All About Propecia

Diets high in vegetables, fruits and soy might cut the risk of developing breast cancer by 30 percent, new research suggests.

In a study, Dr. Lesley M. Butler, of Colorado State University and colleagues, noticed a trend of “decreasing breast cancer risk with increasing intake of a vegetable-fruit-soy dietary pattern” in the 34,000 Chinese women studied.

Even though the researchers identified and analyzed dietary patterns among Chinese women from Singapore, Butler believes the findings are relevant for American women.

The diets “aren’t that different from patterns seen in US populations,” the lead investigator told Reuters Health.

“There’s usually a bad food pattern of meat and lots of starch and saturated fat. And then there’s the good pattern — a prudent pattern in our case — the vegetable-fruit-soy pattern,” she said.

For their study, reported in the American Journal of Clinical Nutrition, Butler and her colleagues used data collected between 1993 and 1995 from 63,257 men and women in the Singapore Chinese Health Study (SCHS).

The large health study used in-person interviews to gather information about diet, weight, education, smoking and exercise habits, and hormone use.

Previous research focusing on individual foods or nutrients has been inconsistent, the authors note.

The SCHS data, however, allowed Butler’s group to identify two dietary patterns: the meat-starch-saturated-fat based “meat-dim sum” pattern and the “vegetable-fruit-soy” pattern characterized by lots of cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, kale, cabbage, and bok choy.

Based on their self-reported intake of 165 foods, participants were assigned a score for the vegetable-fruit-soy and the meat-dim sum dietary patterns.

Butler’s group identified 34,028 women with no history of breast cancer in the data. All women were between the ages of 45 and 74. For the most part, they were thin, they exercised, had gone through menopause, and few smoked or used hormone replacement therapy.

By the end of 2005, 10 years after the enrollment interviews, 629 breast cancer cases had been identified in the Singapore Cancer Registry among study participants.

After analyzing the data, the study authors found that the greater the intake of vegetables, fruits and soy, the lower the breast cancer risk among post-menopausal women.

The researchers did not find an association between higher meat-dim sum consumption and increased breast cancer risk, as suggested in other studies. Butler cautioned, however, that Americans shouldn’t read too much into this finding because the discrepancy could be explained by the way meat is prepared.

Stir-fried meats don’t contain as many Heterocyclic Amines (HCAs) that result from cooking muscle meats at high temperatures. Researchers have identified 17 HCAs that may be associated with increased cancer risk. “The charred barbeque meat that we love contains a lot of these carcinogens,” Butler said.

Despite the cultural differences, Butler believes American women can learn from these study findings. “Eating a diverse diet that can be characterized as having a lot of fruits and vegetables, and possibly adding soy also, would be beneficial,” she said.

SOURCE: American Journal of Clinical Nutrition

National Institutes of Health (NIH) scientists investigating how prion diseases destroy the brain have observed a new form of the disease in mice that does not cause the sponge-like brain deterioration typically seen in prion diseases. Instead, it resembles a form of human Alzheimer’s disease, cerebral amyloid angiopathy, that damages brain arteries.

The study results, reported by NIH scientists at the National Institute of Allergy and Infectious Diseases (NIAID), are similar to findings from two newly reported human cases of the prion disease Gerstmann-Straussler-Scheinker syndrome (GSS). This finding represents a new mechanism of prion disease brain damage, according to study author Bruce Chesebro, M.D., chief of the Laboratory of Persistent Viral Diseases at NIAID’s Rocky Mountain Laboratories.

Prion diseases, also known as transmissible spongiform encephalopathies, primarily damage the brain. Prion diseases include mad cow disease or bovine spongiform encephalopathy in cattle; scrapie in sheep; sporadic Creutzfeldt-Jakob disease (CJD), variant CJD and GSS in humans; and chronic wasting disease in deer, elk and moose.

The role of a specific cell anchor for prion protein is at the crux of the NIAID study. Normal prion protein uses a specific molecule, glycophosphoinositol (GPI), to fasten to host cells in the brain and other organs. In their study, the NIAID scientists genetically removed the GPI anchor from study mice, preventing the prion protein from fastening to cells and thereby enabling it to diffuse freely in the fluid outside the cells.

