Aggressive Surgical Treatment of Bladder Cancer Benefits Patients over the Age of 80

Researchers from the University of Michigan have reported that aggressive surgical management of bladder cancer in patients over the age of 80 may improve survival.

Bladder cancer occurs predominantly in elderly men and less frequently in women and younger men. Most bladder cancers are not diagnosed until they have become very large. As a result, bladder cancers are typically treated with surgery and in many cases, the surgery is very aggressive, or extensive, in order to remove all of the cancer. In patients 80 years old or older, the management of bladder cancer typically includes watchful waiting (7%), radiotherapy alone (1%), full or partial cystectomy (12%), and transurethral resection (79%).

Data for this study was derived from the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry. The researchers evaluated treatment and survival information from 13,796 patients who were diagnosed with bladder cancer. In this group, 24% were older than 80 years of age.

Patients 80 years or older were less likely to be treated with curative surgery. However, results indicate that the elderly patients who were treated with aggressive surgery consisting of a radical or partial bladder removal (cystetectomy) experienced the greatest reduction in risk of death.

The researchers concluded that elderly patients may benefit from aggressive treatment and that factors other than age should be used to identify patients (young and old) who would be better served by less aggressive management.

Patterns of Proteins in Urine Help Detect Bladder Cancer

According to an early, online article published recently in the Lancet Oncology, specific patterns of proteins (polypeptides) that are voided in a urine sample provide high accuracy in detecting bladder cancer.

Bladder cancer is diagnosed in 55,000-60,000 individuals annually in the U.S. If detected and treated early, prior to spread, cure rates are high following standard treatment. Cure rates fall dramatically, however, once the cancer has spread from the bladder. Therefore, it is crucial to establish and implement screening measures that can accurately detect bladder cancer in its earliest stages.

Researchers from the U.S. and Europe conducted a clinical trial to evaluate use of specific proteins in voided urine samples as indicators of bladder cancer. The study included patients diagnosed with bladder cancer as well as individuals without bladder cancer. This trial included 31 patients with urothelial bladder cancer (the most common type of bladder cancer), 11 individuals who were healthy, and 138 patients with diseases other than cancer that affected the urinary system.

Based on the presence of the specific proteins, 100% of individuals with bladder cancer were correctly identified and 100% of the healthy individuals were correctly identified.
Based on the presence of the specific proteins, accurate identification of individuals with bladder cancer compared to individuals who had non-cancerous diseases of the urinary system occurred in 86%-100% of the samples.
The researchers concluded that, although this specific screening procedure needs further study to validate these findings, the accuracy of this test, as well as its non-invasive nature, appears promising in the early detection of bladder cancer.

Patients who are at a high risk of developing bladder cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating screening measures for the early detection of their cancer. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Repeated Surgery May Benefit Patients with Stage I Bladder Cancer

Among patients with stage I bladder cancer, repeated transurethral resection may improve patient outcomes. These results were published in The Journal of Urology .

Bladder cancer is a common cancer; approximately 55,000 new cases are diagnosed in the U.S. each year. Stage I bladder cancer refers to cancer that has spread to the connective tissue just beneath the inner lining of the bladder, but does not involve the bladder muscle.

Patients with stage I bladder cancer are often treated with surgical removal of the cancer and adjuvant therapy to decrease the risk of cancer recurrence or progression to more invasive disease. Adjuvant therapy often involves intravesical therapy (placement of the drug directly into the bladder) with mitomycin or Bacille Calmette-Guérin (BCG). Surgery may involve transurethral resection (removal of the tumor using an instrument passed through the urethra), or removal of all or part of the bladder.

While this therapy is beneficial, recurrences are common. In an attempt to reduce the risk of recurrence, researchers in Turkey evaluated the effect of repeated transurethral resection.

