Prostate Cancer: Causes, Symptoms and Treatments

Prostate cancer is a disease which only affects men. Cancer begins to grow in the prostate - a gland in the male reproductive system.

The word "prostate" comes from Medieval Latin prostate and Medieval French prostate. The ancient Greek word prostates means "one standing in front", from proistanai meaning "set before". The prostate is so called because of its position - it is at the base of the bladder.

Contents of this article:

1. What is the prostate?
2. Prostate cancer
3. Classification of prostate cancer
4. Signs and symptoms of prostate cancer
5. Causes of prostate cancer
6. Prostate cancer treatments
7. Possible complications

Fast facts on prostate cancer

Here are some key points about prostate cancer. More detail and supporting information is in the main article.

• After non-melanoma skin cancer, prostate cancer is the most common cancer among men in the US.
• Prostate cancer is one of the leading causes of cancer death among men of all races and Hispanic origin populations.
• In the US around 209,292 men are diagnosed with prostate cancer per year.
• Around 27,970 men die from prostate cancer in the US each year.
• According to the American Cancer Society about 1 man in 7 will be diagnosed with prostate cancer during his lifetime.
• Prostate cancer mainly occurs in older men - about 6 cases in 10 are diagnosed in men 65 years or older.
• Almost all prostate cancers are adenocarcinomas - cancers that begin in cells that make and release mucus and other fluids.
• Prostate cancer often has no early symptoms.
• Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine.
• Most men diagnosed with prostate cancer do not die from it. More than 2.9 million men in the US diagnosed with prostate cancer at some point are still alive today.

What is the prostate?

The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.

Diagram of the location of the prostate gland and nearby organs

The urethra - a tube that goes from the bladder to the end of the penis and carries urine and semen out of the body - goes through the prostate.

There are thousands of tiny glands in the prostate - they all produce a fluid that forms part of the semen. This fluid also protects and nourishes the sperm. When a male has an orgasm the seminal-vesicles secrete a milky liquid in which the semen travels. The liquid is produced in the prostate gland, while the sperm is kept and produced in the testicles. When a male climaxes (has an orgasm) contractions force the prostate to secrete this fluid into the urethra and leave the body through the penis.

Urine control

As the urethra goes through the prostate: the prostate gland is also involved in urine control (continence) with the use of prostate muscle fibers. These muscle fibers in the prostate contract and release, controlling the flow of urine flowing through the urethra.

The Prostate Produces Prostate-specific antigen (PSA)

The epithelial cells in the prostate gland produce a protein called PSA (prostate-specific antigen). The PSA helps keep the semen in its liquid state. Some of the PSA escapes into the bloodstream. We can measure a man's PSA levels by checking his blood. If a man's levels of PSA are high, it might be an indication of either prostate cancer or some kind of prostate condition.

It is a myth to think that a high blood-PSA level is harmful to you - it is not. High blood PSA levels are however an indication that something may be wrong in the prostate.

Male hormones affect the growth of the prostate, and also how much PSA the prostate produces. Medications aimed at altering male hormone levels may affect PSA blood levels. If male hormones are low during a male's growth and during his adulthood, his prostate gland will not grow to full size.

In some older men the prostate may continue to grow, especially the part that is around the urethra. This can make it more difficult for the man to pass urine as the growing prostate gland may be causing the urethra to collapse. When the prostate gland becomes too big in this way, the condition is called Benign Prostatic Hyperplasia (BPH). BPH is not cancer, but must be treated.

Prostate cancer

In the vast majority of cases, the prostate cancer starts in the gland cells - this is called adenocarcinoma. In this article, prostate cancer refers just to adenocarcinoma.

Prostate cancer is mostly a very slow progressing disease. In fact, many men die of old age, without ever knowing they had prostate cancer - it is only when an autopsy is done that doctors know it was there. Several studies have indicated that perhaps about 80% of all men in their eighties had prostate cancer when they died, but nobody knew, not even the doctor.

Experts say that prostate cancer starts with tiny alterations in the shape and size of the prostate gland cells - Prostatic intraepithelial neoplasia (PIN).

Doctors say that nearly 50% of all 50-year-old men have PIN. The cells are still in place - they do not seem to have moved elsewhere - but the changes can be seen under a microscope. Cancer cells would have moved into other parts of the prostate. Doctors describe these prostate gland cell changes as low-grade or high-grade; high grade is abnormal while low-grade is more-or-less normal.

Any patient who was found to have high-grade PIN after a prostate biopsy is at a significantly greater risk of having cancer cells in his prostate. Because of this, doctors will monitor him carefully and possibly carry out another biopsy later on.

