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Background: Products made from botanicals that are used to maintain or improve health are known as herbal supplements, botanicals, or phytomedicines. Many herbs have a long history of use and claimed health benefits. However, many herbal supplements and botanicals have potent pharmacologic activity that can contribute to adverse effects and drug interactions. The use of herbal supplements by cancer patients in the perioperative period is common and consistent with the substantial increase in the use of alternative medical therapies. Methods: We reviewed the literature to examine the constituents, safety, pharmacokinetics, and pharmacodynamics of those herbal supplements that are predominantly used by cancer patients. Results: Different supplements possess antiplatelet activity, adversely interact with corticosteroids and central nervous system depressant drugs, have gastrointestinal manifestations, produce hepatotoxicity and nephrotoxicity, and produce additive effects when used with opioid analgesics. Conclusions: With the increasing use of herbal supplements by cancer patients, surgical staff need to screen patients presurgically for use of these supplements. Clinical practice guidelines are needed for screening and prevention of herbal supplement usage to prevent potential adverse events that may arise from herbal medications taken alone or combined with conventional therapies during the perioperative period. Herbal supplements commonly used by cancer patients in the perioperative period can produce pharmacokinetic interactions that can complicate surgery.

The objective of this case-control study was to investigate the relationship between purposeful physical activity, body fat distribution, body mass index, and steroid hormones. These factors are known to be implicated in modulating breast cancer risk in premenopausal women. A total of 112 newly diagnosed, premenopausal breast cancer patients and 106 age-matched premenopausal disease-free controls were admitted to the study. Information regarding personal, medical, hormonal, and reproductive history, smoking and alcohol use, physical activity history, and anthropometric measurements was obtained. Serum samples for steroid hormone assays were collected and analyzed. Disease-free premenopausal controls had a significantly higher physical activity index (PAI) (p ≤ 0.05), however, significantly higher weight (p ≤ 0.05), body mass index (BMI) (p = 0.01), waist (p ≤ 0.005) and hip (p ≤ 0.05) circumferences, waist:hip ratios (p ≤ 0.05), and serum total estradiol levels (p

Obesity and adult weight gain are well-established risk factors for postmenopausal breast cancer. Although there are a few studies demonstrating the contribution of adult weight gain to breast cancer risk, whether weight gain during a critical time period is specifically associated with risk, or whether subsequent weight loss among women who have gained weight will reduce the excess risk, is not firmly established. We investigated the association of changes in weight (loss or gain in excess of 5% of body weight) using two risk factor models: (a) age 18 to 30 years and age 30 years to menopause and (b) age 30 years to menopause and after the menopause to the baseline study in 1986 on risk of postmenopausal breast cancer in a prospective cohort of 33,660 postmenopausal women in Iowa. Over 15 years of follow-up, 1,987 cases of breast cancer occurred. Data were analyzed using proportional hazards regression models adjusted for established breast cancer risk factors. The most frequently observed pattern of body weight over time was a consistent increase; these women were observed to have the highest rates of breast cancer and served as the reference category for all comparisons. The lowest-risk groups were (a) women who maintained or lost weight from age 18 to 30 years and then lost weight from age 30 years to menopause [risk ratio (RR), 0.36; 95% confidence interval (95% CI), 0.22-0.60] and (b) women who maintained or lost weight from age 30 years to menopause and then lost weight after the menopause (RR, 0.48; 95% CI, 0.22-0.65). Women who gained weight from age 30 years to menopause but then lost weight after the menopause experienced risk reductions (RR, 0.77; 95% CI, 0.64-0.92) although perhaps slightly smaller in magnitude than women who maintained their weight in both time intervals (RR, 0.63; 95% CI, 0.55-0.73). Women who gained weight from age 18 to 30 years and then lost weight from age 30 years to menopause had comparable risk reductions (RR, 0.61; 95% CI, 0.46-0.8) with women who maintained their weight in both time intervals (RR, 0.73; 95% CI, 0.64-0.84). Women who gained weight during the period from age 30 years to menopause but who had stable weight after menopause had rates similar to the reference group. These data suggest prevention of weight gain between age 18 years and menopause or weight loss and maintenance during these years reduces risk of postmenopausal breast cancer.

