Prostate cancer treatment risk

What we all want, with any form of medical treatment and certainly with cancer, is the certainty that it will cure our condition. What we don’t look for is that it might cause us even further problems. This seems to be indicated in the treatment of prostate cancer, according to a study conducted at Johns Hopkins University School of Medicine and published in the journal ‘Cancer Research’.

Androgen deprivation therapy, which commonly used in the treatment of prostate cancer, may actually make cancer more likely to spread to other parts of the body. This sounds like scare mongering, but the logic behind it is certainly real. Because prostate tumour growth is generally stimulated by male sex hormones, androgen deprivation therapy, in which those hormones are suppressed, is often given to patients in order to slow down the tumour growth.

Earlier research has demonstrated that a protein called nestin tends to be produced by prostate cancer cells that have metastasized to other parts of the body. Nestin does not appear to be produced by cancer cells, however, in cases where the cancer has not spread. In this latest study, researchers experimented on androgen-dependent prostate cancer cells in the laboratory. When they cut off the cells’ access to androgens, the cells increased their production of nestin.

While this does suggest that nestin levels increased when prostate cancer cells are deprived of androgens and may encourage the cells to metastasise, the lead researcher, David Berman, warned that there is not yet enough evidence to advise the abandonment of androgen deprivation therapy as a treatment. The study, which was funded by the Evensen Family Foundation, the German Cancer Foundation, the National Cancer Institute and the National Institutes of Health will continue to be ongoing and I will report on any progress.

Alert – The placebo effect and antidepressants

Five centuries ago, the Swiss alchemist and physician Paracelsus (1493-1541) wrote: “You must know that the will is a powerful adjuvant of medicine.” In a nutshell that sums up the effect that placebos can have on our bodies: they can effect change without containing any active chemical ingredients that could medically make a difference to the state of our health, and yet they often can provoke therapeutic effects – both positively and negatively – when administered to patients.

Researchers now believe that belief in the placebo as being part of a curative treatment seems to stimulate the body’s own healing mechanism – if we believe it is doing us good, then it is. Our belief stimulates certain bio-chemical responses and reactions and increases our ability to initiate our own healing process.

The term placebo literally means “I shall please” and was used in mediaeval prayer in the context of the phrase Placebo Domino (“I shall please the Lord”). Much later, during the 18th century, the term was adopted by medicine and was used to imply preparations of no therapeutic value that were administered to patients as “decoy drugs.” Over time it became recognised as having an important role in the therapeutic treatment of patients and in more recent studies, the placebo effect was estimated at 60% of the overall therapeutic outcome. In a recent review of 39 studies regarding the effectiveness of antidepressant drugs, psychologist Guy Sapirstein concluded that 50 per cent of the therapeutic benefits came from the placebo effect, with a poor percentage of 27% attributed to drug intervention. Now an even more startling study by the FDA has revealed that the new generation of SSRI anti-depressant drugs are even less effective than Sapristein’s study showed.

I have a vested interest in the subject as I have been treated for depression since my teens and now 50 years on have tried many drugs, therapies and natural alternatives and finally discovered that I just have to learn to recognise it and live with it as for me nothing has proved effective over the long term and the side effects of antidepressants have seriously affected both my creativity and natural personality. Depression is a serious medical illness caused by imbalances in the brain chemicals that regulate mood. I am certainly not alone with my experience of depression as it affects one in six people at some time during their life, making them feel hopeless, worthless, unmotivated, even suicidal.

Doctors measure the severity of depression using the “Hamilton Rating Scale of Depression” (HRSD), a 17-21 item questionnaire. The answers to each question are given a score and a total score for the questionnaire of more than 18 indicates severe depression.

Mild depression is often treated with psychotherapy or cognitive-behavioural therapy to help people to change negative ways of thinking and behaving. For more severe depression, current treatment is usually a combination of psychotherapy and an antidepressant drug, which is used to normalize the brain chemicals that affect mood.

Antidepressants include “tricyclics,” “monoamine oxidases,” and “selective serotonin reuptake inhibitors” (SSRIs). SSRIs are the newest class of antidepressants and the FDA (Food and Drug Administration) in the USA has reported on both published and unpublished trials on SSRIs submitted to them during their licensing process. The findings have rocked the medical world as it has indicated that these drugs have only a marginal clinical benefit. On average, the SSRIs improved the HRSD score of patients by just 1.8 points more than the placebo. The most effective clinical rating for SSRI’s was for severely depressed patients and the FDA again reported that this reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants. I am not saying don’t take antidepressants, I have done so myself, but I am saying think before you go down the drug intervention route.

