The Influence of Modifiable Factors on Breast and Prostate Cancer Risk and Disease Progression

Fatigue Level Associated with Quality of Life for Prostate Cancer Patients: Results from the All of Us Research Program

BACKGROUND/OBJECTIVES

Prostate cancer (PCa) patients frequently experience extended survivorship, highlighting the importance of quality of life (QoL) in cancer care. QoL has been shown to influence survival and PCa progression. For PCa patients, fatigue is a common issue due to cancer itself or its treatments. However, many QoL studies on PCa patients are limited by small sample sizes in clinic settings and often overlook the impact of fatigue and health-related behaviors. To fill this gap, this study aims to evaluate fatigue associated with QoL and related health measures among PCa patients.

METHODS

This study used the All of Us cohort with 6426 PCa patients. Factors associated with QoL and health outcomes were tested using logistic models.

RESULTS

Among PCa patients, 8.8% reported poor QoL, 20.9% reported poor physical health, and 9.0% reported poor mental health. Around 24.5% and 5.0% of PCa patients had a moderate and high fatigue level, respectively. A high fatigue level was significantly associated with poor QoL (OR = 2.33, p < 0.001), poor physical health (OR = 8.20, p < 0.001), and poor mental health (OR = 3.62, p < 0.001), adjusting for other factors. Social function ability also played a critical role in QoL and health outcomes. In addition, PCa therapy was associated with a higher risk of poor physical health (OR = 1.30, p = 0.030) but not associated with QoL and mental health.

CONCLUSIONS

This study provides valuable insights about fatigue's important role in QoL, physical health, and mental health for PCa patients. Effective fatigue management is suggested to enhance QoL and overall well-being for PCa patients.

Gendered interpretations of the causes of breast cancer: a structured review of migrant studies

BACKGROUND

Breast cancer is the most prevalent cancer in women worldwide. Despite it having an etiology that has fixed, genetic as well as modifiable, environmental risk factors, the narrative around breast cancer prevention emphasizes gendered interpretations of the etiology, such as "reproductive factors cause breast cancer" and women should change their behaviors to reduce their risk. Since migrant studies can distinguish environmental from genetic risk factors, we conducted a structured review of migrant studies and assessed prominent cancer website resources to determine evidence of gender bias between breast and prostate cancer.

METHODS

We searched ten online databases for articles with migration as the exposure and breast cancer mortality and/or incidence as the outcome. We also searched using prostate cancer as the outcome to generate a comparison group. We developed rubrics to categorize the studies by study design (single, double, and time dimensional), convergence (a change in incidence or mortality for the migrant population), and concordance (consistency between results and author-attributed etiology). We used chi-square tests to test for differences by cancer type. We web-scraped four notable cancer websites to extract website layouts, risk factor information, and language describing breast cancer etiology and compared it to the content used for prostate cancer.

FINDINGS

Of all 140 studies and 220 comparisons, breast (n = 131) outnumbered prostate cancer studies (n = 89; p-value = 0·005). For both cancers, studies that compared all three populations (the non-migrant, origin, and destination population outcomes) or measured length of stay demonstrated that cancer rates converged with migration. Most authors attributed breast cancer etiology to genetic and environmental factors. Yet, the migrant study results were inconsistent with public health messaging; all four websites framed breast cancer as more modifiable than prostate cancer.

CONCLUSION

Research efforts and public health messaging for breast cancer should consider gendered barriers to changing individual-level risk factors and develop more prevention strategies at the health systems level.

Perceptions, Knowledge, and Attitudes of General Population About Prostate Cancer-Associated Risk Factors: A Systematic Review of Qualitative Studies Focusing on Lifestyle

PURPOSE OF REVIEW

Prostate cancer (PCa) is the most prevalent cancer and the third deadliest in Europe among men. PCa has several well-established risk factors; however, the influence of lifestyle factors remains under investigation, which may hinder efforts to encourage healthier behavior adoption. Thus, this systematic review explored the general population's perceptions, knowledge, and attitudes regarding PCa-related risk factors.

