Diet change among prostate cancer patients under expectant management

期待治疗下前列腺癌患者的饮食变化

• 批准号: 7941693
• 负责人: James Marshall
• 金额: $ 48.5万
• 依托单位: ROSWELL PARK CANCER INSTITUTE CORP
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-28 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7941693
• 关键词: Adoption; American; Anxiety; Biopsy; Blood; Cancer Control; Cancer Patient; Cancer and Leukemia Group B; Carotenoids; Cessation of life; Clinical; Clinical Data; Cold Therapy; Community Clinical Oncology Program; Complication; Consumption; Coronary heart disease; Counseling; Detection; Diagnosis; Diet; Dietary Intervention; Dietary Practices; Disease; Disease Progression; Enrollment; Environmental Exposure; Epidemiology; Fostering; Fright; Gleason Grade for Prostate Cancer; Goals; High Vegetable Diet; Hour; Incidence; Individual; Indolent; Intake; Intervention; Investigation; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Monitor; Morbidity - disease rate; Operative Surgical Procedures; Patient observation; Patients; Phenotype; Plants; Plasma; Prevalence; Probability; Prostate Cancer therapy; Quality of life; Questionnaires; Radiation; Radiosurgery; Recommendation; Relative (related person); Research; Risk; Screening procedure; Staging; Telephone; Testing; Time; Vegetables; active method; arm; base; cancer diagnosis; cancer initiation; clinical research site; conventional therapy; cruciferous vegetable; experience; fruits and vegetables; hormone therapy; improved; meetings; men; mortality; novel; oncology; oncology program; pre-clinical; primary outcome; programs; public health relevance; randomized trial; tumor; tumor progression

DESCRIPTION (provided by applicant): Prostate cancer, diagnosed in over 200,000 American men each year, remains a significant cause of mortality; in 2007, it will be responsible for approximately 27,000 deaths. Advances in screening have fostered tremendous improvements in detection, such that most prostate cancers are now diagnosed at extremely early stages amenable to cure by surgery or radiation. Nonetheless, although cure for these early cancers is readily possible, the therapy that produces this cure often significantly diminishes quality of life. A complication of prostate cancer control is that the prevalence of undiagnosed, apparently occult prostate cancer is high relative to the incidence of symptomatic or fatal disease. Prostatic cancer among many men is occult, non-symptomatic and not life-threatening; these men will die with, rather than of, their disease. Many screen-detected prostate cancers, especially those diagnosed at a very early stage, might otherwise never cause symptomatic disease. Given the substantial morbidity of prostate cancer therapy, it would be of great benefit to identify men with early stage disease for whom radical intervention can be delayed. The focus of this study is low grade, low-volume prostate cancer (LGLV prostate cancer). Prostate cancer in these men is increasingly being monitored by an approach known as expectant management (EM). The probability that an early-stage prostate cancer will develop into aggressive disease may be altered by environmental exposures, including diet. There is observational evidence that a diet high in fruits and vegetables is negatively associated with the risk of prostate cancer initiation and progression. It would be valuable to know whether adoption of a plant-intensive diet could decrease the risk that LGLV prostate cancer progresses to more advanced stages. This proposal is to assess whether a diet emphasizing plant consumption decreases the probability that LGLV prostate cancer in EM patients progresses to a more aggressive form of cancer that merits active treatment. The intervention will be conducted through one of the leading cooperative oncology research groups: Cancer and Leukemia Group B (CALGB). Patients will be enrolled through individual CALGB and Cooperative Community Oncology Program clinical sites. Experimental patients will receive a telephone-based intervention that has been shown to alter the dietary practice of prostate cancer patients; control patients will receive a packet of diet-recommendation materials issued by the NCI. Diet change will be evaluated by 24-hour recalls and by blood carotenoids. Disease will be monitored by PSA and appropriate clinical surveillance for 24 months. PUBLIC HEALTH RELEVANCE: Prostate Cancer is diagnosed in over 200,000 American men each year. A substantial proportion of prostate cancer is low-grade, low-volume and apparently indolent. Expectant management, which does not lessen the quality of life as intervention does, may be appropriate for such patients; interventions intended less to cure disease than to forestall its progression to a more aggressive phenotype are worth investigation. This proposal is to investigate whether a dietary intervention emphasizing a plant-based diet slows or blocks progression of prostate cancer.

描述（由申请人提供）：前列腺癌，每年在超过200，000名美国男性中诊断，仍然是死亡的重要原因;在2007年，它将导致大约27，000人死亡。筛查的进步促进了检测的巨大改进，使得大多数前列腺癌现在在非常早期的阶段被诊断出来，可以通过手术或放射治疗。尽管如此，尽管这些早期癌症的治愈是容易的，但产生这种治愈的治疗通常会显着降低生活质量。前列腺癌控制的一个并发症是未诊断的、明显隐匿的前列腺癌的患病率相对于有症状或致命性疾病的发病率很高。前列腺癌在许多男性中是隐匿性的，无症状的，不危及生命;这些男性将与疾病一起死亡，而不是死于疾病。许多筛查发现的前列腺癌，特别是那些在非常早期诊断的前列腺癌，可能永远不会引起症状性疾病。考虑到前列腺癌治疗的发病率很高，识别出早期疾病的男性，对于他们来说，根治性干预可以延迟，这将是非常有益的。本研究的重点是低级别、低体积前列腺癌（LGLV前列腺癌）。这些男性的前列腺癌越来越多地通过一种称为期待管理（EM）的方法进行监测。早期前列腺癌发展为侵袭性疾病的可能性可能会因环境暴露（包括饮食）而改变。有观察证据表明，水果和蔬菜含量高的饮食与前列腺癌发生和进展的风险呈负相关。了解采用植物密集型饮食是否可以降低LGLV前列腺癌进展到更晚期的风险是有价值的。该建议旨在评估强调植物消费的饮食是否会降低EM患者LGLV前列腺癌进展为值得积极治疗的更具侵袭性的癌症形式的可能性。干预将通过一个主要的肿瘤学合作研究小组进行：癌症和白血病小组B（CALGB）。患者将通过各个CALGB和合作社区肿瘤计划临床研究中心入组。实验患者将接受基于电话的干预，该干预已被证明可以改变前列腺癌患者的饮食习惯;对照患者将收到NCI发布的一包饮食建议材料。饮食变化将通过24小时回忆和血液类胡萝卜素进行评估。将通过PSA和适当的临床监测对疾病进行24个月的监测。 公共卫生相关性：每年有超过20万美国男性被诊断出患有前列腺癌。相当大比例的前列腺癌是低级别、低体积和明显惰性的。期待治疗，这并不降低生活质量的干预，可能是适当的，这样的患者，干预措施，而不是为了治愈疾病，以防止其进展到一个更积极的表型是值得研究的。这项提案旨在调查强调植物性饮食的饮食干预是否会减缓或阻止前列腺癌的进展。