Classification of prostate cancer

It is important to know the stage of the cancer, or how far it has spread. Knowing the cancer stage helps the doctor define prognosis - it also helps when selecting which therapies to use. The most common system today for determining this is the TNM (Tumor/Nodes/Metastases). This involves defining the size of the tumor, how many lymph nodes are involved, and whether there are any other metastases.

When defining with the TNM system, it is crucial to distinguish between cancers that are still restricted just to the prostate, and those that have spread elsewhere. Clinical T1 and T2 cancers are found only in the prostate, and nowhere else, while T3 and T4 have spread outside the prostate.

There are many ways to find out whether the cancer has spread. Computer tomography will check for spread inside the pelvis, bone scans will decide whether the cancer has spread to the bones, and endorectal coil magnetic resonance imaging will evaluate the prostatic capsule and the seminal vesicles.

The Gleason Score

A pathologist will look at the biopsy samples under a microscope. If cancer tissue is detected, the pathologist then grades the tumor. The Gleason System of grading goes from 2 to 10. The higher the number, the more abnormal the tissues are compared to normal prostate tissue.

Two numbers are added up to get a Gleason score:

1. A number from 1 to 5 for the most common pattern observed under the microscope. This is the predominant grade and must be more than 51% of the sample.
2. A number from 1 to 5 for the second most common pattern. This is the secondary grade and must make up more than 5% but less than 50% of the sample.

A Gleason score of 7 can have two meanings. Look at these two examples below:

1. If the predominant grade is 3 and the secondary grade is 4, the Gleason score is 7.
2. If the predominant grade is 4 and the secondary grade is 3, the Gleason score is also 7.

However, the first example, with a predominant score of 3, has a less aggressive cancer than the second example, with a predominant score of 4.

It is crucial that the tumor is graded properly, as this decides what treatments should be recommended.

Signs and symptoms of prostate cancer

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

• The patient urinates more often
• The patient gets up at night more often to urinate
• He may find it hard to start urinating
• He may find it hard to keep urinating once he has started
• There may be blood in the urine
• Urination might be painful
• Ejaculation may be painful (less common)
• Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

• Bone pain, often in the spine (vertebrae), pelvis, or ribs
• The proximal part of the femur can be painful
• Leg weakness (if cancer has spread to the spine and compressed the spinal cord)
• Urinary incontinence (if cancer has spread to the spine and compressed the spinal cord)
• Fecal incontinence (if cancer has spread to the spine and compressed the spinal cord).

Causes of prostate cancer

Nobody is really sure of what the specific causes are. There are so many possible factors, including age, race, lifestyle, medications, and genetics, to name a few.

1) Age

Age is considered as the primary risk factor. The older a man is, the higher is his risk. Prostate cancer is rare among men under the age of 45, but much more common after the age of 50.

2) Genetics

Statistics indicate that genetics is definitely a factor in prostate cancer risk. It is more common among certain racial groups - in the USA prostate cancer is significantly more common and also more deadly among Afro-Americans than White-Americans. A man has a much higher risk of developing cancer if his identical twin has it. A man whose brother or father had/had prostate cancer runs twice the risk of developing it, compared to other men.

Studies indicate that the two faulty genes - BRCA 1 and BRCA 2 - which are important risk factors for breast cancer and ovarian cancer, have also been implicated in prostate cancer risk.

In a study scientists found seven new sites in the human genome that are linked to men's risk of developing prostate cancer.

Faulty BRCA2 gene linked to aggressive form of prostate cancer - researchers at the The Institute of Cancer Research, UK, reported in the Journal of Clinical Oncology (April 2013 issue) that men who have inherited the faulty BRCA2 gene are more likely to have the faster-spreading type of prostate cancer. The scientists say these men should receive treatment immediately after diagnosis with surgery or radiation therapy, rather than receive the "watchful waiting" approach.

Senior author Ros Eeles wrote that experts have already known that those with the faulty BRCA2 gene have a higher risk of developing prostate cancer. This is the first large study to demonstrate that the faulty gene is also linked to a faster spread of the disease and poorer survival.

This new discovery will make some health authorities around the world rethink their policies and procedures. In the United Kingdom, the National Health Service offers the same prostate cancer treatment for both carriers and non-carriers of the faulty BRCA2 gene.

Prof. Eeles said "It must make sense to start offering affected men immediate surgery or radiotherapy, even for early-stage cases that would otherwise be classified as low-risk. We won't be able to tell for certain that earlier treatment can benefit men with inherited cancer genes until we've tested it in a clinical trial, but the hope is that our study will ultimately save lives by directing treatment at those who most need it."

