An Interview with Jacek Pinski, MD, PhD
How did your training prepare you to develop a dietary supplement like PHC?
I went to medical school and earned my PhD in Frankfurt, Germany, where I also did a two-year residency in Internal Medicine. Then in 1990 I came to the United States to work with a very famous man named Dr. Endo Schally. He’s been a great mentor to me. And, of course, Schally is a Noble Prize recipient. Basically, his work forms the theoretical foundation for using hormone therapy to treat some forms of cancer.
Did that discovery relate to the research you two did together on prostate cancer?
Dr. Schally’s research proved that certain hormones produced by the brain’s hypothalamus can, down the line, stimulate the pituitary gland to produce other hormones. And that second tier of hormones stimulates the production of sex hormones: estrogen and testosterone. So basically, Schally analyzed and defined the cell signaling pathway that leads to the production of testosterone in the testicles of men and estrogen in the ovaries of women.
By putting that knowledge together with the fact that prostate cancer is highly hormone dependent, he went on to develop drugs that block the production of testosterone in men. And that’s the kind of work we did together for five years, focused mainly on the development of new hormonal agents to treat prostate cancer. The work resulted in at least 60 publications in very prestigious journals. It was a very productive time for me.
So are all cancers hormone dependent?
No, but prostate cancer depends highly on testosterone. Without that hormone, prostate cancer cells die. Not all of them, unfortunately, or we could cure prostate cancer completely with drugs that block testosterone production. But the fact is: the vast majority of prostate cancer cells will die without testosterone. So Dr. Schally came up with the idea of developing drugs which interrupt and block that signaling pathway from the hypothalamus to testosterone production. Today, this approach is called hormone ablation therapy. Unfortunately, it can only do so much; and the benefits are of limited duration.
What’s the most common treatment for men with prostate cancer?
There are three distinct groups of prostate cancer patients. The first group consists of men who have very localized cancer. It’s there, but strictly confined to the prostate. It hasn’t spread to the bone or lymph node, lungs or other areas. So long as these patients have no evidence of penetration beyond the prostatic capsule—and have no aggressive features like bad pathology—they can likely be cured with surgery or radiation therapy. The cure rates are very, very high for this group.
What about the second group?
The second group is made up of men with similarly localized disease but they express features of prostate cancer that put them at a high risk for relapse in the future. So when we look at their cancer tissue under a microscope, we see that the cells are very aggressive. There’s an actual scoring system we use to calibrate this spectrum of aggression. We call it the Gleason Score. If a patient has a very high Gleason Score along with a very high PSA level, then we’re seeing clear evidence that prostate cancer cells are present in the blood. And we know these men are likely to relapse after initial surgery or radiation therapy. In fact, half or more of them will eventually relapse because a population of cancer cells has managed to escape the prostate gland. You can’t see the cells on any imaging study, but they’re there. It often takes many years before tumors become visible. But it’s still prostate cancer.
Similarly, when we find that the cancer has already penetrated beyond the prostate capsule and now involves the seminal vesicle or potentially some regional lymph nodes, then we know those patients are at high risk of disease relapse. Since we know to be on-guard, we typically augment surgery with additional therapy. We might opt to do hormone ablation or potentially chemotherapy following surgery.
And the third group?
These are men diagnosed with advanced prostate cancer, which means their disease has already spread, for example to the bone, where prostate cancer likes to go if given the chance. These patients, unfortunately, cannot be cured with surgery or radiation therapy. And currently, there is no combination of treatments that can cure all of them. Hormone therapy is the first line of treatment; and by hormone therapy I mean hormone ablation, where testosterone is blocked. Unfortunately, the duration of benefits associated with this therapy is of limited duration, usually 15-18 months. Then the prostate cancer becomes resistant and chemotherapy is typically started. The good news is that chemotherapy can slow down the progress of prostate cancer and potentially prolong life. Nonetheless, for the vast majority of patients, it’s not a permanent cure.
How do you know when the cancer is starting to return?
You measure prostate specific antigen (PSA) in the blood, a marker for prostate cancer. As soon as you see the PSA level start to rise, you know you’re dealing with cancer again. Many times you can’t see where the cancer cells are hiding because they’re microscopic. You don’t see them on an x-ray, or any imaging study. You just see the PSA rising. In those patients it takes several years, from the time the PSA starts rising, until we actually detect something in a bone or CAT scan.
Since you don’t know where the cancer cells are, what can be done for those patients?
