Heads Up for our June Meeting – Special Featured Speaker

 Jocelyn Dubin, MS, RD will speak to our group about nutrition for prostate cancer survivors. Jocelyn has a Master’s in Nutritional Science from San Jose State University and is a registered dietitian with the Commission on Dietetic Registration. Before she developed her private practice, Jocelyn worked to improve the nutritional health of individuals in hospitals, clinics, nonprofit organizations, schools, and private homes. In her private practice, Jocelyn visits clients’ homes to perform kitchen makeovers, takes clients grocery shopping, and teaches them how to order the healthiest items from a restaurant menu. She also develops and delivers customized nutrition presentations for the public, corporations, and nonprofit organizations. Jocelyn encourages her clients to use the power of their plates to be proactive about their health.

SUPPORT GROUP FOR MEN WITH ADVANCED PROSTATE CANCER

The Advanced support group is for men diagnosed with prostate cancer which has spread outside the prostate or who have experienced a recurrence after primary treatment. Our purpose is to address the special problems and issues of men with advanced prostate cancer.  This group meets every TWO months on the second Monday of the month, at the Katz Cancer Resource Center at Dominican Hospital. If you have any questions, please contact Tony Calvo at 

684-0940. Refreshments provided. 2007 MEETING DATE: MONDAY, 5 – 7PM  June 11th

SUPPORT GROUP FOR WIVES & PARTNERS OF MEN WITH PROSTATE CANCER

This group is for women to share information with each other, learn more about prostate cancer, and how to cope with the impact of the disease individually and within the family in a supportive, caring and confidential environment. The June meeting has been cancelled, however stay tuned for some very special upcoming events……… for women only!  For more information or questions, contact Julie Batz at 724-2701.

….PROSTATE CANCER IN THE NEWS..…

Emotional stress may contribute to development of cancer and reduce effectiveness of treatments

Wednesday, 11-Apr-2007 - Scientists from Wake Forest University School of Medicine are the first to report that the stress hormone epinephrine causes changes in prostate and breast cancer cells that may make them resistant to cell death. "These data imply that emotional stress may contribute to the development of cancer and may also reduce the effectiveness of cancer treatments," said George Kulik, D.V.M., Ph.D., an assistant professor of cancer biology and senior researcher on the project. The study results are reported on-line in the Journal of Biological Chemistry and will appear in a future print issue.

Levels of epinephrine, which is produced by the adrenal glands, are sharply increased in response to stressful situations and can remain continuously elevated during persistent stress and depression, according to previous research. The goal of the current study was to determine whether there is a direct link between stress hormones and changes in cancer cells.

While a link between stress and cancer has been suggested, studies in large groups of people have been mixed.

"Population studies have had contradictory results," said Kulik. "We asked the question, "If stress is linked to cancer, what is the cellular mechanism, There had been no evidence that stress directly changes cancer cells."

Studying prostate and breast cancer cells in the laboratory, Kulik and colleagues found that a protein called BAD , which causes cell death , becomes inactive when cancer cells are exposed to epinephrine.

Kulik said that connection between stress and prostate cancer has been largely unexplored. However, recent studies suggest that these laboratory findings may apply to cancer patients. "A study from Canada showed that men who took beta blockers for hypertension for at least four years had an 18 percent lower risk of prostate cancer," said Kulik. "These drugs block the effects of epinephrine, which could explain the finding. Another study of men after radical prostatectomy reported increased mood disturbances, which are often associated with elevated stress hormones. Although these studies do not directly address the role of stress hormones, they suggest that stress hormones may play an important role in prostate cancer."

Kulik said the findings have several implications for patients and for researchers. "It may be important for patients who have increased responses to stress to learn to manage the effects," said Kulik. "And, the results point to the possibility of developing an intervention to block the effects of epinephrine." Kulik is now studying blood samples of prostate cancer patients to determine if there is a link between levels of stress hormones and severity of disease and has begun studying the effects of epinephrine in mice with prostate cancer.   Source:  http://www.wfubmc.edu

Prostate Cancer Patients: Do Research To Ensure You Make The Right Decisions

 23 Apr 2007 - For many men with early-stage prostate cancer, sorting out the treatment options can be overwhelming. Yet they feel pressured to choose a course of therapy quickly. The first issue of a new quarterly bulletin about prostate disease published by Harvard Medical School says that the most important thing to do is to take your time and make sure you explore all treatment choices thoroughly.

