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Raphael JE, Danagogo O. Pilot Study on the Locoregional Demographics of Prostate Cancer in River State, Nigeria. Niger Med J 2021; 62:340-345. [PMID: 38736520 PMCID: PMC11087682 DOI: 10.60787/nmj-62-6-65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background The aetiology of prostate cancer is a subject of intense research and has been attributed to several risk factors. Geographical variations have also been observed with high incidence in western countries and rising rates in developing countries. This study aims to evaluate the locoregional distribution of histologically confirmed prostate cancer patients and discuss the risk factors for the observed variations according to their Local Government Areas (LGA) in Rivers State. Methodology This is a descriptive retrospective study on patients with histologically confirmed prostate cancer from three hospitals that take urology referrals over 10years. The patient's hospital records were obtained, and records of their ages, permanent place of residence, prostate biopsy histopathology reports, and Gleason's scores were extracted. These data were collated and analyzed using SPSS version 20. Results There were 278 patients managed over a 10year period with a mean age of 68.39years+_10.06. Prostate cancer was the commonest in the 60-69year age group (37.1%), followed by the 70-79year range. The high-risk, poorly differentiated cancer (Gleason 8-10; ISUP 4,5) was the commonest, followed by the intermediate-risk cancers (Gleason 7; ISUP 2,3). Port Harcourt (41.0%) and ObiaAkpo (36.0%) Local Government Areas (LGAs) in Port Harcourt City had the highest frequencies of prostate cancer. There was no relationship between age and Gleason's score in the men. Conclusion Prostate cancer appears more common in the LGAs in Port Harcourt City compared to the semi-urban and rural LGAs in Rivers State. High-grade cancers are more frequent both in rural and urban LGA. High Gleason score cancers appear more frequently in the metropolitan Port Harcourt City than rural LGAs.
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Affiliation(s)
- John E. Raphael
- Urology Division, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Okigbeye Danagogo
- Urology Division, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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Yannitsos D, Murphy RA, Pollock P, Di Sebastiano KM. Facilitators and barriers to participation in lifestyle modification for men with prostate cancer: A scoping review. Eur J Cancer Care (Engl) 2019; 29:e13193. [PMID: 31797478 DOI: 10.1111/ecc.13193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/23/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Diet and physical activity changes have been shown to improve quality of life and health outcomes for prostate cancer (PC) survivors; however, few survivors make lifestyle changes. We aimed to identify PC-specific facilitators and barriers to dietary and physical activity changes and participation in survivorship-based lifestyle management programmes. METHODS A scoping review investigating facilitators and barriers of PC survivor's participation in lifestyle management programmes was conducted in June 2018. A total of 454 studies were identified, 45 studies were assessed in full, and 16 were included in the scoping review. RESULTS Barriers to lifestyle change included perceived lack of evidence for lifestyle guidelines, treatment side effects, perception of change as unnecessary, time pressure and age. Facilitators for lifestyle change included advice from health professionals, support systems (family and peer), diagnosis as a time for change, lifestyle as a coping strategy to manage side effects and improve well-being. CONCLUSIONS Health professionals, peers and family have a significant role in lifestyle management for PC survivors to facilitate engagement. Specific and clear messaging of the benefits of lifestyle management is warranted. Treatment-related side effects, time pressure, current health perception and age should be considered when developing lifestyle management programmes for PC survivors.
