One of the “hottest” fads in the world of prostate cancer prevention and treatment is the potential of extract of pomegranate and pomegranate juice to affect risk for prostate cancer and maybe even treat early stage disease.
Fads like this are not new. We have seen the coming and going (more than once) of tomatoes and lycopene. We have seen the selenium craze rise (in the 1990s) and crash to the ground in 2008. We have seen the vitamin E hypothesis rise and fall as well … along with hypotheses about vitamin C and vitamin D. Tofu is still a food of choice for some — based on its supposed cancer preventive properties.
And having made all the usual cynical noises, we feel compelled to state that the potential of pomegranate extract is stronger than that of many other “natural” or “dietary” regimens that we have ever seen hyped in prostate cancer.
For starters there appears to be some real scientific justification for the concept. There is now a growing literature on the clinical potential of agents present in pomegranate juice, and specifically a biochemical known as delphinidin, in the prevention and management of cancers in general and prostate cancer in particular.
Yun et al. have published data from laboratory studies on the mechanism of action of delphinidin in colon cancer cells; Afaq et al. have reported that delphinidin is “an effective inhibitor of EGFR signaling in breast cancer cells;” Syed et al. have reviewed data on the possible roles of several agents, including delphinidin and pomegranate juice, in the prevention of prostate cancer specifically; and Rettig et al. have studied the effect of a “pomegranate extract” on the growth of androgen-independent prostate cancer cell lines.
Almost all of this literature, to date, is laboratory data and not clinical data. As a consequence, we really don’t yet know whether something in pomegranate juice can specifically prevent the onset or the progression of prostate cancer in man. However, there are now a total of eight ongoing trials and one completed trial that have explored or are exploring the potential of pomegranate extract in the treatment of prostate cancer. One of the ongoing trials is a randomized, double-blind, multi-center, placebo-controlled study that could potentially show true efficacy of pomegranate extract in the management of localized prostate cancer after first-line therapy. To date, there are no trials of pomegranate extract in prevention of prostate cancer.
What should the patient or the average man who thinks he may be at risk for prostate cancer do under circumstances like these? Well in this case it seems as though the opportunity is fairly straightforward. If you like the taste and can afford the product, go for it! There are no known adverse effects associated with the daily consumption of pomegranates, pomegranate juice, or pomegranate extract.
As with any use of dietary management to impact health, we would add the usual caution that a balanced diet is wise. If pomegranate juice becomes the only fluid you drink, you may be going “over the top.” Also, if you are on treatment with some type of drug for prostate cancer or for any other clinical condition, make sure that you talk to your doctor about this dietary change, just in case there are any reasons why pomegranate juice in significant quantities may present risks of interactions with the drugs you are taking. (For a comparative example, people who take statins to lower their cholsterol level are advised not to drink grapefruit juice because of the risk for an interaction.)
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ongoing trials on the
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