Showing posts with label Prevention. Show all posts

What are BRCA1 and BRCA2 gene mutations?

Wednesday, May 9, 2012 · Posted in , , , ,

Jill Stopfer, MS, is a certified genetic counselor at the Mariann and Robert MacDonald Women’s Cancer Risk Evaluation Center at Penn’s Abramson Cancer Center. Here she explains genetic risk due to the BRCA1 or BRCA2 genes.

Women with breast cancer or ovarian cancer may want to ask their physicians if their cancer has a genetic link.

The BRCA1 and BRCA2 genes, breast cancer susceptibility gene 1 and breast cancer susceptibility gene 2, are genes with several roles. One important role is to repair certain types of DNA errors that may occur each time a cell makes a copy of itself. Without a gene mutation, functional BRCA1 and BRCA2 genes help ensure the stability of the cell’s genetic material, or DNA, and help prevent uncontrolled cell growth. Mutations of these genes have been linked to an increased genetic risk for multiple forms of cancer, but most notably breast and ovarian cancer.

The lifetime risk of developing breast and/or ovarian cancer is greatly increased for women who inherit a harmful mutation in BRCA1 or BRCA2. These women have an increased risk of developing breast and/or ovarian cancer at an earlier than average age and may have multiple, close family members who have been diagnosed with these conditions.

Mutations in BRCA1 or BRCA2 may also increase the risk for pancreatic cancer and melanoma in both women and men. Men also have a higher chance to develop an earlier onset prostate cancer if a BRCA2 gene mutation is present. Men with BRCA1 or BRCA2 mutations also have an increased risk of male breast cancer.

Should you get tested for a BRCA gene mutation?


In a family with a history of breast and/or ovarian cancer, the first step may be to test a family member who has had breast or ovarian cancer. If that person is found to have a harmful BRCA1 or BRCA2 mutation, then other family members can be tested to see if they also have the mutation.

The Mariann and Robert MacDonald Women's Cancer Risk Evaluation Center provides genetic counseling to help people identify their genetic risk of breast cancer, ovarian cancer and other cancers.

The center assists patients with cancer as well as those individuals who may be at an increased risk for cancer.

The program is designed to:

  • Help people understand their genetic risk of breast cancer, ovarian cancer and other cancers.
  • Obtain and assess detailed family history information for possible inherited cancer conditions.
  • Provide expert genetic counseling and the option of genetic testing.
  • Arrange genetic testing and provide consultation regarding results.
  • Provide a clinical breast examination.
  • Provide tailored medical recommendations.
  • Review outside genetic testing results and make recommendations for follow-up.
  • Coordinate screening and long-term, follow-up care for those with a known inherited genetic risk for cancer.
  • Review medical history and lifestyle risk factors.
  • Provide a written summary of a genetic consultation.
  • Evaluate eligibility for participation in research studies.

The Mariann and Robert MacDonald Women's Cancer Risk Evaluation Center also provides information for those who have been diagnosed with cancer and are interested in learning about the role of genetics in their disease.

Some people are interested in obtaining this information for the benefit of their siblings, children and grandchildren. The center also holds education and support programs periodically throughout the year for individuals at high risk for developing cancer.

*Some of this information was adapted from the National Cancer Institute.

Watch the Abramson Cancer Center’s Focus On Your Risk of Breast and Ovarian Cancer Conference to learn more about cancer genetics and risk assessment.

The Basser Research Center to Focus on BRCA1 and BRCA2

The Basser Research Center — BRC for BRCA — supports research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

The Basser Research Center was established with a $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

Learn more about the Basser Research Center.


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Prostate Cancer Treatment and Prevention

Monday, May 7, 2012 · Posted in , , ,

Prostate cancer is the number one cancer affecting men in North America. The risk of getting prostate cancer increases with age, lifestyle and family history. While there is nothing you can do about aging, you can make some lifestyle changes that will help with prevention.

For better prostate health, avoid foods that are high in fat, like meats and dairy, that can elevate testosterone levels and can stimulate prostate cell enlargement and growth. Minimize alcohol consumption. Certain foods can also help prevent prostate cancer and slow down the growth.

Increase your intake of soy - use it to replace high fat foods like red meats and cheese. Increase your zinc by eating foods like pumpkin seeds in the shell, nuts, oysters and beans. Selenium is also important and can be found in tuna, eggs, shellfish, wheat germ, herring, kelp, onions, garlic, mushrooms, brazil nuts, sunflower seeds, sesame seeds and cashews.

Exercise is very important for prostate health. It helps improve circulation and blood flow to the prostate gland. It also helps digestion which includes the removal of waste. Exercising also helps to keep the weight off since obesity leads to an increased risk. Be sure to get enough sleep as well. It helps with stress levels and allows the body to repair itself.

Early screening and detection is crucial, since success rates are very high when the cancer is in the early stages and confined to the prostate. Men over 50 should get annual screenings. While prostate cancer in men younger than 50 is rare, men with a family history of prostate cancer should begin screening at age 40.

For men that have been diagnosed with prostate cancer, they should speak to their urologists to consider treatment options. There are the traditional options like surgery and radiation, which can have unfortunate side effects including incontinence and impotency. There are also alternative treatments including chemotherapy, hormone therapy, cryotherapy, brachytherapy and high intensity focused ultrasound or HIFU.

HIFU is one of the newer prostate cancer treatments where high intensity focused ultrasound is used to destroy cancer tumors with pinpoint accuracy. The procedure is non-invasive and non-surgical, using computerized imaging and controlled by specially trained urological surgeons. The procedure takes approximately 2-2.5 hours and recovery time is much faster than with other forms of treatment. The success rate is similar to traditional treatment methods, like surgery and radiation, but with fewer side effects.

