An Anti-Cancer Compound Hiding in Front of Us: Gluconate

Gluconate, a cheap, available and harmless substance

I recently came across this scientific article reference by one of the active members of this website (J) and realised that something very valuable was hidden in there. In this article, the authors are discussing Gluconate.  Their research suggests that the anti cancer effect of Gluconate could be relevant for most types of tumours. In addition, the authors identified cases where patients were responding to various anti cancer treatments possibly not due to the main medication intended to be used against cancer but because of Gluconate, a substance often present in the drugs and supplements.

Gluconate forms when gluconic acid comes in contact with aqueous solutions at neutral pH. Gluconic acid, occurs naturally in fruits, wine, honey but it is also present in foods where it is used as food additive. Gluconic acid production dates back to 1870 when Hlasiwetz and Habermann discovered gluconic acid. (Ref.) As a food additive, it is identified as E574 where it is used as an acidity regulator. Gluconate chelates various elements such as Calcium, Iron, Copper and as a result it is used in manufacturing drugs and supplements (Ref.). It it is even used in cleaning products to dissolve mineral deposits. (Ref.) Therefore, gluconic acid and gluconate are used in the formulation of food, pharmaceutical and hygienic products. 

What is great about Gluconate as an anti cancer treatment is that it is a cheap and widely available substance, considered by the FDA to be a harmless substance. (Ref.)

Citrate is back 

As I will further discuss in this post, Gluconate represents not only one more tool to fight cancer. Instead, it also helps us acquire new knowledge regarding the relevance of modulating Citrate (which is what Gluconate does) to fight cancer. While the ingestion of Citrate as a way to fight cancer has been previously discussed on this website here and here, the info I am sharing below is different. It shows that working in the opposite direction, towards reducing intra-cellular Citrate, is another good strategy to fight cancer.  I will explain below why both strategies (increasing or decreasing intra-cellular Citrate) can work.

Indeed, we have seen so often that there is not just one way to fight cancer. What is important is to chose a strategy and be consistent with that. For example, it’s possible to fight cancer with both pro-oxidant strategies and anti-oxidant strategies. Choosing to focus on a weak point and fight from one or the opposite direction can be effective against same type of cancer. What doesn’t work is when we mix them up.

Gluconate, reduces intracellular Citrate

Citrate plays a central role in the metabolism of cancer cells (Ref.). Citrate is the primary substrate for fatty acid synthesis, cholesterol production and contributes to the amino acid synthesis. In addition, it has impact on many other intra-cellular processes such as those discussed here (Ref.) as it is the primary “fuel” for the mevalonate pathway (next to acetate).

Cells have two major sources of Citrate:

  • Extracellular Citrate received through the blood supplies, with it’s origin in our diet, and
  • Citrate produced inside the cells. 

Manipulating Citrate via diet to fight cancer has been a subject intensively debated on this website (Ref.). Increasing intra-cellular citrate, is a scientifically recognised way to inhibit glycolisis (fermentation) in cancer cells (Ref.) and according to various reports, it has been applied successfully to induce remissions in cancer patients. That was achieved by administrating relatively high doses of Citric Acid to the patients. (Ref.)

Contrary to this approach, other scientist have suggested that another effective way to fight cancer is to lower the Citrate available for tumors. That would reduce fatty acid synthesis, cholesterol production and the amino acid synthesis. In line with this, recently, Dr. Maria E. Mycielska, et al. observed that extracellular Citrate is taken up by cancer cells through a plasma membrane Citrate transporting protein more than in normal tissue. They have also found that decreased blood Citrate levels is associated with patients presenting tumors  such as those in the lung, bladder, and pancreas (Ref.). Furthermore, the scientists have found that:

  • tumors demand even more citrate when they are in hypoxic area where typical nutrients are harder to find – indeed it is known that citrate transport is stimulated by acidification of extracellular pH (Ref.). 
  • plasma membrane citrate transporting protein is even more expressed in advanced tumors and metastases
  • in line with the above, the presence of extracellular citrate raised the level of (unlabeled citrate) in the cells
  • citrate consumption lead to a reduction of glucose and glutamine uptake by the cancer cells (Ref.)

The scientists and medical doctors at the University Hospital Regensburg in Germany also discovered an inhibitor of plasma membrane Citrate transporting protein. The inhibitor they found is Gluconate. In my view, this is a great finding – I was looking for such inhibitor for long time to also add to the anti-cholesterol strategy I developed and shared here (Ref.).

Furthermore, the authors demonstrated that the  application of Gluconate on cancer cells blocks extracellular Citrate influx and as a result reduces the tumor growth. As expected, the tumor growth reduction was not only effective on prostate cancer cells but also pancreatic cells. However, because plasma membrane Citrate transporting protein is highly expressed in most cancer types and even more in the aggressive ones, the authors expect that Gluconate could reduce the tumor growth in most cancer types. (Ref.)

With this, the scientific team has demonstrated a new way to fight cancer, that lowers the intracellular Citrate with inhibitors of Citrate membrane cell transporters responsible for the absorption of Citrate from the extracellular space.

The publication of these findings, triggered a discussion in the academic space regarding the two different apparently contradictory approaches to kill cancer: one that has been discussed before (Ref.1, Ref.2), focused on increasing intracellular Citrate, and this one discussed here focused on decreasing intracellular Citrate. Here is, on short, the answer of the authors:

“Although these approaches seem contradictory, they are actually based on the same ability of cancer cells to specifically import extracellular citrate. Both the “low” and “high” citrate uptake approaches do make sense, because low uptake limits citrate availability for critical cancer cell metabolic processes such as fatty acid synthesis, and high intracellular citrate levels inhibit glycolysis and disturb other cellular functions, which are also important for cancer cells” (Ref.)

Anti cancer results in humans after the application of Gluconate

The fact that Gluconate inhibits Citrate absorption into the cell is new and as a result there is no case report directly focused on Gluconate. However, the authors of the paper above have investigated the literature and have publish a new paper entitled “Potential Use of Gluconate in Cancer Therapy” (Ref.). In this papers the authors, based on various arguments, suggest that Gluconate may be the one responsible in achieving the positive results in the fallowing cases:

  • Treatment of acute lymphocytic leukemia using zinc adjuvant with chemotherapy and radiation–a case history and hypothesis (Ref.).Here, great results were obtained in a case of a 3-year-old girl, who received Zn gluconate next to the chemo. While the results were attributed to Zn, the authors suggest that the results were due to Gluconate, since the same results could not be reproduced when Zn sulfate was used (Ref.)
  • Disulfiram inhibits activating transcription factor/cyclic AMP-responsive element binding protein and human melanoma growth in a metal-dependent manner in vitro, in mice and in a patient with metastatic disease. (Ref.) This is a very nice case report we previously discussed in the post I wrote on zinc (Ref.), where a patient experienced reduction in hepatic metastases and finally the treatment produced clinical remission of the stage IV metastatic ocular melanoma. The treatment used included Disulfiram and Zn Gluconate.  Also here, the authors of the paper above suggest that the patient may have been successfully treated due to the Gluconate element, since the clinical trials including Disulfiram withouth Gluconate did not showed positive results, such as this trial.

To me, it is not clear if Gluconate played the major role in the treatment leading to the results presented in the above case reports. However, since it’s a safe, cheap and easy to get compound, I would try it anyway, as a part of a more extensive treatment strategy.

Where to get Gluconate and how to use

Gluconate can be found online as a supplement, in combination with e.g. Zn, Mg, etc. Since I would prefer to use a higher dose, I would better go for Mg Gluconate. Here is an example of Mg Gluconate and here is another one. I would probably take 500 mg Mg Gluconate, 3x/day. As a reference, the melanoma patient in the successful case report above used 50 mg Zn Gluconate 3x/day.

Strategy to support the anti-cancer action of Gluconate

  • In order to further increase the potential of Gluconate activity towards lowering intracellular Citrate, I would also add mithocondrial inhibitors such as those discussed here (Ref.)
  • In order to further increase the potential of Gluconate towards cholesterol inhibition (due to citrate minimisation) I would add Statins and other drugs and supplements mentioned here (Ref.) and/or here (Ref.)
  • In order to further increase the potential of Gluconate towards fatty acids synthesis inhibition (due to citrate minimisation) I would also add high dose EGCG green tea extract.

Strategy to support anti angiogenesis treatments

It is important to mention that in hypoxic areas, citrate is often provided by the tumor micro environment (fibroblasts) (Ref.). We have seen that fibroblasts are also feeding the tumors withe acetate (Ref.) and lactate.

Therefore, as a side note, this makes me realise that a strong strategy to support anti angiogenesis treatments would include the following

  • inhibitors of citrate export by fibroblasts or import by cancer cells – Gluconate, as discussed in this post
  • inhibitors of acetate export by fibroblasts or import by cancer cells – such as discussed here (Ref.)
  • inhibitors of lactate export by fibroblasts or import by cancer cells – use MCT1 and MCT4 inhibitors – some are discussed here (Ref.)
  • other resources from fibroblasts such as cystein can also be addressed as discussed here (Ref.)
  • another source of nutrients is from glycogen stored inside the cells – to address this, use a combo of repurposed drugs as discussed here (Ref.) or at least one of them, e.g. Valproic Acid
  • and yet another source of nutrition is autophagy – use authophagy inhibitors as discussed here (Ref.)