That ‘will’ that Paracelsus referred to that certainly has a powerful role to play, particularly in the area of whether we regard our treatment positively or negatively, regardless of what it contains. Positive or negative thinking seems to be a decisive risk factor for every treatment, perhaps even more important than medical intervention, so looking at our attitude to life could be the first place to start. Research clearly indicates that positive thinkers live on average 6 years longer than those who always respond negatively to life – it’s not about being a ‘Pollyanna’ and forever looking on the bright side but it is about taking those lemons life hands out and making some lemonade, or in my case lemon curd, rather than leaving them in the bowl to rot and decay.

Celebrate Sardines!

Although National Sardine Day falls on the 25th of November 2008, yes really, I thought I would encourage you to look ahead and plan for later in the year to celebrate this remarkable fish. The humble sardine isn’t something people usually rave about, but in terms of the health benefits per square inch they really are quite something. Whether you opt for the fresh fish, delicious grilled and stuffed with lemon, or the tinned variety in oil – not sauce – they are packed with inexpensive, high- yielding health benefits and nutritional value.

For such a small fish they can have a big impact as they contain substances that are proven to benefit your skin, joints, memory, and even boost your energy. Sardines are rich in omega 3 fatty acids — the crucial long chain variety you can only find in seafood, not vegetable matter high – and also have good levels of calcium and vitamin D.

Sardines also contain high levels of Coenzyme Q10 which is essential for so many important functions in the body. It is a supernutrient that’s great for heart health, energy, immune support, and healthy brain function. It is also an effective antioxidant and has been used for decades in Cancer treatment.

CoQ10 is also very important for cardiovascular health as it has many of the antioxidant properties of vitamin E. Inadequate levels of CoQ10 have been linked to heart attacks, strokes, high blood pressure, atherosclerosis and arrhythmias. In addition, CoQ10 is believed to lower blood pressure, prevent the oxidation of low density lipoprotein cholesterol (LDL), and help with irregular heartbeat. CoQ10 is also good for the teeth and gums, helping to fight oral infection.

Sardine sandwich anyone?

Lets hear it for nuts!

This is another natural food that can get a bad press. They are shunned because people – particularly those on a diet – believe that they are bad for you as they are high in natural fats and oils, but this is far from being the case. Raw, not processed or salted, nuts can help fight depression, heart disease and bad cholesterol. That last one may be a bit of a shock, but although it is true that nuts in general contain as much as 80 per cent fat, but there are good fats and bad ones. The type of fat found in nuts is unsaturated fat – specifically monounsaturated and polyunsaturated fat and both of these unsaturated fats are known for their ability to reduce low-density lipoprotein (LDL), also called “bad” cholesterol, when consumed in moderation.

A few months ago in the USA, a survey examined and reported on the diets of more than 31,000 Seventh Day Adventists – chosen for the similarity of their lifestyle choices – and it was found tha t those who ate nuts more than four times per week experienced 51% fewer heart attacks compared to those who ate nuts less than once per week.

If you want to stick to the most healthy nuts around, these are the top 5 to go for:

1 Pistachios can produce a 10 point drop in your triglycerides and a 16 point decline in your LDL (bad) cholesterol, according to the Journal of the American College of Nutrition.

2 Walnuts Contains omega 3s which may help ward off depression and heart attack, according to Harvard research. Maybe you should stuff those sardines with lemon and walnuts for extra benefit!

3 Brazil nuts contain selenium, a mineral linked to prostate cancer protection, according to scientists at the University of Arizona.

4 Pecans have the most antioxidants of any nut. Could help reduce the risk of cancer, heart disease and Alzheimer’s disease.

5 Hazelnuts a handful daily boosts HDL (good) cholesterol levels by 12 percent, according to a study in the European Journal of Clinical Nutrition.

Tape Measure Predictor

Identifying children most likely to have an early form of metabolic syndrome needs only a scale and a tape measure, researchers at the University of Verona in Italy have recently discovered during a long study of just under 1500 Italian children. Metabolic syndrome is the term they used to describe the combination of excess weight, hypertension, and high cholesterol and plasma glucose found in children and adolescents.

We know that childhood obesity is a growing problem, but if parents were to monitor the waist-to-height ratio of those aged 5-15 they could help prevent their child developing serious conditions later in life that are linked to obesity such as cardiovascular disease and risk of diabetes.

