[Cancer of the prostate: influence of nutritional factors. Vitamins, antioxidants and trace elements]. / Cancer de la prostate: influence des facteurs nutritionnels. Vitamines, antioxydants et oligo-éléments.

CANCER OF THE PROSTATE AND VITAMINS: Four vitamins have been studied, vitamins A, E, D and C. the results of these studies have been contradictory. Vitamin A and vitamin E would have a protective effect. ANTIOXIDANTS: Carotenes have an activity similar to that of vitamin A. Beta-carotene was positively associated with risk of cancer of the prostate in one study while two others were unable to demonstrate any relationship. Lycopene, the red color in fruits and vegetables, particularly tomatoes, would contribute to a lower risk of prostate cancer. TRACE ELEMENTS: Cadmium would increase the risk of cancer while selenium would have a protective effect. However studies concerning selenium carry certain methodological biases.

[Cancer of the prostate: influence of nutritional factors. A new nutritional approach]. / Cancer de la prostate: influence des facteurs nutritionnels. Une nouvelle approche nutritionnelle.

FIBERS: A group of vegetarian subjects have been shown to have a lower risk of cancer of the prostate than a control group. But the exact role of food fiber remains to be determined because plant foods also have an antioxidant effect on their own. PLANT PRODUCTS AND EXTRACTS: A compound called PD SPEC has been showed to have antitumor effects both in vitro and in vivo. Evaluated in patients with a cancer escaping hormone control, the clinical response was a lower level of prostate specific antigen (PSA). SOYBEANS: Several studies have demonstrated the interesting properties of soybeans. No study has however been able to demonstrate the optimal dose per day. A prospective study is currently under way using a 40 g/day dose. OVERALL NUTRITIONAL APPROACH: Several studies are being conducted using a proposed diet where 15% of the total energy intake comes from fat (associated with a low saturated/unsaturated ratio), high fiber content (18 g/100 kcal) and 40 g daily soybean protein. Although large-scale studies with rigorous methodology are lacking, an overall nutritional approach could be an interesting strategy for the management of cancer of the prostate.

Induction of apoptosis and inhibition of cell proliferation by the lipido-sterolic extract of Serenoa repens (LSESr, Permixon in benign prostatic hyperplasia.

BACKGROUND: To determine the mechanism by which prostate volume increases during the development of BPH and to evaluate the effect of LSESr (Permixon), a phytotherapeutic agent, we investigated apoptosis and cell proliferation in the stroma and epithelium of normal prostate and of BPH tissues from patients treated with or without LSESr. METHODS: MIB-1 staining and the in situ end-labeling assay were used to evaluate the proliferative-apoptotic balance in normal prostates and in BPH tissues. Quantitative assessment was performed using an image analysis system. RESULTS: In normal prostates, there was no significant difference between apoptotic and proliferative indices. Cell numbers and proliferative indices were higher in BPH than in normal prostates, while apoptosis values were similar. In the BPH treated group, LSESr significantly inhibited proliferation and induced cell death in both epithelium and stroma. CONCLUSIONS: Induction of apoptosis and inhibition of cell proliferation are likely to be the basis for the clinical efficacy of LSESr.

Assessment of penile small nerve fiber damage after transurethral resection of the prostate by measurement of penile thermal sensation.

PURPOSE: To determine the occurrence of penile small nerve fiber damage following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy (BPH). MATERIALS AND METHODS: Penile nerve function was evaluated in 18 consecutive patients prior to and one month after TURP for BPH. To test nerve fibers of small diameter, the penile warm and cold sensory thresholds were measured by means of a Peltier-based device, as well as the penile sympathetic skin potentials obtained following electrical stimulation at the wrist. To test nerve fibers of large diameter, the pudendal nerve somatosensory evoked potentials (pSEPs) and the penile vibratory thresholds were recorded. Clinical erectile function was quantified using a standardized questionnaire (erectile dysfunction symptom score, EDSS). Urinary handicap was assessed by the measurement of maximum flow rate (MFR) at uroflowmetry and by a standardized questionnaire (AUA symptom score, AUASS). RESULTS: Penile warm threshold (+7.8 vs +6.3C, p = 0.005), cold threshold (-8.5 vs -5.7C, p = 0.003) and vibratory threshold (9.3 vs 7.9 microm., p = 0.03) were significantly higher after than prior to TURP. The amplitude of pSEPs tended to decrease (1.7 versus 2.3 microV, p = 0.06), whereas the remaining neurophysiological parameters were unchanged. Clinical assessment by EDSS demonstrated a significant postoperative erectile function impairment (20.2 vs 17.5, p = 0.04), whereas mictional function improved (MFR: 19 vs 8.8 ml./s and AUASS: 4.9 versus 15.1, p < 0.0001). CONCLUSIONS: This study highlights the occurrence of penile small nerve fiber damage following TURP and supports the hypothesis of neurogenic damage as the primary cause of post-operative erectile dysfunction.

Herbal therapy PC-SPES: in vitro effects and evaluation of its efficacy in 69 patients with prostate cancer.