The scientists then exposed those mice to infectious scrapie and observed them for up to 500 days to see if they became sick. The researchers documented signs typical of prion disease including weight loss, lack of grooming, gait abnormalities and inactivity. But when they examined the brain tissue, they did not observe the sponge-like holes in and around nerve cells typical of prion disease. Instead, the brains contained large accumulations of prion protein plaques trapped outside blood vessels in a disease process known as cerebral amyloid angiopathy, which damages arteries, veins and capillaries in the brain. In addition, the normal pathway by which fluid drains from the brain appeared to be blocked.

Their study, Dr. Chesebro says, indicates that prion diseases can be divided into two groups: those with plaques that destroy brain blood vessels and those without plaques that lead to the sponge-like damage to nerve cells. Dr. Chesebro says the presence or absence of the prion protein anchor appears to determine which form of disease develops.

The new mouse model used in the study and the two new human GSS cases, which also lack the usual prion protein cell anchor, are the first to show that in prion diseases, the plaque-associated damage to blood vessels can occur without the sponge-like damage to the brain. If scientists can find an inhibitor for the new form of prion disease, they might be able to use the same inhibitor to treat similar types of damage in Alzheimer’s disease, Dr. Chesebro says.
Scientists from the Veterinary Laboratories Agency in Scotland also participated in the study.

Scientists are making headway in finding ways to treat and detect stubborn forms of prostate cancer.

The new hope comes from three studies being presented this week at the annual Genitourinary Cancers Symposium in San Francisco.

“Genitourinary cancers include cancers of the prostate, kidney, bladder and testicles,” Dr. Nicholas J. Vogelzang, chairman and medical director of the developmental therapeutics committee at U.S. Oncology, explained at a Wednesday teleconference announcing the various findings. “The most common of these is prostate cancer, which is diagnosed in 192,000 men and claims 27,000 lives each year.”

The first study, led by Dr. Oliver Sartor of Tulane Cancer Center, New Orleans, found that a new investigational drug called cabazitaxel improved overall survival in men whose prostate cancer had progressed despite being treated with hormone therapy and docetaxel-containing chemotherapy.

Men receiving cabazitaxel plus mitoxantrone (a chemotherapy drug) lived 15.1 months compared to 12.7 months for patients who received mitoxantrone plus prednisone. This represents a 30 percent increase in survival, which may not seem long but is seen as significant for men with a poor prognosis.

“Advances in cancer therapy have always been incremental. We have only a few examples of massive improvements with one drug,” Vogelzang noted. “Three months is a major clinical advance.”

Other studies are looking at whether giving the drug earlier in the course of the cancer would improve survival even more.

“Until today, experimental agents have never been shown to have a survival advantage in this group of patients,” said Sartor, who is Piltz Professor for Cancer Research at Tulane. “This potentially represents a new therapy option for these patients who are very difficult to treat. We don’t know when this is going to the FDA [U.S. Food and Drug Administration] for approval, but we’re working very hard to prepare the submission.”

A second group of researchers reported that the PCA3 urine test, which measures levels of prostate cancer gene 3, can predict when a biopsy of the prostate gland will come out positive.

The PCA3 gene is overexpressed in men who have prostate cancer, but not in men with benign disease, raising the possibility that the finding may cut down on the number of unnecessary prostate biopsies.

According to study author Jack Groskopf, director of research and development in cancer diagnostics at Gen-Probe Inc., which makes the test, most prostate biopsies that are currently performed after elevated prostate-specific antigen (PSA) test results actually turn out to be negative for cancer.

“The ability of this test to predict biopsies positively could potentially be very helpful and may also may help us identify those more aggressive cancers, which we still do not have a great way to identify other than [with] repeat biopsies,” said Vogelzang.

The final prostate cancer study found that short-term hormone therapy — either before or during radiation therapy — could help men with intermediate-risk, early-stage prostate cancer live longer and live longer without a recurrence.

But the therapy did not seem to help men with low-risk, early-stage tumors.

Since that study was conducted, however, standard radiation doses to treat prostate cancer have become higher and more efficient, raising the question as to whether these results are applicable to modern-day procedures.

In addition, said study co-author Dr. Christopher Jones, a partner of Radiological Associates of Sacramento, Calif., “there are consequences from short-course hormone therapy such as hot flashes and impotence, and we don’t know the long-term effect on sexual function. We need to know if there’s a real benefit to the individual patient of adding hormones to radiation before adopting this as standard practice.”

