Cancer Survival Depends on Where You Live

(HealthDay News) -- Your odds of surviving cancer depend on which country you live in. And, in the United States, it also depends on whether you're black or white, a new study finds.

Economic differences among countries, access to health care, and the availability of cancer treatments feed the disparities in survival, the report said.

"There is a very wide global range in the odds of survival after a cancer diagnosis," said lead researcher Michel Coleman, a professor of epidemiology at the London School of Hygiene and Tropical Medicine in Great Britain. "Some of the range is understandable on the basis of the relative wealth of these countries," he added.

The study also confirms the disparity in cancer survival among blacks and whites in the United States, Coleman said. "The differences are large across the U.S.A., and even in different metropolitan areas," he said.

Coleman believes the differences among countries -- and within regions of countries -- is directly related to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."

The report was published in the July 17 online edition of The Lancet Oncology.

For the study, called the CONCORD study, Coleman's team collected data on 1.9 million cancer patients in 31 countries. Using cancer registries from each country, the researchers compared the five-year survival rates for breast, colon, rectal and prostate cancer.

The United States has the highest rates of survival for breast and prostate cancers, while Japan has the highest survival rates for colon and rectal cancers among men. France has the highest survival rates for colon and rectal cancer among women, the report found.

In addition, Canada and Australia also have very high survival rates for most cancers. The lowest rate of survival among both men and women was seen in Algeria.

In the United States, the lowest survival rates are in New York City, except for rectal cancer in women, where Wyoming scores worse. The best survival rate for cancer in the United States is in Hawaii, the researchers found.

Idaho also has a high survival rate for rectal cancer, and Seattle has the highest survival rate for prostate cancer.

But, there's a big disparity in cancer survival rates between whites and blacks in the United States, and it favors whites. The differences range from 7 percent for prostate cancer to 14 percent for breast cancer. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.

There's also a significant difference in cancer survival rates between the United States and Europe, with survival rates 10 percent and 34 percent higher in the United States for breast cancer and prostate cancer, respectively, the study found.

In Europe, France has the highest survival rate for rectal and colon cancers. Sweden has the highest survival rate for breast cancer, and Austria has the highest survival rate for prostate cancer.

The worst performing European countries are Poland and Slovakia.

Coleman said he hopes that political leaders will use the findings to provide better cancer diagnosis and treatment.

"Where the system is either slow in diagnosis, has too few doctors, has very few radiotherapy machines or in some countries, none, you would expect differences in outcome, and that's what these overall survival estimates are helping us provide," he said.

Dr. Elmer Huerta, president of the American Cancer Society's National Volunteer Board of Directors, said the study provides evidence for what has long been suspected -- namely, that where you live plays a role in cancer survival.

"The world needs to wake up to the fact that cancer is the second leading cause of death all over the place," he said. "Policymakers don't really put the weight to cancer care."

Huerta thinks more emphasis needs to be placed on the prevention, diagnosis and treatment of cancer.

"The world needs to smell the coffee and realize cancer can be prevented, and cancer can be cured if found early," he said.

More information
For more on cancer, visit the American Cancer Society.

Cancer Killed Almost 8 Million Worldwide in 2007

(HealthDay News) -- Cancer continues to cut a deadly swath across the globe, with the American Cancer Society reporting 12 million new cases of malignancy diagnosed worldwide in 2007, with 7.6 million people dying from the disease.

The report, Global Cancer Facts & Figures, finds that 5.4 million of those cancers and 2.9 million deaths are in more affluent, developed nations, while 6.7 million new cancer cases and 4.7 million deaths hit people in developing countries.

"The point of the report is to promote cancer control worldwide, and increase awareness worldwide," said report co-author Dr. Ahmedin Jemal, director of the society's Cancer Occurrence Office.

The number of cancers and cancer deaths around the world is on the rise, Jemal said, mostly due to an aging population. "There is increasing life expectancy, and cancer occurs more frequently in older age groups," he noted.

Lifestyle may be another reason for the rise in malignancies in developing countries, Jemal said, as people adopt Western behaviors such as smoking, high-fat diets and less physical activity.

The best way to stem the increasing number of cancer cases and deaths is prevention, especially in poorer countries, the expert said. In many developing nations, the health-care infrastructure simply isn't there to offer cancer screening and treatment for most people, Jemal added.

In developed countries, the most common cancers among men are prostate, lung and colorectal cancer. Among women, the most common cancers are breast, colorectal and lung cancer, according to the report.

However, in developing countries the three most common cancers among men are lung, stomach and liver, and among women, breast, cervix uteri and stomach.

Worldwide, some 15 percent of all cancers are thought to be related to infections, including hepatitis (liver cancer) and human papilloma virus (cervical cancer). But the incidence of infection-related cancers remains three times higher in developing countries compared with developed countries (26 percent vs. 8 percent), according to the report.

In addition, cancer survival rates in many developing countries are far below those in developed countries. This is mostly due to the lack of early detection and treatment services. For example, in North America five-year childhood cancer survival rates are about 75 percent compared with three-year survival rates of 48 percent to 62 percent in Central America, the report notes. The report estimates that 60 percent of the world's children who develop cancer have little or no access to treatment.

The report also includes a section on the toll tobacco use takes around the world. In 2000, some 5 million people worldwide died from tobacco use. Of these, about 30 percent (1.42 million) died from cancer -- 850,000 from lung cancer alone.

Jemal believes smoking is a key culprit.

"Smoking prevalence is decreasing in developed countries. So, as tobacco companies are losing market in developed countries they are trying to expand their market in developing countries," he said.

In China alone, more than 350 million people smoke. "That's more than the entire population of the United States," Jemal said. "If these current patterns continue, there will be 2 billion smokers worldwide by the year 2030, half of whom will die of smoking-related diseases if they do not quit," he added.

In the 20th century, tobacco use caused about 100 million deaths around the world. In this century, that figure is expected to rise to over 1 billion people. Most of these will occur in developing countries.

One expert agreed that many cancer deaths can be avoided through lifestyle changes.
"What is most provocative here is not the total global burden of suffering and death cancer causes, dramatic though that may be, but the variations in cancer occurrence around the world, and the insights provided about how much of the cancer burden need not occur at all," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

In developing countries, cancer of the uterine cervix is a leading cause of death in women, Katz noted.