The inaugural issue of Perspectives on Prostate Disease explains that treatment decisions can be complicated for a number of reasons. First, there's no one-size-fits-all treatment for early-stage prostate cancer. Even the experts do not agree about which men with such cancers should be treated, which therapy is best or whether, for some tumors, treatment is even necessary. Indeed, doctors are now advising many patients to undertake a program of "active surveillance" rather than pursue aggressive treatment. The choice can become even more difficult when a man takes into account the side effects of treatment, which can be devastating to his quality of life.

Marc B. Garnick, M.D., Harvard oncologist and editor-in-chief of Perspectives, says, "For all these reasons, I encourage patients to ask detailed questions and perform due diligence to ensure that they are making the right decisions about their medical care. Due diligence begins with having the confidence to question your physician about treatment recommendations after all, you are the person who has to live with the results."

Garnick recommends men also consider these questions:

Will you be able to deal with impotence if it occurs? What about incontinence? How will the possible side effects of treatment affect your relationship with your partner and your sense of self?

It's vital to think about these issues carefully: Studies show that 30% to 70% of men treated with surgery or radiation therapy experience impotence, and at least 1% to 2% experience urinary incontinence and some experts think the true numbers are much higher. According to Garnick, truly informed patients are much better able to deal with adverse consequences than patients who don't have the all the facts, or who rush into making a decision.

Source: Harvard Medical School http://www.medicalnewstoday.com/medicalnews.php?newsid=68569

UCLA study finds prostate cancer treatments impact on quality of life

3 most common treatments affect men in different ways

23-Apr-2007 - A rigorous, long-term study of quality of life in patients who underwent one of the three most common treatments for prostate cancer found that each affected men's lives in different ways. The findings provide invaluable information for men with prostate cancer who are facing vital treatment decisions.

Researchers studied quality of life in men who either underwent radical prostatectomy, implantation of radioactive seeds in their prostate gland or had external beam radiation therapy. The three treatment options rank about equally in survival outcomes for most men, so specific impacts on quality of life become paramount in making treatment decisions, said Dr. Mark Litwin, the study's lead author and a researcher at UCLA's Jonsson Cancer Center.

"The good news is that overall mental and physical well-being were not profoundly affected by any of the three treatment choices," Litwin said. "That's good news for men with the sword of prostate cancer hanging over their heads. In general, they'll be OK no matter which of the three options they choose." However, each of the three options did negatively affect quality of life, at least temporarily, with problems ranging from erectile dysfunction and minor incontinence to urinary and bowel irritation.

The study tracked 580 men for five years. The study results, published in the June 1, 2007 issue of the peer-reviewed journal CANCER, represent data from the first two years of the study. Those years, Litwin said, are when most of the negative impacts surface and resolve.

Seed implantation, also known as brachytherapy, has been touted in marketing campaigns as the best of the three options with the shortest recovery time and the fewest sexual dysfunction side effects, Litwin said. "These campaigns say 'Get your seed implants on Monday, play golf on Tuesday' and that's just not true," said Litwin, a professor of urology and health services. "Men need to have the most accurate information when making vital decisions about what type to treatment they'll get.. They need facts, not hype."

The study found that brachytherapy patients often experience obstructive and irritating urinary symptoms such as frequency of urination and feeling an urgent need to urinate. They also reported bowel dysfunction such as frequency and urgency, diarrhea and pain with stool. External beam radiation patients suffered from urinary irritation and bowel dysfunction similar to brachytherapy patients.

 Surgery patients more often reported incontinence symptoms such as urine leakage when coughing or sneezing as well loss of sexual dysfunction, although this was mitigated when the surgeon was able to spare the patient's erectile nerves.

The impacts caused by brachytherapy and external beam radiation were most similar and patients who choose those options suffered less erectile dysfunction. While they had more erectile dysfunction, surgery patients did not suffer from bowel dysfunction as often.

"Different men are bothered by different things, so it depends on what their baseline function is," Litwin said. "If a man is already impotent, for example, loss of sexual function won't be an issue in making a treatment decision."

Litwin said the study is unique in that it took baseline measurements before the patients, all cared for at UCLA, underwent any treatment. It did not ask patients to recall what their function and quality of life were prior to treatment, as many studies do. That resulted in a more accurate baseline measurement, Litwin said. The study also was unique in that it assessed and tracked individuals using their own baselines, not a "mean" or "median" ranking determined by looking at group statistics. "This is important because these treatments can have significant effects on sexual, urinary and bowel function," Litwin said. "It's critical to be able to say as accurately as possible what percentage of men got back to the pre-treatment baseline, as well as the percentage that did not. This information helps the next man that comes along. He can use the data to weigh his chances of returning to his own pre-treatment baseline in terms of function and quality of life."

