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Friday, September 30, 2011

Blog Updates for September 2011

Sep 29. In Biochemical PSA Recurrence we added:
  • "In conclusion, consumption of eggs may increase risk of developing a lethal-form of prostate cancer among healthy men." [PMID: 21930800]. Quoting from the same abstract: "Men who consumed 2.5 or more eggs per week had an 81% increased risk of lethal prostate cancer compared to men who consumed less than 0.5 eggs per week."

  • "In conclusion, cruciferous vegetable intake after diagnosis may reduce risk of prostate cancer progression." [PMID: 21823116]. The study was based on "1,560 men men diagnosed with non-metastatic prostate cancer taken from a famous US database (known as CaPSURE – 40 sites, mostly community-based clinics). ... Men that reported a regular (about once a day) intake of cruciferous vegetables had a significant 59% reduction in risk of cancer returning compared to men that occasionally consumed these veggies." (quoted from Dr. Moyad article in Sep 2011 US Too). Cruciferous vegetables include brocolli, brussel sprouts, cabbage, cauliflour, bok choy, radishes, daikon, kohlrabi, rutabaga, collard greens, turnip greens, arugula and cress. See Wikipedia for a longer list.

  • "Brisk walking after diagnosis may inhibit or delay prostate cancer progression among men diagnosed with clinically localized prostate cancer." [PMID: 21610110] Quoting from the same abstract: "Men who walked briskly for 3 h/wk or more had a 57% lower rate of progression than men who walked at an easy pace for less than 3 h/wk (HR = 0.43; 95% CI: 0.21-0.91; P = 0.03). Walking pace was associated with decreased risk of progression independent of duration (HR brisk vs. easy pace = 0.52; 95% CI: 0.29-0.91; P(trend) = 0.01). Few men engaged in vigorous activity, but there was a suggestive inverse association (HR =3 h/wk vs. none = 0.63; 95% CI: 0.32-1.23; P(trend) = 0.17). Walking duration and total nonvigorous activity were not associated with risk of progression independent of pace or vigorous activity, respectively."

  • "Our results suggest that the postdiagnostic consumption of processed or unprocessed red meat, fish, or skinless poultry is not associated with prostate cancer recurrence or progression, whereas consumption of eggs and poultry with skin may increase the risk." [PMID: 20042525] Quoting from the same abstract: "Intakes of processed and unprocessed red meat, fish, total poultry, and skinless poultry were not associated with prostate cancer recurrence or progression. Greater consumption of eggs and poultry with skin was associated with 2-fold increases in risk in a comparison of extreme quantiles: eggs [hazard ratio (HR): 2.02; 95% CI: 1.10, 3.72; P for trend = 0.05] and poultry with skin (HR: 2.26; 95% CI: 1.36, 3.76; P for trend = 0.003). An interaction was observed between prognostic risk at diagnosis and poultry. Men with high prognostic risk and a high poultry intake had a 4-fold increased risk of recurrence or progression compared with men with low/intermediate prognostic risk and a low poultry intake (P for interaction = 0.003)."

Except for large randomized trials the nutrition studies provide only provisional evidence and can be overturned once such large randomized trials are performed. If the effect that they find is large it makes the nutrition study more likely to hold as competing reasons must then also be large to overturn them; however, such alternative explanations (such as those who consume X tends to also have good or bad lifestyle habits in general) are always a possibility. In fact the SELECT trial has already overturned a number of the provisional conclusions in the prostate cancer section of the WCRF/AICR report.

Sep 26. In Advice to the Newly Diagnosed we added: Although the statistics are generally much more favorable than for other cancers, it should still be noted that according to the American Cancer Society about 30,000 men died of prostate cancer in 2010 and according to the European Cancer Observatory about 70,000 men died of prostate cancer in 2008 so in total about one man dies every 5 minutes of prostate cancer in the US or EU. Thus prostate cancer should not be neglected and appropriate medical attention should be taken to minimize any risks.


Sep 8. In Prostate Cancer Calculators we add: A 2011 paper by Corcoran et al [PMID: 21895937] analyzed 684 patients with Gleason 6 or 7 on biopsy and found that 50% were upgraded. The upgraded patients had tumors which were significantly smaller than patients not upgraded suggesting that tumor volume can help in predicting an upgrade.

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