Vegetable Fat Slashes Prostate Cancer Deaths

prostate cancerThe link between cancer and diet has been extensively studied, It is known for example that being overweight is related to as many as one in five cancer-related deaths. Weight is most closely connected with cancers of the breast and uterus in postmenopausal women. Other cancers associated with obesity include:

              • Esophagus
              • Pancreas
              • Colon and rectum
              • Kidney
              • Thyroid
              • Gallbladder

But less is known about the association between diet and prostate cancer.  The three well-established risk factors for prostate cancer: are race (specifically, African American race), family history, and age. Unfortunately, these are three things we cannot change. So given this reality, there is much interest in identifying modifiable risk factors for prostate cancer, not least among the roughly 2.5 million men in the United States currently live with prostate cancer.

Now, a new study might provide some hope. It showed that replacing carbohydrates and animal fat with vegetable fat may be associated with a lower risk of death in men with non-metastatic prostate cancer.

olive-oil-walnuts-healthy-fatsErin Richman, a postdoctoral scholar at the University of California, San Francisco, and colleagues at UCSF examined fat intake after a diagnosis of prostate cancer in relation to lethal prostate cancer and all-cause mortality in 4,577 men diagnosed with non-metastatic prostate cancer. Their findings have just been published in Online First by JAMA Internal Medicine.

Between 1986 and 2010, the researchers noted 315 lethal prostate cancer events and 1,064 deaths during a median follow-up of 8.4 years. They also discovered that replacing 10% of calories from carbohydrates with vegetable fat, such as oil or nuts, was associated with a 29% lower risk of lethal prostate cancer and a 26% lower risk of death from all-cause mortality.

Overall, the findings suggest that men with prostate cancer should be advised to follow a heart-healthy diet in which carbohydrate calories are replaced with unsaturated oils and nuts to reduce the risk of all-cause mortality.

And although the exact reason for the reduction in mortality is unknown, the authors conclude; “the potential benefit of vegetable fat consumption for prostate cancer-specific outcomes merits further research.”

SRxA’s Word on Health agrees.

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Ho Ho Ho: health hazards for Santa

santa_claus obesityAfter weeks of harried holiday shopping, when the stores finally close on the evening of December 24, it will be a welcome reprieve from the madness. Families and friends gather together and enjoy a relaxing day or two of rest.

But for one man, the real work is just beginning. That’s right – Santa Claus is coming to town!

And while he spends most of the year enjoying a flexible work schedule, monitoring naughty-and-nice behaviors around the world and occasionally checking in on his elves and reindeer, things are about to get frantic for Old Nick.

And to be honest, this year we’re a little concerned about his health.  That belly fat!  The all-nighter he’s about to pull!  All those cookies!

He may know when you are sleeping, but the only way for Santa to get the job done is to stay up all night on December – and that can lead to some serious health concerns.
Studies have suggested that drowsy driving is as dangerous as drunk driving.  Even if he manages to get Rudolf and his friends safely parked on the rooftops, sleep deprivation could cause his judgment to become fuzzier, leading to the wrong presents traveling down the wrong chimneys.
What’s worse is that sleep loss has a cumulative effect. So while people in the Southern hemisphere might do OK, those of us in Northern climes, and especially those on the West Coast aren’t so lucky. Chronic sleep deprivation could mean he could fly over some houses altogether.

santa + sackBut even if we manage to keep him awake with coffee and Red Bull rather than the usual glass of milk, we’ve got to change Santa’s sack. By carrying something that weighs more than 10% of his body weight, one shoulder is going to end up taking on most of the burden, which could lead to back strains, sprains and spasms.
If you’re thinking of getting Santa a gift this season maybe you could consider a backpack, or better still, a rolling suitcase.

That’s not to say Santa doesn’t need the exercise of his Christmas Eve jaunt. Like 70% of adult men in the US, he is severely overweight. The health risks linked to obesity include Type 2 diabetes, coronary heart disease, stroke, hypertension, certain types of cancer and osteoarthritis.

With his giant waist comes the risk of belly fat associated problems such as insulin resistance, high triglycerides, heart disease and metabolic syndrome.

Santa beardThen there’s that beard to worry about. After a month or so of letting thousands upon thousands of kids sit on your lap at the mall, we wouldn’t be surprised if he’s harboring some germs in his whiskers.  So if Santa touches his beard followed by his eyes, ears or mouth, he’s pretty much bound to catch something, especially in the midst of this cold and flu season.

We suggest leaving some hand sanitizer next to the milk and cookies this year to give him a fighting chance.

