URINARY TRACT
GENERALURINARY TRACT INFECTION
Blueberries and cranberries prevent infection New England Journal of Medicine , October 8, 1998; Volume 339, Number 15;
According to research findings at the Rutgers Blueberry Cranberry Research Center in Chatsworth, N.J., blueberries help promote urinary tract health. Explains Rutgers scientist Amy Howell, Ph.D, blueberries, like cranberries, contain compounds that prevent the bacteria responsible for urinary tract infections from attaching to the bladder wall.
KIDNEY
stay away from chocolate if you have kidney stones However, the increases in both calciuria and oxaluria (induced respectively by sucrose and cocoa) following chocolate ingestion might contribute to urinary conditions favoring the development of calcium oxalate calculi
BLADDER
New Urine Test Helps Find Bladder Cancer Recurrences
SEXUAL DYSFUNCTION
VASECTOMY
New Urine Test Helps Find Bladder Cancer Recurrences
Inexpensive Test Improves Accuracy of Standard Follow-up American Cancer Society
Yahoo! Health: Cancer News
January 20, 2006 05:03:32 PM PST
Summary: A simple urine test may help doctors find more relapses in people who have had bladder cancer, according to a new study. The test was used along with cystoscopy, a visual exam of the bladder using a long lighted tube. Together, the two tests found 99% of recurrences, researchers reported in the Journal of the American Medical Association.
Why it's important: People who have had bladder cancer are at very high risk of getting it again. There are about 500,000 bladder cancer survivors in the US, the researchers note. Most survivors have to be checked for a relapse every 3 to 6 months for the first few years after their initial treatment, and every year after that. Cystoscopy is the main way to look for recurrences, but it can't always find all of them. As a backup, doctors usually use urine cytology, a lab analysis that looks for cancer cells in urine. But this test also misses many cancers.
Patients and doctors need better ways to find bladder cancer recurrences early so they can be treated promptly. If a relapse is caught early, the patient has a better chance of surviving, said lead study author H. Barton Grossman, MD, professor of urology at the University of Texas M.D. Anderson Cancer Center.
What's already known: The new urine test, called BladderChek, measures the protein NMP22. High levels may signal bladder cancer. On its own, the NMP22 test hasn't been very accurate at finding bladder cancers. But researchers thought it might be better than urine cytology at finding cancers that cystoscopy missed.
BladderChek has several advantages over urine cytology and other urine tests that are used to look for bladder cancer relapses. It can be done in a doctor's office and usually gives results within 30 to 50 minutes. It is also less expensive and less complicated than urine cytology, which must be performed by trained specialists in a laboratory. It is already approved by the US Food and Drug Administration for helping diagnose bladder cancer and for helping find relapses. The test's manufacturer, Matritech, Inc., was involved in designing, funding, and reviewing the current study.
How this study was done: The researchers recruited 668 bladder cancer survivors who were being followed-up at 23 facilities across the US. Before having cystoscopy, each patient gave a urine sample. Part of that sample was used for the BladderChek test, and part was used for standard urine cytology. The researchers gauged the cancer detection rate of each of the 3 methods alone, and of each urine tests combined with cystoscopy.
What was found: Bladder cancer was diagnosed in 103 patients. Cystoscopy was the most accurate test, finding 94 of those cancers (91%) all by itself. The BladderChek test alone found only 51 cancers. But BladderChek combined with cystoscopy found 99% of the cancers. In fact, the BladderChek test found 8 of the 9 cancers that cystoscopy missed.
"We depend on the urine test to show us whether there's a possibility of cancer that we're not seeing with the scope," explained Barry Stein, MD, a co-author of the study and professor of urology at Brown Medical School in Rhode Island. "If the result is positive and you didn't see anything from the cystoscopy, you would check to see if you missed something."
Urine cytology also improved the performance of cystoscopy, but not by as much. It found only 3 of the 9 cancers cystoscopy missed. Together, the 2 tests found 94% of cancers, but that improvement was statistically no better than cytoscopy alone. Urine cytology alone found just 12 cancers. That's unusually poor performance for urine cytology, said Samuel Cohen, MD, PhD. He's a professor of oncology and chair of pathology and microbiology at the University of Nebraska Medical Center and a member of the panel that wrote the bladder cancer treatment guidelines for the National Comprehensive Cancer Network. He was not involved in the new study.
The study did not look at what happened to the patients after their relapse was detected.
The bottom line: The results of this study suggest the BladderChek test could be a useful tool for improving detection of bladder cancer recurrences and reducing the cost of follow-up care, the researchers say. It also raises some intriguing questions about whether it might be possible to find these recurrences earlier, said Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society. He was not involved in the study.
"If [this test] were able to pick up a recurrent cancer before it could be seen," he said, "would that mean that some of the more aggressive cancers could be treated more effectively, with a greater rate of long term survival? We know that the longer a recurrence of bladder cancer is present, the more difficult the situation for the patient. So, earlier detection of a recurrent bladder cancer translates into better treatment."
But this study, while promising, isn't enough to say for certain that the BladderChek test is better than urine cytology, Cohen said. It's also not enough to tell whether this new urine test really can improve outcomes for patients by finding their cancer earlier. For that, researchers need to carry out head-to-head comparisons (randomized trials) of this test and other bladder cancer detection tests that also look at long-term patient results. The study authors call for such work in their paper. In the meantime, Grossman warns that the BladderChek test should be used only together with cystoscopy, not instead of it.
Citation: "Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay." Published in the Jan. 18, 2006, Journal of the American Medical Association (Vol. 295, No. 3: 299-305). First author: H. Barton Grossman, MD, University of Texas M.D. Anderson Cancer Center.
Mortality Not Higher for Most with Prostate Cancer
NEW YORK (Reuters Health) - The mortality rates for most men diagnosed with prostate cancer in the United States are no higher than those in the general population, a new analysis shows. "The bottom line is that most men diagnosed with the disease today can expect to live as long as, or longer than, men their age without the disease," two editorialists comment.