Among the numerous polyphenols isolated from green tea, the catechin EGCG predominates and is the target of anticancer research. But studies suggest that EGCG and other catechins are poorly absorbed and undergo substantial biotransformation to species that include glucuronides, sulfates, and methylated compounds. Numerous studies relate the antioxidant properties of the catechins with anticancer effects, but recent research proposes other mechanisms of action, including those involving methyl transfers that are subject to allelic variability in the enzyme catechol O-methyl transferase. However, preclinical research is promising and EGCG appears to be ready for further study in phase II and III trials.

AIMS To evaluate the effectiveness of supplementing a group of early stage prostate cancer patients, with 60 mg of soy isoflavones in producing a change in hormonal and proliferative risk parameters that are implicated in prostate cancer promotion. METHODS Seventy six eligible prostate cancer patients with a Gleason score of 6 or below, between ages 50 and 80 were admitted and supplemented with soy isoflavones or placebo for a 12 week period and changes in PSA and steroid hormones were analyzed at baseline and post intervention. RESULTS Fifty-nine patients completed the 12-week intervention. Serum free testosterone was reduced or showed no change in 61% of subjects in the isoflavone group compared to 33% in the placebo group. Serum total PSA decreased or was unchanged in 69% of the subjects in the isoflavone treated group compared to 55% in the placebo group. However, we did not see an increase in SHBG levels. Nineteen percent of subjects receiving soy isoflavones reduced total PSA by two points or more during the intervention period. CONCLUSIONS These data suggest that supplementing early stage prostate cancer patients with soy isoflavones, even in a study of short duration, altered surrogate markers of proliferation such as serum PSA and free testosterone in a larger number of subjects in the isoflavone supplemented group than the group receiving placebo. The study establishes the need to explore further the effects of prolonged and consistent soy consumption, which could potentially delay onset of histologic disease in this patient population. © 2004 Wileey-Liss, Inc.

The purpose of this study was to prospectively observe the relative contribution of each viable mechanism such as hyperphagia, physical activity, body composition, steroid hormonal and thyroid function, fatigue scores on changes in body weight in breast cancer patients, receiving adjuvant chemotherapy.This was a prospective observational research design where 198 consecutive breast cancer patients receiving adjuvant chemotherapy were monitored from start to end and 6 months post-therapy on changes in anthropometics, fatigue, nutritional intake, physical activity, thyroid and steroid hormones.We observed a weight gain over5 lb in 22.2% of this patient population with a significant and progressive gain of 6.7 lb (P0.0001) at 6 months. Ninety four percent of all patients reported fatigue and 56% of patients reported lowered physical activity. A significant reduction in serum free and total estradiol (P0.0001) was observed indicative of reduction in ovarian function with 86% amenorrehic at the end of treatment. A significant reduction in mean serum triiodothyronine uptake levels (P0.05), in addition to a significant increase in TBG (P0.0001) from baseline to end of chemotherapy, was observed. In addition 20-25% of this patient group was already diagnosed with clinical hypothyroidism at diagnosis and treated. Changes in fatigue frequency and serum sex-hormone-binding globulin (SHBG) were variables significantly predictive of weight gain (P0.0001).Cytotoxic agents may influence thyroid function in breast cancer patients contributing to and progressively worsening symptoms such as weight gain, amenorrhea, fatigue and lowered physical activity in this population. The present study indicates the value of screening breast cancer patients for thyroid function at diagnosis or pre-treatment.

Animal studies have demonstrated that a dietary polyphenol known as tannic acid (TA) exhibits anticarcinogenic activity in chemically induced cancers. Most recently, we have reported that TA and ester-bond containing green tea polyphenols are potent proteasome inhibitors in vitro and in vivo. We hypothesize that CellQuest, a patented formula which contains high level of TA obtained from a musaceas (plantain) plant extract, will inhibit the tumor cell proteasome activity. Here, we report that a partially purified CellQuest fraction, S3, potently inhibits the proteasomal chymotrypsin-like activity of Jurkat T cell extracts in a concentration-dependent manner. Inhibition of the proteasome by S3 in leukemia Jurkat T, simian virus 40-transformed and prostate cancer LNCaP cells results in accumulation of ubiquitinated proteins and the natural proteasome substrate p27Kip1, followed by induction of apoptosis. In contrast, non-transformed, immortalized human natural killer cells and normal human fibroblasts are resistant to S3-mediated proteasome inhibition and apoptosis induction. Our present study suggests that CellQuest targets and inhibits the proteasome selectively in tumor cells, which may contribute to the claimed anticancer activity.

