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Nutrition and Lifestyle Changes in Patients With Previously Untreated Stage I or Stage II Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
exercise intervention
gene expression analysis
polymerase chain reaction
proteomic profiling
reverse transcriptase-polymerase chain reaction
laboratory biomarker analysis
medical chart review
questionnaire administration
psychosocial assessment and care
quality-of-life assessment
support group therapy
therapeutic dietary intervention
Sponsored by
University of California, San Francisco
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring adenocarcinoma of the prostate, stage I prostate cancer, stage IIB prostate cancer, stage IIA prostate cancer

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)MaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma (small cell acinar type) of the prostate

    • Has undergone an extended pattern biopsy (defined as 8+ cores) within the past 2 years OR is scheduled to undergo an extended pattern clinical biopsy within 6 weeks of starting study intervention and is willing to undergo 4 additional research core biopsies
    • No more than 33% of biopsy cores positive (> 33% of biopsy cores positive allowed if due to microfoci of adenocarcinoma)
    • No more than 50% of the length of a tumor core involved by carcinoma
  • Clinical stage T1 or T2a disease
  • Previously untreated disease
  • Gleason score ≤ 6 with no pattern 4 or 5 histology (Gleason pattern 4 seen as a microfocus [< 2 mm in length] allowed)
  • Prostate-specific antigen (PSA) ≤ 10.0 ng/mL (PSA < 15 ng/mL allowed for patients with benign prostatic hyperplasia or prostatitis)

    • Must have had 3 serum PSA levels performed ≥ 2 weeks apart over the past year to allow calculation of a PSA doubling time

      • No PSA doubling time of < 3 months
  • Has chosen watchful waiting as treatment

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy > 3 months
  • Living in the greater San Francisco Bay Area
  • Willing to make comprehensive lifestyle changes
  • Baseline dietary fat intake ≥ 15%
  • Able to participate in the exercise portion of this study, as determined by the cardiologist or primary care physician
  • No limited exercise tolerance precluding participation in the lifestyle intervention component of this study
  • No comprehensive lifestyle change similar to the lifestyle intervention used in this study
  • No concurrent uncontrolled illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Coronary artery disease requiring a revascularization procedure
    • Cardiac arrhythmia
    • Psychiatric illness/social situation that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

  • No prior or other concurrent treatment for prostate cancer, including any of the following:

    • Surgery
    • Radiotherapy
    • Hormonal therapy (e.g., leuprolide acetate, bicalutamide, flutamide, goserelin, megestrol acetate, nilutamide, or DES/estrogen)
    • Chemotherapy
    • PC-SPES
    • Investigational agents
  • More than 4 weeks since prior and no concurrent finasteride or dutasteride
  • More than 4 weeks since prior and no concurrent saw palmetto or any other herbal/nutritional preparation that would affect hormone levels
  • More than 4 weeks since prior multivitamin/mineral and/or supplemental soy protein, vitamin E, vitamin C, selenium, fish oil, or any other preparation intended to supplement levels of omega-3 unsaturated fatty acids
  • More than 1 month since prior and no concurrent NSAIDs, COX-2-inhibitors, and/or aspirin used for > 7 consecutive days

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Changes in gene expression in prostate tissue core biopsy samples as measured before and after a low-fat diet and lifestyle intervention

    Secondary Outcome Measures

    Correlation of quality of life changes and adherence to dietary and lifestyle changes with gene expression outcomes
    Telomere length and telomerase activity in blood samples in response to the dietary and lifestyle intervention as measured by quantitative polymerase chain reaction and telomerase repeat amplification protocol (TRAP)