The value of prostate specific antigen (PSA) screening in reducing prostate cancer mortality is still in question, Dr. Hermann Brenner and Dr. Volker Arndt of the German Center for Research on Aging in Heidelberg report in the Journal of Clinical Oncology.
Widespread use of the PSA test in the US since the late 1980s means many more men are living with a diagnosis of prostate cancer, the physicians point out.
They used "the recently introduced period analysis methodology" to evaluate 5- and 10-year survival rates for 183,484 men diagnosed with prostate cancer between 1990 and 2000 included in the Surveillance, Epidemiology and End Results Program (SEER), a large US database.
Overall, relative 5-year survival rates for prostate cancer patients were 99 percent, and 10-year survival rates were 95 percent, Drs. Brenner and Arndt found. "That is, excess mortality compared with the general population was as low as 1 percent and 5 percent within 5 and 10 years following diagnosis, respectively," they explain.
For the two thirds of men with well or moderately differentiated localized or regional prostate cancer, there was no excess mortality at all.
The researchers note that it is possible that earlier diagnosis might not in itself mean longer survival. The question of whether PSA screening does in fact reduce mortality from prostate cancer must be answered by large-scale clinical trials, which are currently underway, they add.
In an accompanying editorial, Dr. George Wilding and Patrick Remington of the Comprehensive Cancer Center at the University of Wisconsin in Madison write: "Given the many uncertainties about this disease, this information alone will be helpful for clinicians and their patients when discussing treatment options and when considering what life will be like living as a prostate cancer survivor."
SOURCE: Journal of Clinical Oncology, January 20, 2005.
Prostate drug might cut cancer risk
Last Updated: 2004-10-15 13:45:01 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Men who take Avodart (dutasteride) to treat an enlarged prostate apparently have a reduced risk for developing prostate cancer, a new study indicates.
Avodart and a similar drug, Propecia (finasteride), are technically classified as 5-alpha-reductase inhibitors. They suppress the potent male hormone dihydrotestosterone and thereby inhibit growth of the prostate in men with benign prostatic hyperplasia, commonly known as BPH.
Dr. Gerald L. Andriole from Washington University School of Medicine in St. Louis, Missouri, and colleagues used data from three recently completed trials to investigate whether dutasteride treatment, in comparison to treatment with an inactive placebo, had a meaningful effect on the rate of prostate cancer detection.
The cumulative rate of prostate cancer detected during the first 24 months of dutasteride treatment was 1.1 percent, compared with 1.9 percent in patients treated with placebo, the researchers report in the medical journal Urology.
Additional cancers reported between month 24 and month 27 slightly changed the cumulative incidence rates (1.2 percent for dutasteride, 2.5 percent for placebo), resulting in a 51 percent lower risk of prostate cancer for the dutasteride group relative to the placebo group.
Referring to another study, Andriole told Reuters Health: "The results from the Prostate Cancer Prevention Trial (PCPT), which shows that finasteride reduces the incidence of prostate cancer, strongly suggest that 5-alpha-reductase inhibition will play a key role in the reduction in risk of prostate cancer development and progression."
Based on these findings, the investigators write, a trial "has been designed to establish further the efficacy of dutasteride" for the prevention of prostate cancer.
"We anticipate complete enrollment of the trial by the spring of 2005," Andriole said, "and results should be available after participating men complete 4 years of treatment and their end-of-study biopsies."
SOURCE: Urology, September 2004.
Impotence Common After Radiation, Surgery on Prostate Tue Sep 14,11:48 PM ET
By Ed Edelson HealthDay Reporter
TUESDAY, Sept. 14 (HealthDayNews) -- A large majority of men who have surgery or external beam radiation treatment for prostate cancer are impotent five years after either procedure, a new study finds.
Previous research had found that surgery was likelier to lead to impotence in the short term, but this study from the National Cancer Institute (news - web sites) (NCI) discovered that men who had radiation underwent a decline in sexual function between two and five years later.
The incidence of urinary incontinence was higher in men who had surgery, but bowel urgency and painful hemorrhoids were more common in those who had radiation therapy, said a report on the research in the Sept. 15 issue of the Journal of the National Cancer Institute.
The study results "are one element to be considered among men who want to be treated for prostate cancer," said study author Arnold L. Potosky, an epidemiologist at the NCI's division of cancer control and prevention.
But the findings provide only partial guidance, since they do not cover the long-term side effects of hormonal therapy or implanted radioactive seed treatment, which were not available when the study began, Potosky said.
Moreover, the study says nothing that could help resolve a heightening debate about whether watchful waiting, rather than any treatment, is best for men who are newly diagnosed with prostate cancer on the basis of elevated readings of prostate-specific antigen (PSA), a test now widely used to screen for the cancer, he said.
Potosky's cautious appraisal is that, "given the uncertainty about which treatment is best in terms of survival, having information about possible side effects can be useful in determining treatment."
Other studies have shown that surgery reduces deaths from prostate cancer compared to watchful waiting, but does not improve overall survival. There have been no studies that directly compare the survival benefits of radiation therapy vs. surgery.
The new report is the latest on a study that has followed more than 1,100 men with prostate cancer that had not spread beyond the gland. Earlier reports found a higher incidence of impotence -- the inability to achieve an erection -- after two years among men who had surgery (82.1 percent) than for those who had radiation therapy (50.3 percent).
But the difference had narrowed greatly after five years, with impotence reported in 79.3 percent of the surgical patients and 63.5 percent of those who had radiation. While that difference is significant, "I'm not sure it is critical in a decision about treatment," Potosky said.
Urinary incontinence was reported by 15.3 percent of men who had surgery and 4.1 percent of those treated with radiation. Bowel urgency was experienced by 29 percent of the men who had radiotherapy and 19 percent of those who had surgery, while the incidence of painful hemorrhoids was 20 percent in the radiation group, 10 percent in the surgery group."
The report is "an update on a very important study showing that interventions have a substantial impact on the quality of life" of men diagnosed with prostate cancer," said Dr. Howard L. Parnes, chief of the prostate group at the NCI's division of cancer control.