3) Diet

A review of diets indicated that the Mediterranean diet mayreduce a person's chances of developing prostate cancer.Another study indicates that soy, selenium and green tea, offer additional possibilities for disease prevention - however, a more recent study indicated that combination therapy of vitamin E, selenium and soy does not prevent the progression from high-grade prostatic intraepithelial neoplasia (HGPIN) to prostate cancer. A diet high in vegetable consumption was found in a study to be beneficial.

A US pilot study on men with low risk prostate cancer found that following an intensive healthy diet and lifestyle regime focusing on low meat and high vegetable and fruit intake, regular exercise, yoga stretching, meditation and support group participation, can alter the way that genes behave and change the progress of cancer, for instance by switching on tumor killers and turning down tumor promoters.

Other studies have indicated that lack of vitamin D, a diet high in red meat may raise a person's chances of developing prostate cancer.

A study published in the journal Clinical Cancer Research suggests vitamin D deficiency may predict aggressive prostate cancer.

4) Medication

Some studies say there might be a link between the daily use of anti-inflammatory medicines and prostate cancer risk. A study found that statins, which are used to lower cholesterol levels, may lower a person's risk of developing prostate cancer.

5) Obesity

A study found a clear link between obesity and raised prostate cancer risk, as well as a higher risk of metastasis and death among obese people who develop prostate cancer.

6) Sexually transmitted diseases (STDs)

Men who have had gonorrhea have a higher chance of developing prostate cancer, according to research from the University of Michigan Health System.

7) Agent Orange

Veterans exposed to Agent Orange have a 48% higher risk of prostate cancer recurrence following surgery than their unexposed peers, and when the disease comes back, it seems more aggressive, researchers say. Another study found that Vietnam War veterans who had been exposed to Agent Orange have significantly increased risks of prostate cancer and even greater risks of getting the most aggressive form of the disease as compared to those who were not exposed.

8) Enzyme PRSS3 linked to aggressive prostate cancer

Scientists from the Mayo Clinic, Florida, reported in Molecular Cancer Research that PRSS3, an enzyme, changes the environment of prostate cancer cells, making the cancer much more likely to metastasize.

Senior researcher, Evette Radisky, Ph.D., said "This molecule is a protease, which means it digests other molecules. Our data suggests PRSS3 activity changes the environment around prostate cancer cells - perhaps by freeing them from surrounding tissue - to promote malignancy and invasiveness. I don't think PRSS3 is the only factor involved in driving aggressive prostate cancer, but it may be significant for a certain subset of this cancer - the kind that is potentially lethal."

Recent developments on prostate cancer causes from MNT news

Chronic prostate inflammation tied to nearly double risk of prostate cancer - a study reported in the journal Cancer Epidemiology, Biomarkers & Prevention, finds that compared to men with no such signs, men with chronic inflammationin non-cancerous prostate tissue may have nearly double the risk of developing prostate cancer.

Vasectomy linked with aggressive prostate cancer risk - In the largest and most comprehensive study of its kind, researchers from Harvard School of Public Health in Boston, MA, find that vasectomy is associated with a small increased risk of prostate cancer, and a larger increased risk for advanced or lethal prostate cancer.

Prostate cancer: high cholesterol, triglyceride levels may raise risk of recurrence - Among men who have surgery for prostate cancer, those who have high total cholesterol and triglyceride levels - two types of fat found in blood - may be at increased risk of disease recurrence. This is according to a study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

Western diet could be fatal for prostate cancer patients - A new study has suggested that following a Western diet - high in red and processed meats, refined grains and high-fat dairy products - could increase the risk of death for people with prostate cancer from both prostate cancer and all causes.

Prostate cancer treatments

The following treatments are separated into early stage and advanced stage prostate cancers.

Early stage prostate cancer

If the cancer is small and contained - localized - it is usually managed by one of the following treatments:

• Watchful waiting - not immediate treatment is carried out. PSA blood levels are regularly monitored.
• Radical prostatectomy - the prostate is surgically removed.
• Brachytherapy - radioactive seeds are implanted into the prostate.
• Conformal radiotherapy - the radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment, thus minimizing healthy tissue exposure to radiation.
• Intensity modulated radiotherapy - beams with variable intensity are used. An advanced form of conformal radiotherapy usually delivered by a computer-controlled linear accelerator.
  Treatment recommendations really depend on individual cases. In general, if there is a good prognosis and the cancer is in its early stages, all options can be considered. However, they all have their advantages and disadvantages. The patient should discuss available options thoroughly with his doctor.

