Hutchens Cancer Prevention finds that it is a deeply unfortunate fact and one that we don’t want to admit to as a society but according to a U.S. study, women are six times more likely to end up separated or divorced upon being diagnosed with cancer than if their male counterpart were facing the same disease. This confirms earlier research of divorce/separation rates among cancer patients of 12%, which is similar to the genpop. However the rate has jumped to 21% when the woman was sick rather than 3% when the man was diagnosed with the disease.
It is interesting to note that the reason men leave a sick spouse is partially explained by their lesser ability to quickly adjust to becoming a caregiver and be the primary homemaker. Links were discovered between age and length of marriage and the probability of separation. Longer marriages seem to remain more stable however the older the woman, the more likely the partnership would end.
The study that Hutchens Cancer Prevention is reporting on was conducted with the Huntsman Cancer Institute at the University of Utah School of Medicine and Stanford University School of Medicine. For the study, patients were divided into three diagnostic groups: those with malignant primary tumors, those with solid tumors with no central nervous system involvement, and those with multiple sclerosis. Approximately one half were women.
Chamberlain said the study was begun since doctors noticed that in their neuro-oncology practices, divorce occurred almost exclusively when the wife was the patient, but in all cases the woman was more likely to end up alone. Researchers also looked at the quality of life among the patients who separated or divorced.
They found that these patients used more psychotropics for depression, took part in less clinical trials, had a greater frequency of hospitalizations, were less likely to continue their courses of radiation therapy and it was more common for them to not die in their own homes.
The findings will be published in the journal Cancer. Medical professionals should be sensitive to potential marital problems in couples afflicted by a serious medical illness, especially when the one diagnose is a woman.
“Early identification and psychosocial intervention might reduce the frequency of divorce and separation, and in turn improve quality of life and quality of care,” claimed the researchers.
Men with low cholesterol levels have a decreased risk of high-grade prostate cancer..
A study, including almost 5,600 men aged 55 years and over randomized to the placebo section of the Prostate Cancer Prevention Trial (PCPT), showed that men whose cholesterol levels were below 200 mg/dL had a 60% decreased risk of Gleason 8 to 10 prostate cancer compared with men who had higher cholesterol levels, researchers reported in Cancer Epidemiology, Biomarkers & Prevention. Clinicians diagnosed prostate cancer in 1,251 men (22%).
The investigators, led by Elizabeth A. Platz, ScD, MPH, of Johns Hopkins Bloomberg School of Public Health in Baltimore, found no association between cholesterol levels and prostate cancer overall.
“Our findings add to the literature supporting a role for cholesterol in the etiology of prostate cancer with a worse prognosis,” the authors wrote.
The PCPT, which started in 1993, investigated whether finasteride could prevent prostate cancer. Researchers randomized subjects to receive 5 mg/day of finasteride or placebo for seven years. The study showed that finasteride treatment was associated with a 25% decreased incidence of prostate cancer.
In contrast to their findings in the placebo arm of the trial, Dr. Platz and her collaborators observed no association between serum cholesterol and high-grade prostate cancer in the finasteride arm. The researchers said the pattern they observed in the placebo arm, in theory, could be explained by a lower sensitivity for detecting high-grade prostate cancer in the men with low rather than high cholesterol, “but this is not the expectation.” Men with low cholesterol, the group explained, on average have a lower prostate volume. Thus a greater proportion of the total prostate could be sampled by needle biopsy, increasing the sensitivity of detecting high-grade tumors. Another explanation, they noted, is that finasteride prevented the same subset of high-grade cancers that low cholesterol would have prevented. It also is possible that the accuracy in detecting high-grade cancers differed in men with low cholesterol in the placebo arm compared with the finasteride arm.
A prostate cancer researcher not involved with the new study, Stephen J. Freedland, MD, of the Duke Prostate Center at Duke University Medical Center in Durham, N.C., said the study by Dr. Platz’s team is consistent with previous research and “provides some of the strongest data to date” linking high cholesterol with an increased risk of high-grade prostate cancer.
Dr. Freedland said he has started to mention this association to men with high cholesterol when counseling them about whether to go for PSA testing. “I say to patients, ‘There are increasing data to suggest that high cholesterol may increase your risk of aggressive prostate cancer.’”
As for whether a man should be placed on a statin to reduce his risk of aggressive prostate cancer, Dr. Freedland observed, “If he has high cholesterol, he should probably be on a statin anyway.” It is unknown whether statin treatment would further reduce the risk in men with low cholesterol, he said.
Previous studies suggest that statin use may protect against advanced prostate cancer. For example, a study published in the Journal of the National Cancer Institute (2006;98:1819-1825) showed that statin use was associated with a 43% decreased risk of advanced prostate cancer and a 65% decreased risk of fatal or metastatic prostate cancer.
Recently, researchers reported on a study involving 1,351 prostate cancer patients who underwent radical prostatectomy (504 who used statins and 847 who did not). Preoperative PSA levels, tumor volume, and percentage of cancer in the surgical specimen were significantly lower in the statin users, who overall had a proportionately lower rate of adverse tumor pathology features, including a significantly reduced risk of positive surgical margins, researchers reported in BJU International (2009; published online ahead of print).
Dr. Freedland—whose research has focused on risk factors for prostate cancer and its recurrence following treatment, as well as on prostate cancer chemoprevention—said it is biologically plausible for cholesterol to be involved in the pathogenesis of high-grade prostate cancer. Cholesterol is the precursor for testosterone, which promotes prostate tumor growth, Dr. Freedland said. Hypothetically, high cholesterol concentrations could mean greater testosterone production, he said. Evidence is mounting that high-grade, castration-resistant tumors can make their own testosterone from cholesterol, he noted.
Cholesterol also may directly stimulate tumor growth, he explained. In addition, all new cells need cholesterol as part of their membranes. “Thus, lower cholesterol means it is harder for the cells to replicate,” he said. “Given that high-grade tumors grow faster, this could explain why low cholesterol only reduced the risk of high-grade disease. All of these mechanisms suggest that it is indeed plausible that high cholesterol could promote more aggressive cancers.”
From the November 2009 Issue of Renal And Urology News
Cholesterol: What Your Doctor Didn’t Tell You
A growing body of laboratory and animal evidence as well as epidemiological data shows low levels of vitamin D may contribute to certain types of cancer. Conversely, strong biological and mechanistic bases indicate that vitamin D may play some role in the prevention of colon, prostate, and breast cancers.
Vitamin D is essential for promoting calcium absorption for bone and overall health in people. Low levels of vitamin D can lead to rickets in infants and children and the loss of bone density in adults.
More than 25 million adults in the United States have or are at risk of developing osteoporosis, a disease characterized by the loss of bone density that makes bones fragile and significantly increases the risk of fractures. When it comes to Osteoporosis, it’s a chicken and egg scenario: osteoporosis is most often associated with inadequate calcium intakes (generally less than 1,000-1,200 mg/day), but insufficient vitamin D contributes to osteoporosis by reducing the body’s calcium absorption.
While the evidence is far from conclusive, vitamin D may also prove to be an important protective nutrient in the prevention and treatment of cancer.
Video: Possible 75% cancer mortality reduction with Vitamin D
In a new study, researchers at the Moores Cancer Center and Department of Family and Preventive Medicine, UC San Diego used a complex computer prediction model to determine that intake of vitamin D3 and calcium would prevent 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer annually in the US and Canada. The researchers model also predicted that 75% of deaths from these cancers could be prevented with adequate intake of vitamin D3 and calcium. Dr. Cedric Garland, UCSD School of Medicine, lead researcher on the study discusses the implications of this finding and the proposed actions.
