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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47965

RESUMO

Prevenção é primordial no combate ao câncer de próstata


Assuntos
Neoplasias da Próstata/prevenção & controle , Urologistas
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47954

RESUMO

Novembro Azul é o mês que reafirma a importância de as pessoas ficarem atentas a fatores de risco, sinais, sintomas e, quando diagnosticadas com um tumor urológico, aos tipos de tratamento existentes


Assuntos
Neoplasias Renais , Neoplasias da Próstata/prevenção & controle , Neoplasias Urológicas
3.
Med Clin North Am ; 104(6): 1051-1062, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33099450

RESUMO

This article gives an overview of the current state of the evidence for prostate cancer early detection with prostate-specific antigen (PSA) and summarizes current recommendations from guideline groups. The article reviews the global public health burden and risk factors for prostate cancer with clinical implications as screening tools. Screening studies, novel biomarkers, and MRI are discussed. The article outlines 7 key practice points for primary care physicians and provides a simple schema for facilitating shared decision-making conversations.


Assuntos
Neoplasias da Próstata/prevenção & controle , Humanos , Masculino , Atenção Primária à Saúde , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estados Unidos
4.
Prostate ; 80(11): 895-905, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32506665

RESUMO

BACKGROUND: Intraprostatic inflammation is an emerging prostate cancer risk factor. Estrogens are pro-inflammatory while androgens are anti-inflammatory. Thus, we investigated whether serum sex steroid hormone concentrations are associated with intraprostatic inflammation to inform mechanistic links among hormones, inflammation, and prostate cancer. METHODS: We conducted a cross-sectional study among 247 men in the placebo arm of the Prostate Cancer Prevention Trial who had a negative end-of-study biopsy, most (92.7%) performed without clinical indication per trial protocol. Serum estradiol, estrone, and testosterone were previously measured by immunoassay in pooled baseline and Year 3 serum. Free estradiol and free testosterone were calculated. Inflammation was visually assessed (median of three prostate biopsy cores per man). Polytomous or logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of some or all cores inflamed (both vs none) or any core inflamed (vs none) by hormone tertile, adjusting for age, race, and family history. We evaluated effect modification by waist circumference and body mass index (BMI). RESULTS: In all, 51.4% had some and 26.3% had all cores inflamed. Free (P-trend = .11) but not total estradiol was suggestively inversely associated with all cores inflamed. In men with waist circumference greater than or equal to 102 cm (P-trend = .021) and BMI ≥ 27.09 kg/m2 (P-trend = .0037) free estradiol was inversely associated with any core inflamed. Estrone was inversely associated with all cores inflamed (T3: OR = 0.36, 95% CI 0.14-0.95, P-trend = .036). Total (T3: OR = 1.91, 95% CI 0.91-4.02, P-trend = .11) and free (T3: OR = 2.19, 95% CI 1.01-4.74, P-trend = .05) testosterone were positively associated with any core inflamed, especially free testosterone in men with waist circumference less than 102 cm (T3: OR = 3.51, 95% CI 1.03-12.11, P-trend = .05). CONCLUSIONS: In this first study in men without prostate cancer and irrespective of clinical indication for biopsy, contrary to the hypothesis, circulating estrogens appeared to be inversely associated, especially in heavy men, whereas androgens appeared to be positively associated with intraprostatic inflammation.


Assuntos
Hormônios Esteroides Gonadais/sangue , Prostatite/sangue , Idoso , Biópsia , Peso Corporal , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Neoplasias da Próstata/prevenção & controle , Prostatite/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Curr Urol Rep ; 21(5): 22, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32367257

RESUMO

PURPOSE OF REVIEW: To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, preventive vaccinations, and some prescription heart healthy medications for prostate cancer prevention within a 3-part series of publications. RECENT FINDINGS: The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with additional prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy. The primary goal for medical providers of reducing all-cause and cardiovascular disease (CVD) morbidity and mortality correlates with maximizing prostate cancer prevention. The obesity epidemic in children and adults along with research from multiple, diverse disciplines has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded reduction in the probability of CVD and aggressive cancer. Preventing prostate cancer via dietary supplements should encourage a "first do no harm" or less-is-more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. A discussion of quality control (QC) before utilizing any pill also requires attention. Medications or interventions that potentially improve heart health including statins, aspirin, and metformin (S.A.M.), specific beta-blocker medications, and even preventive vaccines are in general generic, low cost, "natural," and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appears to exist within the same forest.


