NPCC PAPERS REVIEW William Nelson, MD, PhD – Cause of PC, Oxidative Damage, Obesity Dr. Nelson is Director, Molecular Pharmacology Lab in the Dept. of Radiation Oncology at Johns Hopkins and has published extensively on the subject of PC etiology. In this lecture he discussed hints that the inflammatory response brought on by infection may be a contributor to the development of PC as distinct from the infectious agent itself. There is another type of inflammation Dr. Nelson described: Proliferative Inflammatory atrophy (PIA). This is a precursor to PIN (Prostatic inflammatory neoplasia) which is normally identified as the immediate pre-cursor to PCa development. He discussed the phenomenon widely reported about Asiatic men who come from environments with low incidences of PC who, after moving to places like Hawaii and adopting a Western (or more exactly, a US type of diet) begin having PC rates similar to men of the same age group. Identifying those food components that actually produce the inflammatory response has been difficult. Certain fats have been identified and a component produced in meats that have been over broiled. Anti-cancer components have been named in fruits and vegetables but few prospective trials have been run to prove these ideas. Most such food related data comes from retrospective studies that involve too many uncertainties to reach high confidence levels. (ED. NOTE: As in so many other similar situations where the data is inconclusive and much uncertainty exists with conflicting studies, COMMON SENSE should rule: all things in moderation! Because the anti-oxidant properties of many fruits and vegetables are widely known, they should be made a staple in everybody’s diet). Obesity, he pointed out has been increasing in the USA. BMI (Body Mass Index) has increased over the period 1985 to 2002. It is a high risk factor for cardiovascular disease. An anomaly is that the rate of death from CV disease has decreased over the same period. Obesity is still a good prognostic indicator for CV, is “associated with” higher rates of PCa, but no definitive cause/effect relationship has been established. Dr. Nelson emphasized strongly that inflammatory reactions may underlie all chronic diseases! Because statin drugs are in such wide usage, they may contribute to a reduction of inflammation related disease. Retrospective studies will have to be conducted to test this hypothesis. He referred to a study of Asian prostates that did not find inflammation present. In the USA, Prostatitis is a common disease of the gland and there is literature that indicates it is an early stage in the carcinogenesis progression. In a panel discussion that followed, Dr. Coffey made the point that diet and/or dietary changes wont change the progression of PCa once it has been diagnosed. (ED NOTE: Given the almost knee jerk reaction of most men who learn they have PCa, dietary changes are often quickly made. Supplements are consumed in larger quantities but the PCa progresses). He also discussed some gene changes and their causes that might be contributory to PCa development. Much work remains to develop an understanding of these complex genetic factors. The reader is referred to Dr. Nelson’s many publications in which he discusses in detail several of the proposed genetic mechanisms leading to prostate inflammation and then to prostate cancer. Stephen B. Strum, MD – The End of Prostate Cancer This was the last presentation of the Conference. Dr. Strum, one of the most active medical oncologists specializing in prostate cancer, took his time to show men how their lack of unity in fighting this disease has resulted in low funding and slow progress. He cited the differences between how AIDS patients and breast cancer patients used unity to gain strength to shake much greater funding from the Federal money tree. Using data for the period 1995-1997 he showed that prostate had the lowest level of money spent per life lost than did either breast, lung, colorectal or AIDS! The differential in research spending was huge. AIDS funding in 1997 was approximately $65,000/death, breast was about $10,000/death and prostate somewhere near $2,500 (difficult to detect level on the graph presented by Strum). Overall funding for AIDS reported at $2.5 billion, breast cancer at $870 million and prostate at $485 million. Recalling how the AIDS community went about getting this kind of Federal funding, Dr. Strum urged the Prostate Community to unite and together go after increased research funding from Congress. Considering that the Government is run by concentrations of middle aged white men at highest risk of the disease why hasn’t greater effort been expended on the disease? Strum suggested that the American male simply refuses to step out an make the necessary noise to gain attention. He emphasized the necessity of getting an early diagnosis. The several variants of PSA, e.g., doubling time, PSA density, velocity, and % Free PSA were identified by him as highly useful in determining the nature of the PC being dealt with. He finished his lecture with a direct appeal to the audience to become more active in seeking greater funding and in increasing the use of some diagnostic tests that are currently under-utilized. He is a proponent of such measurements as CGA, CEA, PAP, and others in addition to PSA. In his Book, A Primer on Prostate Cancer, he goes into depth on the utility of these other clinical parameters for more accurately describing the biology of the PCa. NPC Program Review, 6/05 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.