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Affiliation(s)
- Demetra Yannitsos
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Phil Pollock
- Prostate Cancer Supportive Care Clinic, Vancouver Prostate Centre, Vancouver General Hospital, Diamond Healthcare Centre, Vancouver, BC, Canada.,BC Cancer - Victoria, Victoria, BC, Canada
| | - Katie M Di Sebastiano
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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Stolley MR, Sheean P, Matthews L, Banerjee A, Visotcky A, Papanek P, Woodley L, Flynn KE. Exploring health behaviors, quality of life, and support needs in African-American prostate cancer survivors: a pilot study to support future interventions. Support Care Cancer 2019; 28:3135-3143. [PMID: 31705377 DOI: 10.1007/s00520-019-05092-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Prostate cancer incidence and mortality rates are highest among African-American men. Comorbidity burden and quality of life (QOL) challenges are also high. Many factors drive these differences; health behaviors are important modifiable contributors. Studies document positive results for lifestyle interventions targeting NHW prostate cancer survivors, but inclusion of African-Americans is limited. We conducted an exploratory mixed-methods study with AAPCS to inform the development of a culturally relevant lifestyle intervention. METHODS Twenty-two AAPCS completed questionnaires and a discussion group on dietary and physical activity patterns, QOL, and unmet needs related to lifestyle changes. RESULTS Seventy-five percent of the participants were overweight or obese, 82% had physical activity patterns considered insufficiently active and only 10% did resistance training at least twice weekly in accordance with current survivorship guidelines. Diets were high in saturated fat and sugar, low in fiber, fruit, and vegetable intake. PROMIS-29 scores indicated that AAPCS had worse physical functioning, pain interference, and sexual functioning, but less social isolation compared to the general population. Compared to other prostate cancer survivors, participants reported poorer status on all domains. Qualitative data highlighted barriers to healthy lifestyles including access, knowledge, and skills, as well as motivators including health benefits and building strength to feel more "manly." Participants shared high interest in programs to exercise, learn about affordable healthy eating, and bring survivors together to discuss survivorship issues. CONCLUSIONS Lifestyle interventions targeting AAPCS are warranted. To increase impact of these efforts, consideration of environmental, cultural, and survivor contexts will be key.
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Affiliation(s)
- Melinda R Stolley
- Cancer Center and Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Patricia Sheean
- School of Nursing, Loyola University Chicago, Maywood, IL, USA
| | - Lauren Matthews
- Cancer Center and Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Anjishnu Banerjee
- Institute of Health and Equity, Division of Biostatistics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Alexis Visotcky
- Institute of Health and Equity, Division of Biostatistics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Paula Papanek
- Department of Exercise Science, Marquette University, Milwaukee, WI, USA
| | - Liana Woodley
- Cancer Center and Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Kathryn E Flynn
- Cancer Center and Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
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Abstract
Prostate cancer is the second most frequent cancer diagnosis made in men and the fifth leading cause of death worldwide. Prostate cancer may be asymptomatic at the early stage and often has an indolent course that may require only active surveillance. Based on GLOBOCAN 2018 estimates, 1,276,106 new cases of prostate cancer were reported worldwide in 2018, with higher prevalence in the developed countries. Differences in the incidence rates worldwide reflect differences in the use of diagnostic testing. Prostate cancer incidence and mortality rates are strongly related to the age with the highest incidence being seen in elderly men (> 65 years of age). African-American men have the highest incidence rates and more aggressive type of prostate cancer compared to White men. There is no evidence yet on how to prevent prostate cancer; however, it is possible to lower the risk by limiting high-fat foods, increasing the intake of vegetables and fruits and performing more exercise. Screening is highly recommended at age 45 for men with familial history and African-American men. Up-to-date statistics on prostate cancer occurrence and outcomes along with a better understanding of the etiology and causative risk factors are essential for the primary prevention of this disease.
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Affiliation(s)
- Prashanth Rawla
- Hospitalist, Department of Internal Medicine, SOVAH Health, Martinsville, VA 24112, USA.