And finally we’re worried about that thin Red Suit. While we’ll give Santa props for covering his head with a hat, traveling outside all night in December in a red velvet suit and a touch of faux fur seems ill advised. In addition to the hat, he should probably throw on a scarf or knit mask, mittens, thermals and a water-resistant coat to ward off hypothermia.

So whether you’ve been naughty or nice, there’s still time to give some thought to Santa’s Health, as well as your own this Christmas season.

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Coping with the challenges of cancer…one bead at a time

Childhood cancer is almost always devastating for the patient, their family and friends. But now, in an innovative program patients at St. Jude Children’s Research Hospital, are using beads to help them put everything in perspective.  The beads help to commemorate the cancer journey and come to represent treatment milestones, such as losing their hair to completing chemotherapy.

The Legacy Bead program was launched in 2009. In the first year alone the hospital purchased more than 90,000 beads.  If placed end-to-end, this string of baubles would have extended longer than six football fields. And the program has been growing ever since.

When eight year old Kayla Dehnert tells friends and family in Northern California about life as a St. Jude Children’s Research Hospital patient, she pulls out a string of beads taller than she is.  “This is a learning-to-take medicine bead,” Kayla explains, fingering the bumps of a bluish-lavender bead and working her way down the long strand. “This yellow bead is the change-the-bandage bead, and the tiger bead is the losing-your-hair bead.”

Kayla, is just one of the hundreds of St. Jude patients who have participated in the program. Patients and their families discover a tangible way to illustrate their journeys using 55 glass beads as unique as they are.  Patients receive vivid green cylindrical beads for blood transfusions; sapphire round beads for lumbar punctures; tear-drop beads in assorted colors for homesickness; and blue, triangle-shaped beads for clinic visits. Other beads mark triumphs such as the completion of radiation or chemotherapy or challenges ranging from cancer’s return to the death of a friend.

Each bead represents an important part of her journey,” said Denny Dehnert, Kayla’s father. “They’ve made some harder days more bearable.”

According to Shawna Grissom, author of a newly published paper that outlines the benefits of the program, some patients use the beads to express how they are feeling about their treatment. Other patients have the beads as a memory of what happened during this step in their journey of life and still others will leave the string as a memory for their families to have and pass on.

Because patients collect the beads throughout the hospital, Grissom said the program also gives staff the opportunity to talk to patients about their care, including, for example, why needle sticks are necessary.

Kayla’s bead collection started December 6, 2011, the day she arrived at St. Jude for treatment of her brain tumor. Her string begins with beads that spell out her name and a bead with the hospital’s logo. While she has added many more since, the bead Kayla is most anxious to get is silver and barrel-shaped, which marks the end of chemotherapy.

The Legacy Bead program was so popular the hospital added a similar program for patient siblings. Brothers and sisters earn beads for contributions ranging from serving as bone marrow donors to traveling to St. Jude with their families.

Paola, another patient, who lost both her eyes to a rare eye cancer can identify her favorite Legacy Beads by shape, size and texture.  “This triangle bead is for a needle stick,” she says with a smile. “It’s sharp and pointed like a needle.”

As her hands wander down the necklace with practiced ease, she pauses at a round, yellow bead.  “I got this one for changing the dressing on my leg,” says Paola, who is now receiving treatment for the bone cancer osteosarcoma. With maturity that belies her years, Paola explains the significance of the beads she finds most interesting. “I strung them myself,” she proudly declares.

The St. Jude families find novel ways to display their Legacy Beads. While many end up as jewelry, others are hung from the ceiling or adorn strollers, purses or backpacks.  Teens say the beads give weight and heft to their stories, providing a tactile method for demonstrating the breadth of their experiences. They help bridge that gap as they talk with people who don’t understand what they’ve been through.

When the times get really tough, stringing beads is a good way to get our minds off the bad things that are happening,” says the mother of Tyler, a 7 year old cancer patient.

In the past year, she has collected 307 beads, signifying operations, chemotherapy treatments and hair loss, bad days and good days, needle sticks, inpatient admissions, platelet transfusions and many other events. She plans to hang the long strings of beads in her son’s bedroom as a symbol of his treatment and a celebration of his bravery.

The Legacy Bead program is one of several methods, including journaling and memory boxes, which the St. Jude Child Life Program offers to patients and families to chronicle their journeys.

 

Putting the squeeze on anti-cancer drugs?

For years, doctors have warned patients that grapefruit juice can cause overdoses when combined with anything from cholesterol medication to antihistamines. Now, researchers at the University of Chicago medicine have discovered that drinking one glass of grapefruit juice a day can actually reduce the dosage, cost and side effects of certain drugs, including those used to treat cancer.

