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Active monitoring does not increase prostate cancer-specific mortality risk, study shows

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Active monitoring of prostate cancer has the same high survival rates after 15 years as radiotherapy or surgery, reports the largest study of its kind today.

The latest findings from the ProtecT trial, led by the Universities of Oxford and Bristol, are presented today at the European Association of Urology (EAU) Congress in Milan and published in the New England Journal of Medicine.

The trial was funded by the National Institute for Health and Care Research (NIHR).

Although men on active monitoring – which involves regular tests to check on the cancer – were more likely to see it progress or spread than those receiving radiotherapy or surgery, this didn’t reduce their likelihood of survival.

The trial also found that the negative impacts of radiotherapy and surgery on urinary and sexual function persist much longer than previously thought – for up to 12 years.

The findings show that treatment decisions following diagnosis for low and intermediate risk localized prostate cancer do not need to be rushed, according to lead investigator, Professor Freddie Hamdy from the University of Oxford.

It’s clear that, unlike many other cancers, a diagnosis of prostate cancer should not be a cause for panic or rushed decision making. Patients and clinicians can and should take their time to weigh up the benefits and possible harms of different treatments in the knowledge that this will not adversely affect their survival.”

Professor Freddie Hamdy, University of Oxford

The trial was conducted in nine UK centers and is the longest running study of its kind. It is the first to fully evaluate three major treatment options: active monitoring, surgery (radical prostatectomy) and radiotherapy with hormones for men with localised prostate cancer.

Between 1999 and 2009, 1,643 men aged 50-69 years across the UK, who were diagnosed with localized prostate cancer after a PSA blood test, agreed to be randomized to active monitoring (545), radical prostatectomy (553) or radical radiotherapy (545). The research team followed the men over an average of 15 years, to measure mortality rates, cancer progression and spread, and the impact of treatments on quality of life.

They found that around 97% of the men diagnosed with prostate cancer survived 15 years after diagnosis, irrespective of which treatment they received. Around a quarter of the men on active monitoring had still not had any invasive treatment for their cancer after 15 years.

Patients from all three groups reported similar overall quality of life, in terms of their general mental and physical health. But the negative effects of surgery or radiotherapy on urinary, bowel and sexual function were found to persist much longer than previously thought.

In earlier findings released in 2016, the researchers found that, after ten years follow up, men whose cancer was being actively monitored were twice as likely to see it progress or metastasize than those in the other groups. The assumption had been that this might lead to a lower survival rate for men on active monitoring over a longer time period. However, the results from the 15-year follow-up show that this isn’t the case and that survival rates remain similarly high across all groups.

Professor Freddie Hamdy said: “This is very good news. Most men with localized prostate cancer are likely to live for a long time, whether or not they receive invasive treatment and whether or not their disease has spread, so a quick decision for treatment is not necessary and could cause harm.”

“It’s also now clear that a small group of men with aggressive disease are unable to benefit from any of the current treatments, however early these are given. We need to both improve our ability to identify these cases and our ability to treat them.”

Co-investigator, Professor Jenny Donovan, from the University of Bristol, said: “Patients and doctors now have the necessary information on the long-lasting side effects of treatments to better understand the trade-offs between their benefits and harms. Survival no longer needs to be considered when deciding on treatment – as that’s the same for all three options. Now men diagnosed with localised prostate cancer can use their own values and priorities when making the difficult decisions about which treatment to choose.”

The trial has also highlighted flaws in current methods to predict which prostate cancers are likely to grow quickly and spread. Initially, all those recruited to the trial were diagnosed with localized cancer and 77% of them were deemed low risk. A reassessment using more modern methods showed that a far greater number would now be considered intermediate-risk – and in around 30% of men, the disease had spread beyond the prostate already. This means that the participants in the study had higher grade and stage disease than was thought initially. Despite this finding, mortality was still low, even when men with intermediate disease delayed or did not have radical treatment. Some of the men who subsequently died of their prostate cancer had been assessed as low risk at diagnosis, which the researchers highlight as an issue of concern.