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Antwi SO, Steck SE, Zhang H, Stumm L, Zhang J, Hurley TG, Hebert JR. Plasma carotenoids and tocopherols in relation to prostate-specific antigen (PSA) levels among men with biochemical recurrence of prostate cancer. Cancer Epidemiol 2015; 39:752-62. [PMID: 26165176 DOI: 10.1016/j.canep.2015.06.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 06/26/2015] [Accepted: 06/28/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although men presenting with clinically localized prostate cancer (PrCA) often are treated with radical prostatectomy or radiation therapy with curative intent, about 25-40% develop biochemically recurrent PrCA within 5 years of treatment, which has no known cure. Studies suggest that carotenoid and tocopherol intake may be associated with PrCA risk and progression. We examined plasma carotenoid and tocopherol levels in relation to prostate-specific antigen (PSA) levels among men with PSA-defined biochemical recurrence of PrCA. METHODS Data analyzed were from a 6-month diet, physical activity and stress-reduction intervention trial conducted in South Carolina among biochemically recurrent PrCA patients (n=39). Plasma carotenoids and tocopherol levels were measured using high-performance liquid chromatography (HPLC). Linear regression was used to estimate least-square means comparing PSA levels of men with high versus low carotenoid/tocopherol levels, adjusting for covariates. RESULTS After adjusting for baseline PSA level, plasma cis-lutein/zeaxanthin level at 3 months was related inversely to PSA level at 3 months (P=0.0008), while α-tocopherol (P=0.01), β-cryptoxanthin (P=0.01), and all-trans-lycopene (P=0.004) levels at 3 months were related inversely to PSA levels at 6-months. Percent increase in α-tocopherol and trans-β-carotene levels from baseline to month 3 were associated with lower PSA levels at 3 and 6 months. Percent increase in β-cryptoxanthin, cis-lutein/zeaxanthin and all-trans-lycopene were associated with lower PSA levels at 6 months only. CONCLUSIONS Certain plasma carotenoids and tocopherols were related inversely to PSA levels at various timepoints, suggesting that greater intake of foods containing these micronutrients might be beneficial to men with PSA-defined PrCA recurrence.
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Affiliation(s)
- Samuel O Antwi
- Division of Epidemiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, United States
| | - Susan E Steck
- Epidemiology and Biostatistics Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States; Cancer Prevention and Control Program, Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States.
| | - Hongmei Zhang
- Epidemiology, Biostatistics, and Environmental Health, University of Memphis, 3825 Desoto Avenue, 224 Robison Hall, Memphis, TN 38152, United States
| | - Lareissa Stumm
- Epidemiology, James Madison University, 800 Madison Drive, Harrisonburg, VA 22807, United States
| | - Jiajia Zhang
- Epidemiology and Biostatistics Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States
| | - Thomas G Hurley
- Epidemiology and Biostatistics Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States; Cancer Prevention and Control Program, Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States
| | - James R Hebert
- Epidemiology and Biostatistics Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States; Cancer Prevention and Control Program, Arnold School of Public Health, 915 Greene St, Columbia, SC 29208, United States
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Coa KI, Smith KC, Klassen AC, Thorpe RJ, Caulfield LE. Exploring important influences on the healthfulness of prostate cancer survivors' diets. QUALITATIVE HEALTH RESEARCH 2015; 25:857-870. [PMID: 25857653 PMCID: PMC4643213 DOI: 10.1177/1049732315580108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A cancer diagnosis is often conceptualized as a teachable moment when individuals might be motivated to make lifestyle changes. Many prostate cancer survivors, however, do not adhere to dietary guidelines. In this article, we explore how cancer affected prostate cancer survivors' diets and identify important influences on diet. Twenty prostate cancer survivors completed three 24-hour dietary recalls and an in-depth dietary interview. We analyzed interviews using a constant comparison approach, and dietary recall data quantitatively to assess quality and qualitatively to identify food choice patterns. Most men reported not making dietary changes following their cancer diagnosis but did express an interest in healthy eating, primarily to facilitate weight loss. Men portrayed barriers to healthy eating that often outweighed their motivation to eat healthy. Public health programs should consider alternative ways of framing healthy eating programs for prostate cancer survivors that might be more effective than a cancer-specific focus.