Animal studies have demonstrated that a dietary polyphenol known as tannic acid (TA) exhibits anticarcinogenic activity in chemically induced cancers. Most recently, we have reported that TA and ester-bond containing green tea polyphenols are potent proteasome inhibitors in vitro and in vivo. We hypothesize that CellQuest, a patented formula which contains high level of TA obtained from a musaceas (plantain) plant extract, will inhibit the tumor cell proteasome activity. Here, we report that a partially purified CellQuest fraction, S3, potently inhibits the proteasomal chymotrypsin-like activity of Jurkat T cell extracts in a concentration-dependent manner. Inhibition of the proteasome by S3 in leukemia Jurkat T, simian virus 40-transformed and prostate cancer LNCaP cells results in accumulation of ubiquitinated proteins and the natural proteasome substrate p27Kip1, followed by induction of apoptosis. In contrast, non-transformed, immortalized human natural killer cells and normal human fibroblasts are resistant to S3-mediated proteasome inhibition and apoptosis induction. Our present study suggests that CellQuest targets and inhibits the proteasome selectively in tumor cells, which may contribute to the claimed anticancer activity.

Background The objectives of this study were to determine the prevalence and characterize the use of complementary/integrative nutritional therapies (CINTs) by patients during cancer treatment. Methods This retrospective review used data collected as a part of standard clinical care provided by the registered clinical dietitians and included nutritional history, demographic variables, anthropometrics, prevalence of use, and the specific integrative nutritional therapies used by these patients during cancer treatment. Results Twenty-nine percent of 820 patients reported use of CINTs not prescribed by their physician. Caucasians and patients over age 60 were the principal users of CINTs during treatment. Modular vitamins were the most frequently reported additive (86.9%), followed by botanicals/biologics (43.8%) and mineral supplements (28.6%). Conclusions A considerable proportion of cancer patients use unproven CINTs during cancer treatment. The health professional should become more aware of the complementary/integrative therapies that their patients are using during cancer treatment.

There is increasing evidence that dietary factors may play a role in the production, metabolism, and bioavailability of sex hormones and their impact on target tissues. The specific objective of this study was to evaluate the effectiveness of supplementing a group of premenopausal women who were free of breast carcinoma with a dietary supplement of isoflavones (40 mg per day) in producing a change in steroid hormones and menstrual cycle length.Sixty-eight consecutively recruited, premenopausal, omnivorous women of all races and ethnicities between the ages of 25 years and 55 years were admitted to the study and randomized to an experimental group supplemented with soy (40 mg genistein per day) or to a control group that consumed a placebo for a 12-week period. Changes in their anthropometric, nutritional, and hormonal biomarkers from early follicular phase were analyzed at baseline and post-intervention.Serum-free estradiol and estrone levels decreased moderately in the experimental group. Serum hormone-binding globulin levels increased in 41.4% of women in the experimental group compared with 37.5% of women in the placebo group. Free estradiol decreased in 53.85% of women in the experimental group compared with 37.5% of women in the placebo group. Estrone decreased in 55.56% of women in the experimental group compared with 42.86% in the placebo group. Those women in the experimental group who were consuming soy had their mean menstrual cycle length increased by 3.52 days compared with a mean decrease of 0.06 days for women in the placebo group (P = 0.04) from baseline to the third menstrual cycle. In addition, women who were taking soy had their mean follicular phase increase by 1.46 days compared with a mean increase of 0.14 days for women who were taking the placebo (P = 0.08).These data suggest that increased isoflavone intake affects estrogen metabolism by altering the steroid hormone concentrations and menstrual cycle length, thereby demonstrating a potential to reduce the risk for breast carcinoma.