Professor Peter Albers, chair of the EAU’s Scientific Congress Office and a urologist at Düsseldorf University, said: “The fact that the greater progression of disease seen under active monitoring didn’t translate into higher mortality will be both surprising and encouraging to urologists and patients. Active monitoring and biopsy protocols today are much more advanced than at the time this trial was conducted, so it’s possible we could improve on these outcomes still further. It’s an important message for patients that delaying treatment is safe, especially as that means delaying side effects as well.”

“But it’s also clear that we still don’t know enough about the biology of this disease to determine which cancers will be the most aggressive and more research on this is urgently needed.”

Journal reference:

Hamdy, F.C., et al. (2023) 15-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. New England Journal of Medicine. doi.org/10.1056/NEJMoa2214122.

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Several Vitamins Recalled Due to Potential Metal Contamination, Including Products Sold at Costco and Walmart

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Several types of vitamins, including some popular brands sold at major retailers like Costco and Walmart, are being recalled due to the possible presence of metal fibers. Health Canada issued three recall statements on Friday, highlighting the affected products and advising consumers on the necessary steps.

Among the brands involved in the recall is Kirkland Signature, a staple at Costco, along with Webber Naturals and other brands sold at multiple retailers across Canada, including Walmart and Shoppers Drug Mart.

The vitamins listed in the recall are:

  • Kirkland Signature: B100 Complex Timed Release
  • Life: Vitamin B Complex with Vitamin C
  • Option+ & Life: Prenatal Multi-vitamins 100 Tablets with Folic Acid, Spectrum Prenatal Postpartum, Multivitamins & Minerals Women, Spectrum Women 22 Vitamins & Minerals plus Lutein, Lycopene
  • Webber Naturals: B50 Complex Timed Release, Most Complete Multi Womens 50+ One Per Day, Most Complete Multi Mens 50+ One Per Day, Vitamin B50 Complex
  • Wellness by London Drugs, Option+ & Life: Multi Women/Femmes 50+ with Lycopene and Lutein Multivitamin and Mineral, Multivitamin & Minerals Women 50+, 50+ SPECTRUM Women/Femmes 50+ 23 Vitamins & Minerals plus Lutein, Lycopene
  • Wellquest, Equate, Option+, Wellness by London Drugs & Life: Vitamin B100 Complex, Timed Release
  • Natural Factors: Hi Potency B Complex, RevitalX, Super Multi® IRON FREE
  • VegiDay Vegan Organic ALL IN ONE: VegiDay Vegan Organic ALL IN ONE

Health Canada advises consumers who have purchased any of the affected products to consult their healthcare provider before discontinuing use and to monitor for any health concerns.

Customers with concerns or questions can contact the recall firm directly. Additionally, any side effects or health product safety complaints should be reported to Health Canada.

For more detailed information, you can access the three Health Canada notices, which are listed under the Factors Group of Nutritional Companies Inc. recall, on the Health Canada website.

This recall serves as a reminder to consumers to stay vigilant about product safety and to follow recall advisories to ensure their health and well-being.

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8 Tips for Incorporating More Fruits into Your Dessert

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Incorporating more fruits into your desserts is not just a way to enhance flavours, but also a smart approach to add nutritional value to your treats. While desserts are often indulged as guilty pleasures, introducing fruits can transform these moments into healthier delights, enriching them with vitamins, minerals, and fibres. Whether you’re a home cook looking to improve your family’s diet or a culinary expert aiming to innovate your menu, adding fruits offers a myriad of benefits. These range from boosting the aesthetic appeal of your dishes with vibrant colours to enhancing the natural sweetness with a lower calorie count.

The tips provided here will help you seamlessly integrate more fruits into your dessert recipes, making them irresistibly wholesome and appealing to all ages. This approach not only caters to the health-conscious consumer but also opens up a palette of fresh, tantalizing flavours that can redefine what dessert means.

Explore Variety

Diversity is key in enriching desserts with fruits. Experiment with different textures and flavours, from berries to tropical fruits. This variety ensures each bite is unique and delightful. Try combining sour cherries with sweet mangoes, or add citrus segments to balance richer desserts. Even blending frozen bananas into a creamy texture can mimic ice cream. Consider adding a double fudge bar frozen dessert to your fruit platter for an indulgent twist.