A final study demonstrated that adding high-tech urine biomarker tests to regular cystoscopy was not cost-effective in detecting recurrences of bladder cancer. Adding the biomarker screen also increased the risk for false-positive results, the researchers found.

Cystoscopy involves looking at the inside of the bladder with a camera.

“This data suggest that cystoscopy alone remains the most cost-effective strategy,” said study author Dr. Jose Karam, a urologic oncology fellow at The University of Texas M.D. Anderson Cancer Center in Houston. “The addition of urine tests adds to the cost without detection of invasive disease, suggesting that we should be using these markers carefully and judiciously when surveying patients with bladder cancer.”

Both Vogelzang and Sartor disclosed numerous ties with pharmaceutical companies.

The Genitourinary Cancers Symposium is sponsored jointly by the American Society for Clinical Oncology, the American Society for Radiation Oncology and the Society of Urologic Oncology.

SOURCES: teleconference with Nicholas J. Vogelzang, M.D., chair and medical director, developmental therapeutics committee, U.S. Oncology; Oliver Sartor, M.D., Piltz Professor for Cancer Research, Tulane Cancer Center, New Orleans; Jack Groskopf, Ph.D., director of research and development in cancer diagnostics, Gen-Probe Inc., San Diego; Christopher Jones, M.D., partner, Radiological Associates of Sacramento; and Jose Karam, M.D., urologic oncology fellow, The University of Texas M. D. Anderson Cancer Center, Houston; study abstracts

Cholesterol-lowering statins significantly reduce prostate tumor inflammation, which may help lower the risk of disease progression, new study findings suggest.

Duke University Medical Center researchers found that the use of statins before prostate cancer surgery was associated with a 69 percent reduced likelihood of inflammation inside prostate tumors.

For the study, the researchers examined tissue samples of prostate tumors from 236 men undergoing prostate cancer surgery. The patients included 37 who took statins during the year prior to their surgery.

Overall, 82 percent of the men had inflammatory cells in their prostate tumors and about one-third had marked tumor inflammation. After they accounted for factors such as age, race and body-mass index (a measurement that is based on weight and height), the Duke team concluded that statin use was associated with reduced inflammation within tumors. They also determined that inflammation was more likely among older men with more advanced prostate cancer who’d waited a longer time between prostate biopsy and surgery.

The findings are published in the Feb. 22 online edition of the journal Cancer Epidemiology, Biomarkers & Prevention.

“Increasing evidence suggests that statins may reduce risk of prostate cancer progression, and some studies have even suggested that widespread statin use over the past 15 years has contributed to a decline in prostate cancer mortality,” lead author Dr. Lionel Banez, an assistant professor of surgery and urology, said in a Duke news release.

But that doesn’t mean that all prostate cancer patients should take statins, said study senior author Dr. Stephen Freedland, an associate professor of urology and pathology at the Duke Prostate Cancer Center.

“More studies have to be done before such a recommendation can be made. However, men taking statins for heart health may already be enjoying a beneficial side effect against prostate cancer,” Freedland said in the news release.

Testosterone deficiency in young male cancer survivors often causes low energy levels and reduced quality of life, and these patients may benefit from testosterone replacement therapy, a new study suggests.

About 15 percent of male cancer survivors experience testosterone deficiency, which is a late side effect of chemotherapy or radiation therapy.

In this study of 176 young male cancer survivors and 213 young men without cancer, English researchers looked at the association between testosterone levels, quality of life, self-esteem, fatigue and sexual function.

The young male cancer survivors reported reduced energy levels, impaired sexual function and a markedly reduced quality of life. These problems were most severe in those with testosterone deficiency.

However, the cancer survivors had no problems with self-esteem, sexual relationships or mental health.

“This is an important study demonstrating that low testosterone levels are common in male cancer survivors and associated with an impaired quality of life,” said lead investigator Dr. Richard Ross, of the University of Sheffield. “However, the relationship between testosterone levels and quality of life is complex and appears to depend on a threshold level rather than on a direct correlation. We now need interventional trials with testosterone to determine which young male cancer survivors will benefit from replacement therapy.”

Results are similar for men with prostate cancer whether they have open surgery or laparoscopic surgery, a new study has found.