Assuntos
Neoplasias da Próstata/prevenção & controle , Adulto , Aspirina/uso terapêutico , Doenças Cardiovasculares/complicações , Criança , Dieta , Suplementos Nutricionais , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Estilo de Vida , Masculino , Metformina/uso terapêutico , Obesidade/complicações , Neoplasias da Próstata/etiologia , Neoplasias da Próstata/mortalidade
6.
N Z Med J ; 133(1514): 10-15, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32379735

RESUMO

AIM: To evaluate the impact of public health campaigns for glaucoma and age-related macular degeneration compared to breast cancer and prostate cancer using Google Trends data. METHODS: Relative search volumes for the terms 'glaucoma', 'macular degeneration', 'breast cancer' and 'prostate cancer' for New Zealand from October 2008-September 2018 were obtained via Google Trends. Intervention time-series analyses were used to compare observations before and after each awareness campaign. RESULTS: Of the campaigns occurring in the 10-year study period, statistically significant increases in search behaviour were observed for breast cancer (45%, p<0.01), prostate cancer (32%, p<0.01) and glaucoma (16%, p<0.01). Macular degeneration search behaviour increased on average 14% but this was not statistically significant (p>0.1), although increased activity (294%) was observed in December 2016, corresponding with the release of a report, public meeting and media release on the socioeconomic impact of macular degeneration. CONCLUSIONS: Glaucoma and macular degeneration search behaviour in New Zealand has a low impact following health awareness campaigns in comparison to breast and prostate cancer. This implies there is scope for improvement with these campaigns and a large increase in macular degeneration activity following a public meeting, and report release suggests that increased funding may increase impact. This study also highlights the utility of internet data for cost-effective monitoring of public interest in health issues.


Assuntos
Neoplasias da Mama/prevenção & controle , Glaucoma/prevenção & controle , Promoção da Saúde , Degeneração Macular/prevenção & controle , Neoplasias da Próstata/prevenção & controle , Ferramenta de Busca/estatística & dados numéricos , Feminino , Humanos , Comportamento de Busca de Informação , Masculino , Nova Zelândia , Saúde Pública
7.
Curr Urol Rep ; 21(3): 15, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32185555

RESUMO

PURPOSE OF REVIEW: To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention. RECENT FINDINGS: The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, and heart unhealthy is prostate unhealthy. The primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also coincides with maximizing prostate cancer prevention. The obesity epidemic in children and adults along with recent diverse research has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded improved probability of CVD and potentially aggressive cancer risk reduction. Preventing prostate cancer via dietary supplements should encourage a "first do no harm," or less is more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. A discussion of quality (QC) before utilizing any pill also requires attention. Medications or interventions that potentially improve heart health including statins, aspirin, and metformin (S.A.M.), specific beta-blocker medications, and even preventive vaccines are in general generic, low-cost, "natural," and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appear to exist within the same forest.


Assuntos
Dieta , Suplementos Nutricionais/normas , Estilo de Vida , Neoplasias da Próstata/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais/efeitos adversos , Óleos de Peixe/uso terapêutico , Ácido Fólico/uso terapêutico , Alimentos/normas , Nível de Saúde , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Medicamentos sob Prescrição/normas , Controle de Qualidade , Comportamento de Redução do Risco , Vitamina B 12/uso terapêutico
8.
Hum Cell ; 33(3): 730-736, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32146706

RESUMO

The present study investigated the antitumor activity and chemopreventive effects of a nanoparticle formulation of curcumin in preclinical models of mouse Pten-deficient prostate cancer. The antitumor activity of the nanoparticle curcumin was evaluated in mouse castration-naïve (7113-D3) and castration-resistant prostate cancer (2945-E10) derived cell lines in vitro. Cell viability was reduced in both cell lines in a dose and time-dependent manner. The effects of long-term dietary supplementation with the nanoparticle curcumin formulation were evaluated in a conditional Pten-deficient mouse model. Prostate tissues from Pten-deficient prostate cancers were obtained after sixteen weeks of dietary supplementation of 76 mg/kg/day or 380 mg/kg/day nanoparticle curcumin. Daily supplementation of nanoparticle curcumin did not affect mouse bodyweights or spleen size but did result in enlargement of the liver. Dietary supplementation did not influence tumor burden, however, mice fed high-dose curcumin had lower cancer cell proliferation rates at 12 and 16 weeks of age. Together, these results show that daily supplementation of a nanoparticle formulation of curcumin is tolerable and suggest that curcumin could have chemopreventive activity in early-stage prostate cancer.


