An Interview with Jacek Pinski, MD
How did your training prepare you to develop a dietary supplement like PHC?
Dr. Jacek Pinski: I went to medical school and earned my PhD in Frankfort, Germany. Then I did a two-year residency in Internal Medicine. Then in 1990 I came to the United States, to work at Tulane University in New Orleans. I came actually 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?
Yes, it’s very definitely related to prostate cancer. Dr. Schally’s research proved that certain hormones produced by a region in the brain called the 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, he 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. He had already started this work, before I went to work in his laboratory. And that’s the kind of work we did together for five years. Although we worked on other tumor cells, we 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, his approach is called hormone ablation therapy, and it’s still used today. 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?
Really, 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 spread or 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 which puts them at a high risk of having a disease relapse in the future. So when we look at their cancer tissue under a microscope, we see that their cancer cells are very aggressive. There’s an actual scoring system we use to calibrate this spectrum of aggression. We call it the Gleason Score. Well, 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. So half or more of them will eventually experience a relapse. Their disease will return at some point, even if they undergo surgery. Why? Because a population of cancer cells escaped the prostate gland prior to surgery. You can’t see the cells on any imaging study, but they’re there, hiding somewhere in the bone or lymph nodes. 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 through 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, in order to achieve a better outcome. We might opt to do hormone ablation therapy or potentially chemotherapy following surgery.
And the third group?
These are men diagnosed with advanced prostate cancer, which means that their disease has already spread to the bone, for example, 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 recognize it by measuring prostate specific antigen (PSA) in the blood, which is a tumor marker for prostate cancer. As soon as you see the PSA starting to come up, 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 really know where their cancer cells are, or how aggressive they are, what do you do 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 today—it’s not a magic bullet. First and foremost, it’s simply 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.
So these men need something non-toxic—something to slow down disease progression, something that can kill some of the cancer cells and 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 patients. They’re not toxic and have been scientifically shown to provide benefit.
Are you alone in holding this opinion?
Many laboratory scientists and clinicians in the field 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?
Well, prostate cancer is a common disease across the board. It’s the second leading cause of cancer-related death in men, after lung cancer. Last year, 225,000 men in the U.S. were diagnosed. Roughly 27,350 men died from the disease. If we assume that each of them had one mate, two children, five grandchildren and a dozen friends, then it is fair to say that 574,350 people in this country lost their fight against prostate cancer last year. That is a slightly larger number than the entire population of Washington, D.C. This is not a medical rarity. It’s everywhere.
And, of course, prostate cancer is a disease of the elderly. As you get older, no matter what your ethnic background, your risk of prostate cancer increases significantly. It’s the most common malignancy in men over the age of 60. And by age 70, there’s more than a 50% likelihood that a biopsy of the prostate will reveal at least early prostate cancer.
More specifically, studies 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.
A lot higher?
Research tells us that African American men have an incidence over 50% higher. And when they develop prostate cancer, it’s usually more aggressive than what we observe in Caucasian or Asian patients.
Why? Do they produce more testosterone or something?
Actually, there are studies which show that young African American men do have higher testosterone levels than Caucasians. I don’t think that’s the full explanation for their higher risk rate, but it’s not irrelevant.
So when you formulated PHC, were you thinking about these high risk groups?
Having products which are as natural as possible, which can slow down or prevent this from happening, is not a bad idea for any man, starting around age 40. And people are conducting studies, conducting clinical trials with supplements and vitamins of all kinds, to see if they inhibit the development of prostate cancer. Researchers are also looking to see if various natural substances can cause prostate cancer cell death in patients who’ve already developed prostate cancer.
Have you grown disenchanted with traditional cancer therapies?
No, I utilize those therapies every single 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, man-made recreations 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. The true distance between them isn’t so big after all.
But wouldn’t you expect most oncologists to 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, with my own laboratory, with an outstanding research team; and part of my research focuses on the effects of genistein. And I can see in my own research how genistein works, how effective it is in inducing prostate cancer cell death. So my perspective is the result of solid research experience. And 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 indicates 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?