Preventive medicine and men's health
Gespeichert in:
| Format: | Buch |
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| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2004
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| Schriftenreihe: | Urologic clinics of North America
31,2 |
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| Online-Zugang: | Inhaltsverzeichnis |
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| 245 | 1 | 0 | |a Preventive medicine and men's health |c guest ed. Mark A. Moyad |
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Datensatz im Suchindex
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| adam_text | PW.V1 VII F MMWlNIi AM) VIFIN S TTFALTH . .
CONTENTS
Preface xiii
Mark A. Moyad
I. CARDIOVASCULAR DISEASE AND UROLOGY
Introduction to Risk Assessment and Serum Risk Markers for the Prevention
of Coronary Heart Disease and Other Potential Conditions that Impact Men s
Health, Part I: What Do I Tell My Patients? 195
Mark A. Moyad
Introducing patients to risk markers for cardiovascular disease is especially daunting in
urology, where patients are being evaluated for noncardiovascular conditions. There are
several important reasons for discussing cardiac risk factors and assessment in urology.
Patients and clinicians need to know their cardiovascular risk markers as well as they
know the results of their cancer screening tests because there may be a profound overlap
between the two conditions. This article provides a foundation for clinicians and patients
regarding cardiovascular risk markers and overall risk, covering the well known mark¬
ers and risk assessment. Knowing these basic markers and suggesting intervention
may help to reduce cardiovascular risk, some urologic conditions, and, most impor¬
tantly, all cause mortality.
Introduction to Risk Assessment and Serum Risk Markers for the Prevention
of Coronary Heart Disease and Other Potential Conditions that Impact Men s
Health, Part II: What Do I Tell My Patients? 199
Mark A. Moyad
Introducing patients to risk markers for cardiovascular disease is daunting in urology,
where patients are being evaluated for noncardiovascular conditions. There are several
important reasons for discussing cardiac risk factors and assessment in urology. Patients
and clinicians need to know their cardiovascular risk markers as well as they know the
results of their cancer screening tests because there may be a profound overlap between
the two conditions. Knowing risk markers and suggesting intervention may help pre¬
vent cardiovascular risk, some urologic conditions, and all cause mortality. This article
introduces markers for cardiovascular risk screening and provides a balanced approach
to disease prevention for patients that need an objective reassessment of health risks,
especially those with a medical condition that is more unlikely to cause early morbidity
and mortality.
VOLUME 31 ¦ NUMBER 2 • MAY 2004 v
Prostate Cancer and Coronary Heart Disease: Correlation or Coincidence? 207
Mark A. Moyad and Markus Sonnleithner
Cardiovascular disease (CVD) is the leading cause of death in men in the United States
and most countries worldwide, the leading cause of death in most cancer prevention
trials, and the primary or secondary cause of death in most prostate cancer patients.
Some risk factors for prostate cancer are similar to the risk factors for CVD, and some
methods to reduce the risk for are similar to the methods to reduce the risk for prostate
cancer. Recent evidence suggests a correlation between CVD and prostate cancer, but
more research is needed. Regardless, reducing the risk for CVD could reduce the pri¬
mary or secondary cause of mortality in men with or without prostate cancer.
II. CHEMOPREVENTION/SCREENING
The Potential Role of Cyclooxygenase 2 Inhibitors and 5a Reductase
Inhibitors in the Prevention of Urologic Conditions 213
Javier Hernandez, Joseph W. Basler, and Ian M. Thompson
There is growing interest across multiple medical and surgical specialties in the preven¬
tion of disease. Interest in preventing urologic malignancies is gaining momentum with¬
in urology. Cyclooxygenase 2 inhibitors and 5a reductase inhibitors are two classes of
potential prevention agents against urologic malignancies. This article summarizes data
from preclinical studies, epidemiologic and clinical observations, and clinical trials eval¬
uating the role of these agents in the chemoprevention of urologic malignancies.
Screening for Prostate Cancer: Current Recommendations 219
Shandra S. Wilson and E. David Crawford
An estimated 220,900 new cases of prostate cancer were diagnosed in the United States
in 2003, and 28,900 men died of the disease during that year. A global effort to decrease
the incidence, morbidity, and mortality from prostate cancer is underway. As with other
disease processes, techniques to ameliorate prostate cancer can be applied at three gen¬
eral levels: prevention, screening, and treatment. Although it is important to direct atten¬
tion to all three arenas to decrease prostate cancer morbidity and mortality, this article
focuses on prostate cancer screening.
Potential Pathologic Markers for Prostate Chemoprevention Studies 227
Wael A. Sakr and M. Scott Lucia
The field of exploring potential biomarkers for prostate cancer prevention continues to
expand rapidly. In addition to a limited scope of histologic alterations, a growing array
of promising technologies (eg, computer assisted analysis) and molecules involved in
cell cycle regulations, angiogenesis, and structural and numerical chromosomal alter¬
ations are potential surrogate endpoint biomarkers for prevention trials. Before adopting
any these potential candidates, however, the technical, interpretational, and validation
requirements must be satisfied. More important, it is crucial to demonstrate that modu¬
lation of the frequency of the biomarker decreases the rate of cancer development.
