Friday, February 17, 2012

Botanical Formula Effective In Treating Prostate Cancer

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A study published online in The International Journal of Oncology reports findings from a team of scientists at Indiana University, Methodist Research Institute, who examined a botanical formula containing botanical extracts, phytonutrients, botanically-enhanced medicinal mushrooms, and antioxidants, that kills aggressive prostate cancer tumors.

The researchers conducted experiments in mice using a human prostate cancer tumor model. This is the third publication from a major university study reporting important findings of this particular multi-nutrient prostate formula to fight the invasive behavior of aggressive prostate cancer cells, tumor growth and metastasis.

Dr. Daniel Sliva, who led the research, commented:

"Multiple studies demonstrate that this prostate formula is a possible treatment for hormone refractory (androgen independent) prostate cancer."

The findings of the study demonstrate that the prostate formula substantially inhibited tumor growth in aggressive, hormone refractory, androgen independent human-prostate cancer cells. After evaluating the formula's potential toxicity, it was deemed safe, with no signs of toxicity at the highest dosages.

Dr. Isaac Eliaz, researcher and formulator, declares:

"This study is a milestone in the research of this formula, demonstrating its safety and effectiveness in treating human prostate cancer in an animal model. These positive results offer a significant contribution to the field of prostate cancer research, and add to the growing body of published data substantiating the role of natural compounds in the treatment of prostate cancer."



The study, which used a xenograft tumor model of human prostate cancer in mice, revealed that in comparison to controls, oral administration of the formula achieved a statistically important suppression of 27% in tumor growth.

What proved even more significant was that the formula suppressed the expression of several genes that affect cancer proliferation and metastasis, three of which, IGF2, NRNF2 and PLAU/uPA are connected to potentially producing metastasis, other than controlling aggressive prostate cancer growth. The formula was also observed to substantially increase the expression of CDKN1A, a gene that fights prostate cancer by specifically inhibiting other cancer promoting cellular mechanisms.

The formula's abilities to suppress specific genes that are associated with aggressive prostate cancer growth and proliferation, and increase the expression of cancer-fighting genes, proves that this integrative formula has multiple anti-cancer mechanisms and genetic targets. The pre-clinical in vivo study supports earlier published in vitro data, which also demonstrate the formula's ability of decreasing expression of PLAU/uPA genes in aggressive, hormone-independent prostate cancer cells.

Dr. Sliva concludes:

"In summary, this dietary supplement is a natural compound for the possible therapy of human hormone refractory (independent) prostate cancer."

The formula's ongoing research in prostate cancer models continue to demonstrate promising results, with further studies coming up.

Thursday, February 16, 2012

Four new drugs will change prostate cancer care, Colorado expert says

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Four new drugs could transform prostate cancer from terminal to chronic disease
Not just chemo — new, targeted drugs act in novel and interesting ways
These drugs mark first major advances in prostate cancer care in nearly 15 years
After a decade and a half of near stagnation, four new drugs could help make advanced prostate cancer a chronic illness instead of a terminal disease, a leading Colorado prostate cancer expert says.

“It’s not just chemotherapy. The drugs have different and innovative methods of action. One is a bone protective agent; another’s a more effective hormone agent; another is radiotherapy; and the final one is the first drug tested for cancer immunotherapy,” says E. David Crawford, MD, investigator at the University of Colorado Cancer Center and head of urologic oncology at University of Colorado Hospital.

“Even without the addition of any more drugs, we may now have the tools that in combination will allow us to extend the survival prognosis of a prostate cancer patient long enough to make prostate cancer a disease a patient is more likely to die with than from,” Crawford says.

Along with Thomas Flaig, MD, Crawford describes these advances in prostate cancer treatment in a recent review for the journal Oncology.

First is the drug Denosumab, which Crawford says, “has three uses in protecting the bones of prostate cancer patients.” It can prevent bone fractures in patients with existing bone metastasis; it can prevent osteoporosis in patients whose calcium is depleted as a side-effect of hormone therapy; and (pending FDA approval) it has been shown to hold off the occurrence of bone metastasis for an average of four months in patients whose spiking PSA scores predict the likely onset of bone involvement.

Second is the drug Alpharadin, which is one of a novel and exciting class of “radiopharmaceuticals” – drugs that emit radiation and allow doctors to precisely deliver radiation to tumor sites. In the case of Alpharadin, it emits alpha rather than beta particles, which allows more precise tumor targeting of bone metastasis sites with less collateral damage to surrounding bone marrow.

Third, the drug Prostvac is the first “immunotherapy” drug used for the treatment of cancer. The drug acts like a vaccine, priming the immune system to recognize and thus fight against prostate cancer cells. In a phase II clinical trial of 125 patients, the drug extended the median survival time from 16.6 to 25.1 months.

