Prostate Cancer Symptoms Tips What is prostate cancer symptoms? We have tips about prostate cancer symptoms

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New study links active lifestyle to reduced risk of glaucoma

Physical activity may be what the doctor orders to help patients reduce their risk of developing glaucoma. According to a recently published scientific paper, higher levels of physical exercise appear to have a long-term beneficial impact on low ocular perfusion pressure (OPP), an important risk factor for glaucoma.

Published in the Investigative Ophthalmology & Visual Science journal (Physical Activity and Ocular Perfusion Pressure: The EPIC-Norfolk Eye Study), this study examined the relationship between physical activity and current OPP in 5,650 men and women aged 48 to 90 who live in the U.K. and were part of initial cohort from 1993 - 1997.

Using a detailed self-administered health and lifestyle questionnaire, participants were assessed for combined physical activity at work and leisure. From 2006 to 2010, study participants were examined for eye pressure -- medically termed intraocular pressure (IOP )-- and systolic and diastolic blood pressure measurements. The results showed that moderate physical exercise performed approximately 15 years previously is associated with a 25% reduced risk of low OPP.

"It appears that OPP is largely determined by cardiovascular fitness," said author Paul J. Foster, MD PhD, FRCS(Ed), of the University College London Institute of Ophthalmology. "We cannot comment on the cause, but there is certainly an association between a sedentary lifestyle and factors which increase glaucoma risk."

While there have been a large number of studies that have examined the effect of physical activity on intraocular pressure (IOP) and on blood pressure -- the two components of OPP -- this is the first time the relationship between physical activity and OPP has been investigated, according to the authors.

"Before now, the only modifiable risk factor for glaucoma was IOP, altered by medication, laser or surgery," said Foster. "We believe our study points toward a new way of reducing glaucoma risk, through maintaining an active lifestyle. This is a way that people can participate in altering their risk of glaucoma and many other serious health problems."

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Update in Breast Cancer: Coverage of the American Society of Clinical Oncology (ASCO) Annual Meeting CME/CE Certified Course. The course is under the direction of Kevin Fox, MD, medical director of the Rena Rowan Breast Center. This is the last of four posts about the latest findings in treating breast cancer.

More News on Aromatase Inhibitors (AIs)
A group of bone health-related studies (Abstracts 516, 517, 518) presented at the 2011 ASCO conference provided some good news on bone loss. The studies showed that postmenopausal breast cancer patients undergoing endocrine therapy (aromatase inhibitors) do not experience an increase in their total number of fractures, despite having some level of bone loss.

Over a period of approximately six years, 5 percent of patients receiving aromatase inhibitors (AIs) suffered fragility fractures, the same percentage as occurred in the control group. Studies also show that exemestane may result in less bone loss than other AIs.

A third set of AI studies (Abstracts 522,523 525) strengthened the data supporting the proposition that women who experience endocrine-related symptoms, specifically arthralgia and bone pain, while taking AIs do have improved treatment efficacy.

Regional vs. Whole Breast Irradiation for Node-Positive Cancer
The controversy regarding the optimal treatment approach for breast cancer with one to three positive nodes has existed for some time. Current treatment guidelines call for regional lymph node irradiation (RNI) for all patients with four or more positive nodes, but have been less clear about the role of RNI in cases involving one to three nodes.

Another trial highlighted at the ACO conference, NCIC-CTG MA.20, bolsters the view that all node-positive breast cancer patients should be considered for RNI.

In this large, intergroup trial, women with positive nodes or high-risk node negative breast cancer were treated with breast-conserving surgery. They were then randomized to receive either standard whole breast irradiation (WBI) or WBI plus RNI. The study demonstrated a clear advantage for the WBI plus RNI group for five year overall and disease-free survival. They did experience modestly increased toxicity, mostly attributable to a slight increase in grade II lymphedema.

