Archive | Prostate Health

Study Shows Good Outcome for Delayed Prostate Surgery

Men with early prostate cancer who put off surgery is almost the same as men who had prompt surgery. On average, their tumors were no likely to develop into a more aggressive form than men who had surgery immediately after diagnosis. Additionally, after eight years, .9 percent of men who delayed surgery had died compared to .7 percent of men who had prompt surgery.

“Our findings show that if a man is diagnosed with a localized low-risk prostate cancer, there is no rush to decide which treatment choice (is) best,” said lead researcher Dr. Benny Holmstrom, of Gavle Hospital in Sweden.

The results add to data that some patients can safely opt for “active surveillance” — where the prostate cancer is monitored with regular PSA blood tests, digital rectal exams and possibly prostate biopsies and costly, painful surgical procedures are avoided.

A study published last year in the Journal of the National Cancer Institute estimated that since 1986, around 1 million U.S. men received unnecessary treatment for prostate tumors that were not life threatening.

As experts and health providers are increasingly calling for expanded use of active surveillance in monitoring prostate cancer, this study is particularly significant. However, Holmstrom warned that further, long-term studies are still needed to insure that active surveillance is truly the best option for prostate cancer patients.

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Cranberry for a Healthy Prostate

According to a new study from the Czech Republic, cranberries may provide men’s prostates with protection from disease.  The British Journal of Nutrition published the results from a study conducted by scientists from Palacky University in Olomouc.  The team reported that six months of supplementation with 1,500 mg per day of dried powdered cranberries significantly improved measures of prostate health.

Several other significant improvements were reported in the Czech study, including improvements in the International Prostate Symptom Score, quality of life measures, urination parameters, and lower levels of prostate specific antigen (PSA).  The PSA is a marker used to screen for prostate cancer and for tracking the disease after its diagnosis.

Dr. Jitka Vostalova, head of the research team, explains, “Our trial is the first to evaluate cranberry in the treatment of lower urinary tract symptoms (LUTS) specifically in men with benign hyperplasia (BPH), elevated PSA levels and non-bacterial prostatitis.”  Dr. Vostalova continues, “Unlike currently used medication for prostatitis and LUTS, cranberry has no adverse effects.  Our findings may assist men suffering from LUTS, and also their clinicians, to decide on a treatment that is both inexpensive and natural, like cranberry.”

Researchers have already established a link between urinary tract health and cranberries, and they understand that the benefits are associated with cranberries’ proanthocyanidin (PAC) content.  In 2004, France approved a health claim for the North American cranberry (Vaccinium macrocarpon), which contains at least 36 mg of PAC, to “help reduce the adhesion of certain E. coli bacteria to the urinary tract walls.”  Scientists in France also agreed that this process is what fights urinary tract infections.

The study conducted in the Czech Republic extends cranberries’ effectiveness to prostate health, improves our understanding of cranberries, and indicates a unique role for the red fruit.

Benign prostatic hyperplasia and chronic prostatitis are conditions that prove problematic for the lower urinary tract system.  Both are non-cancerous, and BPH is a swelling in the prostate gland of older men.  In fact, BPH is quite common and affects millions of men in the United States over the age of 50, with an estimated aggregate cost of $1.1 billion annually.

“The results of the present trial are the first firm evidence that cranberries may ameliorate LUTS, independent of benign prostatic hyperplasia or C-reactive protein level,” note researchers of the study.  No longer is cranberry solely for women’s health, and men with prostate issues may now begin to see a market expansion of supplements that include cranberry in their ingredients.

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Low-Fat Diet May Reduce Risk of Prostate Cancer

According to a study lead by a team of researchers at Jonsson Cancer Center at the University of California, Los Angeles, a diet high in unhealthy types of fats is a potential cause of prostatic diseases, which includes benign prostatic hyperplasia and prostate cancer.

The researchers focused on mice that were fed a diet high in fat from corn oil.  Corn oil is primarily comprised of omega-6 fatty acids, which is the type of polyunsaturated fat found in processed baked goods and fried foods.  This type of fat should not be confused with omega-3 fatty acids, which are the healthiest fats and are found in fish, or monounsaturated fats, which are found in almonds, pecans, cashew nuts, peanuts, avocados, olive oil, and canola oil.

In the study, researchers fed one group of mice a diet with 40 percent of calories coming from fat, which is similar to the amount found in a typical Western diet.  The second group of mice received 12 percent of their caloric intake from fat.  The results showed a 27 percent lower incidence of prostate cancer in the low-fat diet group.  Further, precancerous cells grew at a much slower rate in the low-fat diet group, compared to those in the high-fat group.

