Originally published 2/5/2020
Less than a year after we posted the blog below, an Israeli research team published results of a study involving 59 prostate cancer (PCa) patients, all of whom initially had surgery or radiation but now had biochemical relapse (rising PSA).[i] None had evidence of metastasis at the time of the study, and all were treated for 6 months with modified citrus pectin as described below. Most patients (75%) had a favorable response, as tracked by PSA, with no severe reactions.
Then, in Nov. 2023, the same group published a “second long-term treatment phase of an additional 12 months of P-MCP therapy … in patients without disease progression after the initial 6 months of therapy.”[ii] Of the 39 patients who remained in the entire study, 85% had a PSA that was either stable or reduced, and the average PSA doubling time improved from 10.3 months at the beginning to 43.5 months at the time of reporting.
The authors note that administering modified citrus pectin was a feasible and safe way to treat PCa patients with rising PSA after treatment. Among their participants, 58% had no further PSA rise, and 75% of those who did had a significant slowdown in PSA doubling time. Further research is warranted.
There’s a saying that beauty is only skin deep. Whether or not you buy that philosophy of beauty, you may be interested to know that scientists are studying a supplement formulated from something that’s found skin deep in citrus fruits. It is a modified form of pectin, which is a soluble fiber found in most plants. Pectin is used to thicken jams and jellies, but in its natural state it difficult for our bodies to digest and absorb. By modifying the pectin from the peel of lemons, oranges and grapefruit, it can be converted to a compound called modified citrus pectin (MCP), which has health benefits due to its ability to inhibit the harmful action of a protein in our bodies called galectin-3.
Galectin-3 is a troublemaker. It is implicated in inflammation, cardiovascular disease, neurodegenerative disease, immune system disruption, and other conditions. On top of that, because it is a binding protein that is overexpressed on the surface of certain tumor cells, it helps the cells adhere to each other (clump together), proliferate, trick the immune system and spread (metastasize). As you can imagine, galectin-3 fosters the growth and progression of prostate cancer (PCa).
MCP and advanced prostate cancer
MCP is prepared as a white powder, and as an over-the-counter supplement it is generally sold in capsule form. Several companies manufacture oral modified citrus pectin in various doses; perhaps the most-studied preparation is a particular formula sold under the trade name PectaSol-C® (produced by ecoNugenics in Santa Rosa, CA). According to the manufacturer, it is prepared using technology that “… reduces its molecules to the correct size and structure required for clinical efficacy,”[iii] thereby setting it apart from its competitors. The effects of PectaSol-C on cancer cells, including ovarian and prostate cancer, have been studied in the lab, in animals and in humans.
In 2012, an Israeli team launched a clinical study of the safety and effectiveness of MCP on PCa patients with biochemical relapse (rising PSA) after primary treatment with surgery, radiation or both.[iv] The objective was to evaluate disease progression as demonstrated by PSA, PSA doubling time, imaging. Their study design was to recruit, treat and follow 60 patients for 18 months, and as of 2019 they had presented initial results with 31 patients,[v] and later in 2019 with 46 patients who had completed at least 6 months of MCP treatment[vi].
Their announced results with the latter group of 46 patients were as follows:
- 76% (35 men) had no signs of disease progression at 6 months
- 59% of them (27 men) had stable or lower PSA
- 70% of them had increased PSA doubling time
- All of them had no metastasis on imaging scans at 6 months
- 20% (9 men) experienced side effects of gas and bloating
- 24% (11 men) had disease progression at 6 months
- Rising PSA was the only indicator in 9 of them
- PSA plus scans was the dual indicator in 2 of them
This study illustrates the potential use an all-natural product, PectaSol-C, as an alternative to Androgen Deprivation Therapy (ADT), the conventional treatment offered men when PSA rises after primary treatment. Because ADT deprives the body of testosterone or blocks cancer cells from taking it up, it does halt progression for a period of time until the PCA outsmarts it—but the side effects of ADT are unpleasant (loss of sex drive, breast tenderness, bone loss, mood swings, etc.). How many patients would happily put up with intestinal gas and bloating in exchange for PSA control without ADT side effects?
The final results of the above study have yet to be published, and certainly more research is needed. I would also add a note of caution about possible conflict of interest in the MCP study: the owner of the company (ecoNugenics) that formulates and markets PectaSol-C, Dr. Isaac Elias, is listed as an author on the later study. However, given the background research that has gone into MCP leading up to human clinical trials, I would say that this natural supplement offers a promising substitute for ADT.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you have health concerns or questions of a personal medical nature.
ADDITIONAL NOTE: This content is not an endorsement for PectaSol-C or any other formulation of modified citrus pectin. For prostate cancer treatment, professional supervision is necessary. Consult your physician before taking modified citrus pectin or any other supplement.
[i] Keizman D, Frenkel M, Peer A, Kushnir I et al. Modified Citrus Pectin Treatment in Non-Metastatic Biochemically Relapsed Prostate Cancer: Results of a Prospective Phase II Study. Nutrients. 2021 Nov 28;13(12):4295.
[ii] Keizman D, Frenkel M, Peer A, Rosenbaum E et al. Modified Citrus Pectin Treatment in Non-Metastatic Biochemically Relapsed Prostate Cancer: Long-Term Results of a Prospective Phase II Study. Nutrients. 2023 Aug 11;15(16):3533.
[iii] https://econugenics.com/products/pectasol
[iv] https://clinicaltrials.gov/ct2/show/NCT01681823
[v] Dresler H, Keizman D, Frenkel M, Peer A et al. Long term effect of PectaSol-C modified citrus pectin treatment in non-metastatic biochemically relapsed prostate cancer patients: Results of a prospective phase II study. European Urology Supplements, Volume 18, Issue 11, e3467. https://www.eu-openscience.europeanurology.com/article/S1569-9056(19)34628-7/fulltext
[vi] Daniel Keizman, Moshe A. Frenkel, Avivit Peer, Eli Rosenbaum et al. Effect of pectasol-c modified citrus pectin (P-MCP) treatment (tx) on PSA dynamics in non- metastatic biochemically relapsed prostate cancer (BRPC) patients (pts): Primary outcome analysis of a prospective phase II study. J Clin Onc 2019 37:15_suppl, e16609-e16609
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