Since angiogenesis inhibitors cut the blood supply, tumor rely on micro environment to receive the much needed supplies and be able to proliferate. Indeed, it is known that tumors can grow even without blood supplies, and addressing fibroblasts is the key in this case.

References and additional reading

Combination of Mitochondrial and Plasma Membrane Citrate Transporter Inhibitors Inhibits De Novo Lipogenesis Pathway and Triggers Apoptosis in Hepatocellular Carcinoma Cells https://www.hindawi.com/journals/bmri/2018/3683026/

Increased expression levels of both mitochondrial citrate transporter (CTP) and plasma membrane citrate transporter (PMCT) proteins have been found in various cancers. The transported citrates by these two transporter proteins provide acetyl-CoA precursors for the de novo lipogenesis (DNL) pathway to support a high rate of cancer cell viability and development. Inhibition of the DNL pathway promotes cancer cell apoptosis without apparent cytotoxic to normal cells, leading to the representation of selective and powerful targets for cancer therapy. The present study demonstrates that treatments with CTP inhibitor (CTPi), PMCT inhibitor (PMCTi), and the combination of CTPi and PMCTi resulted in decreased cell viability in two hepatocellular carcinoma cell lines (HepG2 and HuH-7). Treatment with citrate transporter inhibitors caused a greater cytotoxic effect in HepG2 cells than in HuH-7 cells. A lower concentration of combined CTPi and PMCTi promotes cytotoxic effect compared with either of a single compound. An increased cell apoptosis and an induced cell cycle arrest in both cell lines were reported after administration of the combined inhibitors. A combination treatment exhibits an enhanced apoptosis through decreased intracellular citrate levels, which consequently cause inhibition of fatty acid production in HepG2 cells. Apoptosis induction through the mitochondrial-dependent pathway was found as a consequence of suppressed carnitine palmitoyl transferase-1 (CPT-1) activity and enhanced ROS generation by combined CTPi and PMCTi treatment. We showed that accumulation of malonyl-CoA did not correlate with decreasing CPT-1 activity. The present study showed that elevated ROS levels served as an inhibition on Bcl-2 activity that is at least in part responsible for apoptosis. Moreover, inhibition of the citrate transporter is selectively cytotoxic to HepG2 cells but not in primary human hepatocytes, supporting citrate-mediating fatty acid synthesis as a promising cancer therapy.

Flipping a citrate switch on liver cancer cells https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566541/

Energy homeostasis and oncogenic signaling are critical determinants of the growth of human liver cancer cells, providing a strong rationale to elucidate the regulatory mechanisms for these systems. A new study reports that loss of solute carrier family 13 member 5, which transports citrate across cell membranes, halts liver cancer cell growth by altering both energy production and mammalian target of rapamycin signaling in human liver cancer cell lines and in both an in vitro and in vivo model of liver tumors, suggesting a new target for liver cancer chemoprevention and/or chemotherapy.

Citrate transport and metabolism in mammalian cells: prostate epithelial cells and prostate cancer. https://www.ncbi.nlm.nih.gov/pubmed/19153992

Extracellular Citrate and Cancer Metabolism—Response https://cancerres.aacrjournals.org/content/canres/early/2018/08/16/0008-5472.CAN-18-1899.full.pdf

Understanding the central role of citrate in the metabolism of cancer cells. https://www.ncbi.nlm.nih.gov/pubmed/22101401/

Cancers cells strongly stimulate glycolysis and glutaminolysis for their biosynthesis. Pyruvate derived from glucose is preferentially diverted towards the production of lactic acid (Warburg effect). Citrate censors ATP production and controls strategic enzymes of anabolic and catabolic pathways through feedback reactions. Mitochondrial citrate diffuses in the cytosol to restore oxaloacetate and acetyl-CoA. Whereas acetyl-CoA serves de novo lipid synthesis and histone acetylation, OAA is derived towards lactate production via pyruvate and / or a vicious cycle reforming mitochondrial citrate. This cycle allows cancer cells to burn their host’s lipid and protein reserves in order to sustain their own biosynthesis pathways. In vitro, citrate has demonstrated anti-cancer properties when administered in excess, sensitizing cancer cells to chemotherapy. Understanding its central role is of particular relevance for the development of new strategies for counteracting cancer cell proliferation and overcoming chemoresistance.

Targeting FBPase is an emerging novel approach for cancer therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845355/

Citrate targets FBPase and constitutes an emerging novel approach for cancer therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225682/

Extracellular Citrate Affects Critical Elements of Cancer Cell Metabolism and Supports Cancer Development In Vivo https://cancerres.aacrjournals.org/content/78/10/2513# 

Glycolysis and fatty acid synthesis are highly active in cancer cells through cytosolic citrate metabolism, with intracellular citrate primarily derived from either glucose or glutamine via the tricarboxylic acid cycle. We show here that extracellular citrate is supplied to cancer cells through a plasma membrane-specific variant of the mitochondrial citrate transporter (pmCiC). Metabolomic analysis revealed that citrate uptake broadly affected cancer cell metabolism through citrate-dependent metabolic pathways. Treatment with gluconate specifically blocked pmCiC and decreased tumor growth in murine xenografts of human pancreatic cancer. This treatment altered metabolism within tumors, including fatty acid metabolism. High expression of pmCiC was associated with invasion and advanced tumor stage across many human cancers. These findings support the exploration of extracellular citrate transport as a novel potential target for cancer therapy.

Potential Use of Gluconate in Cancer Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593216/

We have recently discovered that cancer cells take up extracellular citrate through plasma membrane citrate transporter (pmCiC) and advantageously use citrate for their metabolism. Citrate uptake can be blocked with gluconate and this results in decreased tumor growth and altered metabolic characteristics of tumor tissue. Interestingly, gluconate, considered to be physiologically neutral, is incidentally used in medicine as a cation carrier, but not as a therapeutically active substance. In this review we discuss the results of our recent research with available literature and suggest that gluconate may be useful in the treatment of cancer.

Disclaimer

This site is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this site and linkages to other sites, I provide general information for educational purposes only. The information provided in this site, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider. I am not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site. This is just my own personal opinion regarding what we have learned on this road.

Please read an extended version of the Disclaimer here: https://www.cancertreatmentsresearch.com/?page_id=1794

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93 thoughts on “An Anti-Cancer Compound Hiding in Front of Us: Gluconate

  1. I really like this line of thinking, D! And this is a fruit acid, the link to diet pops up again and again. Each time we eat or drink something is an opportunity (or a missed one) to try and slow down cancer. My choice would also be Mg Gluconate. It’s exciting to see how you’re producing a variety of options that are readily available and cheap. Cheers!

  2. Thanks, D! Needs a lot of updating though! I started it to share the story of my father-in-law’s recovery from recurrent primary glioblastoma, I try to keep that page updated with relevant new information.

  3. Good afternoon,

    Another awesome thread Daniel, thank you.

    I have just ordered the magnesium and zinc gluconate. Just a doubt about zinc, is too much daily 50 mg zinc ?

    warm regards

    Inaki

    1. Hi Inaki,

      Thank you.

      On your question related to Zn:
      – Zn Gluconate was take in doses of 50mg 3x/day in the studies and in the successful case report. So it should not be much taking 50mg Zn Gluconate/day
      – currently, the recommended dietary allowance for zinc in the United States is 8 milligrams (mg) a day for women and 11 mg a day for men. This would lead to a 50mg Zinc Gluconate
      – but if you are asking about elemental zing, taking 50mg elemental zinc, that would be 385 mg zinc gluconate, which is on te high side indeed.

      Is this answering your question?

      Kind regards,
      Daniel

      1. Hi Daniel,

        I think i have understood it. I´m going to take zinc (1-2 capsules ) and magnesium (2-3 daily )in the gluconate form to help to mantain the current situation 🙂

        Warm regards

        Inaki

  4. Hi D- Thanks for this post, it is so easy to add this in, and inexpensive. For us, it just means switching the form of some of the nutrients my husband is already taking. -Shanti

    1. Hi Shanti, thank you for the info. I don’t like potassium that much so I am happy to read zinc and magnesium gluconate.
      (One other category of anti cancer substances that I investigated a lot in the past but did not had the chance to speak about includes Na/K exchange inhibitors.)
      Kind regards,
      Daniel

  5. Hi D-
    Apart from potassium concerns around cardio and electrolyte balance, do you see concerns with high potassium intake from supplements and cancer? Is that what you are alluding to with the Na/K inhibitors?
    Thank you!

    1. Hi Shanti,

      Yes, I don’t like K supplements due to impact on tumor growth. This is why NaK inhibitors are effective against cancer (such as Bufalin, Ouabain, Oleander, etc.). For prostate tumors I would be even more careful with K due to its relation with testosterone.

      Kind regards,
      Daniel

      1. Hi D, Dr. Max Gerson(Gerson Therapy) said there’s a need for potassium supplementation to reverse cancer and other chronic diseases. You’re saying that’s potentially harmful in cancer?

        1. Hi Johan,

          most aggressive tumors are surrounded by potassium due to necrosis and cellular breakdown. This logically would indicate that there is no point in adding more.

