Soy Isoflavones & Recurrent Prostate Cancer

February 28, 2010 by Robert Wascher  
Filed under prostate cancer

 

Welcome to Weekly Health Update



“A critical weekly review of important new research findings for health-conscious readers” 


SOY ISOFLAVONES & RECURRENT PROSTATE CANCER

 

The interest level in natural and complementary treatments for cancer has never been higher in the medical and scientific communities than it is now.  For decades, now, this area of research was often relegated to the fringes of the clinical research community, while most mainstream academic research centers and Big Pharma companies focused on the design and testing of new biochemical therapies with improved therapeutic and safety profiles.  With the 5-year overall survival rate among all patients with cancer approaching a record 65 percent, we have, unquestionably, made enormous improvement in our ability to cure many of the cancers that, not too long ago, were associated with a very high risk of death.  Cancer physicians also have far more effective medications available now to control the noxious side effects of many of our “front-line” cancer therapies, which have had the beneficial effect of further reducing suffering and morbidity among thousands of cancer patients as they undergo their daily treatments. 

Despite the  admirable (and ongoing) progress that has been achieved over the past four decades in cancer care, however, nearly 600,000 cancer patients will still succumb to their disease this year in the United States, alone.  Thus, more effective cancer prevention strategies are necessary to reduce the number of new cases of cancer, and more effective (and less toxic) cancer therapies must be identified.  Moreover, with the annual cost of many new cancer therapies now running into the hundreds-of-thousands of dollars per patient, per year, our already unsustainable (and still rising) health care costs demand that the cancer care community rigorously evaluate less costly approaches to cancer prevention and treatment.

Because so-called “natural products” are relatively inexpensive, widely available, and generally non-toxic, there is a growing interest in studying these agents using the same high-level prospective, randomized clinical trials that are routinely used by pharmaceutical companies and academic medical centers to evaluate promising new drug therapies.  Because of their great complexity and high cost, however, randomized clinical trials are best reserved for studying novel therapies for which there is at least some laboratory (“preclinical”) or early-phase clinical data available that suggests some potential benefit to humans.  Until recently, however, and most likely due to inherent biases against natural products by the mainstream clinical research community in the past, very little high-level clinical research has been performed to definitively evaluate natural products as disease prevention and treatment agents.  Fortunately, and despite shrinking research funding over the past decade, there has been a recent surge in the number of large randomized, prospective, controlled clinical research trials reporting their findings of the effects of natural products on disease prevention and treatment.

As the vast majority of natural products and lifestyle-related research in the past has been based upon low-powered research methods, it should come as no surprise that recent high-level prospective clinical research studies have, more often than not, found little or no benefit associated with the use of many of these supplements and products.  (Moreover, in some cases, several very popular and highly recommended vitamins and dietary supplements have actually been found to be potentially harmful.)   However, a great deal of promising high-level clinical research has yet to be done in order to fully and accurately assess the, literally, hundreds of natural products for which there is at least some preclinical data supporting potentially beneficial health effects.  (In my forthcoming book, “A Cancer Prevention Guide for the Human Race,” I will be comprehensively reviewing and analyzing the available laboratory and clinical research data on natural products and lifestyle strategies as an integral approach to a cancer prevention lifestyle.  The publication of this groundbreaking and authoritative evidence-based cancer prevention guide is tentatively scheduled for May of this year.)

 

In many respects, prostate cancer is the male counterpart of breast cancer in women.  Analogous to breast cancer in women, prostate cancer is the most common cancer that occurs in men (excluding minor skin cancers), and the second most common cause of cancer death.  In 2009, an estimated 192,000 new cases of prostate cancer were diagnosed in the United States alone, and approximately 27,000 American men died of this disease in the same year.  In most industrialized nations, prostate cancer accounts for approximately 25 percent of all cancer diagnoses in men (similar to the percentage of breast cancer cases among all cancer cases diagnosed in women).

A newly published prospective, early-phase, clinical pilot study from Canada evaluated the effects of a soy beverage (“soy milk”) on the progression of recurrent prostate cancer in 29 men following radiation therapy for their cancers.  This study, which has just been published in the journal Nutrition and Cancer, was not a placebo-controlled randomized study, however, this small phase II clinical study prospectively followed these patient volunteers for 6 months, during which time serial measurements of the level of prostate-specific antigen (PSA) in their blood was performed (PSA is the primary prostate tumor marker that is measured both to detect early prostate cancer and to identify recurrences of this type of cancer.)

