Someday medical experts will figure out what everyone wants to figure out about prostate cancer: how to distinguish aggressive, life-threatening cancer from indolent, unusual cell growth that will harmlessly hang around until something else kills you first. On recent attempt at the Brigham & Women’s Hospital has persuaded researchers that measuring PSA levels in younger men (between the ages of 40 and 59) could predict future risk of lethal prostate cancer later in life. Science Daily reports on the research, which studied 30 years of data from the Physicians’ Health Study (PHS), and looked at 234 men who were diagnosed with prostate cancer, including 60 who developed lethal prostate cancer, and 711 controls, all between 40 and 59 years of age at the start of the trial. The research team measured PSA levels from stored plasma samples and followed the men’s outcomes over time. Here’s what they found: Of the lethal prostate cancer events, 82 percent, 71 percent and 86 percent occurred in men with a baseline PSA above the median at ages 40-49, 50-54 and 55-59, respectively. The study also found that men who had a PSA below median (<1.0 ng/ml) at age 60 were unlikely to develop lethal prostate cancer in the future. Senior author Lorelei Mucci, ScD, associate professor of Epidemiology in the Department of Epidemiology at Harvard T.H. Chan School of Public Health, says the study “does not imply prostate biopsy or definitive treatment is immediately required in younger men with higher PSA levels at baseline, as this could lead to over diagnosis. Rather, these men should undergo more intensive PSA screening to enable earlier identification of cancer and potential cure while still possible.”
For years, experts have debated the likelihood that testosterone therapy will increase the risk of aggressive prostate cancer. That’s because, as Science Daily points out, standard therapy for advanced prostate cancer decreased tumor growth with drugs that drastically reduce rather than increase male hormones. Now come researchers from the NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center, who are convinced that the best thing men can do is keep testosterone levels balanced and within a normal range. Science Daily reports that the researchers, who analyzed more than a quarter-million medical records of mostly white men in Sweden, found that men prescribed testosterone for longer than a year had no overall increase in risk of prostate cancer and, in fact, had their risk of aggressive disease reduced by 50 percent. The researchers found an increase (of 35 percent) in prostate cancer in men shortly after starting therapy, the increase was only in prostate cancers that were at low risk of spreading and was likely a result from more doctor visits and biopsies performed early on. They noted that the long-term reduction in aggressive disease was found only in men after more than a year of testosterone use, and the risk of prostate cancer did not differ between gels and other types of preparations.
Researchers offer no guarantees, but it looks like regular exercise increases the chances that prostate cancer will not spread beyond the prostate. HealthDay reports on an American Cancer Society study that included more than 10,000 men, aged 50 to 93, who were diagnosed with localized prostate cancer between 1992 and 2011. Researchers surveyed the men, asking about their physical activity before and after their diagnosis. Ready? The envelope please….the researchers found that men with the highest levels of exercise before their diagnosis were 30 percent less likely to die of their prostate cancer than those who exercised the least. In fact, more exercise appeared to provide more protection: Men with the highest levels of exercise after diagnosis were 34 percent less likely to die of prostate cancer than those who did the least exercise.
Men with prostate cancer who have chosen to watch and wait may also want to watch their levels of vitamin D. Researchers at Northwestern University have found what they describe as “a major link between low levels of vitamin D and aggressive prostate cancer.” A Northwestern news release reports that the study included 190 men, average age of 64, who underwent a radical prostatectomy to remove their prostate from 2009 to 2014. Of that group, 87 men had aggressive prostate cancer. Those with aggressive cancer had a median level of 22.7 nanograms per milliliter of vitamin D, significantly below the normal level of more than 30 nanograms/milliliter. The research also point out that earlier research revealed that African American men who live in low sunlight locations are up to 1½ times more likely to have vitamin D deficiency than Caucasian men. What to do? The researchers suggest that people who live in Chicago take vitamin D supplements, particularly in the winter.
For men with slow-growing prostate cancer, three aspirin a week can reduce the risk of developing lethal cancer by 34 percent, and the risk of dying of prostate cancer by 39 percent. That’s the finding of a new analysis from the long-running Physicians’ Health Study, a longitudinal trial at Brigham and Women’s Hospital in Boston and the Harvard T.H. Chan School of Public Health. The Wall Street Journal reports that 99 percent of men with slow growing cancer are alive after five years, and 98 percent are alive after a decade, but once the tumor spreads other parts of the body, five-year survival falls to 28 percent. The paper reports that aspirin had little effect on the overall incidence of prostate cancer, but did appear to slow the progression of the disease.
