As seen on the Sally Show 4/17/2000
Despite the fact that prostate cancer has no definitive set of symptoms,
all of the following have been identified by the National Cancer Institute
as possible indicators of prostate cancer -- and many other clinical problems:
||Frequent urination (especially at night)
||Inability to urinate
||Trouble starting to urinate or trouble holding back urination
||Pain during ejaculation
||A weak or interrupted urine flow
||Pain or a burning feeling during urination
||Blood in the semen or in the urine
||Frequent pain or stiffness in the lower back, hips, or upper thighs.
Since all these symptoms may be caused not only by prostate cancer, but also by a number of other disorders (and not just other disorders of the prostate), it would be wise to talk to your family doctor if you or someone else in your family is having one or more of these problems on a regular basis. Only a properly trained, experienced physician will be able to tell whether these symptoms are, in fact, associated with the possibility of prostate cancer.
PSA test -
The PSA test has revolutionized our knowledge of prostate cancer. We use the PSA to look for prostate cancer. If the PSA is above 4.0 ng/ml, as in your case, we biopsy the prostate to see if cancer is present. But an equally important use for the PSA test is to find out if men are cured of cancer. Prior to 1996, the medical profession did not know how to use the PSA test to determine cure. Instead, doctors used the PSA test in a variety of different ways to determine cure, always showing their particular treatment method was curing prostate cancer. That is what almost all the confusion is about there was no standard use of the PSA test after treatment of prostate cancer.
Now, based on our medical research, (Critz 1996, 1997 a, b, c) we know how to use the PSA test to determine cure of prostate cancer. We determine cure by the PSA nadir, which means the lowest PSA level reached after any type of treatment of prostate cancer. For a man to be cured of prostate cancer, his PSA nadir must become undetectable after treatment and his PSA must remain undetectable for at least 10 years. This finding appears to be true for any type of treatment for prostate cancer. Make this observation the cornerstone to your understanding about prostate cancer and deciding which is the best treatment to undergo.
What is Free PSA?
Free PSA, or PSA II, is a new way of evaluating PSA results. PSA can exist in the blood either bound to other proteins or in the free (unbound) state. The proportion of free PSA should be more than 15-25% depending on the assay; if it is less, this may be a signal that indicates prostate cancer. Now, six patients with mildly elevated PSA are biopsied for every patient whose biopsy results in a diagnosis of cancer. Although still under clinical evaluation, it is hoped that Free PSA will be able to highlight those patients with a PSA between 4 and 10 who could benefit most from biopsy. Thus, with this test, fewer patients may need to be biopsied for a mildly elevated PSA.
Prostate biopsy specimens are given to a pathologist who examines the tissue under a microscope and assigns a number between 2 and 10 to indicate how aggressive the prostate cancer is. The higher the number, the more aggressive the cancer. Most men with prostate cancer have a Gleason score of 5 or 6. Approximately 30% of men have Gleason scores between 7 to 10 and are the more aggressive cancers.
Treatments for Prostate Cancer
Men diagnosed with early-stage prostate cancer should discuss all treatment options-including:
Seed Implantation ( Brachytherapy ) -
Brachytherapy is a form of radiation treatment in which tiny pellets containing radioactive material, such as Iodine-125, are implanted directly into the tumor containing organ. This form of radiation therapy has long been used in other types of malignancies including cervical, breast, endometrial as well as head and neck cancers. Brachytherapy offers the appealing concept of delivering high doses of radiation to the prostate while limiting the exposure to the adjacent organs.
Precise placement of seeds a crucial factor in the success of brachytherapy. Without the benefit of modern day imaging techniques accurate placement of the radioactive seeds is not attainable.
Finding the best physician in your area may not be good enough. Find one that has specialized in seed implantation and has done many.
The chance of Impotence and or Incontinence varies on your doctors ability. Locate the best to minimize your chance of being left with either of the above mentioned.
Radical Prostatectomy involves surgery to actually remove the prostate gland. This procedure has the possibility of curing early prostate cancer; however older men who are not in good overall health may not tolerate the procedure well. Some possible side affects may occur including incontinence, and there is also a high risk of impotency.
Anatomical Radical Retropubic Prostatectomy (nerve sparing) -
Radical Retropubic Prostatectomy with its nerve sparing option allows for preservation of erections, improved urinary continence, decreased blood loss, and lower operative mortality and morbidity rates.