Currently, open radical prostatectomy (ORP) is considered the standard treatment but the use of laparoscopic radical prostatectomy (LRP), with or without robotic assistance, is becoming more widespread.

In the new study, researchers at Memorial Sloan-Kettering Cancer Center in New York City compared ORP and LRP outcomes in nearly 6,000 men, age 66 or older, with localized prostate cancer.

After they adjusted for patient and tumor characteristics, the researchers found no differences in the rates of general medical/surgical complications, genital/urinary/bowel complications, or in use of postoperative radiation and/or androgen deprivation.

Patients in the LRP group had a 35 percent shorter hospital stay and a lower rate of bladder neck/urethral obstruction, the study authors noted.

“All men considering radical prostatectomy should be clearly informed about the differences between the two techniques and similarities in their expected outcomes, and make treatment decisions in collaboration with an experienced surgeon,” Dr. William T. Lowrance and colleagues wrote in their report, which is published in issue of the Journal of Urology.

A muscle cramp can occur during virtually any activity, even while sleeping.

The American Academy of Orthopaedic Surgeons says the slightest movement that shortens a muscle can make it contract forcibly and involuntarily, leading to a cramp.

Here are the academy’s suggestions for what to do when a muscle cramp strikes:
Immediately stop any activity or exercise that led to the cramp.
Gently stretch out the muscle, holding it in a gentle stretch until the cramp and pain subside.
Gently massage the muscle.
Apply heat if the muscle continues to be very tight or tense.
Apply cold if the muscle is tender or sore.

Any head injury should be taken seriously, but certain warning signs indicate that the injury needs immediate medical attention.

The American Academy of Family Physicians says a doctor’s evaluation is required if you notice the following:
Any symptom that begins to worsen, including sleepiness, nausea or a headache.
Nausea that doesn’t subside.
Behavioral changes, such as acting confused or irritable.
Enlarged eye pupils, or pupils that are a different size in each eye.
Difficulty talking or walking.
Any bloody or unusual discharge from the nose or ears.
Seizures or vomiting.
Weakness or numbness in the legs or arms.

A new treatment for overuse injury of the Achilles tendon doesn’t appear to be effective, a new study shows.

Researchers in the Netherlands concluded that platelet-rich plasma (PRP) injections are no better than placebo in reducing pain or improving a patient’s ability to be active.

The study included 54 patients, aged 18 to 70, with chronic Achilles tendinopathy. All the patients did eccentric exercises (stretching the Achilles tendon while contracting the calf muscle) and were randomly selected to receive either a PRP injection or saline injection. Both groups showed significant improvement in pain reduction and increased activity within 24 weeks after the start of the study.

“Among patients with chronic midportion Achilles tendinopathy treated with an eccentric exercise program, a PRP injection compared with a saline injection did not result in greater improvement in pain and activity. Therefore, we do not recommend this treatment for chronic midportion Achilles tendinopathy,” wrote Dr. Robert J. de Vos, of Erasmus University Medical Center in Rotterdam, and colleagues.

“These findings are important and clinically relevant as PRP is thought to be growing in popularity and recent reviews supported its use for chronic tendon disorders,” they added.

The study appears in the Jan. 13 issue of the Journal of the American Medical Association.

New research is giving scientists a greater understanding of how a brain becomes susceptible to depression and anxiety on a molecular level and why some people are resistant to antidepressants.

Scientists think two things — biological factors and stressful life events — cause the mental disorders. Antidepressants (such as Prozac) are available to treat them, often by increasing serotonin levels, but they don’t always work.

“Unfortunately, more than half of all depressed patients fail to respond to their first drug treatment,” senior study author Rene Hen, of Columbia University, said in a news release. “The reasons for this treatment resistance remain enigmatic. Elucidating the exact nature of both the factors predisposing to depression and the mechanisms underlying treatment resistance remains an important and unmet need.”

In the study, researchers used mice to investigate the way the brain deals with serotonin. The brain’s mechanism for handling serotonin appears to be related to levels of so-called “autoreceptors,” the study authors found. Mice with higher levels didn’t respond to treatment with antidepressants, but they did better when the levels went down, the study showed.

The research could lead to treatments to make people more responsive to antidepressants before they take them, Hen said.

The findings are published in the Jan. 14 issue of the journal Neuron.