          It has been recently found that this high density of potassium around tumors inhibits the activation of T cells. In addition, ion dynamics is overactive in cancer cells and potassium is one key element here. Potasium channels are over-expressed in tumors. There is a lot of research indicating that inhibition of the potassium exchange leads to tumor growth inhibition. This is why alternative treatments such as oleander can work or repurposed drugs such as cardiac glycosides can work against cancer. Interfering with ion dinamics is also one of the key mechanisms related to the influence of electro/magnetic fields on tumors.

          I usually don’t like when I see potassium given intravenously to cancer patients, specifically when they are in advanced stage.

          I do not know if in early stage of cancer development would be any mechanism that would work opposite to the above, i.e. pushing more potassium to kill cancer cells.

          In any case, these are the reasons why I would stay away from supplementing with potassium in cancer patients.

          Kind regards,
          Daniel

  6. Hi Daniel,

    I am looking through all the references for Prostate Cancer, we are needing to add to our existing protocols. My husband’s PSA is still rising, currently at 226, although he is still feeling good and has a good appetite. He is going resistant to ADT, which includes Firmagon and Xtandi. His Onc only has chemo to offer and being stage IV with mets, this isn’t want he wants to do. So far Fenbendazole has to be the one addition that is working for him, giving him a good quality of life right now. He has been on it for four months, taking 8/10ths of a gram daily. A recent X-ray shows that he has mets in his right hip that has apparently “healed”.

    We are planning to add Zinc Gluconate and I have been able to order 4-MU from the UK, which should be here in a week. I too have read that Zinc might promote tumor growth, so we haven’t used zinc before.

    Also I just read also this discussion regarding potassium, we too are using Gerson’s protocol and have been adding the potassium to the juices. We have been doing this for three years, yikes…. the vegetarian diet is high in potassium, correct?

    Thank you for all you do.
    Carol

    1. I think we should all keep in mind that there is reason for caution but that there is no data showing taking potassium or eating high potassium foods will worsen cancer, only that inhibiting the Na/K pump is a potential proven target, and that in later stage cancer, high potassium around the tumor has some immune inhibitory effect. It could be a situation like glutamine, where depleting/blocking it may be part of a metabolic cancer strategy, but if we are not focused on that strategy, taking doesn’t seem to worsen the cancer, we just don’t know. With regards to Testosterone, hypokalemia can lead to low testosterone, but if you are not potassium deficient, will taking more potassium than needed cause you to produce more testosterone, I tend to think it wouldn’t, but I couldn’t find data one way or the other.

      1. Dear Shanti, Johan, Carol,

        Your points made me think more about Gerson diet, which is not a subject that I researched deeply so far.

        First, I agree with you Shanti in that there is not enough research to make a strong conclusion on the relation between potassium and testosterone. But whenever there is a doubt I would prefer to be cautious.

        As you know, I always try to think constructive. So I thought a little more about this subject and wondering why Gerson therapy may work as well, from a mechanism point of view. Here are some more thoughts on that:

        – from a cancer fighting point of view, like with many other compounds we previously discussed, I can imagine that strategies could also be build to focus on overloading cells with potassium, that could in turn trigger cancer cell death.
        – that is because cancer cells and their survival is extra sensitive to intracellular Ca. Overloading or depletion of intracellular Calcium in cancer cells leads to their death as discussed here https://www.cancertreatmentsresearch.com/just-another-perspective-a-calcium-perspective/
        – therefore, potassium overload may lead to depletion of intracellular Calcium, triggering cell death (Cytosolic Calcium is precisely regulated in cells as it controls essential cell functions including proliferation and apoptosis) – this would also happen with Calcium overload
        – as we previously discussed, in cancers, there is a large amount of potassium around the tumor that inhibits T cell function
        – getting all this potassium removed, via e.g. transfer into the cells, could on one hand trigger cancer cell death on the other hand trigger reactivation of immune system
        – it is well known that insulin activates sodium-potassium ATPases in many cells, causing an influx of potassium into cells
        – it is also well known that the juices from Gerson diet lead to an important increase of blood glucose level, which in turn leads to release of insulin
        – therefore, insulin release following juicing should get the potassium into the cells and achieve the above, i.e. reactivation of immune system near the tumors and possibly cancer cell death due to the potassium overload and in turn Ca depletion

        Off-course, a major risk following so much juicing is related to the blood sugar increase. For those who want to go this route, a way to try to convert this risk into a potential advantage against cancer, could be achieved by combining Gerson diet with the pH strategy https://www.cancertreatmentsresearch.com/ph-cancer-a-top-treatment-strategy/ In case too much glucose gets to the cancer cells, adding the pH strategy would lead to acidifying cancer cells (known to trigger cell death) as well as reducing acidity around the tumors that is an additional positive point for the immune activity. Or at least combine Gerson with bicarbonate to maintain the tumor environment friendly for the immune activity.

        However, I still don’t think it’s a good idea regarding potassium supplementation, even less when given intravenously (because if we do not succeed to overload cancer cells with potassium to a level that triggers cancer cell death, that may just support cancer growth).

        Kind regards,
        Daniel

        1. Thank you, D! A few years ago I wanted to know if the Gerson Diet was something I could recommend to a family member, so I tried it and it’s really not easy to follow. 13 fresh organic juices a day, plus the Hippocrates soup, and some supplements (the easy part). It’s almost a full-time job. And you need to do regular/hourly coffee enemas (that I didn’t try). It’s also important to know this protocol was designed a long time ago, about 100 years ago. With all the new science, If Dr. Max Gerson would be alive today I believe he’d design a different protocol. That said, people are being helped/cured following this protocol. There’s Don’s case here on the site, and the many testimonials and case reports on the Internet. In the documentary “Dying to Have Known” there are a few amazing testimonials, especially from the MD’s in Japan. The problem is they don’t say if they did any other treatments.

          1. Thank you Johan! I do believe in the contribution of fresh organic juices. I’ve seen how well my wife did on that when we did it intensively. We did took extreme approaches from a diet point of view – I remember I lost 15kg in a few months, leading the change in diet so that my wife would do it too. But like you said, it’s an almost full time job … so it’s not sustainable if you also want to have a life. Sustainability is one of the reason why I am not so much a supporter of extreme approaches anymore. Regarding testimonials, while I believe in the outcome, the question it’s always about what else the patient is doing. I’ve seen so many cases of patients claiming they were doing well on something. But that something was just a small part of everything they were doing. That reminds me of a friend who invested over one million dollars in treatments at clinics around the world. He was doing well and several of the clinics where he was treated was using him as an example (even on TV) of how well the patients were doing on their own treatments. Regarding Don, I remember more than a year ago we had a e-mail discussion regarding Keto diet for hormonal cancers. After that he decide to stop with keto diet, he than made a choice for Gerson. Now the questions is: was PSA suddenly drooping because of stooping with KD or because of starting with Gerson? I think both had their own contribution. In any case, in my view a balanced plant-based diet including juicing it’s the best, as long as that is not a full time job, for a sustainable and positive support of life. I do believe that such approach in cancer will at least help to slow down cancer evolution.

            1. Hi Daniel,
              We have added the Budwig diet to a more lenient Gerson diet. Gerson didn’t heal my husband’s prostate cancer after following it 3.5 years very strictly. The Budwig pudding is well tolerated by my husband and improves digestion and all that is connected to lower GI health which he really needs. We wish now that we had added Budwig AND all of the repurposed drugs (which we didn’t know about until a friend sent us the book “How to Starve Your Cancer” by Jane McClelland. Then I found your wonderful website which goes into more depth and research. We think beginning to think that there are parts of Gerson that may feed Prostate cancer. Gerson seems to work well for for Melanoma and soft tissue tumors.
              Thanks!
              Carol

            2. Thanks Johan, this reference is very helpful: for long time it was my belief that ketogenic diet is best avoided by those fighting hormonal cancers.

          2. I agree that Dr. Gerson would have made some modifications, I have a doctor friend who recently went to work at a Gerson clinic in Mexico for a couple of weeks and she told me that at that particular clinic they had emphasized vegetable juice and limited the fruit juice to 2 per day.

        2. Hi D,
          Thank you for the well thought out points on the Gerson therapy. We considered trying it, but it was the sustainability aspect made us hesitate, along with the sugar the fruit juices. My sense is that people can respond to this and other similar diets, but the cancer often returns when the diet is discontinued. Apart from potassium and other MOAs, I think calorie restriction (CR)/ protein restriction is likely a main mechanism of action. Below is a link to a post I made while you were traveling on the observations of Dr. George Yu on cancer response rates to fasting, CR, juicing diets. Dr. Yu is the author of the case report on the treatment of advanced prostate cancer with Cabergoline and Clioquinol.
          https://www.cancertreatmentsresearch.com/update-from-don-on-the-healing-from-prostate-cancer/#comment-8686
          Warmly,
          Shanti

          1. Hi Shanti,
            Very interesting article by Dr. George Yu. Possibly we stayed too long on a CR diet. The past several months we’ve carefully added more foods and eliminated the fruit in the vegetable juices. My husband has talked to other Gerson patients who have healed their prostate cancers in about two years. They did not do convention treatments. There may be something about using ADT that might have interfered with this therapy?
            Thanks,
            Carol

            1. Hi Carol-
              I think you have done a great job with the diet you have implemented for your husband, and that it has probably given him great benefit. I don’t think it is the case that staying on CR too long has worsened the situation, or that ADT has interfered with the therapy. My thought is that cancer is highly adaptive, and while some people may respond to Gerson or get results for some sustained period, for others it will not work, or will only work temporarily, or partially. This doesn’t mean it hasn’t helped or isn’t continuing to help. While my husband hasn’t done Gerson, he does drink a celery, kale juice daily, eat mostly raw food and have a blueberry shake at night. The time when I would avoid CR is when there is cachexia. As we learn we can make modifications, for example, less fruit juice and more veggie juice.
              Warmly, Shanti

          2. Hi Shanti,

            Thanks a lot for the link. I’ve seen this page before, probably from your earlier post, but it’s good to see it again. This reminds me that there are so many organisations around the world contributing to the fight against cancer (such as https://yufoundation.org), but each in it’s own way, and as a result fragmented. We have to find a way to unite as much as possible this positive energy into one.