The procedure began in Europe, and there are now 10 year published results showing the high success rates. In North America, the procedure is not available in the U.S., but was approved in Canada in 2003. The first clinic to open in North America was the Maple Leaf HIFU clinic in Toronto. They have performed over 700 treatments - more than any other North American clinic. They are staffed by top urologists who prefer this less invasive option because of the positive outcome with fewer side effects. If you are diagnosed with prostate cancer, speak to your urologist about HIFU and other treatment options, and do your own research online.

Nancy Stonecutter is a nurse who writes about family and child care. She recommends the http://www.hifu.ca/ site for more information on this prostate cancer treatment option.


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Prostate Cancer - 6 Prevention Tips

Friday, February 10, 2012 · Posted in , ,

Prostate cancer is the most common cancer for men in Canada and the USA. Men over the age of 65 are most often diagnosed, but men as young as 40 may be at risk. The risk of getting prostate cancer increases with age. While there is nothing you can do about aging, there are other changes you can make that decrease your odds of contracting the disease. Here are 6 steps you can take towards preventing prostate cancer:

Eat well. This simple rule holds true to prevent most forms of cancer. Start to eat healthier including 8-10 fruits and vegetables a day. Eliminate or restrict red meat and processed meat and replace it with healthier proteins including soy, fish, chicken, beans, etc. Avoid foods with saturated fat. Reduce salt/sodium intake as well as processed sugars.Supplement your diet. Increase your intake of vitamins A and E as well as lycopene and selenium. Take a quality multi vitamin each day.Avoid alcohol. This applies to wine and beer as well. Research shows that the less you drink, the more you decrease your risk for cancer. Men should limit themselves to no more than 2 drinks a day. (This does not mean you can add days you don't drink to days you do!)Stay active. Even if you don't have time to join a gym, add exercise in your daily routine by taking the stairs, walking a few extra blocks, playing with the kids, etc.Keep a healthy body weight. If you are obese, you are at increased risk. Begin a healthy weight reduction plan.Know your family's cancer history. If there is prostate cancer in your immediate family (father, brother, son, etc.) then you may be at increased risk. If more than one close male relative had prostate cancer, then you are at a much higher risk.

It is important to get regular screenings for early detection of prostate cancer. The good news is that early detection means catching any prostate cancer at an earlier stage, where there is a much greater likelihood of cure.

If you are diagnosed with prostate cancer, you have several treatment options. Some cancers grow very slowly and watchful waiting is good enough until doctors see higher levels of PSA in testing or other indications that the cancer is becoming more aggressive. Some cancers can be very aggressive and treatment should start as soon as possible. It is important to research all your prostate cancer treatment options and discuss with your doctor which ones are best for your particular situation. There are traditional treatments like surgery and radiation, as well as some newer alternative treatments. One of the increasingly popular alternative treatments is HIFU - or High Intensity Focused Ultrasound. This non-surgical and non invasive treatment options is safe and effective, with less down time and side effects. Your age, health, stage of cancer and other factors will play a role in which treatment option is right for you.

Although there are no guarantees for prostate cancer prevention, following the above steps can help you reduce your risk of getting the disease. A healthier lifestyle will also help you prevent other types of cancer and disease, and keep you feeling younger as your body ages.

Nancy Stonecutter is a nurse who writes about family, men's and child care. Visit her blog at http://www.nancythenurse.wordpress.com/ for more information.


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Prostate Cancer Prevention That Is Free, Effective And Mandatory For Men

Tuesday, December 27, 2011 · Posted in , , , ,

Prostate cancer prevention is never a 100% sure thing. Men who thought they would never get it have gotten it. Even guys with low PSA scores sometimes get the disease -- even though they eat right, exercise and follow all the usual health rules.

But, there is one thing most of these men do not do.

And, if they simply did more of it, would probably never have to worry about getting cancer in their prostate.

What is this thing most men are missing?

Getting enough sunshine.

Very simple, isn't it?

Yes, it is simple -- but also powerful for prostate cancer prevention.

The power of sunshine is in the vitamin D your body produces as a result of being in the sun. This vitamin D is extremely potent. In fact, I have heard respected doctors say that if the vitamin D in the sunshine (that you cannot get in a pill) were bottled and patented, it would be marketed as a prostate cancer cure.

But it's not just prostate cancer it's good for.

It's good for other kinds of cancers and diseases, too.

Now, obviously, this does not mean you can go out in the sun for 10 hours per day and be okay.

Like anything, you have to use common sense and moderation.

For example, if you are someone who burns easily, then you will want to limit your exposure as compared to someone who can be out in the sun longer.

The point is, to get sunshine often, even if in short doses of 15 minutes at a time.

It's one of the best prostate cancer prevention discoveries ever made.

Click the link below to get your FREE copy of "The Prostate Healing Food That Is So Sexually Potent Priests Were Forbidden To Eat It." A strange, but true, way to get relief from most prostate problems and reclaim the raging sex drive you once had. I'm not giving this report away free much longer, so grab it while you still can at http://prostateproblemsfixed.com/


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Prostate Cancer Prevention - What Can You Do?

Saturday, December 24, 2011 · Posted in , ,

One out of 36 men will die because of prostate cancer. It ranks second, behind lung cancer, for the leading causes of death in America. People are still unaware that prostate cancer can go undiagnosed up until they become aggressive or have spread throughout the body which can particularly impair the bones and the lymph nodes.

