Welcome to Weekly Health Update

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

VITAMIN D REDUCES RISK OF COGNITIVE DECLINE & DEMENTIA

Regular readers of this column are already well aware of the preventive effects of Vitamin D with respect to falls in the elderly, certain cancers, and cardiovascular disease.  (My new book, “A Cancer Prevention Guide for the Human Race,” which is scheduled to be published in August, 2010, contains an exciting and comprehensive update on the role of Vitamin D in cancer prevention.)  Now, a newly published research study, which appears in the current issue of the Archives of Internal Medicine, has linked low Vitamin D levels in the blood with an increased risk of cognitive decline and dementia in adults over the age of 65.

A total of 858 adults at or over the age of 65 participated in this prospective public health study, which was conducted over a period of 7 years.  All of these study volunteers underwent extensive evaluation of their cognitive function, using validated, standardized tests, when they entered into the study.  All patients also underwent testing of their blood for Vitamin D levels.  This extensive evaluation and testing was then repeated every 3 years during the course of this important clinical research study.

The results of this study indicated that patient volunteers with low Vitamin D levels in the blood (less than 25 nmol/liter), when compared with volunteers with normal blood levels of Vitamin D (75 nmol/liter, or higher), experienced significant declines in their intellectual function over the course of this study.  Indeed, the patient volunteers with decreased Vitamin D levels in their blood were as much as 60 percent more likely to experience progressive cognitive decline or dementia over the relatively brief duration of this study, when compared with the patients who had normal levels of Vitamin D in their blood! 

The results of this study are very similar to the findings of a similar study, which has just been published in the journal Neurology.  In this particular study, an inadequate level of Vitamin D in the blood of elderly men and women was associated with a significantly increased risk of cognitive decline and dementia from all causes, including Alzheimer’s disease and stroke.  Moreover, abnormalities of the brain, as detected by MRI scans, were also more commonly observed in patients who were deficient in Vitamin D.

Vitamin D deficiency is very common in older men and women.  An estimated 80 percent of people over the age of 65 have inadequate levels of Vitamin D in their blood, while as many as 45 percent of older men and women also have severe Vitamin D deficiency.

The results of these two studies strongly suggest that adequate levels of Vitamin D in the blood may be associated with a significantly reduced risk of aging-associated cognitive decline and dementia in older men and women, in addition to improving muscle strength, decreasing the risk of certain cancers, and decreasing the risk of cardiovascular disease. 

Not everyone should take large doses of Vitamin D, however, as the unmonitored use of this potent hormone-like vitamin can cause dangerous elevations in the level of calcium in the blood, as well as calcifications in the soft tissues of the body, kidney failure, pancreatitis, and gastrointestinal ulcers.  (Prior to starting Vitamin D supplements, you should certainly discuss the risks and benefits of Vitamin D supplementation with your physician.)

To learn more about the critical role of Vitamin D and the risk of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the August of this year. 

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

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

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 visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Welcome to Weekly Health Update

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

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

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 visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Welcome to Weekly Health Update

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

IRRITABLE BOWEL SYNDROME: CAUSE DISCOVERED?

Irritable bowel syndrome (IBS) is a poorly understood cluster of gastrointestinal (GI) tract symptoms that typically includes varying degrees of abdominal bloating and crampy pain, diarrhea, constipation, and the frequent discharge of mucus-like stools from the rectum.  At any one time, an estimated 10 to 20 percent of all Americans chronically experience one or more of these intestinal symptoms.  In most patients with IBS, these symptoms begin in childhood.  In the United States, and in most other Western countries, IBS is at least 3 times more common in women than in men although, interestingly, in Southeast Asia, men are 2 to 3 times more commonly afflicted with IBS.

Numerous theories about the cause(s) of IBS have been proposed, but none have been definitively proven to cause this common syndrome, thus far.  Because the precise cause(s) of IBS has not yet been determined, there is no specific medical test available to diagnose this condition.  Likewise, there is no specific treatment available for IBS, although fiber supplements and careful attention to dietary “triggers” are often helpful.  Moreover, as IBS is frequently associated with chronic depression and/or anxiety, the use of some types of antidepressant medications has also been associated with an improvement in IBS symptoms.

Among the numerous proposed causes of IBS, an excess of a powerful hormone and neurotransmitter, serotonin, within the GI tract has been the focus of considerable research, lately.  (Serotonin is also commonly known as 5-HT, which is an abbreviated form of serotonin’s chemical name.) 