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Affiliation(s)
- Kisha I Coa
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine C Smith
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ann C Klassen
- Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura E Caulfield
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Coa KI, Smith KC, Klassen AC, Caulfield LE, Helzlsouer K, Peairs K, Shockney L. Capitalizing on the "teachable moment" to promote healthy dietary changes among cancer survivors: the perspectives of health care providers. Support Care Cancer 2014; 23:679-86. [PMID: 25160494 DOI: 10.1007/s00520-014-2412-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/18/2014] [Indexed: 12/16/2022]
Abstract
PURPOSE Although cancer is often thought of as a teachable moment, many cancer survivors do not adhere to behavioral recommendations that might improve their health. This study explored health care providers' perspectives on the importance and feasibility of addressing behavior change, specifically healthy diet, with cancer survivors. METHODS In-depth interviews were conducted with 33 health care providers who care for posttreatment survivors of breast cancer, prostate cancer, and non-Hodgkin's lymphoma. Interviews were analyzed thematically. RESULTS Health care providers emphasized the strength of evidence linking diet/obesity to recurrence in their assessment of the importance of promoting dietary change among their survivor patients. Cancer specialists (e.g., oncologists, surgeons) generally brought up dietary change with patients if they considered the evidence to be strong. In contrast, primary care providers viewed health promotion as important for all patients and reported treating cancer survivor patients the same as others when it came to making dietary recommendations. There was a lack of consensus among providers on the best timing to bring up behavior change. Providers described specific subgroups of patients who they saw as more motivated to make behavior changes and patient barriers to making dietary changes. CONCLUSIONS Health care providers can play an important role in promoting healthy diet among cancer survivors. As the evidence base around diet and cancer recurrence/prognosis grows, it is important that this information is communicated to providers. Strategies such as incorporating behavior change messages into survivor care plans may help standardize recommendations to survivors.
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Affiliation(s)
- Kisha I Coa
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St., Baltimore, MD, 21205, USA,
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Green H, Steinnagel G, Morris C, Laakso EL. Health behaviour models and patient preferences regarding nutrition and physical activity after breast or prostate cancer diagnosis. Eur J Cancer Care (Engl) 2014; 23:640-52. [DOI: 10.1111/ecc.12190] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- H.J. Green
- Griffith Health Institute Behavioural Basis of Health Program & School of Applied Psychology; Griffith University; Gold Coast Queensland Australia
| | - G. Steinnagel
- Griffith Health Institute Behavioural Basis of Health Program & School of Applied Psychology; Griffith University; Gold Coast Queensland Australia
- City of Gothenburg; Gothenburg Sweden
| | - C. Morris
- Griffith Health Institute Behavioural Basis of Health Program & School of Applied Psychology; Griffith University; Gold Coast Queensland Australia
- School of Psychology; The University of Queensland; Brisbane Queensland Australia
| | - E.-L. Laakso
- Griffith Health Institute Centre for Musculoskeletal Research & School of Allied Health Sciences; Griffith University; Gold Coast Queensland Australia
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10
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Hébert JR, Hurley TG, Harmon BE, Heiney S, Hebert CJ, Steck SE. A diet, physical activity, and stress reduction intervention in men with rising prostate-specific antigen after treatment for prostate cancer. Cancer Epidemiol 2012; 36:e128-36. [PMID: 22018935 PMCID: PMC3267863 DOI: 10.1016/j.canep.2011.09.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 09/25/2011] [Accepted: 09/26/2011] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nearly 35% of men treated for prostate cancer (PrCA) will experience biochemically defined recurrence, noted by a rise in PSA, within 10 years of definitive therapy. Diet, physical activity, and stress reduction may affect tumor promotion and disease progression. METHODS A randomized trial of an intensive diet, physical activity, and meditation intervention was conducted in men with rising post-treatment PSA after definitive treatment for PrCA. Intention-to-treat methods were used to compare usual care to the intervention in 47 men with complete data. Signal detection methods were used to identify dietary factors associated with PSA change. RESULTS The intervention and control groups did not differ statistically on any demographic or disease-related factor. Although the intervention group experienced decreases of 39% in intakes of saturated fatty acid (SFA as percent of total calories) (p<0.0001) and 12% in total energy intake (218 kcal/day, p<0.05)], no difference in PSA change was observed by intervention status. Signal detection methods indicated that in men increasing their consumption of fruit, 56% experienced no rise in PSA (vs. 29% in men who did not increase their fruit intake). Among men who increased fruit and fiber intakes, PSA increased in 83% of participants who also increased saturated fatty acid intake (vs. 44% in participants who decreased or maintained saturated fatty acid intake). CONCLUSION Results are discussed in the context of conventional treatment strategies that were more aggressive when this study was being conducted in the mid-2000s. Positive health changes in a number of lifestyle parameters were observed with the intervention, and both increased fruit and reduced saturated fat intakes were associated with maintaining PSA levels in men with biochemically recurrent disease.