In a supplemental study, Dr. Sanjay Gupta, MS, PhD, and colleagues found that high-fat diets actually activate a protein complex which leads to prostatic inflammation.  The researchers noted that when non-obese mice were fed a high-fat diet for four, eight, and 12 weeks, they exhibited significant increases in the protein complex activation, prostate weight, and prostate expression of inflammation when compared with mice that were fed a regular diet.

While most of the information has come from mice studies, researchers say that the finding translates to people.  Human clinical trials will be following shortly to prove that lowering dietary fat intake results in an increase in levels of a protein that slows prostate cancer development by reducing the amount of growth factor that encourages prostate cancer.

“A low-fat, high-fiber diet combined with weight loss and exercise is well known to be healthy in terms of heart disease and is known to reduce the risk of heart attacks and strokes, so that would be a healthy choice to make,” said Dr. William Aronson, a Jonsson Cancer Center researcher and the UCLA study’s senior author.  “Whether or not it will prevent prostate cancer in humans remains to be seen.”

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Flossing and Prostate Disease: Is There a Link?

For years, toothpaste ad campaigns have touted, “Healthy teeth, healthy smile, and healthy life.”  But only in recent years have periodontists and urologists began to work together in a study focused on a link between gum disease and prostate disorders.

Previous studies have found a connection between inflammation in the mouth from gum disease and heart disease, diabetes, rheumatoid arthritis, and Alzheimer’s disease.  Now the Journal of Periodontology has published a study conducted by Case Western Reserve University and University of Hospitals Case Medical Center, both in Cleveland, Ohio, that shows a link between gum and prostate diseases.

The PSA, or prostate-specific antigen, is often used as a marker to determine the degree of inflammation of the epithelial cells of the prostate acini.  Normally, the PSA levels of healthy individuals are around 2; however, in the presence of inflammation or cancer of the prostate, the PSA levels may jump to 4 or greater.  In the study conducted in Cleveland, thirty-five subjects who underwent prostate biopsy participated in the study.  In these subjects, the amount of plaque, bleeding on probing, probing depth, and clinical attachment level (CAL) were also determined.  The results showed higher PSA levels for patients with moderate to severe prostate inflammation.  Further, those patients with high CAL levels and severe prostatitis had significantly higher mean PSA levels than those with neither gum disease nor prostatitis.

As a result of the study, researchers have theorized that flossing, which reduces gum disease and thus inflammation in the mouth, may also reduce prostate gland inflammation.  More clinical studies with a larger patient base need to be conducted to confirm and actually identify the linking factor.  And, although flossing is an important step in dental health, dentists still stress the importance of brushing at least twice daily and yearly dental exams.  If gum disease and the resultant inflammation truly prove to be another link to prostate cancer, then total mouth health must be sought after.

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Beta-Sitosterol and Your Prostate Health

For men who are suffering from prostate related symptoms and are seeking for safe alternative therapies, beta-sitosterol may be the answer.

Beta-sitosterol is a plant sterol found in several everyday foods and has effectively been shown to -
* Inhibit growth of prostate cancer cells and can even destroy the cells through protein phosphatase.
* Decrease inflammation by binding to the prostate.
* Improve urinary flow and help with urinary incontinence and urgency.
* Prevent difficult urination.

To incorporate beta-sitosterol in your diet, use vegetable oil as this is its best food source. Canola, corn and soybean oil, vegetable shortening, margarine made from corn or soybean oil, and tofu or soybean mayonnaise all contain high amounts of beta sitosterol.

Other significant sources of beta sitosterol are avocados, grape leaves, fava beans, saw palmetto, pumpkin seed, cashew fruit, rice bran, wheat germ, pistachio nuts, almonds, hazel nuts, walnuts, macadamia and pecans.

Another pleasant source of beta sitosterol is unsweetened baking chocolate. Now brownies will be a good source of beta sitosterol by using ingredients with high beta sitosterol – vegetable oil or margarine, unsweetened baking chocolate with chopped nuts of your choice.

Beta sitosterol is safe when taken in normal amounts such as amounts found in food. Clinical studies though have shown it may cause side effects, most of which are not usually dangerous.

An added benefit of beta-sitosterol is it has been found to lower cholesterol, by inhibiting the amount of cholesterol that is permitted to enter the body.

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The Importance of Knowing Your Baseline PSA For Prostate Health

If you have been recently diagnosed with prostate cancer, then your urologist most likely provided you with a PSA score. The PSA baseline score is your prostate specific antigen at the time of your first measurement of the antigen. This baseline is important because subsequent PSA values that are higher than the baseline may indicate a disease of the prostate, such as prostate cancer or benign prostatic hyperplasia. Further, your oncologist or urologist may consider your PSA before treatment has been administered.