"Yet this infection-related cancer is now preventable by vaccine, and long treatable when detected early using the Pap smear. As a result, death from cervical cancer in developed countries is dramatically lower. Its toll in the developing world is testimony to missed opportunities to apply our resources effectively, and equitably," he said.

Cancer of the liver, often related to hepatitis infection, is a leading cause of death in developing countries, but not so in developed countries. "Again, an infection preventable with vaccine is causing death because of inequities in the distribution and use of existing resources," Katz said.

Prostate and colon cancers are more common in wealthier countries, where they are likely related to poor diet and obesity, Katz said. "Unnecessary suffering and death are occurring in affluent countries due to dietary excesses," he said.

Katz also noted that tobacco-related cancer is largely preventable. "The toll of tobacco-related disease, including lung cancer, is an appalling example of a global willingness to tolerate preventable suffering and death for the sake of profit," he said.

These data show both developed and developing countries how to move toward the lower rates of specific cancers, Katz said.

"It will be a tragic failure for public health if instead of applying these lessons developed countries continue to export tobacco and dietary transgressions so that the developing world adds to its current cancer burden ours as well," he said.

More information
For more information on cancer, visit the American Cancer Society.

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Prostate Cancer Treatments Often Compound Existing Health Problems

(HealthDay News) -- More than a third of prostate cancer patients may receive treatments that are inappropriate because of problems they are already having with urinary, bowel or sexual function, a new study suggests.

These mismatches might occur, because patients don't give enough information to their doctor or because their doctor favors a particular type of treatment, according to the report in the Nov. 26 online edition of Cancer.

"We found an awful lot of patients whose treatment seemed to be contraindicated by urinary, bowel or sexual problems they had before they got treated," said lead researcher Dr. James Talcott, from the Center for Outcomes Research at Massachusetts General Hospital Cancer Center in Boston. "That's pretty good evidence that information wasn't transmitted or didn't factor in with the treatment decision."

Unlike other cancers, there are several treatment options for prostate cancer. The treatment that is best for an individual patient is based on several factors, including stage at which the cancer is diagnosed, age of the patient, and existing problems with urinary, bowel or sexual function that the patient has.

Treatments include external radiation therapy; brachytherapy, in which tiny radioactive particles are implanted into the prostate gland, and the surgical removal of the prostate gland.
Although these treatments are effective, each has a different set of side effects. External radiation can lead to bowel dysfunction, brachytherapy can cause urinary problems, and surgery can damage nerves involved in sexual function.

Treating patients who already have problems in these areas with a procedure that could exacerbate their problem is usually not recommended.

For example, treatment designed to preserve normal functions, such as nerve-sparing, prostate-removal surgery, is not appropriate for patients who have already lost sexual function, Talcott said.

To find the extent of treatment mismatches, Talcott's team collected data on 438 prostate cancer patients. Patients were asked to complete questionnaires that included questions about urinary incontinence and other urinary problems, and bowel and sexual dysfunction.

The researchers found that 89 percent of the patients had some level of urinary, bowel or sexual problem before starting treatment. Among these patients, 34 percent of those with one serious symptom had a mismatched treatment, as did 37 percent who had a less serious symptom. Moreover, 40 percent of those who had several symptoms also received contraindicated therapy.

In addition, among patients with significant dysfunction in all three areas for whom no treatment would be recommended, only 5 percent chose watchful waiting. In this strategy, patients are not treated but are followed closely.

These mismatches appear to occur because doctors and patients don't communicate well. Patients are often reluctant to talk about urinary, bowel and sexual problems, Talcott said. "And, sometimes patients override their doctor's recommendation," he added.

Talcott also thinks that physicians can be wedded to a particular treatment at the exclusion of others. "Surgeons believe in surgery, and radiation oncologists believe in radiation," he said. "That may be part of the problem."

To counterbalance physician bias, patients should get another opinion, Talcott said. "Patients should always get a second consult," he said. "It's a good idea to talk with a surgeon, a radiation oncologist and possible a medical oncologist."

One expert thinks that patients need to make an informed decision about which treatment is best.

"The kind of doctor that you see often predetermines the treatment you receive," said Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society. "Urologists are much more likely to have a surgical solution, and those who see a radiation oncologist are more likely to have radiation."

Patients need to be well-informed about their condition and the possible treatments and their side effects, Brooks said. "Patients need to arm themselves with as much information as possible about what their treatment options are, and what some of the contraindications of particular treatments are," he said.

Men also need to know what all the treatment options are, Brooks said. "Men need to be aware that, in some cases, depending on their overall medical condition and the stage of their cancer, that it is, at times, appropriate not to have any active treatment," he said. "Watchful waiting is a legitimate option in a significant proportion of men."

"In addition, doctors need to work with their patient to choose the best treatment option, Brooks said.

"If one takes the time to have a discussion, educate the patient and not rush them into a decision, then you may be able to allow them to get past their emotional response and make a more educated, logic-based response," Brooks said.

Brooks noted that because there are so many treatment options in prostate cancer, patients may insist on a particular treatment even though it's not the best choice for them.

"Where treatments are contraindicated in other places in medicine, doctors don't provide a treatment for a patient just because that's what they say they want," Brooks said. "You explain that that treatment is simply the wrong treatment for you, and therefore, we are not going to take that approach."

More information
For more on prostate cancer, visit the American Cancer Society.

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Low-Carb Diet May Slow Prostate Tumor Growth

(HealthDay News) -- In mice, a low-carbohydrate diet slowed prostate tumor growth, possibly because fewer carbohydrates leads to a drop in insulin production, U.S. researchers say.

"This study showed that cutting carbohydrates may slow tumor growth, at least in mice. If this is ultimately confirmed in human clinical trials, it has huge implications for prostate cancer therapy through something that all of us can controls, our diets," lead researcher Dr. Stephen Freedland, a urologist at Duke University Medical Center, said in a prepared statement.

Previous studies linked insulin and a related substance called insulin-like growth factor (IGF) with the growth of prostate tumors in mice. Freedland and his colleagues theorized that reducing levels of these substances might slow prostate tumor growth.

They compared tumor growth in mice eating either a low-carbohydrate diet; a low-fat but high-carbohydrate diet; or a Western diet high in fat and carbohydrates.

Mice fed the low-carbohydrate diet had the smallest tumor size and longest survival, the team found.