More advanced prostate cancer

If the cancer is more aggressive, or advanced, the patient may require a combination of radiotherapy and hormone therapy. Radiotherapy requires treatment on an everyday basis for up to about eight weeks. Radical surgery is also an option - the prostate is removed. Traditional surgery requires a hospital stay of up to ten days, with a recovery time that can last up to three months. Robotic keyhole surgery has the advantage just a couple of days in hospital, followed by a much shorter recover period. However, even robotic keyhole surgery may not be ideal for very elderly patients.

In advanced prostate cancer hormone therapy is very effective in slowing down, and even stopping the growth of cancer cells. Even if the hormone therapy stops working after a while, there are still other options the patient will be able to discuss with his doctor, such as participating in clinical trials.

Radioactive injection helps advanced prostate cancer patients live longer - scientists at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, UK, reported in NEJM (New England Journal of Medicine) that radium-233, a radiation injection, directly targets tumors in the bone delivering short range radiation, causing minimal damage to healthy tissue. Radium, like calcium, is absorbed by the bone.

Delivering estrogen through skin patches may be an easier and safer way to treat prostate cancer than the hormone therapies that are currently used, British researchers explained in Lancet Oncology (March 2013 issue).

In May 2013, the US FDA approved Xofigo (radium Ra 223 dichloride) for metastatic castration-resistant prostate cancer that has reached bones but not other organs. Enzalutamide is taken in combination with docetaxel, another cancer medication.

Richard Pazdur, M.D., from the FDA, said "Xofigo binds with minerals in the bone to deliver radiation directly to bone tumors, limiting the damage to the surrounding normal tissues. Xofigo is the second prostate cancer drug approved by the FDA in the past year that demonstrates an ability to extend the survival of men with metastatic prostate cancer."

Xtandi (enzalutamide) was approved by the FDA in August 2012 for patients with metastatic castration-resistant prostate cancer that has spread or recurred.

Continue to Read more ...

Eating out 'raises risk for high blood pressure'

 The first ever study to show a link between eating meals away from home and high blood pressure has been published in the American Journal of Hypertension.

The researchers believe that their findings are particularly applicable to young adults of Asian descent.

Also known as hypertension, high blood pressure is the main risk factor for cardiovascular disease-associated death.

In hypertension, the greater the force of blood pushing up against the walls of the blood vessels, the harder the heart has to pump, which can lead to heart failure and heart attack. People with hypertension are also at increased risk for kidney failure, aneurysm and stroke.

About 70 million adults and 2 million children in the US are affected by hypertension.

Previous studies have found that eating meals away from home is associated with a higher intake of calories, saturated fat and salt - eating behaviors believed to be linked with high blood pressure.

To investigate whether eating out could therefore be associated with hypertension, the researchers behind the new study surveyed 501 young adults aged 18-40 who attended university in Singapore. The surveys collected information on the students' blood pressure, body mass index (BMI), lifestyle, physical activity levels and how often they eat out.

Statistical analysis of the data showed that:

• 27.4% of the students had pre-hypertension
• 49% of the male participants and 9% of the female participants had pre-hypertension
• 38% of the students ate more than 12 meals away from home per week.

The researchers found that students with hypertension or pre-hypertension were more likely than participants without hypertension or pre-hypertension to eat out more often, have a higher BMI, have lower levels of physical activity and be current smokers.

Significantly, the study also found that eating just one extra meal out per week is associated with a 6% increase in risk for pre-hypertension.

Study is first to show association between dining out and increased hypertension risk

Study author Prof. Tazeen Jafar, from the Health Services and Systems Program at Duke-NUS Graduate Medical School Singapore, says that the study is the first to show a link between eating out and pre-hypertension and hypertension:

"While there have been studies conducted in the United States and Japan to find behaviors associated with hypertension, very few have surveyed a Southeast Asian population. Our research plugs that gap and highlights lifestyle factors associated with pre-hypertension and hypertension that are potentially modifiable, and would be applicable to young adults globally, especially those of Asian descent."

Based on the study's results, the authors suggest that clinicians should advise young adults - particularly younger male patients - to modify their eating behaviors and make them more aware of their risk for pre-hypertension. The findings should also inform policy changes, such as regulating salt and fat in eateries, the researchers say.

Next, the team will embark on a related study examining potential interventions that may prevent hypertension among young adults in Singapore.

Elsewhere on Medical News Today, we report on a series of studies by researchers at the University of Illinois that investigate the benefits of making food more porous at a microstructural level to protect against hypertension.

The Illinois team believes that making food more porous will allow more salt to be released during chewing, which should allow manufacturers to lower the overall level of salt content in their foods.