Assuntos
Quimioprevenção , Curcumina/administração & dosagem , Nanopartículas , PTEN Fosfo-Hidrolase/deficiência , Neoplasias da Próstata/prevenção & controle , Animais , Linhagem Celular Tumoral , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Masculino , Camundongos , Neoplasias da Próstata/etiologia
9.
Exerc Immunol Rev ; 26: 80-99, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32139350

RESUMO

An increasing body of evidence suggests that age-related immune changes and chronic inflammation contribute to cancer development. Recognizing that exercise has protective effects against cancer, promotes immune function, and beneficially modulates inflammation with ageing, this review outlines the current evidence indicating an emerging role for exercise immunology in preventing and treating cancer in older adults. A specific focus is on data suggesting that muscle- derived cytokines (myokines) mediate anti-cancer effects through promoting immunosurveillance against tumourigenesis or inhibiting cancer cell viability. Previous studies suggested that the exercise-induced release of myokines and other endocrine factors into the blood increases the capacity of blood serum to inhibit cancer cell growth in vitro. However, little is known about whether this effect is influenced by ageing. Prostate cancer is the second most common cancer in men. We therefore examined the effects of serum collected before and after exercise from healthy young and older men on the metabolic activity of androgen-responsive LNCaP and androgen-unresponsive PC3 prostate cancer cells. Exercise-conditioned serum collected from the young group did not alter cell metabolic activity, whereas post-exercise serum (compared with pre-exercise serum) from the older men inhibited the metabolic activity of LNCaP cancer cells. Serum levels of candidate cancer-inhibitory myokines oncostatin M and osteonectin increased in both age groups following exercise. Serum testosterone increased only in the younger men postexercise, potentially attenuating inhibitory effects of myokines on the LNCaP cell viability. The data from our study and the evidence in this review suggest that mobilizing serum factors and immune cells may be a key mechanism of how exercise counteracts cancer in the older population.


Assuntos
Envelhecimento , Exercício Físico , Sistema Imunitário , Oncostatina M/sangue , Osteonectina/sangue , Neoplasias da Próstata/prevenção & controle , Idoso , Linhagem Celular Tumoral , Humanos , Masculino
10.
Rev. cuba. med. mil ; 49(1): e434, ene.-mar. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126682

RESUMO

Introducción: Según la Organización Panamericana de Salud, la incidencia de cáncer va en aumento. Entre los cánceres más prevalentes en Antioquia (Colombia), se destacan el de pulmón, colorrectal, mama, próstata y estómago. Objetivo: Describir los cambios en el estilo de vida, de las personas que presentan recurrencia o un segundo diagnóstico de cáncer. Métodos: Se estudiaron datos sociodemográficos, tipo de cáncer, tanto primario como secundario, antecedentes personales y familiares, cambios en actividad física, horas de sueño, consumo de cigarrillo y licor. Resultados: El primer diagnóstico de "otros tipos de cáncer" fue el más común. El antecedente más frecuente fue la hipertensión arterial, en casi 50 por ciento de los sujetos. Tras un primer diagnóstico de cáncer, tanto la práctica de actividad física, como el hábito de fumar y el consumo de alcohol, se redujeron de manera notoria en ambos sexos. En relación a la presencia de cáncer y los hábitos poco saludables, 28,1 por ciento de los hombres que reportaron ser fumadores, presentaron cáncer de próstata, donde el 25,8 por ciento tomaba licor. Conclusiones: Se observaron cambios destacados en los estilos de vida, en lo relacionado con el hábito de fumar, el cual disminuyó, al igual que el consumo de licor. Como aspecto negativo se observa la reducción en la práctica de actividad física y las horas dedicadas al sueño(AU)