Doctors were interested in studying the sirolimus, a drug approved to prevent rejection after kidney transplant, on patients with incurable cancer. Knowing that only 14% of the drug is absorbed into the blood stream, and that higher doses can cause nausea and diarrhea, they went about searching for a supplement that would boost sirolimus absorption.

That was when lead researcher Dr. Ezra Cohen remembered grapefruit juice can increase blood levels of certain drugs.  “We saw that not as a problem but as an opportunity to enhance the pharmacology to not only sirolimus but to a wide range of drugs.”

Grapefruit juice’s potential pharmaceutical prowess stems from its ability to inhibit enzymes in the intestine that break down certain drugs. The effect begins within a few hours of drinking it and  wears off gradually over a few days.

So Cohen and his team gave some patients grapefruit juice to see if they could get more sirolimus into their bloodstreams. At first, Cohen gave his patients grapefruit juice, but nothing happened. That was when the Florida Department of Citrus got wind of the study and offered to test a sample of the grapefruit juice Cohen’s team was using.

Dr. Cohen didn’t realize that the compound that enhances drug absorption can be degraded kind of drastically,” said Dan King PhD, the director of scientific research at the department. “This juice he was using didn’t have a whole lot of this compound present.”

The compound is furanocoumarin, and it works by inhibiting enzymes in the intestine that would otherwise limit drug absorption. Cohen’s juice had almost none because it was canned and stored in the non-refrigerated section of the grocery store.  Such juice is heated to temperatures that degrade the furanocoumarin.

Having identified the problem, the Department of Citrus supplied “potent” grapefruit juice for the rest of the study. It worked, increasing sirolimus levels by an incredible 350% and lowering the necessary doses from 90 mg per week to between 25 and 35 mg per week.

Sure enough, what they sent was very potent,” Cohen said. “It allowed us to reduce the dose of sirolimus dramatically.”  It could also reduce the cost of cancer treatments which are problematic for a lot of patients.

Unfortunately, the study didn’t show that the sirolimus-grapefruit combo was completely effective against cancer. None of the 138 patients in the study had a complete response, but about 30% achieved stable disease, meaning a period when their cancers did not advance. And one patient in the grapefruit juice group experienced significant tumor shrinkage that lasted for more than three years.

Jerry Avorn MD, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston, did not work with researchers on the study, but said he is excited about the results.  “It’s important not to see this as a new cure for cancer, but rather, it’s a very interesting way of using a known food-drug interaction as a means of getting better drug levels into cancer patients.”

SRxA’s Word on Health believes this is the first cancer study to harness a grapefruit-drug interaction rather than warn against it. We look forward to more.

The biggest-selling drug in 2018 will be…

EvaluatePharma, a UK based company specializing in pharma and biotech analysis has been gazing long and hard into its crystal ball.

Having scrutinized the world’s leading 3,500 pharmaceutical and biotech companies they have come up with a list of what, they believe, will be the top 10 selling drugs in 2018.

  1. Januvia       (diabetes) – $9.7 billion
  2. Humira        (arthritis) – $8.2 billion
  3. Avastin        (cancer) – $7.5 billion
  4. Enbrel          (arthritis)  – $7.2 billon
  5. Revlimid     (myelodysplastic syndrome) – $6.75 billion
  6. Prevnar 13  (pneumococcal vaccine) – $6.72 billion
  7. Rituxan         (cancer) – $6.3 billion
  8. Lantus           (diabetes) – $5.9 billion
  9. Remicade     (arthritis) – $5.8 billion
  10. Advair            (COPD)  – $5.7 billion

Surprised?  No conventional molecules, no cholesterol lowering agents, no blood pressure meds and not a single new drug among the top ten.  However, they predict the #11 best seller will be GS-7977 – the much anticipated oral hepatitis C drug from Gilead Sciences .

Not so surprising, given the obesity epidemic sweeping the western world that 2 of the front runners are diabetes drugs. Likewise, given the globally aging population – 3 are for arthritis.

#5 may be a surprise to many. Few people had ever heard of myelodysplastic syndrome before ABC news anchor Robin Roberts announced last week that she has the disease.  Still, it’s predicted number 5 status doesn’t mean that an epidemic is expected – it’s still relatively rare with only 10,000 or so new cases detected each year. Its lofty status on the list is more to do with the price. It costs a staggering $10,000 or so for a 28 day supply of the pills.

Other predictions from the EvaluatePharma World Preview 2018 report:

  • Worldwide prescription drug sales are forecast to total $885bn in 2018 an increase of 3.1% from 2011
  • Over $290bn of pharmaceutical sales are at risk from patent expirations between now and 2018
  • Pfizer was the top company for prescription drug sales in 2011, but  Novartis will top the list by 2018
  • Global pharmaceutical R&D spend forecast will grow by 1.5% per year to $149bn in 2018
  • Anti-coagulants (blood thinners) are set to record highest growth of major therapy categories to 2018

Interesting stuff. But the problem with such long term predictive models is that they are but a snapshot  trying to project out six years.