The time interval during which the level of PSA in the blood doubles is an important indicator of the rate of progression of recurrent prostate cancer.  In this small prospective clinical pilot study, the consumption of approximately 500 ml of soy beverage per day, for 6 months, was associated with an actual decline in PSA levels in 4 (14 percent) of these patient volunteers, while another 8 (28 percent) of these recurrent prostate cancer patients experienced a greater than 100 percent increase in their PSA doubling times.  However, another 5 patients (17 percent) experienced a 50 percent or greater decrease in their PSA doubling times during the 6 month duration of this study, which was an unfavorable development.  Thus, during the brief duration of this intriguing small pilot study, 42 percent of men with early recurrence of their prostate cancer experienced either a decrease in the biochemical extent of their recurrent cancers or a significant biochemical slowing of the progression of their recurrent disease.

Whether or not longer durations of soy intake will be able to sustain the impressive results of this study is not clear at this time.  More importantly, whether or not these observed favorable effects of daily soy intake on PSA levels and PSA doubling times will actually translate into prolonged survival (or not) is also unknown at this time.  It will require several larger and longer-term randomized, placebo-controlled, blinded, prospective clinical trials of soy foods and soy isoflavone supplements to answer these critical questions (several of which are already underway).  Meanwhile, the overall safety profile for moderate amounts of soy intake in men appears to be quite favorable, and so many prostate cancer experts are cautiously recommending soy-derived foods for men with prostate cancer, and for men who are at an increased risk of developing prostate cancer, pending the completion of these larger prostate cancer research studies.

For a much more detailed and comprehensive evaluation of the role of soy foods, and other dietary supplements and lifestyle modifications, in the prevention of prostate cancer (and other cancers), look for the publication of “A Cancer Prevention Guide for the Human Race” in the spring of this year.


I and the staff of Weekly Health Update would like to take this opportunity to thank the more than 100,000 new and returning readers who have visited our premier global health information website this month, alone.  As always, we enjoy receiving your feedback and questions, and I continue to try to personally answer as many of your inquiries as I possibly can.


In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti


Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author

For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg




 

Bookmark and Share


Post to Twitter

Testosterone Supplements in Frail Elderly Men

February 21, 2010 by Robert Wascher  
Filed under Uncategorized

 

Welcome to Weekly Health Update



  “A critical weekly review of important new research findings for health-conscious readers” 


 

TESTOSTERONE SUPPLEMENTS IN FRAIL ELDERLY MEN

 

As we age, we tend to lose both muscle mass and bone density.  These adverse effects of aging often lead to an increased risk of generalized weakness, early fatigue, imbalance and falls, bone fractures, long-term disability, and hospitalization or other forms of chronic institutionalization.  In turn, these complications of frailty in the elderly are significantly associated with an increased risk of death.

While an elixir of eternal youth has not yet been discovered (despite many claims to the contrary over the centuries), some of the causes of aging-related frailty can be treated.  Sex hormone replacement therapy in the elderly has been a major focus of clinical intervention, in both men and women, in an effort to reverse many of the debilitating effects of aging, including declines in muscle mass, bone density, and sexual function.  However, the true risks and benefits of sex hormone replacement therapy have not always been well understood.  Indeed, within the past decade, old assumptions about the safety of hormone replacement therapy have been called into question by high-level prospective, randomized, placebo-controlled, blinded clinical research trials, including the recent and disturbing (but not altogether surprising) findings that long-term combination hormone replacement therapy in postmenopausal women is associated with a significant increase in the risk of both breast cancer and cardiovascular disease.

Although aging men do not experience an abrupt and total loss of testicular function, unlike the complete loss of ovarian function that occurs in women following menopause, testicular function does dramatically and progressively decline with advancing age.  Significant decreases in the levels of testosterone (and other “androgens”) in the blood often leads to decreased muscle mass and bone density which, in turn, can result in reduced strength and balance, and an increased risk of falls and serious injuries. 

Testosterone replacement therapy has been shown to be effective in improving muscle mass and bone density (and sexual function) in older men with very low testosterone levels (hypogonadism).  However, the role of testosterone replacement therapy in men with borderline-low circulating levels of androgen hormones has been much less clear.   As with sex hormone replacement therapy in postmenopausal women, there are known side effects associated with male sex hormone replacement therapy.  These include enlargement of the prostate gland (benign prostatic hypertrophy, or BPH), liver disease (especially with oral testosterone supplements), fluid retention, decreased fertility, breast enlargement and pain (gynecomastia), and a potential increase in the risk of prostate cancer, among others.