RECENT FINDINGS

Eighteen qualitative studies were included after searching PubMed, Scopus, Web of Science, and EMBASE scientific databases between January 2013 and February 2023. Five major themes emerged from the 18 included studies: PCa knowledge, risk factors, lifestyle pattern changes, motivation/barriers to changing habits, and lifestyle advice support. Participants identified age, family history, genetics, and race/ethnicity as risk factors for PCa, but no consensus has been reached regarding lifestyle. However, most of the participants were willing to adopt healthier habits. Support from healthcare professionals (HPs), family, and friends, the desire for more time with loved ones, and fear of PCa consequences were cited as motivators for habit changes. However, poor economic conditions, work schedules, age, and PCa limitations hamper lifestyle changes. Effective interventions require personalized support and credible information from healthcare providers. Collaboration between family, friends, and HPs is crucial for promoting healthier behaviors and enhancing PCa management. This systematic review highlights the need for further research and innovative approaches to empower individuals towards healthier lifestyles, which could help prevent PCa or, at the very least, promote better treatment outcomes.

Development of machine learning-based malignant pericardial effusion-related model in breast cancer: Implications for clinical significance, tumor immune and drug-therapy

Background

Malignant pericardial effusion (MPE) is a common complication of advanced breast cancer (BRCA) and plays an important role in BRCA. This study is aims to construct a prognostic model based on MPE-related genes for predicting the prognosis of breast cancer.

Methods

The BRCA samples are analyzed based on the expression of MPE-related genes by using an unsupervised cluster analysis method. This study processes the data by least absolute shrinkage and selection operator and multivariate Cox analysis, and uses machine learning algorithms to construct BRCA prognostic model and develop web tool.

Results

BRCA patients are classified into three clusters and a BRCA prognostic model is constructed containing 9 MPE-related genes. There are significant differences in signature pathways, immune infiltration, immunotherapy response and drug sensitivity testing between the high and low-risk groups. Of note, a web-based tool (http://wys.helyly.top/cox.html) is developed to predict overall survival as well as drug-therapy response of BRCA patients quickly and conveniently, which can provide a basis for clinicians to formulate individualized treatment plans.

Conclusion

The MPE-related prognostic model developed in this study can be used as an effective tool for predicting the prognosis of BRCA and provides new insights for the diagnosis and treatment of BRCA patients.

Nutrigenomics and microbiome shaping the future of personalized medicine: a review article

The relationship between nutrition and genes has long been hinted at and sometimes plainly associated with certain diseases. Now, after many years of research and coincidental findings, it is believed that this relationship, termed "Nutrigenomics," is certainly a factor of major importance in various conditions. In this review article, we discuss nutrigenomics, starting with basics definitions and enzymatic functions and ending with its palpable association with cancer. Now, diet is basically what we eat on a daily basis. Everything that enters through our alimentary tract ends up broken down to minute molecules and amino acids. These molecules interact with our microbiome and genome in discreet ways. For instance, we demonstrate how proper intake of probiotics enhances beneficial bacteria and may alleviate IBS and prevent colorectal cancer on the long term. We also show how a diet rich in folic acid is essential for methylenetetrahydrofolate reductase (MTHFR) function, which lowers risk of colorectal cancer. Also, we discuss how certain diets were associated with development of certain cancers. For example, red and processed meat are highly associated with colorectal and prostate cancer, salty diets with stomach cancer, and obesity with breast cancer. The modification of these diets significantly lowered the risk and improved prognosis of these cancers among many others. We also examined how micronutrients had a role in cancer prevention, as vitamin A and C exert anti-carcinogenic effects through their function as antioxidants. In addition, we show how folic acid prevent DNA mutations by enhancing protein methylation processes. Finally, after a systematic review of myriad articles on the etiology and prevention of cancer, we think that diet should be a crucial feature in cancer prevention and treatment programs. In the future, healthy diets and micronutrients may even be able to successively alter the liability to genetic mutations that result in cancer. It also will play a role in boosting treatment and improving prognosis of diagnosed cancers.