Several NCI studies now are being done to determine whether treatment is better than watchful waiting for men in screening program who have high PSA levels that traditionally have been interpreted as indicators of prostate cancer, he said. Results are not expected for several years.
The new report of a high incidence of major side effects after treatment is important because "if interventions were not toxic, you wouldn't need much proof to do an intervention," Parnes said.
"This is an issue of risk vs. benefits," he said. "The risks have been clear for a while. The benefit is less clear."
For patients and doctors, Parnes recommends "a cautious approach, which takes both risk and benefit into account."
Inventor of PSA Cancer Test Says It's Overused Fri Sep 10, 3:34 PM ET
NEW YORK (Reuters Health) - For many men, a routine PSA blood test to screen for prostate cancer has become an annual ritual. Now the developer of the test says it can't be relied on for this purpose, and has led to overly zealous treatment of men with prostate enlargement.
Dr. Thomas A. Stamey at Stanford University first reported in 1987 that levels of PSA in the blood could be used as a marker of prostate cancer.
"What we didn't know in the early years is that benign growth of the prostate is the most common cause of a PSA level between 1 and 10 ng/mL," Stamey notes in a university press release. Standard units of measurement of PSA are nanograms per milliliter (ng/mL) of blood.
Stamey's group found that the average size and invasiveness of prostate cancers have been dropping over the past two decades, to the point that the cancers being discovered may not be clinically meaningful.
The investigators examined tissue from 1317 prostates removed at Stanford since 1983. During the first 5-year period, 91 percent of cancers were obvious on digital rectal examination (DRE), and average volume of the cancer was 5.33 cc. Between 1999 and 2003, these values had declined to 17 percent and 2.44 cc.
Also, the degree to which the tumor had penetrated the wall of the prostate dropped from an average of 1.54 to 0.22 centimeters between the two periods.
What has happened, Stamey and his colleagues suggest in the Journal of Urology, is that prostate cancer is being over-treated, given that most men will develop the disease if they live long enough and the fact that death from prostate cancer is uncommon in elderly men.
The authors conclude that the extensive use of PSA screening is not warranted. Instead, they recommend "careful palpation of the prostate" by DRE -- since cancers found in this way "almost always require some form of treatment."
SOURCE: Journal of Urology, October 2004.
Protein Prompts Spread of Prostate Cancer
MONDAY, Aug. 23 (HealthDayNews) -- A protein called hepsin promotes the spread of prostate cancer by causing disruption of tissue organization, says a study in the August issue of Cancer Cell.
This finding could lead to the development of new drugs that inhibit hepsin and slow prostate cancer's spread.
Scientists at the Fred Hutchinson Cancer Research Center in Seattle created mice with elevated hepsin levels in the prostate gland and found these mice had marked tissue disorganization of the prostate gland, specifically in a structure called the basement membrane. These mice developed more advanced tumors and had more spread of cancer to the liver, lung and bone.
"We have found that increase in hepsin expression leads to disorganization of the basement membrane and promotes primary prostate cancer progression and metastasis," researcher Dr. Valeri Vasioukhin said in a prepared statement.
"Since hepsin is an enzyme, it should be relatively easy to develop drugs specifically inhibiting hepsin activity. Previous research demonstrated that hepsin is not critical for normal cells within the body and, therefore, inhibition of hepsin with drugs is unlikely to have significant side effects," Vasioukhin added.
Test Predicts Prostate Cancer Death, Study Says
Wed Jul 7, 5:25 PM ET By Gene Emery
BOSTON (Reuters) - The PSA blood test widely used to detect prostate cancer can also predict who is most likely to die from the disease, researchers said on Wednesday.
The study, in this week's New England Journal of Medicine (news - web sites), added to evidence that the rate of increase in prostate-specific antigen level may be more important for predicting cancer than the actual PSA number.
The researchers said their study of 1,095 men showed that men need annual PSA tests so that their year-to-year change -- called PSA velocity -- can be monitored.
They found that when PSA levels rose by at least 2 points during the year before surgery, about one in four patients was dead from prostate cancer within seven years. It raised the risk of death 10-fold.
But if the PSA level had been increasing slowly before surgery, there was very little chance the patient would die from a prostate tumor.
"This study provides, for the first time, solid evidence that PSA testing over a period of time is a reliable indicator of possible risk of death from prostate cancer," said Dr. Anthony D'Amico of Massachusetts General Hospital in Boston, who helped lead the study.
Prostate specific antigen is a protein produced by cells in the prostate, the walnut-sized organ that sits against a man's rectum and produces the semen that carries sperm. The higher the PSA, the more likely the prostate is irritated by an infection or, perhaps, by cancer.
Prostate cancer (news - web sites) affects 220,000 U.S. men a year and kills about 29,000, according to the American Cancer Society (news - web sites).
PSA HIGH
If a man's PSA looks high or looks like it has risen recently, a urologist will usually recommend a biopsy to remove some tissue from the organ to see if it is cancerous.
"A man whose PSA is 3.5 may have nothing to worry about if it was 3.49 the year before, but a lot to worry about if PSA last year was 1," D'Amico said in a telephone interview.
Starting around age 35 or 40, men need annual screening to set their "baseline" PSA level, against which change can be measured, he said.
"The nice thing about starting at age 40 is most men at 40 have a PSA that is like 0.6 or something like that," added Dr. William Catalona of Northwestern University in Chicago, who also helped direct the study.
"If your next annual PSA goes to 1.4, well, you shouldn't wait until next year to check it again."
This contradicts the usual guidelines, which suggest that men can relax until their PSA level reaches 4, Catalona said.
He got the idea of checking "PSA velocity" while doing a large study of 36,000 men over 12 years.
"I had some men come in and their PSA would be 0.6 one year, then 1.4 the next, then 2.4, then 3.2. There would be an obvious trend, and I would say 'We can't do a biopsy until the PSA reaches 4'," Catalona added.
"Then they'd come in and have a PSA of 6," he said. The men would get immediate surgery to get their prostates out and many times the cancer had already spread.
