Complementary medicine in urology:
Gespeichert in:
| 1. Verfasser: | |
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| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2002
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| Schriftenreihe: | The urologic clinics of North America
29,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI, 266 S. Ill., graph. Darst. |
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CONTENTS
Preface xv
Mark A. Moyad
Prevalence of Complementary Medicine in Urologic Practice
A Review of Recent Studies with Emphasis on Use Among Prostate
Cancer Patients 1
Robert A. Zimmerman and Ian M. Thompson Jr
The use of complementary and alternative medicine (CAM) has been used since antiq¬
uity for the relief of symptoms related to many diseases including urologic ailments.
CAM is typically defined as those healing philsophies, approaches and therapies that
are generally not taught in medical schools and are not usually reimbursed by medical
insurance companies. Complementary and alternative medicine therapies are disting¬
uished as those used alone (alternative) or in addition to conventional therapies (comple¬
mentary). Few studies have focused on the urologic population. In this article, we
summarize recent studies assessing the prevalence rate of CAM use with special empha¬
sis in prostate cancer patients.
Dietary Supplements and Other Alternative Medicines
for Erectile Dysfunction. What Do I Tell My Patients? 11
Mark A. Moyad
Dietary supplements and other alternative medicines have enjoyed a tremendous
amount of popularity and use over the past decade. Although, the prevalence of these
therapies for erectile dysfunction (ED) is unknown at this time, numerous media outlets
and alternative medicine publications seem to support the utilization of these therapies
for ED. The placebo effect is approximately 25% (1 out of 4 benefit) from past randomized
trials of FDA approved medications for ED. Adequate clinical trials are needed for di¬
etary supplements for ED to access whether or not a benefit beyond a placebo effect
exists. Clinicians should become aware of these supplements and the current research
espousing or discouraging their use, and they should understand the adverse effects
associated with them in order to effectively discuss these products with any patient in¬
quiring about them.
Herbal Medications in the Treatment of Benign Prostatic Hyperplasia (BPH) 23
Elliot Fagelman and Franklin C. Lowe
Herbal medications are used widely in the treatment of BPH. Recent studies suggest a
benefit for some of these products with few side effects. The results of these studies
are summarized and the possible mechanism of action of these medications are re¬
viewed.
VOLUME 29 • NUMBER 1 • FEBRUARY 2002 vii
Potential Lifestyle and Dietary Supplement Options
for the Prevention and Postdiagnosis of Bladder Cancer 31
Mark A. Moyad
Apart from smoking, certain occupational exposures, and schistosomiasis, little is known
about other potential lifestyle risk factors for bladder cancer. Other investigations thus
far have also been important because of the large number of individuals who are diag¬
nosed with this cancer that apparently have no known risk factors. Preventing the recur¬
rence of bladder cancer has generated some interest because several preliminary trials
have found that a combination dietary supplement of vitamins and minerals or a probio
tic agent (Lactobacillus casei) may impact this outcome favorably. Advising patients on
some of these lifestyle modifications is currently recommended because the majority of
them are also currently recommended for cardiovascular disease reduction.
Green Tea and Prostate Cancer 49
Sanjay Gupta and Hasan Mukhtar
Many laboratory studies and human epidemiological data suggest that most prostate
cancer deaths are attributable to lifestyle, including nutritional factors where diet plays
a major role in initiation as well as subsequent progression of the disease. Under these
circumstances, chemoprevention seems to be a logical and obvious strategy. Because
of its long latency and high incidence, prostate cancer is an ideal disease for chemopre¬
vention. The suitable agent(s) for prostate cancer chemoprevention should be the one(s)
that has efficacy in the laboratory experiments on one hand, and also possesses proven
epidemiological basis on the other hand. In this article, we address the use of green tea
for prostate cancer chemoprevention. Experimental as well as the epidemiological basis
for this possibility is provided.