The study involved 148 patients with newly diagnosed stage I bladder cancer. Patients were randomly assigned to treatment with a single transurethral resection followed by intravesical mitomycin, or a series of two transurethral resections followed by intravesical mitomycin. In patients receiving repeated transurethral resections, the procedures were performed two to six weeks apart. Patients were followed for an average of two-and-a-half years.

26% of patients who received repeated transurethral resection experienced a cancer recurrence, compared to 63% of patients who received only a single transurethral resection.
The benefit of repeated transurethral resection was most apparent for patients with high-grade tumors (grade 2 or grade 3).
Overall survival was similar in the two groups; overall survival was 92% in patients treated with repeated transurethral resections and 90% in patients treated with a single transurethral resection.
For patients with high-grade T1 bladder tumors treated surgically with transurethral resection, a second round of surgery may reduce the risk of cancer recurrence.

Molecular Technique May Improve Detection of Bladder Cancer Recurrences

According to a review published in the journal Urology, a laboratory technique known as fluorescence in situ hybridization (FISH) may allow for earlier and more complete detection of bladder cancer recurrence.

Bladder cancer is common; approximately 55,000 new cases are diagnosed in the U.S. each year. Superficial bladder cancer refers to cancer that has not spread to muscles of the bladder or nearby lymph nodes. Recurrence of superficial bladder cancer is common and often involves cancer invading the muscle of the bladder. Surgery is then required to remove the cancer.

Traditionally, surveillance for bladder cancer recurrence has relied on a combination of cystoscopy and cytology. During a cystoscopy, a physician places a lighted tube into the bladder to search for abnormal areas of tissue that indicate cancer. With urinary cytology, a pathologist examines cells from a urine sample in order to find cancer cells that have been shed from the wall of the bladder.

A limitation of these tests, either alone or in combination, is that they miss some cancers. Researchers are therefore exploring new approaches that increase cancer detection without increasing false positive test results.

Use of a molecular technique known as fluorescence in situ hybridization (FISH) appears to provide earlier and more complete identification of bladder cancer recurrence. This procedure tests bladder cells for changes to DNA that are suggestive of cancer.

To evaluate the accuracy of FISH in the diagnosis of bladder cancer recurrences, a researcher reviewed previously published studies. FISH outperformed cytology and detected cancers before they were apparent by cystoscopy.

74% of bladder cancer recurrences were detected by FISH, compared to 48% by cytology.
The advantage of FISH was apparent for each grade of bladder cancer. For patients with grade 1 bladder cancer, FISH detected 58% of cancers and cytology detected 19%; for grade 2 cancer, FISH detected 77% of cancers and cytology detected 50%; and for grade 3 cancer, FISH detected 96% of cancers and cytology detected 71%.
The researchers conclude that FISH detects changes in cancer cells before they can be detected visually. Integrating FISH into surveillance programs for recurrent bladder cancer may result in earlier and more complete cancer detection.

High-Volume Hospitals Offer Better Outcomes After Radical Cystectomy and Radical Prostatectomy

Among patients undergoing radical cystectomy (removal of bladder) or radical prostatectomy (removal of prostate), the probability of dying during hospitalization was lower at hospitals that performed a greater number of these specific procedures (high-volume hospitals). Hospital volume was not linked with in-hospital mortality after radical nephrectomy (removal of kidney). These results were published in the Journal of Clinical Oncology.

The relationship between patient outcomes and the number of patients seen at a particular hospital or by a particular doctor has received a great deal of attention over the past 25 years. In general, studies report that “high-volume” hospitals and doctors (hospitals and doctors who treat more patients with a particular condition) have better patient outcomes for specific conditions.

To evaluate the link between various measures of hospital volume and patient outcomes after surgery for urologic cancer, researchers evaluated a database containing information from more than 1000 hospitals in the U.S. The researchers collected information about the number of in-hospital deaths after radical prostatectomy for prostate cancer, radical cystectomy for bladder cancer, or radical nephrectomy for kidney cancer.