MNT also recently looked at research published in the Journal of the American College of Cardiology that found Asian-Americans are at increased risk for hypertensive heart disease, ischemic heart disease and hemorrhagic stroke than non-Hispanic white Americans.

Continue to Read more ...

Baldness cured with bone marrow disease drug in alopecia areata patients

Alopecia areata causes hair loss for more than 6.5 million people in the US. Now, researchers have discovered that a drug already approved by the Food and Drug Administration for treatment of a rare bone marrow disease - ruxolitinib - could restore hair growth in these patients.

Researchers found that a drug used to treat a rare bone marrow disease - ruxolitinib - restored the hair of patients with alopecia areata within a few months.
Image credit: Columbia University Medical Center

The research team, led by Dr. Raphael Clynes and Angela M. Christiano of Columbia University Medical Center (CUMC), recently published the initial findings of their ongoing clinical trial in the journalNature Medicine.

"We've only begun testing the drug in patients, but if the drug continues to be successful and safe, it will have a dramatic positive impact on the lives of people with this disease," says Dr. Clynes.

Alopecia areata is a disease whereby the immune system attacks hair follicles - the parts of the skin from which hair grows. The majority of people with this disease experience bald patches over their head, face and body, although the condition can cause total hair loss in some cases.

It is unclear exactly what causes the disease, but this latest study may shed some light, as well as offer a potential treatment.

FDA-approved drugs 'fully restored hair in mice within 12 weeks'

Four years ago, the CUMC team conducted a study of more than 1,000 patients with alopecia areata. Their findings indicated that hair follicles send a "danger signal" to immune cells, which encourages them to launch an attack on the follicles.

The researchers investigated this further by studying mice with the disease. By tracing the danger signal backwards, they identified a certain set of T cells responsible for attacking hair follicles.

Through further research into cells of both mice and patients with the disease, the team pinpointed several immune pathways through which these T cells launch their attack. These pathways, the researchers say, can be targeted by a class of drugs known as JAK inhibitors.

The researchers tested two JAK inhibitors already approved by the Food and Drug Administration (FDA) - ruxolitinib (approved for the treatment of myelofibrosis, a rare bone marrow disease) and tofacitinib (approved for the treatment of rheumatoid arthritis) - on mice with alopecia areata that had severe hair loss from the disease.

These drugs, the researchers say, fully restored the rodents' hair within 12 weeks. Furthermore, this hair regrowth lasted for months after treatment had ceased.

Ruxolitinib restored patients' hair within 4-5 months

In this latest study, the researchers report on the findings of a small, open-label clinical trial of ruxolitinib on patients with moderate-to-severe alopecia areata, defined as having more than 30% hair loss.

Early results of the trial revealed that in three of the participants, hair growth was fully restored within 4-5 months of treatment initiation. Furthermore, the T cells that attack the hair follicles were no longer present in the participants' scalps.

Dr. Clynes says that although further testing is needed to determine whether ruxolitinib can be used for patients with alopecia areata, the findings so far are "exciting news" for those with the disease.

Commenting on the team's findings, Dr. David Bickers, of the Department of Dermatology at CUMC, says:

"There are few tools in the arsenal for the treatment of alopecia areata that have any demonstrated efficacy. This is a major step forward in improving the standard of care for patients suffering from this devastating disease."

Continue to Read more ...

"More harm than good" from red grape antioxidant

A natural antioxidant found in red grapes, resveratrol, may not be as beneficial as previously thought. New research in older men suggests that it may counteract the benefits of cardiovascular exercise.
The study comes from researchers at the University of Copenhagen, who suggest that eating an antioxidant-rich diet may hinder the health benefits of exercise, such as lower blood pressure and cholesterol.
The researchers note that since aging is associated with impaired vascular functions due to oxidative strain, resveratrol - which has been shown to decrease vascular disease and improve cardiovascular health - was initially expected to improve cardiovascular health in older men. After all, it has been proven in animal studies to be of benefit in that department.
But in a surprise twist, the researchers found that unlike in our animal counterparts, resveratrol actually impairs the cardiovascular benefits of exercise in older men.
For 8 weeks, the researchers followed 27 men who were around 65 years of age and in good health. During that time, the men all took part in high-intensity exercise, but half of the men received 250 mg of resveratrol each day, while the other half received a placebo pill.
Lasse Gliemann, a researcher who worked on the study, explains the results and design of the experiment:

"The study design was double-blinded, thus neither the subjects nor the investigators knew which participant received either resveratrol or placebo."
"We found that exercise training was highly effective in improving cardiovascular health parameters, but resveratrol supplementation attenuated the positive effects of training on several parameters, including blood pressure, plasma lipid concentrations and maximal oxygen uptake."