There is a perception that tamoxifen causes weight gain in breast cancer patients. The purpose of this research study was to determine if weight gain is associated with tamoxifen therapy and to observe the impact of weight gain on recurrence and survival. Prognostic indicators, changes in weight, and disease status from diagnosis to the end of treatment were studied in 200 consecutive Stage I and II breast cancer patients, not receiving systemic chemotherapy, admitted from 1986 to the present, with observation periods ranging from 3-5 years. A mean weight gain of 1.2 Kgs was seen in all patients; however, weight gain was not significantly different for those receiving tamoxifen vs. those not receiving tamoxifen, (P = 0.66, CI 95% for the difference -1.8 Kgs to +1.2 Kgs). Weight gain during treatment with tamoxifen was not correlated with treatment duration or with recurrence or survival. Age at diagnosis was positively correlated to weight gain in all groups. Our data failed to show that tamoxifen is associated with weight gain. The moderate weight gain observed in this patient population is comparable to the general aging disease-free population and may no be treatment-related. These findings may help to alleviate some concerns of both physicians and patients when tamoxifen is the drug of choice for adjuvant therapy.

Background Physicians are often asked about complementary therapies by patients with cancer, and data show that the interest in and use of these therapies among patients with cancer is common. Therefore, it is important to assess the current evidence base on the benefits and risks of complementary therapies (modalities not historically used in modern Western medicine). Methods A systematic literature review was carried out and recommendations were made according to the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines development methodology. Results A large number of randomized controlled trials, systematic reviews, and meta-analyses, as well as a number of prospective cohort studies, met the predetermined inclusion criteria. These trials addressed many different issues pertaining to patients with lung cancer, such as symptoms of anxiety, mood disturbance, pain, quality of life, and treatment-related side effects. The available data cover a variety of interventions, including acupuncture, nutrition, mind-body therapies, exercise, and massage. The body of evidence supports a series of recommendations. An evidenced-based approach to modern cancer care should integrate complementary therapies with standard cancer therapies such as surgery, radiation, chemotherapy, and best supportive care measures. Conclusions Several complementary therapy modalities can be helpful in improving the overall care of patients with lung cancer.

Background. Prostate cancer (PCa) racial disparity is likely to be multifactorial, involving the individual's genotype, the environment and their interaction. We investigated the association between selected functional polymorphisms in the metabolism-related genes and the risk of PCa in African American/ Black and Non-Hispanic White men. We further explored if these associations varied by body mass index (BMI) in the two races. Methods. DNA samples from 259 (136 cases and 123 controls) Black and 269 (147 cases and 142 controls) White men, matched by age, Gleason score and PSA were genotyped for 10 selected single nucleotide polymorphisms (SNPs) in 7 metabolism related genes using the TaqMan PCR. The dominant, recessive and additive age-adjusted unconditional logistic regression models were fitted for all men combined, for each race and stratified by BMI, height and smoking habits within each race. Results. Three SNPs showed statistically significant associations with PCa. In Black men: rs7501939 (OR=2.42; CI 1.31-4.47; p=0.0046) and rs4430796 (OR=0.57; CI 0.34-0.97; p=0.0383), both in the HNF1B/ TCF2 gene and associated with diabetes. In White men: rs4962416 (OR=1.52; CI 1.02-2.26; p=0.0384) in the CTBP2 gene. In addition, BMI in Black men (OR=1.06; CI 1.008-1.114; p=0.022), and height in White men (OR=0.92; CI 0.85-0.99; p=0.0434) showed significant associations. Interestingly, rs7501939 in the HNF1B gene was associated with PCa exclusively in obese Black men (OR=2.14; CI 1.2-3.8; p=0.0103). Conclusions. Our results suggest that polymorphisms in the metabolism related genes may be involved in PCa disparity, possibly through the mechanism of obesity-related hormonal shift and disrupted androgen signaling. We are planning a well-powered study to test this hypothesis. Citation Format: Ganna Chornokur, Ernest Amankwah, Jong Park, Catherine Phelan, Nagi Kumar. Polymorphisms in the metabolism-related genes and obesity may explain prostate cancer disparity in African American men. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B52.

