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ProCap Trial - (A Prostate Cancer Prevention
Trial)
| Format: |
Randomized |
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Double Blind |
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Placebo Controlled |
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Age Matched |
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| Trial Accrual: |
1000 Patients divided between the placebo and
the active formula performed at multiple Veterans Administration Clinic Sites (actual number of entrants will depend
upon a statistical significance associated with the projected outcome that the study is powered to measure) |
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| Trial Entry: |
Men Aged 40-69 years old (3 Decades
Represented) |
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| Trial Qualification: |
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No Evidence of Prostate Cancer based on Digital Rectal
Exam |
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PSA must be ≥ 1.0 ng/ml, but less than 4.0 ng/ml; a PSA of
4.1 ng/ml-6.5 ng/ml would also qualify if there is a preceding biopsy that validates a lack of cancer |
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IPSS-Index (International Prostate Symptom Score Index) |
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| Trial Variables: |
1. |
Prostate Specific Antigen (PSA) using Quest Diagnostics |
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2. |
Digital Rectal Exam |
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3. |
International Prostate Symptom
Score Index |
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| Frequency of Office Visits: |
Every 6 Months (Evaluate and record all Variables) |
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| Study Trial Endpoint: |
Prostate Cancer Diagnosis |
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| Length of Study Trial: |
5-7 years |
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Study Guideline:
In the event that men evaluated note a change in PSA (velocity change) or digital rectal findings that support suspicion
for prostate cancer, a prostate biopsy will be performed following a complete consented disclosure. In the event the
biopsy is negative the patient will be returned to the previously assigned treatment arm while the diagnosis of prostate
cancer will prompt immediate consideration and/or implementation of appropriate valid treatment options.
Funding:
Private Resources Requested (Opportunity to Create a Legacy through a Foundation Donation)
Premise:
Prostate disease is the number one health risk that an adult male will face with 82 men dying daily from this menacing
disease while a new case of prostate cancer is diagnosed every three minutes (reference: American Cancer Society). Based
upon scientific data, it is believed that a patented prostate nutritional formula (Peenuts ®,) will provide a major health
care benefit. Specifically, Peenuts ®, is expected to decrease the pool for prostate biopsy candidates based on eradication
of prostatitis as a sentinel disease that many experts believe is associated with the evolution of prostate cancer
(reference: American Association of Cancer Research). Improvement in prostatitis will be noted by a reduction in PSA
(prostate specific antigen), a surrogate marker for prostatitis. Therefore, it is believed that a reduction in prostatitis
(non-bacterial inflammation) will lead to a decrease in the diagnosis of prostate cancer. To reiterate, the expectation is
noted for the Health Care system to benefit through a reduction in unnecessary prostate biopsies associated with a
reduction in PSA, improved patient health anticipated with improvement in voiding abilities, with an ultimate decrease in
the incidence of prostate cancer (validated by study design).
Background Data:
Prostate disease is the number one health risk that men face associated with prostate enlargement (benign prostatic
hyperplasia), prostatitis (inflammation of the prostate), and/or prostate cancer. All diseases of the prostate are
epidemic individually and collectively. 50% of 50 year old men have evidence of benign prostatic hyperplasia (BPH), while
the signs and symptoms are the number one reason that men visit the doctor (reference: McNaughton-Collins). Voiding
symptoms common to BPH are also common to prostatitis. In a clinical trial presented at the National Institute of Health
in 1999, 235 consecutive men with any level of voiding symptoms were evaluated clinically for prostatitis. Prostatitis was
noted to be present in 81% of men less than 50 years old (n=83) while 88% of men 50 years old or older (n=152) were noted
with the disease (reference: R. Wheeler).