One of the first questions patients who have been diagnosed, or re-diagnosed, with metastatic prostate cancer ask is, “How long do I have to live?” The answer to this question has changed over the years. While in the 1980s and early 1990s men were given an estimated 18 to 36 months from the time of diagnosis to live, the current understanding and estimation of survival is 5 to 6 years, maybe longer. The difference in survival rates is, in part, due to treatments; however, the major factor is the inclusion of PSA scores, velocity numbers, etc. These numbers allow researchers to form a clearer picture of the individual cancer and a closer estimation of survival.

And for those who have already been diagnosed with prostate cancer and have been treated, recurrence is a reality. According to the Prostate Cancer Foundation, out of those who have undergone treatment for prostate cancer, 20-30% will relapse after the five-year mark and begin to show signs of disease recurrence.
But survival for recurrence has also been extended. Many men in the United States are actually diagnosed at an earlier stage of the disease because of wide-spread PSA testing. Further, we now have a better understanding of cancer therapies, including hormone manipulation and taxane chemotherapy.

According to Duke University Medical Center researchers, men with a baseline PSA value of 10 or higher are up to 11 times more likely to die from prostate cancer than are men with lower initial values. In the study conducted by Duke University, 4,568 men over the past 20 years who have had PSA tests and were eventually diagnosed with prostate cancer were followed. With age and race taken into account, the risk of death from prostate cancer was calculated.

The study released showed a median age for their study as 65 years. The median baseline PSA was 4.5. Nearly 3.5% of the men died from prostate cancer during the study period, while more than 20 percent died from other causes. The analysis showed that men with a baseline PSA of less than 4 had a very low risk of death from prostate cancer, but those with 4 to 9.9 baselines were three times more likely to die from prostate cancer. And men with a baseline PSA value of greater than 10 were 11 times more likely to die than were men with PSAs under 2.5.

Given these results, it is evident that early diagnosis of prostate cancer, when the baseline PSA is lower, will decrease the mortality rate from prostate cancer. With PSA screenings and digital rectal exams, men may be saved from early, unnecessary death.

Baseline PSA scores are important in determining predicted survival rates for men who have been diagnosed with prostate cancer. Ping Tang, MD, a member of the Duke Prostate Center and the department of urology at Guangzhou First Municipal People’s Hospital, Guangdong, China comments, “It’s commonly held that men over the age of 75 don’t need to bother with PSA screening any longer, but [this study] tells us that chronological age alone may not be enough. Patients need to take into account their initial baseline value, and if it’s over 4, continuous screening may be beneficial.”

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Brisk Walking Slows Down Prostate Cancer Progression

A recent study at the University of California, San Francisco (UCSF) and the Harvard School of Public Health found that an association between brisk walking and lowered risk of prostate cancer progression in a study of 1,455 men in the U.S. diagnosed with early-stage prostate cancer.

The research team found that men who walked briskly at least at three miles per hour for at least three hours each week after diagnosis were about sixty percent less likely to develop biochemical markers of cancer recurrence or less likely to need a second round of prostate cancer treatment.  The study was published in the journal Cancer Research.

This new finding complements an earlier study published by UCSF’s June Chan, ScD, and collaborators at the Harvard School of Public Health showing that physical activity after diagnosis could reduce disease-related mortality in a distinct population of men with prostate cancer.  The recent study by Erin Richman, ScD, a postdoctoral fellow at UCSF is the first to focus on the effect of physical activity after diagnosis on early indications of disease progression, such as rise in prostate-specific antigen (PSA) blood levels.

An advantage of this study is the focus on early recurrence of prostate cancer, which occurs before men may experience painful symptoms of prostate cancer metastases, a frequent cause for men to decrease their usual physical activity. Additionally, the researchers reported that the benefit of physical activity was independent of the participants’ age at diagnosis, type of treatment and clinical features.  This work was funded by the Department of Defense, the Prostate Cancer Foundation, Abbott Labs, and through a National Institutes of Health training grant.

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No Relationship Between Small Prostate Size and High Grade Cancer

Previously, radical prostatectomy series have shown an inverse relationship between prostate size and high grade cancer.  It was suggested that smaller sized prostates arise in a low androgen environment, which enables development of more aggressive cancer.  A recent study by a team of authors from Stanford University School of Medicine in the Journal of Urology, however, shows that small prostate size is not associated with high grade cancer.  The authors argue that previous observations are the result of ascertainment bias driven by prostate specific antigen performance.