There are so many ways to prevent prostate cancer:
1. Regular Checkups
Most men will only go the Doctor if the pain they're feeling is very serious and unbearable. Regular checkups will allow for early diagnosis of possible illnesses and from there can be easily cured. Men who reach their 50's are advised to at least get annual prostate screening.

2. Check with Your Family History
Yes, prostate cancer is hereditary and the risk of developing prostate cancer is five-fold if more than one of your 1st degree relatives such as your father or brother has developed prostate cancer.

3. Talk to Your Doctor
If you suspect that you might have prostate cancer or have been experiencing its symptoms, talk to your Doctor about it so he can prescribe proper medication and treatment and at least confirm if it is prostate cancer or a symptom caused by an unhealthy lifestyle or symptoms to other possible illnesses.

4. Know the Signs.
There are so many signs that will tell you if you're possibly suffering from prostate cancer:
- You feel the need to urinate most especially during nighttime.
- There is intense urgency in the need to urinate.
- Having a hard time in starting or stopping the urine flow.
- You have unsatisfactory feelings of emptying the bladder after you've urinated.
- Difficulty urinating.
- Urine stream is either little or weak, decreased or constantly interrupted.
- Painful burning sensation during urinating.
- Presence of blood in the urine and semen.
- Ejaculation is extremely painful.

5. Do not play Doctor - unless you are one.
Self examination is good but do not self prescribe when you start feeling more symptoms. I know some people who have self prescribed in the past and have ended up making the condition even worse. And what's more worst that self prescribing is prescribing a medication to other just because you have the same symptoms.

6. Don't shrug it off.
Especially if one or more of the symptoms are constant and consistent. Set an appointment with your Doctor as soon as possible.

7. Talk to a Person close to you about it.
A spouse, a relative close to you, someone who is also going or has gone through the ordeal and who you trust is a great pillar of support especially during the early stages of prostate cancer or even if you're just speculating until the actual results come out.

8. Eat Well.
A good diet of low fat foods and a good amount of vegetable is a good cancer prevention.

9. Exercise.
Exercising does not only keep you fit but most importantly keeps your body and mind in good condition. If you know someone who you think might be suffering from the possibility of having prostate cancer, there are various things you can do to help:

a. Talk to the person about his symptoms and help him get the medical attention he needs.
b. Encourage him to stay optimistic. Prostate cancer is curable.

10. Consider prostate massage.
Administering prostate massage from time to time has been believed to lessen the percentage of men acquiring prostate cancer. However, it is necessary to discuss this with your doctor first.

A healthy lifestyle is a great prevention. Live Healthy. If you are diagnosed with prostate cancer, this is the time make a reality check on how you've been living your life. Vices can worsen your condition but most importantly, stay strong and optimistic.

Martin Stonehaven has many years writing about male sexuality. He specialises in advanced techniques for men to gain maximum enjoyment from their sexuality. He's the author of the Male G Spot website, [http://www.malegspot.co.uk]


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Cancer Prevention - Diet and Exercise Are Important

Wednesday, December 14, 2011 · Posted in , , ,

According to data collected by the World Health Organisation, high income countries tend to be more obese, are greater consumers of alcohol, do much less exercise generally and have a much higher risk of cancer than other lower-income countries, by comparison.

Denmark is rated the number one country for highest cancer risk, with the UK at number 22. This goes to show that cancer is closely related to lifestyle factors and is that there is therefore something that can be done to lower the risks and prevent many cancers from developing, including cancers of the breast, lung, mouth, colon, liver, bowel and prostate cancer.

Lifestyle Changes

It is envisaged that if we did something to change these lifestyle habits, in other words if we drank less alcohol, exercised more and followed a healthy diet plan with less fatty meats, biscuits, cakes, pastries and more fresh fruits and vegetables cancer cases could be cut by as much as a third. Some of the results may be slightly skewed by higher income countries being better able to diagnose cancer and better able to collect and organise the data they collect. But it cannot be denied that these countries also have the highest level of potentially dangerous lifestyle habits and this needs to be addressed.

Early Diagnosis

Having said that, the higher income countries also have better screening facilities in place, more awareness among the population at large and in medical establishments generally and better treatments on offer once cancer is actually diagnosed. This has resulted in higher rates of survival than ever before. If it is diagnosed early enough, most people will survive.

Cancer Prevention

In my opinion, however, prevention is definitely better than cure. Obesity leads to all kinds of problems, not just cancer, such as diabetes and bowel obstruction and it also puts a strain on the heart. Heavy drinking takes its toll on the liver which is the main organ for cleansing toxins from the body, so a damaged liver can lead to all kinds of complications from the toxins left in the body that cannot be cleared out.

Lack of exercise results in not enough oxygen going into the blood cells and this weakens them and makes it harder to fight off infections and other invading viruses. Cancer also thrives in a poorly oxygenated environment so the risk goes up as exercise goes down. All of these things can be addressed. Simply limit your consumption of alcohol to a level that the liver can manage, eat fresh foods, leaner meat and less pastries and exercise just 20 minutes a week.