Focus on Neoadjuvant Therapy for HER2-Positive Breast Cancer
Neoadjuvant therapy, or therapy that is given before primary cancer treatment, is becoming a standard way to study new approaches to treating breast cancer. Angela DiMichele, MD, assistant professor of medicine and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, noted the emphasis on neoadjuvant therapy at the ASCO meeting, citing several studies for women with HER2-positive breast cancer, a group for which there is a growing number of treatment options.

The first (abstracts 505, 507) combined lapatinib and trastuzamab in a neoadjuvant setting without chemotherapy for women with HER2-postive tumors >3cms or >2cms with palpable nodes. The results were positive with an overall pCR of 28 percent and a 40 percent pCR in ER- negative patients and strengthened the evidence for the dual receptor blockade as the new standard of therapy for HER2-positive tumors. The study did have an 8 percent drop out rate resulting from toxicity, primarily diarrhea and acne form rash.

The other studies (abstracts 531, 532) looked at the results of adding chemotherapy to the dual receptor blockade. The first demonstrated a clear advantage to lapatinib and trastuzamab with anthracycline-taxane therapy in terms of pCR, but left unanswered issues as to whether the increased toxicity with chemotherapy is worth the risk and whether the pCR will translate into long-term survival.

Triple-Negative Breast Cancer
While the options for HER2-postive patients continue to expand and improve, the need remains to discover more effective therapies for the 15 percent of patients diagnosed with triple negative breast cancer (TNBC). While considerable attention was focused on TNBC at ASCO 2011, the meeting did not yield significant progress for women with this disease.

Several trials offered data suggesting that basal subtypes of breast cancer might be sensitive to platinum, but much more information is needed to clarify which subgroups of patients and under which circumstances will benefit from this therapy (Abstract 1015). Similar issues apply to the use of agents targeted to the mTOR and PI3K pathways (abstract 1016). The conclusion: For TNBC, a commitment to larger, well-designed trials with integrated, adequately-powered biomarker assessment are needed.

Abstracts can be found on the 2011 ASCO meeting website.

Learn more about breast cancer treatment at Penn’s Abramson Cancer Center.

Are you at risk for breast cancer? Attend Penn Women’s Cancer Conference – Focus on Your Risk of Breast/Ovarian Cancer

Are you a breast cancer survivor? Attend the Penn Women’s Cancer Conference – Life after Breast Cancer

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There is no link between long-term use of mobile phones and tumours of the brain or central nervous system, finds new research published on bmj.com today.

In what is described as the largest study on the subject to date, Danish researchers found no evidence that the risk of brain tumours was raised among 358,403 mobile phone subscribers over an 18-year period.

The number of people using mobile phones is constantly rising with more than five billion subscriptions worldwide in 2010. This has led to concerns about potential adverse health effects, particularly tumours of the central nervous system.

Previous studies on a possible link between phone use and tumours have been inconclusive particularly on long-term use of mobile phones. Some of this earlier work took the form of case control studies involving small numbers of long-term users and were shown to be prone to error and bias. The International Agency for Research on Cancer (IARC) recently classified radio frequency electromagnetic fields, as emitted by mobile phones, as possibly carcinogenic to humans.

The only cohort study investigating mobile phone use and cancer to date is a Danish nationwide study comparing cancer risk of all 420,095 Danish mobile phone subscribers from 1982 until 1995, with the corresponding risk in the rest of the adult population with follow-up to 1996 and then 2002. This study found no evidence of any increased risk of brain or nervous system tumours or any cancer among mobile phone subscribers.

So researchers, led by the Institute of Cancer Epidemiology in Copenhagen, continued this study up to 2007.

They studied data on the whole Danish population aged 30 and over and born in Denmark after 1925, subdivided into subscribers and non-subscribers of mobile phones before 1995. Information was gathered from the Danish phone network operators and from the Danish Cancer Register.

Overall, 10,729 central nervous system tumours occurred in the study period 1990-2007.