""Low-fat mice had shorter survival and large tumors , while mice on the Western diet had the worst survival and biggest tumors. In addition, though both the low-carb and low-fat mice had lower levels of insulin, only the low-carb mice had lower levels of the form of IGF capable of stimulating tumor growth," Freedland said.

The study is published in the Nov. 13 online edition of the journal Prostate.

Freedland is currently organizing a clinical trial to examine the impact of a low-carbohydrate diet on prostate tumor growth in men.

More information
The American Cancer Society has more about prostate cancer.

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Experts Offer Tips on Lung Cancer Prevention

(HealthDay News) -- People, especially smokers, should not rely on vitamin and mineral supplements to prevent lung cancer, say members of the American College of Chest Physicians in their second annual guide to lung cancer prevention, care and treatment.

The new evidence-based guidelines also include a strong statement opposing the use of low-dose CT scans for the general screening of lung cancer.

Lung cancer is the leading cause of cancer death in the United States. More people die from lung cancer than from colon, breast, prostate and pancreatic cancer combined.

"Each year, great strides are made in the diagnosis and treatment of lung cancer, allowing patients with the disease to live longer and increase the quality of their lives. However, the real culprit behind lung cancer is tobacco," Dr. Mark J. Rosen, president of the American College of Chest Physicians (ACCP), said in a prepared statement. "Avoiding tobacco is the key to preventing most forms of lung cancer. Until we eliminate tobacco use completely, we will continue to deal with its devastating health consequences."

Published as a supplement to the September issue of the college's journal Chest, the guidelines note there is little evidence to show lung cancerscreening changes the outcome for patients, including those considered to be at high risk.

"Even in high-risk populations, currently available research data do not show that lung cancer screening alters mortality outcomes," Dr. W. Michael Alberts, chairman of the ACCP lung cancer guidelines, said in a prepared statement. "We hope that, one day, we can find a useful and accurate tool for general lung cancer screening but, at this time, the evidence does not support the use of LDCT screening."

This is the second edition of Diagnosis and Management of Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines. The guide contains 260 recommendations, including a review of complementary and integrative therapy for the prevention and treatment of lung cancer.

Due to the lack of supporting evidence, the guidelines recommend against the use of LDCT, chest X-rays or single or serial sputum cytologic evaluation for lung cancer screening in the general population, including smokers or others at high risk. The exceptions are for patients in well-designed clinical trials.

"Population screening for lung cancer is not recommended and may, ultimately, put the patient at risk for further complications," Dr. Gene L. Colice, vice chairman of the ACCP lung cancer guidelines, said in a prepared statement. "Nodules are commonly found during screening; however, to determine whether they are cancerous requires additional testing, which is fairly invasive and extensive. This may cause the patient needless risk, both physically and psychologically."

In terms of prevention, the guidelines recommend against the use of several common supplements and medications in at-risk patients or those with a history of lung cancer.

Beta carotene tops the list of supplements that the ACCP recommends against. According to the data, there is a actually a higher incidence of lung cancer in people who use these supplements.

Other supplement recommendations:
Vitamin A, including isotretinoin, has not been shown to decrease the number of second tumors and actually increases the risk of early death for current smokers.

Vitamin E is not recommended for lung cancer prevention, as studies show that there is no difference in the occurrence of lung cancer between people taking vitamin E and those who are not.

Aspirin has been shown in some studies to play a protective role, but the guidelines do not recommend aspirin for preventing lung cancer. Studies show aspirin does not decrease the risk of death or lung cancer incidence.

This is also the first edition of the guidelines to include recommendations on techniques that can help reduce the anxiety, mood disturbances and chronic pain associated with cancer.
Massage therapy is recommended as a way to reduce anxiety and pain.

Acupuncture is recommended for patients experiencing fatigue, dyspnea and chemo-induced neuropathy. Acupuncture is also recommended for people whose nausea, vomiting or pain is poorly controlled.

Electrostimulation wristbands are not recommended for managing chemo-induced nausea or vomiting. Studies show they do little to delay nausea or vomiting.

A multidisciplinary group of 100 pulmonologists, medical oncologists, radiation oncologists, thoracic surgeons and other health professionals reviewed the 260 recommendations.

More information
To learn about lung cancer, visit the U.S. Centers for Disease Control and Prevention.

PSA Test Still Important to Detect Prostate Cancer, Studies Find

(HealthDay News) -- Despite questions as to whether early screening for prostate cancer is accurate, new research suggests it continues to be important.

And even more encouraging news indicates that statins, drugs designed to lower cholesterol, might also reduce the risk of developing prostate cancer. Both sets of findings were presented Sunday at the American Urological Association's annual meeting, in Anaheim, Calif.

Screening for prostate cancer has become controversial, particularly the issue of whether a prostate-specific antigen (PSA) blood test is useful as an early detector of malignancy. Two studies presented at the conference indicate it is still worthwhile to have such a test.

In one study, Dr. Hans Lilja, from Memorial Sloan-Kettering Cancer Center in New York City, and colleagues found that PSA testing of men in their 40s was predictive of developing prostate cancer later. In fact, the higher the initial PSA, the greater was the probability that the cancer would be aggressive, the research showed.

As recently as last month, a study published in the Journal of the National Cancer Institute found that PSA tests "perform poorly in distinguishing between those who develop a lethal prostate cancer from those at low or no risk of disease progression."

But among the patients in the Sloan-Kettering study, risk for prostate cancer was concentrated, with 89 percent of advanced cancers occurring in men with the top 10 percent of PSA levels, the researchers found.

Lilij thinks that men should have an initial PSA test when they are in their 40s rather than waiting. "It is surprising that this marker can predict cancer 20 years later," he said. "We should focus our efforts on those men who are on the highest risk for cancer."

Another study found that among patients who had a radical prostatectomy (removal of the prostate and some of the tissue surrounding it), those who had been screened for prostate cancer were more likely to have malignancy confined to the prostate, compared with men who had not been screened.

"Patients should be screened," said lead researcher Dr. Alexandre E. Pelzer, from the Medical University Innsbruck, Austria. "Screening reduces mortality from prostate cancer by 50 percent in our part of Austria, where screening is done, compared with other parts of the country where it isn't," he said.

Another debate in prostate cancer care is whether patients diagnosed with the disease should be treated immediately or whether watchful waiting is best.