Additionally, the study used the most rigorous methodology available and employed established instruments to measure quality of life factors, tools that have been used for years on thousands of patients from around the world and "are known to be valid measurements," Litwin said. The data also were collected by a third party, not the surgeon or radiation oncologist involved in the treatment. That also allowed for collection of more accurate information. "Patients have an unconscious desire to please their doctor and we wanted to ensure they were as forthcoming as possible in discussing problems related to their treatment," Litwin said.

The study also was novel in that is used a specially designed web-based data collection system that allowed participants to complete surveys online. Litwin and his team will continue to analyze the study data out through the five-year point. However, he expects little to change as most symptoms surface early on and typically begin to improve after the two-year mark.

Litwin said it is important for men to make treatment decisions based on their individual needs. It's also vital, he said, to find the best doctor to administer the treatment. "The experience of the doctor and the institution do matter," he said. "Results can vary."

Prostate Cancer is the most frequently diagnosed cancer in men and the leading cause of cancer death in men. About 218,890 cases of prostate cancer will be diagnosed this year alone, according to the American Cancer Society. UCLA's Jonsson Comprehensive Cancer Center comprises more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education.

Source: http://www.eurekalert.org/pub_releases/2007-04/uoc--usf042307.php

 Obesity boosts prostate cancer mortality

 3/15/2007 - Obese men diagnosed with prostate cancer are more than twice as likely to die of the disease than their leaner peers, a new study shows.

They also have more than triple the risk that the cancer will spread beyond their prostate gland, Dr. Alan R. Kristal of Fred Hutchinson Cancer Research Center in Seattle and colleagues found. "These results provide yet one more important reason for men to adopt healthful patterns of diet and physical activity to achieve and maintain a normal weight," Kristal and his team conclude in the medical journal Cancer.

A number of studies have linked excess weight with more advanced prostate cancer, Kristal and his team note, but evidence for the effect of obesity on actual outcome from the disease has been unclear. To investigate, they looked at 752 men who had been diagnosed with prostate cancer between 1993 and 1996 and followed for an average of 9.5 years.

Men who were obese in the year before they were diagnosed with prostate cancer, meaning their body mass index (BMI) was 30 or higher, were 2.6 times more likely to have died of the disease, the researchers found. They were also at 3.6 times greater risk of disease metastasis.

The data also suggested that the effect of obesity on mortality risk was stronger among men with more aggressive disease. A clinical trial would be needed to determine if weight loss could actually help treat prostate cancer, Kristal and colleagues add. Source: Cancer, http://news.yahoo.com/s/nm/20070329/hl_nm/obesity_prostate_dc_1

Excessive Intake of Vitamins Linked With Prostate Cancer

Men who take multiple vitamins in the hope of improving their health may be raising their risk of the deadliest form of prostate cancer, especially if they have a family history of the disease By Julie Steenhuysen

TUESDAY, May 15 (Reuters) - Men who pop too many vitamins in the hope of improving their health may in fact be raising their risk of the deadliest form of prostate cancer, especially men with a family history of the disease, researchers reported on Tuesday.        

Researchers at the National Cancer Institute found that men who exceeded the recommended dose - taking more than seven multivitamins a week - increased their risk of advanced cancer by about 30 percent.

The researchers followed 295,344 men over five years to see if there was a link between multivitamin use and prostate cancer. "We didn't see any relationship with overall prostate cancer," said Dr. Michael Leitzmann, a National Cancer Institute investigator who worked on the study. The increased risk from overuse of multivitamins was linked to more aggressive cancer that has spread beyond the prostate gland or cancer that proved fatal.

In men who took too many multivitamins, the risk of aggressive cancer increased by one third, and the risk of fatal prostate cancer doubled compared to those who took no multivitamins, according to the study, published in the Journal of the National Cancer Institute. "We only saw the increase among the subgroup of men who used multivitamins in excessive amounts," Leitzmann said in a telephone interview.

The researchers said the association was strongest in men with a family history of prostate cancer and men who also took selenium, beta-carotene or zinc supplements.

No studies have yet found that people benefit from multivitamins or mineral supplements and some vitamins, like A and iron, are toxic at high levels. Beta-carotene has been found to increase the risk of lung cancer in smokers.

Leitzmann said the researchers were not able to pinpoint which vitamin or supplement ingredient could be driving the cancer. What it does suggest is the need for more study. "It's certainly a red flag," he said.

The important thing, Leitzmann said, is that men should heed the dosage on their vitamin bottle and use as directed.