Success rates very tremendously with the experience and training of the physician. If your doctor recommends this procedure, or you do, make sure you find the best physician to treat you.
Sixty percent of all prostate cancers are discovered while the are still localized.
The five-year survival rate for men diagnosed with prostate tumors discovered at this stage is 100 percent, including:
68 percent survive beyond 10 years
52 percent survive beyond 15 years
In the past 20 years, the survival rate for all stages has risen from 67 percent to 93 percent.
30% patients have reported incontinence one year after surgery.
When the urinary catheter is first removed following surgery, nearly all patients lack control of urinary function and will leak urine for at least a few days. Continence usually improves swiftly, but some leakage often remains for several weeks or even months.
The other major side effect of radical prostatectomy is loss of sexual function, which occurs in between 30% and 60% of surgical patients. We, and many in the medical community feel the main factor is the experience of the surgeon.
The chance of Impotence and or Incontinence varies on your doctors ability. Locate the best to minimize your chance of being left with either of the above mentioned.
Radiation is the use of radiation beams to kill cancer cells. Two types of external radiation are being used to treat prostate cancer - external beam and proton beam. External beam delivers energy to healthy tissues as well as to the targeted cancer tumor. To minimize the negative effects on normal tissue, treatment is spread over a relatively long period, normally once a day, five days a week for seven weeks. A new form of radiation therapy called proton beam radiation therapy uses atomic particles to treat the targeted tissue. Because proton beam therapy deposits most of its energy at the end of its travel, and can be delivered more selectively, it may reduce damage to surrounding healthy tissue. It therefore may have the potential to deliver a higher tumor-destroying dose with fewer side effects than standard external beam radiation. However, little long term data is available, and the procedure is still practiced at very few sites and is very expensive.
Free Press Medical Writer
A freezing technique for prostate cancer is as effective as surgery and conventional radiation with comparable side effects, according to the largest U.S. study of cryosurgery with the longest follow-up results.
The study by Crittenton Hospital researchers in Rochester Hills will be presented Wednesday in Chicago to the Radiological Society of North America, the world's largest annual gathering of radiologists.
It is likely to rekindle the debate about cryosurgery, a technique pioneered at Crittenton and a handful of other centers. Prostate cancer groups have shown increasing interest in the technique because it involves a minimal amount of surgery and quicker recovery. But many doctors belittle it as unproven, and insurance often doesn't cover its $13,000 cost.
Even if the new results don't change thinking in medicine, they still show that a key team is doing the follow-up needed to gain acceptance.
"The data do not change my opinion," said Dr. Isaac Powell, a Harper Hospital urologist. Like many doctors, he tells patients that surgery and conventional radiation offer the best results and that cryosurgery and radioactive seed implants remain under study.
The treatment debate is significant because 184,500 U.S. men will be diagnosed with prostate cancer this year. It usually is curable when found early. But death rates aren't declining with improved detection. This year, about 39,000 men will die of prostate cancer.
The Crittenton study followed 583 men, 40 percent from Michigan, who had cryosurgery at Crittenton since 1993. The technique uses super-cooled tubes inserted into the prostate to freeze tumors.
While 79 percent of the men had early stage tumors, 21 percent have cancer classified as T3 or T4, ones that spread outside the prostate to nearby tissue. None of the men had any anti-hormone drugs or other treatment after cryosurgery.
Five years later, 79 percent of the men are free of cancer in biopsy tests.
Among men with more aggressive T3 and T4 tumors, 71 percent were free of cancer on biopsy.
Survival also was measured by checking for the prostate-specific antigen (PSA) levels in blood tests. Three-fourths (76 percent) of men with tumors confined to the prostate (T1 and T2) had a PSA of less than 0.5; 56 percent of men with the more aggressive T3 and T4 tumors had PSA levels of less than 0.5.
The biggest sacrifice men make with cryosurgery is potency. Eighty-five percent of men become impotent, though half of those men regain at least partial potency with medicines such as Viagra, according to a companion study to be presented Monday by Dr. Duke Bahn, chairman of radiology at Crittenton. He is the protege of research partner Dr. Fred Lee, one of the nation's foremost cryosurgery proponents. Lee turned to cryosurgery when his own prostate cancer returned after radiation treatments.
"This is a procedure that deserves more credit than it has received," Bahn said. He said he is saddened that many patients can't afford it because their health plans won't pay for a procedure they deem investigational.
