Vegetable Fat Slashes Prostate Cancer Deaths

The link between cancer and diet has been extensively studied, It is known for example that being overweight is related to as many as one in five cancer-related deaths. Weight is most closely connected with cancers of the breast and uterus in postmenopausal women. Other cancers associated with obesity include:

• Esophagus
• Pancreas
• Colon and rectum
• Kidney
• Thyroid
• Gallbladder

But less is known about the association between diet and prostate cancer.  The three well-established risk factors for prostate cancer: are race (specifically, African American race), family history, and age. Unfortunately, these are three things we cannot change. So given this reality, there is much interest in identifying modifiable risk factors for prostate cancer, not least among the roughly 2.5 million men in the United States currently live with prostate cancer.

Now, a new study might provide some hope. It showed that replacing carbohydrates and animal fat with vegetable fat may be associated with a lower risk of death in men with non-metastatic prostate cancer.

Erin Richman, a postdoctoral scholar at the University of California, San Francisco, and colleagues at UCSF examined fat intake after a diagnosis of prostate cancer in relation to lethal prostate cancer and all-cause mortality in 4,577 men diagnosed with non-metastatic prostate cancer. Their findings have just been published in Online First by JAMA Internal Medicine.

Between 1986 and 2010, the researchers noted 315 lethal prostate cancer events and 1,064 deaths during a median follow-up of 8.4 years. They also discovered that replacing 10% of calories from carbohydrates with vegetable fat, such as oil or nuts, was associated with a 29% lower risk of lethal prostate cancer and a 26% lower risk of death from all-cause mortality.

Overall, the findings suggest that men with prostate cancer should be advised to follow a heart-healthy diet in which carbohydrate calories are replaced with unsaturated oils and nuts to reduce the risk of all-cause mortality.

And although the exact reason for the reduction in mortality is unknown, the authors conclude; “the potential benefit of vegetable fat consumption for prostate cancer-specific outcomes merits further research.”

SRxA’s Word on Health agrees.

A Breath of relief for Colorectal Cancer diagnosis

According to the American Cancer Society, colorectal cancer is the second leading causes of cancer-related deaths in the United States.  In 2008, 142,950 people were diagnosed and 52,857 people died from it.

Although early diagnosis can often lead to a complete cure, many people who should get tested, don’t.  Maybe it’s because the current diagnostic tests for colorectal cancer include colonoscopy and sigmoidoscopy.

Few people in America will forget that day almost 12 years ago when  Katie Couric underwent a colonoscopy, live on the “Today” show in an effort to encourage screening after her husband, Jay Monahan, died of colon cancer in 1998.  And while she did her best to show that the procedure does not have to be either uncomfortable or embarrassing, and there was a 20% spike in colonoscopies in the years that followed, according to the CDC half of colorectal cases are still being diagnosed in the late stages

This is, please excuse the pun, a huge bummer, because if found in the early stages, colon cancer has a survival rate of over 90 percent.

Which is why SRxA’s Word on Health was excited to read a new study, published in a supplement to the British Journal of Surgery, which showed that a simple breath analysis could be used for colorectal cancer screening.

Apparently, cancer tissue has different metabolism compared to normal healthy cells and produces some substances which can be detected in the breath of these patients. Analysis of the volatile organic compounds (VOCs) linked to cancer represents a new frontier in cancer screening.

Donato Altomare, MD, of the Department of Emergency and Organ Transplantation and his team of researchers at the University Aldo Moro of Bari, collected exhaled breath samples from 37 patients with colorectal cancer and 41 healthy controls.

Results showed that patients with colorectal cancer have a different selective VOC pattern compared with healthy controls. Tests based upon these VOC’s are able to discriminate patients with colorectal cancer with an accuracy of over 75%.

“The technique of breath sampling is very easy and non-invasive, although the method is still in the early phase of development,” Altomare notes. “Our study’s findings provide further support for the value of breath testing as a screening tool.”

A previous pilot breath test study showed that the technique is not only able to detect cancer, but it can also differentiate between the four most common forms of cancer: lung, bowel, breast and prostate.

While this is all still at an early stage there is no doubt that simplifying the methods for early diagnosis of cancer, will have a significant impact on cutting death rates.

There’s a Shot for That

On May 14, 1796 Edward Jenner injected fluid from the cowpox blisters on the hands of dairymaid Sarah Nelmes, into James Phipps, an 8-year-old boy.  Jenner hoped the fluid from the cowpox lesion would somehow inoculate the boy against the smallpox scourge which at the time was killing over 400,000 Europeans a year. His hunch proved correct.

Today vaccines save 3 million lives per year worldwide. By training the human immune system to recognize and ward off dangerous pathogens, vaccines can protect against disease for decades, or even for a lifetime. Preventive vaccines work by introducing harmless microbial chemical markers, known as antigens, which resemble the markers on living microbes. The antigens train the immune system to recognize and destroy those microbes should they ever appear in the body. By injecting cowpox antigens into Phipps bloodstream, Jenner primed his immune system to attack the similar smallpox virus.