"Then they'd be really angry," Catalona said.
Prostate cancer can be a slow-growing disease and some men are advised just to watch it carefully -- especially if they are older and likely to die of something else before the prostate cancer becomes serious. (Additional reporting by Maggie Fox in Washington)
Diet and Kidney Stones www.marinurology.com
Changing your diet can dramatically reduce your risk of making more kidney stones. We recommend that patients perform a 24 hour urine collection to measure urinary minerals. Sometimes we uncover important metabolic abnormalities. Most commonly, however, a diet too rich in oxalate or purine and too poor in water or citrate is the culprit.
Athletic and chronically dehydrated patients are common in our practice. We tell them to carry water, especially in Marin's semi-arid summer environment. The issue is not how much you drink, but the amount left over for urine after you sweat. Our endurance athletes who start drinking a quart per hour of exercise report improved exercise tolerance despite carrying the extra weight.
Calcium restriction is only occasionally appropriate and only after testing demonstrates that urinary calcium concentrations fall to normal levels on a restricted diet. Calcium supplements rarely lead to stone formation.
Oxalate, the other common factor in stones, however should be reduced when possible. Many of our patients take a lot of Vitamin C. Vitamin C over 200mg/day is converted into oxalate and excreted in the gut and urine. We ask our patients to stop taking Vitamin C and to reduce nuts, chocolate and green leafy vegetables in their diet.OXALATE-RICH FOOD ITEMS
Excessive sodium (table salt) in the diet predisposes to stones.
Uric acid is a waste product from purines in food. You will notice that the foods highest in purines are luxury items.
Citrate, an acid that complexes calcium, helps reduce stone production. It is commonly found in fruit juices, which we encourage.By the same token, increasing your magnesium intake may reduce stone production.
OXALATE-RICH FOOD ITEMS
|
|
OXALATE
|
FOOD
|
SERVING
|
CONTENT(mg)
|
Beet greens, cooked
|
1/2 cup
|
916
|
Pursiane, leaves, cooked
|
1/2 cup
|
910
|
Rhubarb, stewed, no sugar
|
1/2 cup
|
860
|
Spinach, cooked
|
1/2 cup
|
750
|
Beets, cooked
|
1/2 cup
|
675
|
Chard, Swiss, leaves cooked
|
1/2 cup
|
660
|
Rhubarb, canned
|
1/2 cup
|
600
|
Spinach, frozen
|
1/2 cup
|
600
|
Beets, pickled
|
1/2 cup
|
500
|
Poke greens, cooked
|
1/2 cup
|
476
|
Endive, raw
|
20 long leaves
|
273
|
Cocoa, dry
|
1/3 cup
|
254
|
Dandelion greens, cooked
|
1/2 cup
|
246
|
Okra, cooked
|
8-9 pods
|
146
|
Potatoes, sweet, cooked
|
1/2 cup
|
141
|
Kale, cooked
|
1/2 cup
|
125
|
Peanuts, raw
|
1/3 cup (1-3/4 oz.)
|
113
|
Turnip greens, cooked
|
1/2 cup
|
110
|
Chocolate, unsweetened
|
1 ounce
|
91
|
Parsnips, diced, cooked
|
1/2 cup
|
81
|
Collard greens, cooked
|
1/2 cup
|
74
|
Pecans, halves, raw
|
1/3 cup (1-1/4 oz)
|
74
|
Tea, leaves (4 mm. infusion)
|
1 level tsp in 7 oz water
|
72
|
Wheat germ, toasted
|
1/4 cup
|
67
|
Gooseberries
|
1/2 cup
|
66
|
Potato, Idaho white, baked
|
1 medium
|
64
|
Carrots, cooked
|
1/2 cup
|
45
|
Apple, raw with skin
|
1 medium
|
41
|
Brussels sprouts, cooked
|
6-8 medium
|
37
|
Strawberries, raw
|
1/2 cup
|
35
|
Celery, raw
|
2 stalks
|
34
|
Milk chocolate bar
|
1 bar (1.02 oz)
|
34
|
Raspberries, black, raw
|
1/2 cup
|
33
|
Orange, edible portion
|
1 medium
|
24
|
Green beans, cooked
|
1/2 cup
|
23
|
Chives, raw, chopped
|
1 tablespoon
|
19
|
Leeks, raw
|
1/2 medium
|
15
|
Blackberries, raw
|
1/2 cup
|
13
|
Concord grapes
|
1/2 cup
|
13
|
Blueberries, raw
|
1/2 cup
|
11
|
Currants, red
|
1/2 cup
|
11
|
Apricots, raw
|
2 medium
|
10
|
Raspberries, red, raw
|
1/2 cup
|
10
|
Broccoli, cooked
|
1 large stalk
|
6
|
Cranberry juice
|
1/2 cup (4 oz)
|
6
|
purines in food
#1 FOODS HIGHEST IN PURINE
Sweetbreads
Anchovies
Sardines, canned
Liver
Kidneys
Heart
Meat extracts, broths, bouillion
Salmon, canned
Gravies
Scallops
Herring
Smelts
Roe
Yeast
#2 FOODS HIGH IN PURINES
Bacon
Beef
Calf tongue
Carp
Chicken soup
Cod fish
Duck
Goose
Halibut
Lentils
Liver sausage
Meat soups
Perch
Pike
Pork
Rabbit
Mutton
Shellfish
Trout
Turkey
Veal
#3 FOODS MODERATELY HIGH IN PURINE
Asparagus
Navy beans
Bluefish
Oatmeal
Cauliflower
Oysters
Chicken
Peas
Crab
Salmon
Eel
Shad
Finnan Haddie
Spinach
Ham
Tuna fish
Kidney beans
White fish
Lima beans
Lobster
Mushrooms
#4 FOODS CONTAINING LITTLE PURINE
Beverages, carbonated; chocolate;
cocoa; fruit juices; postum
Breads, white bread and crackers,
cornbread
Cereals and cereal products; corn
macaroni, noodles, rice, tapioca,
refined wheat
Cheese of all kinds
Eggs
Fats (use only amounts allowed)
Fruits of all kinds
Gelatin
Milk in all forms
Nuts of all kinds
Pies except mincemeat
Shad roe
Sugar and sweets
Vegetables of all kinds except those mentioned above
Vegetable and milk soups
Vitamin concentrates
Antioxidants: Potential cancer fighters
Researchers are studying the role of many vitamins and minerals — such as vitamins C, E and the minerals selenium and zinc — on prostate cancer risk. These vitamins and minerals are antioxidants, substances that slow down oxidation — a natural process that can damage cells. Antioxidants may reduce your risk of prostate cancer by protecting cells from cancer-causing substances.