Interest in cryosurgery has grown, despite insurance hurdles and opposition by doctors, as men demand effective treatments with fewer side effects.
ENDOCARE’S TARGETED CRYOABLATION OF THE PROSTATE(TCAP)
TCAP utilizes cryoprobes to “reach inside the body through key hole access” freezing and killing cancer cells while minimizing the risk of unintended damage to tissue surrounding the prostate. Endocare’s CRYOcare system gives the physician fine-tuned control of the procedure by combining state-of-the-art ultrasound and patented temperature monitoring. The procedure offers the advantage of quick patient recovery time (usually same day surgery or overnight stay).
Targeted Cryoablation of the Prostate by Endocare is showing great success with clinical evidence that is superior to other technologies, such as, permanent seed implants and external beam radiation therapy.
CRYOSURGERY – HOW DOES IT WORK?
The procedure involves advancing slender cryoprobes into the prostate gland. Circulating within each cryoprobe is liquefied argon gas. This gas creates ice balls at the tip of the cryoprobe. The probes are inserted through a small incision and are strategically placed in the prostate targeting the entire gland while minimizing damage to surrounding healthy tissue. A warming catheter is used to protect the urethra while the probes simultaneously freeze the cancerous tissue at temperatures of -40C. The procedure is done using epidural anesthesia.
Cryosurgery is a minimally invasive procedure that offers patients the benefits of a quicker recovery period and reduced severity of potential side effects such as incontinence. Incontinence rates are 1%, much lower than other procedures. Also, the short hospital stay and quick recovery period contrasts sharply with typical long recovery and extended hospital stays associated with major surgery.
Recent technological advancements have brought about a safer and more effective cryosurgical procedure called TCAP. Targeted cryosurgery uses between 6 and 8 ultrasound-guided cryoprobes to produce ice balls in specified areas. Using more cryoprobes ensures that all cancer cells are destroyed. This procedure is clinically more effective because it uses thermosensors in addition to cryoprobes, enabling physicians to carefully monitor the freezing process and determine when target temperatures have been reached. The treatment is effective for cancer that is confined to the prostate (Stage 1) through more advanced cases that have spread to tissue surrounding the gland (Stage T3).
Unlike radical prostatectomy or radiation therapy, the targeted cryosurgery procedure can be repeated if any cancer cells recur after initial treatment. Clinical data indicates that for locally confined prostate cancer, 97% of patients receiving targeted cryosurgery remain disease-free after one year and 82% of patients have a negative biopsy at five years.
Surgery and radiation -- the two main options when prostate cancer is found early -- can cause side effects ranging from impotency to incontinence, bowel problems and rectal bleeding. But improvements in techniques have lowered side effects to rates better than those the Crittenton team is reporting, some doctors say.
Cryosurgery also highly depends on who is doing it.
"I'm skeptical it will stand the test of time," said Dr. James Montie, chief of urology at the University of Michigan Medical Center in Ann Arbor. "Most places around the country are abandoning it. It clearly is the kind of thing only a few people can do. It doesn't translate into a treatment."
The Crittenton team is training physicians around the country to teach refinements. Bahn attributed problems mainly to poor equipment; unfamiliarity of urologists with ultrasound, a key tool in the procedure; and failure to use sensor devices to ensure sufficiently cold enough temperatures to freeze tumors.
The technique should receive a better reception, Bahn said, because it provides an option to men with the more aggressive T3 and T4 tumors who are poor candidates for surgery.
In a companion study to be presented Monday, Bahn will report on results of a questionnaire of 267 cryosurgery patients. Other than potency problems, 4.3 percent used an incontinence product, even for a few drips of urine. It also found these problems: scrotal swelling, 17 percent of men; penile tingling, 14 percent; and pelvic pain, 11 percent.
Doctors agree it is hard to compare survival rates and complications of treatments because studies measure the problems differently. Some results also might look more favorable because doctors may include only less aggressive cancers in their studies.
Dr. Patrick McLaughlin, director of radiation therapy at Providence Hospital in Southfield, said radiation results have vastly improved in recent years with computer-planned treatment programs that allow higher doses targeted at smaller areas. Providence also has encountered fewer complications by performing the treatments with men lying on their stomachs, not backs. The approach now is used many other places, McLaughlin said.