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Affiliation(s)
- James R Hébert
- South Carolina Statewide Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA.
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Prostate Cancer. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Su LJ, Arab L, Steck SE, Fontham ETH, Schroeder JC, Bensen JT, Mohler JL. Obesity and prostate cancer aggressiveness among African and Caucasian Americans in a population-based study. Cancer Epidemiol Biomarkers Prev 2011; 20:844-53. [PMID: 21467239 DOI: 10.1158/1055-9965.epi-10-0684] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study evaluated obesity and prostate cancer aggressiveness relationship in a population-based incident prostate cancer study. METHODS The North Carolina-Louisiana Prostate Cancer Project includes medical records data for classification of prostate cancer aggressiveness at diagnosis by using clinical criteria for 1,049 African American (AA) and 1,083 Caucasian American (CA) participants. An association between prostate cancer aggressiveness and obesity, measured using body mass indices (BMI) and waist-to-hip ratio (WHR), was assessed using ORs and 95% CIs adjusted for confounders. RESULTS A significantly positive association was found between prostate cancer aggressiveness and obesity. The ORs for high aggressive prostate cancer among prediagnosis obese and severely obese were 1.48 (95% CI = 1.02-2.16) and 1.98 (95% CI = 1.31-2.97), respectively, compared with normal weight research subjects. Race-stratified results suggested the association is stronger among CAs. Interaction model showed that normal weight AAs had more aggressive prostate cancer than normal weight CAs (OR = 2.69, 95% CI = 1.36-5.30); severe obesity was associated with aggressive disease in AAs (OR = 3.90, 95% CI = 1.97-7.75). WHR > 0.98 among all research subjects adjusted for race was significantly associated with high aggressive prostate cancer (OR = 1.42, 95% CI = 1.00-2.00) when compared with WHR < 0.90. The stratified result is less clear among AAs. CONCLUSIONS This study shows a positive association between obesity and aggressive prostate cancer. AAs have more aggressive prostate cancer in general than CAs even at normal weight. Therefore, the association between obesity and aggressiveness is not as evident in AAs as in CAs. IMPACT This study provides a unique opportunity to examine impact of race on obesity and high aggressive prostate cancer relationship.
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Affiliation(s)
- L Joseph Su
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana, USA.
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Mróz LW, Chapman GE, Oliffe JL, Bottorff JL. Prostate cancer, masculinity and food. Rationales for perceived diet change. Appetite 2010; 55:398-406. [DOI: 10.1016/j.appet.2010.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 06/25/2010] [Accepted: 07/20/2010] [Indexed: 10/19/2022]
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Mróz LW, Chapman GE, Oliffe JL, Bottorff JL. Men, food, and prostate cancer: gender influences on men's diets. Am J Mens Health 2010; 5:177-87. [PMID: 20798140 DOI: 10.1177/1557988310379152] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although healthy eating might enhance long-term survival, few men with prostate cancer make diet changes to advance their well-being. Men's typically poor diets and uninterest in self-health may impede nutrition interventions and diet change. Food choice behavior is complex involving many determinants, including gender, which can shape men's health practices, diets, and prostate cancer experiences. Developing men-centered prostate cancer nutrition interventions to engage men (and where appropriate their partners) in promoting healthy diets can afford health benefits. This article presents an overview and synthesis of current knowledge about men's food practices and provides an analysis of diet and diet change behaviors for men with prostate cancer. Masculinity and gender relations theory are discussed in the context of men's food practices, and suggestions for future applications to nutrition and prostate cancer research and diet interventions are made.
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Affiliation(s)
- Lawrence W Mróz
- Food, Nutrition, and Health, University of British Columbia, 2205 East Mall, Vancouver, British Columbia, Canada V6T 1Z4.