To learn more about preventing or treating prostate cancer through diet and other natural methods go now to: http://www.prostatecancerdiet.org/


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Tips for Washing Fresh Produce (and a Note About Raw Sprouts)

Monday, July 4, 2011 · Posted in , ,

Content for this post provided by Joan Karnell Cancer Center

In Beware of Pesticides, we discussed how some produce items are rife with pesticides. Here are some tips for preparing fruits and vegetables for patients undergoing cancer treatement  that reduce the chance of becoming ill from food.
  1. All fruits and vegetables should be thoroughly washed under running water just before eating, cutting or cooking.
  2. Cut away any damaged or bruised areas of fresh fruits and vegetables before preparing and/or eating. Produce that looks rotten should be discarded.
  3. Even foods that are peeled  before eating, should be washed first.
  4. Washing fruits and vegetables with soap or detergent or using commercial produce washes is not recommended.
  5. Scrub firm produce, such as melons and cucumbers, with a clean produce brush.
  6. Dry produce with a clean cloth towel or paper towel to further reduce bacteria that may be present. 
  7. Many precut, bagged produce items like lettuce are pre-washed. As an extra measure of caution, wash the produce again just before use.
Health Risks with Raw Sprouts
Raw sprouts may contain bacteria that can cause foodborne illness, or food poisoning. Rinsing sprouts before eating does not remove bacteria. Even home-grown sprouts present a health risk if they are eaten raw or lightly cooked.

To reduce the risk of illness, do not eat raw bean, alfalfa, clover, or radish sprouts. All sprouts should be cooked thoroughly before eating to reduce the risk of illness.   
Information is adapted from FDA “Resources for You. Produce Safety: Safe Handling of Raw Produce and Fresh-Squeezed Fruit and Vegetable Juices”.

The full report is available at http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm114299
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Prostate Cancer and Obesity: A Deadly Combination

Saturday, April 9, 2011 · Posted in , ,

After I diagnose a patient with prostate cancer, we often have a lengthy discussion about treatment options and prognosis for the disease.  Many patients have a great mentality and express the desire to fight the cancer in any way possible.  Invariably, I hear a recurring question from these patients: “Doc, what can I do to increase my odds of beating this thing?”  If they are overweight or obese, I answer very emphatically, “Lose some weight.” 

Obesity is becoming an all too common phenomenon worldwide.  In the United States approximately 50% of men are considered overweight and 30% of men are considered obese.  Obesity is usually determined through a calculation of the Body Mass Index (BMI) which is weight in kilograms divided by height in meters squared.  Overweight men are classified as those with a BMI over 25 while obese men have a BMI greater than 30.  This excess weight exerts a tremendous toll on health by contributing to heart disease, diabetes, and hypertension.  Studies have demonstrated that men who are considered obese have a 50-100% higher chance of dying than men who are considered normal weight.  While we all know that obesity is a major risk factor for heart disease and some related illnesses, what does this have to do with prostate cancer?  Well, studies have also shown that men who are obese have a 40-80% higher risk of getting cancer (nonspecific) than those men that are considered to have a normal weight.  One of the cancers that has been greatly studied in the context of obesity is prostate cancer. 

While there has been no definitive proof of how obesity affects prostate cancer, numerous theories have been described.  First, studies have postulated that obesity affects prostate cancer through it impact on sex steroids within the body.  Fat in the body converts circulating testosterone to estrogen.  While testosterone is basically the “food” of prostate cancer, studies have shown that men undergoing surgery for prostate cancer have a higher risk of advanced stage cancer if there testosterone values are low. In addition, other studies have demonstrated that lower levels of blood testosterone actually correlate with a small but significant increase in the risk of prostate cancer.  All of this data seems to point to the fact that, by lowering testosterone levels in the bloodstream, excess body fat can actually predispose men to more aggressive prostate cancers.  Another theory of how fat and obesity impacts prostate cancer has to do with insulin like growth factor-1(IGF-1).  In obese men, high levels of IGF-1 are usually found in the bloodstream.  Laboratory studies have demonstrated that prostate cancer cells multiply more quickly in environments with higher levels of IGF-1.  In addition, clinical studies have shown significant correlations between IGF-1 and prostate cancer risk. 

While these theories are interesting, they do not really show us the true impact of obesity on prostate cancer.  Numerous clinical studies have evaluated the role of obesity in clinical prostate cancer.  The evidence linking obesity with the development of prostate cancer has been mixed.  While some studies have found a relationship between obesity and an increased risk of prostate cancer, others have shown no association.  Still other studies have actually demonstrated an inverse relationship, meaning that obesity was actually associated with a lower risk of developing prostate cancer.

Once prostate cancer has been diagnosed, however, there is no confusion as to the impact of obesity.  Multiple studies have demonstrated that obese men appear to have pathologically more aggressive cancer in terms of higher Gleason scores.  In addition, surgery to treat prostate cancer has been found to result in significantly higher rates of positive surgical margins in obese men.  Positive surgical margins are noted when the removed prostate gland is examined under the microscope by the pathologist after surgery.  A pathology report consistent with positive margins means that prostate cancer cells were seen at the cut edge of the removed prostate gland, meaning that the surgeon cut across some cancer when removing the prostate and that some cancer has been left behind.  Many studies have attributed this higher rate of positive margins to the fact that the body habitus of an obese man makes surgery more technically challenging.  As a result, more bleeding can occur, making visualization more difficult and positive margins more likely.  Given this theory, some have argued that robotic surgery, which enhances visualization and minimizes bleeding, should lead to better margins in obese men.  However, at least one large study, which divided patients into open versus laparoscopic surgery groups, still demonstrated a higher rate of positive margins in obese men, regardless of surgery type undertaken.

