Moyad Mark A
University of Michigan Medical Center, Ann Arbor, MI, USA.
Curr Urol Rep. 2018 Oct 27;19(12):104. doi: 10.1007/s11934-018-0846-4.
To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention.
The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy. The primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also allows for maximizing prostate cancer prevention. The obesity epidemic in children and adults along with recent diverse research has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded improved probability of CVD and potentially aggressive cancer risk reduction. Preventing prostate cancer via dietary supplements should encourage a "first do no harm", or less is more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. Medications that improve heart health including statins, aspirin, and metformin (S.A.M.), and specific beta-blocker medications are primarily generic or low-cost and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appear to exist within the same forest.
探讨饮食、生活方式、补充剂以及一些预防前列腺癌的心脏健康处方药物的总体及最新观察结果。
随着更多前瞻性观察和随机对照试验数据的增加，通过最大化心脏健康来预防侵袭性前列腺癌的概念不断得到巩固。心脏健康即前列腺健康，心脏不健康则前列腺不健康。降低全因和心血管疾病（CVD）发病及死亡风险的主要目标也有助于最大化前列腺癌的预防。儿童和成人中的肥胖流行以及近期的各种研究进一步强化了心脏与前列腺健康之间的联系。对各种健康食物的更高饮食依从性与CVD概率的逐步改善以及潜在侵袭性癌症风险的降低相关。通过膳食补充剂预防前列腺癌应鼓励采取“首先不造成伤害”或少即是多的方法，直到未来的证据能够扭转令人担忧的趋势，即更多的补充剂要么没有效果，要么增加前列腺癌风险。用于减轻某些癌症治疗副作用的补充剂似乎有更令人鼓舞的数据。改善心脏健康的药物，包括他汀类药物、阿司匹林和二甲双胍（S.A.M.）以及特定的β受体阻滞剂药物，主要是通用的或低成本的，应继续引起研究关注。医学教育的一个分水岭时刻已经到来，过去看似被广阔距离分隔的众多树木的观念，实际上现在似乎存在于同一森林中。