New Five-Year Study Supports Cryosurgery As Primary Prostate Cancer Treatment
Endocare Inc., Irvine, CA, developer of FDA-approved cryosurgical technologies for the treatment of cancer and temperature-based treatments for benign prostate growth, announced that five-year follow-up data presented by clinical researchers at the American Urological Association (AUA) annual meeting in Atlanta showed that the use of cryoablation as a first-line treatment for prostate cancer can be as effective as radiation therapy.
The five-center, 975-patient study showed that the overall success rate across several cryosurgical techniques and risk groups was 63 percent; meaning patients had a prostate specific antigen (PSA) score of less than 1.0 ng/mL upon five-year follow-up. A patient with a PSA score higher than 1.0 is considered to be at higher risk of recurrence.
John P. Long, MD, director of the urological oncology department at the Boston-based New England Medical Center, and lead clinician for the study, stated, "This five-year data has reversed some thinking on the effectiveness of cryosurgery and actually indicates that cryosurgery as a treatment for prostate cancer, can be comparable to radiation therapy."
Drawback – 80%-90% of patients after procedure are impotent.
Watchful Waiting -
Just as it states. Watch to see how fast the cancer grows.
Hormonal Deprivation Therapy, also known as Androgen Ablation Therapy is a well established form of treatment for various stages of prostate cancer. Historically, bilateral orchiectomy ( removal of the testicles ) and estrogens have been the main methods of hormonal manipulation. This is based on the fact that the male hormone (androgen ) is responsible for tumor growth. Recently, a combination androgen ablation therapy was introduced, and is currently commercially available to maximize androgen blockade.
There are two organs in the human that body that excrete the male hormone. The major source is the testicles. It can be blocked by utilizing LHRH agonists such as LUPRON or ZOLADEX. The other source of androgen is the adrenal glands. The adrenal activity can be blocked by using anti-androgen drugs, such as FLUTAMIDE or CASODEX. Lupron and Zoladex are injectable forms of medication.
However, Flutamide and Casodex are oral medications. There are known side effects of these drugs which include : impotence, hot flashes, enlarged breasts, nausea, diarrhea, liver damage and untoward effects on the cardiovascular system. Therefore, strict supervision by a physician is mandatory. Combination Androgen Ablation Therapy can be used as a primary form of treatment if someone has an advanced cancer (Stage D, cancer spread to bones, lymph node, etc.). However, in many cases, these are temporary measures.
This treatment is effective for an average of 3 - 5 years, and then often the cancer starts to re-grow and become hormone refractory. Lately, use of hormonal blockade along with other treatment options has proven to be effective and beneficial. The major problem of prostate cancer treatment is under -estimation of the disease (understaging). Approximately 50 % of all cancers which are considered to be localized in the prostate have actually already escaped outside of the prostatic capsule. In these instances,the success of radical prostatectomy, radiotherapy, or cryotherapy is compromised. Since androgen blockade therapy can kill the tumor, or decrease the size of the tumor (downstage), the chances of having unexpected tumor extension outside of the prostate at the time of surgery can be minimized . A Small volume prostate gland and tumor are the most important factors for successful cryotherapy, and are also beneficial to radiotherapy and surgery.
In conclusion, hormonal deprivation therapy is known to be an effective primary form of treatment in selected cases. However, it is recommended that this therapy be used in combination with other treatment modalities, for the reasons mentioned above. Pre-treatment with hormonal therapy followed by more definitive measures (cryosurgery, radical surgery, radiation therapy) may lead to a better outcome.
Vitamin D Slows Prostate Cancer
Vitamin D Therapy Can Prolong Life Expectancy - Won't Cure, But Inhibits Spread Of Cancer
Must Be Prescribed By Doctor
Friday, November 12,1999 - 04:13 PM ET
Researchers have discovered a new treatment that can help men with prostate cancer live longer, reports Correspondent Kris Eisenhauer of CBS affiliate KOIN-TV in Portland, Oregon.
Fifty-five year old Teddy Deane was diagnosed with prostate cancer three years ago. To control his cancer, Teddy's options are either hormone treatments or aggressive chemotherapy-- both of which have some pretty tough side effects.
"Having prostate cancer is like having a time bomb inside you and if you don't get it all out the first time, the best you can do is hope to lengthen the fuse," Deane says.
Cancer specialists Dr. Tomasz Beer and Dr. David Henner of Oregon Health Sciences University (OHSU) are investigating use of Vitamin D to fight the disease.
Their findings show Vitamin D therapy can't cure prostate cancer, but regular doses can hold it at bay indefinitely.
