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Prostate Cancer Test Is Useless, Warn Scientists
Provided by Daily Mail on 9/11/2004
by ROBIN YAPP
Back to Healthy News

THOUSANDS of men may have had needless surgery because the test commonly used to diagnose prostate cancer is flawed, scientists revealed yesterday.

They warned that the prostate specific antigen ( PSA) test was ' all but useless' for predicting the risk of the disease becoming serious.

But doctors still use it to test for early signs of cancer, and the discovery of raised levels of the protein PSA can lead to men having radical surgery, sometimes leaving them incontinent or impotent.

A study by experts at Stanford University Medical School of Medicine in the U.S. suggests the test can no longer be relied upon to produce accurate results. The authors declared: 'The PSA era is over.' Experts increasingly believe the test leads to needless treatment such as radiotherapy, when men could be monitored and live with the cancer without it ever causing a problem. Researchers studied prostate tissues collected over 20 years, from the time it first became standard to remove prostates in response to high PSA levels to the present.

The team, led by Professor Thomas Stamey, said in the Journal of Urology that, as a screening test, the PSA indicated nothing more than the size of the prostate gland.

Professor Stamey added: 'Our study raises a very serious question of whether a man should even use the test for prostate cancer.' PSA screening has become more commonplace in the U.S. In the UK there is no screening programme, with men only having the test at their own request. But nonetheless thousands have opted for it on the NHS with the number rising.

Cancer experts here have voiced concerns that the test could not distinguish between cancers which were 'tigers' and those which were 'pussycats', leading many men into treatments they did not need. Professor Stamey said raised levels of the protein PSA reflected only a condition known as benign prostatic hyperplasia - a harmless increase in prostate size.

Prostate cancer was a disease all men developed if they lived long enough, so, given the chance to carry out a biopsy, doctors were likely to find it.

The Institute of Cancer Research in the UK advocates a system of 'active surveillance' whereby men with slightly raised PSA levels could be monitored for further increases which would warrant treatment.

The Department of Health said: 'We recognise the PSA test is not as accurate as some screening tests for other cancers, and is available on the NHS only by request if a man has been counselled on the risks and limitations.' Prostate cancer is the most common form of the disease to affect men in Britain, with 27,000 cases diagnosed each year and around 10,000 deaths.

r.yapp§dailymail.co.uk

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Vitamin D, NSAIDS provide double whammy against prostate cancer, Stanford study finds

STANFORD, Calif. - The growth of prostate cancer cells can be halted by combining a form of vitamin D, available only by prescription, with low doses of an over-the-counter painkiller, researchers at the Stanford University School of Medicine have found. The combination reduced prostate cancer cell growth in a laboratory dish by up to 70 percent, according to the findings, published in the Sept. 1 issue of Cancer Research.

The study's senior author, David Feldman, MD, professor of medicine, who has been studying vitamin D for 25 years, had shown in previous studies that a form of the vitamin, known as calcitriol, limits the growth of prostate cancer cells. Calcitriol, the active form of vitamin D, is the metabolite that is created in the body after consumption of vitamin D-containing food or exposure to the sun.

Feldman wanted to see if he could boost calcitriol's effects and lower the dose by using it in conjunction with another drug. He and his colleagues, including professor of urology Donna Peehl, PhD, who specializes in developing models of prostate cancer in cultured cells, found that by using calcitriol with nonsteroidal anti-inflammatory drugs, or NSAIDs, they could suppresses prostate cancer growth in vitro even more-and with smaller doses-than using either drug alone.

"There is great enhancement when the drugs are given together, using what we think is a safe dose in humans," said Feldman. "It's hard to make an exact comparison, as we are talking about cells in a dish and not a person." Still, based on the findings, he and his colleagues have already begun a clinical trial in men who have a post-treatment recurrence of prostate cancer. Both calcitriol and nonselective NSAIDs have been used in humans for years, and the safety and risks of these drugs are well known.

According to the Centers for Disease Control and Prevention, nearly 30,000 men die annually in the United States from prostate cancer. Among cancers, only lung cancer kills more men. Although prostate cancer is often a slow-growing, noninvasive type of cancer, there are some cases where a deadly migration of cancer cells invades other parts of the body. The standard treatment for such cases is hormone therapy, but that treatment ultimately does not work for most patients. Slowing the growth of the prostate cancer cells could buy time for patients before beginning this last-ditch therapy.