So even though the men were gaining health benefits from exercising, the ones who took a daily dose of resveratrol saw many of these benefits effectively wiped out.
There have been several studies lately both lauding and denouncing the health benefits of resveratrol. A 2012 study, for example, shows resveratrol's potential as a therapy for diabetes, Alzheimer's disease and heart disease. Yet, another study from the same year reveals that the antioxidant may not benefit healthy women.
Though there are arguments for and against the compound found in red wine, this particular study from the University of Copenhagen suggests that "reactive oxygen species, generally thought of as causing aging and disease, may be a necessary signal that causes healthy adaptions in response to stresses like exercise."
In short, ingesting too many antioxidants may not be a good thing, but the researchers do say that the amount of resveratrol given to the men in the study exceeds what would normally be ingested through food alone.

Continue to Read more ...

Boys' Academic Achievement Hindered By Negative Stereotyping

Negative stereotypes about boys may hinder their achievement, while assuring them that girls and boys are equally academic may help them achieve. From a very young age, children think boys are academically inferior to girls, and they believe adults think so, too. Even at these very young ages, boys' performance on an academic task is affected by messages that suggest that girls will do better than they will.

Those are the conclusions of new research published in the journal Child Development and conducted at the University of Kent. The research sought to determine the causes of boys' underachievement at school.

"People's performance suffers when they think others may see them through the lens of negative expectations for specific racial, class, and other social stereotypes - such as those related to gender - and so expect them to do poorly," explains Bonny L. Hartley, a PhD student at the University of Kent, who led the study. "This effect, known as stereotype threat, grants stereotypes a self-fulfilling power."

In three studies of primarily White schoolchildren in Britain, Hartley and her colleague investigated the role of gender stereotypes. They found that from a very young age, children think boys are academically inferior to girls, and they believe that adults think so, too.

The first study looked at children's stereotypes about boys' and girls' conduct, ability, and motivation. Researchers gave 238 children ages 4 to 10 a series of scenarios that showed a child with either good behavior or performance (such as "This child really wants to learn and do well at school") or poor behavior or performance (such as "This child doesn't do very well at school"), then asked the children to indicate to whom the story referred by pointing to a picture, in silhouette, of a boy or a girl. From an early age - girls from 4 and boys from 7 - children matched girls to positive stories and boys to negative ones. This suggests that the children thought girls behaved better, performed better, and understood their work more than boys, despite the fact that boys are members of a nonstigmatized, high-status gender group that is substantially advantaged in society. Follow-up questions showed that children thought adults shared these stereotypes.

Researchers then did two experiments to determine whether stereotype threat hindered boys' academic performance. In one, involving 162 children ages 7 and 8, telling children that boys did worse than girls at school caused boys' performance in a test of reading, writing, and math to decline (compared to a control group that got no such information). In the other experiment, involving 184 children ages 6 to 9, telling children that boys and girls were expected to do equally well caused boys' performance on a scholastic aptitude test to improve (compared to a control group). Girls' performance wasn't affected.

"In many countries, boys lag behind girls at school," according to Hartley. "These studies suggest that negative academic stereotypes about boys are acquired in children's earliest years of primary education and have self-fulfilling consequences. They also suggest that it is possible to improve boys' performance, and so close the gender gap, by conveying egalitarian messages and refraining from such practices as dividing classes by gender."

Continue to Read more ...

How Vitamin D can Benefit Men's Health

How can we get American men interested in vitamin D? Most men could care less. Say vitamin D did something men find really important, like improve athletic performance or induce hair growth? Or, say it improved sexual performance or increased virility? Nothing would get men treating their vitamin D deficiency like a study that showed vitamin D increased organ size!

Sixteen years ago, Professor Walter Stumpf (who taught me at UNC School of Medicine) first made the case that vitamin D is intimately involved with sex and reproduction. Male genital tissue contains lots of vitamin D receptors but their significance and function remain unknown. One researcher actually gave a vitamin D-like-drug to see if it improved sexual performance in patients with renal failure! To bad for the instant popularity of vitamin D, the results showed no improvement.
Am J Obstet Gynecol. 1989 Nov;161(5):1375-84
Clin Nephrol. 1980 May;13(5):208-14

Vitamin D does appear to improve virility. Conception peaks in the summer, when vitamin D levels are highest, and ebbs in the winter, when vitamin D stores are low. Vitamin D deficiency has profound effects on rat testicles, including dramatically reducing spermatogenesis. Vitamin D deficient male rats were 73% less likely to successfully father pups than vitamin D sufficient males. Vitamin D restored virility to vitamin D deficient male rats and should do the same for vitamin D deficient male humans.
Hum Reprod. 1992 Jul;7(6):735-45
Ann Nutr Metab. 1992;36(4):203-8
Ann Nutr Metab. 1995;39(2):95-8
J Nutr. 1989 May;119(5):741-4

