More weekend news reports: March 15, 2009


We have added information about three more recent studies for your weekend reading, dealing with:

  • Soy, diet, and prostate cancer prevention
  • Outcomes of bladder neck preservation during radical prostatectomy
  • A predictive model for chemotherapy outcomes in HRPC patients

Some studies have suggested that eating soy-based foods may reduce your risk for prostate cancer. Based on a systematic literature review, Yan and Spitznagel identified 15 epidemiologic publications on soy consumption and 9 on isoflavones in association with prostate cancer risk. They then extracted relevant data from these studies to conduct a meta-analysis, showing that (a) consumption of soy foods is in fact associated with a reduction in prostate cancer risk and (b) that this protection may be associated with the type and quantity of soy foods consumed. What this study does not tell us is for how long and starting at what age one needs to eat a significant amount of soy in one’s diet to lower one’s risk for prostate cancer. Nor does it offer any specific guidance on whether soy in the diet can also lower risk for those men with specific risk factors (ethnicity, family history, etc.) — although there does appear to be a difference in the effect of soy on risk for prostate cancer between Asian and Western populations.

Razi et al. have carried out a retrospective analysis of data from their institution confirming that bladder neck preservation during radical retropubic prostatectomy may improve long-term results of urinary continence and be effective in eradicating prostate cancer without increasing the cancer recurrence rate.

We still do not know when or whether to initiate hormone therapy in men who are failing first or second-line treatments or chemotherapy in men who are hormone refractory. Good predictive models might be able to help us with such decisions. Bellmunt et al. have used data from one of the randomized, multi-center, phase III trials of docetaxel to develop a model  to predict survival at 1, 2, and 5 years in men with metastatic HRPC treated with chemotherapy. Their model includes such criteria as baseline pain, type of progression at baseline (measurable disease or bone scan compared with PSA only), presence of liver metastases, and the number of metastatic disease sites. They argue that their nomogram will be a helpful tool to stratify patients for further docetaxel-based trials and could also help to delineate the potential benefits of chemotherapy at certain points during the natural history of HRPC.

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