When the figures were restricted to people with the longest mobile phone use – 13 years or more – cancer rates were almost the same in both long-term users and non-subscribers of mobile phones.

The researchers say they observed no overall increased risk for tumours of the central nervous system or for all cancers combined in mobile phone users.

They conclude: "The extended follow-up allowed us to investigate effects in people who had used mobile phones for 10 years or more, and this long-term use was not associated with higher risks of cancer.

"However, as a small to moderate increase in risk for subgroups of heavy users or after even longer induction periods than 10-15 years cannot be ruled out, further studies with large study populations, where the potential for misclassification of exposure and selection bias is minimised, are warranted."

In an accompanying editorial, Professors Anders Ahlbom and Maria Feychting at the Karolinska Institutet in Sweden say this new evidence is reassuring, but continued monitoring of health registers and prospective cohorts is still warranted.

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A paper from the National Institutes of Health in the United States has evaluated the separate and combined effects of the frequency of alcohol consumption and the average quantity of alcohol drunk per occasion and how that relates to mortality risk from individual cancers as well as all cancers. The analysis is based on repeated administrations of the National Health Interview Survey in the US, assessing more than 300,000 subjects who suffered over 8,000 deaths from cancer. The research reports on total cancer deaths and deaths from lung, colorectal, prostate, and breast cancers.

The overall message of this analysis is that light to moderate alcohol intake does not appear to increase the risk of all-site cancer (and light drinking was shown in this study to be associated with a significant decrease in risk). Similarly, light to moderate consumption was not associated with site-specific cancers of the lung, colorectum, breast, or prostate.

As quantity consumed increased from 1 drink on drinking days to 3 or more drinks on drinking days (US drinks are 14g), risk of all-site cancer mortality increased by 22% among all participants. For total alcohol consumption (frequency x quantity), the data indicate a significant reduction in the risk of all-site cancers (RR=0.87, CI 0.80-0.94). Moderate drinking consistently shows no effect in the analysis, and only heavier drinking was associated with an increase in all-site cancer risk. For site-specific cancers, an increase in risk of lung cancer was seen for heavier drinkers, with a tendency for less cancer among light drinkers. There was no evidence of an effect of total alcohol consumption on colorectal, prostate, or breast cancer.

The authors excluded non-drinkers in a second analysis in which they used categories of usual daily quantity and of frequency of consumption in an attempt to investigate their separate effects. For all-site cancer and for lung cancer, these results again show an increase in risk only for drinkers reporting greater amounts of alcohol. The data also show an increase in cancer risk from more frequent drinking among women but not among men. For colorectal, prostate, and breast cancer, there is no clear pattern of an increase in risk from quantity of alcohol consumed. For frequency of drinking, again there is a suggestion of an increase in mortality risk with more frequent drinking, although the trends are not statistically significant.

Heavier drinking (three drinks or more per occasion) is known to be associated with a large number of adverse health effects, including certain cancers, as was shown in this study. When considering cancer, alcohol consumption should not be considered in isolation, but in conjunction with, other lifestyle behaviours (especially smoking when considering lung cancer). We agree with the authors that both quantity and frequency of consumption need to be considered when evaluating the relation of alcohol to cancer; further, beverage-specific effects need to be further evaluated.

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A new study published online in the European Journal of Clinical Nutrition shows that soy protein compared to dairy milk protein supplementation improves the lipid profile in healthy individuals. This study investigated the effect of soy and milk protein supplementation on lipids compared with carbohydrate among healthy adults. Numerous research studies have demonstrated that soy protein reduces LDL ("the bad") cholesterol and increases HDL ("the good") cholesterol, supporting the soy protein heart health and cholesterol-lowering claim that is approved in 12 countries around the globe.