e21155 Background: Over 50% of new lung cancers occur in former smokers, who often are seeking strategies to reduce their lung cancer risk. However, recruitment and retention of participants in chemoprevention trials continues to be costly and presents unique challenges. Evaluation of feasibility and knowledge of challenges are critical to inform design and ensure accrual in chemoprevention trials.The study assessed interest and willingness of former heavy smokers to participate in a chemoprevention clinical trial using a botanical agent to prevent lung cancer. Methods: An introductory letter and survey instrument that included the goal of the survey, epidemiological and smoking history, acceptability of trial procedures, perception of lung cancer risk and interest in participating in this trial were mailed to 500 consecutive, former heavy smokers with no cancer from a database of 826 subjects at the Moffitt Cancer Center. Results: 202 (40.4%) men and women returned completed surveys. 98% of respondents were over age 60 and 56% had an undergraduate education or higher. The average years smoked was 40.7 (SD 11.9) pack years. 76% believed there was a 50% chance or greater of developing lung cancer. In response to interest and motivation to participate, 92-96% reported interest in receiving free lung exams, health status monitoring and knowing their lung cancer risk. 88% were interested in being a part of a trial to evaluate a botanical agent for lung cancer prevention. Over 92% of subjects reported a willingness to comply with study requirements, multiple blood draws and trips to the Center, spiral CTs and chest x-rays. Subjects were relatively less enthusiastic (73-79%) about undergoing bronchoscopy, taking multiple study agents and possible assignment to a placebo arm. Conclusions: Our study strongly suggests feasibility, highlights potential challenges and the significant interest and willingness of former smokers to participate in chemoprevention trials.

Background. African American men have 1.6 times the incidence and 2.4 times the mortality rate of prostate cancer, compared to Caucasian men. Thus, prostate cancer constitutes one of the most striking racial health disparities, the causation of which is not well understood. Main hypothesis. We hypothesized that select clinical and/or bio-behavioral risk factors are associated with prostate cancer in African American men. Participants and Methods. 105 African American men aged 34-80 (35 cases and 70 controls) were recruited. Univariable and multivariable logistic regression models were built to test the marginal and joint effects of the variables when predicting the cancer status. Results. In the univariable regression models, PSA (ng/ml; p Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3592. doi:1538-7445.AM2012-3592

Ninety-two undergraduates were assigned into groups to evaluate the effectiveness of interactive, computer-delivered programmed instruction for nutrition education on the topic of diet and cancer compared to traditional passive modes of instruction. Students were monitored for knowledge gains by means of a single 50-item test and an application task, using a 4-day diet record, administered 4 weeks prior to and 3 weeks after intervention. Results indicated that although subjects in the interactive group took nearly twice as long to complete the program, having the opportunity to respond to program blanks, this group produced significantly greater knowledge gains and lowered their fat intake by 41.8% compared to 26.1% reduction in fat intake in the noninteractive computer group and 18.6% in the passive prose text groups. Results suggest that interactive, computer-delivered, programmed instruction can be a very important adjunct to health care and cancer prevention programs at high schools and university settings.

Prostate cancer remains the most common cancerous malignancy and the second leading cause of cancer death among men of all races in the United States. However, the men of African descent are 1.4 times more likely to be diagnosed, and two to three times more likely to die of prostate cancer, compared to their counterparts of European descent. Even though the multifaceted nature of the striking racial disparity has been recognized, the majority of research efforts geared towards its resolution is focusing on exploring a discrete contribution of a single factor or a small group of similar factors. This approach has failed to comprehensively elucidate the etiology or the mechanism(s) responsible for the disparity, neither it has been utilized for an efficient prostate cancer screening and early detection in the high risk group of African American men. Therefore, we hypothesize, that a combination panel (DETECT) of biobehavioral population-specific biomarkers and factors, associated with prostate cancer in African Americans, will provide a valuable screening and risk assessment tool. The purpose of this study is to expound a prostate cancer screening tool that is based on a collective, rather than individual, assessment of prostate cancer bio-behavioral diagnostic markers and risk factors. The bio-behavioral markers are grouped into four general categories: genetic, biochemical, lifestyle and socio-cultural. The category “genetic markers” refer to factors associated with any bodily molecules containing genetic information. We include the measure of family history in this category since it gives an indication of the underlying genetic factors. Age is also included in this section, as the mechanism of aging has genetic background. The group “biochemical markers” refers to biomolecules of any nature (other than nucleic acids, which are classified as genetic markers) found anywhere in the body. The category “lifestyle markers” references the personal habits which heavily dependent upon individual choice. Finally, “sociocultural factors” reflect societal-and cultural-level influence on an individual's risk of prostate cancer. The choice of biobehavioral markers, together with the descriptive statistics, used to summarize distribution of each marker, is based on the review of current relevant literature. Two approaches are applied to evaluate the potential combined markers. The markers which are marginally significantly associated (p This study contributes into effort to eliminate the prostate cancer racial disparity by offering a prototype of comprehensive prostate cancer screening tool. This may result in higher levels of compliance, lower cost and higher effectiveness of screening, and decreased overall burden of prostate cancer in the high risk African American population. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A53.