Introduction: According to the Pan American Health Organization, the incidence of cancer is increasing. Among the most prevalent cancers in Antioquia (Colombia), there are lung, colorectal, breast, prostate and stomach. Objective: Describe the changes in lifestyle of people who have recurrence or a second diagnosis of cancer. Methods: Sociodemographic data, type of cancer, both primary and secondary, personal and family history, changes in physical activity, sleep hours, cigarette consumption and liquor were studied. Results: The first diagnosis of "other types of cancer" was the most common. Arterial hypertension was reported in almost 50 percent of the subjects. After a first diagnosis of cancer, both the practice of physical activity, smoking and alcohol consumption, were significantly reduced in both sexes. In relation to the presence of cancer and unhealthy habits, 28.1 percent of the men who reported being smokers had prostate cancer, where 25.8 percent consumed liquor. Conclusions: Notable changes in lifestyle were observed, in relation to the decrease in smoking, as well as the consumption of liquor. The negative aspect is the reduction in the practice of physical activity and the hours dedicated to sleep(AU)


Assuntos
Humanos , Masculino , Feminino , Neoplasias da Próstata/prevenção & controle , Sobreviventes/psicologia , Estilo de Vida/etnologia , Recidiva , Estudos Retrospectivos
11.
Medicina (Kaunas) ; 56(2)2020 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-32102219

RESUMO

Background and Objectives: Prostate cancer is the second most harmful disease in men worldwide and the number of cases is increasing. Therefore, new natural agents with anticancer potential should be examined and the response of existing therapeutic drugs must be enhanced. Stevia pilosa and Stevia eupatoria are two species that have been widely used in traditional medicine, but their effectiveness on cancer cells and their interaction with antineoplastic drugs have not been studied. The aim of this study was to evaluate the anticancer activity of Stevia pilosa methanolic root extract (SPME) and Stevia eupatoria methanolic root extract (SEME) and their effect, combined with enzalutamide, on prostate cancer cells. Materials and Methods: The study was conducted on a human fibroblast cell line, and on androgen-dependent (LNCaP) and androgen-independent (PC-3) prostate cancer cell lines. The cell viability was evaluated using a Trypan Blue exclusion test for 48 h, and the migration by a wound-healing assay for 24, 48, and 72 h. Results: The results indicate that SPME and SEME were not cytotoxic at concentrations less than 1000 µg/mL in the human fibroblasts. SPME and SEME significantly reduced the viability and migration of prostate cancer cells in all concentrations evaluated. The antiproliferative effect of the Stevia extracts was higher in cancer cells than in normal cells. The enzalutamide decreased the cell viability in all concentrations tested (10-50 µM). The combination of the Stevia extracts and enzalutamide produced a greater effect on the inhibition of the proliferation and migration of cancer cells than the Stevia extracts alone, but not of the enzalutamide alone. Conclusion: The results indicate that SPME and SEME have an inhibitory effect on the viability and migration of prostate cancer cells and do not interfere with the enzalutamide anticancer effect. The data suggest that Stevia extracts may be a potential source of molecules for cancer treatment.


Assuntos
Neoplasias da Próstata/prevenção & controle , Fatores de Proteção , Stevia , Proliferação de Células/efeitos dos fármacos , Humanos , Masculino , Células PC-3/efeitos dos fármacos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Cicatrização/efeitos dos fármacos
12.
Int J Mol Sci ; 21(4)2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32093338

RESUMO

The incidence of prostate cancer (PCa) displays widespread regional differences, probably owing to differences in dietary habits. Nutrients, including fat, protein, carbohydrates, vitamins (vitamin A, D, and E), and polyphenols, potentially affect PCa pathogenesis and progression, as previously reported using animal models; however, clinical studies have reported controversial results for almost all nutrients. The effects of these nutrients may be manifested through various mechanisms including inflammation, antioxidant effects, and the action of sex hormones. Dietary patterns including the Western and Prudent patterns also influence the risk of PCa. Recent studies reported that the gut microbiota contribute to tumorigenesis in some organs. Diet composition and lifestyle have a direct and profound effect on the gut bacteria. Human studies reported an increase in the abundance of specific gut bacteria in PCa patients. Although there are few studies concerning their relationship, diet and nutrition could influence PCa, and this could be mediated by gut microbiota. An intervention of dietary patterns could contribute to the prevention of PCa. An intervention targeting dietary patterns may thus help prevent PCa.


