Posts Tagged ‘prostate cancer’

Genome: Repair Thyself

Sunday, March 21st, 2010
How damaged is your genetic sheet metal?

How damaged is your genetic sheet metal?

Imaging parking your car at home after work and all the nicks and scratches are removed while you sleep, before heading to work the next day. All shiny and new, polished even, while you sleep. Believe it or not, this is normally what happens to your genes and chromosomes on a minute-to-minute basis. DNA mismatch repair is a constant and vigilant process, occurring in all cells of the body. Why the biologic vigilance?  Well, It keeps us whole, healthy and cancer free.

About 11 years ago, we published a paper showing for the first time that infertile men can’t repair the errors normally encountered in their DNA as well as normal men. This was startling news in part because it implied that infertile men may be more likely to develop other problems later in life, including cancer. Why cancer? Because the development of cancer has been associated with the inability to normally repair the frequent daily errors that occur to one’s DNA as the body’s cells divide and renew.

Today, however, we know much more. We know that testis cancer is 3-fold more likely to occur in previously infertile men than in fertile men as they age. And our latest research has shown that prostate cancer, thought to be a disease exclusive to older men, occurs more seriously and more commonly in previously infertile men.

So what does this mean? Is male infertility the first sign of a larger problem in our species? It is the ultimate medical problem of a species trying to reproduce?  Well, honestly it isn’t entirely clear. However, to me it indicates that male infertility should certainly be considered an insurable and real medical condition that should be taken as seriously as a heart attack. Even more worrisome is the issue of whether the use of sperm from severely infertile men is putting their offspring at even higher risk of medical issues than that experienced by their fathers.

So do not ignore the infertility issue when it strikes and get that male partner evaluated by a specialist. Teach him to perform testicular self-examination, a simple maneuver performed once monthly in the shower that has far more potential to extend his life than even exercising or weight control. Educate him about prostate cancer so that he does not ignore the powerful screening tools available to find it early. The age of innocence is over. The warning signs are now clear; get men the care that they deserve.

Stem Cells are People Too

Sunday, March 14th, 2010
A stem cell in a dish is worth a hundred different therapies.

A stem cell in a dish is worth a hundred different therapies.

Not all stem cells are alike. News to you? Maybe not, but it has hit researchers pretty hard over the past several weeks. As you may have garnered from prior essays on this blog, stem cells are potentially capable of morphing into many different tissues, such nerves, heart or liver, and are the next wave in medical therapy for all kinds of diseases affecting both the young and the old. The medical treatment that they will bring to the table is called “personalized, cell based therapy.”

One huge problem is that the best kind of stem cell, the one that can do the most, is created from embryos. The embryonic stem cell has many “issues” though: derived from embryos, retrieval ethics, not patient specific, created by cloning, inefficient to produce and the like. Because of this, research has focused on alternatives like transformed adult stem cells or our very own untransformed testicular stem cells. The news today concerns the quality of adult-type stem cells that are “reprogrammed” and transformed into embryonic-like stem cells, also termed induced pluripotency stem (iPS) cells.

Well, there appear to be growing pains for the iPS cell, an embryonic stem cell alternative. Developed in 2006 from adult skin cells, researchers genetically manipulated a specialized adult cell, transforming it back to an unspecialized state. Since then, hundreds of labs have leaped into the burgeoning adult stem cell field.

The ideal stem cell is like a blank slate. It is capable of becoming any other tissue, and is immortal. True embryonic stem cells are like this, but, according to several recent publications, many iPS cell lines are not really blank slates. Also, it appears that nerve and blood cells made from iPS cells grow poorly and age quickly and may even “remember” what cell from whence they came. Some even conclude that iPS cells may not even be considered a practical choice for cell-based therapy down the line.

The realization that iPS cells are not exactly like the gold standard embryonic stem cells has slowed the field down a bit, but it is an important observation. Like people or even wine, stem cells are a bit different from one another, each with their own personality, temperament and potential. Some do this better than that, and others do that better than this. It suggests that stem cell-based therapy may eventually involve tapping into a mixture of different stem cells to cure the problem. Now that’s an old fashioned idea: a little of this and a little of that…

Your DNA Barcode

Sunday, February 21st, 2010
Can we be DNA barcoded like a soup can in a grocery store?

Can we be DNA barcoded like a soup can in a grocery store?

How many of you would take a blood test to learn exactly how long you will live? How about whether or not you will become demented? Since the Human Genome Project ended, the genes and mutations associated with a vast array of diseases are being discovered daily and it is pretty easy to just put them on “chip” and make them available to the public.

