Dr. Susan B. Kowalsky, N.D.
Prostate Testing & Naturopathic Treatment Options
Prostate Specific Antigen (PSA) Screening Recent press reports have questioned the usefulness of Prostate Specific Antigen (PSA) screening in the general male population because elevated test results often lead to unnecessary and invasive procedures. While it is true that elevated PSA levels are much less attributable to prostate cancer than they were twenty years ago, prostate cancer is extremely common. By age 70, 70% of men will have it but the mortality rate is low, only 226 per 100,000 men over 65 years old. The problem isn’t the PSA test but rather what to do about the results. PSA testing can be made more specific by including “percentage free” PSA results. The higher the percent PSA that is free, or unbound, the lower the risk of cancer. Secondly, and annual rectal prostate exam (DRE) is 90% diagnostic for cancer if a hard nodule is felt. All men over 40 should have this test done every year. The PSA, free PSA and DRE are still the highest standard of diagnostic tools available. The benefit of these tools for screening and following prostate cancer and benign prostate enlargement (BPH) becomes even more evident in conjunction with non-invasive naturopathic treatments.
PSA & Saw Palmetto Question: My doctor told me not to take saw palmetto because it would interfere with my PSA test even though it's good for my prostate. What can I do? Anthony, Vermont Ask your doctor to back up statements like this! Two studies have shown that saw palmetto supplementation does not interfere with PSA readings. No studies suggest it does and it can be very helpful for prostate problems.
Recently Diagnosed Question: I was just diagnosed with early stage prostate cancer. I feel depressed. Should I "watch and wait"? Jon P., New Hampshire I believe "watchful waiting," sometimes referred to as "surveillance," is not a good idea for most people. From my point of view this means that a person is accepting the possibility of cancer spreading and not doing anything to prevent its advancement. In almost all circumstances following a naturopathic oncology treatment plan with proper follow-up and monitoring (such as PSA and Percent-Free PSA blood tests) provide the most benefit for the majority of prostate cancer patients. Natural medicines for prostate cancer are non-toxic at therapeutic doses, and may include PSK and maitake mushroom extracts, lycopene, CoQ10, vitamin D, modified citrus pectin, ascorbic acid, IP-6, DHA & EPA from fish oil, proteolytic enzymes, immune modulating herbs, green tea, high doses of melatonin, as well as additional natural compounds depending on the patient's circumstances. This may all seem overwhelming to you, as it does at first to most of my patients with prostate cancer. You should consider learning about natural medicine options under the guidance and counsel of a naturopathic doctor. Because you have early stage cancer there is no reason to rush into making decisions, but getting started is important and may help you feel better emotionally. If at a later date you choose conventional treatments, the benefits of naturopathic treatments do not end because many naturopathic medicines may decrease the side effects while increasing the effectiveness of conventional treatments.
Prostate Cancer, ADT & Osteoporosis Question: I'm starting hormone therapy for my prostate cancer. I read on the internet that this can increase my chance of fractures in my bones. What can I take to avoid this side effect? William, New Hampshire Osteoporosis, the bone thinning associated with low hormones, and bone fracture is a serious risk for men with prostate cancer who choose any kind of androgen hormone deprivation therapy (ADT). There are many supplements that can help prevent osteoporosis, such as calcium citrate-malate, magnesium, vitamin D, vitamin K, strontium and ipriflavone. It is also very important that you get DEXA bone scans yearly, as well as checking measurements of pyridinium crosslinks and deoxypyridinoline from a simple urine test that will detect smaller changes of bone loss over shorter periods of time enabling you to stay on top of any potential bone loss.
Prostate Cancer & Vitamin D Question: In your last newsletter you said that vitamin D is good for prostate cancer. How much vitamin D should someone with prostate cancer take? David S., New York Most good quality multivitamins contain 400 iu of vitamin D3 (cholecalciferol). This would be the absolute minimum. Those with prostate cancer can also take an additional 1,000 - 2,000 iu daily For a few of my patients with prostate cancer, I prescribe calcitriol (available by prescription only) and increase the dose gradually. This requires monitoring blood levels of calcium and phosphorous which is simple to do. Research shows the benefit of vitamin D in lowering PSA levels, a strong indicator of prostate cancer changes. Vitamin D has also been shown to slow increases in PSA, called PSA doubling time by over 25%. Supplementation also reduces bone pain and increases muscle strength in patients with advanced hormone-refractory prostate cancer with bone metastases. There are over 130 in-vitro studies, 27 animal studies and at least five human studies of vitamin D in various cancers, most showing favorable responses. In addition, there are studies showing vitamin D will increase the effectiveness of chemotherapy.