In reality, life is a movie, with a frequently changing plot. For example if J&J’s canagliflozin can reduce obesity and improve blood sugar levels better than Januvia then the projected No. 1 ranking is suspect, at best.

Breaking Cancer News– 122 years later!

On December 3, 1890 William Russell, a pathologist in the School of Medicine at the Royal Infirmary in Edinburgh, gave an address to the Pathological Society of London.  In it he outlined his findings of “a characteristic organism of cancer” that he had observed microscopically in all forms of cancer that he examined, as well as in certain cases of tuberculosis, syphilis and skin infection.

On May 8, 2012, Catherine de Martel and Martyn Plummer from the International Agency for Research on Cancer in France announced: “Infections with certain viruses, bacteria, and parasites are one of the biggest and preventable causes of cancer worldwide.”

In case you haven’t already done the math, that means it’s taken 122 years for someone to take notice.

A hundred and twenty two years ago!  That’s the year Eiffel Tower was completed, it’s around the time that  serial killer Jack the Ripper was terrorizing London, the same year Thomas Edison used electric Christmas lights for the first time and the year Vincent Van Gogh, the Dutch painter, committed suicide.

How, you might ask, have scientists put men on the moon, developed the internet, flying cars and metal-free underwear bombs, but yet remain so ignorant about cancer and its origin?

How can the infectious causes of tuberculosis, leprosy, syphilis, smallpox, polio, malaria, and other viral and bacterial and parasitic diseases be so well understood, but the cause of cancer be unknown?

The fact that all cancers could conceivably be caused by an infectious agent now seems a distinct possibility. That, until now,  this has been overlooked, ignored, or unrecognized by twentieth century doctors is simply incredible.

According to de Martel and Plummer, one in six cancers, accounting for around two million cases a year, are caused by preventable infections. They claim “application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on future burden of cancer worldwide.”

The percentage of cancers related to infection is about three times higher in developing than in developed countries. For example the fraction of infection-related cancers is around 3.3%in Australia and New Zealand to 32.7% in sub-Saharan Africa.

Many infection-related cancers are preventable, particularly those associated with human papillomaviruses (HPV), Helicobacter pylori (H. pylori), hepatitis B (HBV) and C viruses (HCV).

Of these infection-related cancers, cervical cancer accounts for around half of the cancer in women. In men, liver and gastric cancers accounted for more than 80%.

Dr. de Martel says: “Although cancer is considered a major non-communicable disease, a sizable proportion of its causation is infectious and simple non-communicable disease paradigms will not be sufficient.

Clearly we need to start making up for 122 years of lost time and directing further research and treatment efforts into these preventable causes of cancer.  Since vaccines for HPV and HBV are available, and increasing their availability, and lowering the cost should be a priority for governments and health systems around the world.

Sweet Protection Against Parkinson’s Disease

New research shows men and women who regularly eat berries may have a lower risk of developing Parkinson’s disease.  Men may further lower their risk by regularly eating apples, oranges and other sources rich in dietary flavonoids.

The study which was supported by the National Institutes of Health involved 49,281 men and 80,336 women. Researchers gave participants questionnaires and used a database to calculate intake amount of flavonoids. They then analyzed the association between flavonoid intakes and risk of developing Parkinson’s disease. They also analyzed consumption of five major sources of foods rich in flavonoids: tea, berries, apples, red wine and oranges or orange juice. The participants were followed for 20 to 22 years.

During that time, 805 people developed Parkinson’s disease. In men, the top 20% who consumed the most flavonoids were about 40% less likely to develop Parkinson’s disease than the bottom 20% of male participants who consumed the least amount of flavonoids.

In women, there was no relationship between overall flavonoid consumption and developing Parkinson’s disease. However, when sub-classes of flavonoids were examined, regular consumption of anthocyanins, which are mainly obtained from berries, were found to be associated with a lower risk of Parkinson’s disease in both men and women.

This is the first study in humans to examine the association between flavonoids and risk of developing Parkinson’s disease,” said study author Xiang Gao, MD, PhD, with the Harvard School of Public Health in Boston.

Fruit consumption has also been related to health benefits in a whole range of conditions including cancer, stroke, heart disease, diverticulosis, hypertension, cataracts, diabetes, asthma, and bronchitis.

Do you have any fruity stories to share?  SRxA’s Word on Health would love to hear from you.