            Kind regards,
            Daniel

  7. Hi John & Shanti,

    It’s all so confusing isn’t it. We dropped the coffee enemas a couple of months ago, and then recently I read that since CEs may raise Glutathione levels, which may not have been the best thing for Prostate Cancer. His testosterone is low with all the ADT at 22 at last blood test, so with rising PSA and ALK we are now faced with changing up what we are doing to slow down growth. He is still has a good appetite, on a low protein, low fat -only flax oil, no dairy or egg diet. We are thinking about adding these new treatments to his supplements (Curcumin, Lycopene, Vit D, Vit E, Green tea, CoQ10, B-12, Folic Acid, Quercetin, Resveratrol, Sulforaphane, Pomegranate, Magnesium, Boron, Melatonin, Niacin, Pancreatin, Liver glands, CBD, Aspirin, Milk Thistle)

    1. Cemetidine
    2. Increasing Fenbendazole from .8 g to 1-1.5 grams daily / splitting the dose possibly
    3. Berberine or Metformin (We have the presc, but he doesn’t feel good at all taking Metformin so have held off)
    4. 4-MU
    5. Zinc Gluconate
    6. Atorvastatin – we have a presc. but his cholesterol is already low at 116 so have held off

    We could also go in for a IVC 25 g – but I am confused about whether this is right for PC now, since I’ve learn it is not glycolic – sugar driven in the later stage. Any thoughts to share?

    Thx!
    Carol

    1. Hi Carol,
      Does your husband have any soft-tissue mets or lymph node mets? Do you know if the cancer has gone at all into the bone marrow? As you know, conventional cancer treatments have varying degrees of side effects. Two treatments that have relatively few side-effects are provenge and Lu-177. The window for provenge is after 2nd line ADT failure and before chemo, after chemo it won’t work as well and before 2nd line ADT failure, insurance won’t cover it.

      If you and you and your Husband are able to travel physically and financially, please consider Lu-177 as an option. It has been shown to work better than Chemo for most men once they fail 2nd line ADT. It has also been show to work better before chemo has been tried. Lu-177 has relatively few side effects.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787223/
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355374/
      I have been following various men on HealthUnlocked’s Advanced Prostate Cancer Forum, and while some did not respond, others have gone into remission with low PSAs and negative scans.
      Regarding some of the supplements you mention, I agree with Johan about the B12 and Folic acid. Sulforaphane and a product called Pomi-T (combo of curcumin, green tea, pomegranate and broccoli extract) each have a clinical trial showing some response in PSA decrease or slowing. You want at least 30mg of sulforaphane (or precursors that will give you that amount once ingested). I like the others you have listed and my husband takes several of them. Below is a study in which weekly 60g IVC did not slow progression in metastatic castrate resistant men, however, I think the therapy may still be of some value if combined with other therapies, or as some have suggested on this site, given daily as an extended infusion. We were doing IVC when my husband was first diagnosed and just started it up again this week after over a year of not doing it. We are starting with weekly 75g IVC combined with a water fast the day before and until after the therapy is completed. Since IVC is an oxidative therapy, we also add in ozone therapy, colloidal silver, artemisinin, and hyperthermia. He also eliminates all antioxidants the day of and the day before the therapy. We may stack on other therapies as tolerated, for example there are some cell studies indicating that doxycycline and azithromycin will work well the vit C to kill cancer, including stem cells, but I am often in the same boat as you in that hubby often responds poorly to medication and can not tolerate.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503969/
      Best to you,
      Shanti

      1. Hi Shanti & Daniel,

        My husband only has bone mets but fast rising PSA and ALK. We stopped the addition of potassium liquid today. Yes, the cancer has gone into the bone marrow, he had a collapsed vertibrae and a Kiphoplasty done this past April to burn out the cancer and they put in cement. That took care of the the pain and his back structure. There are bone mets in his right hip and various other places in the spine and ribs. They come and go – showing they healed and then flare up. We think the Gerson Therapy has kept him from totally falling apart, and feeling and looking healthy, albeit very skinny.
        Gerson therapy is very strenuous. I have been his helper for 3.5 years and we don’t go anywhere. Food and juice prep takes most of my time – I finished for the day today (shopping, soup & salad making, cooking & cleanup) and could finally sit down and answer your messages! 😉
        I sprout broccoli and add to the green juice.
        1. We learn about sulforaphane from this video: https://www.youtube.com/watch?v=zz4YVJ4aRfg
        2. And this article: https://www.sciencedirect.com/science/article/abs/pii/S0306452206006130
        3. He supplements with the tablet that was used in a clinical trial since it has the precursor Mirosinase (usually only available in raw, frozen and crushed broccoli sprouts: https://www.nutramaxstore.com/products/avmacol-60-tablet#Wellness
        But doing more research tonight I read that Sulforaphane enhances Glutathione which helps with brain disorders…. which may not be the best for late stage Prostate cancer ???

        I did hear and have read this trial for weekly 60g IVC in the Copenhagen study. I’ve read more since then and IVC is best for Prostate cancer as a Kill, only after the cancer has been starved off and weakened. If I can get my husband up to steam with the repurposed drugs and new supplements, our plan is to do twice a week, but a lower dose for a whole 6-8 hour day to really stress the stem cells. Our oncologist is hesitant to give us the doxycycline prescription, which we need to have. All MY great plans – moving too slow for me! The tough part is getting him to take the doses and the meds. He is doing great with Fenbendazole, just added Cimetidine today at a 1/2 tab, with plans to increase to 1 tab and up to the 400mg 2/day.

        Thanks!
        Carol

        1. Hi Carol,
          Daniel has a nice post on the benefits of caffeine: https://www.cancertreatmentsresearch.com/how-caffeine-makes-chemo-radio-immunotherapy-more-effective/, so those coffee enemas may have been of some benefit 😊. You bring up that sulforaphane increases glutathione. My decision to use sulforaphane was because clinical evidence in castrate-resistant men shows that it has benefit despite the glutathione concern. Perhaps we would stop using it if we decided to use glutathione depletion intentionally as an anti-cancer strategy, but otherwise, I think it has more benefit than harm. I like the Avmacol product, I think it is the best one out there. Thanks for sharing more about what you are doing and your husband. There are some great hearts and minds on this site who are willing to help and answer questions. I know this site has been a great blessing to me.
          Best,
          Shanti

          1. Hi Shanti,

            I very much agree: Sulforaphane is a very good addition, even more when the choice is an anti-oxidant therapy. I intend to write posts on both anti-oxidant and pro-oxidant strategies. And while writing here I realise that the combo of anti-oxidant strategy + anti-angiogenesis strategy + pH strategy could be even more powerful. This will essentially be a strategy focused on the micro (and macro) environment of the tumor.

            Kind regards,
            Daniel

          2. Hi Shanti,

            I just read Daniel’s post on the benefits of caffeine and found it reassuring. Although, they didn’t specifically mention coffee enemas, the oral doses in high amounts were very beneficial. That would be a great natural substance to add to our growing cocktail except those high doses of caffeine might be quite unpleasant, lots of jitters and possible headaches. In my own personal experience with migraines in the years before Gerson therapy, I could actually feel the opening of my blood vessels in my neck once the high dose of caffeine in aspirin took effect. But I would get “rebound headaches the next day”. I wonder if the caffeine combined in aspirin would synergistically prevent mets from attaching as well. My husband really enjoyed the coffee enemas, they made him feel good and it was relaxing for him. He got to where he only did one in the AM before breakfast for the last year and quit them all together this past April as he started incorporate other therapies, including Fenbendazole.

            I read that sulforaphane needs to be stopped before doing IVC with the other antioxidants. Daniel ‘s comment below about choosing either anti or pro-oxidant would be very helpful.

            You don’t know what it means to me to be able to discuss these therapies with people who understand and research as well. We’ve been on our own all these years, very thankful for the information we could find on the internet. Thank you for your time in answering questions and I hope sharing our personal experiences can help you too.