The vitamin can latch onto cancer cells, alter their cells structure, then kill them.
"It can also inhibit the formation of abnormal blood vessels which feed the cancer," explains Dr. Tomasz Beer. "It can decrease the production of enzymes which the cancer needs to invade other tissues and spread to bones and so forth." But don't run off to the corner drug store just yet.
"This is not something that people can do on their own," says Dr. David Henner. "We're giving them a special form of it that's already activated -- called calcitrial -- and we are giving it at a very high dose on a weekly basis."
It can taken only once a week because higher dosages would be toxic.
Vitamin E, C May Combat Prostate Cancer
NEW YORK, Jul 20
Vitamins C and E appear to counteract some of the negative effects of male hormones on prostate cells linked to the development of prostate cancer, results of a study in laboratory-cultured prostate cancer cells suggest.
The finding may explain why some past studies have found that vitamin E supplements could reduce prostate cancer mortality in smokers and other antioxidants reduced prostate cancer risk. "Understanding how antioxidants act to reduce cancer risk will aid in developing prevention strategies," report Dr. George Wilding and colleagues from the University of Wisconsin-Madison in the July 21st issue of the Journal of the National Cancer Institute. The researchers treated two prostate cancer cell lines with R1881 -- a synthetic male hormone -- by itself and in the presence of the antioxidant vitamins C and E. Previous research had shown that one of the cell lines grows in response to male hormones, also known as androgens, while the other cell line did not respond to the hormones.
The study authors found that androgen-sensitive cells had up to a 57% reduction in reactive oxygen species (ROS) if they were treated with a high dose of vitamins C and E in addition to R1881, compared with cells treated with R1881 alone.
ROS are DNA-damaging particles that are believed to play a role in tumor development and aging. The study findings indicate that androgens stimulate ROS production. "Previous studies have suggested that male hormones (androgens) and certain forms of oxygen (reactive oxygen species) are linked to the development of prostate cancer," according to the report.
The findings suggest that antioxidants such as vitamins C and E may reduce androgen-related production of reactive oxygen species, the authors conclude. But more research is needed to define the cell pathways that play a role in the development of prostate cancer, and the effects of antioxidants on these pathways.
Milk and Prostate Cancer:
The Evidence Mounts
by Neal D. Barnard, M.D.
Could milk cause prostate cancer? The question has come up repeatedly in recent months, as billboards portraying New York City Mayor Rudolph Giuliani with a milk mustache carried the words, "Got Prostate Cancer?" The outraged mayor countered that milk had nothing to do with his newly diagnosed disease, which also killed his father. For the public, this was completely new territory. Does drinking milk actually contribute to cancer?
Here are the facts: Major studies suggesting a link between milk and prostate cancer have appeared in medical journals since the 1970s. Two of six cohort studies (research studies following groups of people over time) found increased risk with higher milk intakes. Five studies comparing cancer patients to healthy individuals found a similar association. One of these, conducted in northern Italy, found that frequent dairy consumption could increase risk by two and one-half times.
In 1997, the World Cancer Research Fund and the American Institute for Cancer Research concluded that dairy products should be considered a possible contributor to prostate cancer. And yet another research study came out in April 2000 pointing to a link between dairy and prostate cancer: Harvard's Physicians' Health Study followed 20,885 men for 11 years, finding that having two and one-half dairy servings each day boosted prostate cancer risk by 34 percent, compared to having less than one-half serving daily.
A Smoking Gun?
Researchers are looking, not only at whether milk increases cancer risk, but how. The answer, apparently, is in the way milk affects a man's hormones. Dairy products boost the amount of insulin-like growth factor (IGF-I) in the blood. In turn, IGF-I promotes cancer cell growth.3-5 A small amount is normally in the bloodstream, but several recent studies have linked increased IGF-I levels to prostate cancer and possibly to breast cancer as well.
Milk does other mischief. Its load of calcium depletes the body's vitamin D, which, in turn, may add to cancer risk. Most dairy products are also high in fat, which affects the activity of sex hormones that play a major role in cancer. And it would come as no surprise that milk might affect the growth of cancer cells. After all, its biological purpose is to support rapid growth in all parts of a calf's body. After the age of weaning, calves (like all mammals) have no need for milk at all, and there is never a need to drink the milk of another species.
Researchers are investigating whether dairy products might be culprits in other forms of the disease. Ovarian cancer, in particular, may be linked to galactose, a sugar produced from the milk sugar lactose. Yogurt, cheese, "lactose-free" milk, and other dairy products contain substantial amounts of galactose.