In addition to assessing the number of prostatectomies, cystectomies, and nephrectomies performed by a particular hospital, the researchers also assessed the number of other complicated medical procedures performed. These other procedures included coronary bypass surgery, aortic aneurysm repair, pancreatic surgery, and esophageal surgery. The researchers hypothesized that hospitals with a high volume of these other complicated procedures may also have better outcomes after urologic cancer surgery.

In-hospital death occurred in 169 out of 6,577 patients (2.6%) undergoing radical cystectomy for bladder cancer; 66 out of 61,039 patients (0.11%) undergoing radical prostatectomy for prostate cancer; and 237 out of 24,013 patients (0.99%) undergoing radical nephrectomy for kidney cancer.
Hospitals that performed a greater number of radical cystectomies or radical prostatectomies had lower rates of in-hospital deaths after these procedures.
The number of radical nephrectomies performed by a hospital was not linked with the rate of in-hospital death after radical nephrectomy.
The number of other complicated medical procedures performed by a hospital did not influence the rate of in-hospital death after radical cystectomy, radical prostatectomy, or radical nephrectomy.
The researchers conclude that in-hospital mortality after radical cystectomy or radical prostatectomy was lower in hospitals that performed a greater number of these specific procedures.

Delay in Cystectomy for Bladder Cancer Can Compromise Outcomes

According to an article recently published in the Journal of Urology, delaying a cystectomy (surgical procedure to remove the bladder) by more than 3 months following diagnosis of bladder cancer can affect outcomes of a patient.

The bladder is a hollow organ in the lower abdomen. Its primary function is to store urine, the waste that is produced when the kidneys filter the blood. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied.

Bladder cancer is diagnosed in 55,000-60,000 individuals annually in the US.

Patients with stage II (T2) bladder cancer have cancer that invades through the connective tissue into the muscle wall of the bladder, but has not spread outside the bladder wall or to local lymph nodes.

Standard treatment for stage II bladder cancer typically includes a cystectomy. Optimal timing of a cystectomy following diagnosis has not yet been clearly established. Due to the arbitrary timeline, busy surgical schedules, and obtaining a second opinion, cystectomies may not be performed for quite some time following diagnosis.

Researchers from the University of Michigan recently evaluated data including 214 patients with stage II bladder cancer. The researchers compared outcomes among patients who had undergone cystectomies at different time periods following their cancer diagnosis. The average follow-up was approximately 40 months.

Patients who underwent a cystectomy earlier had improved survival:

Overall survival was significantly improved among patients who underwent a cystectomy within 93 days (3.1 months) or less of their diagnosis.
A schedule delay was the most common factor contributing to a delay in undergoing a cystectomy; these delays occurred in 46% of the cases.
The researchers concluded that it appears that undergoing a cystectomy 3 months or less following diagnosis affects survival in patients with stage II bladder cancer. The authors state that “clinicians must strive to schedule patients efficiently and complete surgical treatment within this time frame.”

Patients diagnosed with stage II bladder cancer who are to undergo a cystectomy may wish to speak with their physician regarding the scheduling of their procedure.

Less Toxic Chemotherapy Regimen for Metastatic Urothelial Cancer Shows Promise

According to the results of a phase II clinical trial published in the journal Cancer, the chemotherapy combination P-HDFL (cisplatin, high-dose 5-fluorouracil, and leucovorin) reduced or eliminated detectable cancer in 63% of patients with metastatic urothelial cancer. There were few serious toxic effects.

Urothelial cancer develops in the lining of the urinary tract. These cancers most commonly involve the bladder, but may also develop in the part of the kidney known as the renal pelvis, the ureters (the tubes that connect the kidneys to the bladder), or the urethra (the tube that empties urine from the bladder).

Among patients with metastatic urothelial cancer (cancer that has spread beyond the urinary tract to other sites in the body), treatment often involves a combination of chemotherapy drugs. One commonly used chemotherapy regimen is M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin).