    Full Information

    First Posted
    August 21, 2008
    Last Updated
    September 12, 2012
    Sponsor
    University of California, San Francisco
    Collaborators
    National Cancer Institute (NCI)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00739791
    Brief Title
    Nutrition and Lifestyle Changes in Patients With Previously Untreated Stage I or Stage II Prostate Cancer
    Official Title
    Pilot Trial of Gene Expression Modulation by Intervention With Nutrition and Lifestyle
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2012
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2003 (undefined)
    Primary Completion Date
    June 2005 (Actual)
    Study Completion Date
    June 2005 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    University of California, San Francisco
    Collaborators
    National Cancer Institute (NCI)

    4. Oversight

    5. Study Description

    Brief Summary
    RATIONALE: Learning about changes in DNA over time in patients with prostate cancer undergoing diet and lifestyle changes may help doctors learn about the long-term effects of these changes on disease progression. PURPOSE: This clinical trial is studying nutrition and lifestyle changes in patients with previously untreated stage I or stage II prostate cancer.
    Detailed Description
    OBJECTIVES: To measure changes in gene expression in prostate tissue core biopsy samples before and after a low-fat diet and lifestyle intervention in patients with previously untreated stage I or II adenocarcinoma of the prostate. To collect health information from these patients to enable better understanding of the long term impact of diet and lifestyle changes on prostate cancer progression. OUTLINE: Intervention phase: Patients are placed on a comprehensive lifestyle change program comprising a low-fat vegan diet, stress management, moderate aerobic exercise, and regular participation in a support group for 3 months. Follow-up phase: Patients undergo core tissue biopsies at baseline and at 3 months for genomic and gene expression analysis. Insulin-like growth factor 1 (IGF-1) and selenium-binding protein 1 levels are measured by quantitative reverse transcription-polymerase chain reaction (PCR). Patients also undergo blood sample collection periodically for biomarker analysis, proteomic analysis, and for telomere length and telomerase activity analysis as measured by quantitative PCR and telomerase repeat amplification protocol (TRAP). Blood and urine samples are also collected and stored for future analysis. Patients complete questionnaires at baseline, at 3 months, and then every 6-12 months for up to 3 years to assess dietary and lifestyle behaviors (exercise, stress management practice, and group support), quality of life, and psychological adjustment. Questionnaires include the Semi-Quantitative Food Frequency Questionnaire; the SF-36 Health Survey; the UCLA Prostate Cancer Index; the Impact of Event Scale; the Memorial Anxiety Scale for Prostate Cancer; the Post Traumatic Growth Inventory; the Mindful Attention Awareness Scale; and the Received Social Support subscale from the Berlin Social Support Scale. Patients' medical records are reviewed every 6-12 months for up to 3 years to collect information on clinical events and biomarkers (e.g., prostate-specific antigen and Gleason score).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Prostate Cancer
    Keywords
    adenocarcinoma of the prostate, stage I prostate cancer, stage IIB prostate cancer, stage IIA prostate cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Enrollment
    34 (Anticipated)

    8. Arms, Groups, and Interventions

    Intervention Type
    Behavioral
    Intervention Name(s)
    exercise intervention
    Intervention Type
    Genetic
    Intervention Name(s)
    gene expression analysis
    Intervention Type
    Genetic
    Intervention Name(s)
    polymerase chain reaction
    Intervention Type
    Genetic
    Intervention Name(s)
    proteomic profiling
    Intervention Type
    Genetic
    Intervention Name(s)
    reverse transcriptase-polymerase chain reaction
    Intervention Type
    Other
    Intervention Name(s)
    laboratory biomarker analysis
    Intervention Type
    Other
    Intervention Name(s)
    medical chart review
    Intervention Type
    Other
    Intervention Name(s)
    questionnaire administration
    Intervention Type
    Procedure
    Intervention Name(s)
    psychosocial assessment and care
    Intervention Type
    Procedure
    Intervention Name(s)
    quality-of-life assessment
    Intervention Type
    Procedure
    Intervention Name(s)
    support group therapy
    Intervention Type
    Procedure
    Intervention Name(s)
    therapeutic dietary intervention
    Primary Outcome Measure Information:
    Title
    Changes in gene expression in prostate tissue core biopsy samples as measured before and after a low-fat diet and lifestyle intervention
    Secondary Outcome Measure Information:
    Title
    Correlation of quality of life changes and adherence to dietary and lifestyle changes with gene expression outcomes
    Title
    Telomere length and telomerase activity in blood samples in response to the dietary and lifestyle intervention as measured by quantitative polymerase chain reaction and telomerase repeat amplification protocol (TRAP)