Prostate Cancer & Selenium Question: I have prostate cancer and wonder how much selenium I should be taking. John P., Massachusetts There have not been any clinical trials on the use of selenium supplementation in relation to existing cancers. There is however, an abundance of research related to cancer prevention and occurrence in humans, as well as the many animal studies showing the importance of selenium supplementation in those diagnosed with various cancers. For example, a study of over 30,000 men revealed that the men with the highest level of selenium intake showed a 65% less chance of having advanced prostate cancer compared to the men with the lowest levels of selenium. Similar results have been obtained in other cancer types, including lung, colon, pancreatic and gastric cancers. A placebo controlled study of over 20,000 people found a 50% decrease in the incidence of liver cancer in those with higher intakes of selenium. A good quality multi-vitamin/mineral supplement would contain 200 mcg.of selenium, which is adequate. For some of my patients with more advanced cancers or for patients who prefer a more aggressive approach, I will often recommend an additional 200 mcg. daily of seleno-methionine, the best absorbed form of selenium.
About Dr. Kowalsky Dr. Susan B. Kowalsky is a naturopathic physician specializing in cancer and chronic medical conditions. Dr. Kowalsky provides a responsible, rational and integrative approach to the treatment of cancer. Naturopathic medicines can help increase longevity, heighten quality of life and reduce the side effects of chemotherapy and radiation while enhancing their effectiveness. As a naturopathic doctor she is trained in both conventional medicine and natural therapies, providing her patients with the most holistic, integrative and effective medical care available.
Therapies Include: *Vitamins, Minerals & Amino Acids
The Highest Standard of Care "I provide strong guidance and caring medicine that foster hope and optimal health. I prescribe treatments based on the best scientific evidence available, while also developing a healing and supportive relationship with each patient. I adjust treatments to address the individual needs of each person based on mental, emotional and social factors as well as their physical health and symptoms. Only by really listening can a doctor understand the pieces of the puzzle that make up a patient's health concerns. I believe the highest standard of care can only happen when the doctor is totally dedicated and committed to your health -- Susan B. Kowalsky, N.D.
Credentials Dr. Kowalsky received her undergraduate degree at the University of
What is a Naturopathic Physician? Naturopathic physicians (N.D.s) are general practitioners trained as specialists in natural medicine. They are the only physicians with comprehensive medical training that includes a wide variety of natural therapeutics, such as herbal medicine, nutritional medicine, homeopathy, natural hormones, intravenous supplementation and physical medicine. Naturopathic physicians cooperate with all other branches of medical science, referring patients to other specialists for diagnosis or treatment when necessary. Health and disease come from a complex interaction of physical, emotional, dietary, genetic, and environmental, lifestyle and other factors. Naturopathic physicians treat the whole person, taking all these factors into account. Naturopathic physicians prefer non-invasive treatments which minimize the risks of harmful side-effects. Treatments are tailored to the needs of the individual patient based on a cogent philosophy that acknowledges the patient as participant. Naturopathic medical colleges are four-year postgraduate schools with admission requirements like those of conventional medical schools. Because the coursework in naturopathic theory and natural medicine is added to a standard medical curriculum, naturopathic doctors receive significantly more hours of classroom education than the graduates of leading medical schools, including Yale, Stanford, John Hopkins and Mayo medical schools. Patients are demanding evidence that medical practice be safe and effective. Natural medicine has been demonstrated to be both safe and effective through clinical studies and scientific evaluation. There are over 90,000 medical studies on complementary and alternative medicine, mostly from conventional medicine database resources. In fact, one textbook on naturopathic therapeutics references over 10,000 citations to peer-reviewed scientific literature documenting the efficacy of natural treatments.
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DISCLAIMER: The information contained in the document and website is provided FOR INFORMATIONAL USE ONLY AND MAY NOT BE CONSTRUED, CONSIDERED OR USED IN PLACE OF MEDICAL ADVICE OR INSTRUCTION. No action should be taken based only on this newsletter. Readers should consult a licensed naturopathic physician or medical doctor. The information and editorials in this newsletter are believed to be accurate, but readers who fail to consult with a physician assume the risk of injuries. (C) Copyright 2002 - 2007 Susan B. Kowalsky, N.D. All rights reserved. |