Prostate Cancer
Conditions
Keywords
stage I prostate cancer, stage IIB prostate cancer, stage IIA prostate cancer, stage III prostate cancer
Brief summary
RATIONALE: A diet that is low in fat and/or high in flaxseed may slow or prevent disease progression of prostate cancer. PURPOSE: Randomized phase II trial to study the effectiveness of a diet that is low in fat and/or high in flaxseed in slowing or preventing disease progression in patients who have newly diagnosed prostate cancer.
Detailed description
OBJECTIVES: * Compare tumor proliferation in patients with newly diagnosed prostate cancer eating fat- and/or flaxseed-modified diets. * Compare differences in histopathological markers associated with prostate cancer (rates of apoptosis, extent of high-grade prostatic intraepithelial neoplasia) among patients in these diet groups. * Compare changes in serum prostate specific antigen among patients in these diet groups. * Compare changes in hormone-related factors (total serum testosterone and free androgen index, insulin-like growth factor \[IGF\], and IGF-binding protein-3) among patients in these diet groups. * Compare the effects of diet on nutritional biomarkers (levels of lignans in the urine and ejaculate, fatty acid profiles of erythrocytes and prostatic tissue) in these patients. * Determine associations between dietary modification and changes in dietary biomarkers, hormonal intermediates, and study endpoints in these patients. OUTLINE: This is a randomized study. Patients are stratified according to Gleason score (less than 7 vs at least 7) and race (black vs non-black). Patients are randomized to 1 of 4 diet groups. * Arm I (Flaxseed-supplemented diet): Patients are instructed to incorporate ground flaxseed into their daily diets. * Arm II (Low-fat diet): Patients are instructed on ways to achieve a diet with no greater than 20% of total energy from dietary fat. * Arm III (Flaxseed-supplemented, low-fat diet): Patients are instructed as in arm I and arm II. * Arm IV (Control diet): Patients are contacted weekly, but do not receive dietary counseling until after surgery. All patients ingest the diets for at least 3 weeks and complete diet diaries until surgery. After surgery, all patients receive dietary counseling. PROJECTED ACCRUAL: A total of 160 patients (40 per treatment arm) will be accrued for this study.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed prostate cancer * At least 3 weeks until planned prostatectomy (24 days between day 1 visit and surgery) * Current diet that provides more than 30% of calories from fat PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Not specified Life expectancy * Not specified Hematopoietic * Not specified Hepatic * Not specified Renal * Not specified Other * Mentally competent * Able to speak and write English * Must have telephone access PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Not specified Endocrine therapy * No concurrent hormonal therapy Radiotherapy * Not specified Surgery * At least 2 weeks since prior prostate biopsy Other * At least 7 days since prior antibiotics * No prior therapy for prostate cancer * No concurrent dietary supplements initiated within the past 3 months or anticipated to begin during study except standard multivitamin/mineral preparations (e.g., One-A-Day, Theragran, or Centrum) that do not supply \> 100% of the recommended daily allowance of any vitamin or mineral * No other concurrent neoadjuvant therapies * No other concurrent flaxseed consumption
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Prostatic Carcinoma Proliferation Rate by MIB-1 assay at time of prostatectomy | — |
Secondary
| Measure | Time frame |
|---|---|
| Prostatic Carcinoma Apoptotic Index by TUNEL assay at time of prostatectomy | — |
| Prostate-specific antigen by Hybritech assay at baseline and follow-up | — |
| Total testosterone, sex hormone binding globulin, insulin-like growth factor (IGF), and IGF-binding protein-3, total cholesterol, and low-density lipoprotein cholesterol by ELISA assays at baseline and follow-up | — |
Countries
United States