A combination of tomato and soy products for men with recurring prostate cancer and rising prostate specific antigen.

Tomato and soy products are hypothesized to reduce the risk of prostate cancer or enhance efficacy of therapy. A study was completed to determine if men with active prostate cancer will adhere to a dietary intervention rich in tomato products and a soy protein supplement men (n = 41) with recurrent, asymptomatic prostate cancer were randomized among 2 groups: Group A (n = 20) consumed tomato products (no soy) for Weeks 0 through 4, targeting a minimum of 25 mg of lycopene/day. Group B (n = 21) consumed soy (no tomatoes) for Weeks 0 through 4, providing 40 g of soy protein/day. For Weeks 4 through 8, all men consumed a combined tomato-rich diet and soy supplements. No grade II through IV toxicities were observed. During Weeks 0 through 4, mean daily lycopene intake for Group A was 43 mg (+/- 15 mg) and mean soy intake for Group B was 39 g (+/- 1 g), remaining similar during Weeks 4 through 8. Serum lycopene increased from 0.72 +/- 0.09 micromol/l to 1.21 +/- 0.10 micromol/l (P < 0.0001) and urinary isoflavone excretion increased from not detectable to 54.1 +/- 5.7 micromol/l (P < 0.05) with 8 wk of diet intervention. Serum prostate-specific antigen decreased between Weeks 0 and 8 for 14 / 41 men (34%). Mean serum vascular endothelial growth factor for the entire group was reduced from 87 to 51 ng/ml (P < 0.05) over 8 wk. In conclusion, prostate cancer patients will consume diets rich in tomato products and soy with excellent compliance and bioavailability of phytochemicals. Further studies combining tomato and soy foods to determine efficacy for prostate cancer prevention or management are encouraged.

Consumption of dietary supplements and over-the-counter and prescription medications in men participating in the Prostate Cancer Prevention Trial at an academic center.

OBJECTIVE: It is hypothesized that dietary patterns, individual nutrients, and specific prescription and over-the-counter medications may influence prostate carcinogenesis. Little information is available regarding the use of these products among men who are participating in prevention trials targeting prostate cancer. MATERIALS AND METHODS: A total of 92 men (mean age 69 years) participating in the Prostate Cancer Prevention Trial (PCPT) at an academic center were asked to bring all nutritional supplements and medications to regularly scheduled study visits. RESULTS: Data were collected on 86 of 92 men. We found that 85% of men in the PCPT regularly consumed at least 1 nutritional supplement. The mean (+/-standard deviation) number of dietary supplements consumed per man was 3.3 +/- 3.5 (range 0-21). A multivitamin and multimineral (73%) supplement was the most common product consumed. Single-nutrient supplements regularly consumed included: vitamin E (48%), vitamin C (31%), calcium (24%), and selenium (7%). Of men, 36% reported consumption of herbal products. Medications frequently consumed during the study period that may influence prostate carcinogenesis included nonsteroidal antiinflammatory drugs (57%), antihypertensives (49%), lipid lowering agents (27%), and aspirin (64%). CONCLUSIONS: Participants in the PCPT at an academic center have a high propensity for dietary supplement use. Many, such as vitamin E and selenium, are hypothesized to influence the risk of prostate cancer. Several of the medications commonly consumed, including aspirin, nonsteroidal antiinflammatory drugs, and statins, are being investigated as chemopreventive agents. Investigators designing prostate cancer chemoprevention trials should consider including detailed documentation of exposure to these products that may influence study outcomes.

Managing benign prostatic hyperplasia.

Medical and surgical options for the treatment of benign prostatic hyperplasia have expanded in recent years. Saw palmetto, the most widely used complementary medication, is less effective than standard medical therapy but has fewer side effects. Although non-selective alpha blockers provide rapid relief of symptoms and are relatively inexpensive, they can cause dizziness and orthostatic hypotension. These effects occur less often with tamsulosin, a more selective alpha blocker. Finasteride, a 5alpha-reductase inhibitor, slowly reduces prostatic volume but is not as effective as alpha blockers, especially in men with a smaller prostate. Dutasteride, a new 5alpha-reductase inhibitor, has recently been labeled for the treatment of benign prostatic hyperplasia. Surgery may be appropriate initial treatment in patients with severe symptoms who are not at high risk for complications. Surgery may also be indicated in patients who have failed medical therapy or have recurrent infection, hematuria, or renal insufficiency. Transurethral resection of the prostate is effective in most patients, but it carries some risk of sexual dysfunction, incontinence, and bleeding. Surgical procedures that use thermal microwave or laser energy to reduce hyperplastic prostate tissue have recently become available. In general, the newer procedures are less expensive than transurethral resection of the prostate and have fewer complications; however, the need for retreatment is somewhat greater with these less invasive techniques.