Serotonin has been shown to have multiple functions within the human body.  Decreased serotonin levels in the brain have been associated with both depression and anxiety, which explains why the most commonly used antidepressant medications, the selective serotonin reuptake inhibitors (SSRIs), are used to treat both chronic depression and anxiety.  (Commonly prescribed SSRIs include Prozac, Paxil, Zoloft, Lexapro and Celexa, among others.)  Because more than 95 percent of the body’s serotonin is found in the GI tract, SSRI drugs also have a profound effect on GI tract function, in addition to their effects on brain serotonin levels.  Indeed, previous observations that certain SSRI antidepressant medications worsen cramping and diarrhea in patients with diarrhea-predominant IBS have at least suggested that serotonin in the GI tract may play an important role in this common form of IBS.

Another serotonin-related disease that is associated with severe abdominal cramping and diarrhea is carcinoid syndrome.  In this relatively rare condition, serotonin-secreting carcinoid tumors of the GI tract cause profuse, watery diarrhea in affected patients after these tumors spread to the liver.

Based upon these apparent clinical links between IBS and serotonin (and for diarrhea-predominant IBS, in particular), additional research into the metabolism of serotonin in the GI tract of IBS sufferers is sorely needed.  Fortunately, a newly published research study, which appears in the current issue of the journal Gastroenterology, sheds further light on the potential link between serotonin and at least some forms of IBS.

In this novel clinical research study, 98 children with chronic GI tract symptoms were evaluated.  Twelve of these children presented with chronic symptoms suggestive of IBS.  Endoscopic GI tract biopsies were performed on these 12 children, and the results of these biopsies were compared with similar biopsies performed on other age-matched children who were undergoing endoscopy for reasons other than IBS symptoms.

When compared with the biopsy results on the “control” children without IBS symptoms, the children with IBS symptoms were found to have significantly elevated levels of serotonin (5-HT) in the mucosal cells lining their GI tract.  At the same time, the children with IBS symptoms were also found to have lower levels of a protein that is responsible for removing serotonin from the GI tract (serotonin transporter protein, or SERT) when compared to the children without IBS symptoms.  Therefore, these two findings, in children with chronic IBS symptoms, further and strongly suggest that an excess of serotonin in the gut may be associated with classic IBS symptoms.

In view of the varying degrees of diarrhea and constipation (and other IBS-associated symptoms) observed among individual patients considered to have IBS, it is highly likely that this syndrome has more than just one cause.  However, the biopsy-proven excess of serotonin in the GI tracts of the 12 children in this study with chronic IBS symptoms is a powerful indication that the abnormal regulation and metabolism of GI tract serotonin likely plays an important (if not causative) role in many, if not most, cases of this chronic and very common GI affliction.  The data from this powerful little clinical study also supports the continued development and clinical testing of serotonin/5-HT blocking (antagonist) agents in patients with diarrhea-predominant IBS.

For additional information on IBS, please see my previous column on this topic:

Irritable Bowel Syndrome (IBS), Diet & Fiber

To learn more about the critical role of diet in the prevention of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year. 

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

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

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 visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Welcome to Weekly Health Update

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

SOY, CURCUMIN & PROSTATE CANCER RISK

Because chronic inflammation within the prostate gland is through to be an important risk factor for prostate cancer, anti-inflammatory dietary supplements and medications may be able to reduce the risk of prostate cancer by reducing inflammation.

Isoflavones from soy-based foods are known to act as a weak form of estrogen (the dominant female sex hormone).  Based upon this estrogen-like behavior, as well as potential anti-inflammatory properties, soy isoflavones are being studied as possible prevention and treatment agents for prostate cancer, and other types of cancer. 

Curcumin, which is present in the Indian curry spice turmeric, is also known to have potent anti-inflammatory properties, and has also been the subject of considerable cancer prevention and cancer treatment research.

A newly published prospective, randomized, blinded, placebo-controlled research study, published in the current issue of the journal Prostate, suggests that the combination of soy isoflavones and curcumin may have important potential prostate cancer prevention properties.

In the first part of this study, human prostate cancer cells were treated with a combination of soy isoflavones and curcumin.  Treatment of these human cancer cells with soy isoflavones and curcumin resulted in a significant reduction of prostate-specific antigen (PSA) production by these malignant cells (PSA is a marker of both prostate gland inflammation and prostate gland cancer).