Obesity has been demonstrated to have perhaps its most significant impact on prostate cancer recurrence after surgery.  Most studies have been in agreement that obese men are substantially more likely to have a PSA recurrence (consistent with cancer recurrence) after prostatectomy as compared to those men that are of normal weight.  One large study actually demonstrated that moderately to severely obese men are 2.5- 3 times more likely to have a PSA recurrence as compared with their non-obese counterparts.  This finding is even more astounding in that it accounts for other factors that can affect cancer recurrence like preoperative PSA and Gleason score, stage, positive margins, and lymph node status.  An interesting study from Johns Hopkins published this year evaluated the effects of weight gain on men undergoing prostate cancer surgery.  The study found that men who gained approximately 5 pounds (2.2 kg to be exact) during the period of time starting 5 years prior to surgery and continuing to 1 year post surgery had twice the likelihood of  a PSA recurrence after surgery as compared to those men who maintained a steady weight.  Not surprisingly, with its impact on surgical outcomes and PSA recurrence, obesity has also been uniformly associated with an increased risk of prostate cancer mortality

I think the take home message of this post is fairly obvious.  If you have prostate cancer, probably the most important, proactive thing you can do (aside from getting treatment) is making sure to control your weight.  Find out what your BMI is from your doctor or calculate it online.  If you fall into the obese category, lose some weight.  Studies have shown that the very process of exercise can help men with prostate cancer.  A healthy, low fat diet has also demonstrated significant benefits.  Even if all of this data is wrong and you don’t benefit from escaping obesity from a prostate cancer standpoint, there is overwhelming evidence that you would benefit from the standpoint of your heart.  On that note, I want to share 1 more statistic.  The Prostate Cancer Prevention Trial followed 18,000 men for 7 years to study the impact of a drug called Finasteride on prostate cancer.  During the study, a total of 10 men died of prostate cancer.  During the same time period, 1123 men died of other causes, most of which were related to heart disease. Is that not enough of a reason to lose a little weight?


 

   
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Enlarged Prostate Gland

Wednesday, March 30, 2011 · Posted in , , ,

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benign prostatic hyperplasia benign prostatic hypertrophy benign prostatic hypertrophy

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Pomegranate: Prostate Cancer Wonder Drug?

Tuesday, March 22, 2011 · Posted in , ,

Many of my patients ask me about natural ways to fight prostate cancer.  Some of them have been diagnosed with prostate cancer and are looking for ways to control it.  Others are at risk for prostate cancer and are searching for ways to prevent it.  Either way, they are all hoping for a solution that is natural and has minimal side effects.  Believe it or not, one such solution is the pomegranate.  Yes, the funny looking red fruit with all of its little seeds may very well be a prostate cancer wonder drug.

The medicinal properties of pomegranates were described in ancient times.  Recently, the true benefits of the fruit have been discovered to come from flavonoids found in high concentrations within them.  Flavonoids have also been found in high quantities in both wine and green tea.  The main benefit of this compound is its antioxidant and anti-inflammatory properties.  Numerous studies have demonstrated that antioxidants can play an important role in cancer treatment and prevention.  With their high concentration of flavonoids, pomegranates have demonstrated significant effects on numerous malignancies including lung, breast, colon cancer.  Some of the most dramatic effects of pomegranates have been demonstrated against prostate cancer.

Studies have evaluated the efficacy of pomegranates in fighting prostate cancer in cell cultures, animal models and humans.  The most basic of these studies incubated prostate cancer cells with various concentrations of pomegranate extracts to see the effects on the growth of the cells.  These studies demonstrated that the pomegranate kept the prostate cancer cells in suspended animation, preventing them from multiplying.  This effect was demonstrated on both moderate and highly aggressive, hormone resistant prostate cancer cells.  These studies also demonstrated that the pomegranate extract also decreased the propensity of these aggressive cancer cells to invade and spread to adjoining tissues and areas. 

Inspired by the very encouraging results from these basic studies, another set of experiments demonstrated the effects of the pomegranate extracts on the growth of prostate cancer cells in mice.  In these studies, two groups of mice were inoculated with human prostate cancer cells which were then allowed to grow and form tumors.  One group of mice was fed regular water while the other was given water mixed with pomegranate extract at various concentrations.  The study demonstrated that the mice given the pomegranate/water mix grew much smaller tumors.  This reduction in the size of the prostate cancer tumors grown (as compared to mice drinking regular water) was proportional to the concentration of pomegranate extract within the water.  In addition, mice drinking the pomegranate/water mix demonstrated blood PSA levels 70-85% lower than those found in mice drinking plain water.  Again, the extent of the decrease was proportional to the concentration of pomegranate extract in the water.

While no large randomized, controlled trials have been conducted to evaluate the effects of pomegranate in a clinical setting, a small study from UCLA demonstrated some very impressive results.  This Phase II study evaluated 48 patients with prostate cancer who had a recurrence of cancer after initial therapy with either surgery or radiation.  The study determined that these men had a PSA doubling time of 15 months.  PSA doubling time is an indicator of how aggressive the cancer is and how quickly it spreads.  The lower the number of months to double the PSA, the more aggressive the cancer turns out to be.  All of these men were given 8 ounces of pomegranate juice over a 2 year period.  The study found that the PSA doubling time increased to 54 months with the pomegranate juice as opposed to 15 months demonstrated prior to the treatment.  Through this amazing finding, the study demonstrated that pomegranate can actually slow the spread of prostate cancer in humans!   Although the study was limited by its small patient numbers and lack of a control group (a group of patients who were followed but not given treatment), it demonstrated a significant benefit of pomegranate that cannot be ignored.