Finally, the drug Abiraterone Acetate completely suppresses the body’s ability to make testosterone, which many prostate cancers need to grow (as opposed to previous drugs, which hoped to out-compete testosterone with estrogen, or imperfectly controlled testosterone production).

Crawford notes that these drugs are being approved for use only after more established therapies have failed and hopes that in coming years science may accelerate the use of these drugs to first-line therapies.

“Before we just had hormone therapy, then we got chemo, and each therapy we added packed on another couple months of survival. Now with these news drugs we’re tacking on even more time. The light at the end of the tunnel is the hope that we’ll turn this into a chronic disease and now we might have the tools that in some combination will do it,” Crawford says.

* To learn more about these and other cutting-edge strategies to combat advanced prostate cancer, refer for Crawford and Flaig’s recent review, Optimizing Outcomes of Advanced Prostate Cancer: Drug Sequencing and Novel Therapeutic Approaches.

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Thursday, February 2, 2012

A New Screening Method for Prostate Cancer: PSA Velocity Risk Count Testing

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A new study by NYU Langone Medical Center and Northwestern University Feinberg School of Medicine shows novel PSA velocity (PSAV) risk count testing may provide a more effective way for physicians to screen men for clinically significant prostate cancer. The new study, published online by the British Journal of Urology International on February 1, 2012, shows the benefits of tracking a man’s PSA levels over time to help doctors more accurately assess his risk of life-threatening prostate cancer.

“Risk count could represent a new way to screen for prostate cancer by focusing on men with the greatest risk of harmful prostate cancers,” said lead author Stacy Loeb, MD, an urologist in the Department of Urology and the Joel E. Smilow Comprehensive Prostate Cancer Center at NYU Langone. “The goal of risk count is to help identify the aggressive, clinically significant prostate cancers before advanced symptoms develop, while decreasing the diagnosis of insignificant cancers.”

Prostate cancer is the second leading cause of cancer death in American men, with an estimated 1 in 6 men diagnosed with the disease during their lifetime. Prostate cancer does not present symptoms until advanced stages so screening for the disease is vital. Currently, a PSA blood test is the standard screening method to evaluate a man’s risk of prostate cancer. It measures the amount of prostate-specific antigen in the blood, a substance made only in the prostate gland. An elevated PSA can indicate the presence of disease. However, PSA can also be elevated with benign prostate enlargement and one high PSA value does not always mean an aggressive prostate cancer is present.

The new PSAV risk count screening works by monitoring fluctuations in PSA levels over time to analyze a man’s risk of prostate cancer, instead of relying on just one PSA test result to assign prostate cancer risk. The risk count is calculated by counting the number of times in a row that the PSA level in the blood increases by 0.4 ng/mL. If PSA goes up by more than 0.4 units multiple years in a row, the risk count rises indicating the patient has an increased risk of aggressive prostate cancer. For example, a man who has a PSA screening for two years in a row would be given a “2” risk count if his serial PSA velocity measurements increased by more than 0.4 units, a “1” risk count if there was only one increase by more than 0.4 units, and a “0” risk count if there was no increase by more than 0.4 units.

In the study, researchers showed PSAV risk count could improve the specificity of screening for prostate cancer and advanced stages of the disease. Researchers evaluated 18, 214 men undergoing prostate cancer screening, 1,125 of which were diagnosed with the disease. The study results show sustained rises in PSA levels over time indicate a significantly greater risk of prostate cancer and more aggressive disease. In the study, a risk count of “2” was associated with a greater than 8-times risk of prostate cancer and a 5-fold greater risk of aggressive disease.

The authors conclude risk count screening may be useful in diagnosing aggressive prostate cancer earlier while possibly reducing unnecessary biopsy, as well as the overdiagnosis and resulting overtreatment of low-risk prostate cancer.

“A persistently rising PSA is a harbinger for life-threatening prostate cancer,” said the study’s senior author, William Catalona, MD, professor of Urology at Northwestern University. “Our study findings show looking at how much PSA changes over time helps distinguish which cancers are aggressive more so than a single PSA value.”

In an accompanying editorial, Dr. H. Ballentine Carter from the Brady Urological Institute at Johns Hopkins who initially suggested the concept of looking at PSA changes over time, affirms that in order to determine the likelihood of aggressive prostate cancer, “you want to know your patient’s risk count, not just their age and PSA level.”

Occasional binge drinking not harmful

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No effect on heart disease and mortality among moderate drinkers

Most studies have found that binge drinking is associated with a loss of alcohol's protective effect against ischemic heart disease (IHD) and most studies have found an increase of coronary risk among binge drinkers.

This study followed 26,786 men and women who participated in the Danish National Cohort Study in 1994, 2000, and 2005 and sought to see if binge drinking increased the risk of IHD or all-cause mortality among "light-to-moderate" drinkers: (up to 21 drinks/week for men and up to 14 drinks/week for women). A "drink" was 12g.