            Warmly,
            Carol

            1. Hi Carol,

              Since substances often have multiple mechanisms of action, for example, sulforaphane supports glutathione, but also destabilizes the androgen receptor, it is sometimes a judgment call based on our best understanding, of what should be used together. Unfortunately, we often don’t have studies to provide us with a definitive answer. I think sulforaphane is an excellent supplement, but I can see the logic in discontinuing it on the days, or around the days that you do the vitamin C. We decided to add in artemisinin in the days around the vitamin C IV because of its oxidative nature. Every time we share our personal journey, it enriches this site and we learn collectively, so thank you for contributing your experiences.
              Best,
              Shanti

    2. Hi Carol,

      A few more notes regarding your husband’s supplements and considering his rising PSA:

      Resveratrol: possible biphasic effect: https://www.ncbi.nlm.nih.gov/pubmed/18586690 “In a xenograft model, resveratrol delayed LNCaP tumor growth and inhibited expression of a marker for steroid hormone responses. However, exposure to resveratrol also led to increased angiogenesis and inhibition of apoptosis in the xenograft.”

      Vitamin E: https://www.medicalnewstoday.com/articles/324142.php

      Modified Citrus Pectin:
      https://www.cancertreatmentsresearch.com/cancer-treatments/
      https://www.ncbi.nlm.nih.gov/pubmed/14663471 “Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study.”
      https://ascopubs.org/doi/abs/10.1200/JCO.2018.36.6_suppl.14

      1. Hi Johan,

        I greatly appreciate this information and corresponding links! My husband’s PSA rising is of great concern (in the last two weeks the jump was 50% from 226 to 327) prior two weeks it increased 50 pts. We need to find the best pathway to block this rise quickly while he is feeling good and is stable. He doesn’t want chemo and ruin his immune system which he has worked hard over the last almost 4 years to build up. Unfortunately which is the only option offered to us by his oncologist at this time and we know that rates of success for stage IV PC is very low, something like 2% while reducing quality of life.

        He is currently taking 1000 mgs of Resveratrol with 6 grams of Curcumin. From the study you referenced, Resveratrol may help or detract – very disturbing news but necessary for us to know and consider. From my research too, I learned that Resveratrol may block the Glutaminolysis pathway for Glutamine fueling of prostate cancer. Also it works in synergy with Curcumin. One reason we added it.

        Vitamin E – I have always been leery of taking Vitamin E alone. The reports again give such differing results over the years. Vitamin E was included in the Joe Tippen’s protocol with Fenbendazole, which is the only reason we included it. Fenbendazole also worked better with vitamins than the controls without: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687140/

        I have read about the power of MCP for inhibiting metastatsis on this site. The two studies that increased the doubling time for prostate cancer is good reason to start it NOW. Also, last night I found a post by Daniel to a man with prostate cancer about the power of Zinc WHICH we should be combining with the Quercetin my husband is taking (I didn’t realize this!). Found this caution: Not to take Zinc with Selenium. That Zinc is found in normal prostate cells and abnormal cells are low in Zinc. https://www.nature.com/articles/4500712?foxtrotcallback=true
        I also read (so many articles ago) that Zinc is a precursor to citrate in the prostate gland. That citrate is something that abnormal PCa cells make more of to grow and Zinc is suppressed.

        What do you think about adding both the Citrus Pectin and the Zinc Gluconate at the same time – possibly be an advantageous next step?

        Thank you!
        Carol

        1. Hi Carol,
          My rule of thumb in using supplements is to avoid any substance that has the potential to do more harm than good, based on the available literature. For me personally, Vitamin E falls in that category. It’s easy to get enough vitamin E from food. Did your husband’s PSA start to rise after he started Joe Tippens protocol, or was it already rising? In any case, if he’s been doing that protocol for about 4 months and PSA continues to rise, there’s a reason for concern about its effectiveness.

          As mentioned, Resveratrol is also in that good/bad category. 1000mg of Resveratrol is a lot, for example, this study found that ” less is more”: https://www.the-scientist.com/the-nutshell/resveratrols-low-dose-anticancer-effect-35082

          I think MCP(Pectasol-C) would be a good addition to the supplement plan, with or without Zinc gluconate.

          Regards
          Johan

          1. Hi Johan,

            These last two days have been very busy, changing our protocols around. We’ve dropped some of our supplements including Vitamin E, all the B’s and cut back to 500 mg of Resveratrol. It’s interesting that I read a while back something that Dr. Max Gerson wrote in his book, “A Cancer Therapy”, that he said supplements could cause more harm than good. Especially calcium supplementation was to be avoided as he witnessed it caused cancer to grow.

            My husband’s PSA started to rise very slowly right before he started Joe Tippens protocol the first time, this was in April of this year. He did the 3 on/4 off dosing schedule for two weeks and then stopped due to surgery for a vertebrae fracture. We saw his PSA dropped a bit and then stayed stable, in the 30 range for several months. He started Joe Tippen’s protocol seriously June 19, ramping up the dose from .4 g daily until he reached .8 g which he takes daily, even now. It took a while to get used to Fenbendazole, he wouldn’t feel really great and he would get sleepy on it, but he does well on it now. I think it was working for a while, we had great hopes, as we saw dips in his PSA and he continued to have a high energy level. I believe the drug is still is working somewhat. But it seems the cancer has found other ways to break through and fuel itself unfortunately, and becoming ADT resistant. If we don’t use Fenbendazole, we’re afraid he will go cachexic with a high PSA. He’s gone through this in the past, right before starting Xtandi last year, which he delayed too long beginning that drug. Hope this history is helpful.

            Thank you for the suggestion of MCP, I’ll research this next!
            Carol

            1. Hi Carol, good to hear your oncologist is open to the treatment options Shanti’s suggested. The patient case report with Cabergoline is amazing. Quercetin and EGCG, already included in your husband’s supplement plan, are natural zinc ionophores so both compounds should not do any harm, in fact, I’d expect the opposite, to the clioquinol/Cabergoline treatment :

              https://www.researchgate.net/publication/26259848_Epigallocatechin-3-gallate_affects_the_growth_of_LNCaP_cells_via_membrane_fluidity_and_distribution_of_cellular_zinc

              https://www.ncbi.nlm.nih.gov/pubmed/25050823.

              In addition to researching MCP, the following supplements may be good additions at a later date, if more action is needed:

              -Artemisinin
              -Chrysin
              -Honokiol
              -IP6(IP6GOLD)
              -Luteolin
              -D-Limonene
              -I3C
              -Graviola
              -Ginger Extract
              -Vitamin D levels appear to be important in Prostate cancer, you wrote you’re supplementing but
              still might want to check your husband’s levels to see how he´s doing.
              -Phenylbutyrate

              Best Regards,
              Johan

          2. Hi Shanti, Johan & Daniel,

            I spent considerable time early this morning before getting started on the day, researching the fat issue in prostate cancer today and came across this article:

            When Fat goes down, Prostate Cancer is on the Ropes
            https://www.tandfonline.com/doi/full/10.1080/23723556.2019.1595308

            Johan, you asked me a week ago if my husband’s PSA started to rise on Joe Tippen’s protocol. It did start to creep up before but not much change for the first two months, and he was doing well on it. But then we added Budwig for breakfast about 6 weeks ago. Budwig really improved his digestion issues. But this morning we looked at his blood markers on the graph, matched it with my daily journal record and saw immediately a correlation with PSA beginning to climb in rapidly every two weeks (he gets full blood tests every other week). I also read these articles: Inhibition of de novo lipogenesis targets androgen receptor signaling in castration-resistant prostate cancer: https://www.pnas.org/content/116/2/631 and Diet-induced alteration of fatty acid synthase in prostate cancer progression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154344/

            I am just sick to think that we may have made a huge mistake at this time, possibly feeding the fatty acid synthase and caused progression. This morning began the no-fat diet again. Flax seed oil – it is the only oil used in the Gerson Therapy, but Dr. Gerson limited it, he saw that how fats stimulate tumor growth, that is why there is a lack of essential fatty acids in the Gerson diet. The allowed amount of flax oil is 1/2 T on a baked potato twice a day at the most. The Budwig pudding has 3 T of flax oil in 6 T of lowfat cottage cheese in one sitting (we used nonfat greek yogurt instead) and encouraged more flax oil in salad dressing, etc. We used it liberally. So, he is getting his new selection of supplements and he FINALLY started some Atorvastatin (1/2 – 20mg tablet) today (reluctance to take a statin drug delayed this one too long). He’s finally up to 2x500mg of Metformin and 1gram of Fenbendazole daily for 5 days on/weekends off. It was a better day. Hope this information can prevent the same mistake for someone else in the future.

            I really appreciate all of your questions and comments, it really helps.
            Carol

            1. Hi Carol,

              On page 192 of The Gerson Therapy, it says: “during the first 4 weeks on the treatment his patients are alotted 2 tablespoonfuls a day (one at lunch and 1 at dinner). Then for the succeding months, the amount is reduced to 1 tbs a day”.

              In the book it says Max Gerson admired the work of Johanna Budwig, and frankly, that might confuse people, b/c he doesn’t recommend the Budwig Diet, just the use of some flaxseed oil.

              Apparently your husband’s PSA started moving up around the time of the folic acid prescription, and the introduction of the Budwig diet. You’ve stopped folic acid, and I think you’ve made a good decision to stop the Budwig diet. A little fat will never hurt but starting the day each day with fat is not the same. I’d stick with a small serving of sardines, once maybe twice at most a week. Don’t feel bad Carol, it was worth trying, and you’re on top of everything and make changes rapidly.