In one study, Dr. Marc A. Dall'Era, and colleagues from the University of California, San Francisco, found that it was not possible to predict how fast the cancer would progress among the study subjects who had what was termed low-risk prostate cancer.

In the study, more than 400 men had their cancer watched monthly. "Among the men on active surveillance, about 28 percent progressed," Dall'Era said. "Over five years, none of the men died from prostate cancer," he added.

Men who opted for treatment were those who had the highest grade tumors, Dall'Era added.
In another study, Dr. Bradley A. Erickson, from Northwestern University, and colleagues collected data on 347 older men who selected watchful waiting. Among these men, 36 percent showed progression and/or underwent secondary treatment. Overall mortality was 30 percent, with 8 percent dying from prostate cancer.

"Men who were more likely to die were those with higher PSA and those whose cancer progressed," Erickson said. "This is the first study to that gives us a natural history of PSA screening."

In a second group of studies, researchers presented evidence that statins might reduce prostate cancer risk.

In the first report, Dr. Janet Colli, and colleagues from the University of Alabama, Birmingham, were able to make an association between declining prostate cancer rates in the United States and statin use.

The researchers said they found the declining death rates were most noticeable among white men who used statins. "There was a very strong correlation between declining prostate cancer mortality rates and declining high cholesterol levels in white males," Colli said.

Colli thinks statin use may be one reason for this decline in prostate cancer mortality. "Future studies are needed to determine the effect of statins on prostate cancer," she said.

In a second study, a research team led by Dr. Robert J. Hamilton, from Duke University Medical Center, found statins lower PSA levels. "In 1,200 men, we found an average 4.1 percent decline in PSA after starting their statin," Hamilton said. "The PSA dropped more if the patient was on a higher dose of a statin."

Moreover, men whose PSA was highest saw the greatest drop in PSA levels after starting statins, Hamilton said. "These men had an average of a 15 percent drop in their PSA," he noted.
Hamilton said studies need to be done to see if statins actually protect against prostate cancer.

He added the concern that statins may not prevent cancer, but rather mask the malignancy through the decline in PSA levels, so some prostate cancers may go undiagnosed.

In a third study, a group headed by Dr. Teemu J. Murtola from the University of Tampere, Finland, collected data on 78,484 Finnish men between the ages of 55 and 67.

They found that there were fewer cases of prostate cancer among men who used statins. "There was a dose-dependent reduction in prostate cancer among users of statins, but not among users of other cholesterol drugs," Murtola said. "The overall risk of prostate cancer was around half of that of non-statin users."

In addition, Murtola's team found that PSA levels were also lower among study subjects without cancer who used statins.

"The association of statins with the reduced risk of prostate cancer should be made known to men taking statins," Murtola said.

More information
For more information on prostate cancer, visit the U.S. National Cancer Institute.

Periodic Health Checkups Boost Cancer Screening Rates

(HealthDay News) -- For people age 50 and older, getting a checkup every year or two may improve the likelihood they'll get the cancer screenings experts recommend, a U.S. study finds.

"Because people go to the doctor anyway when they feel sick or have a medical problem, some authorities have questioned whether preventive, or general, health examinations are worth the extra time and effort," study lead author Joshua Fenton, assistant professor of family and community medicine at the University of California, Davis, said in a prepared statement.

"Our study suggests they are. If people over 50 have checkups every year or two, they're more likely to go ahead and get the cancer screenings they need," Fenton said.

The two-year study, published in the March 26 issue of the journal Archives of Internal Medicine, included over 64,000 patients, ages 52 to 78, who were eligible for breast, colon or prostate cancer screenings. Patients who had a regular checkup during that time were more than three times as likely to get a colon or prostate cancer screening than those who didn't have a checkup. Women who had a checkup were also more likely to be screened for breast cancer.

This difference in screening rates persisted, regardless of how many "illness" visits patients made to doctors during the study. This suggests that doctors may not have time to promote cancer screening when they're assessing a sick patient.

Fenton noted that a recent survey found that 97 percent of primary care doctors said they recommend appropriate cancer screening tests to patients during checkups, but few doctors discuss cancer screening during other types of patient visits.

"The preventive health exam may be an auspicious time to promote cancer screening. These visits may afford primary care physicians the opportunity to discuss and recommend cancer screening when indicated, and physicians' recommendations have been consistently associated with timely cancer screening," Fenton said.

More information
The U.S. National Cancer Institute has more about cancer screening.

Post-Surgery Radiation Boosts Prostate Cancer Results

(HealthDay News) -- A series of studies in this week's Journal of the American Medical Association offers good news to men battling prostate cancer or concerned about healthy prostate function.

One trial found that the use of radiation therapy after prostate removal improves results for men at high risk for prostate cancer recurrence.

"The benefit of adjuvant radiation is now confirmed in prostate cancer, like it is in many other cancers. Finally, we have the data to show that these patients can be helped further after their surgery," said Dr. Gregory Swanson, associate professor of radiation oncology at the University of Texas Health Science Center, San Antonio.

A second study, focused on the biology of prostate tissue in older men, found that links between testosterone replacement therapy (TRT) and prostate cancer "may not be as great as once feared," according to the trial's lead author, Dr. Leonard Marks, medical director of the Urological Sciences Research Foundation in Culver City, Calif. His team found no changes in the prostate tissue of older men after six months of TRT.

Both researchers presented their findings Tuesday at an American Medical Association news briefing in New York City that was timed to the release of the Nov. 15 issue of JAMA, which is focused on men's health.

Despite advances in early detection and treatment, prostate cancer remains a leading killer of American men. Most fatal cases of the disease occur when it is allowed to migrate beyond the gland, sparking disease recurrence.

According to Swanson, about one-third of the 230,000 new prostate cases diagnosed in the United States each year are treated with radical prostatectomy -- surgical removal of the organ. In up to half of those cases -- 30,000 men -- post-surgical tests reveal traces of lingering cancer cells that boost the risk of a recurrence.

Post-surgical ("adjuvant") radiation has a long record of "mopping up" these stray cells and improving the survival of patients with other types of cancer. However, the jury has been out as to whether the same might be true for prostate cancer.

