Could Coffee Lower Men's Risk for Prostate Cancer?

Men who drink at least six or more cups of coffee a day may be cutting their risk for advanced prostate cancer by 60 percent, new research suggests. This is the first large study looking specifically at the relationship between coffee and metastatic prostate cancer, lead researcher Kathryn Wilson said. "This is an exciting finding, because there aren't many modifiable risk factors for prostate cancer." A definite cause-and-effect link is still far from proven, experts say, and just how coffee might help thwart prostate malignancy isn't clear.

"There are a lot of compounds in coffee that have various biological effects. It's a major source of antioxidants and that might have anti-cancer effects," said Wilson, a research fellow in epidemiology at the Harvard School of Public Health, Boston. "Also, coffee seems to have effects on insulin and has been associated with a lower risk of type 2 diabetes. In addition, insulin is thought to play a role in many cancers, including prostate cancer." Compounds in coffee also have an impact on sex hormone levels, according to the study.

But right now, the findings point only to an association between a love of "java" and a healthier prostate. More study will be needed to confirm the findings and to see if a biological explanation for the phenomenon exists, Wilson said. The bottom line, she said: "It's probably too early to tell someone that should go out and start drinking coffee just because of this study." The report was published in the May 17 online edition of the Journal of the National Cancer Institute. Prostate cancer is the most common cancer diagnosed and the second leading cause of cancer death in men in the United States. In the U.S. it affects one in six men during their lifetime. More than 2 million Americans and 16 million men around the world are prostate cancer survivors, the researchers say.

Genome Scans May Reveal Life-Saving Alternatives for Cancer Patients

A 39-year-old woman is referred to Washington University's Siteman Cancer Center in St. Louis with suspected acute myeloid leukemia (AML), a cancer that can be treated relatively simply with medication, or not so simply with a high-risk stem cell transplant, depending on the tumor subtype. But finding out which type of cancer she has proves trickier than expected. While the pathologist sees a type of leukemia known as M3AML, which generally has a good outcome and can be treated with the drug ATRA, the cytogeneticist sees something entirely different.

In his analysis, the woman has a type of leukemia with poor long-term survival that is usually treated with stem cell transplantation a risky therapy that sometimes leads to death. Fortunately, in this case study, documented in the April 20 issue of the Journal of the American Medical Association, the woman's oncologist is aware of a clinical trial and, deferring treatment for six weeks, refers her there so the researchers can do a full scan of her genome and come up with an answer.

Full-genome sequencing involves scanning all the thousand of genes on the human genome to try to find a mistake. It's different from the more common gene testing these days, which looks only for specific DNA that might or might not be responsible for a particular problem. In the St. Louis case, the more in-depth sequencing, done in only seven weeks, uncovered a new genetic "mistake" that showed the woman could be treated with ATRA and not the more-complicated, risky stem cell transplantation.

Starting HIV Drugs Earlier May Delay AIDS But Not Death

New research suggests that HIV-infected patients are most likely to stay clear of AIDS longer if they start drug therapy when their immune systems are still relatively strong. However, starting treatment earlier, compared to waiting, didn't affect dying from AIDS. "There wasn't a clear benefit in terms of preventing death" by prescribing the drugs before some guidelines suggest, said Dr. Keith Henry, director of HIV clinical research at Hennepin County Medical Center in Minneapolis and co-author of a commentary accompanying the study, published in the April 19 edition of Annals of Internal Medicine.

The issue of when to begin drug treatment is a hot topic in the field of AIDS/HIV medicine. If physicians wait to begin treatment, patients can delay the expense not to mention the side effects of pricey anti-HIV drugs. But such delays may also give the virus a chance to become more powerful and better able to fend off medications. If they're not treated with drugs, HIV-infected people almost always go on to develop AIDS. So when should doctors turn to the drugs? In the U.S., guidelines suggest that HIV-infected patients take them when the level of CD4 cells an important part of the immune system dips below 0.500 X 109 cells per liter (cells/L).

In Europe, the guideline number is frequently lower meaning a weaker immune system at under 0.350 X 109 cells/L.In the new study, researchers examined how patients did when they began drug therapy with their CD4 cells at a variety of levels. The study authors examined the medical records of almost 21,000 HIV-infected patients who sought treatment in HIV clinics in Europe and through the Veterans Health Administration system in the United States. The researchers found that the death rate was about the same regardless of whether patients began treatment when their CD4 levels dipped under 0.500 X 109 cells/L or if they waited until their immune systems deteriorated more and reached below the level of 0.350 X 109 cells/L.

New Heart Failure Therapy Proves Most Effective in Women

A therapy to prevent heart failure is twice as effective in women as in men, a new study finds. It's the first time that a heart treatment has been shown to offer greater benefit to women, the researchers added. The finding was "unexpected, but extremely important," study author Dr. Arthur J. Moss, a professor of medicine at the University of Rochester Medical Center, said in a news release. He and his colleagues looked at the effectiveness of cardiac resynchronization therapy with defibrillator (CRT-D) in 1,820 patients in Canada, Europe and the United States.