To establish a novel environment for elucidating the relative socioenvironmental and biological etiologies of racial and ethnic disparities in prostate cancer, we are conducting a 10-year retrospective cross-racial and ethnic analysis of prostate cancer incidence and mortality within the Florida Department of Corrections (FDOC). Prostate Cancer is the most common cancer in men and exhibits the most profound racial and ethnic disparity of all cancers, with a 60% higher incidence rate and an astonishing 140% higher mortality rate in African Americans than in Caucasians. Successful efforts to thwart prostate cancer health disparities depend understanding the relative contributions of biological and socio-behavioral factors on prostate cancer disparities; however, the inherent heterogeneity of a of unlinked factors within and among racial and ethnic groups precludes the effectual determination of the relative contributions of prostate cancer health disparities. We propose that the etiologies of health disparities can be defined within the context of large, racially and ethnically diverse settings in which several variables thought to contribute to prostate cancer health disparities are normalized across racial and ethnic groups. Correctional facilities are vast congregate settings, inherently unique due to the remarkably similar socio-behavioral environments between and within racial and ethnic groups relative to non-incarcerated communities. Prisons are home to over 1.6 million people, primarily African American, Caucasian, and Hispanic men. The FDOC offices of Health Care, Food Services, and Wellness and Recreation provide services that may circuitously reduce racial and ethnic cancer disparities. Prisoners of all races and ethnicities have equal access to free and identical health care services including prostate cancer education, routine prostate cancer screening, and prostate cancer treatment. Inmates are all provided the same nutritionally balanced diets, meeting or exceeding the National Academy of Sciences’ standards, including nutritional supplements, soy-rich products, and nearly 3 million pounds of fresh produce cultivated on FDOC farms; reflecting diets thought to decrease prostate cancer risk. Physical activity in the form of exercise is a regular component of approximately 95% of prisoner's lifestyles. Cigarette smoking is common across racial and ethnic groups in the FDOC; however, alcohol consumption and drug use are prohibited. The FDOC's wellness efforts, and similar efforts by the majority of United States correctional facilities, inadvertently address several conjectural bases of health disparities, thereby providing an environment ripe for distinguishing the factors that contribute to prostate cancer and it vast racial and ethnic disparities. With support and approval by the FDOC, we have begun to elucidate the complex etiologies of racial and ethnic disparities in prostate cancer incidence and mortality by conducting a 10-year, cross-racial and ethnic retrospective analysis of prostate cancer incidence and mortality within the FDOC. The data from this study will provide the foundation for further studies to better understand the socio-environmental and biological factors that contribute to racial and ethnic disparities in prostate cancer incidence and mortality. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A75.

