C^O^N^T^E^N^T^S

CALENDAR OF EVENTS.................................................. 119

DABCI SCHEDULE/7WZZ.4, MISSOURI........................ 120

DABCI SCHEDULE/T(7ZA4, OKLAHOMA .....................121

FROM THE EDITOR'S DESK .........................................122

Virginia Kes singer

THE CLINICAL IMPORTANCE OF VITAMIN D(CHOLECALCIFEROL)A PARADIGM SHIFT WITH IMPLICATIONS FOR ALL^K4ZT^C47?£TP2?OF72)^^^......................................................................124

Alex Vasquez, DC, NDGilbert Manso, MDJohn Cannell, MD

RESOLUTION OF PROSTATE CANCER AFTERNUTRITIONAL PROTOCOLS AND LIFESTYLEMODIFICATIONS:^C4^£'^T£72)y.............................................................................................l38

Jason Nardi, DC, DABCI, DACBN, FIAMA

THOUGHTS AT LARGE: Issue 18CONTROVERSIES IN CLINICAL NUTRITIONAND FUNCTIONAL MEDICINEA NUTRITIONAL SUPPORT FOR CANCER PATIENTS........................ 148

Jeffrey Moss, DDS, CNS, DACBN

DABCIs AND WHERE THEY ARE........................................................... 155

CLINTPUBLICA TIONS

VOL. 26, N0.4 • ISSN 1529-4722 • DECEMBER 2020

Resolution of Prostate Cancer after Nutritional

Protocols & Lifestyle Modifications: A Case Study

by: Jason Nardi, DC, DABCI,, DACBN

, FIAMA.

Keywo rds: Prostate Cancer; Remission Induction; Clinical Nutrition; Food Habits; Lifestyle Factors

Abstract: Introduction: This case study focused on the use of lifestyle, diet and nutritional supplementation to support the treatment of prostate adenocarcinoma.

Case Presentation: The subject was a 72 year-old male recently diagnosed with prostate cancer co.nfirmed with a 12-needle biopsy by his urologist. History was positive for past prostati­tis, benign prostatic hypertrophy and environmental exposure associated with prostate carcinoma.

Management & Outcome: Serological inflammatory and immunological markers were high. Focus was on the use of botanicals with high flavonoid and polyphenol content to help support the immune system to reduce inflammatory pathways. Dietary restrictions and lifestyle modifications were implemented to also lower inflammation. Vitamin ther­apy using oral vitamin C in combination with vitamin K as an anti-cancer method. This combination has long been thought to have benefits in preventing neoplastic activity.

After six months of following protocols, blood markers were mostly improved and imaging showed no cancer present in the prostate.

Discussion: While the use of vitamin C and vitamin K is currently being used as an adjunct to traditional prostate cancer treatment as Apatone®, oral supplementation in the same ratio may have equal benefit. This case also showed there may be evidence that botanical support and vitamin therapy may be a viable vehicle in battling prostate carcinomas. The association between infec-

THE ORIGINA l lNTERNJST DECEM

BER 2020

tious prostatitis and prostate cancer has long been sus­pected. Systemic and localized applications of botani­cal agents showed benefits, while PSA remained

_ele­

vated. The use of botanicals in prostate adenocarcmo­mas warrants further investigation.

Introduction: Prostate cancer is the second leading cause of death in American males and the most common cancer. Accord­ing to recent figures, 1 in 9 men will be diagnosed with prostate cancer during his lifetime with an estimated 164,690 new cases th.is year with an estimated 29,430 1

deaths. The most prevalent risk factors are age and race·2 Other factors include diet, tobacco use, alcoholconsumption, low physical activity and exposure to environmental contaminants.3 Data also supports pastprostatitis and infections have a strong link to future prostate cancer.4·5

The presented case focused on a 71 year-old Caucasian male with prostate cancer confirmed with a needle bi­opsy, who presented for nutritional support before tra­ditional treatment. Suppo1t included oral zinc, vitamin C (VC), and vitamin K 1 and K2, as MK.7 (VK) supple­mentation and botanical agents.