Assuntos
Carcinogênese , Dieta Ocidental/efeitos adversos , Comportamento Alimentar , Microbioma Gastrointestinal , Estado Nutricional , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/etiologia , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/microbiologia , Neoplasias da Próstata/prevenção & controle , Fatores de Risco
13.
Int J Radiat Oncol Biol Phys ; 106(4): 693-702, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-32092343

RESUMO

PURPOSE: To clarify the relative effects of duration of androgen suppression (AS) and radiation dose escalation (RDE) on distant progression (DP) in men with locally advanced prostate cancer. METHODS AND MATERIALS: Participants with locally advanced prostate cancer in the TROG 03.04 RADAR trial were randomized to 6 or 18 months AS ± 18 months zoledronic acid (Z). The trial incorporated a RDE program by stratification at randomization and dosing options were 66, 70, or 74 Gy external beam radiation therapy (EBRT), or 46 Gy EBRT plus high-dose-rate brachytherapy boost (HDRB). The primary endpoint for this study was distant progression (DP). Secondary endpoints included local progression, bone progression, prostate cancer-specific mortality and all-cause mortality. Effect estimates for AS duration and RDE were derived using Fine and Gray competing risk models adjusting for use of Z, age, tumor stage, Gleason grade group, prostate-specific antigen, and treatment center. Cumulative incidence at 10 years was estimated for each RDE group. RESULTS: A total of 1051 out of 1071 randomized subjects were eligible for inclusion in this analysis. Compared with 6 months AS, 18 months AS significantly reduced DP independently of radiation dose (subhazard ratio 0.70; 95% confidence interval [CI], 0.56-0.87; P = .002). No statistically significant interaction between effect of AS duration and RT dose was observed (Wald test P = .76). In subgroup analyses, DP was significantly reduced by the longer duration of AS in the 70 Gy and HDRB groups but not in the 66 Gy and 74 Gy. Compared with 70 Gy, HDRB significantly reduced DP (subhazard ratio 0.68 [95% CI, 0.57-0.80]; P < .0001) independently of AS duration. At 10 years, adjusted cumulative incidences were 26.1% (95% CI, 18.9%-33.2%), 26.7% (22.9%-30.6%), 24.9% (20.0%-29.8%) and 19.7% (15.5%-23.8%) for DPs in the respective radiation dose groups. CONCLUSIONS: Compared with 6 months AS, 18 months AS reduced DP independently of radiation dose. Men treated with HDRB gained a significant benefit from a longer duration of AS. Evidence of improved oncologic outcomes for HDRB compared with dose-escalated EBRT needs to be confirmed in a randomized trial.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Androgênios/metabolismo , Progressão da Doença , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Doses de Radiação , Idoso , Idoso de 80 Anos ou mais , Braquiterapia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/prevenção & controle , Dosagem Radioterapêutica , Fatores de Tempo , Resultado do Tratamento
14.
Database (Oxford) ; 20202020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31950190

RESUMO

The interaction between genes, lifestyles and environmental factors makes the genesis and progress of prostate cancer (PCa) very heterogeneous. Positive lifestyle is important to the prevention and controlling of PCa. To investigate the relationship between PCa and lifestyle at systems level, we established a PCa related lifestyle database (PCaLiStDB) and collected the PCa-related lifestyles including foods, nutrients, life habits and social and environmental factors as well as associated genes and physiological and biochemical indexes together with the disease phenotypes and drugs. Data format standardization was implemented for the future Lifestyle-Wide Association Studies of PCa (PCa_LWAS). Currently, 2290 single-factor lifestyles and 856 joint effects of two or more lifestyles were collected. Among these, 394 are protective factors, 556 are risk factors, 45 are no-influencing factors, 52 are factors with contradictory views and 1977 factors are lacking effective literatures support. PCaLiStDB is expected to facilitate the prevention and control of PCa, as well as the promotion of mechanistic study of lifestyles on PCa. Database URL: http://www.sysbio.org.cn/pcalistdb/.