What else are men interested in besides sex? Hair growth! In fact, hair follicles have large numbers of vitamin D receptors but their function is unknown. Although there are no human studies showing vitamin D will grow men a new head of hair, vitamin D like drugs do grow hair in mice. (By the way, both my wife and my barber have told me my head has stopped balding and I've kept my 25(OH)-vitamin D level around 50 ng/ml for several years.) One relevant animal study should get the attention of men; the title contains two of their favorite words: "nude" and "hair growth."
Endocrinology. 2002 Nov;143(11):4389-96


What about weight? Can you see the headlines in the men's' fitness magazines: "Vitamin D Reduces Weight." Although dozens of studies have found that those with the highest 25(OH)-vitamin D blood levels weigh the least, most vitamin D scientists explain this by pointing out that vitamin D is stored in fat tissue, thus lowering blood levels. Of course that does not preclude vitamin D from also having either a direct or indirect effect on weight.
J Clin Endocrinol Metab. 2003 Jan;88(1):157-61
J Clin Endocrinol Metab. 2004 Mar;89(3):1196-9
J Clin Endocrinol Metab. 2005 Feb;90(2):635-40
Am J Clin Nutr. 2000 Sep;72(3):690-3

One study tried to answer that question by looking directly at vitamin D intake and body weight. The authors found an inverse correlation. That is, the more vitamin D in your diet, the less you weighed! If you have a few minutes, test your knowledge by taking our quiz on obesity and vitamin D.
J Nutr. 2003 Jan;133(1):102-6
Obesity and Vitamin D Quiz.

Finally, we turn to athletic performance. After sex, hair growth, and obesity, improving athletic performance would certainly make American men pay attention to vitamin D. Actually, what we are asking is: "Does the most potent steroid hormone system in the human body have any effects on balance, muscle strength, muscle mass, reaction time, etc?" When asked that way, it would be surprising if it had none. In fact, dozens of studies suggest vitamin D will improve athletic performance.

If vitamin D improves athletic performance, then we'd predict physical fitness should peak in the late summer when 25(OH)-vitamin D levels peak. The only two studies that looked at season of the year and athletic performance of trained athletes found physical fitness peaked exactly then.
Acta Physiol Pol. 1981 Nov-Dec;32(6):629-36
Rom J Physiol. 2000 Jan-Dec;37(1-4):51-8

Genetic ablation of vitamin D receptors caused profound impairment in the motor functions of mice. Furthermore, mice without the vitamin D receptor gene showed increased anxiety; performance anxiety is something all men want to avoid. Babies born to vitamin D deficient rats are permanently and irreversibly brain damaged, proving that vitamin D has profound effects on developing neural tissue. (We will have more on this important, and tragic, research coming out of Australia in a future newsletter.)
Brain Res Bull. 2004 Jul 30;64(1):25-9

Muscle strength is important to athletes and it correlated with 25(OH)-vitamin D levels in older men. A vitamin D like drug improved muscle strength in vitamin D deficient older women. In fact, it did the same thing to a group of vitamin D deficient younger women. Furthermore, improved lower extremity function was directly associated with higher 25(OH)-vitamin D levels.
Arch Phys Med Rehabil. 1999 Jan;80(1):54-8

Athletes need to be quick. A single injection of 600,000-units of vitamin D significantly improved reaction times in older adults. Furthermore, higher 25(OH)-vitamin D levels were also independently associated with better reaction time and better performance time.
Age Ageing. 2004 Nov;33(6):589-95

Athletes need good balance. The beneficial effect vitamin D has on balance (reduced falls) is not limited to profoundly vitamin D deficient populations; a vitamin D-like-drug improved balance in the general elder population, even those with "normal" 25(OH)-vitamin D levels. A more recent study showed higher 25(OH)-vitamin D levels correlated with better gait speed, balance and muscle strength.
J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):497-501.