PC SPES and Prostate Cancer 59
William K. Oh and Eric J. Small
PC SPES (Botanic Lab, Brea, CA) is a combination of eight herbal therapies with activity
against prostate cancer, both in vitro and in vivo. Studies in human prostate cancer cell
lines demonstrate significant dose dependent decreases in cellular viability after expo¬
sure to extracts of PC SPES. Clinical studies suggest that PC SPES can reduce specific
antigen levels in both androgen dependent and androgen independent prostate cancer
patients. Toxidty is mild, thought there is an approximately 5% risk of thromboembolic
events with treatment. Although PC SPES has apparent estrogenic activity, controversy
exists over the exact mechanism of its effects.
Prostate Cancer and Selenium 67
Mark A. Nelson, Mary Reid, Anna J. Duffield Lillico, and James R. Marshall
Prostate cancer is the second leading cause of cancer deaths in men. Therefore, new ap¬
proaches for the primary and secondary prevention of this malignancy are desperately
needed. Chemoprevention, with selenium compounds, is a promising new approach
that is presently under study. This article summarizes epidemiological data and inter¬
vention trial results with high selenium containing yeast that suggest that higher intakes
of selenium may reduce the risk of prostate cancer. In addition, we describe four studies
underway at the Arizona Cancer Center designed to increase our understanding of the
relationship between selenium and the risk of prostate cancer.
The Role of Soy Phytoestrogens in Prostate Cancer 71
Erik P. Castle and J. Brantley Thrasher
Epidemiological data of phytoestrogens and prostate cancer strongly supports the cancer
protective effects of isoflavones found in soy products. Inhibition of cell proliferation via
viii CONTENTS
hormone dependent and hormone independent mechanisms by soy phytochemicals has
been studied extensively in cell culture and animal studies. Herein, we review the cur¬
rent literature on the epidemiology and effects of two soy phytoestrogens, genistein
and daidzein, and would stress the need for controlled human trials to assess the true
preventive and therapeutic effects of these compounds.
Tomato Products, Lycopene, and Prostate Cancer Risk 83
Elizabeth C. Miller, Edward Giovannucci, John W. Erdman Jr, Robert Bahnson,
Steven J. Schwartz, and Steven K. Clinton
Epidemiologic studies have suggested that men consuming tomato products have a
lower risk of prostate cancer. Tomato products may contain a number of components
that could influence risk. Lycopene is the carotenoid in tomato products that provides
the familiar red color and has been demonstrated in laboratory studies to be a potent
antioxidant. Ongoing studies will further characterize the potential benefits of tomato
products or lycopene for the prevention of prostate cancer.
Vitamin D and Prostate Cancer 95
Badrinath R. Konety and Robert H. Getzenberg
Current approaches to the management of prostate cancer include surgery, radiation
therapy or hormonal manipulation either individually or in combination. Diet is increas¬
ingly being recognized as playing a role in many cancers including that of the prostate.
There is now considerable evidence suggesting a role for vitamin D in prostate cancer. In
this article, we have reviewed the current evidence supporting the use of vitamin D in
the prevention and treatment of prostate cancer.
Vitamin E and Prostate Cancer 107
Neil E. Fleshner
Descriptive epidemiologic evidence suggests that environmental exposures, such as diet,
have an important causative role in the progression of prostate cancer. Increasing evi¬
dence also suggests that vitamin E may be beneficial in preventing prostate cancer or de¬
laying disease progression. Clinical trials have been initiated that should definitively
determine the therapeutic befefit, if any, of vitamin E.
Lifestyle/Dietary Supplement Partial Androgen Suppression and/or Estrogen
Manipulation. A Novel PSA Reducer and Preventive/Treatment Option for
Prostate Cancer? 115
Mark A. Moyad
There is a large interest in prostate cancer prevention and/or slowing the progression
of this disease via dietary/lifestyle/supplement interventions. Numerous mechanisms
have been suggested as to how these interventions may lower PSA levels. However,
it is possible that the primary mechanism of action is partial androgen suppression
and/or estrogen manipulation.
The Placebo Effect and Randomized Trials
Analysis of Conventional Medicine 125
Mark A. Moyad
Randomized controlled trials are generally regarded as the gold standard of study de¬
signs to determine causality. The inclusion of a placebo group in these trials, when ap¬
propriate, is critical to acces s the efficacy of a drug or supplement. The placebo response
itself has received some attention in the medical literature over the past fifty years. The
CONTENTS i*
recent increasing utilization of dietary supplements and herbal medications by patients
makes it imperative to reevaluate the placebo response in conventional and alternative
medicine. This article will review a whole series of unique conditions (allergies/asthma,
alopecia, BPH, erectile dysfunction, osteoporosis, weight loss...) and the placebo re¬
sponse associated with them from conventional medical randomized trials.