As regular readers of this column are already aware, treatments performed in the laboratory that have beneficial effects on cancer cells, or on mice or rats, do not always have the same positive effects on living, breathing human beings.  Therefore, the findings of the second part of this study are of particular interest.  A total of 85 men with elevated PSA levels, but without prostate cancer (as confirmed by prostate biopsy), were enrolled in the second phase of this intriguing small study.  These 85 men were divided into two groups, and one group received daily supplements containing both soy isoflavones and curcumin, while the second (control) group of men received placebo (sugar) pills that were identical in appearance to the supplement pills (neither the 85 men, nor the nurses who dispensed the supplement pills and placebo pills, were aware of which pills each study volunteer was receiving until after the research study had been completed).

PSA blood levels were tested at the beginning of the clinical portion of this study, and once again 6 months later.  As was observed in the prostate cancer cells during the first part of this study, men with a PSA level of 10, or higher, experienced a significant reduction in their blood PSA levels 6 months after starting daily supplementation with soy isoflavones and curcumin.

Although this brief study cannot definitively confirm that soy isoflavone and curcumin supplements reduce the risk of prostate cancer, their ability to reduce elevated PSA levels in men with chronic prostate inflammation, but without evidence of prostate cancer, at least suggests a potential role in the prevention of prostate cancer (presumably through a reduction in prostate gland inflammation).

While there are multiple human research studies underway that are evaluating the effectiveness of soy isoflavones as cancer prevention agents, currently, there are no major human studies looking at the effects of curcumin on prostate cancer risk.  Based upon the findings of this small, interesting study of soy isoflavones and curcumin, which suggest a potential additive effect on PSA reduction when both of these dietary supplements are taken together, human research trials should be developed to look at the long-term impact, if any, of combined soy isoflavone and curcumin supplementation on prostate cancer risk.

For additional research information on soy isoflavones and curcumin in cancer prevention and cancer treatment, please review the following previous columns:

Soy Foods & Stomach Cancer Risk

Cruciferous Vegetables, Soy & Breast Cancer Risk

Soy Isoflavones & Recurrent Prostate Cancer

Soy Isoflavones Decrease Breast Cancer Recurrence Risk

Genistein (Soy Isoflavone) & Prostate Cancer

Diet, Soy & Breast Cancer Risk

Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

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  

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

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 visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Welcome to Weekly Health Update

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

GREEN TEA EPICATECHIN REDUCE HEART DAMAGE & CHF

Epicatechin is a member of a group of dietary antioxidants known as flavonoids.  Epicatechin is found in a variety of plant-based foods, but is particularly abundant in green tea and dark chocolate. 

Regular readers of this column are already familiar with previous research studies suggesting that green tea flavonoids, including epicatechin, have been linked to a potential decrease in the risk of cardiovascular disease and cancer, as well as decreased blood pressure in patients with high blood pressure (hypertension).  Now, an innovative new laboratory research study has suggested that daily epicatechin supplements may dramatically reduce heart damage, and the risk of congestive heart failure (CHF), following heart attacks (myocardial infarction).

In this study, which appears in the current issue of the Journal of the American College of Cardiology, laboratory rats underwent surgical blockage of their main coronary artery, which reproduces the acute blockage of human coronary arteries that cause heart attacks (myocardial infarctions).  In one group of rats, daily oral supplements of epicatechin (1 mg/kg per day) were started prior to tying off the rats’ coronary arteries, and were continued after coronary artery ligation.  In a second group of “control” rats, daily water supplements (without epicatechin) were started 10 days prior to coronary artery ligation.  Yet another “control group” of rats underwent “sham surgery,” wherein the chest wall was surgically opened (as with the other two groups of rats), but the coronary arteries were not tied off.  In this group of rats, daily epicatechin supplements were also started 10 days before their sham operations were performed.

When the hearts of these laboratory animals were evaluated 48 hours after their surgically induced heart attacks, the animals that had received daily epicatechin supplements (before and after coronary artery ligation) were found to have 52 percent less permanently damaged heart muscle (myocardial infarction) when compared to the animals that received only daily “placebo” water supplements.  Moreover, these “control” animals, that underwent coronary artery ligation but did not receive epicatechin supplements, were observed to develop signs of CHF, as was expected, following the surgical induction of a massive heart attack.  Amazingly, the animals that were pretreated with epicatechin prior to surgical ligation of the main coronary artery did not display evidence of CHF (these animals’ heart function did not significantly differ from that of the “sham surgery” rats that did not have their coronary arteries tied off)!