Assuntos
Estilo de Vida , Neoplasias da Próstata , Bases de Dados Factuais , Humanos , Masculino , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/prevenção & controle , Fatores de Risco
15.
PLoS One ; 15(1): e0226972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31914160

RESUMO

Mounting evidence indicates that coffee, a commonly consumed beverage worldwide, is inversely associated with various chronic diseases and overall mortality. Few studies have evaluated the effect of coffee drinking on telomere length, a biomarker of chromosomal integrity, and results have been inconsistent. Understanding this association may provide mechanistic insight into associations of coffee with health. The aim of our study was to test the hypothesis that heavier coffee intake is associated with greater likelihood of having above-median telomere length. We evaluated the cross-sectional association between coffee intake and relative telomere length using data from 1,638 controls from four previously conducted case-control studies nested in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Coffee intake was assessed using a food frequency questionnaire, and relative telomere length was measured from buffy-coat, blood, or buccal cells. We used unconditional logistic regression models to generate multivariable-adjusted, study-specific odds ratios for the association between coffee intake and relative telomere length. We then conducted a random-effects meta-analysis to determine summary odds ratios. We found that neither summary continuous (OR = 1.01, 95% CI = 0.99-1.03) nor categorical (OR <3 cups/day vs. none = 1.37, 95% CI = 0.71-2.65; OR ≥3 cups/day vs. none = 1.47, 95% CI = 0.81-2.66) odds ratio estimates of coffee drinking and relative telomere length were statistically significant. However, in the largest of the four contributing studies, moderate (<3 cups/day) and heavy coffee drinkers (≥3 cups/day) were 2.10 times (95% CI = 1.25, 3.54) and 1.93 times as likely (95% CI = 1.17, 3.18) as nondrinkers to have above-median telomere length, respectively. In conclusion, we found no evidence that coffee drinking is associated with telomere length. Thus, it is unlikely that telomere length plays a role in potential coffee-disease associations.


Assuntos
Cafeína/farmacologia , Café , Homeostase do Telômero/efeitos dos fármacos , Idoso , Café/metabolismo , Neoplasias Colorretais/prevenção & controle , Estudos Transversais , Feminino , Humanos , Neoplasias Pulmonares/prevenção & controle , Masculino , Pessoa de Meia-Idade , Neoplasias Ovarianas/prevenção & controle , Neoplasias da Próstata/prevenção & controle
16.
Int J Clin Oncol ; 25(1): 175-186, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31473884

RESUMO

PURPOSE: To determine whether patients can avoid systematic prostate biopsy (PBx) if their Prostate Imaging Reporting and Data System version 2 (PI-RADs v2) score is ≤ 3 and how we clinicians make decisions that can maximize benefit. MATERIALS AND METHODS: We reviewed our prospectively maintained database of consecutive men who received transrectal ultrasound-guided 24-core biopsy as well as pre-biopsy multi-parametric magnetic resonance imaging (mp-MRI). Of the 1276 men who were performed PBx in our institution from 2012 to July 2018, 491 patients conformed to the criteria. Negative predictive value (NPV) of negative mp-MRI (defined as PI-RADs < 3) combined prostate-specific antigen density (PSAD) were calculated. Models based on PI-RADs v2 were developed to predict the absence of clinically significant prostate cancer (CSPCa) and prostate cancer (PCa). Nomograms as well as receiver operating curves (ROC) were established to estimate the discrimination. Calibration curves were used to assess the concordance between predictive value and true risk. Decision curves were made to measure the overall net benefit. RESULTS: Prostate cancer and CSPCa detection rates were 21.6%, 7.3% and 36.7%, 23.4% in PIRADs v2 < 3 cohort and PIRADs v2 = 3 cohort, respectively. Men with biopsy-proved CSPCa had higher prostate-specific antigen (PSA), lower prostate volume (PV) and higher PSAD (all p < 0.05 in the two cohorts) than patients with clinically insignificant prostate cancer (CIPCa) or negative results. NPV of negative mp-MRI for detection of PCa was much higher when the PSAD was less than 0.15 (p < 0.001) and 0.2 for CSPCa (p = 0.007). According to multivariate analysis, we developed the model comprising Age, PSAD and PI-RADs v2 to predict the absence of CSPCa and PCa. The area under the curve (AUC) of the model for non-CSPCa was 0.75 (95% CI 0.68-0.80, PSAD cutoff 0.20), better than 0.71 (95% CI 0.65-0.80, PSAD cutoff 0.15). As for model for non-PCa, the AUC was 0.76 (95% CI 0.70-0.80, PSAD cutoff 0.15), higher than 0.71(95% CI 0.67-0.78, PSAD cutoff 0.20). Internally validated calibration curves showed that the model might overestimated the risk of the absence of CSPCa when the threshold was between 53 and 72%, and if the threshold was between 72 and 87%, it might underestimate the risk. As for the absence of PCa, the model might overestimate the risk between 52 and 76%. Decision curves showed that a better clinical net benefit was met when the threshold was 55% for non-PCa and 70% for non-CSPCa. CONCLUSIONS: NPV of negative mp-MRI for detection of CSPCa and PCa was improved with decreasing PSAD. The nomograms based on PI-RADs v2, age and PSAD showed internally validated high discrimination and calibration for the absence of PCa and CSPCa. When the predictive value was greater than 70% for the absence of CSPCa and 55% for the absence of PCa, we could avoid unnecessary PBx to maximize net benefit.