The Placebo Effect and Randomized Trials
Analysis of Alternative Medicine 135
Mark A. Moyad
Randomized controlled trials are generally regarded as the gold standard of study de¬
signs to determine causality. The inclusion of a placebo group in these trials, when ap¬
propriate, is critical to access the efficacy of a drug or supplement. The placebo response
itself has received some attention in the medical literature over the past fifty years. The
recent increasing utilization of dietary supplements and herbal medications by patients
makes it imperative to reevaluate the placebo response in conventional and alternative
medicine. This article will review some of the negative and positive results from ran¬
domized trials utilizing dietary supplements (androstenedione, beta carotene, CoQIO,
garlic, soy, vitamin C and E...) for a number of non urologic and urologic conditions,
including cancer.
Chemoprevention of Bladder Cancer 157
Ashish M. Kamat and Donald L. Lamm
A concise review of the agents purported to have a protective role against the develop¬
ment of bladder cancer with special emphasis on dietary and nutritional modifications.
Vitamins, micronutrients, dietary fat, and water intake are emphasized and chemically
synthesized protective agents are also discussed.
Festschrift 169
Introduction
Festschrift Urology Conference in Honor of Dr. Thomas A. Stamey 171
William R. Fair
Prostate Cancer Trends in the Era of Prostate Specific Antigen
An Update of Incidence, Mortality, and Clinical Factors
from the SEER Database 173
Robert A. Stephenson
Observed trends in the SEER database demonstrate dramatic changes in prostate cancer
incidence, mortality, and clinical factors in the era of prostate specific antigen testing.
These data indicate that prostate cancer incidence has risen to a new steady state level,
that prostate cancers are being diagnosed substantially earlier in the natural history of
the disease, and that mortality rates are declining. These findings indicate that the de¬
cline in prostate cancer mortality comes in concert with increases in overdiagnosis and
overtreatment of prostate cancer.
Racial Differences in Prostate Carcinogenesis
Histologic and Clinical Observations 183
Jackson E. Fowler Jr and Steven A. Bigler
This study found that the prevalence of high grade prostatic intraepithelial neoplasia
(HGPIN) in black men was 2.2 times greater than in white men. However, black men
x CONTENTS
are underdiagnosed when compared with white men. Racial differences exist in the prev¬
alence of HGPIN and in the Gleason score of local stage cancers, suggesting racial
variability in prostate carcinogenesis. Prostate cancer screening programs need to reach
out to this underserved population.
Clinical Usefulness of Assays for Complexed Prostate Specific Antigen 193
Michael K. Brawer
Tests for the tumor marker prostate specific antigen (PSA) vary widely in specificity and
sensitivity. Use of an assay that tests the complexed form of PSA (cPSA) results in im¬
proved specificity and sensitivity. By improving specificity, similar results are obtained
by cPSA compared with use of the free to total PSA ratio but are measured by a single
analyte instead of two. Assays for cPSA can serve as a substitute for total PSA in all cur¬
rent applications.
Prostate Biopsy Strategies
Past, Present, and Future 205
Martha K. Terris
Endorectal sonography for prostatic imaging was first described in 1968 and gained
wide acceptance, particularly since the 1980s. Presently, extended biopsies consist of
the sextant biopsy pattern plus various combinations of anteriorly directed biopsies
and posterolateral sampling that includes the anterior horn of the peripheral zone.
The cancer detection rate for transrectal ultrasound guided prostate biopsies has fallen,
and the repeat biopsy rate has risen. The future will most likely see fewer biopsies per¬
formed but with wiser guiding systems.