Other parts of the diet affect cancer risk, too. Meat and fatty foods in general are implicated in increased risk, while tomatoes, watermelons, and other bright red fruits contain lycopene, which reduces cancer risk.
The bottom line: While researchers will study the causes of cancer for years to come, health-conscious families may well want to trade dairy—and all animal products—for a healthy, vegan diet rich in vegetables, fruits, whole grains, and legumes. When to make the switch? Evidence suggests that the earlier in life healthy diet habits begin, the better your protection.
What?! Does Everything Cause Cancer? As a matter of fact, no. Whole grains, beans and other legumes, vegetables, and fruits are cancer fighters. Plant foods are low in fat, high in fiber, and loaded with protective cancer-fighting nutrients. But animal products—meat, dairy, eggs—are linked to several forms of the disease. They contain plenty of fat to harbor cancer-causing chemicals and to drive up the levels of cancer-promoting hormones in your body. They have no fiber that would normally sweep carcinogens from your digestive tract and are low in cancer-fighting antioxidants. And under cooking temperatures, the creatine, amino acids, and natural sugars in meat can actually turn into cancer-causing chemicals.
A cancer-prevention diet includes plenty of:
Vegetables: sweet potatoes, carrots, broccoli, spinach, asparagus
Fruits: strawberries, kiwi, melon, bananas, apples
Whole grains: breads, cereal, oatmeal, pasta, rice
Legumes: beans, peas, lentils
The most healthful diets eliminate meat, dairy products, eggs, and fried foods. To make the transition easy, you may wish to use rice milk, soymilk, meat substitutes, or egg substitutes.
1. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, and the Prevention of Cancer: A Global Perspective. American Institute for Cancer Research, Washington, D.C., 1997, p. 322.
2. Chan JM, Stampfer MJ, Ma J, Ajani U, Gaziano JM, Giovannucci E. Dairy products, calcium, and prostate cancer risk in the Physicians' Health Study. Presentation, American Association for Cancer Research, San Francisco, April 2000.
3. Cohen P. Serum insulin-like growth factor-I levels and prostate cancer risk—interpreting the evidence. J Natl Cancer Inst 1998;90:876-9.
4. Cadogan J, Eastell R, Jones N, Barker ME. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. BMJ 1997;315:1255-60.
5. Heaney RP, McCarron DA, Dawson-Hughes B, et al. Dietary changes favorably affect bone remodeling in older adults. J Am Dietetic Asso 1999;99:1228-33.
My thoughts? - Vitamin D slows prostate cancer? Yet milk is linked to prostate cancer? Vitamin D is in milk.
What is going on?
Dear Mr. Kalinksy,
Thanks for your inquiry into the relationship between vitamin D and prostate cancer. Calcium and vitamin D in the body work in harmony together. When calcium levels are low in the blood, we increase our levels of parathyroid hormone (PTH) and decrease our levels of calcitonin (CT).
This causes a chain reaction of processes in our body. It decreases our excretion of calcium through our renal system, increases our level of active vitamin D (1,25(OH)2 D), increases our intestinal absorption of calcium, and decreases our resorption of calcium from our bones. So why does milk not prevent prostate cancer when vitamin D seems to prevent it?
There are two answers to this pretty confusing question.
Just as the cycle above occurs when we have low levels of calcium in the blood (i.e. an increase in the active form of vitamin D), the opposite occurs when we have large doses of calcium in our blood. When we have high serum calcium levels, we decrease our PTH and increase our CT levels.
Milk, with its large dose of calcium, seems to provide this calcium load which in turn, decreases the amount of active vitamin D produced. But, if milk contains vitamin D, wouldn't dairy products avoid this depleting effect?
The problem is, dairy products do not contain the active form of vitamin D. This inactive form has to be sent to the liver where it is later turned to the active form of vitamin D.
So, milk's combination of being high in calcium and low in active vitamin D is why it seems to have its effect on the prostate in regards to cancer. The study you sent us was studying the role of active vitamin D. Prostate cancer and dairy consumption is a relatively confusing area of nutrition and I appreciate you sending us this article. I hope my explanation was helpful for you.
Brie Turner-McGrievy, MS, RD
Physicians Committee for Responsible Medicine
5100 Wisconsin Ave. NW, Suite 404
Washington, D.C. 20016
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