The study’s authors analyzed 1,404 patients from the Stanford Radical Prostatectomy Database with clinical stage T1c (723) and T2 (681) disease who had surgery between 1988 and 2002 and underwent detailed morphommetric mapping by a single pathologist.  They used multivariate linear regression to analyze the effects of age, prostate weight and prostate specific antigen on total and high grade cancer volume and percentage of high grade disease.

Patients who underwent biopsy due to abnormal prostate specific antigen (stage T1c had a prostate weight that was negatively associated with total cancer volume, which is the volume of high grade disease and percentage of high grade disease.  For patients who underwent biopsy based on abnormal rectal examination (stage T2), these relationships were not present.

The authors conclude that improved prostate specific antigen performance for high grade disease results in ascertainment bias in patients with T1c disease.  For this reason, the relationship between prostate size and high grade disease may be a result of grade dependent performance of prostate specific antigen rather than true tumor biology.

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Six Cups or More of Coffee May Lower Men’s Risk for Prostate Cancer

New research suggests that men who drink six or more cups of coffee a day may be lowering their risk for advanced prostate cancer by 60 percent.

Kathryn Wilson, a research fellow in epidemiology at Harvard School of Public Health in Boston and lead researcher for this study said “There are a lot of compounds in coffee that have various biological effects.  It’s a major source of antioxidants and that might have anti-cancer effects.  Coffee also seems to have effects on insulin which has been associated with a lower risk of type 2 diabetes and insulin is thought to play a role in many cancers, including prostate cancer. Compounds in coffee also have an impact on sex hormone levels.”

For the study, the researchers collected data on almost 48,000 men who took part in the Health Professionals Follow-Up Study in 1986 and followed them until 2008. Every four years these men reported on how much coffee they drank.

The researchers then calculated the risk for prostate cancer tied to the amount of coffee consumed. During the period of the study, they identified 5,035 cases of prostate cancer, of which 642 were fatal cases in which the cancer was metastatic, meaning that it had spread beyond the original site.

The Harvard team found that drinking six or more cups of coffee each day was associated with an almost 20 percent lower risk of developing prostate cancer, compared to those who did not drink coffee.

In addition, the odds of developing a more lethal or advanced prostate cancer dropped by 60 percent, compared to men who abstained from coffee – a statistically significant and “substantially lower” relative risk, according to the researchers.

Even men who drank less coffee — one to three cups a day — had a 30 percent lower risk of developing lethal prostate cancer, and reductions in risk were observed whether the men drank caffeinated or decaffeinated coffee.

After taking into account other lifestyle factors, such as age, smoking, obesity and exercise, the decline in the odds for prostate cancer remained.

The study was limited by self reported data and the lack of data on coffee intake from earlier periods of the men’s lives, the researchers noted.

Right now the study findings point only to an association between coffee and a healthier prostate. More study will be needed to confirm the findings and to see if a biological explanation for the phenomenon exists.

The finding comes on the heels of a published Swedish study that found that women who drank five or more cups of coffee per day saw a significant drop in their risk for a particularly aggressive form of breast tumor.

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Pomegranate Extract Slows Down Prostate Cancer Progresssion

In a phase 2 double-blind study led by Michael A. Carducci, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, researchers found that treatment with the pomegranate extract (POMx) was associated with a greater than six-month median increase in PSA doubling time (PSADT).  Previous research had shown that pomegranate extract, which is rich in antioxidants and vitamin C, has antitumor effects.

This study had an enrollment of 92 men who were randomized to receive a low or high dose of POMx.  None of the mens’ cancer had spread beyond the prostate at the beginning of this study.  The low-dose group took one POMx capsule (1 gram of extract) plus two placebo capsules), and the high-dose group took three POMx capsules (3 grams of extract).  Men were treated until they had disease progression or for 18 months.  PSA levels were measured every three months.

Carducci reported that the median PSADT increased from 11.9 months prior to treatment to 18.5 months after treatment at the Genitourinary Cancers Symposium.  PSADT did not differ significantly between the treatment arms.  In the low-dose arm, it increased from 11.9 to 18.8 months.  In the high-dose arm, it increased from 12.2 to 17.5 months.  Dr. Carducci’s group observed PSA declines in 13 patients during the study.  There were no significant changes in testosterone observed in either group.  There were no clinically significant toxicities, but eight patients experienced mild to moderate diarrhea.  He noted that one of the limitations of this study is the lack of a control arm with patients only taking a placebo.  Additional research is necessary because it remains unclear whether reducing the doubling time of the PSA levels in fact improved the prognosis of the patient.

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