So what do we take from these very impressive studies?  Should a good daily helping of pomegranate juice replace surgery, radiation, or other accepted therapies for prostate cancer.  Of course not!  While these studies are very impressive, they do not show that pomegranates can CURE prostate cancer.  Instead, they demonstrate that pomegranates MAY decrease the growth of prostate cancer.  However, because pomegranates are natural fruits without any significant side effects, they should be strongly considered as a great ADJUNCT to any normally accepted treatment for prostate cancer.  The pomegranates may work synergistically with surgery or radiation to improve outcomes for patients with prostate cancer.  In addition, patients at risk for prostate cancer may want to consider pomegranates as a preventative measure. 

As I always tell my patients, medicine almost never offers a free lunch.  Any treatment you chose has its own side effects to tolerate.  Pomegranates offer as close to a free lunch as you can get.  Aside from causing some loose stools in some patients, pomegranates are a safe, natural way to battle prostate cancer.  I look forward to more studies evaluating this very promising fruit!


 

   
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Prostate Cancer Prevention: Is Avodart Friend or Foe?

Thursday, March 17, 2011 · Posted in , , , , ,

Whenever I discuss prostate cancer prevention with my patients, the topic of  Avodart always comes up.  Avodart  ( Dutasteride is the generic name) is a hormonal medicine that is used to treat urinary symptoms associated with BPH (benign prostatic hyperplasia) in men with very large prostates.  It has been shown to work synergistically with another class of drugs called alpha blockers ( Hytrin, Cardura, Flomax) to help improve urinary symptoms and prevent urinary retention.  The way Avodart works is that it blocks an enzyme located in the prostate which converts the male hormone Testosterone to a more potent hormone Dihydrotestosterone.  By blocking this hormone, Avodart actually causes the glands of the prostate to shrink, allowing urine to more easily flow through it.

If Avodart is a medicine used to treat BENIGN enlargement of the prostate, why does it come up in conversations about prostate CANCER prevention?  The answer to that question comes in the form of a landmark study called the Prostate Cancer Prevention Trial which was published in the New England Journal of Medicine in 2003.  This study evaluated a drug similar to Avodart called Proscar (Finasteride is the generic name) in over 10,000 men.  The theory of the study was that the medicine can not only shrink normal glands in the prostate but also prostate cancer glands as well.  In so doing, the authors thought, Proscar could actually prevent small areas of prostate cancer in the prostate from growing and developing into full blown cancer.  The study had some groundbreaking and yet confusing results.  The authors demonstrated that taking Proscar could decrease the risk of prostate cancer by 25%.  This was truly an astounding discovery!  Unfortunately, however, it came with a catch.  The men who did get prostate cancer while taking Proscar were 27% more likely to have a more aggressive, life threatening form. 

The results of the Prostate Cancer Prevention Trial really put patients and urologists in a tough situation.  On one hand, Proscar significantly decreased the overall risk of prostate cancer.  On the other hand, however, those that did get prostate cancer got a more aggressive form.  Numerous theories were offered to explain these conflicting findings.  Some doctors argued that by shrinking the prostate, Proscar only helped to FIND the more aggressive prostate cancer on biopsies because the cancers were more noticeable with less benign prostate tissue around.  Others maintained that by shrinking the normal glands, Proscar allowed aggressive prostate cancer to grow without restriction in the prostate.  Taking all of this into account, experts finally recommended that men who have enlarged prostates that would benefit from Proscar from a urinary standpoint should still be offered the medicine.  In terms of prostate cancer prevention, however, the substantial benefits and risks meant that the medicine had to be considered on a patient by patient basis.

A few years after the Prostate Cancer Prevention Trial, a new medicine called Avodart was brought to market.  As I mentioned, this medicine, like Proscar, blocked the enzyme transforming Testosterone into a more potent compound called Dihydrotestosterone.  Avodart had the added advantage in that it blocked two forms of this enzyme as opposed to Proscar which only blocked one.  The theory is that Avodart may be more effective because of this additional enzyme which it blocks. Given this new drug, another large study was carried out to determine if it could prevent prostate cancer as well.  Called the REDUCE trial, the study compared the risk of cancer in over 3,000 men who took Avodart as compared to another 3000 similarly matched men who did not.  The study found that Avodart decreased the risk of Prostate Cancer by 23%.  In addition, over the 4 year course of the study, no difference in high grade, aggressive cancers was noted between the two groups.  Interestingly, however, in the last 2 years of the study, 12 of the patients taking Avodart developed prostate cancer as opposed to only 1 of the patients not taking it.  Once again, like Proscar, while Avodart appeared to reduce the overall risk of prostate cancer significantly, it appeared to also increase the chance that people who did get prostate cancer would have more aggressive variants. 

Recently, a request was made to the FDA for approval to market Avodart and Proscar for the indication of prostate cancer prevention.  The committee rejected the proposal unanimously.  They felt that the benefits of prostate cancer prevention did not outweigh the risks of at least potentially causing more aggressive prostate cancer in some patients.  So what is the take home message of all of this information?  Is it to tell you not to ever take Proscar or Avodart?  No. People who would benefit from it from a urinary standpoint should consider it.   The point of the post is simply to inform you that trying to prevent prostate cancer with these medicines is not a straightforward endeavor.  If your doctor recommends that you take these drugs solely to prevent prostate cancer, make sure you discuss these risks with him or her and are comfortable that they are worth taking.


 

   
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Exactly about Milking the Prostate

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Lung Cancer - Classification, Stages, Symptoms, Causes, Effects, Prevention, Detection and Treatment

Tuesday, August 3, 2010 · Posted in , , , , , , , ,

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Lung cancer is caused by uncontrolled rapid growth of cells in tissues. This type of cancer is most common and results in more than a million deaths every year. This form of cancer is indicated by weight loss or coughing up blood or regularly going out of breath. It can be noticed on chest radio graph also called CT Scan. The treatment that one gets depends on the stage that one is in. Treatment of cancer include surgery, chemotherapy and radiotherapy.