At 3 weeks after coronary artery ligation, the rats that had received epicatechin supplements, in addition to coronary artery ligation, had, on average, a 33 percent decrease in the extent of dead heart muscle (myocardial infarction) when compared to the “placebo control” animals that received only water supplements (but no epicatechin) before and after coronary artery ligation.  Once again, there was a significant incidence of CHF in the rats that received only water supplements, in addition to coronary artery ligation, 3 weeks after surgical induction of myocardial infarction, while the animals that received epicatechin supplements in addition to coronary artery ligation retained normal heart function (similar to what was observed in the “sham surgery” rats that did not have their coronary arteries ligated).

This is quite an amazing research study, as the protective effects of daily epicatechin supplementation following ligation of the main coronary artery in rats was profoundly significant, and essentially prevented the onset of CHF in these laboratory animals.  If epicatechin was to be shown to have similar “cardio-protective” effects in humans, then this would enormously increase the potential role of epicatechin, and other related green tea and dark chocolate flavonoids, in the prevention and treatment of coronary artery disease!Fortunately, there are several clinical research studies that are evaluating the potential cardio-protective effects of epicatechins, and other green tea and dark chocolate flavonoids, in patients with elevated cholesterol, diabetes, and other conditions that are associated with an increased risk of coronary artery disease and heart attack.  (At least one other study is also evaluating these same dietary flavonoids in patients who already have CHF.)

Meanwhile, green tea is well tolerated by most people, and if there are no preexisting medical illnesses that prevent you from drinking green tea, then a few cups or glasses of green tea a day may help to decrease your risk of heart attack and CHF.  (As always, however, I must remind readers that laboratory experiments with rats and mice often do not translate to human beings once the same treatments are evaluated in high-quality prospective, randomized, placebo-controlled clinical research trials with human volunteers.)

To learn more about the role of green tea, dark chocolate, epicatechin, and other dietary flavonoids in the prevention of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.

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

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

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

Welcome to Weekly Health Update

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

Diacylglycerols (also known as diglycerides) are dietary fatty acids that are found, in small concentrations, in many vegetable-based cooking oils, including canola and soybean oils.  However, triacylglycerols, known more commonly as triglycerides, make up the vast majority of the fat content in vegetable-based cooking oils.  Triglycerides, which are the most common sources of dietary fat, are rapidly absorbed by the body and are easily converted into body fat.  (High levels of triglycerides in the blood have also been linked to obesity and cardiovascular disease.) 

Compared with triglyceride fats, diglycerides are more rapidly metabolized in the human body, and are less prone to being deposited as body fat.  In laboratory studies, dietary supplementation with diglyceride oil has been shown to reduce the accumulation of body fat in rats, and to improve overall fat energy metabolism.

A newly published clinical research study, which appears in the current issue of the Journal of Nutrition, further suggests a potential role for diglyceride oils in the prevention and treatment of obesity in humans.

In this study, 26 overweight women with elevated blood triglyceride levels participated in a “crossover” study of diglyceride oil dietary supplementation.  In the first phase of this study, these women volunteers were secretly randomized to receive either diglyceride-enriched vegetable oil (Enova oil, 40 grams per day) or an oil blend containing standard sunflower, safflower and rapeseed oils (40 grams per day, in a 1:1:1 ratio) for 28 days.  After a 4-week break, these patient volunteers were then switched (or “crossed over”) to the opposite dietary oil group for an additional 28 days.

In this study, diglyceride oil supplementation did not appear to alter overall energy metabolism, nor did it reduce blood levels of triglycerides.  However, the daily intake of diglyceride-enriched cooking oil did, indeed, significantly decrease the accumulation of body fat in these overweight women during the course of this small, brief clinical research study.

While switching to diglyceride-enriched cooking oil, alone, is unlikely to prevent or completely eliminate obesity, this vegetable-based fat source may have an important role to play as part of a lifestyle- and diet-based approach to maintaining a healthy weight. 

Now for some bad news related to diglyceride-enriched cooking oils.  Kao Corporation, the manufacturer of Enova oil (also sold as Econa oil), has recently suspended the sales of this product due to concerns about high levels of potentially carcinogenic glycidol fatty acid esters in this and other diglyceride-enriched products.  (These same fatty acid esters are also present in other vegetable-based cooking oils, but at much lower concentrations.)  Hopefully, though, Kao Corporation, or another manufacturer, will find a way to reduce the concentration of glycidol fatty acid esters in diglyceride-enriched food products, and these products will then return to the marketplace.   

