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Saw Palmetto: Symptom Management for Men During Radiation Therapy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01585246
Recruitment Status : Completed
First Posted : April 25, 2012
Results First Posted : July 14, 2017
Last Update Posted : September 30, 2019
Information provided by (Responsible Party):
Gwen Wyatt, Michigan State University

Brief Summary:
The aim of this study is to test whether Saw Palmetto, is useful in preventing or reducing the side effects for men undergoing radiation therapy for prostate cancer. Urinary symptoms will be recorded each week, as well as assessment of quality of life through: 1) Physical Well-Being 2) Social/Family Well-being 3) Emotional Well-Being, and 4) Functional Well-Being.

Condition or disease Intervention/treatment Phase
Prostate Cancer Drug: Saw Palmetto Drug: soybean oil soft gel Phase 1 Phase 2

Detailed Description:

Lower urinary tract symptoms (LUTS) affect from 75-80% of men undergoing radiation therapy (RT) for prostate cancer. The purpose of this study was to determine the feasibility, safety and efficacy of inexpensive, non-toxic herbal supplement, Saw Palmetto (SP), in treating these distressing symptoms.

The study consisted of two phases: Dose Finding phase (DFP), and Exploratory Randomized Controlled Trail (RCT) phase. In the 12 week DFP, participants were given one of three doses (SP 320 mg, SP 640mg, and SP 960 mg) using the Time-to-Event Continual Reassessment Method to determine the maximum therapeutic dose (MTD). Once the MTD was determined the RCT phase was begun, participants were allocated to receive either the predetermined MTD (960 mg) in the DFP or a placebo to obtain preliminary evidence of efficacy of SP on LUTS.

Safety data consisted of the Common Terminology for Adverse Events criteria for nausea, gastritis, and anorexia. Efficacy of the MTD was evaluated by weekly symptom data and voiding diary. A pill diary was used to ensure the intervention fidelity.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 48 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: Saw Palmetto Use During Radiation Therapy for Symptom Management Among Prostate Cancer Patients
Study Start Date : October 2011
Actual Primary Completion Date : April 2015
Actual Study Completion Date : April 2015

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Phase 1: The dose finding phase (DFP)
Patients received Saw Palmetto Soft Gel capsules in 320mg or 640mg or 960mg to determine the maximum therapeutic dose
Drug: Saw Palmetto
1 of 3 doses of Saw Palmetto (320, 640, 960mg/day)
Other Name: SP

Active Comparator: Phase 2: RCT phase- Saw Palmetto
Patients received the predetermine the maximum therapeutic dose of Saw Palmetto Soft Gel capsules in phase 1, which is 960mg.
Drug: Saw Palmetto
1 of 3 doses of Saw Palmetto (320, 640, 960mg/day)
Other Name: SP

Placebo Comparator: Phase 2: RCT phase- Placebo
Patients received Soybean Oil Soft Gel as the placebo treatment
Drug: soybean oil soft gel
placebo (soybean oil soft gel)
Other Name: Placebo

Primary Outcome Measures :
  1. Feasibility [ Time Frame: Baseline to Week 12 for each phase. ]
    Assess a Saw Palmetto supplementation protocol for feasibility by evaluation if at least 70% of eligible men consent, and if at least 70% of men enrolled at each dose complete the study.

  2. Efficacy [ Time Frame: HRQOL: Baseline, week 12, 14, & 22. IPSS: Baseline, week 3-12, 14, & 22. ]
    Evaluate preliminary efficacy of Saw Palmetto at the MTD as compared to the placebo group with respect to Health-Related Quality of life (HRQOL) including physical functioning and symptoms. The outcomes were measured using 1) the International Prostate Symptoms Score (IPSS) and 2) the total and subscales of the Functional Assessment of Cancer Therapy-Prostate (FACT-P). The IPSS which ranges from 0-35. A lower score indicates better symptoms. The FACT-P has the following subscores and ranges: emotional well-being (0-24), functional well-being (0-28), physical well-being (0-28), social well-being (0-28), and prostate-specific concerns (0-48). The FACT-P total is comprised of the sum of the subscales and ranges from 0-156. For the FACT-P, a higher score indicates better quality of life. Each values was created as an average over time from a linear mixed effects model that adjusted for baseline values.

  3. Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose [ Time Frame: Baseline to Week 12 ]
    Dose limiting toxicities was defined as the Common Terminology Criteria for Adverse Events (CTCAE) Grade 2 or higher for gastrointestinal symptoms (nausea, gastritis, anorexia). The maximum tolerated dose (MTD) was established among 320mg, 640mg,or 960mg, at which less than 10% of men report less than a grade 2 of gastrointestinal symptoms.

Information from the National Library of Medicine

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Ages Eligible for Study:   21 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 21 years or older
  • Adenocarcinoma of the prostate
  • Serum Prostate Specific Antigent (PSA) ≤ 40ng/ml
  • Combined Gleason Score ≤ 8
  • Karnofsky level of performance of > 70%
  • Consented to undergo definitive Radiation Therapy

Exclusion Criteria:

  • Stage T4 or M1
  • Patient using own supply of Saw Palmetto or any other supplement containing the following herbs: Pygeum (African Plum), Urtica Dioica (Stinging nettle), Cucurbita peponis (pumpkin seed), PC-SPES (combination of 8 herbs), Beta-sitsterol (plant sterols) or Cernilton (rye grass pollen).
  • Prior pelvic radiation therapy
  • Abnormality in liver and kidney function as evidenced by greater than twice the normal values of Blood Urea Nitrogen (BUN), serum creatine, serum transaminases, and alkaline phosphatase.
  • Uncontrolled hypertension despite use of antihypertensive medication
  • Presence of major psychiatric or medical illness (e.g., major cardiovascular events within the previous 12 months)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01585246

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United States, Michigan
Allegiance Health
Jackson, Michigan, United States, 49201
McLaren Greater Lansing
Lansing, Michigan, United States, 48910
Sparrow Cancer Center
Lansing, Michigan, United States, 48912
McLaren Macomb
Mount Clemens, Michigan, United States, 48043
McLaren Central Michigan
Mount Pleasant, Michigan, United States, 48858
St. Joseph Mercy Oakland Hospital
Pontiac, Michigan, United States, 48341
Sponsors and Collaborators
Michigan State University
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Principal Investigator: Gwen Wyatt, PhD, RN MichiganState University
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Responsible Party: Gwen Wyatt, Professor, Michigan State University Identifier: NCT01585246    
Other Study ID Numbers: Application ID 213
First Posted: April 25, 2012    Key Record Dates
Results First Posted: July 14, 2017
Last Update Posted: September 30, 2019
Last Verified: September 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Gwen Wyatt, Michigan State University:
Prostate Cancer
Radiation Therapy
Quality of Life
Symptom Management
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Prostatic Diseases
Saw palmetto extract
Urological Agents