Now, medical scientists are taking Jenner’s ideas in a whole new direction. By exploiting a growing understanding of the immune system they are developing therapeutic vaccines targeting established diseases rather than trying to prevent them.

Last spring, the FDA approved Provenge, a personalized immunotherapy that activates a patient’s own immune cells to target and attack advanced prostate cancer. To make the Provenge prostate cancer vaccine, biochemists at Seattle’s Dendreon Corporation extract a sample of a patient’s own immune cells and bathe them in a chemical soup of prostate cancer antigens that are chemically linked to a cytokine that screams, “Attack this!”.  The activated immune cells are then injected back into the patient’s body to spread the call to arms.

While Provenge was the first of the new generation of therapeutic vaccines, it’s certainly not the last. BCC Research has identified 113 therapeutic vaccines in development, many of which are already in human trials. They even go so far as to estimate that the market for therapeutic vaccines will have an annual growth rate of 115% and reach an estimated $2.9 billion in 2014.

Other cancer vaccines are among the front runners. With a near-endless supply of patients willing to undergo novel treatments, cancer researchers have been among the most aggressive in experimenting with therapeutic vaccination. The Cancer Vaccine Collaborative is working on treatments that target multiple cancer antigens, which should trigger a more aggressive immune response and increase the odds of defeating tumors. All of which is good news for the 1.5 million Americans diagnosed with cancer each year.

While cancers cause a proliferation of diseased cells, some autoimmune diseases, cause the cells of the immune system to turn against healthy tissues. In diabetes, for example, the immune system attacks insulin-making pancreatic beta cells.

In multiple sclerosis, it’s the myelin sheaths that are designed to protect the nerves that come under attack.

Autoimmune vaccines hold the promise of shutting down these attacks. One promising approach boosts T-regulatory cells, a subgroup of the white blood cells. At the University of Calgary’s Diabetes Research Centre in Alberta, immunologist Pere Santamaria has attached a cocktail of antigens from pancreatic beta cells to synthetic iron oxide nanoparticles. This stimulates the development of T-regulatory cells into killer T cells that destroy the immune cells which cause the serial killer like autoimmune attack.

Santamaria’s team recently tested his vaccine in diabetes-prone mice. It restored normal blood sugar and insulin levels in animals that already had diabetes and prevented or slowed its onset in young mice that had not yet developed the disease. The team is now readying the vaccine for human trials and is designing related vaccines to treat other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease.

If effective, such therapeutic vaccines could help the three million Americans with type 1 diabetes and the 400,000 people diagnosed with multiple sclerosis. Vaccines against dust mites and asthma are also in the works.

Some of the new therapeutic vaccines are actually designed to attack the body, albeit in a selective way. A new experimental heart-disease vaccine takes aim at unwanted biochemicals within the body, specifically low-density lipoprotein (LDL), better known as bad cholesterol. When large quantities of LDL cholesterol circulate through the bloodstream, it can be deposited on artery walls, leading to a buildup of plaque and triggering inflammation. Anti-cholesterol vaccines encourage the immune system to attack LDL and remove plaques. Scientists have also discovered that the vaccine lowers blood pressure and protects against the rupture of aneurysms, at least in mice.

Clinical trials in humans are expected to start later this year and if successful could help to prevent the 800,000+ deaths per year from cardiovascular disease.

Even more people could be helped by an anti-obesity vaccine. Nearly 75 million adults are classified as obese in the United States. Researchers are working on a vaccine that targets ghrelin – a gastrointestinal hormone that appears to stimulate appetite.

Others, are looking at vaccines to prevent addiction to cocaine, methamphetamines, opiates and nicotine.

It is too soon to know how and when these vaccines will come to market or how effective they will be, but it’s clear that therapeutic vaccines are coming and will be used against a host of the most prevailing public health issues of the 21^st century.

A vitamin-a-day may do more harm than good

One of the few businesses that has benefitted from the current U.S. recession has been the dietary supplements industry. While some predicted that falling disposable income would hamper sales of vitamins and supplements, the opposite actually occurred: As more people lost their jobs and ability to pay for healthcare, many turned to supplements to remain healthy and ward off expensive doctor visits and pharmaceutical drugs. 

However, the results of two studies, published last week may signal a  reverse of the fortunes of this $30 billion per year industry.

Last week researchers from the Cleveland Clinic announced that vitamin E can enhance chances of prostate cancer. A study involving more than 35,000 men found that those who took a daily dose of 400 IU of vitamin E had a 17% increased incidence of prostate cancer than men who took a placebo.

“For the typical man, there appears to be no benefit in taking vitamin E and, in fact, there may be some harm,” said Dr. Eric Klein, an internationally renowned prostate cancer expert who served as the national study coordinator.

This surprising news was followed in short order by a report that dietary supplements can also increase mortality rate in older women.

The Iowa Women’s Health Study, which started in 1986, set out to determine to what degree diet and other lifestyle factors influence risk of chronic disease.

By the end of the study period in 2008, a total of 41,836 postmenopausal women were investigated – of which 15,594 had died. Multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper were all associated with increased total mortality risk.  Supplemental iron was most strongly associated with increased mortality whereas, calcium supplements, were associated with a decreased risk.