Food is the best source of vitamins and minerals. Fruits, vegetables, whole grains and legumes provide a wide variety of nutrients — known and unknown — that may protect your body against disease. Here are several antioxidants and their food sources:
Antioxidant
|
Food source
|
Beta carotene
|
Carrots, broccoli, sweet potatoes, squash, spinach, red bell peppers and cantaloupe
|
Vitamin C
|
Red and green bell peppers, broccoli, guava, cauliflower, strawberries, papayas, oranges and grapefruit
|
Vitamin E
|
Seeds, nuts, wheat germ, fortified cereals, spinach and tomato products
|
Selenium
|
Brazil nuts, seafood, wheat germ, whole-wheat bread, bran, oats and brown rice
|
Zinc
|
Meat, seafood, poultry and whole grains
|
vegetables may protect against prostate cancer
There is extensive and consistent evidence that fruits and vegetables are protective against most cancers. A study by the Fred Hutchinson Cancer Research Center looked at particular foods in the diets of men who recently were diagnosed with prostate cancer, and controls (men of similar age and from the same population area without prostate cancer). They found that a high intake of vegetables was significantly related to a lower risk of prostate cancer. Men who averaged four or more servings of vegetables daily, compared to those who ate fewer than two servings per day, had a 35 percent lower risk of getting prostate cancer. Vegetables that were most protective were those in the cabbage family (cabbage, cauliflower, broccoli, et cetera). Those men who ate three or more servings of these foods weekly, compared to those who ate them less than once per week, had a 40 percent reduced risk of prostate cancer.
Move over tomatoes! All vegetables -- especially the cruciferous kind -- may prevent prostate cancer
Eating a wide variety of vegetables is key to reducing one's risk, according to a new study
SEATTLE - Move over, tomatoes! All vegetables - especially broccoli, cabbage and their cruciferous cousins - may substantially reduce the risk of prostate cancer, according researchers at the Fred Hutchinson Cancer Research Center. Eating just three servings of vegetables a day can cut a man's risk of prostate cancer nearly in half. While carrots, beans, greens and cooked tomatoes all were found to decrease risk, the strongest effect was for cruciferous vegetables. These findings will appear in the Jan. 5 issue of the Journal of the National Cancer Institute.
"The bottom line is that if you eat a lot of vegetables, you can cut your risk of prostate cancer by about 45 percent," says Alan Kristal, Dr.P.H., co-investigator of the study. "And, if some of those vegetables are from the cruciferous family, like broccoli and cabbage, you may reduce your risk even further."
Kristal and Jennifer Cohen, Ph.D., from the Center's Cancer Prevention Research Program, led the data analysis. Janet Stanford, Ph.D., head of the Center's Prostate Cancer Research Program, also participated. All are from the Center's Public Health Sciences Division.
The study looked at the associations of total fruit and vegetable consumption, as well as specific types of fruits and vegetables, on prostate-cancer risk in 1,230 Seattle-area men. Half of the men had been diagnosed with prostate cancer and the other half were randomly selected men living in the Puget Sound region. Funded by the National Cancer Institute, this study was unique because it examined risks for prostate cancer in younger men (ages 40-64). By focusing on men who are at a very low risk of prostate cancer, the researchers were better able to assess the impact of lifestyle factors, such as diet, on cancer risk. The men were interviewed about their dietary habits three to five years prior to diagnosis (or an equivalent time frame among the control group). They also completed a detailed dietary questionnaire that asked how much and how often they ate 99 foods.
Men who ate three or more servings of vegetables a day (about 15 percent of the sample) had a 48 percent lower risk of prostate cancer, compared to men who ate fewer than one serving a day (also about 15 percent of the sample). This association was independent of other dietary factors, such as fat intake, and for medical factors, such as history of prostate cancer in a father or brother.
The strongest effect was for cruciferous vegetables, which include broccoli, cauliflower, brussels sprouts, and cabbage-based dishes such as sauerkraut and coleslaw. Men who ate three or more half-cup servings of cruciferous vegetables per week had a 41 percent decreased risk for prostate cancer, compared to men who ate fewer than one serving per week.
"At any given level of total vegetable consumption, as the percent of cruciferous vegetables increased, the prostate-cancer risk decreased," Kristal says.
Fruit, on the other hand, was a different story. When measuring the impact of total fruit intake as well as that of specific fruits, such as citrus, the researchers found no associations with reduced risk of prostate cancer. The researchers also found no special benefits for cooked tomatoes. This finding contradicts much-publicized research extolling the prostate-cancer-fighting properties of cooked tomato products, an effect attributed to a carotenoid called lycopene, a pigment that gives the fruit its red color.
"We found no association between lycopene and decreased prostate-cancer risk," Kristal says. "We also looked at foods that were good sources of lycopene, such as spaghetti sauce and pizza. These were not related to cancer risk at all." These results support four earlier studies that found no association between either tomato consumption or lycopene intake and risk of prostate cancer. The handful of studies to date that have shown protective effects have not controlled for total vegetable consumption, a flaw in study design, Kristal believes, that makes it difficult to accurately assess the cancer-fighting role of specific types of vegetables.
Scientists believe that vegetables protect against cancer because they contain a wide variety of phytochemicals. Many phytochemicals increase the activity of enzymes that can detoxify cancer-promoting compounds in the body. So if vegetables are good, would specific dietary supplements containing megadoses of these phytochemicals be better? "I think it would be a complete mistake; a significant error," Kristal says. "Vegetables - all food, actually - contain many biologically active components. We have some clues about which ones may be active in preventing prostate cancer, but it's not likely to be lycopene or any one single compound. It's much more likely to be the result of many compounds working together in very complex ways.