To learn more about the critical roles of diet and weight control in the prevention of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.

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

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

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

Welcome to Weekly Health Update

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

IMPORTANT NEW ADVANCE IN BREAST CANCER TREATMENT:

INTRAOPERATIVE RADIATION THERAPY

The surgical management of breast cancer has undergone several very important revolutions over the past 20 years.  When I began medical school, there was essentially only one treatment available to women newly diagnosed with breast cancer.  Irrespective of how small or how large the tumor, every woman was advised to undergo complete removal of her breast (mastectomy).  Likewise, a radical removal of the lymph nodes in the armpit area, on the same side as the breast cancer, was also considered mandatory back then, even if there were no clinically enlarged lymph nodes detected prior to surgery.

Thanks to a landmark prospective clinical research study, conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP) cancer study group, we know that radical mastectomy offers no improvement in breast cancer survival when compared to simply removing the breast tumor with a margin of normal surrounding breast tissue (partial mastectomy, also known as “lumpectomy”).  The NSABP B-04 study, which was initiated in 1971, has now reached an average duration of patient follow-up of nearly 30 years, and the compelling findings of this study have made it possible for hundreds of thousands of women with breast cancer to preserve their breasts.

More recently, the application of the sentinel lymph node (SLN) concept has enabled surgeons to locate the one, or a couple, of lymph nodes most likely to contain breast cancer cells.  By removing a very small number of SLNs, the complications associated with removal of the armpit (axillary) lymph nodes can be reduced by ten-fold when compared to removal of most of the lymph nodes in the axilla.  Since 60 to 65 percent of all breast cancer patients will not have their SLNs involved with breast cancer cells, the vast majority of these women are now able to avoid a complete axillary lymph node dissection, and its associated 30 to 35 percent incidence of complications, including chronic swelling of the arm (lymphedema), numbness or chronic discomfort the arm, and decreased shoulder mobility and strength.  (Unfortunately, at the present time, women with “positive” SLNs are still advised to have their remaining armpit lymph nodes surgically removed.)

For most women, “breast-conserving” surgery carries an additional price, though.  Radiation treatments are administered to the breast after all other treatment has been completed, as this has been shown to cut the risk of recurrence of cancer within the same breast in half.  For most patients, conventional “external beam” radiation therapy lasts approximately 5 weeks.  Although these treatments are given on an outpatient basis (Monday through Friday, typically), this somewhat prolonged duration of treatment is enough of an inconvenience to some breast cancer patients that they, ultimately, decide to undergo mastectomy instead of lumpectomy combined with radiation.

A number of techniques have been devised to speed up the process of radiation therapy for breast cancer patients.  These approved methods of accelerated breast irradiation include the use of more frequent treatment sessions, using a standard “external beam” radiation machine, as well as various forms of radiation treatments collectively referred to as brachytherapy.  Unlike external beam irradiation, where beams of radiation pass from a machine, and through space, before entering the breast from outside the body, brachytherapy techniques all involve placing a device inside the breast (within the lumpectomy cavity).  These catheter-based brachytherapy devices are then loaded with radioactive seeds that emit therapeutic radiation to the inside of the breast.  Based upon recent research data, brachytherapy appears to be just as effective as conventional external beam irradiation in reducing the risk of breast cancer local recurrence.  However, both brachytherapy and other forms of accelerated breast irradiation still require 1 to 2 weeks of treatment.

One potential alternative to standard accelerated breast irradiation methods has been the use of a one-time treatment of the lumpectomy cavity with radiation at the same time that the patient undergoes lumpectomy in the operating room.  Intraoperative radiation therapy has been utilized for other types of cancer, primarily within the abdomen, but its usefulness in treating breast cancer has been less clear.  Now, a newly published prospective, multi-institutional clinical study, just published in the journal Lancet, offers hope that a single application of radiation, administered while the patient is still under anesthesia at the time of her lumpectomy, might be able to replace the more cumbersome and time-consuming radiation therapy modalities currently in use.

