In a recent letter to Cancer Investigation, David Steinberg, a hematologist at Lahey Clinic, Burlington, Mass, wrote:

“A $1,000 lottery ticket for a Porsche Boxster automobile was offered to the investigator who accrued the most patients to a Southwest Oncology Group prostate cancer protocol.”

“This was done” Dr. Steinberg says,” with the admirable intention of increasing patient accrual and improving the outlook for men with high risk prostate cancer.”

From the point of view of the patients pulled in as “bodies” for this trial, a skeptic might say, the intention was not necessarily admirable. How is a doctor going to give a patient a fair and unbiased evaluation of whether a trial is good for that indivual to enter when a Porsche beckons – And the patient doesn’t know about this? At the very least, the doctors should have been obliged to disclose their chance of winning the Porsche among other information required for the patient’s informed consent.

The Boxster is the fastest selling Porsche in history with a base price of $42,000, nicely loaded for $9,000 more.

Kudos to Dr. Steinberg for protesting this sleaze.

Vitamin E succinate suppresses prostate tumor growth by inducing apoptosis.
Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL. Int J Cancer. 2005 Dec 27; [Epub ahead of print]

Vitamin E (VE) has been under intensive study as a chemopreventive agent for various types of cancers. Preclinical studies suggest that vitamin E succinate (VES) is the most effective antitumor analogue of VE, yet there are scarce studies of VES in prostate cancer. In this study, we investigated the effects of VES on a panel of prostate cancer cells, and a xenograft model of prostate cancer. Our results indicate that VES significantly inhibited proliferation and induced apoptosis of prostate cancer cell lines in a dose and time dependent manner. The results of microarray analysis followed by real-time RT-PCR and inhibitor analyses indicated that the VES-induced apoptosis is mediated by caspase-4 in prostate tumor cells. In our animal model of prostate cancer in SCID mouse, daily injection of VES significantly suppressed tumor growth as well as lung metastases. These results suggest a potential therapeutic utility of VES for patients with prostate cancer.

African American men have the highest prostate cancer incidence and mortality rates in the world.

African-American women who develop breast cancer are more likely to die from the disease than white women of the same age.

Survival rates are worse among African-Americans for colon and ovarian cancers as well.

And now a new study from Dana-Farber has found that even when they have equal access to specialized care, blacks with potentially curable lung cancer are about half as likely as whites to undergo surgery that could save their lives.

These findings point to a subtle and complex “communications problem” underlying the inequality, said Christopher Lathan, MD, of Dana-Farber and lead author of the report that is published online by the Journal of Clinical Oncology and will be in the journal’s Jan. 20 print issue.

“Something’s not happening. There was no specific reason that could be found, but there needs to be more attention paid to the doctor-patient interaction.” Full story:

Blacks’ lower rate of lung cancer surgery not just due to access to care

Study suggests racial disparities stem from doctor-patient interaction

A study from Fred Hutchinson Cancer Research Center, the University of Alberta, Canada and in Ankara, Turkey has found that for women whose diet is already high in folic acid, adding a folic acid supplement weakens the immune system. The women’s natural killer cells function fell below that of women deficient in folate who were not taking any supplement.

“Mounting evidence indicates that the amount and type of fat in the diet can have important effects on bone health. Most of this evidence is derived from animal studies. Of the few human studies that have been conducted, relatively small numbers of subjects and/or primarily female subjects were included. The present study assessed the relation of dietary fat to hip bone mineral density (BMD) in men and women … ”

“Models were adjusted for age, sex, weight, height, race, total energy and calcium intakes, smoking, and weight-bearing exercise. Data from women were further adjusted for use of hormone replacement therapy. Including dietary protein, vitamin C, and ß-carotene in the model did not influence the outcome.”

“Saturated fat intake was negatively associated with BMD at several hip sites. The greatest effects were seen among men below 50 y old (linear trend P = 0.004 for the femoral neck). For the femoral neck, adjusted mean BMD was 4.3% less among men with the highest compared with the lowest quintile of saturated fat intake … These data indicate that BMD is negatively associated with saturated fat intake, and that men may be particularly vulnerable to these effects.

Abstract and link to full article: American Society for Nutrition J. Nutr. 136:159-165, Corwin et al. January 2006

Dr Debra L. Bemis of Columbia University College of Physicians and Surgeons, New York, seems to be promoting an herbal mix called Zyflamend on the basis of lab tests even while she is running a Phase I trial of the same commercial product.

