Risk of Prostate Cancer? Check Your Hairline
Prostate cancer is the leading cancer among American men, but little is actually known about its causes or risk factors. Androgens — male sex hormones — are necessary for the growth and functioning of the prostate gland and contribute to the growth of tumors of the prostate. Androgens are also necessary for the growth and development of hair. A new study expands on this association and reports that men with prostate cancer are more than twice as likely to have had male pattern baldness beginning at age 20 than men without prostate cancer.
The recent study, published in Annals of Oncology, evaluated 388 men who had been diagnosed with prostate cancer and 281 controls without prostate cancer. The average age of the group with cancer was 67.2 years, and the control group, 66.4 years. Other than prostate cancer diagnosis, the groups had similar family and medical histories. The men in both groups were asked to report their own, as well as their father’s, history of prostate cancer. They also described their pattern of balding at ages 20, 30, and 40.
The researchers concluded that any balding at age 20 was associated with a two-fold increased risk of prostate cancer later in life. Early balding was not associated with an earlier cancer diagnosis, nor with being diagnosed with aggressive types of tumors. No association was found between balding at ages 30 or 40 and increased prostate cancer risk.
Increased androgen levels have long been associated with both prostate cancer and baldness, and androgen-based treatments have been used for the treatment of both conditions. For example, finasteride (marketed by Merck under the brand names Proscar and Propecia) is an anti-androgen that inhibits the conversion of testosterone to dihydrotestosterone, the active metabolite of testosterone in the body. It is used to treat benign prostatic hypertrophy, prevent the occurrence of certain types of prostate cancer, and treat male pattern baldness.
Prostate cancer is the most common cause of death from cancer in men over age 75. It rarely occurs in men younger than 40. While age over 60 years and African-American race are the most well-known risk factors, in addition to a positive family history of prostate cancer, certain behaviors can reduce the risk of developing prostate cancer: limit alcohol consumption, reduce the amount of fat in the diet, and avoid exposure to certain hazardous chemicals. However, there is truly no way to prevent prostate cancer. Luckily, in the United States, treatment options for prostate cancer are highly effective and response rates are generally high. Many prostate cancers may be cured completely. And, even in patients whose cancer cannot be cured entirely, many treatments are available that can extend the duration and quality of life. Anecdotally, it is said that many men die with prostate cancer, not from prostate cancer.
Though the sample size of the current study was small, and self-reporting contains inherent bias, the study confirms earlier reports that prostate cancer and baldness might be linked. The production of androgens in the development of prostate cancers needs further investigation, but early balding appears to be a simple marker for prostate cancer. Whether men with early-onset balding would benefit from routine prostate cancer screenings early in life, or these men should be systematically treated with agents like finasteride remains to be seen.
References
Demark-Wahnefried W, Conaway MR, Robertson CN, Mathias BJ, Anderson EE, & Paulson DF (1997). Anthropometric risk factors for prostate cancer. Nutrition and cancer, 28 (3), 302-7 PMID: 9343840
Demark-Wahnefried W, Lesko SM, Conaway MR, Robertson CN, Clark RV, Lobaugh B, Mathias BJ, Strigo TS, & Paulson DF (1997). Serum androgens: associations with prostate cancer risk and hair patterning. Journal of andrology, 18 (5), 495-500 PMID: 9349747
Denmark-Wahnefried W, Schildkraut JM, Thompson D, Lesko SM, McIntyre L, Schwingl P, Paulson DF, Robertson CN, Anderson EE, & Walther PJ (2000). Early onset baldness and prostate cancer risk. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 9 (3), 325-8 PMID: 10750672
Sofikerim M, Eskicorapci S, Oruç O, & Ozen H (2007). Hormonal predictors of prostate cancer. Urologia internationalis, 79 (1), 13-8 PMID: 17627161
Yassa M, Saliou M, De Rycke Y, Hemery C, Henni M, Bachaud JM, Thiounn N, Cosset JM, & Giraud P (2011). Male pattern baldness and the risk of prostate cancer. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO PMID: 21324955
Jennifer Gibson, PharmD
Dr. Gibson is a practicing clinical pharmacist and freelance medical writer and editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. Her clients include academic research institutions, international authors, pharmaceutical companies, professional organizations, and public advocacy groups.
Cancer – To Screen or Not to Screen?
I once treated a patient who was in her 90s. She was less than 5 feet tall and had never weighed more than 90 pounds. But, she was tough as nails and had lived a great life. I came to advocate for her when the internist at the skilled nursing facility in which she lived insisted that she have a mammogram. She had already been diagnosed with breast cancer in her 70s, but was healthier than anyone else her age now. She knew that even if she did receive another diagnosis of breast cancer at this stage in her life, it would probably not be treated and it almost certainly would not shorten her life. She refused the mammogram, much to the dismay of the healthcare providers that treated her like a checklist of tests and screenings and medications. She lived to be well over 100 years old, without her mammogram.
Stories like this could be more likely if some cancer researchers have their way. An opinion piece in a recent issue of the Journal of the American Medical Association (JAMA) offers a new perspective on cancer screening. For decades, clinicians, researchers, advocacy groups, and public service announcements have touted the benefits of early cancer screening and insisted that women get routine screenings for breast and cervical cancer, and men get tested for prostate cancer, among other testing and prevention strategies. Still, while the nearly-30 years of research on early cancer screening and prevention has led to a vast body of scientific knowledge, it has not led to decreased deaths from cancer, calling in to question the effectiveness of cancer screening.