Though the commonly used chemotherapy regimens reduce or eliminate detectable cancer is some patients, they can produce severe toxic effects. Researchers therefore continue to explore effective but less toxic treatment alternatives.

To evaluate the safety and effectiveness of the chemotherapy combination P-HDFL (cisplatin, high-dose 5-fluorouracil, and leucovorin), researchers in Taiwan conducted a phase II clinical trial among 35 patients with metastatic urothelial cancer. Twenty-one patients had cancer of the bladder, nine patients had cancer of the renal pelvis or ureter, and five subjects had cancer of both the bladder and the renal pelvis or ureter. Median patient age was 71 years. All patients were treated with four-week cycles of P-HDFL.

32 of the 35 patients received at least two cycles of P-HDFL.
28% of these patients experienced a complete disappearance of detectable cancer.
34% experienced a partial disappearance of detectable cancer.
Overall survival was 12.3 months.
Survival without cancer progression was 10.5 months.
Severe (grade 3 or grade 4) toxic effects of treatment were rare. Severe nausea developed in three patients, severe vomiting developed in two patients, severe diarrhea developed in two patients, and low white blood cell levels developed in one patient.
The researchers concluded that the chemotherapy regimen P-HDFL produces a treatment response in some patients with metastatic urothelial cancer, with few serious toxic effects. They note that these characteristics may make this regimen particularly appropriate for patients in poor health. The researchers recommend clinical trials to directly compare P-HDFL with the chemotherapy regimens that are generally used for metastatic urothelial cancer.

Radiation to the Pelvis Increases Risk of Pelvic Fractures

According to a recent article published in the Journal of the American Medical Association (JAMA), women who undergo radiation to the pelvis for cancers of the cervix, rectum, or anus are at an increased risk for pelvic fractures compared to women with these types of cancer who do not undergo pelvic radiation as part of their treatment regimen.

Radiation to the pelvis is a rather common treatment for patients with cancers involving the cervix, rectum, or anus. Unfortunately, older women are at an increased risk for bone fractures than their younger counterparts, particularly hip fractures. These bone fractures result in a significant decline in quality of life, often necessitating surgery, hospital stays, and rehabilitation.

Researchers from the University of Minnesota and the University of North Carolina School of Medicine reviewed extensive data to determine if radiation to the pelvis may be associated with the risk of pelvic fractures. This study included 6,428 women diagnosed with cancers of the cervix, rectum, or anus between 1986 and 1999. The women were aged 65 or older; approximately half had received radiation to the pelvis as part of their treatment regimen, while the other half had not received pelvic radiation.

Pelvic radiation was associated with an increased risk of pelvic fractures among these women:

Among women with cervical cancer, 8.2% who underwent radiation to the pelvis had a pelvic fracture, compared to 5.9% of those who did not undergo pelvic radiation.
Among women with rectal cancer, 11.2% who underwent radiation to the pelvis had a pelvic fracture, compared with 8.7% of those who did not undergo pelvic radiation.
Among women with anal cancer, 14% who underwent radiation to the pelvis had a pelvic fracture, compared with 7.5% of those who did not undergo pelvic radiation.
The majority of fractures (90%) were hip fractures.
Women with anal cancer who were treated with pelvic radiation had the highest risk of developing a pelvic fracture.
The researchers concluded that elderly women diagnosed with cervical, rectal, or anal cancer who undergo radiation to the pelvis as part of their treatment regimen have a significantly higher risk of developing a pelvic fracture than those who do not undergo pelvic radiation. Elderly women who are to receive pelvic radiation for treatment of cancer may wish to speak with their physician regarding possible ways to reduce the risk of developing a pelvic fracture.

Reference: Baxter N, Habermann E, Tepper J, Durham S, Virnig B. Risk of Pelvic Fractures in Older Women Following Pelvic Irradiation. Journal of the American Medical Association. 2005; 294:2587-2593.