CLASSIFICATION

Lung cancers are classified after studying under them microscope. Classification is necessary as different type of cancer is treated differently. Large portion of lung cancer are carcinomas - malignancies that grow from epithelial cells. Lung-carcinomas are categorized into two types: non -small and small-cell lung carcinoma. Non-small cell lung carcinoma and small cell lung carcinoma account for 80. 4% and 16. 8% frequency of lung cancer, respectively.

1. NON -SMALL CELL LUNG CARCINOMA

The non -small cell lung carcinomas are grouped together as their prognosis and management are same up to some extent. They are further classified into three types: squamous cell lung carcinoma, adenocarcinoma and large cell lung carcinoma. Squamous cell lung cancer originates near a central bronchus. They account for 25% of lung cancers. Adenocarcinoma starts in peripheral lung tissue. The cases of adenocarcinoma are a result of smoking. They accounts to 40% of non -small cell lung cancers.

2. SMALL CELL LUNG CARCINOMA

This type of lung cancer is rare. It is sometimes referred to as "oat cell" carcinoma. Most of the times they originate from larger airways (primary and secondary bronchi ) and from there they grow at a rapid pace. This type of lung cancer if mostly associated with smoking.

SECONDARY CANCERS

These cancers are classified on the basis of site of origin like breast cancer but has spread to the lung. Majority of the lung cancers in children are secondary.

STAGING OF LUNG CANCER

Lung cancer staging is used to asses the degree of spread of the cancer from its place of origin. It is an important factor that determines the potential treatment of lung cancer. The degree starts from 1A to 4, 1A being best prognosis and 4 being worst.

SIGNS AND SYMPTOMS

Following are the symptoms of lung cancer: 1. Voice becoming hoarse. 2. Sudden loss of weight. 3. Feeling pain in chest region or abdomen. 4. Difficulty in swallowing. 5. Loss of appetite. 6. Running out of breath. Many of the symptoms mentioned above are non -specific. By the time they notice symptoms or signs, cancer has already spread from place of origin. Very few people with this cancer have signs at time of diagnosis, these cancers are noticed on routine chest radio graph.

CAUSES

The three main causes of cancer are: carcinogens (which is found in tobacco ), viral infection and ionizing radiation. If exposed, it causes changes to DNA in tissue lining the bronchi of the lungs. With more and more tissues getting damaged, cancer develops.

1. SMOKING

Smoking is the main cause of cancer. In one cigarette, there are 60 different known types of carcinogens like radioisotopes and nitrosamine. Smoking is believed to cause 80% of these type of cases. The risk is generally less in non -smokers. The time that a person smokes proportionately increases the chances of this cancer. There has been cases that if a person stops smoking, the damaged cells gradually gets repaired. In non-smokers, passive smoking is the main causes of lung-cancer. Passive smoking is one inhaled from another person smoking.

2. RADON GAS

The gas produced from breakdown of radium. This gas is colourless and odorless. Exposure to radiation ionize the genetic material, causing mutations that sometimes turn cancerous. Exposure to radon gas is the second major cause of lung-cancer after smoking.

3. ASBESTOS

Asbestos is responsible for causing a number of cancer, one among them is lung cancer. In UK, asbestos accounts for 2 to 3% of the total cases of this cancer.

4. VIRUS

Viruses are responsible for causing lung-cancer in animals. And research has shown of similar potential in humans.

5. PARTICULATE MATTER

Particulate matter has a direct link to lung cancer cases. The size and quantity of particles in air determines the risk of getting lung-cancer. If concentration of particles increases beyond 1%, then the chances of getting this increases by 14%.

PATHOGENESIS

Just like may other cancer forms, lung cancer is started by activation of ocnogenes or inactivation of tumor suppressing genes. Ocnogenes are those genes that make people more vulnerable to cancer. Ocnogenes are produced from proto-ocnogenes, when the latter is exposed to particular carcinogens. In k-ras proto-oncogene, mutations takes place which are responsible for 10 to 30% of lung adenocarcinomas. Tumor invasion, angiogenesis, apoptosis, cell profileration are regulated by the Epidermal growth factor receptor. Mutations and amplification of EGFR are common in non -small cell lung cancer. The basis for treatment with EGFR-inhibitors are also provided by Mutation and amplification of EGFR. Chromosomal damage can lead to loss of heterozygosity which can result in inactivation of tumor suppressor genes. Damage to four of these chromosomes:3p, 5q, 13 q and 17 p are common in small cell lung-carcinoma. The p53, which is a tumor suppressor gene, located on chromosome 17p is affected in most of the cases. c-MET, NKX2-1, LKB1, PIK3A and BRAF are also mutated or amplified. Various genetic polymorphisms are supplementary to this cancer. Some of them include polymorphisms in genes coding for interleukin-1, cytochrome p450, apoptosis promoters such as caspase-8, and XRCC1, which is DNA repair molecule. People having these polymorphisms are more likely to develop lung cancer on being exposed to carcinogens. The research has revealed that MDM2 309G allele is a low-penetrant risk factor for developing this in Asians.

DIAGNOSIS

If a person has reported symptoms that might suggest cancer related to lungs, then chest radio graph is performed in the first step. The test reveals the widening of mediastinium, atelectasis and pleural effusion. Even if there are no radio graphic findings but the hint of this is high because of things like the person being heavy smoker with blood-stained sputum then CT-Scan may provide the necessary data. If findings are unnatural in cells in sputum, then they multiplies the risk of this type of cancer. Early detection can be done by Sputum cytologic examination together with other screening examinations. The differential diagnosis for those patients who show irregularities on chest cardiograph consider cancer related to lungs along with non malignant diseases. These consider infectious reasons like tuberculosis or pneumonia. The above mentioned diseases can lead to lung nodules.