In its study, the largest and longest of its kind to date, Swanson's team compared 10-year outcomes in a group of 425 older prostate cancer patients who had undergone radical prostatectomy but who still showed suspicious cells in the surrounding margins. His group randomly assigned half of the men to adjuvant radiation therapy, while the other half did not receive the treatment.

Ten years later, 35.5 percent of men who received radiation had developed fatal or nonfatal metastatic disease, compared to 43 percent of those who didn't get irradiated. Overall survival rates were similar between the two groups -- 71 of 214 men who received radiation died vs. 83 of 211 men who did not get the treatment.

Both of these results came very close to -- but did not meet -- so-called statistical significance, meaning that definite proof of treatment benefit is still lacking. However, Swanson believes "there is a compelling, although not conclusive" trend toward better survival in the irradiated group.

He also noted that about one-third of patients in the group who originally did not receive radiation eventually did receive it once they encountered a recurrence.

"People recognized that there was a benefit to radiation and said, 'Let's treat those patients,' " Swanson said. This probably caused more patients in the control group to survive than normally would have, confounding the results, he said.

Swanson said changes in other prostate cancer "markers" -- such as elevated blood levels of prostate specific antigen (PSA), a harbinger of cancer -- did meet statistical significance and were much more prevalent in men who did not undergo radiation, compared with those who did. Men who did not have radiotherapy were also 38 percent more likely to suffer disease recurrence that those who had had the adjuvant therapy, the study found.

The bottom line, according to Swanson: "The message to the urological community is that, yes, your patients will do better [with radiation] than with just surgery alone."

Prostate cancer risk was the focus for Marks' group of researchers, as well. He said recent media hype on the power of testosterone to boost aging males' libido and muscle tone have pushed annual U.S. sales of testosterone replacement therapy (TRT) to more than $700 million.

However, doctors have long known that testosterone can also raise a man's risk for prostate malignancy. So, Marks' team decided to look at the biological effect of six months of standard TRT, given in injections every two weeks, on the prostate tissue of 44 men ranging from 44 to 78 years of age.

All of the men had relatively low levels of circulating testosterone upon entering the study, with no sign of prostate malignancy. Forty of the men agreed to provide the researchers with prostate tissue biopsies at the beginning and end of the six-month trial.

The researchers said they found no detectable change in prostate tissue after six months of TRT, despite the fact that the therapy caused blood levels of circulating testosterone to rise to mid-normal levels. Concentrations of male hormones in prostate tissues differed only slightly after therapy, and the team saw no changes in cells -- for example, alterations in gene expression or cell proliferation -- that might point to an increased risk for cancer.

While this is good news for men who are taking or might take TRT, Marks stressed that the study only examined the prostate tissue biology of a select group of men with no prior signs of cancer.

"These data do not assure prostate safety for populations of older men harboring highly prevalent subclinical disease," said Marks, who is also clinical professor of surgery/urology at the University of California, Los Angeles. "We know that if you do thorough studies of the prostate glands of aging men, microscopic [traces] of cancer are present in many of them."

So, while this tissue sampling of 44 men found testosterone therapy to have no cancer-promoting effects, those results might not be borne out in larger epidemiological studies, he said. Until such studies are done, Marks said, "My concern is that some physicians may misinterpret these data and start using testosterone willy-nilly. My hope is that it won't be used that way."

A third study in the same issue of JAMA offered some guidance to millions of men bothered by urinary incontinence triggered -- at least in part -- by an enlarged prostate.

The study of more than 700 men found that a combination of two widely used medications, tolterodine (Detrol LA) and tamsulosin (Flomax), worked better in combination at reducing urinary trouble than either drug alone.

"In those men who don't respond to a single therapy -- and that's a host of men -- we're able to now, with this combination, provide a real improvement in their quality of life," said lead researcher Dr. Stephen Kaplan, professor of urology at Weill Medical College of Cornell University, in New York City.

More information
Find out more about prostate health at the U.S. Food and Drug Administration.

Do You Need These Tests?

Q: Do You Need These Tests?
Can you tell me what tests we all should have as we get older? Which ones do you recommend?

A: As we get older, a variety of medical tests can warn of impending problems, with hearts, bones and other chronic disorders. As long as you're in good health and have no unusual symptoms, I don't necessarily recommend an annual physical exam. But here's a list of the tests I do think everyone should have periodically as they age:

Cholesterol: This simple blood test can give you an idea of your heart disease risk. Have your cholesterol tested every five years beginning at age 20 and have your HDL ("good") cholesterol and LDL ("bad" cholesterol) checked if your total cholesterol is over 200. You should also request measurement of serum homocysteine and C-reactive protein, other indicators of heart disease risk.

Bone density: Any woman at high risk of osteoporosis (because her mother had it or because she is light boned and fair-skinned) should have this DEXA scan to determine her bone mineral density and keep track of how it is declining over time.

All women age 65 and older should have at least one DEXA scan to gauge the condition of their bones. We have good drugs to halt and reverse osteoporosis and reduce risk of hip fractures in old age. You should know, however, that DEXA tests also identify bone weakness (osteopenia) that is nowhere near the range of osteoporosis.

As a result of these findings, women may be put on the same strong drugs used to treat osteoporosis - not a wise move, in my judgment.

PSA: This test for prostate specific antigen, a protein produced by prostate cells, can warn men of prostate cancer.

However, false positives are common, and even when the test does detect cancer, it provides no information about how aggressive it is or how likely it is to spread. Until we have a reliable follow-up test to show whether or not a tumor is aggressive, I doubt the wisdom of using PSA as a screening tool, except for men at high risk of prostate cancer on the basis of family history or lifestyle. A newer test, the pro-PSA, may do better.

Discuss prostate screening with your physician.

Mammogram: Every one to two years for all women over 40 to detect early (and curable) breast cancer. Women with a positive family history of breast cancer may want to start screening earlier.

Colonoscopy: A test for early signs of colon cancer; every 10 years starting at age 50, earlier if there is a positive family history.

Blood pressure: Every two years after the age of 18 as long as your blood pressure is normal.
Eye exams: Every two to four years between ages 40 and 65; every one to two years after age 65. If you wear glasses or contacts, you should have your eyes checked annually, regardless of age.

Dental exams: Everyone, regardless of age, should have a dental check-up once or twice a year.
Full body skin exams: Check yourself monthly for moles; an annual skin exam by a physician regardless of age; follow your doctor's recommendations for more frequent exams if you've had any type of skin cancer.