    10. Eligibility

    Sex
    Male
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    DISEASE CHARACTERISTICS: Histologically confirmed adenocarcinoma (small cell acinar type) of the prostate Has undergone an extended pattern biopsy (defined as 8+ cores) within the past 2 years OR is scheduled to undergo an extended pattern clinical biopsy within 6 weeks of starting study intervention and is willing to undergo 4 additional research core biopsies No more than 33% of biopsy cores positive (> 33% of biopsy cores positive allowed if due to microfoci of adenocarcinoma) No more than 50% of the length of a tumor core involved by carcinoma Clinical stage T1 or T2a disease Previously untreated disease Gleason score ≤ 6 with no pattern 4 or 5 histology (Gleason pattern 4 seen as a microfocus [< 2 mm in length] allowed) Prostate-specific antigen (PSA) ≤ 10.0 ng/mL (PSA < 15 ng/mL allowed for patients with benign prostatic hyperplasia or prostatitis) Must have had 3 serum PSA levels performed ≥ 2 weeks apart over the past year to allow calculation of a PSA doubling time No PSA doubling time of < 3 months Has chosen watchful waiting as treatment PATIENT CHARACTERISTICS: ECOG performance status 0-2 Life expectancy > 3 months Living in the greater San Francisco Bay Area Willing to make comprehensive lifestyle changes Baseline dietary fat intake ≥ 15% Able to participate in the exercise portion of this study, as determined by the cardiologist or primary care physician No limited exercise tolerance precluding participation in the lifestyle intervention component of this study No comprehensive lifestyle change similar to the lifestyle intervention used in this study No concurrent uncontrolled illness including, but not limited to, any of the following: Ongoing or active infection Symptomatic congestive heart failure Unstable angina pectoris Coronary artery disease requiring a revascularization procedure Cardiac arrhythmia Psychiatric illness/social situation that would limit compliance with study requirements PRIOR CONCURRENT THERAPY: No prior or other concurrent treatment for prostate cancer, including any of the following: Surgery Radiotherapy Hormonal therapy (e.g., leuprolide acetate, bicalutamide, flutamide, goserelin, megestrol acetate, nilutamide, or DES/estrogen) Chemotherapy PC-SPES Investigational agents More than 4 weeks since prior and no concurrent finasteride or dutasteride More than 4 weeks since prior and no concurrent saw palmetto or any other herbal/nutritional preparation that would affect hormone levels More than 4 weeks since prior multivitamin/mineral and/or supplemental soy protein, vitamin E, vitamin C, selenium, fish oil, or any other preparation intended to supplement levels of omega-3 unsaturated fatty acids More than 1 month since prior and no concurrent NSAIDs, COX-2-inhibitors, and/or aspirin used for > 7 consecutive days
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Peter R. Carroll, MD
    Organizational Affiliation
    University of California, San Francisco
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    18799354
    Citation
    Ornish D, Lin J, Daubenmier J, Weidner G, Epel E, Kemp C, Magbanua MJ, Marlin R, Yglecias L, Carroll PR, Blackburn EH. Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncol. 2008 Nov;9(11):1048-57. doi: 10.1016/S1470-2045(08)70234-1. Epub 2008 Sep 15. Erratum In: Lancet Oncol. 2008 Dec;9(12):1124.
    Results Reference
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    Nutrition and Lifestyle Changes in Patients With Previously Untreated Stage I or Stage II Prostate Cancer

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