Vitamin D also appears to maintain muscle mass in older people but, no one has reported similar studies of young adults. A recent review concluded that vitamin D is an authentic strength preserving hormone, at least in the elderly. There is no reason to think it has any less effect on vitamin D deficient younger persons.
J Clin Endocrinol Metab. 2003 Dec;88(12):5766-72

Finally, debilitating chronic pain sidelines many athletes. One Mayo clinic study found that virtually all patients treated for chronic pain have low 25(OH)-vitamin D levels. Furthermore, in what must be one of the largest open studies ever reported, 360 patients with low back pain in Saudi Arabia responded exceptionally well to treatment with physiological doses of vitamin D. Like virtually all areas of vitamin D research, we are still awaiting definitive research.
Mayo Clin Proc. 2003 Dec;78(12):1463-70

An impressive scientific literature suggests that vitamin D may improve athletic performance. This should surprise no one as other steroid hormone systems improve athletic performance. One difference is that the U.S. government is going to find it hard to regulate the vitamin D steroid hormone system; the sun is both a free and robust source of vitamin D. Of course, oral vitamin D is toxic in overdose and vitamin D toxicity would greatly impair athletic performance. Smart athletes would get enough sun, or take enough cholecalciferol, to keep their 25(OH)-vitamin D levels around 50 ng/ml, year around. But then, smart non-athletes would do the same.

What would happen if researchers gave physiological doses of cholecalciferol to men for a year or two and studied their sex life, hair growth, weight and athletic performance? Would vitamin D improve men's sex life? Would it make them more virile? Would they stop going bald? Would they lose weight? Would they become better athletes?

We don't know. However, a rapidly expanding scientific literature indicates vitamin D lowers their risk of heart disease, diabetes, hypertension, multiple sclerosis, autoimmune illness, depression and seventeen different types of cancer. It now appears likely that vitamin D has an important role in treating those killer diseases as well.

But that doesn't really interest most American men. Men want to know about the important stuff. Why not start taking 2,000 units of cholecalciferol every day and see if your sex life improves, your hair grows back, you lose weight, and you become a better athlete? (And, don't forget to measure down there; after all, you never know).

Continue to Read more ...

Diseases & Its Solutions in Foods

HEADACHE	EAT FISH	Eat plenty of fish -- fish oil helps prevent headaches. So does ginger, which reduces inflammation and pain.
HAVE FEVER	EAT YOGURT	Eat lots of yogurt before pollen season. Also-eat honey from your area (local region) daily.
TO PREVENT STROKE	DRINK TEA	Prevent buildup of fatty deposits on artery walls with regular doses of tea. (actually, tea suppresses my appetite and keeps the pounds from invading....Green tea is great for our immune system)
INSOMNIA (CAN'T SLEEP )	HONEY	Use honey as a tranquilizer and sedative.
ASTHMA	EAT ONIONS	Eating onions helps ease constriction of bronchial tubes.
ARTHRITIS	EAT FISH, TOO	Salmon, tuna, mackerel and sardines actually prevent arthritis. (fish has omega oils, good for our immune system)
UPSET STOMACH	BANANAS - GINGER	Bananas will settle an upset stomach. Ginger will cure morning sickness and nausea.
BLADDER INFECTION	DRINK CRANBERRY JUICE	High-acid cranberry juice controls harmful bacteria.
BONE PROBLEMS	EAT PINEAPPLE	Bone fractures and osteoporosis can be prevented by the manganese in pineapple.
PREMENSTRUAL SYNDROME	EAT CORNFLAKES	Women can ward off the effects of PMS with cornflakes, which help reduce depression, anxiety and fatigue.
MEMORY PROBLEMS	EAT OYSTERS	Oysters help improve your mental functioning by supplying much-needed zinc.
COLDS	EAT GARLIC	Clear up that stuffy head with garlic. (remember, garlic lowers cholesterol, too.)
COUGHING	USE RED PEPPERS	A substance similar to that found in the cough syrups is found in hot red pepper. Use red (cayenne) pepper with caution-it can irritate your tummy.
BREAST CANCER	EAT Wheat, bran and cabbage	Helps to maintain estrogen at healthy levels.
LUNG CANCER	EAT DARK GREEN AND ORANGE AND VEGGIES	A good antidote is beta carotene, a form of Vitamin A found in dark green and orange vegetables.
ULCERS	EAT CABBAGE ALSO	Cabbage contains chemicals that help heal both gastric and duodenal ulcers.
DIARRHEA	EAT APPLES	Grate an apple with its skin, let it turn brown and eat it to cure this condition. (Bananas are good for this ailment)
CLOGGED ARTERIES	EAT AVOCADO	Mono unsaturated fat in avocados lowers cholesterol.
HIGH BLOOD PRESSURE	EAT CELERY AND OLIVE OIL	Olive oil has been shown to lower blood pressure. Celery contains a chemical that lowers pressure too.
BLOOD SUGAR IMBALANCE	EAT BROCCOLI AND PEANUTS	The chromium in broccoli and peanuts helps regulate insulin and blood sugar.

Continue to Read more ...