Source: http://www.prostatecancerfoundation.org

Lycopene-Rich Tomatoes May Not Prevent Prostate Cancer

New data suggest that eating lycopene-rich tomatoes offers no protection against prostate cancer, contrary to the findings of some past studies

FRIDAY, May 18 (Reuters Health) - A new study suggests that eating lycopene-rich tomatoes offers no protection against prostate cancer, contrary to the findings of some past studies. In fact, the researchers found an association between beta carotene, an antioxidant related to lycopene, and an increased risk of aggressive prostate cancer.

 In a written statement, Dr. Ulrike Peters of the Fred Hutchinson Cancer Research Center in Seattle said the finding is "disappointing, since lycopene might have offered a simple and inexpensive way to lower prostate cancer risk for men concerned about this common disease. Unfortunately, this easy answer just does not work."

It's thought that antioxidants may help shield against cancer and heart disease by neutralizing harmful molecules known as oxygen free radicals. But studies to date on the role of lycopene in prostate cancer have been mixed; some suggest a protective effect, while others yield contradictory or inconclusive results.

The current study involved 28,243 men between the ages of 55 and 74 with no history of prostate cancer who were enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. As part of the trial, the men provided a blood sample and completed a questionnaire related to their health, diet and lifestyle.

During follow-up of up to 8 years, 692 men developed prostate cancer, and were matched to 844 men who were free of prostate cancer.  Data analysis failed to show any significant difference in blood lycopene levels between men who developed the disease and those who did not. "Our results do not offer support for the benefits of lycopene against prostate cancer," Peters said.

The study, published in the current issue of Cancer Epidemiology, Biomarkers & Prevention, is one of the largest to evaluate the role of blood levels of lycopene and similar antioxidants in preventing prostate cancer.

Unexpectedly, the investigators noted an association between an increased risk of aggressive prostate cancer -- defined as disease that has spread beyond the prostate -- and higher intake of beta carotene, another antioxidant found in many vegetables and commonly used as a dietary supplement.

DOC MOYAD’S WHAT WORKS & WHAT IS WORTHLESS COLUMN

ALSO CALLED “NO BOGUS SCIENCE” COLUMN…….“You say tomatoe (from the Ex-Vice President Dan Quayle spelling bee) and I say watermelon – lets call the whole thing off or just worthless!”

By Mark A. Moyad, MD, MPH University of Michigan Medical Center, Department of Urology

Hey, just a few years ago, lycopene and lycopene supplements were hotter than my bell bottom, powder blue, ruffled feathered tuxedo I wore at the high-school prom as I suffered numerous groin injuries attempting to dance to disco music, and lycopene was even hotter than my tight fitting Calvin Klein jeans I wore on my first date in ninth grade that probably increased my chances of permanent infertility (no wonder she never called me again). Let’s face a simple fact, there was tremendous excitement that lycopene would solve prostate problems, but a lot of this initial excitement around the pills, in my opinion, was generated by advertising dollars and greed. In short, lycopene has simply cooled off. In the past year, two separate wonderful studies have tried to determine the impact of lycopene in patients diagnosed with prostate cancer. The first was by Clark, et al1, that found that lycopene supplements at even ridiculously high doses had no impact on a rising PSA after conventional localized therapy (surgery, radiation…). The second and most recent study was by Jatoi, et al, in men with androgen independent prostate cancer. This was

also a fabulous study with 46 patients receiving 30 mg of dietary lycopene daily, but only one patient had a short-term PSA response, which means only 2% of the patients had an impact and this is similar to what would happen by chance using almost nothing.

The ultimate issue or question is that how can these compounds like lycopene help men with more advanced disease?

I think this is asking too much at this stage of the disease for this and for most nutritional products. Perhaps, tons of lycopene early in the disease may help, but this is speculative and it does have side effects. Lycopene interest remains big for prevention or for men with localized disease. However, this will not stop the hype train because the claims made about the pill have been silly. The USDA has determined that watermelon has as much lycopene as a tomato and most of the positive studies of lycopene have centered on just consuming more fruits and vegetables.

The bottom line is that lycopene has hit a bump in the road and unless something spectacular happens soon it may just be time to put these pills in the exact same place you just had to put that 10-week-old Chinese takeout that you left in the refrigerator that stunk up the whole kitchen but you didn’t realize it until now and your spouse made you feel guilty about it even though it wasn’t your fault. (Sorry Honey, but I really thought I was going to eat it while watching the Super Bowl—please don’t make me sleep in the garage again with our scary-looking dog).