PREVENTION

Prevention, just like always, is better than cure. Steps in this direction have been taken by may countries by identifying carcinogens and banning them but tobacco, which is the major cause of lung cancer, is still common. Eliminating cigarette smoking is first hand target in the prevention of lung cancer. Steps to lessen Passive smoking have also being taken by banning smoking in public places and workplaces. New Zealand has restricted smoking in open places. A similar step is also taken by Chandigarh, India. Bhutan has criminalized smoking since 2005.

SCREENING

Screening is used to detect disease by doing medical tests when the patient is not showing any symptoms. Chest radio graph or computed tomography are the tests used for screening of lung cancer. But, results have shown, that screening tests for lung cancer rarely has shown any benefit.

TREATMENT

The treatment of lung cancer can be done in following ways, depending on the stage or degree of cancer:

1. SURGERY

If doctors have detected lung cancer, then CT scan and positron emission tomography are usually applied to check if the disease is placed and surgery can be done or it has moved to the point where performing surgery is not possible. Surgery can only be performed if spirometry reveals good respiratory reserve, but if it is poor, then surgery is not possible. Even surgery has a death operative rate of 4. 4% but that is because of patient's lung function and other factors.

2. CHEMOTHERAPY

Chemotherapy, along with radiation, is used to treat small cell lung carcinoma. Primary chemotherapy is also used in metastatic non -small cell lung carcinoma.

3. RADIOTHERAPY

Radiotherapy, with chemotherapy, is given when patient is not fit to under go surgery. This type of high intensity radiotherapy is called radical radiotherapy. CHART (continuos hyperfractioned accelerated radiotherapy ) is refined version of this technique in which a high dose of radiotherapy is given for a short period of time. When cancer affects a short section of bronchus, then brachytherapy is given.

EPIDEMOLOGY

Lung cancer is the most widely reported cancer. There are 1. 35 million cases every year and 1. 18 million deaths. Lung cancer develop among those who have a history of smoking over a long period of years i. e 50 years and above. In addition to smoking, passive smoking is also a factor that causes lung cancer. Even the emissions from factories, automobiles, power plants pose a threat to human health. Lung cancer is found to have a reciprocal effect with sunlight and UVB exposure. This is due to effect of Vitamin D, produced in skin during exposure to sunlight.

We, whealthfitness means world fitness health provide important and valuable health and fitness like Lung Cancer Information on our latest Disease Information Blog. For more information visit our website whealthfitness.com.

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How Asbestos Causes Mesothelioma - New Hope For Prevention and Treatment

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Two researchers at the University of Hawaii Cancer Research Center have found the causal pathway that leads from the presence of asbestos fibers in the lung to the development of the aggressive and deadly cancer mesothelioma. In a study published in the Proceedings of the National Academy of Sciences, Drs Haining Yang and Michele Carbone demonstrated that the microscopic asbestos fibers which become embedded in lung tissue trigger an inflammatory process that leads to cell mutations. They identified a molecule, HMGB1, which cells release when they are exposed to asbestos. HMGB1 regulates the inflammatory response, triggering the chronic inflammation that promotes tumor growth and over time develops into mesothelioma.

The importance of their work is the confirmation of this causal pathway and understanding of HMGB1's involvement. In order to design treatment and prevention strategies, doctors must first understand the causal mechanism, so they know what processes to target and how.

Inflammation has long been understood as a contributor to disease processes as varied as heart disease, Alzheimer's, diabetes, and arthritis. Its involvement in other cancers has been well documented. Recently, researchers have shown that regular consumption of aspirin, which is an anti-inflammatory agent, can slow the growth of colon cancer.

The challenge for prevention of mesothelioma is that once the microscopic asbestos fibers are inhaled and make their way into lung tissue, it is impossible to remove them. The focus instead must be on reducing the embedded fibers' potential to cause inflammation and therefore disease. Drs Yang and Carbone now believe that by focusing on HMGB1 they have a means to reduce the chronic inflammation. This could lead both to preventing the development of mesothelioma, and for people who already have the disease, slowing its growth. Because mesothelioma is a slow-growing cancer, a treatment that could retard that growth process could prolong lives and significantly improve quality of life.

The work that led to these findings was conducted on mice and hamsters, whose lung tissue responds to asbestos very similarly to humans' lungs. Their next study will be with humans, in a region of Turkey where the death toll from mesothelioma is the highest on earth. In rural Anatolia and southeastern Turkey, where the soil is saturated with asbestos, and villagers plaster their houses with an asbestos compound, nearly half the population dies of mesothelioma. Drs Yang and Carbone plan to test a variety of medications, including aspirin, to gain a better understanding of the inflammatory process, and how to control it. Their findings are likely to provide new pathways for treatment of this aggressive cancer.

If you or a loved one has received a diagnosis of mesothelioma, and you believe that the exposure to asbestos, no matter how long ago, occurred in your workplace, you will want to consult with an experienced asbestos attorney to determine whether you may have a legal case.

Frederick Schenk has over 25 years of experience fighting for the rights of asbestos victims and their families. As a California asbestos attorney, he understands the devastating effects a mesothelioma diagnosis can create. He has dedicated his career to pursuing justice for asbestos victims through mesothelioma and asbestos lawsuits.

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