Bemis’s press release about her preclinical study of Zyflamend has created a lot of buzz (Google calculates 598 references). Some media (like the UK Daily Mail) are touting Zyflamend with the headline “Olive Oil Pill Can Cut Prostate Cancer Risk.” The study was published this month in Nutrition and Cancer 52(2):202-12. Zyflamend, a unique herbal preparation with nonselective COX inhibitory activity, induces apoptosis of prostate cancer cells that lack COX-2 expression.

Bemis’s lab found that Zyflamend “suppresses the growth of prostate cancer cells and induces prostate cancer cells to self-destruct.” She says Zyflamend “in culture at least,” had the ability “to reduce prostate cancer cell growth by as much as 78 per cent.”

“Together, these results suggest that Zyflamend might have some chemopreventive utility against prostate cancer in men,” Bemis says.

December 27, 2005 -Taking 1,000 international units (IU) of vitamin D3 daily appears to lower an individual’s risk of developing certain cancers – including colon, breast, and ovarian cancer – by up to 50 percent, according to cancer prevention specialists at the Moores Cancer Center at the University of California, San Diego (UCSD) Medical Center. The researchers call for prompt public health action to increase intake of vitamin D3 as an inexpensive tool for prevention of diseases that claim millions of lives each year. Full story

$50m pledge will help Therion develop drug

By Stephen Heuser, Globe Staff | December 26, 2005

In an unusual effort by a single wealthy investor to keep a medical idea alive, a German billionaire is promising $50 million to Therion Biologics Corp., a small Cambridge company trying to develop the first-ever therapeutic vaccine for cancer. ….

ts lead product, Panvac-VF, is a series of injections designed to fight pancreatic cancer, which strikes 30,000 Americans each year and is almost always fatal.

Early tests of Panvac showed it extended the lives of patients with late-stage pancreatic cancer, and the company expects results from a larger trial on 250 patients early next year. If it shows significant benefits, the company will apply for FDA approval.

”We’re all figuratively holding our breath waiting for the results of this trial,” said Leuchtenberger.

Like shots for flu or measles, cancer vaccines are designed to train the body’s immune system to fight a specific disease.

Unlike a traditional vaccine, however, the drug being tested by Therion is not preventive. Rather, it is given to people who already have cancer, in the hopes that their immune cells can learn to recognize and attack the cancer as it tries to grow and spread in the body.

A success in the trial would let Therion enter the lucrative niche of last-chance cancer therapies, among the most expensive drugs in modern medicine.

Full story at the Boston Globe’s boston.com business section

John Isaacs in an overview this month in BJU of “New strategies for the medical treatment of prostate cancer” brings up:

novel treatments that target prostate-specific antigen (PSA), human glandular kallikrein-2, or prostate-specific membrane antigen. An inactive prodrug with a thapsigargin analogue, a sesquiterpene lactone from the plant Thapsia garganica, is currently under investigation specifically for the targeted therapy of HRPC. Preclinical data suggest the PSA-targeting abilities of this novel therapy are associated with a nearly complete cessation of tumour growth with minimal toxicity.

When a researcher offers this kind of review you can guess it is a pet project. In this case Isaacs ostensibly talks about all available strategies for treating HRPC, but then he zones in on one rather obscure-sounding novel therapy.

PSAD is determined by dividing the PSA number by the prostate volume (its size as measured by transrectal ultrasound). Johns Hopkins doctors recommend this measurement “to help differentiate between cancer and BPH in men with moderately high PSA levels (4 to 10 ng/mL) and normal DRE results.”

The theory is that cancer causes a greater elevation in PSA per prostate volume than BPH. If so, PSA density should be higher in men with cancer. To find PSA density, doctors divide the PSA results by prostate volume (as estimated by transrectal ultrasound). This method is imperfect, according to the Hopkins experts; but, they add, “studies showing that PSA density levels over 0.15 indicate a high risk of cancer have led doctors to use PSA density tests for men with PSA levels between 4 and 10 ng/mL.”

Some recent studies have shown however that PSA density is not a very useful measurement.
A Spanish teams a couple of years ago said: “We conclude that PSAD and PSADTZ are not excessively useful for adequately discriminating between patients with prostate cancer and those with non-malignant disease, particularly when digital rectal examination is normal.” (Garcia Sisamon F, et al, 2003). Now a study in Kuwait, published this month, has found similarly: