Wednesday, July 29, 2009

The old prostate conundrum again

Prostate cancers may grow too slowly to be fatal

A 15-YEAR study of men who had surgery for prostate cancer found only a small percentage died from cancer, adding to evidence that some men might be able to skip radical surgery to treat the often slow-growing tumors. The US study of more than 12,600 men with prostate cancer who had their prostates removed found only 12 per cent died from cancer 15 years later, even though some showed signs of having an aggressive type of cancer. Many more men - 38 per cent - died from causes other than cancer.

The study "shows a remarkably low risk of dying of prostate cancer within 15 years for treated men and supports the concept that men with slow-growing cancers may not need immediate treatment," study author Dr Peter Scardino said.

Prostate cancer is the second-most common cancer in men worldwide after lung cancer, killing 254,000 men a year globally. Doctors have routinely recommended prostate cancer screening for men over 50 using a blood test for prostate specific antigen, or PSA. The belief was that early diagnosis and aggressive treatment for any cancer is better than standing by and doing nothing.

But many prostate tumors are slow-growing and take years to cause harm. Some studies suggest many men are living with the side-effects of aggressive treatment with surgery and radiation for a cancer that may never have killed them. "Our results demonstrate the low lethality of these cancers after radical prostatectomy," Dr Scardino and colleagues wrote. They said in the United States, fewer than two per cent of men under age 65 opt to forgo prostate surgery in favor of regular testing for their cancers. And 73 per cent of those ultimately have surgery within four years.

But a separate study in the journal Cancer by researchers at the Erasmus Medical Center in Rotterdam, the Netherlands, found that men with early-stage prostate cancer who put off the surgery in favor of regular checkups were not overcome by anxiety. The team sent questionnaires to 150 men to gauge their comfort levels about their treatment decision, as well as levels of depression and anxiety. More than 80 per cent of the 129 men who returned their surveys scored about the same as those in other surveys who decided to undergo treatment for early prostate cancer.

A large, international trial is under way comparing regular checkups versus radical treatment but that study will not be completed for several years.


I am not at all clear on the logic of this. People who had the cancerous tissue removed did not die of cancer. Does that not tell us that the surgery was beneficial?? The issue is obviously metastases but it is not clear how that issue was dealt with. Are we assuming that they ALL had metastases?

Blue food dye may reduce spinal cord damage

A COMMON and safe blue food dye might provide the best treatment available so far for spinal cord injuries. Tests in rats showed the dye, called brilliant blue G, a close relative of the common food dye Blue No 1, crossed into the spinal fluid and helped block inflammation, the University of Rochester Medical Center claimed.

"We have no effective treatment now for patients who have an acute spinal cord injury," Dr Steven Goldman said. "Our hope is that this work will lead to a practical, safe agent that can be given to patients shortly after injury, for the purpose of decreasing the secondary damage that we have to otherwise expect."

When nerve cells in the brain or spine are damaged, they often release a spurt of chemicals that causes nearby cells to die. No one is sure why and stopping this process is key to preventing the damage that continues to build after a stroke or spinal cord injury.

One of the chemicals is ATP. The team looked for something that would interfere with this and found the blue dye, which they called BBG, would do this via the P2X7R receptor or doorway. "We found that IV administration of the P2X7R inhibitor BBG significantly reduced the severity of spinal cord damage without any evident toxicity," they said. "Remarkably, BBG is a derivative of the widely used food additive FD&C Blue No 1.

Currently, US consumers recond a daily intake of more than 16mg per person of the dye. The only known toxicity is in patients with blood infections known as sepsis. Tests in humans are likely still years away, the Rochester team said.


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