"Binge drinking" (more that 5 drinks on an occasion) did not show differences in risk of ischemic heart disease (coronary disease) or total mortality than among always moderate drinkers. These results are somewhat different from results of many other epidemiologic studies that have shown increased risk of health problems (even higher risk of coronary disease) to be associated with what was referred to as "binge drinking."

Why there were no adverse effects of binge drinking in this study has provoked considerable discussion among members of the Forum. The assessments of alcohol were based on consumption in the week prior to the examination, so data was not available to judge whether or not binge-drinking episodes occurred rarely or regularly. Data was available for smoking, education, physical activity, BMI, and self-reported hypertension and diabetes. There was a strong increase in IHD risk and mortality from binge drinking among heavy drinkers, but the authors were comparing outcomes in binge vs. non-binge drinkers among subjects in the "light-to-moderate" categories, and so in all comparisons, the relative risk of IHD and all-cause mortality was higher for non-drinkers than for all other categories of drinkers.

The general consensus of opinion among Forum members is the definition of "binge drinking." The rapid consumption of more than 5 drinks on an empty stomach surely has different effects than the consumption of alcohol over several hours with food, such as during a prolonged dinner. The rate of consumption strongly affects the consequences of alcohol; the speed of drinking and context should constitute part of the definition of 'bingeing' and not just the total number of drinks.

The Forum concludes that "binge drinking," however defined, is not a healthy pattern of alcohol consumption. But the circumstances of consumption (rate of consumption, with or without food, etc.) may also be important in its definition and in judging its effects on health.

The Forum does not take the results of this single study to support binge drinking. What the Danish results suggest is that the occasional "excess" embedded in a moderate consumption pattern is not shown to be harmful in this study. As recognized in responsible drinking guidelines from Australia, Canada and the US, occasional episodes of consumption greater than the recommended daily levels do not necessarily change the classification of a normally moderate drinker into that of an abuser.

Investigational urine test can predict high-risk prostate cancer in men who chose 'watchful waiting'

SEATTLE – Initial results of a multicenter study coordinated by researchers at Fred Hutchinson Cancer Research Center indicates that two investigational urine-based biomarkers are associated with prostate cancers that are likely to be aggressive and potentially life-threatening among men who take a "watchful waiting," or active-surveillance approach to manage their disease. Ultimately, these markers may lead to the development of a urine test that could complement prostate biopsy for predicting disease aggressiveness and progression.

Study principal investigator Daniel Lin, M.D., an associate member of the Hutchinson Center's Public Health Sciences Division, will present these findings today at the 2012 Genitourinary Cancers Symposium of the American Society of Clinical Oncology in San Francisco.

"Prostate biopsies are invasive and don't always pick up all of the cancer. Post-digital-rectal exam urine collection is much less invasive. If a urine-based diagnostic test could be developed that could help predict aggressive disease or disease progression, that would be ideal," said Lin, who is also an associate professor and chief of urologic oncology at the University of Washington Department of Urology.

Lin leads a nationwide consortium of eight institutions called the Canary Prostate Active Surveillance Study, an endeavor dedicated to identifying and validating biomarkers of high-risk prostate cancer.

Because many prostate cancers are slow growing and never become life threatening, many men with early stage prostate cancer choose active surveillance – delaying treatment while closely monitoring to see whether the cancer progresses.

Two urine-based biomarkers were found to correlate with indicators of aggressive disease: tumor volume (the number of biopsy samples that contain cancer) and Gleason score (predicting the aggressiveness of cancer by how it looks under a microscope). The markers that mirrored these correlates of disease aggressiveness were:

PCA3 – a non-coding RNA that is found at high levels in prostate cancer relative to benign prostate cells; and
TMPRSS2-ERG – the fusion of TMPRSS2, a gene that is regulated by androgens, with ERG, an oncogene. These genetic rearrangements are found in about half of all prostate cancers and are thought to play a role in prostate cancer development.
The findings were based on an interim analysis of data collected from 401 men who opted for active surveillance of their cancer. The study compared biomarker performance to clinical data collected at the time of study entry. Ultimately, the study aims to enroll 1,000 men and follow them for at least five years.

"The ultimate goal is that men on active surveillance could use a test based on these biomarkers or others to complement biopsy and PSA data to indicate or rule out the presence of an undetected aggressive cancer or future development of aggressive cancer," said Lin, who cautioned that these initial results, while promising, need to be confirmed in a larger study that would evaluate changes in these urine biomarkers over time, along with correlation to disease progression during active surveillance. Lin further noted that neither PCA3 nor TMPRSS2-ERG are FDA-approved for prostate cancer detection and that their use in active surveillance is investigational.