1: Psychological distress increases the risk of dying from prostate cancer

A study published in the British Medical Journal (BMJ) shows that individuals with higher psychological distress are at increased risk of dying of cancer. The association was particularly strong for leukaemia, colorectal, oesophageal and prostate cancers. The study pooled data from 16 prospective studies, initiated from 1994-2008 in England and Scotland, where baseline distress information was collected using the General Health Questionnaire (GHQ-12). Analysis involved over 160 000 participants and during the study there were 16 267 deaths, of which 4353 were from cancer.

Overall, people in the highest distress grouping had a significantly increased rate of death from cancer compared to people in the lowest distress grouping (HR 1.32; 95% CI 1.18-1.48). Results were adjusted for confounding factors including age, sex, education, smoking and body mass index. When broken down by tumour site, distress was associated with a significantly increased risk of dying of prostate cancer (HR 2.29; 95% CI 1.36-3.86). In addition, for prostate and colorectal cancers a gradient was seen where there was an increased risk of death with each step-wise increase in distress. While this study does not prove that distress is causal to poorer outcomes, it suggests that future work should explore the lifestyle and biological factors associated with distress that may influence cancer mortality. 

2: Diets high in lycopene and coffee are associated with reduced prostate cancer risk

Results from two studies have shown that diets high in lycopene (most commonly ingested in tomatoes) and coffee may reduce the risk of developing prostate cancer. The first paper was a meta-analysis of studies that analysed reported lycopene intake (n=25) or circulating lycopene levels (n=18). In both cases, the highest lycopene levels were associated with a reduced prostate cancer risk (RR 0.88). There was no association seen between lycopene levels and advanced prostate cancer. 

The second Italian study looked at the effect of regular “Italian-style” coffee consumption on prostate cancer risk. The authors found that in a cohort of 6,989 men followed over 4 years, men who were diagnosed with prostate cancer had lower coffee consumption (60.1+/-51.3g/day) than men who were not diagnosed with prostate cancer (74.0+/-51.7g/day) (p<0.05). Further analysis showed that men who drank over 3 cups of coffee a day had a 53% lower prostate cancer risk compared to men who drank 0-2 cups a day (p=0.02). There has been conflicting evidence on the effect of coffee and caffeine on cancer. This study examined a geographically and culturally defined population and the authors hypothesise that, due to its production method, Italian-style coffee may have increased bioactive compounds which may be at least partly responsible for the effect seen.

As with most nutritional studies, these do not provide conclusive proof that tomatoes and coffee will prevent prostate cancer. However, they do seem to add support to the benefits of the famed Mediterranean diet!

Health professional news archive

3: The US Preventative Services Task Force recommends men make an individual informed choice on whether to have PSA test

The US Preventative Services Task Force (USPSTF) published an updated draft recommendation statement on screening for prostate cancer last month in JAMA, based on an updated systematic review and assessment of the evidence. In 2012, the USPSTF recommended against routine PSA-based screening for prostate cancer for men of all ages – a change which has led to a shift towards tumours being of higher grade and stage upon detection (read more on that from Fleshner et al). The new US recommendations, which are more in the line with the PCRMP we have here in the UK, say the decision about whether to be screened for prostate cancer should be an individual one and that clinicians should inform men aged 55 to 69 years about the potential benefits and harms of PSA testing. The draft recommendation is available for public comment on the USPSTF website until 8 May.

comments powered by Disqus