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00:00There's been a lot of interest recently about our gut health, or more specifically the balance between the unhealthy and healthy bacteria, or in other words, the microbiome.
00:13It is now well established that if you have poor gut health, you're more likely to have bloating, indigestion, you're going to feel tired, not sleep very well, be demotivated, have a low mood.
00:28In the long term, poor gut health is linked to an increased risk of viral infections such as COVID, chronic degenerative diseases such as arthritis, dementia, an increased risk of diabetes and heart attacks.
00:45It is also linked with an increased risk of cancer of the gut, but also cancer elsewhere in the body, including prostate cancer.
00:55There are several mechanisms of why poor gut health is linked to an increased risk of cancer.
01:01First of all, you need a healthy gut to break down healthy components in foods called phytochemicals.
01:09The phytochemicals give food its colour, its smell, and its aroma, and they have enormous health benefits.
01:16They reduce inflammation in the body, they improve antioxidant pathways which protect our DNA, and they help increase our immune surveillance.
01:26There's also evidence that men with prostate cancer who have poor gut health are more likely to progress faster.
01:36What has not been established is if you improve the health of the gut in men with established prostate cancer, that would actually slow the rate of progression.
01:48And for some men, that would mean they don't have to go on to have radiotherapy or surgery or hormone treatments, all of which have quite considerable toxicities which will affect their daily quality of life.
02:03For these reasons, it was decided in our research centre to work with patients to design a robust prospective trial to see if we can improve diet and strategies to improve gut health,
02:18and evaluate whether that could slow the rate of prostate cancer progression, and at the same time improve other symptoms related to the prostate, such as the waterworks and erectile function.
02:30So the first thing we did is work with three patient support groups involving over 300 men with prostate cancer to see what was acceptable to them.
02:41This proved really useful because men were able to help us with the design of the study to ensure when we asked people to go into it, it was acceptable to them.
02:51This resulted in over 230 men being recruited in less than six months, and it became the fastest recruiting study in the UK, thanks to the patient involvement.
03:03There are several important lifestyle and nutritional factors which help us maintain or even improve our gut health, and these include reducing processed sugar, sweeteners, stopping smoking, not drinking too much, exercising regularly.
03:18But above all, the two most important factors are increasing foods which contain natural healthy probiotic bacteria, and increasing the intake of phytochemical rich foods.
03:29Phytochemicals are natural substances which give food its colour, taste and aroma, and on top of these wonderful properties, they have enormous health benefits.
03:39We know from clinical studies that populations who have a higher intake of phytochemicals have a lower risk of cancer, including prostate cancer and many other chronic diseases.
03:5014 years ago, we conducted a trial which boosted the intake of phytochemicals using a capsule which contained turmeric, green tea, pomegranate and broccoli, and we showed it slowed prostate cancer progression.
04:02Since then, there's been further evidence for other foods such as cranberry and ginger on the benefits for prostate cancer, but also prostate symptoms.
04:13For this latest study involving men with established prostate cancer, the scientific committee felt it was imperative to include these two new ingredients which have also shown a benefit.
04:25For clinical trials, it's important to control and boost the intake of probiotic bacteria using a capsule.
04:33This particular capsule was developed specifically for our studies as it contains a good quantity of five lactobacillus probiotics combined with a good quantity of a prebiotic inulin and vitamin D within a slow release capsule.
04:51So in other words, it was picked because it has a track record of being effective and safe.
04:58Patients were asked to fill out questionnaires about their urinary symptoms such as how often they get up at night and the quality of their erections.
05:07For strength, we used a grip strength monitor. Now, grip strength is actually an interesting end point in this trial because it does correlate with overall well-being.
05:19To assess tumor size, men underwent an MRI scan before and after the intervention.
05:26In that way, we were able to measure the actual lesion and see if there was any progression, regression or stabilization.
05:33In that way, we can ensure that the PSA changes actually correlated with underlying disease.
05:40Now the trial has finished, the data has been collected by the independent auditors and sent to the statistician.
05:47We will know the final results of the trial when it's presented in the world's largest urological conference called ASCO Urology in January in California.
05:58There was an interim analysis presented in the British site of Lifestyle Medicine Conference which did already show some significant slowing of the PSA, improvement of waterworks and erectile function.
06:11Certainly, a lot of the men who were on the older supplement who changed to this new one had a further reduction in their PSA which is very reassuring.
06:21In the meantime, this trial has clearly shown that it's appropriate for men with prostate cancer to increase their intake of healthy phytochemical rich foods.
06:33It would also be very sensible to adopt strategies to improve their gut health.
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