As we publish this October 2010 Issue 175 of Positive Health PH
Online, news items have been prominent across the media regarding
progress with targeted genome molecular research in melanoma cancer -
the development of PLX4032, which has shown to reduce tumour size in
late-stage melanoma patients.
Customizing treatments, i.e. drugs
to the mutated gene affected - BRAF - will eventually, it is hoped,
result in cancer treatment approaches which are less globally toxic and
more specific to the affected body cells. Less the proverbial slash, cut
and burn approach and more the individualized, gentler approach which
may destroy the cancer but save the patient.
published in this issue Prostate Cancer - Natural Prevention Strategies
and Information for Females
by Aris Antoniou
discusses a variety of nutritional and herbal prevention strategies for
"A sufficient supply of zinc in the diet can
help prevent prostate disorders from developing. Eating foods high in
zinc like seafood and pumpkin seeds, plus zinc supplementation is highly
recommended. This can reverse the zinc deficient diets many of us in
the West consume. Pumpkin seeds also contain plant sterols and essential
fatty acids such as Oleic and Linoleic. They are even used as therapy
for BPH sufferers in some countries.
Plenty of antioxidant rich
fresh vegetables and brightly coloured fruits should be included in the
diet as well, along with lots of fresh still mineral water to keep the
body hydrated. Essential nutrients such as Selenium should be consumed
either in food or supplementation form. Selenium removes heavy metals
such as Cadmium, which can stimulate the growth of prostate tissue, from
the body. The richest source of this nutrient is Brazil nuts.
scientific research suggests that eating tomatoes can help too.
Tomatoes contain an antioxidant called Lycopene. Men who eat tomatoes
and tomato products such as unsweetened puree, every day, are 33 per
cent less likely to develop prostate cancer than those who never eat
Saw Palmetto is another popular natural remedy which
can be used to prevent and treat prostate problems. This berry extract
counteracts the effects of hormonal changes in the body.
an extract from a large evergreen tree - Pygeum Africanum - is also
thought to reduce enlarged prostates by reducing inflammation, fluid
retention and helping to repair damaged blood vessels. Pygeum contains
active components such as Beta Sitosterol and Phytosterols. However,
more research is needed to confirm that it successfully treats prostate
problems as does Saw Palmetto."
Also published today is the
result of a Network Meta-Analysis including 10 randomized controlled
trials including 3803 patients by Wandel et al.  The conclusions from
this meta-analysis, in which "direct comparisons within trials were
combined with indirect evidence from other trials using a Bayesian
model" and in which data regarding osteoarthritis of the knee and hip
were interchanged were as follows:
"Compared with placebo,
glucosamine, chondroitin, and their combination do not reduce joint pain
or have an impact on narrowing of joint space. Health authorities and
health insurers should not cover the costs of these preparations, and
new prescriptions to patients who have not received treatment should be
In these days of instant electronic media, a ripost
to this trial Don't count your chickens until they are ALL hatched
has been issued
by Orthopaedic Registrar Shyan Goh. [Editor's Note: Please see this
letter for full references.]
"I am no fan of health supplements
but I am aware of the increasing use of Glucosamine and similar
preparation promoted for use for osteoarthritis (OA). There is few good
research on the efficacy of glucosamine and chondroitin in their
effectiveness therefore I appreciate the efforts of the authors (Ref 1)
to help differentiate the information available out there.
like several meta-analysis and guidelines including those of American
Academy of Orthopaedic Surgeons (Ref 2), the researchers failed to
consider several current factors in their assessment of these drugs,
1. Glucosamine comes in 2 different
formulation and manufactured often in conditions not the same as
pharmaceutical standards. Higher quality studies reporting favourable
response of glucosamine to knee OA involves glucosamine sulphate not
hydrochloride. It also appears that Rottapharm is involved in these
studies where trials are industry-funded. Whether or not it is only
Rottapharm-patented glucosamine sulphate formulation that gives better
results than other glucosamine formulation is unclear.
2. While I
cannot account for all the guidelines and recommendations of Glucosamine
in the world, I am aware of several prominent groups like
OsteoArthritis Research Society International and Arthritis Foundation
mostly discuss their recommendations of use of glucosamine on knee (and
not hip) osteoarthritis. I believe that the heterogeneity in several
meta- analyses of glucosamine trials may also be due to the group
analysis of knee and hip OA in the attempt to improve the power of the
3. Some studies have remarkably high placebo effect (60.1%
in the GAIT study: Ref 3) and also complicated by the variation in
severity of OA of participants between trials. It is therefore difficult
to conclude if glucosamine is only beneficial to certain stages of knee
OA; in milder OA the gross fluctuation of symptoms make it too hard to
detect a difference while in advanced OA the symptoms is too severe to
I noted that initial results of LEGS trial (ref 4),
which investigates glucosamine sulphate in knee OA with pain score 4 to
10 on Visual Analogue Scale, would not be available before October 2011.
Nevertheless in view of the issues with highlighted above, I do not
believe that we can draw any firm conclusion without the results of this
trial, which addresses all my concerns with the meta-analyses of
efficacy of glucosamine (sulphate) on (knee) osteoarthritis performed so
The last egg has not hatched yet. It may very well be the golden goose you are waiting for, and not a chicken!"
the above, it would appear that this story is far from complete;
however this did not prevent the appearance on Radio 4's Today Programme
of a Senior Author of this study, advocating that glucosamine and
chondroitin supplements should definitely not be available on the NHS.
No doubt similar noises are emanating from the USA and other countries.
is the precursor to Glycosaminoglycans, amino acids that are naturally
produced in your body to help form cartilage. Chondroitin sulfate is a
sulfated glycosaminoglycan (GAG), an important structural component of
cartilage and provides much of its resistance to compression. Hence
these 'supplements' being researched are naturally occurring in joints.
Although the placebo effect is being waved around again, it is unlikely
that research of the past 20 years with osteoarthritis has been figments
of the imagination.
I guess we have to take the long view that
nowadays, argument and counterargument are a necessary component of the
evolution of healthcare - conventional and natural, which appear to be
converging at a faster rate, with the emergence of the human genome
For a view of more natural approaches to bodywork and
rehabilitation, please read the excellent bodywork features: Looking
After Yourself with Trager Mentastics
Taping: Innovative Rehabilitation Technique
Stenosis and Fusion Surgery
Simon Wandel, Peter Jüni, Britta Tendal, Eveline Nüesch, Peter M
Villiger, Nicky J Welton, Stephan Reichenbach and Sven Trelle.
Effects of glucosamine, chondroitin, or placebo in patients with
osteoarthritis of hip or knee: network meta-analysis. BMJ 2010;
341:c4675 doi: 10.1136/bmj.c4675. 16 September 2010.
2. Shyan Goh,
Orthopaedic Registrar, Lismore Base Hospital NSW Australia. Don't count
your chickens until they are ALL hatched