Intense exercise, the kind that brings on a good sweat, may help keep prostate cancer at bay. That’s the suggestion of research conducted at the University of California in San Francisco, where scientists tracked tens of thousands of midlife and older men for more than 20 years, noting their healthy lifestyle habits and their incidence of prostate cancer. Ready? The envelope please….the researchers found that vigorous exercise and other healthy lifestyle habits may cut their chances of developing a lethal type of prostate cancer by up to 68 percent. A UCSF news release reports that the researchers analyzed data from two U.S. studies: the Health Professionals Follow-Up Study that tracked more than 42,000 males ages 40 to 75, from 1986 to 2010; and a second, the Physicians’ Health Study that followed more than 20,000 males ages 40 to 84, from 1982 to 2010. They assigned one point for each affirmative response to questions about regular intense exercise that induced sweating, body mass index (BMI) under 30, tobacco-free status for a minimum of 10 years, high intake of fatty fish, high intake of tomatoes and low intake of processed meat. Men with five to six points in the health professionals’ group had a 68 percent decreased risk of lethal prostate cancer and a 38 percent decreased risk was observed in the physicians’ group for the same comparison. For dietary factors alone, men with three points, versus those with zero points, had a 46 percent decreased chance of developing lethal prostate cancer in the health professionals’ group, while in the physicians’ group the decrease was 30 percent. The researchers are convinced that 47 percent of lethal prostate cancer cases would be prevented in the United States if men over 60 had five or more of these healthy habits.
The decade-long debate over the best treatment for low-risk prostate cancer continues, with some researchers at John Hopkins med school persuaded that watching and waiting is the way to go for many men with low-risk cancer. Here’s why: just two of 1,298 men enrolled over the past 20 years in an active surveillance program died of prostate cancer, and three developed metastatic disease. Science Daily reports that all of the men in the study had cancer that was classified (in part by Gleason score) as low-risk or very low-risk. Of the 1,298 men, 47 died of nonprostate cancer causes, nine of the 47 had received treatment for their prostate cancer. Two men died from prostate cancer, one after 16 years in the active surveillance program, and three were diagnosed with metastatic prostate cancer. The bottom line? The researchers calculated that men in the program were 24 times more likely to die from a cause other than prostate cancer over a 15-year span. Some 467 men in the group (36 percent) had prostate cancers that were reclassified to a more aggressive level within a median time of two years from enrollment in the active surveillance program. For men with very low-risk cancers, the cumulative risk of a grade reclassification to a level that would have generally precluded enrollment in the program over five, 10 and 15 years was 13 percent, 21 percent and 22 percent, respectively. For men with low-risk cancers, this risk increased to 19 percent, 28 percent and 31 percent. Over the same time frames, the cumulative risk of a grade reclassification to a level that would be considered potentially lethal but still curable was no more than 5.9 percent for both very low and low-risk prostate cancers. Read more at Science Daily.
Over the years, vitamin D has been hailed, and often unhailed, as a cure for several unpleasant conditions. Now comes research from the Medical University of South Carolina suggesting that it can slow the progression of some non-aggressive prostate cancers. Science Daily reports that researchers at the school conducted a randomized, controlled clinical trial, which assigned 37 men undergoing elective prostatectomies either to a group that received 4,000 U of vitamin D per day, or to a placebo group that didn’t receive vitamin D. The men’s prostate glands were removed and examined 60 days later. The envelope please… Preliminary results show that many of the men who received vitamin D showed improvements in their prostate tumors, while the tumors in the placebo group either stayed the same or got worse. Note well: all of the men in the study had low-grade prostate cancers, with Gleason scores of 6 and below. There is no evidence that vitamin D can slow aggressive prostate cancer.
Yes, in addition to its folkloric power to deter evil spirits, garlic may slow the spread of some cancers, including prostate, melanoma, and some types of leukemia, all of which weaken the body by over-activating the natural immune system. A University of Copenhagen news release reports that researchers at the school have found that selenium, which is found in garlic and broccoli, slows down the immune over-response, which may improve cancer treatment. How? It’s complicated, but here we go: The immune system is designed to remove things not normally found in the body–things like cells undergoing change, e.g. precursors of cancer cells, are normally recognized and removed by the immune system. Unfortunately, the different cancer cells contain mechanisms that block the immune system’s ability to recognize them, allowing them to freely continue cancer development. The researchers found that certain selenium compounds block the special immunostimulatory molecule that plays a serious role for aggressive cancers such as melanoma, prostate cancer. Read an even more complicated explanation here.
Yes, it appears to be true: walnuts slow the growth of prostate cancer, at least in mice. A UC Davis news release reports that researchers at the school had found, in a previous study, that walnuts reduced prostate tumor size in mice, but the researchers weren’t sure which parts of the nuts generated these benefits. This time around, the researchers used a mixture of fats with virtually the same fatty acid content as walnuts as their control diet. Mice were fed whole walnuts, walnut oil or the walnut-like fat for 18 weeks. The envelope please…the researchers found that while the walnuts and walnut oil reduced cholesterol and slowed prostate cancer growth, the walnut-like fat did not, confirming that other nut components caused the improvements – not the omega-3s. The researchers note that while the study doesn’t pinpoint which combination of compounds in walnuts slows cancer growth, it did rule out fiber, zinc, magnesium and selenium. What it did show is that walnuts modulate several mechanisms associated with cancer growth.