Risk Factors for Adult Renal Cell Carcinoma 237
R. Dhote, N. Thiounn, B. Debre, and G. Vidal Trecan
To rank the most consistent associations between risk factors and renal cell cancer, the
authors performed a systematic review. Tobacco use, obesity, and kidney disease were
identified as risk factors. Oral contraceptive intake and alcohol were protective factors
vi CONTENTS
in women. Drug intake and some types of occupational exposure (iron or steel industry,
petroleum, and dry cleaning solvent) and socioeconomic status may be associated, but
these associations were identified in few studies.
III. ERECTILE DYSFUNCTION
Prevention and Treatment of Erectile Dysfunction Using Lifestyle Changes
and Dietary Supplements: What Works and What is Worthless, Part I 249
Mark A. Moyad, James H. Barada, Tom F. Lue, John P. Mulhall, Irwin Goldstein,
and Ahmed Fawzy, for the Sexual Medicine Society (SMS) Nutraceutical
Committee
Dietary supplements and other alternative medicines are publicized and used widely.
Although the prevalence of these therapies for erectile dysfunction (ED) is unknown,
media and alternative medicine publications advocate such use. Because the placebo ef¬
fect for approved ED medications is approximately 25% to 40%, adequately designed
clinical trials for ED dietary supplements are needed to assess whether an improvement
beyond a placebo effect exists. The potential for dietary supplements to enhance the erec¬
tile response in men that initially fail approved ED medications is intriguing. Clinicians
should understand these supplements, the current research regarding their use, and
the associated adverse effects to discuss them with patients objectively and effectively.
This article summarizes heart healthy lifestyle changes that may affect ED, outlines rules
and regulations governing dietary supplements, and reviews the research regarding
acupuncture.
Prevention and Treatment of Erectile Dysfunction Using Lifestyle Changes
and Dietary Supplements: What Works and What is Worthless, Part II 259
Mark A. Moyad, James H. Barada, Tom F. Lue, John P. Mulhall, Irwin Goldstein,
and Ahmed Fawzy, for the Sexual Medicine Society (SMS) Nutraceutical
Committee
This article reviews popular components of the numerous dietary supplements for treat¬
ment of erectile dysfunction (ED). L arginine in high daily doses may benefit patients
who produce consistently low levels of nitric oxide. Androstenedione and dehydro
epiandrosterone are precursors to testosterone but do not increase testosterone levels
in men with normal gonadal function. Ginkgo biloba may have a circulatory effect,
but randomized trials have not shown a benefit over placebo. Korean red ginseng has
reported positive results from several small clinical studies. Yohimbine as a supplement
lacks quality control and a benefit beyond psychogenic ED. Zinc has not been studied
adequately in men with ED and may be detrimental in high doses. Other newer dietary
supplements need adequate clinical studies.
IV. LIFESTYLE CHANGES/ISSUES
The Impact of Obesity in Urology 275
Jack H. Mydlo
This article discusses the rapid increase in obesity throughout the United States and the
world, and the implications of this disease in urology. Many benign urologic conditions,
such as stress urinary incontinence, erectile dysfunction, infertility, and renal calculi, may
be associated with obesity. Obesity related tumor biology may also play a role in the
etiology or promotion of prostate and renal cancer. The author discusses several theories
at the molecular level to explain this, and reviews the current clinical data.
CONTENTS vii
Lifestyle Recommendations to Prevent Prostate Cancer,
Part I: Time to Redirect our Attention? 289
Mark A. Moyad and Peter R. Carroll
Cardiovascular disease is the primary cause of death in the United States and most coun¬
tries worldwide, and the primary or secondary cause of death in prostate cancer preven¬
tion trials and prostate cancer patients. These findings place men s overall risk for death
in perspective. In general, heart health is tantamount to prostate health. Clinicians need
to provide simple and realistic lifestyle changes to patients to reduce prostate cancer risk
and mortality and affect all cause mortality. Parts I and II of this article summarize life¬
style recommendations that may reduce prostate cancer risk or improve patients lives
overall. These articles should help clinicians and patients discuss practical changes that
may be accomplished quickly, and may impact risk for several diseases that affect men s
health.
Lifestyle Recommendations to Prevent Prostate Cancer,
Part II: Time to Redirect Our Attention? 301
Mark A. Moyad and Peter R. Carroll
Keeping in mind that cardiovascular disease is the leading cause of death in men, part II
of this article proffers more specific recommendations for lifestyle change. After basic
foundations in behavioral change are established, many other heart and prostate
healthy recommendations should be emphasized. Such changes are followed by a com¬
plete summary of the lifestyle recommendations.
V. OSTEOPOROSIS
The Impact of Osteoporosis in Men Treated for Prostate Cancer 313
Michael G. Oefelein and Martin I. Resnick
Prostate cancer patients are at significant risk for skeletal related events (SREs), with up
to 50% of androgen insensitive patients experiencing an SRE at 24 months. The risk in¬
creases with the duration and type of cancer treatment. SREs reduce health related qual¬
ity of life and increase the cost of care, and skeletal fractures are associated negatively
with overall survival. Screening men at greatest risk (slender white men and men with
hormone refractory disease or metastatic disease) with bone mineral density measure¬
ments, and initiating empiric therapy (vitamin D3, calcium, parenteral estrogens, bispho
sphates) may be warranted.