"It is therefore much more important to eat a variety of different vegetables. I don't think pills will take the place of eating a good diet, at least not in my lifetime."
On a related note: Watch for an upcoming editorial by Drs. Alan Kristal and Jennifer Cohen entitled "Tomatoes, Lycopene and Prostate Cancer: How Strong is the Evidence?" in the Jan. 15 issue of the American Journal of Epidemiology (media embargo lifts Jan. 10).
For more information, please contact Kristen Woodward, Hutchinson Center Media Relations, 206-667-5095.
Whether eating to prevent prostate cancer or to promote general good health, it's easy to incorporate at least three servings of vegetables per day into one's diet. Dr. Alan Kristal of the Fred Hutchinson Cancer Research Center, a cancer-prevention researcher who is also a trained chef, suggests the following sample menu:
At breakfast, drink a glass of tomato or other vegetable juice. Put a slice of tomato on toast, or add sauteed vegetables to scrambled eggs or omelets.
For lunch, include a salad with plenty of carrots, red cabbage or other raw vegetables. Eat vegetable soups, such as beef vegetable, minestrone or cream of broccoli soup. Add a side of cooked vegetables.
For dinner, eat two vegetables with your main course, or eat a vegetable and have a salad. Add vegetables, such as peas, to pasta dishes. Add extra vegetables to casseroles.
For snacks, have cut raw vegetables ready to go. Buy baby carrots or cherry tomatoes. Cut up celery, broccoli or cauliflower florets. Keep them in water in your refrigerator, and they will stay crisp.
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The Fred Hutchinson Cancer Research Center is an independent, nonprofit research institution dedicated to the development and advancement of biomedical technology to eliminate cancer and other potentially fatal diseases. Recognized internationally for its pioneering work in bone-marrow transplantation, the Center's four scientific divisions collaborate to form a unique environment for conducting basic and applied science. The Hutchinson Center is the only National Cancer Institute-designated comprehensive cancer center in the Pacific Northwest.
For more information, visit the Center's Web site at http://www.fhcrc.org.
Advancing knowledge, saving lives
Garlic and prostate cancer. A member of the same family as onions, leeks and scallions, garlic appears to reduce the risk of many types of cancer, including prostate cancer. It's thought that sulfur compounds in garlic enhance immune function, which helps combat tumor growth. These compounds may also slow the spread of cancer cells and increase the production of enzymes that help eliminate cancer-causing substances.
Green tea and prostate cancer Made from tea leaves dried and fragmented soon after harvesting, green tea contains a natural substance called epigallocatechin gallate (EGCG). This compound appears to inhibit enzyme activity necessary for cancer growth, but large-scale studies haven't evaluated this theory.
BUT THEN THIS NEXT ARTICLE CAME OUT
[Cancer Research 64, 8715-8722, December 1, 2004]
© 2004 American Association for Cancer Research
Oral Consumption of Green Tea Polyphenols Inhibits Insulin-Like Growth Factor-I–
Induced Signaling in an Autochthonous Mouse Model of Prostate Cancer
Vaqar Mustafa Adhami1, Imtiaz Ahmad Siddiqui1, Nihal Ahmad1, Sanjay Gupta2 and Hasan Mukhtar1
1 Department of Dermatology, University of Wisconsin, Madison, Wisconsin; and 2 Department of Urology, Case Western Reserve University and the University Hospitals of Cleveland, Cleveland, Ohio
We earlier demonstrated that oral infusion of green tea polyphenols inhibits development and progression of prostate cancer in transgenic adenocarcinoma of the mouse prostate (TRAMP) model. Evidence indicates that elevated levels of IGF-I with concomitant lowering of IGF binding protein (IGFBP)-3 are associated with increased risk for prostate cancer development and progression. In this study, we examined the role of IGF/IGFBP-3 signaling and its downstream and other associated events during chemoprevention of prostate cancer by green tea polyphenols in TRAMP mice. Our data demonstrated an increase in the levels of IGF-I, phosphatidylinositol 3'-kinase, phosphorylated Akt (Thr-308), and extracellular signal-regulated kinase 1/2 with concomitant decrease in IGFBP-3 in dorso-lateral prostate of TRAMP mice during the course of cancer progression, i.e., as a function of age. Continuous green tea polyphenol infusion for 24 weeks to these mice resulted in substantial reduction in the levels of IGF-I and significant increase in the levels of IGFBP-3 in the dorso-lateral prostate. This modulation of IGF/IGFBP-3 was found to be associated with an inhibition of protein expression of phosphatidylinositol 3'-kinase, phosphorylated forms of Akt (Thr-308) and extracellular signal-regulated kinase 1/2. Furthermore, green tea polyphenol infusion resulted in marked inhibition of markers of angiogenesis and metastasis most notably vascular endothelial growth factor, urokinase plasminogen activator, and matrix metalloproteinases 2 and 9. Based on our data, we suggest that IGF-I/IGFBP-3 signaling pathway is a prime pathway for green tea polyphenol-mediated inhibition of prostate cancer that limits the progression of cancer through inhibition of angiogenesis and metastasis.
RED MEAT AND PROSTATE CANCER
“There’s a general consensus that saturated fat or red meat is associated with a higher risk of prostate cancer,” says June Chan of the University of California at San Francisco. But so far, studies haven’t been able to tease out what it is in meats or dairy foods that may cause prostate cells to go haywire. Saturated or animal fat is a leading possibility. Among the others:
Red meat. In 1993, Harvard researchers reported that men who ate red meat (beef, pork, lamb, or veal) most frequently had more than double the risk of advanced prostate cancer compared to men who ate those meats least often This year, they updated their findings on the study, which tracks more than 50,000 men.
“Our study still suggests that the less red meat you eat, the better,” says Harvard’s Edward Giovannucci.