Study leader Dr Lisa Harnack, associate professor of epidemiology at the University of Minnesota, said: “Among the elderly, use of supplements is widespread, often with the intention of attaining health benefits by preventing chronic diseases. Our study raises concerns regarding their long-term safety.”

SRxA’s Word on Health won’t be taking any chances. No more once-a-day for us!

Do DIY “spit kits” stress you out?

One of the fastest growing health care trends in “individualized medicine” is home genetic testing. The over-the-counter mail-in kits, with price tags as high as $2,500, use a saliva specimen to identify small variations in the human genome  associated with heightened risk for diseases such as diabetes and prostate cancer.

The U.S. Food and Drug Administration (FDA) has raised concerns about whether the tests are clinically beneficial and has advocated they be conducted under medical supervision, but few studies, to date, have investigated the emotional effects that direct-to-consumer genetic screens have on patients.

Now that’s all changed.  A group of Mayo Clinic physicians and bioethicists have analyzed whether these genetic tests cause patients to experience excessive worry about developing diseases. “We looked for evidence of increased concern about disease based solely on genetic risk, and then whether the concern resulted in changes in health habits,” said co-author Clayton Cowl, M.D.

The randomized study found patients’ worry tended to be modestly elevated one week after the genetic testing, and that people worried more about unfamiliar diseases, for instance the thyroid condition Graves’ disease than those commonly known, such as diabetes.

One year later, however, patients who had undergone testing were no more stressed than those who hadn’t. One surprising result was that men whose genetic risk for prostate cancer was found to be lower than that of the general population, and who also had normal laboratory and physical screening results for the disease, were significantly less stressed about the disease than the control group.

The researchers concluded that the tests may be useful if they prompt patients to make health-conscious changes, such as losing weight or being vigilant about cancer screening.

However, some doctors are concerned that patients who learn they have less-than-average genetic risk for a disease might skip steps to promote good health. Others just think it’s a bad idea – period.  “Genetic testing is a complex, difficult and emotionally laden medical process which requires extensive counseling, contextualization and interpretation,” says Dr. Michael Grodin, professor of bioethics, human rights, family medicine and psychiatry at Boston University.

It’s also worth noting that the current study only assessed the emotional effects of do-it-yourself genetic testing. Nobody yet knows whether a calculation of genetic risk accurately predicts disease.

Have you bought one of these kits?  How did you feel while you waited for the results. SRxA’s Word on Health would love to know.

Asthma inhalers may be linked to increased risk of prostate cancer

Once again, asthma drugs are back in the spotlight.

According to a new study, several of the drugs used to treat asthma may increase the risk of prostate cancer.

The biggest danger appears to be among those with severe asthma who frequently need treatment with steroid tablets or injections.  Among this group, the risk of cancer increased by up to 70% say the researchers from Australia. But they are not alone.  Their data showed that men who regularly use inhaled steroids to keep their asthma under control are 40% more likely to develop a tumor than men without asthma; and those who regularly use a bronchodilator to relieve their wheezing are 36% more at risk of the disease.

Although the same research found having asthma itself appears to increase the risk by around 25%, the chances of a tumor were significantly higher in the men who were taking medication.

The researchers studied 1,179 men who had been diagnosed with prostate cancer and analyzed how many had a history of asthma. They chose to investigate a possible link between the two conditions because both involve an inflammation of the body.

While the results, published in the journal Cancer Epidemiology, Biomarkers and Prevention, raise concerns, Word on Health cautions that they need to be confirmed by much bigger studies, before reviewing or changing current asthma therapy guidelines.

Dr. Elaine Vickers, from Asthma UK agrees.  “We urge men with asthma not to stop taking medication on the basis of these results.”

As always, Word on Health welcomes your views on this.

The Best Father’s Day Gift

Instead of another set of grill tools or yet another tie, a more meaningful gift for Dad this Father’s Day would be to encourage him to get checked for prostate cancer. So say experts at The Cancer Institute of New Jersey (CINJ).

According to the American Cancer Society, prostate cancer is the second most frequently diagnosed cancer in men, (skin cancer is now the #1) and the second leading cause of cancer death in males. It is estimated that approximately 192,000 new cases of prostate cancer will occur in the United States this year, with 27,000 deaths. African American men are at a higher risk of developing prostate cancer.

The good news is that if detected and treated early, the chances of survival are nearly 100 %.

Screening consists of a digital rectal examination and a prostate specific antigen (PSA) blood test.

Most healthy men have PSA levels under 4 ng/mL of blood. The chance of having prostate cancer goes up as the PSA level goes up.

The American Cancer Society recommends that men, especially those with several family members who have had prostate cancer at a young age, should consider screening at age 40. African Americans should begin screening at 45 and most other men at age 50.

Men who choose to be tested and have a very low PSA may only need to be retested every 2 years, whereas they may be tested yearly if their PSA result is higher.

So play it safe this Father’s Day and give your Dad the best gift of all – his health.