The significant figure is when a child has a waist-to-height ratio greater than 0.5 and may seem overweight, but not obese so that warning signals are not raised in time. Such children were found to have a 95% chance of meeting the criteria for metabolic syndrome. As with adults, having a high waist measurement is a red flag, although of course there are more high-tech tools available to assess the risk in such children.

The chief researcher, Dr. Maffeis, says that waist-to-height ratio is easier for parents to monitor and interpret before the stage of intervention may be required.

Warning on Osteoporosis drugs

As the woman who set up the Natural Progesterone Information Service many years ago to alert women to the benefits of progesterone for osteoporosis I used to talk to lots of women who were on drug medication for their condition. I, and others, were concerned about the long-term effects of these drugs and just how effective they actually were.

Now according to a report in the January 19 2008 issue of the British Medical Journal it appears that pharmaceutical companies exaggerate the benefits and downplay the risks of prescribing osteoporosis drugs for women whose bones appear to be slightly weakened. This condition (osteopenia) is not full blown osteoporosis but the pre-stage and this new report says that pharmaceutical companies are pushing doctors to prescribe osteoporosis drugs for this group of women.

The problem with this is that women with osteopenia have such a low risk of experiencing fractures that taking osteoporosis drugs would provide almost no benefit. The study co-author Dr. Pablo Alonso-Coello, a family physician at Hospital Sant-Pau in Barcelona, contends that four studies that found benefits to giving osteoporosis drugs to women with osteopenia exaggerated those benefits.

Statistics can be tricky things, but Dr. Alonso-Coello gives the following example:

** The absolute risk of a woman with osteoporosis having a fracture in a given year might be 10 percent so the effect of an osteoporosis drug is to lower that risk by half, so the absolute benefit is a 5 percent reduction.

** But in women with pre-osteoporosis (osteopenia), the risk of fracture is very low, say 1 percent a year, so if you lower that by half, you go down to 0.5 percent absolute reduction.

One study cited in Dr. Alonso-Coello’s paper claimed a 75% relative reduction in risk of fracture. The absolute risk reduction was 0.9 percent, which, from a statistical perspective, means that up to 270 women with pre-osteoporosis would have to take osteoporosis drugs for three years to avoid a single fracture. Risks of Taking Osteoporosis Drugs These drugs are not risk-free and the pioneering work of the late Dr John Lee alerted many women to the potential hazard to their health they were risking by taking them. Just this month, researchers at the University of British Columbia and McGill University issued a warning on a class of osteoporosis drugs (bisphosphonates) taken by millions of women around the world that can lead to bone necrosis, a painful and disfiguring condition. The U.S. Food and Drug Administration also issued an alert on bisphosphonates, including alendronate and risedronate, warning that these medications can cause severe bone pain.

Ginger up your diet

Ginger may be the single most important ingredient you can add to your diet for maximum health effectiveness. It has proven to be so valuable because it not only has antioxidant and cancer fighting properties, but a new study has also found that the ginger component gingerol exerts anti-inflammatory effects by mediating NF-KB, a protein complex that regulates your immune system’s response to infection.

Not only all that, but it may also prove to be useful for treating and preventing ovarian cancer, according to a new study just reported in the BMC Complementary and Alternative Medicine Journal. Chinese researchers tested the effect of ginger on cultivated ovarian tumour cell growth. Ovarian cancer is the most lethal gynaecological malignancy and is the fifth leading cause of cancer death among women. They found that ginger inhibited growth and modulated the secretion of angiogenic factors, which is a fundamental step in the transition of tumours from a dormant to a malignant state.

This is good news and ginger is only one of a number of foods that when found in good quantities in the diet are thought to thought to contribute to the decreased incidence of colon, gastrointestinal, prostate, breast and other cancers. The other cancer-fighting foods are garlic, soy, cumin, chillies and green tea so sounds like switching to cooking up some Asian food might be a healthy option.

Heart attack risk linked to bodys fat distribution

The link between heart attack risk and being overweight is well-established, but now it seems that it is not so much how much extra weight you are carrying, but where it is on the body that increases the risk factor. Two studies, one in the US at the Medical College of Wisconsin and another at Tel-Aviv University in Israel indicate if extra weight is all carried on the stomach and abdomen then you need to take action. In the two separate studies 20,000 subjects had their body mass index (BMI) compared to their waist measurement in relation to cardiovascular disease risk factors. The bigger the waist, the risk of high blood pressure, high cholesterol and high glucose levels were found to be significantly stronger than the link between those same factors and BMI.