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Abstract
As one of the most prevalent cancers, prostate cancer has enormous public health significance and prevention strategies would attenuate its economic, emotional, physical and social impact. Until recently, however, we have had only modest information about risk factors for this disease, apart from the well-established characteristics of age, family history and place of birth. The large worldwide variation in the incidence of prostate cancer and the increased risk in migrants who move from low-risk to high-risk countries provide strong support for modifiable environmental factors, particularly diet, in its etiology. Thus, dietary agents have gained considerable attention as chemopreventive agents against prostate cancer. Dietary fat, red and processed meat, vitamin E, selenium, tomatoes, cruciforms and green tea have all been linked with the development and aggressiveness of prostate cancer, through a range of molecular mechanisms. The direction of future clinical trials lies in clarifying the effects of these agents and exploring the biological mechanisms responsible for the prevention of prostate cancer. However, owing to the short time period between diagnosis and treatment, conventional dietary intervention techniques are not always realistic. Until large randomized trials confirm the benefit of chemopreventive and dietary modifications, patients can be advised to pursue a diet and lifestyle that enhances overall health.
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van Renterghem K, Van Koeveringe G, Achten R, van Kerrebroeck P. A new algorithm in patients with elevated and/or rising prostate-specific antigen level, minor lower urinary tract symptoms, and negative multisite prostate biopsies. Int Urol Nephrol 2009; 42:29-38. [PMID: 19496018 PMCID: PMC2844972 DOI: 10.1007/s11255-009-9596-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 05/17/2009] [Indexed: 01/21/2023]
Abstract
Patients with elevated and/or rising prostate-specific antigen (PSA), minor lower urinary tract symptoms (LUTS), and no evidence for prostate cancer on (multiple) extended prostate biopsies are a regularly encountered problem in urological practice. Even now, patients are seen with no objective explanation of this persistent elevated and/or rising PSA. So far, many strategic proposals have been elaborated and published to deal with this specific population including the use of different PSA derivates; applying different biopsy schemes—strategies—biopsy target imaging; diagnostic use of prostate cancer genes; and many more. In this review, we propose a new algorithm in which an urodynamic evaluation should be included since bladder outlet obstruction (BOO) can be expected. Once BOO is confirmed, a transurethral resection of the prostate (TURP) can be offered to these patients. This procedure will result in subjective and biochemical improvement and allows extensive histological examination. Current literature was reviewed with regard to this specific population. This research was performed using the commercially available Medline online search tools and applying the following search terms: “diagnostic TURP”; “elevated PSA”; and “prostate biopsy”. Furthermore, subsequent reference search was executed on retrieved articles.
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Watters JL, Gail MH, Weinstein SJ, Virtamo J, Albanes D. Associations between alpha-tocopherol, beta-carotene, and retinol and prostate cancer survival. Cancer Res 2009; 69:3833-41. [PMID: 19383902 DOI: 10.1158/0008-5472.can-08-4640] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Previous studies suggest that carotenoids and tocopherols (vitamin E compounds) may be inversely associated with prostate cancer risk, yet little is known about how they affect prostate cancer progression and survival. We investigated whether serum alpha-tocopherol, beta-carotene, and retinol concentrations, or the alpha-tocopherol and beta-carotene trial supplementation, affected survival of men diagnosed with prostate cancer during the alpha-Tocopherol, beta-Carotene Cancer Prevention Study, a randomized, double-blind, placebo-controlled primary prevention trial testing the effects of beta-carotene and alpha-tocopherol supplements on cancer incidence in adult male smokers in southwestern Finland (n = 29,133). Prostate cancer survival was examined using the Kaplan-Meier method with deaths from other causes treated as censoring, and using Cox proportional hazards regression models with hazard ratios (HR) and 95% confidence intervals (CI) adjusted for family history of prostate cancer, age at randomization, benign prostatic hyperplasia, age and stage at diagnosis, height, body mass index, and serum cholesterol. As of April 2005, 1,891 men were diagnosed with prostate cancer and 395 died of their disease. Higher serum alpha-tocopherol at baseline was associated with improved prostate cancer survival (HR, 0.67; 95% CI, 0.45-1.00), especially among cases who had received the alpha-tocopherol intervention of the trial and who were in the highest quintile of alpha-tocopherol at baseline (HR, 0.51; 95% CI, 0.20-0.90) or at the 3-year follow-up measurement (HR, 0.26; 95% CI, 0.09-0.71). Serum beta-carotene, serum retinol, and supplemental beta-carotene had no apparent effects on survival. These findings suggest that higher alpha-tocopherol (and not beta-carotene or retinol) status increases overall prostate cancer survival. Further investigations, possibly including randomized studies, are needed to confirm this observation.
