Diet change among prostate cancer patients under expectant management

描述（由申请人提供）：前列腺癌，每年在20多万美国男性中被诊断出来，仍然是导致死亡的重要原因；2007年，它将导致大约27,000人死亡。筛查技术的进步促进了检测技术的巨大进步，现在大多数前列腺癌都是在非常早期的阶段被诊断出来的，可以通过手术或放疗来治愈。然而，尽管这些早期癌症很容易治愈，但产生这种治愈的治疗方法往往会显著降低生活质量。前列腺癌控制的一个并发症是，未确诊的、明显隐匿的前列腺癌的患病率相对于有症状或致命疾病的发生率高。前列腺癌在许多男性中是隐匿的、无症状的、不危及生命的；这些人会死于疾病，而不是死于疾病。许多通过筛查发现的前列腺癌，尤其是那些在非常早期就被诊断出来的前列腺癌，可能永远不会引起有症状的疾病。考虑到前列腺癌治疗的高发病率，鉴别出可以延迟根治性干预的早期前列腺癌患者将是非常有益的。本研究的重点是低分级、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预期管理（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而改变，包括饮食。有观察性证据表明，多吃水果和蔬菜的饮食与前列腺癌发生和发展的风险呈负相关。了解采用植物性密集饮食是否可以降低LGLV前列腺癌进展到更晚期的风险是有价值的。本研究旨在评估强调植物摄入的饮食是否能降低EM患者LGLV前列腺癌发展为需要积极治疗的更具侵袭性的癌症的可能性。干预将通过一个领先的肿瘤学合作研究小组：癌症和白血病B组（CALGB）进行。患者将通过单独的CALGB和合作社区肿瘤项目临床站点登记。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；对照患者将收到一份由NCI发布的饮食推荐材料。饮食变化将通过24小时召回和血液类胡萝卜素来评估。疾病监测将通过PSA和适当的临床监测24个月。

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.