[18F]-FDHT PET for the Imaging of Androgen Receptor in Prostate and Breast Cancer: A Systematic Review

The aim of this systematic review is to provide a comprehensive overview of the role of fluoro-5α-dihydrotestosterone ([18F]-FDHT) for the in vivo imaging of androgen receptors (AR) through positron emission tomography (PET) in metastatic breast (mBC) and metastatic castration-resistant prostate cancer (mCRPC). Relevant studies published from 2013 up to May 2023 were selected by searching Scopus, PubMed and Web of Science. The selected imaging studies were analyzed using a modified version of the critical Appraisal Skills Programme (CASP). Eleven studies encompassing 321 patients were selected. Seven of the eleven selected papers included 266 subjects (82.2%) affected by mCRPC, while four encompassed 55 (17.2%) patients affected by mBC. [18F]-FDHT PET showed a satisfying test/retest reproducibility, and when compared to a histochemical analysis, it provided encouraging results for in vivo AR quantification both in mCRPC and mBC. [18F]-FDHT PET had a prognostic relevance in mCRPC patients submitted to AR-targeted therapy, while a clear association between [18F]-FDHT uptake and the bicalutamide response was not observed in women affected by AR-positive mBC. Further studies are needed to better define the role of [18F]-FDHT PET, alone or in combination with other tracers (i.e., [18F]-FDG/[18F]-FES), for patients' selection and monitoring during AR-targeted therapy, especially in the case of mBC.

Metabolic changes during prostate cancer development and progression

Metabolic reprogramming has been recognised as a hallmark in solid tumours. Malignant modification of the tumour's bioenergetics provides energy for tumour growth and progression. Otto Warburg first reported these metabolic and biochemical changes in 1927. In prostate cancer (PCa) epithelial cells, the tumour metabolism also changes during development and progress. These alterations are partly driven by the androgen receptor, the key regulator in PCa development, progress, and survival. In contrast to other epithelial cells of different entities, glycolytic metabolism in prostate cells sustains physiological citrate secretion in the normal prostatic epithelium. In the early stages of PCa, citrate is utilised to power oxidative phosphorylation and fuel lipogenesis, enabling tumour growth and progression. In advanced and incurable castration-resistant PCa, a metabolic shift towards choline, amino acid, and glycolytic metabolism fueling tumour growth and progression has been described. Therefore, even if the metabolic changes are not fully understood, the altered metabolism during tumour progression may provide opportunities for novel therapeutic strategies, especially in advanced PCa stages. This review focuses on the main differences in PCa's metabolism during tumourigenesis and progression highlighting glutamine's role in PCa.

Expansion of the quality of care index on breast cancer and its risk factors using the global burden of disease study 2019

BACKGROUND

Breast cancer (BC), as the top neoplasm in prevalence and mortality in females, imposes a heavy burden on health systems. Evaluation of quality of care and management of patients with BC and its responsible risk factors was the aim of this study.

METHODS

We retrieved epidemiologic data of BC from the Global Burden of Disease (GBD) 1990-2019 database. Epidemiology and burden of BC and its risk factors were explored besides the Quality of Care Index (QCI) introduced before, to assess the provided care for patients with BC in various scales. Provided care for BC risk factors was investigated by their impact on years of life lost and years lived with disability by a novel risk factor quality index (rQCI). We used the socio-demographic index (SDI) to compare results in different socio-economic levels.

RESULTS

In 2019, 1,977,212 (95% UI: 1,807,615-2,145,215) new cases of BC in females and 25,143 (22,231-27,786) in males was diagnosed and this major cancer caused 688,562 (635,323-739,571) deaths in females and 12,098 (10,693-13,322) deaths in males, globally. The all-age number of deaths and disability-adjusted life years attributed to BC risk factors in females had an increasing pattern, with a more prominent pattern in metabolic risks. The global estimated age-standardized QCI for BC in females in 2019 was 78.7. The estimated QCI was highest in high SDI regions (95.7). The top countries with the highest calculated QCI in 2019 were Iceland (100), Japan (99.8), and Finland (98.8), and the bottom countries were Mozambique (16.0), Somalia (8.2), and Central African Republic (5.3). The global estimated age-standardized rQCI for females was 82.2 in 2019.

CONCLUSION

In spite of the partially restrained burden of BC in recent years, the attributable burden to risk factors has increased remarkably. Countries with higher SDI provided better care regarding both the condition and its responsible risk factors.