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Affiliation(s)
- Joanne L Watters
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch and Biostatistics Branch, National Cancer Institute, NIH, Bethesda, Maryland 20892, USA.
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Ma RWL, Chapman K. A systematic review of the effect of diet in prostate cancer prevention and treatment. J Hum Nutr Diet 2009; 22:187-99; quiz 200-2. [PMID: 19344379 DOI: 10.1111/j.1365-277x.2009.00946.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dietary therapy has been proposed as a cost effective and noninvasive means of reducing the risk of prostate cancer (PC) and its progression. There is a large volume of published studies describing the role of diet in the prevention and treatment of PC. This article systematically reviews the data for dietary-based therapy in the prevention of PC, as well as in the management of patients with PC, aiming to provide clarity surrounding the role of diet in preventing and treating PC. Although conclusive evidence is limited, the current data are indicative that a diet low in fat, high in vegetables and fruits, and avoiding high energy intake, excessive meat, excessive dairy products and calcium intake, is possibly effective in preventing PC. However, caution must be taken to ensure that members of the public do not take excessive amounts of dietary supplements because there may be adverse affects associated with their over consumption. The dietary recommendations for patients diagnosed with PC are similar to those aiming to reduce their risk of PC.
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Affiliation(s)
- R W-L Ma
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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Abstract
Prostate cancer prognosis may be improved by healthy behaviors; however, little is known regarding whether prostate cancer survivors make health behavior changes after diagnosis, and there are no data on racial/ethnic differences. This study explored patterns of and factors that influence healthy behavior changes in diet, physical activity, and dietary supplement use among whites and African Americans (n = 30) aged 45 to 70 years, approximately 1 year after diagnosis with localized prostate cancer. Data were collected by telephone using semistructured qualitative interviews. The mean participant age was 59.6 years, 77% had attended college, 87% were married, and 22% were retired. Most (58%) had improved their diet since diagnosis, defined as eating more fruits/vegetables and less fat. Although 77% reported regular use of at least 1 dietary supplement before diagnosis, several discontinued use after diagnosis. Sixty-seven percent exercised regularly before diagnosis, and most of these (75%) continued after diagnosis; however, time and health constraints were barriers. Physician recommendation and family support strongly influenced positive changes. Except for more postdiagnosis dietary improvements in African Americans, there were few racial differences in patterns/motives for behavior changes. Most respondents were motivated to maintain and/or adopt healthy behavioral changes after diagnosis. Nurses/physicians are encouraged to inform their prostate cancer patients about the benefits of healthy eating and regular exercise and about the absence of scientific evidence regarding the benefits/risks of most supplements, particularly herbal formulations.