References:

1. Clark P, et al: Urology 67: 1257-61, 2006.

2. Jatoi A, et al: Urology 69: 289-94, 2007.

Source: May 2007 US-Too “Hot Sheet” monthly newsletter. Copies are always available at our monthly meetings.

Editor's notes:

The following are some of the notes taken from Mark Moyad's talk entitled "Dietary Inhibitors of Prostate Cancer," given on November 19, 1998. (Notes taken by  Bob Southard, a long time prostate cancer survivor)

Mark Moyad is a clinical prostate cancer researcher and educator at the University of Michigan, where he is working with the world-renowned Dr. Ken Pienta. Mark is the author of "The ABCs of Prostate Cancer," and the "The ABCs of Nutrition & Supplements for Prostate Cancer," He advised:

 A single best exercise is walking. The New England Journal of Medicine published that walking one mile per day lowered death rates by 25%. Walking 2 miles per day lowered death rates by 50%. Other studies have shown that walking for just 30 minutes 1 to 6 times per month lowered death rates by 33%. The key point -- walk, walk, walk

Be careful taking supplements at too high a dosage. Many people believe that if one pill is good, two must be better. Often, more of a good thing can be harmful. It is best to take the dosage used in the clinical studies, for best results, and for safety.

If studies show that a particular food may be of benefit to you, try to eat that food. Many people will try to take a supplement in pill form to get the nourishment that is supposedly contained in the beneficial food. You can never be sure that the supplement contains all of the necessary ingredients for you benefit.

Suggested Reading: Available new and used at Amazon.com

Mark A. Moyad, M.P.H.  ABC's of Nutrition & Supplements for Prostate Cancer, ISBN# 1-886947-69-4, published April 2000. A companion book to The ABC's of Prostate Cancer, The ABC's of Nutrition & Supplements for Prostate Cancer offers expert advice on realistic approaches to the treatment of prostate cancer through common sense nutrition and supplements.

Robert Arnot, M.D. The Prostate Cancer Protection Plan: The Foods, Supplements, and Drugs That Could Save Your Life, ISBN: 0316051535.  Dr. Arnot has found that the foods men eat can have a profound influence on whether or not they get clinical prostate cancer. In The Prostate Cancer Protection Plan, Dr. Arnot tells us what these wondrous foods are and how we can use them as part of a sensible, fun, and delicious eating program.

Statins Cut Risk of Metastatic Prostate Cancer in Half

WASHINGTON –(UPI) March 20, 2007-A U.S. epidemiologic study released this week suggests men who use statin drugs may cut in half the risk of advanced prostate cancer.

The study, published in the Journal of the National Cancer Institute also showed that statins appear to cut in half the risk of metastatic or fatal prostate cancer, compared to men who did not use the cholesterol-lowering drugs.

The Health Professionals Follow-up Study involved more than 30,000 men, of whom between 4.4 percent and 9.3 percent initially reported using statins. This percentage had increased to 24% of study participants by 2000.

Compared with non-use of statins, current use was inversely linked to the risk of advanced disease after adjusting for age and other risk factors, the researchers said. In fact, the rate of advanced prostate cancer for the statin users in the study was 38 patients per 100,000 person-years, compared with 89 patients per 100,000 person-years for non-users, they noted. The association was even stronger for risk of metastatic and fatal prostate cancer, the team added.

Among men who used statins continuously for five or more years, the relative risk of higher-grade disease was lower than the relative risk of lower-grade disease, the researchers concluded.

Source: http://www.fightprostatecancer.org/site/News2?page=NewsArticle&id=7751

Statin Use Linked With Decreased Prostate Cancer Mortality Rates; Lower PSA Levels

Science Daily (May 20, 2007)- Urologists and researchers have postulated in recent years that statin medications could have an impact on the growth and progression of prostate cancer. Cholesterol is a primary building block for testosterone, which has in turn been linked with prostate tumor growth (less testosterone results in slower-growing tumors). In recent years, research has indicated a possible link between dietary fat intake and prostate cancer.

Research presented at the 102nd Annual Scientific Meeting of the American Urological Association explores the effect statin medications (which work to reduce low-density lipoprotein, or LDL, levels) may have on prostate-specific antigen, the incidence of prostate cancer, and mortality due to prostate cancer.

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The Santa Cruz County Prostate Cancer Support Group does not endorse any provider, organization, product or individual.  All medical decisions should be made with the advice and consultation of medical professionals.

Our newsletter serves over 260 members. Many THANKS to the American Cancer Society for assisting with the printing and mailing of this newsletter and the Katz Cancer Resource Center for allowing us to use their facility.