PSA (prostate specific antigen) represents the most dominant male health disease marker associated with BPH, prostatitis,
and prostate cancer. Data from Johns Hopkins, associated with the Baltimore Longitudinal Study, notes that men aged 40-60
years with a PSA reading of greater than 0.6-0.7 ng/ml have a 3-4 fold increased risk for prostate cancer within their
subsequent 20 years. In a separate study, Gann and Hennekens noted a 5-9 times increased risk for the evolution of an
aggressive cancer within the subsequent 10 years when the PSA was identified between 2-4 ng/ml. It is further noted that
30% of 30 year old men have prostate cancer, adding an inordinate amount of stress to an already beleaguered health care
system (reference: The Detroit Autopsy Study). While the search for novel, cost effective prostate cancer diagnostic and
treatment models continues, the cost of needless prostate biopsies, based on the PSA blood test primarily, costs the
health care system in excess of 1.5 billion dollars. The most significant portion of these costs would likely be
eliminated by the resolution of prostatitis. Prostatitis, primarily a non-bacterial event, is the number one reason that
PSA rises and arguably the prime culprit in why men are asked to undergo a prostate biopsy. Minimizing the impact of
prostatitis would prompt a quantum shift in health care expenditure to the cost savings side as the majority of the 70-80%
of the negative biopsies could be avoided. Additionally, as prostatitis is resolved, annoying symptoms that prompt men to
visit the doctor may also be eliminated.
A proposed prostate cancer prevention trial comparing a patented, synergistic blend of natural ingredients for the
prostate versus a placebo in a randomized, double blind, age matched study is expected to alter the landscape of disease
understanding. Peenuts ®,, a prostate nutritional formula was chosen for study consideration based on its patent status and
effectiveness in reduction of signs and symptoms associated with prostatitis reported through clinical evaluation.
Peenuts ®,, a synergistic blend of vitamins, minerals, herbs and amino acids (including Vitamin E and Selenium), is
associated with anti-inflammatories, immune boosters, antioxidants and beta sitosterols. Peenuts ®, has been validated
previously to reduce voiding symptoms in a randomized, placebo controlled, double blind study. The study findings were
statistically significant. Reasons for enhanced academic excitement is furthered by the mid-term results of a prospective
study evaluating the benefit of the Peenuts ®, formula with diet in men with known prostate cancer. At an average of 30
months, prostate cancer is suppressed in 90% of the study participants. This is a sentinel finding as it demonstrates that
men can now safely live with prostate cancer similarly to living with rheumatoid arthritis, diabetes or hypertension. The
overall effect on the health care budget could be monumental as 50-60% of men with prostate cancer have characteristics
similar to the men studied in the prospective trial.
The ability of nutritional ingredients to have an impact on the evolution of prostate cancer is well chronicled in the
literature through the Alpha-tocopherol, Beta-carotene (ATBC-Finnish Study) and through the work of Larry Clark, PhD at
the University of Arizona who evaluated the benefit of Selenium on prostate cancer. Vitamin E (50 IU) was noted to
decrease the incidence of prostate cancer by 34% while Selenium (200 mcg) was noted to decrease the incidence of prostate
cancer by 66%. Currently, the NCI (National Cancer Institute) is attempting to corroborate the benefit of these two
ingredients separately and in combination through the Select Trial. Anticipated completion date is 2012.
Notwithstanding the benefits outlined with the Select trial, it is felt that if the Peenuts ®, formula can suppress and/or
stabilize all cases of prostate cancer in the prospective study, it may be possible for this formula to prevent prostate
cancer. The mechanism of action with the Peenuts ®, formula is believed to be associated with the resolution of prostatitis
through a decrease in cellular oxidative stress. Beyond an expected decrease in anxiety as the PSA decreases, voiding
symptoms are expected to improve as the expected number of doctor visits is expected to drop.
While the health care budget is strained due in part to the diagnosis and treatment of prostate cancer, the ability to
prevent prostate cancer gives men an improved opportunity to extend their quality of life while saving the health care
system hundreds of millions of dollars, if not, billions. Beyond the expected prevention of prostate cancer (the ultimate
goal of the study), the number of biopsies requested is expected to drop precipitously with an anticipated decrease in PSA
level with the Peenuts ®, formula when compared to placebo. Presently, in excess of 1.6 billion dollars are spent yearly on
prostate biopsy with the majority of procedures performed based on an elevation of PSA alone. Despite our best efforts,
only 20-30% of biopsies yield a cancer, suggesting our current model for biopsy consideration qualifies men excessively
and inappropriately.
A gateway to an improved health care model for men has been proposed. This study is about more than altering a disease
course…it is about altering or eliminating the number one health threat for every adult male while ensuring a healthier,
more productive society. The only remaining challenge is to locate the financial commitment to fund the study. Finding a
person(s) or organization to embrace this noble project remains difficult despite an anticipated outcome that promises to
tame an epidemic and foster wellness for all men.
Respectfully submitted,
Ronald E. Wheeler, M.D.
Medical Director of the Prostatitis & Prostate Cancer Center |
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