New Colorectal Cancer Test Offers Hope for Early Detection

According to a report in the November issue of the journal Gastroenterology, early detection of colorectal cancer and precancerous tumors may be possible with a new screening test that involves looking for abnormal DNA in stool samples.

When detected early, colorectal cancer is a highly curable disease. Colorectal cancer begins with the development of an adenomatous polyp, which is a small benign tumor that grows in the colon. These polyps take 10 to 15 years to transform into cancer. Since this development phase is so long, screening and early detection can play a crucial role in the prevention of colorectal cancer, as detection and removal of the polyps can prevent the development of the disease.

As the polyp develops, there are changes in the tumor’s DNA. By examining tumors that have been removed from patients, researchers have identified some of these altered DNA molecules. The tumors shed cells into the intestine, which makes it possible to detect the abnormal DNA cells in stool samples.

In a recent study at the Mayo Clinic, researchers examined the stool samples of three different groups: 22 people who had been diagnosed with colorectal cancer, 11 people who had polyps, and 28 people without any colorectal tumors. They found abnormal DNA in 91% of the stool samples from cancer patients and 73% of the stool samples from the patients with polyps. None of the stool samples from tumor-free people had abnormal DNA.

The results of this study show that DNA stool testing has the potential to become an efficient screening test for colorectal cancer. This could be an accurate and non-invasive test that people might be more willing to undergo than other more intrusive and uncomfortable tests. A 3-year clinical trial funded by the National Cancer Institute is scheduled to begin in January in order to further evaluate this procedure. In the meantime, it is still important for people to utilize the existing methods of screening for colorectal cancer, which include the fecal occult blood test (FOBT), sigmoidoscopy, colonoscopy and the double-contrast barium enema. People concerned with screening for this disease can consult with their physicians for more information.

Future clinical trials will help to establish the feasibility of using DNA stool testing as a standard screening procedure. People who are at a high-risk for developing colorectal cancer may wish to speak with their physicians about the risks and benefits of participating in a clinical trial in which DNA stool testing and other promising new screening techniques are being evaluated. Two sources of information about ongoing clinical trials include clinical trials listing services provided by the National Cancer Institute ( cancer.gov) and eCancerTrials.com. eCancerTrials.com also performs personalized clinical trial searches on behalf of patients.

Selenium May Reduce Risk of Developing Lung, Colorectal, and Prostate Cancers

The essential dietary nutrient, selenium, may help reduce the risk of developing cancers of the lung, colon, rectum, and prostate, as well as reduce the number of deaths in persons who have certain types of cancer, according to preliminary research findings.

It is believed that cancer is caused by a number of factors, making prevention of the disease a challenge. Few cases of cancer have a causative association as clear as the one between smoking and lung cancer. However, ongoing research continues to elucidate characteristics or exposures that may increase the chance of developing different types of cancers ( risk factors) as well as characteristics or exposures that may reduce the chance of developing those cancers ( protective factors). Recently, much attention has been given to the potential protective effects of various dietary supplements and nutrients, including selenium.

Selenium is a nutrient that is essential to the human body. A component of a number of the body’s enzymes, selenium is found predominantly in foods but also in water and air. Several scientific reports have shown an increased risk of developing certain cancers when the diet does not contain enough selenium. Similarly, some clinical studies have shown that selenium supplements in the diet may reduce the risk of developing some cancers. The side effects of most forms of selenium are low; however, certain forms (such as selenious acid) can be fatal if ingested. Excessive exposure to selenium, often characterized by a garlic odor on the breath, can result in chronic selenium poisoning. Further investigation of the potential protective effect of selenium from some types of cancer is ongoing.