"Coronary heart disease (CHD) is a major health epidemic, as the No. 1 killer of women and men globally. Research has shown that lowering blood lipids reduces the risk of coronary heart disease and stroke," said Elaine Krul, Ph.D., nutrition discovery lead at Solae. "The results of this study reveal that soy protein supplementation intake can help lower blood lipids, thus helping to reduce the risk of CHD in healthy individuals."

In this study, total cholesterol reduction as well as the total/HDL cholesterol ratio reduction was statistically significant with soy protein supplementation compared with carbohydrate. Compared with milk protein, soy protein supplementation significantly increased HDL and significantly reduced total/HDL cholesterol ratio as well as lowered LDL cholesterol.

The National Cholesterol Education Program emphasizes the importance of therapeutic lifestyle changes for primary prevention of high cholesterol. This includes dietary modification, body weight reduction and increased physical activity. There is increasing evidence that consumption of soy protein in place of animal protein lowers blood cholesterol levels and may provide other cardiovascular benefits. The results of this study are intriguing in that these risk reduction benefits were observed in healthy (non-hypercholesterolemic) individuals.

"It's the simple lifestyle changes, such as including soy protein in your diet, that can often have a positive impact on your health," said Krul. "Research continues to demonstrate that soy protein can help lower LDL cholesterol, an important biomarker for coronary heart disease."

This study was a randomized, controlled trial that included 352 U.S. healthy adults. It was conducted from September 2003 to April 2008. Participants in the study were assigned to 40 g/day supplementation of soy protein, milk protein or complex carbohydrate for 8 weeks in random order. Solae provided the supplements used in this study. For more information on the study, the following is a link to the abstract:

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A new study concludes that men who experience persistently moderate or high levels of stressful life events over a number of years have a 50 percent higher mortality rate.

In general, the researchers found only a few protective factors against these higher levels of stress – people who self-reported that they had good health tended to live longer and married men also fared better. Moderate drinkers also lived longer than non-drinkers.

“Being a teetotaler and a smoker were risk factors for mortality,” said Carolyn Aldwin, lead author of the study and a professor of human development and family sciences at Oregon State University. “So perhaps trying to keep your major stress events to a minimum, being married and having a glass of wine every night is the secret to a long life.”

This is the first study to show a direct link between stress trajectories and mortality in an aging population. Unlike previous studies that were conducted in a relatively short term with smaller sample sizes, this study was modified to document major stressors – such as death of a spouse or a putting a parent into a retirement home – that specifically affect middle-aged and older people.

“Most studies look at typical stress events that are geared at younger people, such as graduation, losing a job, having your first child,” Aldwin said. “I modified the stress measure to reflect the kinds of stress that we know impacts us more as we age, and even we were surprised at how strong the correlation between stress trajectories and mortality was.”

Aldwin said that previous studies examined stress only at one time point, while this study documented patterns of stress over a number of years.

The study, out now in the Journal of Aging Research, used longitudinal data surveying almost 1,000 middle-class and working-class men for an 18-year period, from 1985 to 2003. All the men in the study were picked because they had good health when they first signed up to be part of the Boston VA Normative Aging Study in the 1960s.

Those in the low-stress group experienced an average of two or fewer major life events in a year, compared with an average of three for the moderate group and up to six for the high stress group. One of the study’s most surprising findings was that the mortality risk was similar for the moderate versus high stress group.

“It seems there is a threshold and perhaps with anything more than two major life events a year and people just max out,” Aldwin said. “We were surprised the effect was not linear and that the moderate group had a similar risk of death to the high-risk group.”

While this study looked specifically at major life events and stress trajectories, Aldwin said the research group will next explore chronic daily stress as well as coping strategies.

“People are hardy, and they can deal with a few major stress events each year,” Aldwin said. “But our research suggests that long-term, even moderate stress can have lethal effects.”