Preventing Male Osteoporosis: Prevalence, Risks, Diagnosis and Imaging
Tests 321
Mark A. Moyad
Osteoporosis is becoming a major heath problem in men. Men have a lower rate of frac¬
tures, but have a higher risk for dying from a fracture. Initial studies show the same risk
factors in men as for women, including aging, previous fractures, family history of os¬
teoporosis, and low bone mineral density (BMD). Many causes for low BMD in men
are secondary; for example, men receiving luteinizing hormone releasing agonist treat¬
ment for prostate cancer may lose more bone from the forearm and hip than the spine.
Heel ultrasound, dual energy x ray absorptiometry, and quantitative CT are the most ef¬
fective methods for osteoporosis screening. Peripheral bone density tests are gaining
popularity but need more research. This article provides an important foundation to
an increasingly prevalent condition in men in medical fields including urology.
viii CONTENTS
Understanding Treatments for Bone Loss and Bone Metastases in Patients
with Prostate Cancer: A Practical Review and Guide for the Clinician 331
Celestia S. Higano
Prostate cancer patients frequently develop skeletal complications, including bone loss
resulting from prolonged androgen deprivation therapy (ADT) in nonmetastatic and me
tastatic disease and bone metastases. Prevention and treatment of bone loss and bone
metastases with bisphosphonates, potent bone resorption inhibitors, are evolving. Only
zoledronic acid has been shown to reduce and delay bone complications in patients with
hormone refractory disease; clinical trials are evaluating bisphosphonate treatment in
hormone naive patients with bone metastases and in preventing bone metastases in pa¬
tients with high risk disease. Prostate cancer patients beginning ADT should be assessed
clinically and radiologically for pre existing bone loss; encouraged to modify lifestyles
that increase the risk for bone loss and fractures; participate in a customized resis¬
tance exercise program; take supplemental calcium and vitamin D; and be assessed
regularly for bone loss during ADT. Patients with osteoporosis should receive bispho¬
sphonate therapy; some patients with osteopenia may also benefit from bisphosphonate
thereapy. Drugs targeting specific mediators of bone remodeling seem promising and are
being evaluated in clinical trials.
VI. SIDE EFFECTS PREVENTION
Reducing the Toxidty Associated With the Use of Radiotherapy in Men with
Localized Prostate Cancer 353
Mack Roach III
The risk for serious complications from modern radiotherapy is relatively low. Com¬
pared with conventional radiotherapy, three dimensional conformal radiotherapy
(3DCRT) and intensity modulated radiotherapy (IMRT) allow higher doses to be given
more safely. Although there is a movement toward IMRT, 3DCRT is considered stan¬
dard. Quality assurance procedures and questions regarding IMRT are evolving, includ¬
ing the radiobiologic consequences of altered time dose fractionation and the greater
dose heterogeneity in the target. Defining an accurate target volume and correcting
for set up error and organ movement before each treatment should reduce complications
with external beam radiotherapy. Complications following prostate brachytherapy now
are better understood. Dosimetric or patient selection factors that correlate with a higher
risk for complications often can be avoided. It is hoped these advances will eliminate
toxidty associated with radiotherapy and increase cure rates.
Prevention and Management of Prostate Cancer Chemotherapy
Complications 367
Tomasz M. Beer, and Joseph S. Bubalo
Both patient specific and regimen related factors can influence the risk for chemotherapy
side effects. Prevention of toxicity begins before chemotherapy is considered because
treatments that later impair the ability to tolerate chemotherapy can be avoided or mini¬
mized. When chemotherapy is indicated, initiation of treatment before the patient s per¬
formance status declines and careful, individualized selection of regimens is crucial.
Prophylactic use of adjunctive medications including antiemetics, antihistamines, and,
less commonly, growth factors, is appropriate with some chemotherapy regimens. Early
recognition of toxicity followed by individual dose adjustment or the addition of specific
medical countermeasures is critical once chemotherapy treatment has begun.
Index 379
CONTENTS «
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| spelling | Preventive medicine and men's health guest ed. Mark A. Moyad Philadelphia [u.a.] Saunders 2004 XIV S., S. 195 - 387 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Urologic clinics of North America 31,2 Präventivmedizin (DE-588)4047033-7 gnd rswk-swf Mann (DE-588)4037363-0 gnd rswk-swf Urogenitalkrankheit (DE-588)4132473-0 gnd rswk-swf Urogenitalkrankheit (DE-588)4132473-0 s Präventivmedizin (DE-588)4047033-7 s Mann (DE-588)4037363-0 s b DE-604 Moyad, Mark A. 1965- Sonstige (DE-588)157275000 oth Urologic clinics of North America 31,2 (DE-604)BV000001584 31,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=012794769&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Preventive medicine and men's health |
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