Researchers from several centers in the United States conducted a study to determine whether the use of selenium supplements would result in a reduced risk of developing cancer or a recurrence (return) of cancer in 1312 persons who had a history of basal cell or squamous cell cancer of the skin. The researchers assigned the patients to receive either 200 micrograms of selenium per day or a placebo. The findings showed that the selenium did not have any impact on whether the patients developed the skin cancer again. However, the selenium was associated with fewer cancer-related deaths. Of the group receiving placebo, 57 persons died of cancer; of the group receiving selenium, 29 persons died of cancer. Of the cancers that were diagnosed, 119 were in the placebo group and 77 were in the selenium group. Cancers that were shown to be reduced in the selenium group included lung, colorectal, and prostate cancers. Because of these favorable results showing reductions in the incidence of lung, colorectal, and prostate cancers and the reduction in deaths from cancer, this study was stopped early.

The researchers concluded that the protective effects of selenium shown here appear promising; however, further studies are needed to confirm these findings. ( Journal of the American Medical Society, Vol 276, No 24, pp 1957-1963)

Intensive Chemotherapy and Radiation Therapy Combo May Improve Outcomes for Persons with Cancer of the Anus

Persons who have cancers of the anus that have spread to the nearby lymph nodes or are large in size may require more aggressive therapy than individuals with smaller cancers. Now, researchers say that chemotherapy with fluorouracil and cisplatin, followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin, may help preserve bowel function and improve survival for persons with this type of disease.

Cancer of the anus, the opening at the end of the rectum, is an uncommon cancer. Depending on the stage of disease (extent of disease at diagnosis) and other factors, cancer of the anus may be treated with surgery, chemotherapy, and/or radiation therapy. Persons who have surgery for anal cancer sometimes need a colostomy, an opening created from the skin to the bowel to help dispose of waste; however, a colostomy is usually temporary. Persons who have anal cancer that can be operated upon are often treated with surgery followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Seventy percent of these individuals are cured and maintain bowel functioning. However, persons with anal cancers that are large in size or have spread to the lymph nodes, do not respond as well to the standard therapies and need more aggressive treatment.

Researchers from the Cancer and Acute Leukemia Group B conducted a study with the hope of improving survival rates and preserving bowel function for persons with cancer of the anal canal that were large in size or had spread to the lymph nodes. Forty-five patients first received chemotherapy with fluorouracil and cisplatin. They then received a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Thirty-six patients had a complete response to the therapy. After an average of 21 months, 78% of the patients were alive and 67% were free from any signs and symptoms of cancer. Fifty-six percent of those who were alive were without a colostomy.

The researchers concluded that this more aggressive combination of chemotherapy and radiation therapy appears to result in better survival and better preservation of bowel functioning than the standard regimens for persons with more advanced anal cancer. Persons with this type of disease may wish to talk with their doctor about the risks and benefits of receiving intensive chemotherapy with radiation therapy or of participating in a clinical trial in which other promising new therapies are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute ( cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com ( www.411cancer.com). ( Proceedings of the American Society of Clinical Oncology Thirty-Fifth Annual Meeting, Vol 18, Abstract 909, pp 237a, 1999)

Surgical Salvage Therapy is Effective Treatment for Patients with Rectal Cancer that Relapse Locally after Initial Sphincter-Conserving Treatment

The standard of care for most patients with anal cancer is now initial treatment with radiation or chemoradiotherapy, with the aim of preserving the anus and allowing sphincter function. With this approach, approximately 60-90% of patients can expect to have the cancer eradicated. The majority of these patients will be cured and continue to have a functioning anus.

A portion of patients undergoing this initial treatment will, however, have recurrence of the cancer. If the cancer recurs locally, without the development of distant metastases, the patient then needs to undergo radical surgery in order to "salvage" a second chance of being cured. There has been a paucity of data on how well patients do after this kind of salvage surgery following initial sphincter-preserving treatment.

In a recent publication, doctors from the Geneva University Hospital, Switzerland, analyzed their 20-year experience in treating anal cancer with sphincter-preserving techniques. Approximately 20% of the patients failed locally. Two thirds of the patients failing locally had no evidence of metastases and so were still potentially curable. The surgical salvage treatment consisted mainly of abdominoperineal resections in which the tumor and anus are surgically removed in one piece. Of this group of patients, approximately half continue to enjoy freedom from recurrence at 5 years and, in all likelihood, are cured.