If their quality of life is still extremely good and they’re functioning very well, we don’t like to use chemotherapy because it’s very toxic and many men don’t tolerate it too well. It can suppress the immune system. Make them anemic. Lead to neuropathies in the hands and feet. Cause hair loss and debilitating fatigue. And while hormone ablation therapy is effective—probably the most effective systemic therapy we have for prostate cancer—it’s not a magic bullet. First and foremost, it’s not curative in many cases. What’s more, men lose their libido. Their bones weaken. Their muscle tissue diminishes. They gain weight and often experience hot flashes and night sweats. So while it’s far less toxic than chemotherapy, it has definite undesirable side effects.
These men need something non-toxic to slow down disease progression; something that prolong the time until the disease becomes more prevalent, with actual symptoms. In my view, natural products and supplements are a really viable option for these men. They’re not toxic and have been scientifically shown to provide benefit.
Are you alone in holding this opinion?
Many laboratory scientists and clinicians are looking toward natural therapies, especially for preventing the disease. If I’m ahead of the curve, it’s only because I speculate that particular supplements and vitamins may have a positive impact on patients who’ve already developed cancer. Used in conjunction with established treatments like hormone ablation therapy and chemotherapy, I think they have a role to play in slowing down the disease process. Clinical trials have shown these combinations to be very efficient. As just one example, Vitamin D in combination with chemotherapy has been shown to be more effective than chemotherapy alone.
Are all men at equal risk for developing prostate cancer?
Prostate cancer is a common disease across the board. It’s the second leading cause of cancer-related death in men, after lung cancer. And, of course, prostate cancer is a disease of the elderly. As you age, your risk of developing prostate cancer increases significantly. It’s the most common malignancy in men over the age of 60. And by age 70, there’s a higher than 50% likelihood that a biopsy of the prostate will reveal at least early prostate cancer.
More specifically, studies do indicate that some men are at higher risk than others. Family history is important. A man with a significant family history of prostate cancer is certainly at higher risk. Additionally, African American men have a higher risk of developing prostate cancer than Caucasian or Asian men. Research tells us that they have an incidence more than 50% higher. And when they develop the disease, it’s more agressive.
Have you grown disenchanted with traditional cancer therapies?
No, I utilize those therapies every day. But the truth is, there are undeniable limitations to so-called modern medicine—chemotherapy and other well-established therapies. Patients are still dying. In most cases, traditional treatment is not curative. I’m not saying it’s not effective. It is effective. It works; and it prolongs life. But in many cases, it’s still not curative. So we have to look beyond what we already know.
Beyond all the tools we currently have at our disposal. It’s been decades since doctors and scientists believed in a magic bullet that would obliterate cancer. We’ve known for a long time that we need an arsenal of weapons to fight the disease, each intended to serve a unique purpose, at a particular time, for specific patients.
Besides, when we talk about chemotherapy, what are we really talking about? Many times we’re talking about plant extracts, manmade facsimiles of substances originally extracted from plants. So when we debate the tension between so-called chemotherapeutic agents on the one hand and all-natural products on the other hand— the enormous divide appears more imaginary than real.
But wouldn’t most oncologists doubt the benefits of a dietary supplement in preventing or managing prostate cancer?
No, not those who stay informed and open to new findings. Personally, I don’t see that there’s divisionary thinking between physicians who work in the field of cancer and the researchers who study natural products or the effects of natural products. It’s all part of research. It’s all part of what we’re all trying to do: stop men from dying.
Frankly, it’s not the field of oncology that resists these products or suggests that they are unimportant. In fact, the journals are full of papers that support this notion. A lot of research has been done, in very established laboratories, looking at the effects of these factors on cancer. The real obstacle is the drug companies, because let’s face it, drug companies don’t want to see these products succeed. Because they’re competitive.
Yet you remain hopeful.
I’m a physician-scientist and my perspective is the result of solid research experience. What I’ve learned in my lab has been replicated by other investigators in other labs for each and every ingredient in PHC. The evidence is very powerful, strong scientific evidence indicating that the ingredients in this cocktail are effective in preventing and combating prostate cancer.
Another good thing about the ingredients in PHC is that they’re all very well tolerated by patients. They have a very low toxicity profile. In fact, in the doses we’re using, they are completely toxicity-free. So if you have something that does not have any toxic impact and at the same time prevents you from dealing in the future with a disease which could potentially become deadly—why not use it?