Clinical History: The patient a 71 year-old Caucasian retiree. His social and work history included tobacco use at the age of ten until 22 and exposme to petrochemicals as an auto me­chanic. The subject worked at a family-owned nursery and greenhouse but does not remember using chemical fertilizers or pesticides. He also reported a history of hematospermia eight years before the diagnosis of prostate cancer; Hematospennia is associated with chronic prostatitis. 6

The patient had increasing PSA lab values from 3.8ng/ mL to 4.2ng/mL and was sent by his PCP to a urologist in January 2018, who confirmed with a surgical biopsy of 12 specimens in March 2018. Biopsy results showed prostatic adenocarcinoma in the left apex with a Glea­son Score of 6 (3+3)7consisting of IO¾ of needle core tissue. Using the ISUPS grading, this amounts to a prognostic grade group 1.8 After being told tr

_eatm�nt

would be determined with follow-up labs and unagmg that would be scheduled in July and August, respec­tively, the subject sought immediate alternative treat­ment methods for the interim.

Discussion: Alternative treatment began with simple dietary changes to cut down on and eliminate inflammatory foods. Processed meats were removed due to the high

(Continued on page 140)

138

association in raising overall cancer risks, and red

meats were replaced with grass-fed versions to help

increase Omega 3 intake, especially conjugated linoleic

acid (CLA), due to its anticarcinogenic effect.Other modifications were to increase activities to in-

elude 20 minutes or more of walking, increase water

intake to 2-3 quarts daily, and replace coffee with greentea.12

Initial Phase:The initial 30-day phase of care included nutritionalsupplementation aimed at promoting clearance in the

body using botanicals that also contained anticarcino-

genie properties. A product containing 50 mg each ofMilk Thistle,13 turmeric,14 artichoke,15'16schisandra,17

rosemary,18'19 dandelion,20'2' yellow dock,22 gentian,23

and barberry was used. Dosing was 50 mg of each,

combined in a capsule taken twice daily. Polyphenol

intake from these botanicals showed promise in fight-

ing cancerous cells; polyphenols' anti-carcinogenic

properties include inhibitory effects on cancer cell pro-

liferation, tumor growth, angiogenesis, metastasis, and

inflammation, and help induce apoptosis.25'2 Polyphe-

nols have shown promise in targeting signal transduc-

tion pathways involved in carcinogenesis and reduces

NF-kB mediated pathways, reducing inflammation as-

sociated with tumor cells; Up-regulation of NF-kB in

tumors cells inhibits apoptosis, increases angiogenesis

and metastatic capacity of tumor cells.27'28 Enzymatic

and antioxidative properties of flavonoids add to theireffectiveness; Antioxidative effects of flavonoids in-

duce enzyme deactivation of free radicals and reactive

oxygen species (ROS) and prevent them from becom-

mg mutagens/

Second Phase:

Compliance with suggestions was good after the initial30 days. While dietary restrictions and lifestyle modifi-cations did not change after the initial 30 days, newnutritional support was implemented. This phase of

care was focused on concepts that would arrest and

lower inflammation in the prostate and help support

anticancer pathways.

With ample indicators of prostatitis, a large focus was

on reducing inflammation. It is well known that copper

has a proclivity for prostate tissue. Copper is readily

leached from pipes used for plumbing in the US andcan at times exceed safe levels, depending on the tem-

perature of the water, mineral content, the age of the

plumbing and how long water has been standing in the

plumbing. To remove suspected copper from the pa-

tient, 60 mg of zinc picolinate was given daily. Some

data shows that zinc is essential to good prostate health.

THE ORIGINAL INTERNIST DECEMBER 2020

In one study, zinc levels were examined in several

groups of men with prostate issues: In prostate carci-

noma, zinc levels were decreased by 83%, and in BPH

there was a 61% decrease in tissue link levels com-

pared to normal tissues.

Additionally, Biocidin® capsules were used as anightly rectal suppository to help with possible infec-tious causes of prostatitis. Initial laboratory analysis

showed increases in both lymphocytes and monocytes,

with normal white blood cell counts (Figure 1). Bio-

cidin® was chosen for its ingredient content (Figure 2),

especially bilberry; because it was in capsules that

could be delivered more locally as a suppository. The

most common infectious agents in the prostatitis are

Escherichia coli, Klebsiella, Proteus, Pseudomonas,

Enterobacter, Enterococcus, Serratia, and Staphylo-

coccus aiireus, all of which rely on efflux pumps to get

rid of toxic substances, including antibiotics. Inhibitingefflux pump activity is shown to reduce biofilm forma-

tion.3 Bilberry, or Vaccinium myrtilhis L., contains the

polyphenol proanthocyanidin that has been shown to

prevent bacterial adhesion.

Vitamin K (VK) has been well known to have antioxi-dant effects on cancer, however recent studies are

showing that VK and its analogs have additional effectson cancer, including apoptosis, cell cycle arrest, auto-

phagy and modulation of various transcription fac-

tors.34 It has long been suspected that VK combined

with vitamin C (VC) would be effective in treating can-cer. Tareen, et. al. showed that VC and VK as Apa-

tone® were effective in delaying the progression of

advanced prostate cancer in 17 patients who did not

respond to standard therapy. While VC has been shown

to be an effective anti-oxidant and is shown to reduce

chromosomal damage, thus reducing neoplasm activity.

Taper et al. demonstrated that VC inhibited the growthof both androgen-dependent and androgen-independent

human prostate carcinoma cells in mouse models. Dos-

ing for this phase was Apatone® of 100:1 VC to VK;6,000 mg ofVC was used with 620 mcg ofVK.

Results:

The subject remained compliant with care after four

months of the above dietary and lifestyle modifications,

and nutritional supplementation. A new PSA lab was

taken in July; though still elevated at 5.2 ng/mL, thiswould be within normal for a patient of this age.38 One

month after the PSA lab multiplanar magnetic reso-

nance images of the pelvis were obtained using Gadav-

ist IV contrast. Clinical findings were: post obstmctive

hypertrophy of the bladder wall, most likely due toBPH. The prostate measured 4.3 x 4.8 x 4.8 cm, with

(Continued on next page)

140

an overall volume of 48 ec. This is considered

enlarged39 and was elevated at the bladder base; there

was mild heterogeneity of peripheral zone without sig-

nificant foci of diffusion restriction, or unusual vascu-

larity on computer-aided postcontrast evaluation; The

prostate capsule was intact; The neurovascular bundle

appeared normal bilaterally. The overall impression

was an enlarged prostate with BPH centrally. There

was no evidence of any suspicious lesion in the gland

and no evidence of extracapsular spread of a tumor.

The treating medical doctor agreed and stated their im-

pression overall was an enlarged prostate gland with

benign prostatic hypertrophy. No suspicious lesions in

the gland were noted and no evidence of any tumor.

Post-treatment suggestions were to continue with die-

tary and lifestyle modifications and follow throughwith the urologist's recommendations of annual PSA

and DRE.

Conclusion:

There has been ample study in the use of nutrition, sup-

plementation, lifestyle and dietary changes being used

to help hinder neoplastic activity. There appears to be

much overlap in the lifestyle changes having a benefitin different forms of cancer; from the removal of sugars

and high inflammatory foods to the addition of foodsthat support the body as a whole. Nutritional protocols,

on the other hand, should be aimed at supporting

Figures & Charts

Figure 1: Initial and follow-up lab values

Element

Glucose

AlkPhos

AST

ALT

Femtin

Hs CRP, Male

WBC

RBC

Neutrophils

Lymphocytes

M;onocytes

Eosinophils

Basophils

141

specific functions in treatment; the use of polyphe-

nols and flavonoids to reduce inflammatory signal-

ing pathways and cell proliferation, while inducingapoptosis appears to be a good reason for their in-

clusion.

While there is evidence that associates infection

with prostatitis and evidence that links prostatitis toprostate carcinoma, the connection between infec-

tious prostatitis and the prevalence of prostate can-

cer has never been shidied in-depth. Localized appli-

cation of botanicals may prevent bacterial adhesion

and the reduction of biofilms which may be an ef-

fective, low-cost solution to treat several prostate-

related disorders, most especially benign prostatic

hypertrophy and prostatitis.

The use of VC and VK has long been thought tohave antineoplastic effects. While the drug Apa-

tone® has been shown safe and is moving into ad-

vanced clinical studies, the use of oral VC and VK

supplementation is limited to case and small cohort

studies, which warrant further investigation.

Acknowledgments:

This case would not have been a success without the

guidance of Dr. Delilah Renegar.

Conflicts of Interest:

The author declares that they do not have conflicts

of interest.

3/31/2018

117.00

51.00

36.00

61.00

753.00

4.10

5.40

4.86

45.00

41.60

11.00

2.00

0.40

12/28/2018 Units

113.00

59.00

26.00

34.00

604.00

1.19

5.20

4.56

49.80

11.00

2.10

0.40

mg/dL

IU/L

IU/L

IU/L

ng/mL

mg/L

k/cumm

m/cumm

%

%%

%

Optimal Range

72.00-90.00

70-100

10.00-26.00

10.00-26.00

50.0-150.0

0.00-0.99

5.30-7.50

4.20-4.90

40.00-60.00

0.00-7.00

0.00-3.00

0.00-1.00

Standard Range

65.00-99.00

35-115

10.00-25.00

6.00-29.00

10.0-232.0

0.00-2.90

3.80-10.80

4.20-5.80

40.00-60.00

0.00-7.00

0.00-3.00

0.00-1.00

(Continued on next page)

THE ORIGINAL INTERNIST DECEMBER 2020

Fignre2: Biocidin ingredients &

Ingredient

BilberryNoni

Milk Thistle

Echinacea

Golden Seal

Shitakemushroom

White willowbarkGarlic

Grape Seed

Black Walnut

Raspberry

FumitoryGentian

Tea Tree oil

Galbanum oil

Lavender oil

Oregano oil

Vaccinhim myrtillns

Morinda citrifolia

Silybiim marianum

Echinacea pnrpnrea

Echinacea

angiistifolia

Hydrastiscanadensis

Lentimilaedodes

Salix albaAllium sativum

Vitis vinifera

Juglans nigra

Rubus idaens

Fnmaria

officinalisGenriana lntea

Melalenca

allernifoliaFerula

galbanifluaLavandiila

officinalis

Origanumvulgare

actions

Medicinal Action

Anti-inflammatory, antimicrobial, antioxidant, urinary antisepticAnti-inflammatory, antimicrobial, antioxidant

Antimicrobial, antioxidant, choleretic, hepatic trophorestorative, hepa-

toprotective.

Anti-inflammatory, antifungal, antiviral, depurative,

immune-enhancing, immune-modulating, lymphatic

Antibacterial, antihistamine, anti-inflammatory, antimicrobial, mucous

membrane, trophorestorative.

Antibacterial, antifungal, antioxidant, iiTimune-modulating.

Analgesic, anti-inflammatory.

Anthehnintic, anti-inflammatory, antimicrobial, antioxidant.

Antheknintic, anti-inflammatory, antioxidant.

Anthelmintic, antimicrobial, depurative.

Anti-inflammatory, antimicrobial, antioxidant.

Antimicrobial, antioxidantAnti-inflammatory, antimicrobial, antioxidant.

Antifangal, antimicrobial.

Anti-inflammatory, antimicrobial, antiseptic.

Antifungal, anti-mflammatory, antimicrobial.

Antibacterial, antifungal, anti-inflanimatory

Reference40.41.42

41

40,42

41.42

40.42

42

40

40

42

40

40.42

40,42

44. 45,46

47

48

49

About the AuthorDr. Jason Nardi is a Board-Certifled Chiropractic Intermst

and clinical nntritiomst and he holds a fellow in medical acu-

puncture. Dr. Nardi maintains a private practice in Jimean,

Alaska that focuses on neuro-strnctnral issues, pain condi-

tions, and digestive and hormonal health using a whole-

person, holistic approach. Dr. Nardi has a passion for ediica-

tion and research and has worked with several magazines in

the including HealthLine, LifeZette, Organic Authority, and

CafeMom as an expert source for authors. He is the past Di-

rector of Research and current Director of Education for the

American Chiropractic Association's Council on Nutrition.

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