              Best
              Johan

            2. Carol, a last reflection for tonight, it’s my opinion that a metabolic approach to beat cancer is like trying to run a marathon backward. It’s possible but just too hard. Diet can slow down cancer, but it’s my opinion that in advanced stages you need to combine diet with compounds able to kill/stop cancer, hence the need for drugs and/or supplements to do this task. Switching off growth proliferation genes, switching on growth suppressing genes, inhibiting enzymes that fuel growth etc, that in combination with the proper diet.
              Best
              Johan

            3. Hi Carol,
              Please don’t feel bad, there is no real roadmap for us and one has to weigh the potential of Budwig against the fat preference of prostate cancer. I’m sure everything you have done for your husband has helped him greatly. The statin and HCA will both help inhibit the ability of the cancer to utilize fat.
              Best, Shanti

          3. Hi Johan,

            I just read your comments below, as there isn’t a reply button, I am answering here. You are so correct about running a marathon backwards, stopping the PSA rising is paramount. We have an appointment with the osteopath on Thursday, they recommend an ALA IV and an IVC. I sent them today the list of supplements/drugs so will appeal for the Clioquinol/Cabergolnie treatment again. I was impressed with Yudaitheska’s link about the New Mexico clinic – Dr. Berkson and using ALA IV, IVC, vitamins, diet, exercise and saving that patient. It hit home because the we are in the same situation, losing weight, not able to eat, serious fatigue. I am afraid that we are a little too late for all the new metabolic approaches to catch up…. it’s obvious that his PSA is rising this week and my husband is starting to have more fatigue, some bone pain in the hip and difficulty eating meals, drinking juices and taking pills. He is getting his pills/meds down. We’ve been here before – when cachexia sets in and it’s not pleasant. Usually we had the next level of ADT or another shot to depend on, but this resistance is the slow decline we thought we’d never see and that we could beat with almost 4 years of hard work with Gerson Therapy. Not to knock the diet and therapy, but obviously there is much more going on here that needed to be addressed much earlier. I will fight to get him what he needs – to buy us more time, his oncologist will be seeing him the day after on Friday, I will try to appeal to him if the osteopath won’t. We need to abort this androgen-independent malignancy immediately. I am hoping that my husband won’t be too sick after the IV’s on Thursday, so we can make that appointment on Friday.

            Will touch base again soon,
            Carol

          1. John,
            Yes he is taking more EGCG now. I did find TetraCumin online, we’ve recently switched to using CuraMed, Superior Absorption Curcumin, the formula is BCM-95 which is supposed to be more bioavailable. It comes in a 750 mg softgel and he takes 4xday.
            Carol

            1. Another note, Biotin needs to be taken in doses >5mg to interfere with a lab test result, even at that dose, since it has a short half-life, it is unlikely to interfere unless it was taken relatively close to the blood draw. The supplements you need to be careful of are the skin/hair/nail supplements with the very high doses. The mcg amount in a b complex won’t do it. I spent quite a bit of time researching this and working with labcorp on thresholds, which is why I feel comfortable in relaying this info.

            1. Hi Carol,

              I’d choose the zinc gluconate. The study you included is very interesting. Lower Testosterone as we age, results in lower Zinc? T seems to be crucial in regulating the uptake of Zinc into the prostate:
              http://www.jbc.org/content/274/25/17499.full
              https://medicalxpress.com/news/2019-03-testosterone-prostate-cancer-recurrence-low-risk.html
              I know this information goes against common belief regarding T and prostate cancer but I think it shouldn’t be ignored, especially considering your husband’s very low T.

              About the B-vitamins, you mentioned you eliminated all B vitamins? Was your husband taking a B-complex including Biotin(B7)? I’m asking b/c Biotin can lead lo falsely decreased results on the PSA test, if taken within 72 hours prior to the test.

              Regards,
              Johan

            2. Hi Johan and Carol,
              I agree with Johan that Zinc Gluconate would be the obvious choice. Regarding testosterone and prostate cancer, low T is definitely linked to prostate cancer development, with loss of zinc transport into the cell being one of the mechanisms, but potentially also because low T is associated with insulin resistance, higher BMI and metabolic syndrome, which are all also linked to low T. Even when someone has confined, low-grade, low volume prostate cancer, there is evidence that restoring health T may be of benefit. However, prostate cancer does rely on T to propagate. Having physiologically low T, for example around 250ng/dL, will not slow down prostate cancer, it is only when we bring the T down with medication to less than 50ng/dl (preferably to undetectable), that we can see the benefit of androgen deprivation in the course of the disease. Unfortunately, once the cancer is no longer sensitive to androgen deprivation medication, removing them actually causes the cancer to grow faster. This may be because cancer is heterogenious and not all of the cells are castrate resistant, or because the castrate resistant cells can still respond even though they can also grow in the absense of testosterone. The only way I have seen T used in MCRPC is with a controvercial technique called bi-polar androgen deprivation therapy in which someone on ADT discontinues the meds and the recieves a high dose of T via injection to ‘shock’ the prostate cancer cells and cause them to die. This has worked for some men.

        2. Hi Carol,
          Have you considered trying zytiga? While it is true that when men become resistant to xtandi they typically don’t get much time out of zytiga, but they can get a good initial response, and it seems to me that you need something to put the breaks on and knock the PSA down. In my opinion, metabolic therapies will be more effective if you can do something to lower the cancer burden. There are other conventional therapies that I previously mentioned with lower side effect profiles that can buy you time as you work with your metabolic approach. Based on the unique metabolism of prostate cancer, I believe HCA + ALA and zinc ionophores are highly relevant and generally well tolerated. Clioquinol, in particular, has research with prostate cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392423/. Cabergoline also something to consider: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6578577/.

          1. Hi Shanti,

            My husband and I thank you for so much for giving us this information! This research is so promising, I have to admit that I cried when I read both of the articles earlier today. We contacted our oncologist and provided these two links, they pulled it up on their end without a hitch, and we requested the prescriptions for Clioqinol and Cabergoline immediately, hopefully get them tomorrow. This is surely worth a try. We requested to see if he will switch my husband over to Zytiga. We do understand that the results can be small if any, but as you said we need to put the breaks on the climb and see if we can knock his PSA down again to give him some time as he increases the metabolic approach. Also this afternoon, I was able to purchase HCA (1500 mg capsule – we may have to split the dose and fill an empty capsule since I read therapeutic dosing of HCA should be 3×500 mg/day) and ALA (600 mg capsule – not sure about splitting yet) and he started them both at dinner at full capsule strength.

            It seems that we may need to include a 50mg zinc supplement (will look for a zinc gluconate 50mg online).

            We really appreciate all assistance and will report back the results to you.
            With warm regards,
            Carol

            1. Hi Carol,
              I have been thinking of you all day. I hope that you were able to get the prescriptions and that one of these approaches will work for you. If you didn’t find it already, here is the link to Daniel’s blog post on HCA and ALA: https://www.cancertreatmentsresearch.com/another-weak-spot-of-many-cancer-cells-atp-citrate-lyase-inhibition/. The dose for HCA was between 1.2g and 3g, make sure you are getting that amount of the actual HCA and not just the garcinia cambodia herb (it should be standardized to some amount of HCA). We have used this product, it supplies 840mg HCA per tablet, but be warned, the tablets are huge! https://www.douglaslabs.com/super-hca.html.

              DCA is something else to look into. I have corresponded with a couple of men who had good response to DCA: https://www.cancertreatmentsresearch.com/dichloroacetate-dca-treatment-strategy/. This is something you could add on if needed.
              Also, have you considered Xofigo, your husband is a candidate since his mets are only in the bone. It is generally well-tolerated, with some men reporting no side effects, but 2% have bone marrow suppression/failure, I believe this is more likely if the mets are extensive. It may be worth asking the doc about.

              You and your husband will be in my prayers.
              -Shanti

          2. Hi Shanti,

            It was a rougher day yesterday, with nausea and fatigue, and we appreciated your thoughtful concern and all of your helpful suggestions. Disappointingly, our oncologist refused to prescribe the Clioquinol/Cabergoline drugs, saying it was too risky. He was on vacation and the answer came through his nurse, so we schedule the first available appointment with him, which will be this Friday. Next, I got on the phone with our integrative doctor who provides the IVC and sent the research articles per their request by email. Will talk with them Monday and get an appointment to see if he’ll prescribe, as I’ve found doctors don’t usually like to prescribe over the phone, understandably they prefer to see the condition of the patient in person.

            I appreciate the link to HCA by Douglas Labs. I have great respect for the quality of their products. On Friday I picked up HCA from our nutrition shop, the product says it has 900 mg of HCA, but will switch over if you feel Douglas Labs is superior: https://www.bluebonnetnutrition.com/product/bluebonnet-nutrition-super-fruit-garcinia-cambogia-fruit-rind-extract-90-count/
            The bottle say for “Fat Burn & Appetite Control”, hopefully this won’t curb his appetite too much. How did your husband tolerate HCA and how much did he take daily? If we are taking 2 capsules, right now my husband is getting 1800mg > 1.5g. I haven’t read anywhere what a therapeutic dose of ALA would be. We are at 600mg/daily right now.

