Pomegranate Extract Slows PSA Rise in Recurrent Prostate Cancer Patients

Pomegranate Extract Slows PSA Rise in Recurrent Prostate Cancer Patients

In this double-blind, randomized phase II trial, Paller et al. enrolled 104 men whose prostate cancer had recurred biochemically (i.e., PSA levels rising) after initial therapy but who had no metastases. They were randomized to receive either 1 gram or 3 grams daily of a standardized pomegranate extract, for up to 18 months. The primary outcome was change in PSA doubling time (PSADT), a measure of how quickly PSA levels rise over time.

At baseline, the median PSADT was about 11.9 months. After treatment, in the entire group, PSADT lengthened significantly to 18.5 months. In the low-dose (1 g) arm, it went from 11.9 to 18.8 months; in the high-dose (3 g) arm, from 12.2 to 17.5 months—with no statistically significant difference between the two dose arms.

Some men experienced more than a doubling of their PSADT—you might call it a ≥100% increase compared to their baseline. About 43% achieved that level of PSADT increase. Also, 13% of participants had declining PSA levels at certain time points. Side effects were minimal: mild diarrhea occurred in 1.9% of men in the 1 g group and 13.5% in the 3 g group; no serious toxicities were reported.

In summary, pomegranate extract demonstrated that it can slow PSA doubling, meaning a slower rise in PSA levels, in men with recurrent prostate cancer, with modest side effects. Though this was not compared to a placebo, the findings suggest a potential role for natural extracts in supportive or adjunctive therapy for prostate cancer recurrence.

Reference:

Paller CJ, Ye X, Wozniak PJ, et al. A randomized phase II study of pomegranate extract for men with rising PSA following initial therapy for localized prostate cancer. Prostate Cancer Prostatic Dis. 2013;16(1):50-55