The leader of the Israeli study, Dr David Tanne, pointed out that excessive abdominal fat also raises the risk of other factors associated with metabolic syndrome, such as type 2 diabetes. Their research also found that during a 23-year follow up period that those subjects with excessive abdominal fat were one and a half times more likely to suffer a stroke compared to subjects with the lowest abdominal fat.

What can you do?
Whether you can’t see your feet when looking down, or are just a little soft around the waist, it pays to take preventive action. Heart disease and stroke risk are not to be taken lightly and although regular exercise is certainly essential there is another factor that might help.

Canadian researchers reported in a study published last year in the Journal of Nutrition that having a higher intake of protein might help. Like the other researchers they were also measuring their subjects to assess waist-hip ratio (WHR). The result was that those with the highest waist-hip ratio, indicating excessive abdominal fat, were found to have the lowest intake of protein.

Why would protein have this effect?
A fatty acid called conjugated linoleic acid (CLA) might provide the answer. CLA is most abundant in protein-rich dietary sources such as meat and dairy products. It’s also available in supplement form, and studies have shown that CLA supplements may help reduce body fat mass, but as always take the simplest route first and look at your diet before taking supplements, and then only on the advice of your doctor.

Vitamin D reduces fall risk in older women

Australia is a country with no shortage of sunshine, but even there in the winter months there may not be enough to keep the body adequately supplied so you can imagine that the situation is even more pronounced in more northern climes. Sunshine is the main source of vitamin D, and one very specific element of that – Vitamin D2 – appeared to reduce the risk of falls, especially during the winter months. This is important news for women at high-risk, such as those with osteoporosis, and the simplest advice is to get as much natural sunlight as you possibly can, and make sure you have adequate amounts of calcium in your diet as that helps vitamin D to be best utilized by the body.

Approximately one-third of women over 65 fall each year, and if a woman has a vitamin D deficiency then she is at greater risk of fracture. Those women given a vitamin D2 and calcium supplement in a trial at the University of Western Australia had a 19% lower risk of falls compared with patients given calcium alone. The trial studied 300 women over the age of 70 living in Perth, Australia who had a history of falling in the previous year. Older people who fall frequently do tend to have more risk factors for falling, including greater degrees of disability and poorer levels of physical function, so supplementing with D2 is only one factor to be considered. Taking any one vitamin in isolation can cause problems so before you decide to supplement please talk first to a qualified nutritionist, or treat yourself to a couple of weeks in the sun during the darkest days of winter. If you can’t get away, then take advantage if every ray of sunshine you can find and get outdoors as often as possible.

The shocking news about drug company research

We hear frequently about how expensive it is to develop a new drug, and that is certainly true, though not the whole picture. A Canadian research project has found that US drug companies are spending almost twice as much on marketing and promoting their products than on research and development.

Toronto’s York University found that US drug companies spent $57.5 billion on promotional activities in 2004 but only $31.5 billion in the same year on pharmaceutical research and development. The findings were published this week in the journal ‘Public Library of Science Medicine’ and appear to confirm the public image of a marketing-driven industry, say the study authors.

However, Steve Morgan, Toronto’s University’s Centre for Health Services and Policy Research is not at all surprised. He is an expert on the economics of the pharmaceutical industry and says that it’s been known for a long time that although the pharmaceutical industry has always promoted itself as innovative and research-driven they do indeed spend more money on marketing than they do on research and development. However, he admits even he didn’t realize that the figure was as high as the researchers found it to be.

Nor sadly is this something new as in the late 1950s, then-Democratic US Senator Estes Kefauver launched a public review of the business dealings of the prescription drug industry through the U.S. Senate’s anti-trust and monopoly subcommittee. He accused the industry of predatory pricing, extravagant cost increases brought on by excessive marketing and selling new products that were no more effective than drugs already widely established on the market. The issue didn’t go away and was studied in depth again in the 1960s and 80s, but nothing since then until this report.

Unlike in the UK, in the United States, direct-to-consumer marketing of prescription drugs is allowed, and drug companies buy television, radio and print ads to promote products directly to the public. The US also sees drug companies spending more on advertising to doctors, so they aren’t caught off guard by patients demanding a certain type of prescription after having seen the drugs on television or elsewhere.

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