproven, isn't that the purpose of presenting it to a professional society? How is this woo?

ETA: I have a personal interest in this; I can't yet be called a prostate cancer survivor since I have yet to take the initial post-surgical PSA test.

[SYLVESTER1592]

If the only complaint is that the idea is unproven, isn't that the purpose of presenting it to a professional society? How is this woo?
.

The answer is probably absurdly simple: Is it being subject to proper trialling such that we can have confidence in the test results?

If so, then it's hardly woo, is it. Maybe it will prove efficacious, maybe not. But we will know with confidence.

I don’t think it’s “Woo”, It seems credible, but I like to make sure it’s right.

As I sated earlier, sooner or later a patient will ask for advise about this. Since they will try it anyway, I want to look at this critically before making up my mind about what to say. That’s my interest in this case. Not just fighting “Woo”or labeling this as “Woo”. I think Zep is right, but cancer patients don’t wait for a phase III trial especially not in this case. Being cautious and fast on the trigger when something turns out to have some effect is a practical and sensible attitude, I think.

For all the physicians in this thread, what about this summary:
” I think there might be a possible effect, we are not completely sure at this time, but the studies seem promising and as long as it’s part of your normal diet and you have it once in a while… I see no problem, but don’t overdo it! It’s not an alternative or replacement for treatment and the side effects are not completely clear.”

The patients are also an important factor in this, because I like to know what they would do and how they react to this comment. In the end this may end up to be mostly self-medication instead of prescription. So their input is valuable to make a discission and see what confusion or uncertainty there is...

SYL :)

[Zep]

Being cautious and fast on the trigger...Um, that's contradictory, isn't it? ...when something turns out to have some effect is a practical and sensible attitude, I think.If you mean not rushing in, then I agree. The initial effects may prove to be misleading after all. In which case, all you will get is alarming flatulence but no cure. Or worse still, it may be counterproductive instead.

The only alternative I could see to caution would be if the patient was involved in the testing process itself. In which case the usage would be regulated, and I expect various measurements would be taken regularly.

[SYLVESTER1592]

Um, that's contradictory, isn't it? If you mean not rushing in, then I agree. The initial effects may prove to be misleading after all. In which case, all you will get is alarming flatulence but no cure. Or worse still, it may be counterproductive instead.

The only alternative I could see to caution would be if the patient was involved in the testing process itself. In which case the usage would be regulated, and I expect various measurements would be taken regularly.

I don't want to rush in, but get as much convincing evidence as I can first. :wackyyes:
In the end it may not be up to me, I mean ...it's flaxseed...
An experimental study has crossed my mind, but it would mean I would also need a comparable control group and deny people this stuff in a blinded experiment. I would also have to be careful to avoid selection bias.
I would have to run this one by the medical ethical committee and I don't think I'll get NIH funds to do this experiment. Difficult dilemma... :wackyunsure:

SYL :)