Why red meat? Cooking the meat at high temperatures produces heterocyclic amines, which may promote cancer. “It could also be the animal fat or the high calorie-density of diets rich in red meat,” says Giovannucci. “We’re not sure which.”
If animal fat were a culprit, as some studies suggest, high-fat dairy foods like whole milk and cheese would also put the prostate at risk. But it’s also possible that the calcium in dairy foods poses a threat.
Calcium. It cuts the risk of osteoporosis and possibly colon cancer. And low-fat milk and other dairy foods can help prevent high blood pressure (though not necessarily because of their calcium).
So how could too much calcium promote prostate cancer? The theory: The active form of vitamin D—which we get mostly from sunlight—may protect the prostate And calcium lowers levels of active vitamin D in the blood.
Don’t panic. Not all studies see a link between calcium and prostate cancer. And most men never reach the “too-much-calcium” range.
“Calcium may really be only a concern for men who get more than 2,000 milligrams a day,” says Chan. So it’s still safe to shoot for the latest Recommended Dietary Allowances (RDAs)—1,000 mg a day for men 50 or younger and 1,200 mg for men over 50. (That includes what you get from food and supplements.)
The evidence isn’t strong enough to recommend that men change their calcium intake, she adds. “But they should be aware of the association between calcium and prostate cancer, because they may be getting calcium from fortified foods and not even know it.”
Would it help to simply boost your vitamin D intake?
“Whether vitamin D is related to prostate cancer is still an open question,” says Giovannucci. “But it’s prudent to get adequate vitamin D from a multi-vitamin or sunlight.” Fatty fish and fortified foods are also sources.
1: Journal of the National Cancer Institute 385: 1571, 1993.
2: Cancer Research 58: 442, 1998.
Millions of men who have prostate cancer want to know whether diet or supplements can slow or stop the disease. But so far, research has yielded few answers.
For example, in a Canadian study of 384 men with prostate cancer, those who consumed the most saturated fat were three times more likely to die of the disease over the next five years than those who consumed the least But it isn’t clear from this less-than-perfect study that saturated fat made the difference.
prostate cancer and seven herbs called PC-SPES
Researchers are more confident that a mixture of seven herbs called PC-SPES may slow advanced cancer in men who have no other treatments available. But the pricey supplement may be no more safe or effective than taking an ordinary estrogen pill.
“Many of the herbs that my prostate cancer patients take do nothing,” says William Oh, a researcher and oncologist at Harvard Medical School and the Dana Farber Cancer Institute in Boston. “PC-SPES has effects that are visible to all doctors who work with it, but whether it is any more effective than giving estrogen, we don’t know.”
Oh tracked 23 advanced cancer patients who had been taking six capsules (1,920 milligrams) of PC-SPES a day “Half had more than a 50 percent drop in PSA levels and many had a decrease in symptoms and relief from bone pain,” he reports. “If we can reduce PSA levels significantly, we can predict that they’ll live longer and better.”
But his study and two others like it aren’t definitive, in part because they didn’t compare PC-SPES to anything else. A new clinical trial will. Oh and colleagues will study men whose cancer is progressing even though they’re taking drugs that block testosterone. Half will get PC-SPES; the others will get an estrogen called DES, or diethylstilbestrol.
“We know PC-SPES has hormonal effects like estrogen,” says Oh. “We’re trying to understand to what extent PC-SPES’s effect is due to its estrogen activity.”
That’s why taking PC-SPES is not a good strategy for men who want to prevent prostate cancer. Like estrogen, PC-SPES can cut testosterone to castration levels. “It’s like getting your testicles removed,” explains Oh. “Eunuchs don’t get prostate cancer, but it’s not a price most men are willing to pay.”
What’s more, PC-SPES isn’t as safe as its over-the-counter availability implies. “It has all the side effects of taking estrogen, like nipple tenderness, breast swelling, hot flashes, and fatigue,” cautions Oh. “And the most dangerous side effect is blood clots, which occur in an estimated five to ten percent of patients.
“Clots can stay in the legs or they can break off and go to the lung, which is more serious,” he explains. “In men who have underlying heart disease, the clot can get lodged in a coronary artery,” causing a heart attack.
Those risks may be worth taking for men who have failed the usual anti-testosterone treatment. In fact, Oh now recommends it to all men in that condition. “Their life expectancy is about 12 months,” he says. But a risky supplement that can cost more than $300 a month is not a good gamble for anyone else.
Says Oh: “Right now we have no evidence that PC-SPES prolongs life, but it can reduce the symptoms of cancer and control the disease for some period of time in men who have limited options.”
1: European Urology 35: 388, 1999.
2: Urology 57: 122, 2001.
SEVEN WAYS THAT MAY HELP PREVENT PROSTATE CANCER
1. While it's too early to say for sure, these steps may reduce the risk of prostate cancer:
2. Limit red meat, full-fat cheese, and other fatty animal foods.
3. Eat seafood-especially fatty fish like salmon-three or four times a week.
4. Eat healthy tomato-rich dishes (spaghetti or other pastas, not lasagna or pizza) at least twice a week.
5. Consider taking a daily supplement with 200 micrograms (mcg) of selenomethionine or high-selenium yeast. (If you're looking for SelenoExcell high-selenium yeast, check the ingredient list. It's found in some selenium and multivitamin-and-mineral supplements.)
6. Get some gamma-tocopherol in your diet. Soy oil (often used in salad dressings), corn oil, and sesame oil are good sources. (Some vitamin E supplements contain both alpha- and gamma-tocopherol, but many labels don't say how much gamma you're getting.)
7, Limit calcium intake from food and pills to 1,200 mg a day and take a standard multivitamin with 400 IU of vitamin D.
SELENIUM AND PROSTRATE CANCER
In the 1980s, when Larry Clark and colleagues assigned 1,300 people to take either 200 micrograms of selenium or a placebo every day, no one suspected that selenium might prevent prostate cancer. Their goal was to see whether it could prevent skin cancer in residents of the Southeast, where the soil—and people’s diets—are selenium-poor
“Selenium supplements had no effect on the recurrence of skin cancer,” Clark told Nutrition Action Healthletter in 1996. “But the three leading cancers—lung, prostate, and colon—all decreased.”
