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Greater dietary antioxidant capacity linked with less aggressive prostate cancers

Tuesday, March 29, 2016

The journal Nutrition and Cancer published a report on February 4, 2016 that reveals an association between increased total antioxidant capacity (TAC) of the diet of prostate cancer patients and less aggressive disease. Total antioxidant capacity quantifies the presence in the diet of compounds that decrease the formation of potentially damaging free radicals. "To our knowledge this is the first study of prostate cancer aggressiveness and TAC in both African American and European Americans," authors Terrence M. Vance of the University of Connecticut and colleagues announce.

Dr Vance and associates analyzed data from 855 African Americans and 945 Americans of European heritage enrolled in the North Carolina-Louisiana Prostate Cancer Project, which included men diagnosed with prostate cancer on or after July 1, 2004. Dietary questionnaire responses were analyzed for antioxidant intake from food and supplements. Total antioxidant capacity (TAC) was calculated from the vitamin C equivalent antioxidant capacity of carotenoids, vitamins C and E, flavonoids, isoflavones and proanthocyanidins, and adjusted for energy intake. Prostate cancers were classified as having low, intermediate or high aggressiveness depending upon clinical stage, Gleason scores and prostate-specific antigen (PSA) levels at diagnosis.

High total antioxidant capacity from diet and supplements combined was associated with a 69% lower risk of highly aggressive prostate cancer among all subjects. African Americans whose dietary TAC values were among the highest experienced a 72% lower risk of aggressive cancer compared to those whose values were lowest, and for European Americans, the risk experienced by those in the highest group was 64% lower.

"Men with prostate cancer have been found to have low blood levels of dietary antioxidants, decreased activity of endogenous antioxidant enzymes, and increased levels of lipid peroxidation," Dr Vance and colleagues observe. "These findings could indicate either greater oxidative stress resulting in depletion of antioxidants or lower levels of antioxidants resulting in increased oxidative stress and lipid peroxidation."

They conclude that "Further studies in other populations are required to confirm these results and determine whether dietary components affect the development and progression of prostate cancer."

 
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Deficient vitamin D levels predict prostate cancer aggressiveness
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The May 1, 2014 issue of the journal Clinical Cancer Research published the finding of Northwestern University researchers of an association between vitamin D deficiency and a greater risk of prostate cancer as well as more aggressive disease.

Adam B. Murphy, MD, and colleagues utilized data from 667 African-American and European-American men seen by Chicago urology clinics. Serum prostate specific antigen (PSA) and 25-hydroxyvitamin D levels were ascertained prior to initial prostate biopsies.

Among African-Americans, having a deficient vitamin D level of less than 20 nanograms per milliliter (ng/mL) was associated with more than double the risk of having a biopsy result that was diagnostic of prostate cancer in comparison with men who had higher levels of the vitamin. A severely deficient vitamin D level of less than 12 ng/mL was associated with significantly greater odds of increased tumor aggressiveness and tumor stage in both African and European-Americans.

"Vitamin D deficiency could be a biomarker of advanced prostate tumor progression in large segments of the general population," commented Dr Murphy, who is an assistant professor in urology at Northwestern University Feinberg School of Medicine. "More research is needed, but it would be wise for men to be screened for vitamin D deficiency and treated."

"Vitamin D deficiency is more common and severe in people with darker skin and it could be that this deficiency is a contributor to prostate cancer progression among African-Americans," he noted. "Our findings imply that vitamin D deficiency is a bigger contributor to African-American prostate cancer."

"It is a good idea to get your levels checked on a yearly basis," Dr Murphy recommended. "If you are deficient, you and your doctor can make a plan on how to reverse it through diet, supplements or other therapies."

 
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Health Concern

Prostate cancer

Once a diagnosis of prostate cancer (PC) is established by means of tissue biopsy and microscopic findings showing PC, the foundation of the medical record should have further information added to it to allow for an even greater understanding of the patient's true status. In this context, status refers to the actual extent of disease, or stage of disease. Is the PC really confined to the prostate gland or does it penetrate the capsule of the prostate or perhaps invade local surrounding tissues such as the seminal vesicles and nearby lymph nodes? Are there any clues that the PC has spread or metastasized to more distant lymph nodes or bone?

A dietary history of significant lycopene and/or strawberry consumption correlated with a lower risk of aggressive and extra-prostatic PC. The lycopene source that was found to be most significant in most epidemiologic studies was the tomato, in the form of tomato sauce, stewed tomatoes, and pizza sauce. In one large-scale study involving 812 new cases of PC over the years 1986-1992 with matched controls, of the 46 vegetables and fruits or related products significantly associated with lower PC risk, three of the four identified were related to lycopenes--tomato sauce, tomatoes, and pizza. In this study, the combined intake of tomatoes, tomato sauce, tomato juice, and pizza (accounting for 82% of lycopene intake) was associated with a reduced risk of PC for consumption frequency greater than 10 versus less than 1.5 servings a week. Lycopene intake was also associated with a 53% reduced risk for advanced PC (Stages III and IV). The other nonlycopene product identified with significantly lower PC risk was strawberries.

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