Prostate cancer hormone-related

Prostate Cancer. Evidence that phytoestrogens can influence the incidence of male-speciflc diseases is restricted to prostate cancer, and is largely of an observational nature. In the UK, prostate cancer is the most common hormone-related cancer in men. However, like breast cancer in women, it is comparatively rare as a clinically evident disease in men living in Asian countries. 

In order to get recent advances on the effects of phytoestrogens on hormonal-dependent diseases as well as on human supplementation trials, it might be useful to refer to http //www.venus-ca.org/ (EU-funded project on dietary exposure to phytoestrogens and related compounds and effects on skeletal tissues) http //www.phytos.org (EU-funded project on the prevention of osteoporosis by nutritional phytoestrogens) http //www.phytoprevent.org (EU-funded project on the role of phytoestrogens in the prevention of breast and prostate cancer) and http //www.nutrition.tum.de/isoheart.htm (EU-funded project on cardiovascular health of postmenopausal women). 

There has been some concern that the recently observed decline in sperm quality may be related to exposure to environmental estrogens (Sharpe and Skakkebaek, 1993) and at the same time there has been speculation that these estrogenic compounds may exert inhibitory effects against prostate cancer (Kurzer, 2002). Theoretically, exposure to high levels of dietary estrogens could alter the hypothalamic-pituitary-gonadal axis in men, but dietary studies to date have not shown such an hormonal effects. 

Hormones regulate many important bodily functions and are also associated with cancer. One of the first hints of the relationship of hormones to cancers was the observation that nuns had a greater incidence of breast cancer. This was naturally related to the nuns not having children and now we know that breast cancer may be hormone related. Since then there have been numerous studies on the use of birth control with cancer, childbirth, and most recently hormone replacement association with cancer. In males there is ongoing study of the hormones and prostate cancer. While it is clear that hormones and cancer are related, the exact characterization of this relationship is still unclear. 

Hormone-related cancers of the breast, ovary, endometrium, and prostate have been reported to vary by as much as 5 to 20-fold between populations. Migrant studies indicate that the difference is largely attributable to environmental factors rather than genetics [219,220]. The highest rates of these cancers are typically observed in populations with Western lifestyles that include relatively high fat, meat-based, low fiber diets, whereas the lowest rates are typically observed in Asian populations with Eastern lifestyles that include plant-based diets with a high content of phytoestrogens [219,221]. 

Rabbani, S. A., Gladu, J., Harakidas, R, Jamison, B. and Goltzman, D. (1999). Over-production of parathyroid hormone-related peptide results in increased osteolytic skeletal metastasis by prostate cancer cells in vivo. Inti. J. Cancer 80, 257-264. 

Hormone-refractory prostate cancer Much work relating to the use of suramin in prostatic cancer involves drug combinations, including amino-glutethimide, epirubicin, and hydrocortisone, with or without androgen deprivation, and in these studies it is hardly possible to determine which drug was responsible for a given adverse effect. 

In a randomized study in 390 patients suramin has been given in a fixed low dose (3.192 g/m ), intermediate dose (5.320 g/m ), or high dose (7.661 g/m ) to determine whether its efficacy and toxicity in the treatment of patients with hormone-refractory prostate cancer is dose-dependent (8). There was no clear dose-response relation for survival or progression-free survival, but toxicity increased especially with the higher dose. There were neurological adverse effects in 40% of the patients and cardiac adverse effects in 15%. This raises questions about the usefulness of suramin, particularly in high doses, in advanced prostate cancer. However, in another... 

Palliative responses were noted in 29% of patients in the mitoxantrone plus prednisone group and 12% of patients in the prednisone-alone group. The duration of palliative response was greater and quality-of-life scores for pain, physical activity, constipation, and mood were better in patients who received mitoxantrone plus prednisone. Overall survival was the same in both groups. Patients treated with mitoxantrone plus prednisone experienced tolerable adverse effects, although five patients did develop some cardiac-related adverse effects. Mitoxantrone plus corticosteroids is approved by the FDA for hormone-refractory prostate cancer. 

Terry, P. D., Rohan, T. E., and Wolk, A. (2003). Intakes of fish and marine fatty adds and the risks of cancers of the breast and prostate and of other hormone-related cancers A review of the epidemiologic evidence. Am. J. Nutr. 77,532-544. 

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