Prediction of Tumor Heterogeneity in Localized Prostate Cancer 213
Hartwig Huland, Markus Graefen, Alexander Haese, Peter G. Hammerer,
Juri Palisaar, Uwe Pichlmeier, Rolf P. Henke, Andreas Erbersdobler,
Edith Huland, and Hans Lilja
The clinical T1 T2 prostatic carcinoma is a heterogeneous tumor in respect to pathologic
stage and outcome. Tumor heterogeneity can be fairly good predicted by the use of
classification and regression tree analysis with preoperative parameters, especially a
quantitative analysis of Gleason grade 4 5 cancer in six systematic biopsies and a deter¬
mination of preoperative prostate specific antigen levels, to predict lymph node status,
capsular penetration, and outcome.
Timing Hormonal Therapy in Prostate Cancer 223
Annette E. Sessions and Edward M. Messing
The history of the use of hormonal therapy to treat prostrate cancer is outlined, focusing
on such treatments and disease scenarios as diethylstilboestrol therapy, androgen abla¬
tion alone or in conjunction with radiation, and the treatment of minimal disease bur¬
dens. Studies have pointed to the benefits of initiating androgen ablation therapy
earlier in the treatment of prostate cancer; the greatest benefits of anti androgen therapy
may be gained when only tiny amounts of prostate cancer are present.
Current Concepts of Tumor Markers in Bladder Cancer 229
Michael J. Droller
The clinical value of various tests to detect bladder cancer is assessed in terms of their
sensitivity and specificity. Ideally, markers for urothelial cancer should be expressed only
as a consequence of the presence of cancer. Several markers that have been proposed for
CONTENTS xi
use in detecting bladder cancer are discussed, and issues that comprise their use and the
need for further validation are reviewed.
Management of Chronic Prostatitis Chronic Pelvic Pain Syndrome 235
Rodney U. Anderson
The condition of chronic pelvic pain syndrome in men is put in perspective with regard
to evolving definitions, and the author describes his current personal favorite therapeutic
approach. The Stanford Pelvic Pain Clinic uses a multidisciplinary approach to manage¬
ment that involves a psychologist and a physical therapist in addition to a urologist. In¬
vasive or destructive modalities should be limited.
New Concepts in the Pathogenesis of Urinary Tract Infections 241
Anthony J. Schaeffer
Random amplified polymorphic DNA fingerprinting was used to distinguish among
Escherichia coli bacterial strains creating urinary tract infections (UTIs) in women. Bac¬
teria bound more avidly to cells from postmenopausal donors with history of UTIs
(PK) compared with cells from women without history of UTIs (AO). Nonpiliated bac¬
terial strains did not adhere to the cell lines. Increasing S IgA concentrations has no effect
on AO cell bacterial binding, whereas bacterial adhesion to PK cell epithelium increased
with increasing S IgA concentration.
Prospective Study of Urinary Tract Infections and Urinary Antibodies
After Radical Prostatectomy and Cystoprostatectomy 251
James Iwakiri, Fuad S. Freiha, and Linda M. Dairiki Shortliffe
Men who underwent radical prostatectomy and cystoprostatectomy with orthotopic
ileal bladder substitution were followed to examine their postoperative rate of bacteriuria.
Urinary specimens from these patients before and after surgery were cultured and anal¬
yzed for antibody production. The results show that urethral sources other than the pros¬
tate produce significant amounts of immunoglobulin A and prostate specific antigen.
Significant amounts of immunoglobulin G come from sources above the urethral level.
Bacteriuria is more common in men after cystoprostatectomy with ileal bladder substitu¬
tion than after radical prostatectomy.
Index 259
xii CONTENTS
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| spellingShingle | Stamey, Thomas A. Complementary medicine in urology The urologic clinics of North America Urologie (DE-588)4062158-3 gnd Alternative Medizin (DE-588)4112639-7 gnd |
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| title | Complementary medicine in urology |
| title_alt | Proceedings from a festschrift honoring Dr. Thomas A. Stamey |
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| topic_facet | Urologie Alternative Medizin Festschrift Konferenzschrift |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009926444&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000001584 |
| work_keys_str_mv | AT moyadmarka complementarymedicineinurology AT stameythomasa complementarymedicineinurology AT moyadmarka proceedingsfromafestschrifthonoringdrthomasastamey AT stameythomasa proceedingsfromafestschrifthonoringdrthomasastamey |