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Cabbage & Estradiol
for Men with Prostate Cancer
March 27, 2007
I have just encountered a very good example of the interactions
between food and drugs used to treat prostate cancer that I’d
like to share with you. My goal is to alert you about (1) indole-3-carbinol
and estradiol interactions, and (2) warn those of you on estradiol
about taking in large amounts of cabbage or related veggies.
Multiple studies have shown that eating vegetables related to
the cabbage family (brassica) reduce the risk of a range of cancers.
This has led to rather extensive research into the various plant
chemicals involved in this anticancer effect. One compound that
has emerged is indole-3-carbinol. This compound has a number
of interesting actions. For example, it blocks bcl2, a protein
that appears to help prostate cancer cells to survive hormonal
therapy. It also stimulates the liver enzymes involved in the
metabolism of estradiol, the most powerful form of estrogen.
Indole-3-carbinol treatment results in estradiol being converted
into estrone and other less active estrogenic compounds. This
has been invoked as a possible means to lessen the risk of estradiol-stimulated
cancers, such as carcinomas of the breast and endometrium (lining
of the uterus).
There is also a literature linking exposure to elevated estradiol
levels and the development of prostate cancer. Because of this
and the link to hormone resistance through bcl2, there is a growing
trend for men with prostate cancer to take indole-3-carbinol.
While estradiol may be an actor in the development of prostate
cancer, it is also true that it is well established as a form
of hormonal treatment of this disease and has been since the
1950s. With the recent literature on the use of transdermal estradiol
in the treatment of prostate cancer, I have made this a major
part of my second line hormonal therapy program. Recently, I
was able to observe a very interesting interaction between indole-3-carbinol
and transdermal estradiol.
Patient D has prostate cancer now resistant to treatment with
Lupron and Casodex. We were attempting to treat his disease with
transdermal estradiol and found that it was difficult to reach
serum estradiol levels. After some discussion, the patient pointed
out that over time he had changed his dose of indole-3-carbinol.
When we reviewed the results, we found that his serum estradiol
levels were being suppressed dramatically at the higher doses
of indole-3-carbinol. If you are on forms of estradiol, avoid
the following foods: cabbage, broccoli, rabini, wasabi, radish,
arugula, kale, turnip, mustard and mustard greens, collard greens,
and brussels sprouts.
This finding illustrates several points. First, indole-3-carbinol
is, indeed, powerful enough that it can reduce serum estradiol
levels. Second, this is not a good thing if your goal is to treat
cancer by dramatically increasing serum estradiol levels. Third,
it is often said about supplements that they might help and certainly
will not hurt. This is not necessarily the case. Supplements
can contain very powerful chemicals with the potential to help
or hurt you, depending on the situation.
The rest of this article can be read in Volume 9 Issue 10 of
Prostate Forum. Click here to download this issue now.
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