Over the course of Feldman's years of vitamin D research, he and others had determined that the vitamin has several actions that make it useful in cancer therapy. While a great deal is now known about these effects, there is still much to be learned about how the vitamin stymies tumor growth.

To get an idea of what calcitriol does on a genetic level to halt tumor growth, the researchers used a cDNA microarray, a tool that provides an overview of the genetic changes that occur when prostate cancer cells react to calcitriol. The researchers discovered that two of the affected genes are critical in the production and breakdown of prostaglandins - hormones that cause a range of physiological effects, including inflammation. Inflammation, in turn, is also associated with cancer growth.

Like calcitriol, NSAIDs also block prostaglandin production. Thus, it seemed logical to test calcitriol in various combinations with NSAIDs to see if the double whammy could knock out prostate cancer better than either drug alone, explained study leader Jacqueline Moreno, PhD, a postdoctoral scholar in Feldman's lab.

When the researchers began the study, which was done on cells in culture, they were using selective NSAIDs, such as Vioxx and Celebrex. These drugs specifically target the prostaglandin pathway, reducing the gastrointestinal side effects of the nonselective NSAIDs. But after Vioxx was pulled from the market last year due to cardiovascular risks, the researchers switched to using two nonselective NSAIDs, ibuprofen and naproxen, so that the controversy over selective NSAIDs wouldn't cast a shadow over their work.

The group saw a 25 percent reduction in prostate cell growth using only calcitriol, and approximately the same reduction using only ibuprofen and naproxen. But when they combined calcitriol and an NSAID, they saw up to a 70 percent reduction. This result was obtained using from one-half to one-tenth the concentration required for either of the drugs used alone.

The group's findings are the basis of a new clinical trial Feldman has begun with oncologist Sandy Srinivas, MD, assistant professor of medicine. Men who have been treated for prostate cancer, but who are experiencing a recurrence, take naproxen twice a day combined with a high, once-weekly dose of calcitriol. Weekly administration of calcitriol avoids a pitfall of earlier studies that used daily dosing: too much calcium in the blood, a condition called hypercalcemia, which can lead to kidney stones.

Feldman's group uses calcitriol for both the cell culture studies and the clinical trial to ensure that enough of the active form of vitamin D is in the patients to be effective. Feldman emphasized that calcitriol is available by prescription only. "We don't want the patient to think that if they take over-the-counter vitamin D, it will work in the same way," he said.

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Staff research scientist Aruna Krishnan, PhD, research associate Srilatha Swami, PhD, and urology postdoctoral scholar Larisa Nonn, PhD, also contributed to this work, which was funded by grants from the National Institutes of Health and the Department of Defense.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at mednews.stanford.edu.

PRINT MEDIA CONTACT: Mitzi Baker at (650) 725-2106 (mabaker @ stanford.edu)
BROADCAST MEDIA CONTACT: M.A. Malone at (650) 723-6912 (mamalone @ stanford.edu)

Men, in their youth and prime, are very active. Maintaining that level energy and vigor is of great concern to men of all ages. An overall nutritionally balanced diet plays an important part in a man’s readiness and ability to perform well, athletically and romantically. Better nutrition results in better performance, and nutritional deficiencies can often result in reduced endurance, fatigue, or inability to perform as well as you might have previously.

A well-balanced diet is essential for any active male. However, even with the most balanced food intake, strenuous exercise can often cause rapid use of nutrients; in these cases, supplements may be necessary to help improve performance.

It is vitally important to maintain adequate amounts of vitamins and antioxidants. B vitamins are important to decrease levels of homocysteine, which has been linked to heart attack and stroke. Antioxidants are important to combat the diseases of aging, to minimize oxidation of cholesterol (which can lead to heart attack) and to maintain proper immune function. The best product available for this purpose is Synergy 2000 from NSI. This superior blend of vitamins, minerals and antioxidants is designed to support overall health, and forms the base for a sound supplementation program. For example, if you were to start with Synergy 2000, the daily dose of selenium noted above would be included, and 15mg of the 45 mg of Zinc would be accounted for. Just add your extra zinc in the form of Natrol Optizinc, Pygeum and saw palmetto and you have a superior regimen for men.

