November 08 Newsletter Articles

Prostate Cancer Increases
Hip Fracture Risk by Eight Times
in 50 to 65 Year-Olds

Men who have prostate cancer are on average four times more likely to suffer a hip fracture, with rates rising to eight times in men aged 50 to 65, according to a study of more than 60,000 men published in the October issue of BJU International (BJU Int, Vol. 100, pp. 749-54). Danish researchers looked at 62,865 men aged 50 and over, with an average age of just under 67. 15,716 had suffered a fracture of some description and 47,149 formed the non-fracture control group. They discovered that prostate cancer made men 1.8 times more likely overall to suffer a fracture and 3.7 times as likely to suffer from a hip fracture. But the hip fracture risk was eight times higher in men from 50 to 65 years of age. No increased risk of vertebral fractures was found by the research.

“Our study showed that more than 3% of hip fractures in men aged 50 and over can be attributed to prostate cancer” says lead researcher Dr. Bo Abrahamsen from Copenhagen University Hospital, Gentofte. “And the risk remains even when men have recovered from the disease.” The researchers – urologists and endocrinologists from University affiliated Danish hospitals – are now establishing a multi-centre initiative focusing on early diagnosis and treatment of osteoporosis in men with prostate cancer.

> “Prostate cancer is now the cancer that men are most likely to develop and is a leading cause of male deaths in Europe and the USA” stresses Dr. Abrahamsen. “Medical advances are improving survival rates, but the downside is that treatment can lead to osteoporosis, where the bone loses density and becomes more fragile. This in turn increases the risk of fractures…Men who received hormone therapy or had their testicles surgically removed to slow progression of the disease were 1.7 times more likely to suffer a fracture.”

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STUDY FINDS PROSTATE CANCER IN 25% OF HIGH-RISK MEN WITH 'NORMAL' PSA LEVELS

Men at high risk of developing prostate cancer should undergo aggressive screening for the disease. That is the recommendation following a Fox Chase Cancer Center study of 520 men at high-risk of developing prostate cancer in which 25% were diagnosed with the disease despite having a low PSA. The findings were presented at the American Society of Clinical Oncology 41st Annual Meeting held in Orlando, FL in May 2005.

"This study demonstrates that we can find cancer earlier in high-risk men if we use more aggressive screening criteria," said Andre Konski, M.D., clinical director of the Prostate Cancer Risk Assessment Program at Fox Chase and lead investigator of the study. "Men at high risk of prostate cancer are more likely to develop the disease at a younger age. Catching the cancer early before it has spread is critical to curative treatment"

This report detailed the results of a study involving the first 520 men enrolled in Fox Chase's Prostate Cancer Risk Assessment Program between 1996 and 2004 (200 Caucasians, 315 African-Americans and five others). African-American men and men with a family history of prostate cancer who are between the ages of 35 and 69 are eligible to enroll in the Prostate Cancer Risk Assessment Program. Caucasian men testing positive for the BRAC1 gene are also eligible.

Vegan diet, exercise shown
to help slow prostate cancer

By Rob Stein
WASHINGTON POST

WASHINGTON — Eating better, exercising regularly and cutting stress apparently can slow the progression of early prostate cancer, concludes the first study to provide direct evidence that lifestyle changes can fight the common malignancy.

The study of 93 prostate cancer patients found that at the end of a year those who adopted lifestyle changes that included a primarily vegan diet, regular moderate exercise and yoga and other relaxation techniques scored better on a standard blood test used to monitor prostate cancer growth. They were also less likely to require additional treatment, and their blood showed signs of being able to inhibit prostate cancer cells in lab tests.

Although many studies have suggested that adopting healthy lifestyles can have a host of health benefits, including reducing the risk for various cancers, the new research is the latest of several recent studies that have found that factors such as diet, exercise and stress reduction may have a powerful effect on cancer patients' prognoses.

"Diet and other lifestyle changes play an important role in the development of many health problems," said Dean Ornish of UCSF, who led the new study, which is being published in next month's issue of the Journal of Urology. "Now we have evidence it can slow the progression of prostate cancer."

Other researchers said more studies will be needed to explore which components of the lifestyle changes may be important, and to demonstrate whether the effects translate into a reduced risk of dying from the disease.

More research needed
"There's a building body of evidence that lifestyle may affect cancer progression," said Peter Greenwald of the National Cancer Institute. "This is a very important area, and this is one more important lead that indicates a crucial direction for more research."

But given that a healthful diet and regular exercise can have other benefits, several researchers said there was no reason patients should not consider adopting them in addition to their standard care.

Prostate cancer strikes 232,000 American men each year and kills about 30,000, making it the leading cause of cancer among men and the second-leading male cancer killer after lung cancer.

Ornish and his colleagues studied 93 men who had been diagnosed with early prostate cancer. The men had opted not to seek treatment immediately but, instead, to closely monitor their tumors.

Half the men adopted a regimen that included a vegan diet — primarily fruits, vegetables, whole grains and legumes but no meat, eggs or dairy products — supplemented with soy, vitamins and minerals.

That same group of men also started moderate aerobic exercise, such as walking 30 minutes six days a week; participated in a one hour support group meeting once a week; and began using stress management techniques, such as yoga, breathing exercises, and meditation for an hour a day.

When the study began and then a year later, the researchers gave both groups of men the prostate- specific antigen blood test, which is widely used to monitor the progression of the cancer. Those on the diet and exercise regimen saw their PSA levels drop by an average of 4 percent, while those in the other group saw theirs rise an average of 6 percent, the researchers found.

In addition, blood from the men in the diet and exercise group appeared to inhibit prostate cancer cells in laboratory tests, indicating that something in their diet or their bodies' response to me regimen was inhibiting their cancer, Ornish said.

Moreover, none of those who made the lifestyle changes needed any cancer treatment during the study period, whereas six of those in the other group did.

Diet and exercise
"This is the first randomized trial showing that the progression of prostate cancer can be stopped or perhaps even reversed by changing diet and lifestyle alone," said Ornish, who stressed that the changes should be considered only as an addition to standard treatment and not a substitute.

Two recent studies found that breast cancer patients who ate low-fat diets and exercised regularly were less likely to suffer recurrences, Ornish noted.

Other researchers were cautious, saying the study had not yet demonstrated that the lifestyle changes help people live longer, and it was difficult to pinpoint which aspects of the regimen might be beneficial.

"So many variables were changed in the experimental group that it is not possible to sort out which of the many lifestyle factors ... or combination thereof, was responsible for the observed effects," Howard Fames of the National Cancer Institute wrote in an e-mail.