Heart Disease May Also Increase Prostate Cancer Risk

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New research strongly suggests that coronary artery disease may significantly increase prostate cancer risk.


 

HEART DISEASE MAY ALSO INCREASE PROSTATE CANCER RISK

As I discuss in my recent bestselling book, A Cancer Prevention Guide for the Human Race, many of the same lifestyle and dietary habits that increase our risk of developing cardiovascular disease (including coronary artery disease, heart attacks, peripheral vascular disease, and stroke) also increase our risk of developing certain types of cancer.  However, the data linking lifestyle and dietary factors with prostate cancer risk has, so far, been both weak and contradictory.  Now, a newly published study has found an apparent link between coronary artery disease and prostate cancer risk.  These findings appear in a new update of the ongoing REDUCE (REduction by DUtasteride of prostate Cancer Events) clinical trial, which I previously reported on in 2010 (), and these updated findings appear in the current online issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

Among the 6,390 men enrolled in this prospective, randomized prostate cancer prevention trial, 547 men were known to have coronary artery disease at the time that they entered into this research study.  Not surprisingly, this group of men with heart disease had a greater number of risk factors for cardiovascular disease when compared to the men without coronary artery disease, including obesity, high blood pressure (hypertension), diabetes, and elevated cholesterol.    What was surprising, however, is that over the 4 year course of this clinical study, the risk of prostate cancer in this group of men with coronary artery disease was significantly higher than what was observed among the men without heart disease.  Two years into the REDUCE study, the men with a history of coronary artery disease were 24 percent more likely to be diagnosed with prostate cancer when compared to the men with healthy hearts.  After four years of participation in this clinical study, the men with known coronary artery disease were 74 percent more likely to be diagnosed with prostate cancer!

While this particular research study was not designed to determine which risk factors for cardiovascular disease were specifically involved with prostate cancer risk, as I discuss in A Cancer Prevention Guide for the Human Race, both obesity and smoking have previously been linked to an increased risk of death due to prostate cancer, and these two lifestyle factors are also strongly linked to cardiovascular disease risk.

 

Prostate cancer is the second most common cause of death due to cancer (following lung cancer) in men, and is associated with nearly 35,000 deaths each year in the United States alone.  In many ways, prostate cancer is the male counterpart of breast cancer (which is also the second most common cause of cancer-associated death in women), although prostate cancer has yet to receive the same level of attention and research funding as has breast cancer.  In my view, we men have a lot to learn from our female counterparts about raising cancer awareness, and advocating for increased research funding, when it comes to prostate cancer. Therefore, I urge all men to explore opportunities to actively support prostate cancer awareness, and improved research funding, in their local communities.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


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, professor of surgery, cancer researcher, oncology consultant, and a widely published author


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

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  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.


 







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Avodart (Dutasteride) & Prostate Cancer Prevention

April 4, 2010 by  
Filed under Weekly Health Update

 

Welcome to Weekly Health Update



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


AVODART (DUTASTERIDE) & PROSTATE CANCER PREVENTION

 

Because most prostate cancers, like breast cancer, are fueled by sex hormones, the prevention of prostate cancer through the use of hormone-blocking medications is an attractive potential strategy.

Two medications, finasteride (Proscar) and dutasteride (Avodart), are FDA-approved to treat the benign enlargement of the prostate that commonly occurs with increasing age (also known as benign prostatic hypertrophy, or BPH).  Both of these medications have recently been evaluated in prospective, randomized, placebo-controlled clinical research trials as potential prostate cancer prevention agents.  Finasteride and dutasteride are 5-alpha-reductase inhibitors, and function by blocking the conversion of testosterone into dihydrotestosterone by this enzyme (dihydrotestosterone is the biologically active male sex hormone within the prostate gland).  Finasteride inhibits one of the two known forms of 5-alpha-reductase, while dutasteride (Avodart) inhibits both forms.

Finasteride (Proscar) has previously been evaluated in the Prostate Cancer Prevention Trial, which enrolled nearly 19,000 men (55 years of age and older) who were without any clinical evidence of prostate cancer at the time they entered the study.  These men were randomly assigned to receive either finasteride or an identical placebo pill, and the entire cohort of men was then followed for a period of 7 years.  After 7 years of follow-up, 18 percent of the men who had been secretly randomized to receive finasteride were diagnosed with prostate cancer, while 24 percent of the men who had received the placebo pill (unknown to them at the time) developed prostate cancer.  Thus, taking finasteride for 7 years was associated with a 25 percent reduction in the relative risk of prostate cancer during the relatively brief course of this clinical study.  However, a potentially significant downside was also observed in this study, as the men who received finasteride, and who still went on to develop prostate cancer, tended to have more aggressive tumors when compared to the men in the placebo group (37 percent versus 22 percent, respectively).  Moreover, and not surprisingly, since finasteride blocks the active metabolite of testosterone, sexual dysfunction and breast enlargement were more common among the men taking finasteride when compared to the men in the placebo group. 

Following the intriguing results with finasteride (Proscar) in the Prostate Cancer Prevention Trial, there has been a great deal of anticipation building for results of the recently completed dutasteride (Avodart) prostate cancer prevention trial.  Now, the results of this important cancer prevention study have just been published in the New England Journal of Medicine.  This prospective, randomized, blinded, placebo-controlled study lasted for 4 years, and included 6,729 men at high risk of developing prostate cancer.  These men, all of whom were between 50 and 75 years of age, were secretly randomized to receive either 0.5 mg of dutasteride (Avodart) per day or an identical placebo pill.  As part of this research study’s protocol, all of these men underwent needle biopsies of the prostate gland at 2 years and 4 years after entering the study.  By the end of the study, 20 percent of the men who had received dutasteride (Avodart) had developed prostate cancer, while 25 percent of the men in the placebo (control) group were diagnosed with prostate cancer.  Thus, there was an observed 25 percent decrease in the relative risk of prostate cancer among the group of men that was randomized to receive dutasteride (Avodart) for 4 years (and a 5 percent absolute reduction in prostate cancer risk with Avodart).  As was observed in the finasteride (Proscar) study, however, there was also a higher incidence of more aggressive (i.e., higher grade) tumors observed among the men who took dutasteride (Avodart) when compared to the men in the placebo group, although only a very small number of these high grade tumors were identified in either group of men.  Finally, and not surprisingly, the symptoms of benign prostatic hypertrophy (BPH), including difficulties in passing urine, were much improved among the men randomized to take dutasteride (Avodart).

Because it is still too soon to determine whether or not finasteride or dutasteride are able to significantly reduce the risk of death due to prostate cancer, there is no consensus at this time, among most prostate cancer experts, regarding the use of these hormone-blocking agents as prostate cancer prevention agents.  However, for men with significant prostate cancer risk factors, it may be prudent to consider the use of Proscar or Avodart.

 

To learn more about the potential role of 5-alpha-reductase inhibitors in cancer risk reduction, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the spring/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



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

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 nearly 120,000 new and returning readers who visited our premier global health information website last 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. 


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 those countries to assist the injured, the ill, and the homeless.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti

 


 

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