COMMENTARY

Pomegranate Juice for Prostate Cancer Prevention? Study Says...

Gerald Chodak, MD

Disclosures

August 28, 2015

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Hello. I'm Dr Gerald Chodak for Medscape. Today I want to talk about the possible role of pomegranate juice or extract in men with rising prostate-specific antigen (PSA) levels after local therapy for prostate cancer.

A randomized study[1] has finally been done and now we have some data on the PSA doubling time in men who took a placebo, a liquid extract of pomegranate juice, or pomegranate juice itself.

In approximately 180 men who were enrolled in this trial, the authors found that the PSA doubling time increased in the placebo and treatment groups, but the differences between the three groups were not statistically significant. They did find a slightly better effect of pomegranate juice compared with pomegranate extract. However, there were only 17 men in the extract subgroup, and it is unclear why they received it in the first place.

So, although it certainly tastes good and some preliminary studies have suggested a role for pomegranate juice on the progression of prostate cancer, this study suggests that there isn't much of a benefit.

PSA doubling time tells us nothing about survival. It is a much longer-term event, but it is unlikely that this study is going to be continued long enough to know whether there is a true impact on overall survival.

However, the investigators did find something interesting. They measured manganese superoxide dismutase and found that the PSA doubling time in men who were positive for that marker actually was much greater than the overall effect in all men, with and without that marker. So, further analysis and more time will be necessary to identify whether this dismutase plays a role in determining whether men may benefit from the ingredients that are present in pomegranate juice or extract.

There was certainly a lot of excitement early on about pomegranate juice and its potential role. However, in May 2012, the Federal Trade Commission found that the makers of pomegranate juice were making unfounded claims about the potential role of pomegranate juice in prostate cancer. They were claiming things that were just not proven to be true.

Now, with a randomized trial in place looking at an endpoint of PSA doubling time, we are not seeing a significant impact from pomegranate juice. Will longer follow-up make a difference? Perhaps, but for the moment, the impact of pomegranate juice extract on men with rising PSA levels after prostate cancer therapy is not significant, and for now it is hard to make an argument that it should be used.

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