This clinical trial was started in 2000, and enrolled 2232 women with newly diagnosed breast cancer.  Half of these women underwent conventional external beam radiation therapy, while the other half of these volunteers underwent a single episode of intraoperative radiation treatment at the time of their breast cancer surgery (it should be noted that 14 percent of the women who were randomized to receive intraoperative radiation therapy also subsequently received external beam irradiation as well).

After an average follow-up duration of 4 years, there was no significant difference in the incidence of local breast cancer recurrence between these two groups of women.  Moreover, the incidence of complications associated with radiation therapy was significantly lower in the group of patients who underwent a single intraoperative treatment with radiation when compared to the conventional external beam radiation therapy group.

While the 4-year follow-up of this group of breast cancer patients is too brief to definitively conclude that a single dose of intraoperative radiation provides equivalent long-term protection against local breast cancer recurrence when compared to external beam irradiation and brachytherapy, this study still offers the hope of yet another significant advancement in the treatment of breast cancer.  If intraoperative radiation therapy appears to be as effective as conventional breast irradiation after at least 10 years of patient follow-up, then I predict that eligible breast cancer patients will, someday, be routinely treated in this manner.  Ultimately, this approach to breast cancer treatment has the potential to significantly increase the efficiency and speed of patient care while simultaneously decreasing the overall cost of such care.  It will also improve the quality of the lives of millions of women, over time, and free them to move on with their lives more quickly after receiving the diagnosis of breast cancer.

To learn more about the prevention of breast cancer, and other cancers, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.

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

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

Welcome to Weekly Health Update

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

Welcome to Weekly Health Update

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

SOY & CURCUMIN REDUCE PROSTATE-SPECIFIC ANTIGEN (PSA)

Regular readers of this column are already aware that the regular consumption of foods containing soy isoflavones may be associated with a reduced risk of developing prostate cancer, and other types of cancer as well.  Curcumin, as curry lovers know, is contained within the spice known as turmeric.  Curcumin has been extensively studied, and it too may possess anti-cancer properties as well.  Both of these dietary compounds are thought to have potent anti-inflammatory effects on the prostate gland, and on other organs of the body.  Additionally, soy isoflavones also act weak estrogens (“phytoestrogens”), and may suppress prostate gland activity on this basis too.

Prostate cancers, as well as the normal prostate gland cells that give rise to prostate cancer, produce PSA (prostate-specific antigen), which allows doctors to detect new or recurrent prostate cancers by measuring the level of PSA in the blood.  A newly published research study, which appears in the current issue of the journal The Prostate, adds further evidence that soy isoflavones and curcumin may have an important role to play in prostate cancer prevention and, possibly, prostate cancer treatment.

This study consisted of both a laboratory experiment and a small clinical research trial with human volunteers.  In the laboratory portion of this study, human prostate cancer cells were treated with soy isoflavones and curcumin.  When these prostate cancer cells were treated with soy isoflavones and curcumin, the production of PSA by these cells was dramatically decreased.  Moreover, a receptor for male sex hormones, which prostate cancers use to fuel their growth, was significantly suppressed following treatment of these cells with soy isoflavones and curcumin.

In the clinical portion of this research study, men who had undergone prostate gland biopsies due to an elevated PSA blood level, but who were subsequently found not to have prostate cancer, were also evaluated.  In this prospective, randomized, placebo-controlled trial, 85 men without prostate cancer, but with elevated blood PSA levels, were divided into two groups.  The “experimental group” of men received curcumin and soy isoflavones once per day.  The “control group” of men received a placebo (“sugar pill”) once per day.  Neither group of male volunteers, nor the research assistants who dispensed these pills, knew which men received the placebo pills and which received the soy isoflavone and curcumin pills.

PSA levels were tested in all of these male volunteers at the beginning of the study, and 6 months later.  Among the men randomized to receive daily supplements of soy isoflavones and curcumin, the level of PSA in their blood dramatically declined following 6 months of supplementation with soy isoflavones and curcumin. 

While the results of this small and elegant research study do not prove that soy isoflavones and curcumin can actually prevent prostate cancer in humans, these results do suggest, at least, a biological mechanism whereby these dietary compounds might reduce the risk of developing prostate cancer, and might also have anti-cancer effects in patients with prostate cancer.  However, only large-sale prospective, randomized, blinded, placebo-controlled human clinical trials will be able to prove that these dietary compounds can actually prevent or effectively treat prostate cancer.

At this time, there are multiple ongoing and recently completed prostate cancer prevention and treatment clinical research trials using soy isoflavone supplements.  The results of several of these studies will, hopefully, become available within the next 3 to 5 years. 