A newly published research study, in the Journal of Clinical Endocrinology & Metabolism, evaluated 274 men who were 65 years of age or older, and who were determined, by validated clinical criteria, to be either “intermediate-frail” or “frail.”  All of these men were also confirmed to have “borderline-low” levels of testosterone in their blood. 

In this randomized, prospective, placebo-controlled, double-blind study (which is the “gold standard” method of performing clinical research), these older men were randomly assigned to receive either transdermal testosterone therapy (50 mg per day) or a placebo gel that appeared identical to the testosterone gel.  These treatments were continued for 6 months.  The researchers then assessed both groups of men in terms of their muscle strength, muscle mass, body fat, overall level of physical function, and self-reported quality-of-life.

At the end of 6 months, the men who had been secretly randomized to the testosterone gel group were found to have experienced significant improvements in both muscle mass and muscle strength, as well as a decrease in total body fat.  Overall physical function in the “intermediate-frail” and “frail” older men also significantly improved.  Finally, and not surprisingly, self-reported physical health and sexual health satisfaction scores were substantially improved among the men who, unknown to them at the time, had received the testosterone gel.

Thus, the findings of this prospective, randomized, controlled clinical research trial certainly suggest a potential role for transdermal testosterone supplementation in frail older men with borderline-low testosterone levels.  At the same time, continued follow-up of the men in this study who elected to continue receiving testosterone supplementation is indicated, as the rather short duration of this study (6 months) is not long enough to identify the long-term benefits and risks of androgen replacement therapy.

If you are an older man who is experiencing significant frailty and disability due to progressive muscle mass and bone density loss, and you have borderline-low or low testosterone levels, then you might wish to discuss the potential benefits of a monitored testosterone supplementation regimen with your physician, or with an Endocrinologist who specialize in male endocrinology (Andrology).

 

On a related topic, please also see my recent column on the use of Vitamin D to decrease the risk of falls and fractures in the elderly:

 

http://doctorwascher.com/Archives/10-11-09.htm 




In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:


http://www.redcross.org/

http://www.imcworldwide.org/haiti


Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author



For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg



 

Bookmark and Share


Post to Twitter

Pancreatic Cancer Risk, Sodas & Juice

February 14, 2010 by Robert Wascher  
Filed under Cancer

 

Welcome to Weekly Health Update




“A critical weekly review of important new research findings for health-conscious readers” 


PANCREATIC CANCER RISK, SODAS & JUICE 

Pancreatic cancer is one of the deadliest of all types of cancer.  Nearly 45,000 new cases of pancreatic cancer were diagnosed in 2009 in the United States, and more than 35,000 deaths due to this disease occurred during the same year.  At the time of diagnosis, the vast majority of patients with this terrible disease are already incurable, and overall, 5-year survival rates remain a dismal 5 percent at this time.  Even among the small minority of patients who are diagnosed with pancreas cancer at a relatively early stage, when the tumor is still confined to the pancreas, the 5-year survival rate is only in the 15 to 20 percent range.

The only possible hope for pancreatic cancer cure is very radical surgery, which is often followed by chemotherapy and radiation therapy.  For most patients with pancreatic cancer, however, surgery is not even an option due to the advanced stage of their cancer at the time of diagnosis.  Therefore, efforts to prevent pancreas cancer are critically important in decreasing the death rate from this aggressive and treatment-resistant type of cancer.

There are several known risk factors for pancreatic cancer.  These include smoking, obesity, diabetes, chronic pancreatitis (inflammation of the pancreas), and chronic liver disease.  Because of the known links between pancreatic cancer, diabetes and obesity, there is concern that regularly consuming foods that significantly elevate the level of glucose (sugar) in the blood may also increase the risk of developing pancreatic cancer.

A new large-scale prospective public health study, just published in the journal Cancer Epidemiology, Biomarkers & Prevention, adds further evidence that the regular consumption of sugar-rich foods may indeed increase the risk of developing this deadly type of cancer.  In this study, nearly 61,000 patient volunteers within the Singapore Chinese Health Study were followed for up to 14 years by researchers.  All of these volunteers were extensively surveyed regarding their consumption of juices, sugary sodas (“soft drinks”), and other dietary items.  Additionally, other lifestyle factors and environmental exposures linked to various types of cancer were assessed within this very large group of patients. 