Assuntos
Biópsia Guiada por Imagem/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Idoso , Área Sob a Curva , Calibragem , Humanos , Calicreínas/análise , Imagem por Ressonância Magnética , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Análise Multivariada , Nomogramas , Antígeno Prostático Específico/análise , Neoplasias da Próstata/prevenção & controle , Estudos Retrospectivos , Ultrassonografia
17.
Prostate ; 80(1): 83-87, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31634418

RESUMO

BACKGROUND: Several polygenic risk score (PRS) methods are available for measuring the cumulative effect of multiple risk-associated single nucleotide polymorphisms (SNPs). Their performance in predicting risk at the individual level has not been well studied. METHODS: We compared the performance of three PRS methods for prostate cancer risk assessment in a clinical trial cohort, including genetic risk score (GRS), pruning and thresholding (P + T), and linkage disequilibrium prediction (LDpred). Performance was evaluated for score deciles (broad-sense validity) and score values (narrow-sense validity). RESULTS: A training process was required to identify the best P + T model (397 SNPs) and LDpred model (3 011 362 SNPs). In contrast, GRS was directly calculated based on 110 established risk-associated SNPs. For broad-sense validity in the testing population, higher deciles were significantly associated with higher observed risk; Ptrend was 7.40 × 10-11 , 7.64 × 10-13 , and 7.51 × 10-10 for GRS, P + T, and LDpred, respectively. For narrow-sense validity, the calibration slope (1 is best) was 1.03, 0.77, and 0.87, and mean bias score (0 is best) was 0.09, 0.21, and 0.10 for GRS, P + T, and LDpred, respectively. CONCLUSIONS: The performance of GRS was better than P + T and LDpred. Fewer and well-established SNPs of GRS also make it more feasible and interpretable for genetic testing at the individual level.


Assuntos
Modelos Genéticos , Neoplasias da Próstata/genética , Dutasterida/administração & dosagem , Predisposição Genética para Doença , Humanos , Desequilíbrio de Ligação , Masculino , Polimorfismo de Nucleotídeo Único , Neoplasias da Próstata/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Medição de Risco/métodos
18.
Nutr Cancer ; 72(1): 74-87, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31155953