Thyroid tests: All adults, particularly women, should be screened for thyroid disorders at the age of 35 and every five years thereafter.

Pap smears: Women need Pap smears to detect abnormalities that may precede cervical cancer every one to three years.

Diabetes screening: Fasting blood sugar and insulin levels should be checked if you are overweight or have a positive family history.


Weil, M.D.

An End to Prostate Problems?

Breakthrough Detoxification Research Now Being Conducted
California, August 30, 2006. Prostate conditions such as prostatitis, enlarged prostate and prostate cancer are affecting men worldwide. In fact, more than 50% of all men 50 and over suffer from an enlarged prostate (Benign Prostate Hyperplasia or BPH). The problem gets worse as men age. That’s just one possible prostate condition. Another widespread affliction is prostatitis. It affects younger as well as older men.

This week, World Health Products received full Investigational Review Board (IRB) approval to conduct clinical trial on an innovative detoxifying product, Detoxamin®, in conjunction with the antibiotic, tetracycline. Pre-study trials indicate that this combination therapy will reduce or eliminate prostate problems. The study is slated to begin September 9, 2006 at the Tustin Longevity Center in Tustin, California under the direction of Rita Ellithorpe, MD, a specialist in integrative medicine.

A recent discovery has revealed a minute life form, much smaller than the smallest bacteria. It’s called nanobacteria. Many medical scientists believe these culprits cause hardening of the arteries, kidney stones and other degenerative conditions. These ultra microbes are thought to encase themselves in a shell of calcium. Researchers involved in this current study have uncovered convincing evidence pointing to nanobacteria forming calcifications or stones on the prostate. These continually growing stones are thought to cause pressure on the prostate giving rise to prostatitis and BPH. Studies suggest that calcium biofilm surrounding the nanobacteria can removed by an amino acid, EDTA, contained in a product called Detoxamin.

The nanobacteria are exposed and then destroyed by tetracycline. This one-two approach of killing the nanobacteria with tetracycline and dissolving the calcium deposits with Detoxamin is the foundation for conducting this study. There is evidence that EDTA also has beneficial results in diminishing hardening of the arteries, atherosclosis. Detoxamin also chelates or binds poisonous heavy metals within deep tissues and enables the body to easily eliminate the toxins through urine and feces. “Our clinical trial will determine if prostate calcifications will either reduce in size or be eliminated altogether. Furthermore, we will also find out if symptoms decrease or disappear,” says Larry Clapp, PhD, co-investigator and author of Prostate Health in 90 Days.

Toxic heavy metals have been implicated in many diseases of aging from Alzheimer’s, to cardiovascular disease. “I have over 500 patients with a variety of conditions in my practice that I placed on Detoxamin; the reason, because mostly everyone I have tested has a variety of heavy metal build up in their bodies. Detoxamin is a safe, effective and convenient way to remove these menacing toxins. Therefore, we eliminate the causative agents so that other therapies can work in combination and repair the damage heavy metals cause to cells, tissues and organs,” as stated by Dr. Ellithorpe, the Principle Investigator of the study. This new clinical study supports the use of combination therapy to curtail or eliminate the growing prostate problems.

7 Keys to Prostate Cancer Management

(HealthDay News) -- Early detection and treatment are crucial to defeat prostate cancer, says a Johns Hopkins Health Alerts report that outlines seven key ways to treat prostate cancer and provides advice on how to prevent it.

The 7 Keys to Treating Prostate Cancer report was written by Dr. Jacek L. Mostwin of Johns Hopkins' James Buchanan Brady Urological Institute. The report is meant to help prostate cancer patients make informed decisions about their medical care.

Men over age 50, black Americans and men with a family history of prostate cancer have the greatest risk for the disease and should undergo regular testing for prostate cancer, says the report, which also explains prostate screening and detection methods.

The report offers the following seven keys to prostate cancer treatment:

Understand your prostate biopsy.
Get a second (and third or fourth) opinion.
Choose the right treatment.
Deal with erectile dysfunction.
Seek extra help if needed.
Understand the role of diet.
Consider complementary techniques.
An estimated 232,000 new cases of prostate cancer will be diagnosed in the United States in 2006, according to the American Cancer Society.

The report was released by Johns Hopkins Health Alerts, a consumer health information Web site, in conjunction with Johns Hopkins Medicine.

More information

Here's where you can find the 7 Keys to Treating Prostate Cancer report.



more information abour the products:
http://www.kamarani.com/index.htm?aff=dreddyclinic

An Antioxidant Update?

Q: An Antioxidant Update? You used to recommend taking 1,000-2,000 mg of vitamin C, three times a day. Now it's 250 mg twice a day. Why?

A: It is true that I used to recommend taking 2,000 to 6,000 mg of vitamin C a day divided into three doses. I changed this in 1999, after examining two important studies showing that significantly lower levels of vitamin C more than saturate the body's tissues, and thus are sufficient protection against cancer, heart disease and other chronic illnesses. I now recommend only 200 to 500 mg divided into two doses.

A review of clinical trials published in the April 21, 1999 issue of the Journal of the American Medical Association concluded that 200 mg of vitamin C a day is the maximum human cells can absorb, making anything above that level a waste. The second study came from the Linus Pauling Institute and was published in the June 1999 issue of the American Journal of Clinical Nutrition. It identified a similar dose, 120 to 200 mg, as the optimal amount for reducing the risk of cardiovascular disease, cancer, cataracts and other chronic conditions.

If you've been taking larger amounts, don't worry. There's no danger. Vitamin C is water soluble and any not used by the body is quickly eliminated.

The rest of my antioxidant cocktail is as follows:
Vitamin E: 400 IUs a day of mixed natural tocopherols, or at least 80mg of mixed tocopherol and tocotrienols. Since vitamin E is fat soluble, it must be taken with food to be absorbed. Always choose natural vitamin E (d-alpha tocopherol with mixed tocopherols) and avoid the synthetic form (dl-alpha-tocopherol). The best brands will also include mixed tocotrienols, the other components of natural vitamin E (I take vitamin E at lunch or dinner).