Study Objective. —To determine if body fat distribution affected endometrial cancer risk. Design. —Case-control study. Setting. —This study was carried out at the H. Lee Moffitt Cancer Center at the University of South Florida, Tampa, where all patients in the case group received their diagnoses and histological confirmations. Patients. —Forty consecutive women newly diagnosed with endometrial cancer and 40 controls matched for age and Quetelet index. Main Outcome Measures. —Anthropometric measurements were taken for the abdomen, thigh, suprailiac, subscapular, biceps, and triceps skin fold thicknesses; waist and hip circumferences, weight, and height. Relative risks for endometrial cancer were calculated according to these anthropometric measurements. Results. —Case patients with endometrial cancer had significantly greater waist-to-hip circumference ratios ( P P P =.02) compared with control subjects matched for age and Quetelet index. The relative risk for endometrial cancer increased with an increasing waist-to-hip circumference ratio (≤1.14 = 1.0; >1.14 = 15.0), with an increasing abdomen-to-thigh skin fold ratio (≤0.82= 1.0; >0.82 = 5.0), and with an increasing suprailiac to-thigh skin fold thickness ratio (≤0.67 = 1.0; >0.67 = 3.50). Conclusion. — Upper-body fat localization is a significant risk factor for endometrial cancer in women matched for age and Quetelet index. ( JAMA . 1991;266:1808-1811)

To determine if body fat distribution affects breast cancer risk.Prospective case-control study.The anthropometric measurements of 216 consecutively and newly diagnosed women with invasive carcinoma of the breast were compared with those of 432 age-matched controls. The anthropometric measurements taken were abdomen, thigh, suprailiac, biceps, triceps, subscapular, and midaxillary skinfolds; waist and hip circumference; and weight and height. Women between 25 and 83 years of age were included in the study.Patients with breast cancer had a significantly greater waist:hip circumference ratio than controls (P less than 0.001) and a significantly greater suprailiac:thigh skinfold ratio (P less than 0.001). The relative risk for breast cancer increased with increasing waist:hip circumference ratio (less than 0.73 = 1.00; 0.73 to 76 = 1.90; 0.77 to 0.80 = 2.83; greater than 0.80 = 6.46) and with suprailiac:thigh skinfold ratio (less than 0.42 = 1.00; 0.42 to 0.56 = 1.85; 0.57 to 0.71 = 2.25; greater than 0.71 = 5.85). At other sites of upper body obesity, such as the biceps and triceps, skinfolds were significantly greater in patients with breast cancer.Although obese women are at slightly higher risk for developing breast cancer, women with android obesity are a segment of obese women who appear to be at a significantly higher risk for developing breast cancer.

There is evidence that dietary factors play an important role in the generation of arteriosclerosis resulting in morbidity and mortality due to cardiovascular and cerebrovascular events. 1 Dietary factors have been implicated in the causation of approximately one third of all cancers. 2 An excessive intake of fat or calories has been linked to cancers of the breast, prostate, uterus, and colon. 3-5 The risk of developing certain cancers may be reduced by eating adequate amounts of foods that confer a degree of protection. Adequate intake of fiber, in conjunction with a reduced fat intake, is thought to be important in reducing the incidence of colon cancer. 6-8 Vitamin A is necessary for the normal growth and differentiation of squamous epithelia, and adequate intake of dietary vitamin A appears to protect against cancers of the lung, esophagus, and bladder. 9,10 As a result of epidemiological and laboratory research, certain guidelines

African American Men are 65% more likely to develop prostate cancer and are twice as likely to die of prostate cancer, than are Caucasian American Males. The explanation for this glaring health disparity is still unknown; although a number of different plausible factors have been offered including genetic susceptibility and gene-environment interactions. We favor the hypothesis that altered gene expression plays a major role in the disparity observed in prostate cancer incidence and mortality between African American and Caucasian American Males. To discover genes or gene expression pattern(s) unique to African American or to Caucasian American Males that explain the observed prostate cancer health disparity in African American males, we conducted a micro array pilot project study that used prostate tumors with a Gleason score of 6. We compared gene expression profiling in tumors from African-American Males to prostate tumors in Caucasian American Males. A comparison of case-matched ratios revealed at least 67 statistically significant genes that met filtering criteria of at least +/- 4.0 fold change and p < 0.0001. Gene ontology terms prevalent in African American prostate tumor/normal ratios relative to Caucasian American prostate tumor/normal ratios included interleukins, progesterone signaling, Chromatin-mediated maintenance and myeloid dendritic cell proliferation. Functional in vitro assays are underway to determine roles that selected genes in these onotologies play in contributing to prostate cancer development and health disparity.