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Even though previous studies have been shown the link between regular exercises and improved health the exact dose-response relation remains unclear. Guenther Samitz, researcher in physical activity and public health at the Centre for Sports Sciences and University Sports of the University of Vienna has investigated this relationship with a meta-study representing more than 1.3 million participants. The research project was carried out in collaboration with public health scientists and epidemiologists of the Universities of Bern, Switzerland and Bristol, UK. The results of the study have been published in International Journal of Epidemiology.

One week is 10.080 minutes, already 150 minutes of moderate-intensity physical activity per week protect against chronic diseases and premature death according to the recommendations of the World Health Organisation (WHO). A research group around Guenther Samitz of the Centre for Sports Sciences and University Sports at the University of Vienna investigated that link between increased levels of physical activity of different domains (occupation, daily living, transportation, and leisure) and all-cause mortality. The investigators also assessed to what extent current WHO recommendations for physical activity decrease the risk of premature death in adult populations.

80 studies with 1.3 million study participants

The study was conducted as a systematic review including multiple meta-analyses. Meta-analyses combine the results of individual studies that address a set of predefined research questions. In Public Health and Medicine the evidence from meta-analyses is often used to update or revise recommendations and guidelines for prevention and therapy.

The researchers identified about 7,000 potentially relevant reports, of which a total of 80 cohort studies with more than 1.3 million study participants from Europe, Canada, United States, and Asia fulfilled the strict inclusion criteria. At study onset participants had to be free of cardiovascular disease, cancer and other chronic conditions. Study participants were followed up by a median of 11 years. 'The results of the included studies were combined and controlled for other potential influential factors, e.g. cigarette smoking, alcohol uptake, body mass index, blood pressure, nutrition, education and social factors,' explained Guenther Samitz.
Women benefit more than men

In Europe only about one third of the adult population meets the minimum WHO recommendation for physical activity. Higher levels of physical activity were associated with reduced all-cause mortality, regardless whether in job, daily living, leisure or active transportation. However, the association was higher for leisure time physical activity and activities of daily living, and mortality reductions were more pronounced in women when compared with men. Women and older persons even had a survival benefit when engaging in regular light- to moderate-intensity activities of daily living, e.g. domestic work, gardening, walking or bicycling to the shopping mall. It is unclear why the survival benefit from physical activity across all domains was consistently higher for women. The study authors suspect that changes in female hormone levels, in oestrogen metabolism and body fat distribution could partly be responsible for this difference.

Some physical activity is good, more is better

In a second step the investigators quantified the mortality benefit in dependence upon the physical activity dose per week. For light- to moderate intensity activities of daily living, e.g. housework, gardening, stair climbing, walking and bicycling for transportation, an increase of one hour per week compared to no physical activity was associated with a reduction in mortality of four percent. Dr. Samitz said that with moderate-intensity leisure activities (e.g. Nordic walking, hiking, social dance) the risk reduction increased to six percent, and with vigorous-intensity aerobic activity or sports (e.g. jogging, bicycling (>10 miles per hour), tennis, ball sport), the reduction in all-cause mortality was even nine percent per one hour increment per week.

Meeting the WHO´s recommended level of 150 minutes per week of moderate physical activity of daily life or during leisure was associated with a reduction in mortality risk by ten percent. For vigorous exercise and sports the reduction in mortality risk was more than twofold higher (22 %).

300 minutes (five hours) per week, this activity level is recommended for extended health benefits, were associated with a reduction in mortality risk by 19% and 39% for moderate-intensity activities of daily living, and vigorous-intensity aerobic activity and sports, respectively. But even for lower levels than recommended by the WHO the researchers observed a significant survival benefit.

'Any physical activity is better than none and even activities of daily life are associated with a survival benefit, but more and vigorous-intensity physical activity are associated with a larger reduction in all-cause mortality', summarizes Samitz and he recommends: 'Nonetheless, sedentary adults should start with moderate-intensity physical activities and slowly increase weekly dose and intensity, because in javascript:void(0)sedentary adults vigorous-intensity physical activity is associated with increased risk of musculoskeletal injuries and adverse cardiac events.'