Selenium: 200 micrograms a day. Selenium is a trace mineral with antioxidant and anticancer properties. Selenium and vitamin E facilitate each other's absorption, so take them together. Doses above 400 micrograms a day may not be healthy.
Mixed carotenes: 15,000 IUs a day. I recommend using natural forms of mixed carotenoids, such as alpha and gamma carotene along with beta-carotene, which is easily found in health food stores. Read the label to make sure it gives you lycopene, the red pigment in tomatoes that helps prevent prostate cancer, and lutein, which protects against cataracts and macular degeneration. Better brands will include other important carotenoids like astaxanthin, zeaxanthin, phytoene and phytofluene.

Be sure to take supplements with meals to enhance absorption and reduce the risk of stomach upset.

Andrew Weil, M.D.–Author of:

• Eight Weeks to Optimum Health
• Spontaneous Healing
• The Natural Mind
• The Marriage of the Sun and Moon
• Health and Healing
• Natural Health, Natural Medicine
• From Chocolate to Morphine (with Winifred Rosen)

Prostate Biopsy Doesn't Have to Be Painful

(HealthDay News) -- Pain during prostate biopsy can be reduced by injecting an anesthetic at certain points, according to a new study out of the Mayo Clinic.
Prostate biopsies are commonly performed on men who have had abnormal digital rectal exams or elevated prostate-specific antigen (PSA) tests, both of which look for prostate cancer.

A new study to be presented Thursday at the annual meeting of the North Central Section of the American Urological Association, in San Diego, found that about 16 percent of patients experience a moderate or higher level of pain during their biopsy.
For this study, researchers recruited 243 men scheduled to undergo a prostate biopsy and assigned them to receive an anesthetic to reduce pain at one of three locations.

The men who received the anesthetic injection at the prostate apex -- the part of the prostate closest to the urethra -- and surrounding rectal tissues had the best pain relief.
"Prostate biopsy evokes significant anxiety for some men due to anticipated pain associated with the procedure," Richard Ashley, Mayo Clinic urology resident and lead study investigator, said in a prepared statement.
"Patients should request that anesthetic be used at the time of a biopsy, and pain control should be the standard of care in a urologist's office," he said.

More information
The National Cancer Institute has more about prostate cancer.

Prostate Cancer Trial to Focus on Genetics

(HealthDay News) -- Two Los Angeles-area medical centers are seeking men with prostate cancer and their spouses/partners to take part in the creation of a database that may help lead to a better understanding of the disease.

The Prostate Patient Profiles Project will collect blood and tissue samples, along with medical information, from prostate cancer patients and their spouses/partners. The data will be used in an effort to learn more about the genetics and biology of the disease and to study factors that affect how different kinds of prostate cancer respond to treatment.

The project is a collaboration between Cedars-Sinai Medical Center and Centinela Freeman Regional Medical Center. The researchers are seeking a wide cross-section of patients, including those who have difficulty gaining access to health care.

"This data collection project is being undertaken because very little is known about what causes some individuals to develop cancer while others don't," co-principal investigator Dr. David B. Agus, of the Louis Warschaw Prostate Cancer Center at Cedars-Sinai, said in a prepared statement.

"Once we better understand the genetic and proteomic patterns of men with prostate cancer, we hope to be able to develop more targeted, more individualized -- and ultimately, more effective -- treatments for prostate cancer and other cancers," Agus said.

Prostate cancer patients interested in taking part in the project can phone Cedars-Sinai Medical Center at 310-423-7600 or
Centinela Freeman Regional Medical Center at 310-674-7050, ext. 4664.
More information
The U.S. National Cancer Institute has more about prostate cancer.

Prostate Protection from Vegetables

Attention Men: Need another reason to eat your vegetables?

Research indicates that men who eat plenty of soluble fiber have a lower risk of prostate cancer. Heart-healthy fiber can be found in fresh produce, oatmeal and beans, but fiber from vegetables was shown to be the most beneficial for prostate health.

How to achieve this feat?

Be adventurous! Replace meat with beans in soup and casserole recipes; make a vegetable-based casserole the main dish at dinner; order a veggie pizza instead of a meat version; and include a fresh, organic vegetable salad with lunch and dinner. All taste good…and good for you.
Andrew Weil, M.D. – Author of:

• Eight Weeks to Optimum Health
• Spontaneous Healing
• The Natural Mind
• The Marriage of the Sun and Moon
• Health and Healing
• Natural Health, Natural Medicine
• From Chocolate to Morphine (with Winifred Rosen)

An Antioxidant Update?

Provided by: DrWeil.com

Q: I just bought some supplements and the clerk at the health food store told me I needed to take 6,000 mg of vitamin C per day. That sounds like an awful lot. What do you recommend? -- Barbara B.

A: I used to recommend taking 2,000 to 6,000 mg of vitamin C daily (divided into three doses). However, I changed my recommendation in 1999 to 200 mg daily after examining two well-designed studies showing that lower levels of vitamin C more than saturate the body's tissues, and thus are sufficient to protect against cancer, heart disease and other chronic illnesses.

One of the studies that influenced my decision was a review of clinical trials published in the April 21, 1999, issue of the Journal of the American Medical Association. It concluded that 200 mg a day is the maximum amount of vitamin C that human cells can absorb, making higher doses a waste. The second study came from the Linus Pauling Institute (Pauling himself took 18,000 mg of vitamin C per day) and was published in the June 1999 issue of the American Journal of Clinical Nutrition. It identified a similar dose, 120 to 200 mg, as the optimal amount for reducing the risk of cardiovascular disease, cancer, cataracts and other chronic conditions. I wouldn't worry if you've been taking higher doses. Vitamin C is water soluble and anything not used by the body quickly passes out. In fact, I still recommend higher dosages - up to 1,000 mg a day if you are coming down with a cold.

The rest of my antioxidant recommendations are as follows:

• Vitamin E: 400 IUs of mixed natural tocopherols (or 80 mg of mixed tocopherols and tocotrienols) a day. Since vitamin E is fat soluble, it must be taken with food to be absorbed. Also, choose natural forms of vitamin E (d-alpha tocopherol with mixed tocopherols, or better yet, mixed tocopherols and tocotrienols) instead of the synthetic form (dl-alpha-tocopherol).
• Selenium: 200 micrograms a day of a yeast-bound form. Selenium is a trace mineral with antioxidant and anticancer properties. Selenium and vitamin E facilitate each other's absorption, so take them together. Doses of selenium above 400 micrograms a day may not be healthy.
• Mixed carotenes: 10, 000 - 15,000 IUs a day of beta carotene with other carotenoids, such as alpha carotene, astaxanthin, and zeaxanthin. Make sure the mix gives you lycopene, the red pigment in tomatoes that helps prevent prostate cancer, and lutein, which protects against cataracts and macular degeneration.

