Key words: prostate cancer; 25(OH)-vitamin D 3 ; serum bankVitamin D deficiency has been implicated as risk factor for prostate cancer. 1 In cell culture studies, vitamin D metabolites have had protective action against cancer development (for review see Ylikomi et al. 2 ). Normal and malignant prostate cells contain vitamin D receptor (VDR), 3-5 which mediates the antiproliferative action of 1,25(OH) 2 -vitamin D 3 . 6 In addition to the antiproliferative action of 1,25(OH) 2 -vitamin D 3 , it can cause apoptosis, 7 induce differentiation, 8 inhibit telomerase expression, 9 inhibit tumor cell invasiveness 10 and suppress tumor-induced angiogenesis. 11 Several epidemiologic studies have reported that high serum vitamin D levels or sunlight may protect against prostate cancer. 3,4,[12][13][14][15] Factors that affect prostate cancer include age, dark skin and environment, e.g., latitude and diet. 16 These factors might be linked to vitamin D availability. 17,18 Furthermore, high fish (rich in vitamin D) consumption appears to correlate with lower prostate cancer risk. 19 In addition, VDR gene polymorphism may contribute to the risk of prostate cancer. 20 -24 There is also a study showing no correlation between serum vitamin D metabolites and prostate cancer in Maryland (USA), 25 but the authors concluded that the power of their study was limited. In another study on U.S. male physicians, only a weak protection against prostate cancer was found with the highest quartile of serum 1␣,25(OH) 2 -vitamin D 3 . 26 Similarly, no correlation was found in Hawaii. 27 There are 2 physiologically interesting metabolites of vitamin D, 1␣,25(OH) 2 -vitamin D 3 , regulating calcium homeostasis for bones and muscles in extremely narrow limits, and 25(OH)-vitamin D 3 , regulating target (prostate) cell proliferation and differentiation through activation to 1␣,25(OH) 2 -vitamin D 3 in the target (prostate) cell. Serum 25(OH)-vitamin D 3 is produced by liver 25-hydroxylase, the rate of the synthesis being directly proportional to vitamin D 3 serum concentration. 28 Therefore, serum 25(OH)-vitamin D 3 reflects vitamin D availability in the organism. Serum concentration of 25(OH)-vitamin D 3 is so high that it might possess a significant biologic activity in target cells, but it is also a precursor for the biologically more active 1␣,25(OH) 2 -vitamin D 3 . Prostate as well as many other target organs can activate 25(OH)-vitamin D 3 through 1␣-hydroxylation 29,30 and inactivate it through 24-hydroxylation. 31 In an epidemiologic study, we found that low concentrations (Ͻ40 nmol/l) of 25(OH)-vitamin D in serum were associated with a 1.7-fold increased risk of prostate cancer. 3,4 Since the power of our study was limited, preventing extensive analysis of the data, and we are partners in the Nordic Specimen Banks for Cancer Causes and Control, we had an opportunity to extend our study to other Scandinavian countries located geographically at the same latitude. Our aim was to determine whether our finding could be replicated in a la...
The cases of 208 patients with histologically confirmed oligodendrogliomas were studied. The incidence represents 4.2% of all primary brain tumors diagnosed in the Norwegian population over a 25-year period. All of these tumors were cerebral and the majority affected the frontal lobe. The patients' median age at diagnosis was 47 years, with a range from 3 to 76 years; 6% of the oligodendrogliomas occurred in children. The median duration of symptoms before diagnosis was 20.5 months (mean 43 months). Plain skull x-ray films showed calcified deposits in 28% of the tumors. At operation, most of the tumors were poorly defined, without cyst formation, hematoma necrosis, or calcification. The median duration of disease from onset of symptoms until death was 14 months in nine untreated cases. In surgically treated oligodendroglioma patients the median survival time from onset of symptoms was 74 months. The median postoperative survival time was 35 months (mean 52 months). Tumor calcification, as seen on plain skull x-ray films, was associated with a significantly longer survival period. The surgical findings of gross necrosis, gross hypervascularity, and soft tumor consistency were all related to a shorter total duration of disease. Grossly well demarcated lesions were associated with a significantly longer postoperative survival. The length of postoperative survival correlated with the preoperative clinical status. The cumulative proportion of patients surviving 5 years was 0.342. The patient's age and sex did not have a statistically significant influence on survival time. The extent of surgical excision only seemed to play a role when the neurosurgeon considered that he had removed the whole lesion: these patients had a median postoperative survival period 14 months longer than the other oligodendroglioma patients. The ABO blood group of the oligodendroglioma patient was of prognostic value. In particular, patients with blood group A had a distinctly poorer prognosis than patients with O or B blood. The survival data from this unselected series indicate that cerebral oligodendrogliomas have a less favorable prognosis than has generally been believed.
Ecological and case-control studies have demonstrated a positive correlation between consumption of fat and the risk of prostate cancer. Two recent human studies have focused on a-linolenic acid as a risk factor for prostate cancer. Animal experiments have shown that dietary v-6 polyunsaturated fatty acids have generally stimulated tumour development, whereas v-3 polyunsaturated fatty acids have diminished it. The aim of our study was to investigate the association between these fatty acids and the subsequent risk of prostate cancer. Blood donors to the Janus serum data bank in Norway, who later developed prostate cancer, were matched to blood donors without prostate cancer (141 matched sets); the proportional level of fatty acids measured before diagnosis in the donors' serum was examined. The risk of later prostate cancer was analysed by conditional logistic regression. Increasing risk for prostate cancer was found with increasing quartiles of palmitoleic, palmitic and a-linolenic acid. An inverse risk association was found with increasing levels of tetracosanoic acid, for the ratios of linoleic to a-linolenic acid and arachidonic to eicosapentaenoic acid. There was no clear association between the risk effect of total v-3 and total v-6 fatty acids. There were no indications of a relationship between fatty acids and more aggressive cancers. Our results verify recent findings of a positive association between a-linolenic acid and a negative association between the ratio of linoleic to a-linolenic acid and the risk of prostate cancer. Int.
Enterolactone, a phytoestrogen belonging to the class of lignans, is produced by the intestinal microflora from precursors in plant foods and has been implicated in protection against cancer. We study the effect of enterolactone on the risk of a subsequent diagnosis of prostate cancer. We con-
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