Within 14 years of the beginning of this very large epidemiological study, 140 new cases of pancreatic cancer were diagnosed within this cohort of patient volunteers.  When the researchers analyzed all of their data, they discovered that the consumption of 2 or more sodas per week was associated with nearly twice the risk of developing pancreatic cancer when compared to not drinking any sodas at all (fortunately, there appeared to be no link between juice intake and pancreatic cancer risk). 

The findings of this study add further evidence to previous similar studies regarding the intake of so-called “high glycemic index” foods and pancreatic cancer risk.  As these same sugar-rich foods also directly contribute to the development of both diabetes and obesity, it is not surprising that scientists have begun to identify common biochemical pathways that link excessive calorie intake from sugar-rich foods with all three of these life-threatening diseases. 

I will be discussing the known risk factors (and evidence-based prevention strategies) for pancreatic cancer, and for many other cancers, in much greater detail in my new book, “A Cancer Prevention Guide for the Human Race,” which is due to be published in the spring of this year.  Meanwhile, if you currently drink sodas containing sucrose or fructose on a regular basis, you might want to seriously consider eliminating these soft drinks from your diet altogether. 



In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:


http://www.redcross.org/

http://www.imcworldwide.org/haiti


Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author



For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg


 

Bookmark and Share


Post to Twitter

Vitamin D, Cardiovascular Disease & Death

February 7, 2010 by Robert Wascher  
Filed under Uncategorized

Welcome to Weekly Health Update



  “A critical weekly review of important new research findings for health-conscious readers” 


VITAMIN D, CARDIOVASCULAR DISEASE & DEATH

 

There is mounting evidence that Vitamin D plays a much more complex role in maintaining health beyond its primary function in regulating calcium absorption.  Increasingly, research data suggests that this hormone-like vitamin may also play important roles in the prevention of cardiovascular disease and cancer, as well.  (A comprehensive update on Vitamin D’s cancer prevention properties will appear in my forthcoming book, “A Cancer Prevention Guide for the Human Race.”)

 

The vast majority of published research studies in disease prevention have relied upon low-level research methods, including surveys of patient volunteers and retrospective medical chart reviews.  More recently, however, high-quality prospective, randomized cardiovascular disease prevention and cancer prevention clinical research trials have been performed.  These high-level studies have the potential to significantly improve lifestyle-based approaches to preventing the diseases that, together, cause the majority of all premature deaths.   

 

A newly published prospective clinical research study, from the Chianti region of Italy, enrolled more than 1,000 adults, aged 65 years and older.  All patient volunteers were tested for the level of Vitamin D in their blood when they joined this study, and all of these older adults were then carefully followed for an average of nearly 7 years.  During the course of this study, 228 study participants died.  The researchers then compared the levels of Vitamin D in the blood of the participants who died during the study with those of the volunteers who survived.  (This study is published in the current issue of the European Journal of Clinical Nutrition.)

 

The findings of this prospective clinical study were striking.  The patient volunteers with the lowest levels of Vitamin D in their blood were more than 2 times as likely to die, from any cause, when compared with the patients who had the highest levels of Vitamin D in their blood.  The patients with the lowest Vitamin D levels were also nearly 3 times as likely to die from heart attacks, and other complications related to cardiovascular disease, when compared to the patients with high levels of Vitamin D in their blood.  These dramatic findings held up even after the researchers made statistical adjustments for differences in the age, gender, education level, exercise habits, and other health-related factors among these two groups of study participants. 

 

As we age, our bodies become less efficient in converting sunlight into Vitamin D, and multiple research studies have shown that the majority of older adults are deficient in Vitamin D.  A growing number of high-level clinical research studies, such as this Italian study, continue to suggest that Vitamin D deficiency is associated with an increased risk of cardiovascular disease, cancer, osteoporosis, bone fractures, and decreased muscle strength in older men and women.  Therefore, the importance of this vitamin-hormone in maintaining optimal health is becoming increasingly apparent.

 

 

 

For additional Weekly Health Update articles on Vitamin D, please click the following links:

 

http://doctorwascher.com/Archives/2-3-08

http://doctorwascher.com/Archives/10-11-09.htm

http://doctorwascher.com/Archives/11-8-09.html

http://doctorwascher.com/Archives/9-20-09.htm

http://doctorwascher.com/Archives/8-9-09.htm

http://doctorwascher.com/Archives/12-28-08.htm

http://doctorwascher.com/Archives/10-5-08.htm

http://doctorwascher.com/Archives/6-29-08.htm  


 

In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author



For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg


 

Bookmark and Share


Post to Twitter

Enter Google AdSense Code Here

Comments

Better Tag Cloud