Andrew Weil, M.D. –Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)

New Focus on Nutrition and Health?

New Focus on Nutrition and Health?
Provided by: DrWeil.com

Q: I notice that you're having another Nutrition and Health Conference. What kinds of issues are you going to be discussing this time? Is it only for medical professionals or can members of the public attend? -- Theresa

A: The 2005 Nutrition and Health Conference is scheduled for March 6-9 here in Tucson. I'm very excited about the program we've planned, which will cover a wide range of nutrition and health-related topics, both in the sessions designed for health professionals (including students) and the media and during our Public Forum on "Food, Politics and Society," which will launch the conference on Sunday, March 6 and is open to everyone.

During the forum, we'll deal with such topical issues as "The Optimal Diet" (a subject that I'll discuss), as well as "Micronutrients and the Role of Dietary Supplements" to be reviewed by Bruce Ames, Ph.D., senior scientist at Children's Hospital, Oakland Research Institute and a professor at the Graduate School in Molecular and Cell Biology at the University of California at Berkeley. Others speaking at the Public Forum include Dan Glickman, former U.S. Secretary of Agriculture, who will focus on our national agricultural policy and its effect on U.S. nutrition and Walter Willett, MD, professor of Epidemiology, Nutrition and Medicine at the Harvard School of Public Health, who will discuss obesity, diabetes and the food industry.

The sessions for health professionals will focus on such subjects as nutritional science and the Mediterranean diet, the benefits of a low glycemic-index diet, the challenge to health professionals of the growing epidemic of childhood obesity, and the latest findings on vegetarian nutrition. In separate sessions throughout the three-day conference we'll also discuss the latest research on nutrition for patients with a number of different health problems including arthritis, allergic diseases, attention deficit disorder, osteoporosis, diabetes, Alzheimer's disease as well as nutritional strategies for prevention of breast and prostate cancer and to prevent or minimize the degenerative diseases of aging.

Other sessions will cover what we know about antioxidants, low-carb and fad diets, and whether or not the way you eat really can reduce your risk of cancer. The conference is presented by the Program in Integrative Medicine here at the University of Arizona and sponsored by the Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine at Columbia University's College of Physicians & Surgeons.

An integral part of the conference is the opportunity to sample various high quality organic foods, from fruits and vegetables to soy foods, teas, chocolate, and cheeses as well as learn from nutrition-minded chefs who will be demonstrating their talents. Rather than eating bagels and donuts, as they do at most medical conferences, attendees can eat well and experience how delicious healthy food can be.

You're welcome to attend the public forum, and there's still time for health professionals and the media to sign up for the conference. I expect that we'll have some important insights on nutrition and health to share on this site and elsewhere after the conference.

Andrew Weil, M.D. –Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)

Vegetables Lower Prostate Cancer Risk

Vegetable intake, particularly intake of cruciferous vegetables such as cauliflower and broccoli, substantially lowers the risk of prostate cancer in men.

Prostate cancer risk was not affected by fruit intake.
The investigators considered total vegetable intake, and they found that men who ate 28 or more servings of vegetables per week had a 35% lower risk of prostate cancer compared with men who ate fewer than 14 servings per week.
In addition, men who ate three or more servings of cruciferous vegetables per week had a 41% decreased risk of prostate cancer compared with men who ate less than one serving per week, even after the researchers accounted for total vegetable intake.
Cruciferous vegetables, in particular, are high in substances called isothiocyanates, which activate enzymes that detoxify carcinogens. Vegetables evolved mechanisms to avoid being eaten, such as cytochemicals that are quite bitter and toxic.
Humans evolved the ability to detoxify these cytochemicals, and the enzyme systems that we use to detoxify cytochemicals are the same enzymes that detoxify naturally occurring carcinogens.
It may be that upregulation of these enzyme systems has a protective effect against cancer.

• prostate cancer

Journal of the National Cancer Institute January 5, 2000;92:61-68

A New Tool to Treat Prostate Cancer

A study has revealed that the once highly praised antioxidants found in red wine, grapes and peanuts were not as effective cancer preventatives as green and black tea, in slowing down the progression of prostate cancer.
Participants of the study involved 20 men who had prostate cancer and were pending prostate removal surgery. Each of the men were required to drink five cups of black tea, green tea or soda each day for five days prior to their scheduled surgeries.

The goal of the study was to determine if polyphenols, a substance found in tea, might contribute to slowing down the cell growth of the prostate cancer. One component of the study involved cutting out a piece of each man's prostate for examination. The study revealed a decrease in the growth rate of the cancer cells in the men who had consumed the black or green tea, however there was no change in the men who drank soda.

A second study consisted of six healthy participants who were given resveratrol. The study focused on the effectiveness of resveratrol, a dietary polyphenol, that was thought for several years to provide protection against cancer and heart disease. The results of the study showed that it didn't produce the same positive results.
One expert suggested concentrating on increasing one's intake of fruit and vegetables, rather than targeting single supplements or substances.

Free Radical Biology & Medicine
April 2004;36(7):829-37

Green Tea Helps You Fight Cancer

For those who don't drink green tea, it might be wise to reconsider. According to research, drinking green tea may help prevent the spread of prostate cancer.
This is because the polyphenols found in the tea target molecular pathways that shut down the production and spread of tumor cells.

Further, they inhibit the growth of tumor-nurturing blood vessels.

The study, which involved using a mouse model for human prostate cancer, indicated the consumption of green tea polyphenols (GTP) adjusted and reduced levels of the insulin-like growth factor-1 (IGF-1)-driven molecular pathways in prostate tumor cells.

The findings supported other studies, which found that increased levels of IGF-1 were associated with the increased risk of various cancers, including:

• Prostate
• Breast
• Lung
• Colon

Researchers also discovered that these GTP reduced the expression of proteins typically linked to the metastatic (additional location) spread of cancer cells. This is because the polyphenols inhibited the levels of urokinase plasminogen activator as well as cellular molecules linked to the metastasis.

EurekAlert December 1, 2004