            DCA sounds like another good off-label alterative, I remember reading in Jane McLelland’s book “How to Starve Cancer” about the side effects of reversible neurotoxicity, peripheral neuropathy and encephalopathy, so I moved on. But it does block certain important pathways. I am wondering if the patient is on Metformin, how DCA would combine with it.
            I’m sure that Xofigo could be readily made available, but my husband has avoided chemo and radiation and feels he would rather stay away from doctors and their “house of horrors” as long as possible. Right now, he just has bone mets and he says he may feel differently as pain increases beyond some discomfort in the right hip. We actually saw a reversal of mets (the radiologist in the last back xray said he saw “healed mets” and couldn’t explain it), so perhaps we are doing something right. Gotta stop that PSA rise though.
            Blessing to you, Shani!
            Carol

            1. Hi Yudaitheska- Could you provide a link to the statement about Dr. Berkson and using lipoic acid with the B-vitamins. I can’t find that information anywhere.

            2. Hi Carol,
              Sorry to hear that things have been rough; I hope you are able to make some headway this week. I am not particularly attached to Douglas labs, I’m glad you found a high potency HCA from your local store. My husband tolerates the HCA and the ALA very well. He takes about 2.5g HCA twice a day and 300mg ALA twice a day. We have not noticed them lessening his appetite.
              The DCA combines well with metformin and fenbendazol. In my view, as long as it is used with benfothiamin (fat soluble B1), cycled (2 weeks on 1 week off), and the patient is monitored for neuropathy with dose adjustments made if needed, the safety profile is good. It may not be something you want to add right now, but something to consider once you have the strategies you are currently working to incorporate in place.
              Wishing you the best,
              Shanti

            3. There are 5 cofactors to the pyruvate dehydrogenase complex:
              1.thiamine pyrophosphate
              2.piridoxal phosphate
              3.FAD
              4.NAD
              5.Lipoamide(alpha lipoic acid)

            4. Hi Yudaitheska,
              Thanks for the link! I was asking because there is research coming out that some of the B-vitamins may promote tumor growth. I personally don’t think they are huge promotors, but people using the metabolic approach are more and more opting to avoid some of the B-vitamins, especially the ones needed for cell division. The ones that are on the radar as problematic B12, Folate and NAD precursors (nicotinamide, niacin). I don’t think pyridoxine and thiamine are problematic. My husband takes a B-complex once a week and a B12 once every other week to avoid deficiency, but other than that we opted not to take them regularly. He does use HCA, ALA and IVC.
              Best, Shanti
              PS for some reason I can’t reply directly to you, so I hope you see this.

          3. Hi Shanti,

            I did quite a bit of research about BAT tonight – Bi-polar androgen deprivation therapy. We learned about this a year ago. Here is a text interview with Dr. Samuel Denmeade the original researcher I believe: https://www.hematologyandoncology.net/archives/june-2018/bipolar-androgen-therapy-in-the-treatment-of-prostate-cancer/
            My husband had discussed this in the past with his oncologist, but once again he said “too risky”. Dr. Denmeade gives a very good explanation of who the perfect candidate is and the results of several small trials. ADT has cardiovascular risks and other detrimental side effect, I didn’t mention before that my husband allowed his T to rise and fall the first two years, only taking Firmagon about every 4 months, usually once the PSA rose to a risky level around 50. Our oncologist told his at the last visit that he experienced a type of BAT, which may have helped with a better outcome for a longer time, but there was always the risk of developing a percentage of mutant prostate cancer cells. My husband only received the 8-10 months of suppression with is the average with XTandi. We would love to resensitize him to enzalutamide, he would have to go somewhere else for the T shots…if he chose the risk. More info I found: https://oncology.medicinematters.com/prostate-cancer/androgen-deprivation-therapy/bipolar-androgen-therapy–progress-and-future-directions/15910622

            I don’t know how BAT would work when the PSA is rising 50% in two weeks and there is some bone pain. The first T shot aggravated the pain for about a week in some men. Also it could result in tumor growth.
            Carol

            1. Hi Carol, I can’t blame you for being uneasy with BAT, I agree that it is a gamble, with some men responding very well and others potentially worsening. As you are aware, the latest results from the RESTORE trial were in castrate-resistant men with PSA progression on Enzalutamide, but they did not have symptoms related to their cancer (ie they were asymptomatic). The average PSA was 39 and the highest was 245. You can see the full text here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875180/. I am not sure that I would take the chance on BAT unless I had no other options. Unfortunately, I don’t think that intermittent ADT provides BAT benefit, I think BAT works because of the huge shock to the cancer cells when T goes from castrate levels to very high levels, I don’t think a gradual rise in T to pre-castrate levels would have the same effect as the cell would be able to gradually adjust.
              Best, Shanti

          4. Hi Shanti,

            My husband is now taking HCA + ALA, but I am dismayed by all the lower levels on the back on the bottles compared to the front label which is misleading. Here is what he may “really” be taking — and I need to make sure we are in the best therapeutic range. I see that we are at a much lower daily as you are giving your husband HCA at 2.5g twice a day… and then 300mg ALA twice a day and we have a bigger capsule same amount 1/day.

            Here is a quick review again for comparison and comment:

            Curcumin – 750 mg Proprietary complex (BCM-95) supplying 500 mg of pure curcuminoids – (taking 4/day = 2 g)
            Quercetin – 500 mg – (taking 6/day = 3g)
            HCA – 1500 mg – 900 mg HCA (60%) – (taking 3/day = 2.7g)
            ALA – 600 mg – (1/day = 600 mg)
            Green Tea Extract – 725 mg std to 90% polyphenols, 45% EGCG – (4/day – 1.3g only ??)
            Resveratrol – 180 mg resveratol / 90 mg transresveratrol – (2 / day = 360 mg + 180 mg)
            Magnesium Gluconate – 500 mg / 27 magnesium ? (2/day = ? Just switched from 4/day Mag Oxide 250 mg)
            —-I would like to know how many tablets to take daily on this one as it just came in from Amazon yesterday.
            Metformin – 500 mg – (2/day = 1000 mg)
            Atorvastatin – 20 mg (1/day)
            Aspirin – 81 mg (1/day)
            Fenbendazole – .8g (1/day)
            CBD – 25 mg in one dropperful – (1/day)
            CoQ10 – 100 mg (2/day = 200 mg)
            Pancreatic – 1200 mg (4/day = 4800 mg)
            Vit D – 10,000 IU/day
            Milk Thistle – 200 mg (2/day = 400)
            Sulforaphane – 425 mg – (2/day = 950 mg)
            Lugols 2% solution – (2 drops/day)
            Niacin – 50 mg – (1/day)
            B-12 – 500 mg – (1/day)
            Lycopene – 20 mg – (1/day)
            Saw Palmetto – 1000 mg – (4/day = 4g)

            It’s a bunch of pills to swallow during the day. Do you have a schedule when your husband takes certain pills?

            Thanks Shanti!
            Carol

            1. Hi Carol,
              I am actually dosing higher on the HCA than what was reportedly used in most studies. You can see from Daniel’s post here https://www.cancertreatmentsresearch.com/another-weak-spot-of-many-cancer-cells-atp-citrate-lyase-inhibition/, that the typical HCA dose is 1.2-3g per day, so you are in range. The typical ALA dose was 0.4-1.8g/day. So 600mg (.6g) is also in range.
              The green tea and curcumin seem appropriately dosed.
              I am wondering about the Fenbendazol dose, your write .8g wich would be 800mg. This is a larger a dose than people typically use, so I wanted to make sure that was intentional. Here is D’s post on Febnebdazol and dosing: https://www.cancertreatmentsresearch.com/fenbendazole/. Joe Tippens used 222mg.
              I am glad your husband is taking metformin and the statin; in my opinion it is a good idea to increase the dose of both slowly as he is able to tolerate them.
              The Vitamin D is a robust dose at 10,000IU, if you haven’t had his vitamin D levels checked it may be a good thing to ask for at your next visit to make sure is within the reference range. Vitamin D above the reference range can cause a host of symptoms if it causes calcium levels to elevate in the blood.
              With the sulforaphane product, is the 425mg sulforaphane or sulforaphane precursors? The two human prostate cancer studies I am aware of used about 35mg and 60mg of sulforaphane with the higher dose showing better outcome.
              For the Mg Gluconate, the blog post suggests 500mg 3xday, so if you are after the gluconate, you need at least 1tab 3xday. Gluconate has very little, if any toxicity, so if you want to take more to get a higher dose of magnesium, I don’t foresee any issues.
              I think resveratrol is probably helpful, but the following study introduced doubt in my mind: https://www.nutraingredients-usa.com/Article/2010/07/20/Researchers-Resveratrol-a-double-edged-sword-for-prostate-cancer#, so I decided not to use it “when in doubt, opt-out!”.
              My husband takes half his pills in the morning and half at night, both with food. He doesn’t have difficulty with swallowing them, so he just gets them down. Opening capsules and putting them in a shake, or blending tablets in a shake is always an option, but that obviously, is much more work for the caretaker.
              You can view our basic Prostate Cancer strategy here:
              https://www.cancertreatmentsresearch.com/prostate-cancer/#comment-8625
              My husband was not able to tolerate some of the off-label meds on this plan, but we are working toward it. We did start back up with 75mg IVC recently and combine it with artemisinin, ozone and hyperthermia (all done once a week).
              Warmly,
              Shanti

            2. Hi Again,
              If you are unable to get a clioquinol cream prescription, let me know and I can send you a couple of tubes that we are not using. I got mine overseas here: https://www.buy-pharma.md/, which is where I get most of my off-label meds when needed. It is mixed with 0.1% betamethasone, but any non-compounded clioquinol cream you can find on the market will have a small amount of corticosteroid mixed in with it. I wouldn’t expect the betamethasone to have much a systemic effect if any due to its molecular size and the small amount.