While there are multiple cancer prevention and cancer treatment research trials underway that are evaluating curcumin, none of these ongoing curcumin clinical trials are focused on prostate cancer, unfortunately. 

Based upon the findings of this small and innovative research study of soy isoflavones and curcumin, the next logical step would be a large prospective, randomized, placebo-controlled, blinded study that randomizes patient volunteers to placebo, versus soy isoflavones only, versus curcumin only, versus a combination of soy isoflavones and curcumin.  A cancer prevention study could look at prostate cancer incidence in men who are already at high risk of developing this common form of cancer.  A prostate cancer treatment study, using the same methods, could assess the clinical impact of soy isoflavones and curcumin on the progression or recurrence of prostate cancer in men who have already been diagnosed with this form of cancer.

To learn more about the role of soy isoflavones and curcumin as potential cancer prevention nutrients, look for the publication of my new landmark evidence-based book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.

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

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

Welcome to Weekly Health Update

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

COFFEE & THE RISK OF DEATH FROM HEART DISEASE & CANCER

Last month, I reviewed research showing that increased coffee consumption was associated with a decrease in inflammation and an increase in HDL cholesterol (the “good cholesterol”).  However, as I noted in that column, this small study did not address any long-term health outcomes of frequent coffee consumption (Coffee Improves HDL Cholesterol Levels).  Now, a newly published prospective public health study, from Japan, suggests that regular coffee consumption may, indeed, have long-term health benefits (at least for half of the population…).  (I should also note that, as a disclaimer, I am not a coffee drinker, despite reviewing two coffee-related health research studies in as many months!)

The results of this large Japanese research study appear in the current issue of the Journal of Nutrition.  In this prospective epidemiological study, 18,287 men and 19,455 women (between the ages of 40 and 64 years) were prospectively included in the Miyagi Cohort Study, which began in 1990.  All of these study volunteers were without any clinical history of cancer, heart disease, or stroke when they entered into the Study.  After an average of more than 10 years of follow-up, 2,454 of the volunteers died from various causes, including 426 cases of fatal cardiovascular disease and 724 fatal cases of cancer. 

These volunteers were categorized and analyzed according to their self-reported daily consumption of coffee: “never-drinkers,” “occasional-drinkers,” 1 to 2 cups per day, and 3 or more cups per day.  Other known risk factors for cardiovascular disease (including heart disease and stroke) and cancer were also factored into the analysis of the risk of death associated with coffee consumption for each volunteer.

Among the women in this study, increasing levels of daily coffee consumption were associated a decreasing risk of death, due to any cause.  (This “dose-dependent” relationship between daily coffee consumption and risk of death strongly suggests a direct clinical relationship between increased coffee consumption and a decreased risk of death.)  When compared to the women who did not drink coffee at all, the women who drank 3 or more cups of java per day were 25 percent less likely to die, from any cause, during this decade-long public health study.  The coffee-associated reduction in the risk of death from cardiovascular disease was even more powerful (and also appeared to be “dose-dependent”), as the women who downed 3 or more cups of coffee per day experienced a whopping 55 percent decrease in the risk of death due to cardiovascular causes!  Finally, there was an apparent modest decrease in the risk of dying from colorectal cancer among the female coffee drinkers, but no other reduction in the risk of dying from cancer was observed in association with regular coffee consumption among these women volunteers.

Well, I have just shared with you the good news regarding reduced death rates associated with regular coffee consumption from this large, prospective, long-term public health study; and many of you will notice that I have not yet mentioned the health impact of coffee on men!   This is because, unfortunately, this study did not identify any apparent beneficial health effects of regular coffee consumption in men.  The reason, or reasons, for this gender-related disparity is not clear, although it is well known that there are major differences in both the incidence of cardiovascular disease between men and women, and differences in the way that cardiovascular diseases (and heart disease, in particular) manifest themselves in women versus men.  It is, therefore, possible, that cardiovascular disease factors that are more unique to women are directly impacted upon by regular coffee consumption.  (At least no adverse effects of regular coffee consumption on male mortality were observed in this large public health study!)

So, ladies, keep the favorable results of this clinical research study in mind whenever you order that next cuppa Joe!

To learn more about the role of coffee, and other sources of dietary tannins, as potential cancer prevention nutrients, look for the publication of my new landmark evidence-based book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.

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

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