This study reaffirms the validity of sphincter-preservation as the initial treatment for anal cancer. A good proportion of patients who fail this initial treatment are still salvageable by surgery. Future efforts will be directed at further improving the cure rate with the initial treatment, as well as strategies to detect recurrence at an early stage when surgical salvage is still possible. ( Cancer, Vol 86, No 3, pp 405-409, 1999)

High Cholesterol Levels May Increase Risk of Prostate Cancer

According to an article recently published in the Annals of Oncology, men with high cholesterol levels have an increased incidence of prostate cancer.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. One in six men in the U.S. will develop prostate cancer over the course of his lifetime. Prostate cancer occurs more frequently in older men, in African-American men, and in men with a family history of prostate cancer.

One of the goals of genetic research is to identify risk factors associated with an increased risk of disease. If specific variables prove to be linked with increased risks of developing cancer, it may be possible for patients to alter their behavior in order to reduce their risk. These patients may also benefit from more frequent screening for prostate cancer.

Researchers from Italy recently conducted a clinical trial to evaluate the possible relationship between cholesterol levels and the risk of prostate cancer. This study included nearly 1,300 men who had been diagnosed with prostate cancer, and 1,451 men who had not been diagnosed with prostate cancer (control group). Data had been collected between 1991 and 2002. Men were under the age of 75 years.

Men with high cholesterol levels had an approximate 50% increased incidence of prostate cancer compared to men with normal cholesterol levels.
Men who were 65 years of age or older had with higher cholesterol had a more pronounced increased incidence of prostate cancer than their younger counterparts.
There was a trend of increased rates of prostate cancer among men with gallstones.
The researchers concluded that high cholesterol levels are associated with a higher incidence of prostate cancer. However, it is not yet known if controlling high cholesterol levels would reduce the risk of developing prostate cancer in these men. Further study evaluating the possible link between cholesterol levels and prostate cancer is needed.

Related News: High Intake of Dairy Products and Calcium Linked with Modest Increase in Prostate Cancer Risk

High Intake of Dairy Products and Calcium Linked with Modest Increase in Prostate Cancer Risk

In a combined analysis of 10 published studies, men with the highest intake of dairy products and calcium were more likely to develop prostate cancer than men with the lowest intakes. These results were published in the Journal of the National Cancer Institute.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.

Calcium is a nutrient that has been linked with a decreased risk of osteoporosis, hypertension, and colorectal cancer. Some studies, however, have suggested that high calcium intake may increase the risk of prostate cancer.

The reason for a link between high calcium intake and prostate cancer is unclear, but could potentially involve suppression of plasma 1,25-dihydroxyvitamin D3 (the active form of vitamin D; thought to play role in the control of prostate cell growth and differentiation) or elevation of plasma levels of insulin-like growth factor-I (a hormone associated with an increased risk of prostate cancer).

To evaluate the link between dairy products, calcium, and risk of prostate cancer, researchers combined information from 10 published that addressed this question. All studies were prospective (meaning that subjects were enrolled and exposure information was collected before the men developed cancer). This type of study design minimizes some types of bias.

The studies were conducted in the U.S. or Europe and were published between 1984 and 2005. Information about consumption of dairy products and calcium was collected by questionnaires completed by the study subjects.

Data from the 10 studies suggest a modestly increased risk of prostate cancer among men with the highest intake of dairy products or calcium:

Men with the highest intake of dairy products were 11% more likely to develop prostate cancer than men with the lowest intake.
Men with the highest intake of calcium were 39% more likely to develop prostate cancer than men with the lowest intake.
A trend between increasing intake and increasing risk of prostate cancer was observed for both dairy products and calcium.
The researchers conclude that “High intake of dairy products and calcium may be associated with an increased risk of prostate cancer, although the increase appears to be small.”