              If your doc will write you a script for a compounding pharmacy the dose should be similar to this: Clioquinol 3% (1g once to twice a day), Cape Drugs in Maryland can fulfill it for you via mail. Most compounding pharmacies don’t compound Clioquinol, but this one works with Dr. George Yu who is using it regularly for prostate cancer patients.

              Warmly,
              Shanti

    1. Hi John,

      I just had time to read these two studies…very important information! Hubby’s PSA has been rising since about the time of a Folic Acid prescription just two months ago! YIKE!!!

      Thank you so much for this. Time to discontinuing like you suggested and see what happens.

      Awesome info!
      Carol

      1. Hi Carol, you’re welcome.
        I just noticed Niacin on the list of supplements your husband takes, I know that is one of the supplements on Gerson Therapy. Here’s a study that shows cancer could use it to its advantage: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602294/
        I think Gerson recommends quite a high dose of that vitamin so something to consider. If he’s not against eating some fish, then maybe a small portion of sardines could provide some of the B’s he needs. Sardines are one of the least contaminated fish as they’re small, and also provide omega 3 and iodine, usually low in cancer patients.
        Best,
        Johan

        1. Hi Johan,

          I just read this study and saw that 27% of prostate cancer cases could be affected and possibly the BRCAness gene expression was tied to it? My husband did have the BRCA gene test and it was negative. But with your suggestions we have dropped all these individual B vitamins and Niacin as well for a month to see if there is any change. And today he enjoyed a low-salt sardine sandwich with lots of veggies on Ezkiel bread. That is certainly a forbidden treat for Gersonites. But occasionally it sure really breaks up the monotony.

          Thanks again.
          Carol

          1. Hi Carol, niacin indeed seems less of a problem but I did want to mention it b/c of the possibility it could not be doing any good. The recommended daily intake of niacin for men is on just 16mg, I don’t know how much your husband was taking but on Gerson it’s usually 300mg and even as high as 1200mg. After 3 and 1/2 years on Gerson I’m sure that sardine must have tasted good 🙂

            Best,
            Johan

            1. I wonder if there is a benefit to niacin in higher doses as a cholesterol inhibitor? I would think a statin is better since I believe niacin works primarily in the liver and fat-soluble statins may work inside of multiple cell types.

            2. Hi Johan, Shanti & Yudaitheska,

              We are continuing the 100 mg of Niacin, 500 mg of B-12 since eliminating those did nothing to change PSA rise. I appreciate your comment about adding Citrate, I haven’t looked into it deeply enough and don’t understand it yet. I know that prostate cancer relies on lipogenesis (energy from fat) and glutaminolysis (energy from glutamine). We have just started HCA with the ALA. Also he will need to add Ursolic Acid and Berberine. In researching Berberine I found that it targets multiple pathways for glutamine and fatty acids. Our drug/supplement cocktail is growing, I just hope that we can keep things together for a while.

              Thanks to you all!
              Carol

          2. Hi Carol, If your husband hasn’t had other genetic testing of the tumor cells (either by biopsy or liquid biopsy that looks at circulating tumor cells) it might be worth doing. Guardent360 and Foundation1 are two of the companies I know that do it: http://www.guardant360.com/ , https://www.foundationmedicine.com/genomic-testing. There are other mutations in prostate that can be targeted with immunotherapies besides BRCA, particularly PDL1 and MSI.

            The sardines could be a good addition, especially if your husband’s weight is low, it sounds like he has progressed despite the Gerson therapy, so maintaining healthy weight may be important.
            Warmly, Shanti

            1. Hi Shanti, I think you’re right about niacin and cholesterol, but I can’t find where I read that. I think the statins would be the better choice indeed.

            2. Hi Shanti,

              So much helpful information on dosing, thank you very much! The Fenbendazole was a typo, he is taking 8/10ths of a gram, he weighs it out each day and adds it to the last meal of the day, as it makes him tired. So the total dose weekly works out to 4 grams. More than Joe Tippens 3 grams a week. Thank you, Shanti for the offer of the clioquinol cream too and the links where to order as well. Specially if we can’t get the prescriptions from either of these two doctors. I read about the cabergoline side effects – pretty tough stuff, messing with the pituitary gland. I am going to see if his oncologist can test for prolactin levels. Today was better for my husband, I think that possibly the HCA and ALA might be taking an effect, it’s been almost 4 days (I had him increase HCA to match your dosing) and he was able to eat better and was up and around working on projects in the house. Very different from the last two days. It’s too early to tell – could HCA work that fast? I sure hope so. Tomorrow we see his osteopath for consultation and start with an ALA IV. They told me they have a prostate cancer patient that moved close by from another state just to have weekly IV treatments and he is doing well. Gives us hope for sure.
              We started Mg Gluconate at 2/day so will increase by one more. My husband’s Vitamin D level is tested by-weekly and his level fluctuates between 55-75. Something or the ADT may be causing lower levels, I personally take 8,000 IU daily and my level stays in the 70’s. His calcium level is around 9 I believe. The sulforaphone does include the sulforaphane precursors, it’s a blend. Avmacol was the American brand they had listed in those clinical trials, considered 2nd choice, the best one was from Europe. I’m sorry I don’t have the exact info, but can look it up sometime soon. My husband doesn’t tolerate Cimetidine either. We are now up to 20mg of Atorvastatin which is the table size – I don’t see how COC prescribes 80 mg of a statin daily, I notice his ankles are swelling since started it. There are side effects to every drug.
              I really appreciate reading your journey, your husband is very fortunate to be able to take a break from ADT. My husband tried that, only taking a Firmagon shot three times a year for the first two years, but once his T climbed up, so did the PSA, usually doubling every two weeks. Firmagon would knock it back down, but not as low as before the previous rise. Last summer in September, he finally relented and had to start on XTandi, because Firmagon wasn’t working, XTandi immediately lowered PSA and provided all benefits of quality of life again (cachexia is the worst for us when PSA rises), and he was back to near normal. He only received around the average 8 months of benefit with XTandi until we hit the dreaded resistance this past April, PSA started to slowly climb. He experienced a spinal fracture and underwent a kyphoplasty in April which worked perfectly, no pain anymore. He was terribly sick after surgery, poisoned by all the drugs (remember we are Gerson persons – too clean and very sensitive to drugs, fumes, toxins) and it took a month to nurse him back to health. Fenbendazole helped from June until late September, then bi-weekly doubling began. We had a great summer, enjoying activity and getting things done knowing we might have a time limit of living. I am guessing that when Fenbendazole cuts off certain pathways, the cancer found a way to move to other pathways. We need Doxycycline this week too – the oncologist didn’t want to give that to us last time. Will lobby hard and at least get something from him.
              Thank you for spending all this time helping us, my husband hears about how all of you are assisting us and he is very, very grateful. I will pray for you and your husband’s success!
              Carol

          3. Hi Carol,
            You and your husband certainly have been through a lot. I’m gald you were able to spend time enjoying life and eachother over the summer. We have been fortunate that my huband’s PC, despite being metastatic, has not behaved very aggressively as of yet. We are doing what we can to maintain a low PSA, but if/when it starts to rise, we are planning on going to Germay for Lu-177 treatment.
            I understand what you are saying about the Fenbendazol dosing. It comes in 1g packets and you are using 8/10th of a gram (each gram of powder will have 222mg of fenbendazol).
            Yes, the cabergoline does have a long list of side-effects, but I have corresponded with two men who have been taking it long term for stage IV and neither of them experiencd any of side-effects. My thought would be to try it since he can always stop if needed.
            Thank you for your prayers, and you will be in ours.
            Blessings,
            Shanti

            1. That’s an important observation about side effects, Shanti. I remember now almost 17 years ago when researching for GBM, and for example, reading about side effects of Tamoxifen, and you get terrified by what you read. In the case of my father-in-law, he’s now been taking tamoxifen for almost 17 years! And his health just seems to get better and better 🙂 I’m not downplaying side effects of pharmaceutical drugs, but sometimes the risks are definitely justified.

  8. Very good to see familiar names around, still….. congrats.

    I’m still a failed warrior, PTSD and all that.

    Sharpening the blade, just because there’s not much else to do anymore.

    Started a business, hopefully i will be better at that compared to medicine etc.

    Once the cash starts to pile up, i wish to help. Someone out there, needs help, and since i am no good at medicine, i hope to be able to contribute at least as much.

    BTW if someone needs EGFR inhibitors like erlotinib, gefitinib, i got some left.

    I have some stuff left, a hospital bed, a wheelchair, blood pressure meter and other things, experience with treating bed wounds, i had to return the oxigen concentrator.

    Message me if you need some help etc.

    Best of luck, keep strong!
    Alex

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