The authors of the JAMA article report that the incidence of breast and prostate cancers has increased since the initiation of aggressive screening and detection techniques. Also, the incidence of cancers early in life has increased. The authors contend that screening may increase the diagnosis of low-risk cancers, but still does not adequately diagnose aggressive cancers, explaining the lack of reduction in cancer mortality. The more aggressive the tumor, the less likely it is to be diagnosed in time to save the patient. Further, the authors believe that early screenings have led to over-diagnosis and over-treatment of cancers that would likely not harm an individual or shorten the lifespan.
Currently, nearly half of men at risk for prostate cancer receive routine PSA tests — the standard screening tool for prostate health, and 70 percent of women over 40 have had a mammogram recently. But, the increased prevalence of these screenings has doubled the likelihood that a man will be diagnosed with prostate cancer in his lifetime, and the chance that a woman will be diagnosed with breast cancer has risen from 1 in 12 to 1 in 8 in the last 30 years. Today, more than 800 women need to be screened in 6 years to prevent 1 breast cancer death.
Many studies support the conclusions in JAMA and report that early screening and cancer prevention practices have shown only modest improvements long-term survival over the last 30 years. Mostly, there is still a lot about cancer that remains a mystery. Tumors are all different and therapies are always evolving. Still, strides have been made — through drug therapy intervention, early detection tests, and healthy lifestyle education — in preventing or detecting early the 4 deadliest cancers in the United States (breast, prostate, lung, and colorectal cancer). Some clinicians support increased lifestyle and basic nutrition education instead of, or in addition to, traditional medical approaches for cancer screening and prevention. Still others support reforming the clinical trial system to allow earlier human trials and speed the development of new cancer treatments.
There are inherent limitations to screenings: Who should be a candidate? What should the patient do with the information? What is the success rate of the test? No one is advocating stopping the early detection and prevention strategies for cancer completely — they have saved countless lives. But, patients should be informed before undergoing the testing and the physicians should be able to separate the life-threatening cancers from the not-so-serious ones. Fine-tuning screening techniques and evaluating the patient’s stage in life and overall health are important before proceeding with mass cancer screenings for everyone. But, then again, if you or your family member were the 1 cancer death prevented by early detection, would you want everyone to be screened?
References
Esserman, L., Shieh, Y., & Thompson, I. (2009). Rethinking Screening for Breast Cancer and Prostate Cancer JAMA: The Journal of the American Medical Association, 302 (15), 1685-1692 DOI: 10.1001/jama.2009.1498
Greenwald P (2007). A favorable view: progress in cancer prevention and screening. Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer, 174, 3-17 PMID: 17302181
GREENWALD, P. (2008). S1. Do we make optimal use of the potential of cancer prevention? European Journal of Cancer Supplements, 6 (3), 1-1 DOI: 10.1016/S1359-6349(08)70193-9
Jennifer Gibson, PharmD
Dr. Gibson is a practicing clinical pharmacist and freelance medical writer and editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. Her clients include academic research institutions, international authors, pharmaceutical companies, professional organizations, and public advocacy groups.
Wednesday, April 6, 2011
Posting Pertama Blog kesihatan Saya
Learn About Health fitness
Physical Fitness
Physical fitness comprises two related concepts: general fitness (a state of health and well-being) and specific fitness (a task-oriented definition based on the ability to perform specific aspects of sports or occupations). Physical fitness is generally achieved through exercise, correct nutrition and enough rest. It is an important part of life.
In previous years, fitness was commonly defined as the capacity to carry out the day’s activities without undue fatigue. However, as automation increased leisure time, changes in lifestyles following the industrial revolution rendered this definition insufficient. These days, physical fitness is considered a measure of the body’s ability to function efficiently and effectively in work and leisure activities, to be healthy, to resist hypokinetic diseases, and to meet emergency situations.
Components of physical fitness
The President's Council on Physical Fitness and Sports—a study group sponsored by the government of the United States—declines to offer a simple definition of physical fitness. Instead, it developed the following chart:
A comprehensive fitness program tailored to an individual will probably focus on one or more specific skills, and on age- or health-related needs such as bone health. Many sources also cite mental, social and emotional health as an important part of overall fitness. This is often presented in textbooks as a triangle made up of three points, which represent physical, emotional, and mental fitness. Physical fitness can also prevent or treat many chronic health conditions brought on by unhealthy lifestyle or aging. Working out can also help people sleep better. To stay healthy it's important to participate in physical activity.
Specific fitness
Specific or task-oriented fitness is a person's ability to perform in a specific activity with a reasonable efficiency: for example, sports or military service. Specific training prepares athletes to perform well in their sports.
Examples are:
400 m sprint: in a sprint the athlete must be trained to work anaerobically throughout the race.
Marathon: in this case the athlete must be trained to work aerobically and their endurance must be built-up to a maximum.
Many fire fighters and police officers undergo regular fitness testing to determine if they are capable of the physically demanding tasks required of the job.
Members of the United States Army and Army National Guard must be able to pass the Army Physical Fitness Test (APFT).
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