Nutrient Facts and Recommendations:

Amino Acids, the components of protein, appear to act as performance enhancers. In specific, branched-chain amino acids (BCAAs) appear to help reduce muscle loss and speed muscle build-up. Most active males receive enough amino acids in their regular diet; however, BCAA supplements may be helpful for those doing intense training.

Antioxidants, such as Vitamin C and Vitamin E, are an important part of the body’s defense against muscle damage from exercise. Strenuous exercise increases the body’s production of free radicals, which, in turn, can cause muscle damage which manifests as swollen or painful muscles. While exercise increases the body’s natural defense against free radicals, active men who are doing intense training may benefit from the addition of antioxidant supplements to their diets. Antioxidants also may slow the rate of joint deterioration in osteoarthritis patients. Vitamin E in particular has been shown to reduce the symptoms of osteoarthritis, as well as reduces the risk of prostate cancer by 32%.

Carnitine appears to decrease muscle soreness.

The omega-3 fatty acid DHA, which is found in Fish Oil, works well as an anti-inflammatory in the treatment of arthritis.

A study looked at levels of DHEA in men over the age of 60. It was found that those with erectile dysfunction (ED) had lower levels of DHEA then in those without ED. Supplementation with DHEA at a dose of 50 mg daily improved symptoms of ED in a small group of patients with this disorder.

DMSO has anti-inflammatory properties when applied to the skin. It can help ease the pain of muscle injuries and arthritis pain.

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Green tea extract and its components such as epigallocatechin gallate have been shown in some studies to inhibit tumor cell growth. It may have benefit against metastasis.

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Horny Goat weed (Yin Yang Huo) is an herbal agent. It derived its name from the observation of when goats were grazing on this weed, they became sexually aroused. It has several uses in Traditional Chinese Medicine, including impotence, involuntary ejaculation, fatigue, cardiac disease polio and hepatitis. It contains a number of active constituents, and some of those appear to have both hormonal and blood vessel dilating properties. The usual recommended dosage is 0.5 to 1.5 mg per day of a formulation standardized to 5% icariin flavonoid. Animal studies have shown it to be basically safe. TCM manuals indicate some side effects including dizziness, nausea, dry mouth and nosebleed.

Iron is critical when exercising, as it is necessary for the body’s transferal of oxygen through the blood to muscles. Low iron levels can result in muscle soreness, fatigue, reduced endurance, and more injuries. If an iron deficiency is found, adding supplements to the diet will help increase performance ability.

L-Arginine: This amino acid is a precursor to nitric oxide (NO). High dose arginine (5 grams per day given for 6 weeks) has been shown to improve erection in men with ED. It is generally safe and well tolerated. Doses of 3 grams per day also seem to be beneficial. Arginine at doses of up to 3 grams three times daily has beneficial effects on cardiac blood vessel reactivity. It also may improve cardiac function in those with congestive heart failure. Therefore, it is much safer than Viagra for treating ED, especially in patients with a history of heart disease.

Lower fat diet, especially high in fruits and vegetables. Vegetables containing large amounts of Lycopene appear to be protective against prostate cancer and promote good general health.

Lycopene may offer significant benefit. Lycopene is found in high concentrations in tomato products, especially when processed. Men who ate at least 10 servings of tomato products per week were shown to have a 41% decrease in prostate cancer.

Magnesium is necessary for muscle contraction, heart rate regulation, and muscle growth. Strenuous exercise can rapidly deplete the body’s stores of magnesium; supplements are often helpful.

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Muira Pauma Root is a shrub native to Brazil, and has a long history of use as an aphrodisiac. It reportedly improves libido as well as potency. An unpublished study from France reports that a daily dose of 1 to 1.5 grams of the extract, 62% of patients with loss of libido had significant improvement while 51% of patients with ED felt that Muira pauma was of benefit.

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Selenium, 200 micrograms per day, has been shown to lower prostate cancer risk by 60 % in some studies. Higher doses should be used under a doctor’s supervision

Zinc is critical to prostate health, and adequate intake is essential for proper prostate health and immune system function.

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Statements contained herein have not been evaluated by the Food and Drug Administration, a Nazi type organization which would prefer to favor the greedy pharmaceutical companies. These products are not intended to diagnose, treat and cure or prevent disease. Always consult with your professional health care provider before changing any medication.