CRT-D combines the benefits of both an implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy. ICDs prevent sudden, irregular rhythm-related cardiac death, and resynchronization therapy boosts heart function and reduces the risk of heart failure and related symptoms. CRT-D is approved in the United States to treat patients with severe heart failure and those with mild heart failure to prevent them from progressing to advanced heart failure. The CRT-D device was developed by Boston Scientific, which was a partner in this study.

Among women, CRT-D led to a 70 percent reduction in heart failure and a 72 percent reduction in death. Among men, the treatment led to a 35 percent reduction in heart failure, according to the report published in the Feb. 7 issue of the Journal of the American College of Cardiology. "It's not that men did poorly in the trial, but rather, women had really fantastic results, likely due to the type of heart disease we see more commonly in women," Moss said in the journal news release.

Black Smokers May Face Higher Death Risk Than Whites: CDC

A study conducted in Missouri suggests that smoking may be even more lethal for blacks than it is for whites. In fact, researchers say the smoking related death rate for blacks is nearly one-fifth higher than it is for whites in that state. The study was conducted by researchers at the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. They analyzed data from 2003-2007 found that the average annual smoking-attributable death rate was 358 per 100,000 for blacks in Missouri and 286 per 100,000 for whites, a difference of 18 percent. That racial difference was larger among men than among women.

Blacks had a 26 percent higher smoking-related death rate for cancer and a 53 percent higher smoking-related death for circulatory diseases, but a 32 percent lower smoking-related death rate for respiratory diseases. Overall, smoking caused about a third of all cancer deaths, 15.3 percent of all circulatory disease deaths, and 46.5 percent of all respiratory disease deaths in Missouri between 2003 and 2007, according to the study. The findings appear in this week's issue of Morbidity and Mortality Weekly Report. Based on the data, the CDC says that "states should continue to implement population-wide tobacco control interventions that reach all racial groups."

Unvaccinated Teen's Life Forever Changed

Carl Buher came home from the football game feeling rotten. A strong, healthy, 14-year-old high school freshman, Carl had attended a day's worth of school and then played in the game, but it felt as if he were coming down with the flu. That made sense: A lot of his teammates had recently had the flu, and he figured they'd just passed it on to him. So he came home, ate, did his homework and went to bed, recalled Carl's mother, Lori Buher of La Conner, Wash. When she woke him up in the morning, Carl told her he'd been up all night vomiting. "We figured he had the flu, so he stayed home from school," Buher said. The first sign that Carl might be sicker than they thought came in the form of purple bruises that began to form, first on his face and then down his arms and legs. By 2 p.m., Buher took her son to the doctor, concerned for his health.

The doctor diagnosed Carl quickly and, as it turned out, accurately: The teen had contracted meningococcal meningitis. The diagnosis took Buher by surprise. "He had none of the symptoms you hear about," she said. "No stiff neck. No terrible headache. No high fever." The family physician sent Carl to the local hospital's emergency room. Within hours he was being airlifted to Seattle Children's Hospital. "His heart stopped twice on the helicopter," Buher said. "They had to revive him." This was in 2003, and Buher knew about meningitis and knew that a vaccine was available to prevent it. But at the time, the vaccine Menomune wasn't recommended for kids Carl's age. Teens headed for college were supposed to get the vaccine, but even that was a shaky proposition.

Buher's two college-age kids were on a waiting list for Menomune vaccination but hadn't received it yet because supplies were short. Now her son Carl was incredibly sick with the disease. She and her husband hurriedly made the hour's drive to Seattle. "When we got there, they had a social worker waiting to help us prepare for his death," she remembers. "It was so overwhelming." Doctors put Carl in a drug-induced coma, in which he lingered for five weeks. His mother recalls that he was given more than 25 different medications to keep his body functioning. Nonetheless, meningitis ravaged Carl's body. He had to have both legs amputated below the knee, and he also lost three fingers. The purple bruising turned out to be his skin dying, which led to gangrene. Carl endured skin grafts all over his body, 13 in all, and still bears the scars. His weight fell from 185 to 119 pounds.

Generics As Good As Costly Blood Pressure Meds, Study Finds

Costly, brand-name blood pressure-lowering drugs are no better at preventing cardiovascular disease than older, generic diuretics, reveals long-term data from a large study. It included more than 33,000 patients with high blood pressure who were randomly selected to take either a diuretic or one of two newer drugs a calcium blocker or an ACE inhibitor. Data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial released in 2002 showed that after four to eight years of follow-up, the diuretic was better than the calcium blocker in preventing heart failure and better than the ACE inhibitor in preventing stroke, heart failure and overall cardiovascular disease.

Differences between the drugs narrowed after eight to 13 years of follow-up, the findings show. However, the diuretic was still better in two areas. Compared with patients taking the diuretic, those in the ACE inhibitor group had a 20 percent higher death rate from stroke, and those in the calcium channel blocker group had a 12 percent higher rate of hospitalization and death because of heart failure. The results were to be presented Friday at the China Heart Congress and International Heart Forum in Beijing. "We are continuing to mine data that we collected during the trial," Dr. Paul Whelton, president and CEO of Loyola University Health System and chairman of ALLHAT, said in a university news release. ALLHAT is sponsored by the U.S. National Heart, Lung and Blood Institute.