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Affiliation(s)
- Jessie A Satia
- Departments of Nutrition and Epidemiology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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López Fontana CM, Recalde Rincón GM, Messina Lombino D, Uvilla Recupero AL, Pérez Elizalde RF, López Laur JD. El índice de masa corporal y la dieta afectan el desarrollo del cáncer de próstata. Actas Urol Esp 2009; 33:741-6. [DOI: 10.1016/s0210-4806(09)74225-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Changing patterns of CAM use among prostate cancer patients two years after diagnosis: Reasons for maintenance or discontinuation. Complement Ther Med 2008; 16:318-24. [DOI: 10.1016/j.ctim.2008.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2007] [Revised: 04/01/2008] [Accepted: 04/02/2008] [Indexed: 11/20/2022] Open
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Toles M, Demark-Wahnefried W. Nutrition and the cancer survivor: evidence to guide oncology nursing practice. Semin Oncol Nurs 2008; 24:171-9. [PMID: 18687263 DOI: 10.1016/j.soncn.2008.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To conduct a systematic review of scientific reports related to diet and cancer survivorship published since the 2006 American Cancer Society's Guide for Informed Choices on Nutrition and Physical Activity During and After Cancer Treatment and to integrate these findings into a consistent message that can be delivered by nurses in hopes of improving the health and well-being of cancer survivors. DATA SOURCES Journal articles. CONCLUSION Cancer survivors represent a growing population at high risk for recurrence and other co-morbidities. Evidence continues to accumulate regarding the importance of weight management and a healthful diet (plant-based, low saturated fat) in improving the overall health and promoting disease-free and overall survival in this population. IMPLICATIONS FOR NURSING PRACTICE Cancer survivors are eager for nutrition information and nurses are well-positioned to guide them regarding the importance of weight management and healthy food choices.
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Affiliation(s)
- Mark Toles
- Duke University School of Nursing, Durham, NC, USA
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Van Patten CL, de Boer JG, Tomlinson Guns ES. Diet and dietary supplement intervention trials for the prevention of prostate cancer recurrence: a review of the randomized controlled trial evidence. J Urol 2008; 180:2314-21; discussion 2721-2. [PMID: 18930254 DOI: 10.1016/j.juro.2008.08.078] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE We review the effect of diet and dietary supplement interventions on prostate cancer progression, recurrence and survival. MATERIALS AND METHODS A literature search was conducted in MEDLINE, EMBASE and CINAHL to identify diet and dietary supplement intervention studies in men with prostate cancer using prostate specific antigen or prostate specific antigen doubling time as a surrogate serum biomarker of prostate cancer recurrence and/or survival. RESULTS Of the 32 studies identified 9 (28%) were randomized controlled trials and the focus of this review. In these studies men had confirmed prostate cancer and elevated or increasing prostate specific antigen. Only 1 trial included men with metastatic disease. When body mass index was reported, men were overweight or obese. A significant decrease in prostate specific antigen was observed in some studies using a low fat vegan diet, soy beverage or lycopene supplement. While not often reported as an end point, a significant increase in prostate specific antigen doubling time was observed in a study on lycopene supplementation. In only 1 randomized controlled trial in men undergoing orchiectomy was a survival end point of fewer deaths with lycopene supplementation reported. CONCLUSIONS A limited number of randomized controlled trials were identified in which diet and dietary supplement interventions appeared to slow disease progression in men with prostate cancer, although results vary. Studies were limited by reliance on the surrogate biomarker prostate specific antigen, sample size and study duration. Well designed trials are warranted to expand knowledge, replicate findings and further assess the impact of diet and dietary supplement interventions on recurrence and treatment associated morbidities.
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Bibliography. Current world literature. Adrenal cortex. Curr Opin Endocrinol Diabetes Obes 2008; 15:284-299. [PMID: 18438178 DOI: 10.1097/med.0b013e3283040e80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Our understanding of the relationship between diet and prostate cancer is still developing. Currently, randomized, controlled trials are under way that will yield evidence on which to base recommendations regarding dietary regimens, functional foods, and supplement use. For now, data mostly derive from epidemiologic investigations with limited ability to demonstrate cause and effect, or from benchtop research that may have limited application to in vivo systems, especially in humans. Insufficient evidence currently exists to support the use of specific dietary supplements or functional food. Clinicians striving for best clinical practice should therefore encourage weight management because data consistently show that overweight and obesity are associated with progressive disease and increased overall mortality from prostate cancer and other diseases, especially cardiovascular disease.
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Affiliation(s)
- Wendy Demark-Wahnefried
- Division of Cancer Prevention and Population Sciences, MD Anderson Cancer Center, University of Texas, 1155 Pressler Street, CPB 3.3245, Houston, TX 77030, USA.
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Erratum. Curr Opin Urol 2007. [DOI: 10.1097/01.mou.0000275430.79601.d8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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