PURPOSE: We investigate the potential use of the phytotherapeutic PC-SPES to treat human prostate cancer, and evaluate its in vivo and in vitro activity, and clinical efficacy. MATERIALS AND METHODS: PC-SPES was evaluated for its ability to induce apoptosis on prostate cancer cell lines LNCaP, PC3 and DU145. The effect of oral PC-SPES on growth of PC3 tumors present in male immunodeficient mice was studied. A total of 30 male nude mice were divided in 5 groups. In groups 1 control and 2 full dose therapy was started the same day of the tumor injection. In groups 3 control, 4 half dose and 5 full dose PC-SPES therapy was initiated 1 week after tumor injection. A total of 69 patients with prostate cancer were treated with 3 capsules of 320 mg. PC-SPES daily. Serum prostate specific antigen (PSA) responses and side effects were evaluated. RESULTS: All of the cultured prostate cancer cell lines had a significant dose dependent induction of apoptosis following exposure to an alcoholic PC-SPES extract. Immunodeficient mice xenografted with the PC3 cell line had reduced tumor volume compared with sham treated controls when they were treated with a PC-SPES extract from the time of tumor cell implantation (931 +/- 89 versus 1,424 +/- 685 mm.3, p not significant) but not when the treatment was begun 1 week after tumor cell implantation. The testis, prostate, bladder and seminal vesicles of the treated mice were significantly reduced in weight compared with the sham treated animals. Of the patients with prostate cancer 82% had decreased serum PSA 2 months, 78% 6 months and 88% 12 months after treatment with PC-SPES. Side effects in the treated patient population included nipple tenderness in 42% and phlebitis requiring heparinization in 2%. CONCLUSIONS: An extract of the phytotherapeutic agent PC-SPES proved to be active in inducing apoptosis of hormone sensitive and insensitive prostate cancer cells in vitro, and in suppressing the growth rate of a hormone insensitive prostate cancer cell line in vivo. The overwhelming majority of patients with prostate cancer treated with the agent experienced a decrease in serum PSA but also demonstrated a side effect profile comparable to estrogen treatment.

Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients.

BACKGROUND: Controversy regarding the relative efficacy of treatments for the relief of the symptoms of benign prostatic hyperplasia (BPH). METHODS: This was a 6-month double-blind randomized equivalence study that compared the effects of a plant extract (320 mg Permixon) with those of a 5 alpha-reductase inhibitor (5 mg finasteride) in 1,098 men with moderate BPH using the International Prostate Symptom Score (IPSS) as the primary end-point. RESULTS: Both Permixon and finasteride decreased the IPSS (-37% and -39%, respectively), improved quality of life (by 38 and 41%), and increased peak urinary flow rate (+25% and +30%, P = 0.035), with no statistical difference in the percent of responders with a 3 ml/sec improvement. Finasteride markedly decreased prostate volume (-18%) and serum PSA levels (-41%); Permixon improved symptoms with little effect on volume (-6%) and no change in PSA levels. Permixon fared better than finasteride in a sexual function questionnaire and gave rise to less complaints of decreased libido and impotence. CONCLUSIONS: Both treatments relieve the symptoms of BPH in about two-thirds of patients but, unlike finasteride, Permixon has little effect on so-called androgen-dependent parameters. This suggests that other pathways might also be involved in the symptomatology of BPH.

A comparison of direct and liposomal antibody conjugates of sulfonated aluminum phthalocyanines for selective photoimmunotherapy of human bladder carcinoma.

There is a need to improve the selectivity of photodynamic therapy and for better targeting of tumor cells within specific tumor compartments. Selective in vitro phototoxicity of a human bladder carcinoma cell line 647V has been achieved by targeting sulfonated aluminum phthalocyanines (AlSPc) with monoclonal antibodies. Aluminum tetra-3 sulfonyl chloride phthalocyanine (PC) or rhodamine sulfonyl chloride were directly coupled to antibodies by a sulfonamide linkage and AlSPc or carboxyfluorescein were encapsulated in liposomes of the small unilamellar vesicle type (SUV) bearing antibody. Antibody E7 (IgM subclass), which recognized an antigenic determinant expressed on 647V but was absent on T24 a control human bladder carcinoma cell line, and a control IgM antibody were used. The effects of the two types of conjugate were compared. Immunofluorescence studies on living cells demonstrated specific cell surface localization of conjugates at 4 degrees C and internalization at 37 degrees C. Phototoxicity was measured by 3-(4,5-dimethylthiazol-2-5-diphenyltetrazolium) bromide assay after exposing AlSPc-sensitized cells to red light. Significant AlSPc dose-dependent phototoxicity of the order 4 degrees C < 4 degrees C plus 37 degrees C < 37 degrees C was observed with E7-SUV and E7-PC in the range 1-8 microM AlSPc. At equimolar AlSPc doses absolute toxicity was similar for the two conjugate types, but at equimolar antibody doses, the liposomal conjugate was more effective by up to 13-fold. Addition of urine during illumination decreased toxicity, which was attributed to the presence of protective elements. The results suggest that photosensitizers such as AlSPc could be used for antibody-directed therapy and in particular for selectively damaging tumor cells of the epithelial cell compartment in bladder carcinoma by intrabladder administration. The therapeutic ratio, which takes into account both specific and nonspecific toxicity, was greater for the liposome conjugate than for the direct conjugate indicating their greater suitability for in vivo instillation.