Wednesday, October 29, 2014

Two New Studies on Prostate Cancer with a Surprising Link

Two new studies on prostate cancer have been released in the last couple of days. The first one shows a 3.3 times greater risk of fatal cardiac events (heart attacks) in men who undergo androgen depletion therapy (ADT) for the treatment of prostate cancer (ADT eliminates testosterone from the body).

The new information supports previous studies suggesting that ADT increases risk of cardiovascular disease, risk of depression, induces muscle loss, decreases bone density (leading to osteoporosis), and results in an overall lower quality of life. I'd rather die of the disease than go through any of that. And in the long term, ADT does not stop progression of the disease, it only slows it down for about 6 months. After ADT the risk of a highly aggressive tumor is increased considerably, at which point it is untreatable.

The other study suggests that men who have had more than 20 female sexual partners have a 1/3 lower risk of developing prostate cancer. Strangely, men who sleep with 20 or more male partners are twice as likely to develop prostate cancer. That is a curious result that may be an anomaly, further studies are needed.

The connection between these two studies is testosterone. Men who have more sexual partners tend to have higher testosterone levels, and despite the prevailing belief that ADT is a useful treatment, there is mounting evidence that testosterone provides some protection against developing the most severe prostate cancers (which tend to be estrogen dependent, which makes ADT the most wrong choice possible).

Anyway, here are the press releases for the new studies.

Prostate cancer treatment linked to cardiac death risk 

An increased risk of dying from heart-related causes has been linked with a mainstay treatment of prostate cancer in a subgroup of men who have had prior heart attacks or congestive heart failure.

Written by David McNamee | 10.29.2014
The authors say that the findings of their study should be carefully weighed against larger controlled trials that demonstrate benefits of ADT.

One of the main treatments for prostate cancer, androgen deprivation therapy (ADT) reduced male hormone levels in an effort to prevent them from stimulating cancer cells. However, previous studies have found some adverse effects to be associated with ADT, including increased risk of diabetes, coronary heart disease, heart attacks and sudden cardiac death.

To further investigate this link, a group of researchers from Brigham and Women's Cancer Center and Harvard Medical School - both in Boston, MA - analyzed data from 5,077 prostate cancer patients who were treated between 1997 and 2006. About 30% of the participants had been treated with ADT.

No link was found between ADT and heart-related deaths among men with no risk factors for heart problems after a median follow-up of 4.8 years.

However, among men with congestive heart failure or prior heart attacks, there was a 3.3-times increased risk of death from heart problems. Heart-related deaths occurred in 7.01% of men in this subgroup who were receiving ADT, compared with 2.01% of men not receiving ADT.

The researchers explain that this increased risk works out as one cardiac death for every 20 at-risk men who receive this therapy.

"While androgen deprivation therapy can be a life-saving drug for men with prostate cancer and [can] significantly increase the cure rates when used with radiation for aggressive disease," says Dr. Paul Nguyen, of Brigham and Women's Cancer Center, "this study also raises the possibility that a small subgroup of men who have significant heart disease could experience increased cardiac death on ADT."

Further research should examine different types and durations of ADT

However, the researchers also warn that, as the study - which is published in the journal BJU International - was a retrospective analysis, its findings should be carefully weighed against larger controlled trials that demonstrate benefits of ADT.

It is also possible that changing the type or duration of ADT may reduce cardiac harm, and the researchers suggest that future studies should examine this.

The authors also consider that a longer follow-up period in future studies may reveal associations between ADT and cardiac harms in lower risk subgroups, such as among men with diabetes.

Dr. Nguyen says:
"I would still say that for men with significant heart problems, we should try to avoid ADT when it is not necessary - such as for men with low-risk disease or men receiving ADT only to shrink the prostate prior to radiation. However, for men with high-risk disease, in whom the prostate-cancer benefits of ADT likely outweigh any potential cardiac harms, ADT should be given even if they have heart problems, but the patient should be followed closely by a cardiologist to ensure that he is being carefully watched and optimized from a cardiac perspective."
In March, a study published in the Journal of Clinical Oncology found that prostate cancer patients who received ADT as their primary treatment instead of surgery or radiation therapy did not live any longer than patients who received no treatment.

The authors, from Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, said that their study - which analyzed data from 15,170 patients - "mitigates against any clinical or policy rationale for use of primary androgen deprivation therapy in these men."
* * * * *

Prostate Cancer Risk Reduced By Having More Sex

Trending News: This New Study Suggests The Weirdest Reason You Should Sleep Around

Paul Watson October 28, 2014

Why Is This Important?

Because it may now be medically advisable for men to sleep around.

Long Story Short

Research has revealed that men who have slept with more than 20 women have reduced their risk of prostate cancer by almost a third, but men who have slept with 20 men have doubled their risk.

Long Story

A revolutionary new study has shown that sleeping with more than 20 women can reduce a man’s chances of developing prostate cancer by 28 percent. Conversely, men who sleep with more than 20 male partners are twice as likely to get prostate cancer than a man who has never had sex with another man.

Researchers at the University of Montreal and the Institut Armand-Frappier published their discovery in the journal Cancer Epidemiology after a survey of 3,208 men between 2005 and 2009.

It is suggested that intercourse can protect men from prostate cancer and those who are more promiscuous have more regular sex than those in long-term relationships.

“It is possible that having many female sexual partners results in a higher frequency of ejaculations, whose protective effect against prostate cancer has been previously observed,” lead researcher Dr. Marie-Elise Parent is quoted as saying by The Telegraph.

However, the reason for the reverse effect in homosexual male relationships where men who have slept with 20 male partners have double the chance of getting prostate cancer and a staggering 500% greater chance of developing a less aggressive prostate cancer, is still not clear.

“It could come from greater exposure to STIs, or it could be that anal intercourse produces physical trauma to the prostate,” Parent said, but she stressed that was a “highly speculative" analysis.

This is the first study to find a link between the number of sexual partners and prostate cancer, but it has previously been suggested that intercourse may help guard against prostate cancer because it reduces the concentration of carcinogenic substances in the fluid of the prostate.

Still, many men will be disappointed to hear that Dr. Parent was unwilling to recommend men should be told to sleep with more women, insisting we were “not there yet.”

Own The Conversation
  • Ask The Big Question: Does sleeping with more women really help men avoid prostate cancer?
  • Disrupt Your Feed: I always knew it was medically responsible to sleep with as many women as possible... Kidding.
  • Drop This Fact: Prostate cancer is the most common cancer in Europe for males and the third most common cancer overall.
Expand Your Expertise
  • Prostate cancer risk reduced by sleeping with many women, but increased with many men [Eureka Alert]
  • Sex with 21 women lowers risk of prostate cancer, academics find [The Telegraph]
  • Men who sleep with multiple women REDUCE their risk of prostate cancer [Daily Mail]

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