At the time of radical prostatectomy for prostate cancer, black men are more likely to have adverse pathologic features. Independent of socioeconomic and clinical factors, investigators came to this conclusion in a study presented at a Cancer Symposium.

According to researchers, these adverse pathologic features increase their risk of biochemical recurrence and more frequently lead to an indication for adjuvant radiation therapy.

Using the National Cancer Database, the investigators identified 313,013 men diagnosed with PCa from 2004 to 2014 and who underwent RP. The group included 256,315 whites (85%), 33,725 blacks (11%), and 12,973 patients of other races.

Significantly higher proportions of blacks than whites had Gleason grade group 2 cancer (46% vs 37.7%), PSA levels of 10 ng/mL or higher (18.5% vs 15.9%), and clinical stage T2b disease (17.8% vs 13.8%).

On multivariable analysis, the odds of having indications for adjuvant radiotherapy (pT3 disease or higher or positive surgical margins) were 21% greater among blacks than whites. Blacks had 26% greater odds of having positive surgical margins, but 23% lower odds of having pT3 or higher disease.

As for what might explain the findings, it was noted that black men may be more likely to harbor certain genetic polymorphorisms that give rise to more aggressive PCa. An autopsy study revealed that black men are more likely to have cancer in the anterior of their prostate, which could be a cause of pathologic upstaging. Another possibility is the low vitamin D, which has been linked to an increased risk of aggressive cancer. Black people in general have low vitamin D levels, possibly as a result of their darker skin.

According to the finding of three studies presented at the Genitourinary Cancer Symposiom, statins may improve overall survival among men with metastatic castration-resistant prostate cancer (mCRPC) and improve cancer-specific survival among those with high-risk prostate cancer (PCa).

In a post-hoc analysis of data from the randomized clinical trials COU-AA-301 and COU-AA-302, in which men with mCRPC were treated with prednisone plus placebo or abiraterone, researchers found that statin users had significantly better overall survival than non-users.

The reference group for both studies included patients in the placebo arm who did not use statins. Among statin users in the COU-AA-301 study, patients treated with prednisone plus abiraterone had a significant 29% decreased risk of death compared with the reference group. The investigators observed no significant decrease in death risk among statin users in the placebo arm.

In the COU-AA-302 study, statin users in the abiraterone and placebo groups had a significant 28% and 19% decreased risk of death, respectively, compared with the reference group.

In a completely separate study, researchers examined the effect of statin use on outcomes among patients with mCRPC receiving abiraterone, an anti-androgen that inhibits CYP17A1. Their analysis included 301 patients. Of these, 84 (28%) were statin users. The median overall survival for statin users and non-users was 16.2 and 11.3 months, a borderline significant difference in adjusted analyses.

The study authors concluded: “Although limited by sample size, our data showed a trend that statins may mildly enhance the anti-tumor effects of [abiraterone] in CRPC patients.”

The findings suggest that depletion of de novo cholesterol production may further limit androgen synthesis in concert with CYP17A1 inhibition.

In a population-based study of 12,700 men with high-risk PCa identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, researchers found that post-diagnostic use of statins is associated with a 47% lower risk of PCa mortality compared with patients with no documented statin use. Among obese patients, statin use was associated with a 62% decreased risk of PCa mortality. The investigators observed a synergistic effect of statins and metformin among patients with metastatic disease.

Study suggests that the side effects of therapy might be eased in patients who practice yoga.

A new research study suggests that yoga may be helpful in easing the side effects of prostate cancer therapy.

The study found that men who were novice yoga practitioners had more energy and fewer side effects such as sexual and urinary symptoms that are normally associated with radiation treatment, compared with men who didn’t practice yoga.

The typical levels of patient-reported fatigue that are normally expected to increase by around the fourth or fifth week within a typical treatment course were not evident in the study group that was practicing yoga.

Researchers reported that as many 85 percent of men who undergo radiation therapy for prostate cancer experience erectile dysfunction, often because they are also taking testosterone-depleting treatments. Many men undergoing radiation also report great fatigue after the therapy.

The patients involved in the study underwent six to nine weeks of external beam radiation therapy. Patients who were previously yoga practitioners, those with advanced stages of cancer, and those who’d previously undergone radiation therapy were not included in the study.

Of the patients in the study, 22 attended a structured yoga class two times a week while undergoing radiation therapy, while 28 others did not do yoga. This group served as a comparison group.

The findings, based on self-reported questionnaires, suggest that men who attended yoga classes had less fatigue and better sexual and urinary function than those in the other group. Furthermore, fatigue levels for men taking yoga fell as the classes went on, while they rose for men not in the classes. There was not a drop in sexual functioning scores for the men in the yoga group but these same scores dropped for the men in the non-yoga group.

One of the many theories that may explain these positive results is that yoga is known to strengthen pelvic floor muscles.

The study on yoga and men with prostate cancer was funded by grants from the American Cancer Society and the Prostate Cancer Foundation, and was published recently in the International Journal of Radiation Oncology, Biology, and Physics.

Not just a luxury any more. An adequate number of hours of sleep is not a luxury, it’s essential. A preliminary study suggests that for some men, the amount of sleep they get each night might even mean the difference between life and death.

A new preliminary study found that men younger than 65 who slept just three to five hours a night were 55 percent more likely to develop fatal prostate cancer than those who got the recommended seven hours of shuteye nightly.

Moreover, researchers in this study found that men who got six hours of sleep a night had a 29 percent higher risk of prostate cancer death compared to men who got seven hours of sleep.

The findings need to be confirmed by additional studies, but if confirmed in other studies, these findings would contribute to evidence suggesting the importance of obtaining adequate sleep for better health.

Much more research is needed to better understand the biologic mechanisms, but many experts consider the study “interesting” but not substantive enough to cause sleep-deprived males any alarm.
However, the findings from this study do contribute to evidence that the body’s natural sleep/wake cycle — circadian rhythms — might play a role in prostate cancer development.

The study results were concluded using an analysis of long-term data on more than 823,000 men in the United States. The findings were presented at the annual meeting of the American Association for Cancer Research.

It has long been known that lack of sleep can inhibit production of melatonin, a hormone that affects sleep cycles. When melatonin production is low, many experts believe that it can lead to an increase in genetic mutations, greater oxidative damage, reduced DNA repair and a weakened immune system. Some specialists believe that lack of sleep may also contribute to the disruption of genes involved in tumor suppression.

The National Sleep Foundation recommends adults get at least seven hours of sleep a night.

NOTE: Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.