Don’t get me wrong; gene testing already has already improved our lives. Such tests can clarify a diagnosis and better direct care, while others allow families to avoid having children with life-threatening or disabling conditions. They can be used to prevent disease before it happens, as with monitoring and removal of colon growths among those who have a gene for familial polyposis, and can diagnose common iron-storage diseases early enough to treat them and prevent them from becoming fatal. They can also help to positively identify murderers two decades after the crime.

One real problem is that many commercialized gene tests are targeted to healthy people who might be at high risk because of a strong family medical history for a disorder. Unfortunately, because of how complex we are as biological organisms, the tests give only a “probability” for developing the disorder. That means that some people who carry a mutation may never develop the disease. Another limitation is the possibility of laboratory errors. What this means is that the tests are not perfect and could be wrong.

And what happens to your job prospects and health (or life) insurance rates when it is learned through genetic testing that you might develop a significant disease? Well…nothing. Because of the federal GINA Law (Genetic Information Nondiscrimination Act) passed in May 2008, insurance companies and employers cannot discriminate on the basis of information derived from genetic tests. So, genetics has now been added to the list of characteristics first embodied by the Civil Rights Act of 1964, that states that U.S. employers cannot discriminate according to race, color, national origin, sex, or religion. And this is good.

So, go ahead and take the “23 and Me” “DeCode” or “Navigenics” genomic screens if you so desire. Get to know your DNA barcode. Maybe you will get an idea of what may be around the corner for you. And maybe, just maybe, you will take better care of yourself knowing more about your genes. Just understand that many in the medical community feel that uncertainties surrounding test results, the current lack of available treatment options, the tests’ potential for provoking anxiety and social stigmatization could outweigh the benefits of testing. You know the saying: “Too much information…”

The Prostate: All You Ever Wanted to Know

Monday, June 1st, 2009

One famous fountain: the mannequin pis in Belgium

One famous fountain: the mannequin pis in Belgium

As a man ages, he is more likely to look at travel experiences as a series of restroom stops. He might begin navigating his way to the grocery store, the gas station or to a friend’s house for poker based on whether or not there’s a restroom conveniently located nearby. This may sound like the end of the world, but it’s not. It may be the end of long road trips. It is also the start of the realization that, similar to needing reading glasses, he is not immortal but actually a simple human being.

The prostate is a gland the size of a walnut at the base of the penis. It wraps around the urethra (the tube that urine comes from). A prostate is essential for normal male fertility, as it is responsible for making fluid that protects and nourishes sperm. Everything is shipshape until a man gets older, when two problems can arise. One is benign prostatic hypertrophy (BPH), which is a fancy way of saying enlargement of the prostate. This occurs in about half of all men in their sixties. For reasons still unclear, the prostate continues to grow as a man gets older. It is usually symptomatic – men have urinary urgency, dribbling, weak stream and may have to get up at night to urinate. The other problem is prostate cancer. Most commonly, cancer has no symptoms.

BPH is not preventable, but prostate cancer may be. Following a heart-healthy, low-fat, low carbohydrate diet is key to the prevention strategy, as are exercise, weight management and stress reduction. Concentrate on fruits and vegetables, which are high in antioxidants that protect the cells of your body from becoming cancerous. Soy and green tea may also protect the prostate. Sugar intake should also be limited, as it often ends up stored in your body as fat, and obesity is linked to prostate cancer.

That said it may surprise you to know that prostate cancer doesn’t always kill. Cancer is no one’s friend, but prostate cancer is not as deadly as lung cancer, colon cancer or breast cancer. It is much more slow-growing than these other cancers, doubling in size every 2-3 years instead of every 4-6 months. As such, a man is eight to ten times more likely to die of heart disease than prostate cancer. Even more interesting, some believe that prostate cancer is really a disease of age in men, as the likelihood of having small amounts of cancer in the prostate goes up with age. That means that about 80% of 90 year old men will have prostate cancer, and may never know it. They will likely die of unrelated causes. It also means that there are many prostate cancers occurring in men that are “clinically insignificant,” a rare term in cancer medicine. So, many prostate “cancers” actually don’t act as such.

Although diseases of the prostate are rarely lethal, they can affect your quality of life…and your road trips. Men over forty should start to have the prostate checked regularly, although most men would rather spend quality time with the dentist’s drill than go in for that exam. Blood tests for a substance called PSA, can also help detect cancer. The symptoms of prostatic enlargement can treated with pills; if these don’t work, various, safe but indescribable procedures can remove the symptom-causing prostatic tissue. Some of the FDA approved pills to treat BPH also prevent prostate cancer. Now that’s a pill that men might want to swallow. So, for all kinds of reasons, don’t ignore the prostate. Try to attend to it before it disrupts the flow of your daily life.