Use of complementary and alternative medicine during active surveillance among prostate cancer patients

Background: Prostate Cancer (PCa) is the second leading cause of cancer death in men. Growth and spread of PCa varies. For patients with low-grade, localized prostate cancer, Complementary and Alternative Medicine (CAM) use during active surveillance (AS) is an appealing option because it has few side effects and can be studied without interfering with conventional treatments. Aims: Review studies on use and effectiveness of CAMs among PCa men during AS period. Methods: Studies reviewed focused on the most commonly used CAMs including natural products (NPs) genistein, lycopene, and curcumin, and spiritual prayer. Results: Genistein, a phytoestrogen, has shown that it may reduce PSA levels and lengthen doubling time. Of seven studies reviewed, three found significant reduction in PSA levels, three did not find benefits, and one was inconclusive. Lycopene is a carotenoid and strong antioxidant. Three of five studies showed a reduction in PSA levels. Two studies and one review found statistically significant reduction in PSA levels. Curcumin is a phytopolyphenol and anti-inflammatory isolated from turmeric and may prevent the progression of PCa. One in vivo study and two in vitro studies found statistically significant support for use of curcumin to decrease PSA levels. One study found spirituality (prayer) to be negatively correlated with depression in PCa patients. Conclusion: Studies are needed to maximize statistical power; dose escalation; efficacy, and effects of elevated PSA levels on tumor growth and cancer progression.