The Wednesday news report: March 25, 2009

We have separately addressed data from a 15-year follow-up of a population-based Swedish screening study. Other reports today deal with:

  • The impact of dietary and supplemental zinc on prostate cancer risk
  • Prediction of risk for loss/preservation of erectile function post- prostatectomy
  • Anti-androgen therapy and brachytherapy: options and outcomes

Gonzalez et al. have evaluated the association between dietary and supplemental zinc and prostate cancer within the prospective VITamins And Lifestyle (VITAL) cohort, a study specifically designed to look at the impact of dietary supplements and cancer risk. According to their data, dietary zinc was not associated with prostate cancer but long-term  supplemental zinc intake was associated with a reduced risk of clinically relevant, advanced disease. Few epidemiologic studies have investigated the association between zinc and prostate cancer. To date these studies have not yielded consistent findings.

Marien et al. have reported data on factors predicting the preservation of erectile function in men undergoing open radical retropubic prostatectomy (RRP).Their data suggest that several factors existing prior to surgery were potential indicators of the preservatuion of potency erectile function post-surgery, including age, coronary artery disease, diabetes mellitus, quality of preoperative erections, frequency of intercourse, hypertension, neurovascular bundle preservation and the use of phosphodiesterase type 5 inhibitors. However, on multivariate analysis, only age, no history of diabetes mellitus, and neurovascular bundle preservation were independent predictors of potency post-surgery. The authors suggest that these parameters should be considered when counseling surgical candidates so that erectile function expectations are realistic.

Chen et al. have investigated whether whether maximum androgen blockade (MAB) with a luteinizing hormone releasing hormone (LHRH) agonist and an anti-androgen is associated with a decreased recurrence risk vs. single-agent androgen suppression (monotherapy) for men undergoing brachytherapy (BT) for localized prostate cancer. Their study was based on data from 223 men in the Cancer of the Prostate Strategic Urologic Research Endeavor database who received androgen deprivation therapy (ADT) concurrent with BT for intermediate- or high-risk prostatic adenocarcinoma, of whom 159 (71 percent) received MAB, and 64 (29 percent) received monotherapy (an LHRH agonist or an anti-androgen alone).  After a median follow-up of 49 months, the use of MAB compared to monotherapy was not associated with a decrease in the risk for recurrence, after adjusting for known prognostic factors. The 3-year recurrence free survival was 76 percent for patients in both monotherapy and MAB groups. The authors conclude that both monotherapy and MAB appear to be reasonable options.

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