Decreased by an unheard-of two-thirds, that is. The researchers had to stop the study three years early because the selenium-takers fared so much better that it would have been unethical to keep people on the placebo.
Still, Clark was cautious about his findings. “Selenium is not going to help everybody, and it’s not going to cure all cancer,” he explained.
It’s possible that selenium only works in people who get too little from their food...or that Clark’s results were a fluke.
But worth another trial? You bet.
The National Cancer Institute (NCI) doesn’t expect results from its new trial, called SELECT, for about a decade (see “SELECT One Option,”). Meanwhile, some researchers are worried that SELECT may not be using the right kind of selenium supplement.
Clark’s trial used a high-selenium yeast. (SelenoExcell is the brand that is closest to the supplement Clark used—see “The Bottom Line,”.) SELECT will use selenomethionine, which is the most abundant form of selenium found in the yeast. An expert panel recommended selenomethionine instead of yeast because selenium and other constituents of the yeast vary too much from batch to batch, explains the NCI’s Demetrius Albanes.
Let’s hope it was the right choice.
“I’m concerned that there might be some bioactive compounds in the yeast that aren’t in the selenomethionine supplements,” says Byers, who served on a safety committee for the 1996 study. “If the new study fails, we won’t know why.”
tomato sauce two to four times a week had a 34 percent lower risk of prostate cancer
Spaghetti sauce and pizza were big news in 1995. That’s when Giovannucci’s team found that men who consumed tomato sauce two to four times a week had a 34 percent lower risk of prostate cancer than men who ate no tomato sauce
The possible protector: lycopene, a carotenoid found in tomatoes that’s easier to absorb if they’re cooked
“Lycopene scavenges free radicals and suppresses damage due to oxidation in the tissues,” explains Northwestern University’s Peter Gann. “As an antioxidant, it’s more potent than beta-carotene. And it’s concentrated in the prostate.”
In 1999, Gann, Giovannucci, and their colleagues found a lower risk of prostate cancer in men who had higher blood lycopene levels 13 years earlier
“Not every study shows a benefit, but the ones that were best able to detect an association found it,” says Giovannucci.
Also encouraging: Researchers often wonder if people who take vitamins or eat more fish are more health-conscious, which could confound their results. But there’s less reason to think that pizza and spaghetti eaters are more health-conscious.
Still, Giovannucci’s research is no excuse to load up on lasagna, pizza, or other saturated-fat-laden foods.
“It’s not proven, but eating spaghetti sauce twice a week could certainly be part of a healthy diet,” says Giovannucci. “Eating ten pizzas a week isn’t.”
soy might lower the risk of prostate cancer,
“There’s a strong biological basis for thinking that soy might lower the risk of prostate cancer,” says Mark Messina, a soy expert who is an adjunct professor at Loma Linda University in California and a consultant to the soy industry.
Among the promising clues: In Asia, where tofu and other soy foods are a regular part of the diet, prostate cancer rates are low. And the isoflavones in soy foods inhibit the growth of prostate cancer cells in animals and test tubes.
But when it comes to people, the evidence is thin. “You could put all those animal and test-tube studies in a basket and one good human clinical study would outweigh them,” says Messina.
Large U.S. studies can’t even look at soy because most men don’t eat enough of it. That leaves one study in Hawaiians (it found only a weak link) and another in Seventh-day Adventists,9 That study found a lower risk only in men who drank more than one glass of soy milk a day. However, only two percent of the men drank soy milk that often, so the results aren’t rock-solid.
Also disappointing: When researchers gave men with elevated PSA levels two daily soy beverages (each with roughly 35 milligrams of isoflavones), their PSAs didn’t drop
“Our study only lasted six weeks,” notes investigator Stephen Barnes of the University of Alabama at Birmingham. “So it’s difficult to know what might have happened over the long term.”
Messina remains optimistic. “There’s a consistent story forming,” he says. “But it’s a story waiting to be confirmed.”
It’s too early to know whether selenium, vitamin E, lycopene, soy, or seafood can prevent prostate cancer. Nor is there any guarantee that cutting back on red meat or high-fat dairy foods will lower the risk. But men who follow advice for an overall healthy diet can’t lose.
“We’re not up to the point of giving recommendations on diet and prostate cancer,” says the University of California’s June Chan. “But it’s prudent to eat less meat and animal fat and more vegetables, fruits, and whole grains. There’s good reason to believe that a prudent diet is beneficial for heart disease, and it may help for cancer.”
watermelon help men avoid prostate cancer.
Juicy, red watermelon is not only delicious, it may help men avoid prostate cancer. As long as you spit out the seeds, watermelon is the biggest supplier among fresh fruits and vegetables in the antioxidant lycopene, which is believed to play a big role in the prevention of the killer disease. Antioxidants such as lycopene work in your body by disarming free oxygen radicals, which are thought to contribute to the development of many cancers. A 2-cup serving of watermelon contains 15 - 20 milligrams of this vital plant pigment. Other sources include tomatoes, red grapefruits and guavas.
URINARY SYSTEM ANATOMY
The Urinary System
Your urinary tract is the body system involved in the formation and excretion of urine. The kidneys filter out waste products from the blood. These waste products in combination with water are urine. The urine passes out of the kidneys through two narrow, muscular tubes called ureters. The ureters empty the urine into the bladder, and the urine is then excreted from the body through a tubelike structure called the urethra.
URINARY SYSTEM AND HOW IT WORKS
Your Urinary System and How It Works
Your body takes nutrients from food and uses them to maintain all bodily functions including energy and self-repair. After your body has taken what it needs from the food, waste products are left behind in the blood and in the bowel. The urinary system works with the lungs, skin, and intestines--all of which also excrete wastes--to keep the chemicals and water in your body balanced. Adults eliminate about a quart and a half of urine each day. The amount depends on many factors, the major ones being the amount of fluid and foods