RESUMO

Previous studies suggest compounds such as sulforaphane (SFN) derived from cruciferous vegetables may prevent prostate cancer development and progression. This study evaluated the effect of broccoli sprout extract (BSE) supplementation on blood histone deacetylase (HDAC) activity, prostate RNA gene expression, and tissue biomarkers (histone H3 lysine 18 acetylation (H3K18ac), HDAC3, HDAC6, Ki67, and p21). A total of 98 men scheduled for prostate biopsy were allocated into either BSE (200 µmol daily) or a placebo in our double-blind, randomized controlled trial. We used nonparametric tests to evaluate the differences of blood HDAC activity and prostate tissue immunohistochemistry biomarkers between treatment groups. Further, we performed RNA-Seq analysis on the prostate biopsies and identified 40 differentially expressed genes correlated with BSE treatment, including downregulation of two genes previously implicated in prostate cancer development, AMACR and ARLNC1. Although urine and plasma SFN isothiocyanates and individual SFN metabolites were statistically higher in the treatment group, our results did not show a significant difference in HDAC activity or prostate tissue biomarkers. This study indicates BSE supplementation correlates with changes in gene expression but not with several other prostate cancer biomarkers. More research is required to fully understand the chemopreventive effects of BSE supplementation on prostate cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Brassica , Quimioprevenção/métodos , Isotiocianatos/administração & dosagem , Próstata/efeitos dos fármacos , Neoplasias da Próstata/prevenção & controle , Idoso , Anticarcinógenos/administração & dosagem , Disponibilidade Biológica , Biópsia , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Método Duplo-Cego , Histona Desacetilases/sangue , Humanos , Isotiocianatos/urina , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Próstata/metabolismo , Próstata/patologia , Neoplasias da Próstata/dietoterapia , Neoplasias da Próstata/metabolismo , Racemases e Epimerases/metabolismo , Produtos Vegetais/normas
19.
Aging Male ; 23(1): 81-92, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30782054

RESUMO

Objective: The association between erectile dysfunction (ED), hypogonadism, cardiovascular disease, and type 2 diabetes is well documented, but long-term data are limited. The aim of this study is to investigate effects of long-term testosterone therapy (TTh) with testosterone undecanoate in men with hypogonadism and ED.Patients and methods: Observational, prospective registry of 805 hypogonadal men with different degrees of ED, evaluated by the International Index of Erectile Function - Erectile Function Domain. Four hundred and twelve patients underwent TTh, 393 patients served as controls, with an observation period up to 12 years.Results: TTh led to substantial and sustained reduction of ED; improvement in erectile function was significant for each successive year until year 9. This was accompanied by improvements in cardiometabolic risk factors and urinary function throughout the 12-year follow-up period. Benefits of TTh were stronger for patients with moderate/severe ED than for patients with no/minor ED. Incidence of prostate cancer, major adverse cardiovascular events, and mortality were significantly lower in men on TTh compared with untreated men.Conclusion: Long-term TTh for up to 12 years alleviates ED, improves cardiometabolic risk factors, and reduces prostate cancer. Patients must stay on TTh consistently for a long time to achieve maximum benefits of TTh.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Disfunção Erétil/tratamento farmacológico , Hipogonadismo/tratamento farmacológico , Neoplasias da Próstata/prevenção & controle , Testosterona/análogos & derivados , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Estudos Prospectivos , Qualidade de Vida , Sistema de Registros , Testosterona/administração & dosagem , Testosterona/uso terapêutico
20.
J Cancer Educ ; 35(1): 28-35, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30353474

RESUMO

Some deaf men who use American Sign Language (ASL) experience barriers in patient-physician communication which may leave them at disparity for shared decision making compared to hearing men. Transparent communication accessibility is needed between deaf male ASL users and their physicians to maximize the benefit to risk ratio of using the prostate-specific antigen (PSA) as a screening tool for early detection. The objective is to compare shared decision-making outcomes between deaf and hearing males who are (1) age-eligible for PSA screening and (2) younger than 45 years old with a family history of cancer. An accessible health survey including questions about PSA test, PCC, modes of communication, and cancer history was administered in ASL to a nationwide sample of deaf adults from February 2017 to April 2018. Two subsamples were created: (1) 45- to 69-year-old men who were age-eligible for PSA testing and (2) 18- to 44-year-old men with a family history of cancer. Age-eligible and younger deaf men with a family history of cancer are at disparity for shared decision making compared to their hearing peers. Regardless of age and PSA testing status, deaf men felt significantly less engaged in shared decision making with their health care providers compared to hearing men. Participation in shared decision making requires not only accessible communication but also cultural competency in working with deaf patients. This is critical in the shared decision-making era in maximizing the benefit of prostate cancer screening in deaf male patient population.


Assuntos
Comunicação , Surdez/psicologia , Tomada de Decisão Compartilhada , Detecção Precoce de Câncer/estatística & dados numéricos , Pessoas com Deficiência Auditiva/psicologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Adolescente , Adulto , Idoso , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Médicos , Neoplasias da Próstata/prevenção & controle , Línguas de Sinais , Adulto Jovem
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