Use Fresh and Seasonal Fruits

Seasonal fruits offer the best in flavour and nutrition. Incorporate fresh, local produce into your desserts to capture peak tastiness. Fresh strawberries or peaches can elevate simple dishes like ice cream or cakes. Local farmers’ markets are ideal for finding the freshest options. Remember, the closer the fruit is grown to its consumption point, the more nutrients it retains. This approach supports local agriculture as well.

Make Fruit the Star

Create desserts where fruits are the main attraction. Dishes like fruit tarts or berry-packed pavlovas highlight the natural sweetness of fruits, reducing the need for added sugars. Let fruits dictate the dessert’s flavour profile and design, focusing on the natural colours to attract the eye. This strategy can make even simple dishes feel luxurious and crafted with care. Plus, it often leads to lighter, less calorie-dense desserts.

Opt for Healthier Preparations

Instead of always baking or frying, try raw preparations or use healthier cooking methods like grilling or poaching. Grilled pineapple or poached pears offer a delightful texture and are easy to prepare. These methods preserve the integrity and nutritional value of the fruit better than baking or frying. Cooking fruit in this way can also unlock new flavours, enhancing your dessert experience. Try brushing fruit with a little honey or maple syrup before grilling for a caramelized finish.

Experiment with Spices

Spices can enhance the natural flavour of fruits. A dash of cinnamon, cardamom, or vanilla complements fruits like apples and pears beautifully, adding complexity to any dessert. Nutmeg and ginger are also excellent with juicy fruits like peaches and plums. Experimenting with spices can transform a simple fruit dish into an exotic and enticing dessert. Such additions are simple but effective ways to elevate the taste without added sugar.

Incorporate Dried Fruits

Dried fruits are concentrated in flavour and can be a great addition to desserts. Sprinkle raisins, dried cranberries, or chopped dates over oatmeal cookies or mix them into homemade granola bars for a chewy texture. Dried fruits work well in baked goods because they provide a burst of sweetness and texture. They are also perfect for decorating cakes and adding to snack mixes. Be mindful of the sugar content in store-bought dried fruits, opting for unsweetened varieties when available.

Create Colourful Fruit Layers

Layer fruits in parfaits, trifles, or cakes to create visually appealing and delicious desserts. Layers of colourful fruits not only look spectacular, but also offer varied flavours and textures. This layering technique can be applied in smoothie bowls and gelatin desserts for a stunning visual effect. Try to choose fruits that contrast in colour and texture for the most striking presentations. These desserts are particularly appealing to children and can make eating fruit more exciting for them.

Finish with A Healthy Twist

Top off your desserts with a nutritious twist, such as a dollop of Greek yogurt or a sprinkle of nuts and seeds for extra crunch and nutrients. These additions provide a contrast in textures and increase the health benefits of your dessert. Nuts add healthy fats and proteins, making the dessert more satisfying. Consider using a drizzle of natural sweeteners like honey or agave nectar to enhance flavour without resorting to refined sugars. Such finishes not only improve taste but also boost nutritional value, aligning with a healthier lifestyle.

Incorporating fruits into your desserts is an enjoyable way to make your sweet dishes healthier and more flavourful. By using fruits in various forms, from frozen to dried, and employing them in creative ways, such as natural sweeteners or vibrant toppings, you can transform any dessert into a delightful and nutritious treat. So next time you prepare a dessert, remember these tips and enjoy the added benefits of fruits in your culinary creations.

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5 Life-Transforming Tips to Make it More Fun-Filled

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Everyone wants to make the most out of life. From personal life to establishing a successful career, enjoyment is all that people crave the most. But the key to happiness is having fun most of the time. It can be challenging to find time and moments of fun in the routine as life becomes boring and dull for many.

However, you can cultivate your mindset and embrace more pleasure and laughter in your everyday routine. To transform your boring and dull life into a fun-filled one, here are a few tips that you can consider in this blog.

Read on to explore!

 

1.    Start Enjoying Little Moments

The fun doesn’t need to come from an extensive and spectacular event happening around your life all the time. There are so many small moments in your life that can turn into more fun. All you have to do is embrace those little times in your life and be happy.

For example, you can give yourself a little break from a hectic day and enjoy some chocolate. Or you can make time to enjoy things that you like.

 

2.    Be Spontaneous In Life

Just like life becomes unexpected most of the time, you can be a little unpredictable with it as well. To bring fun to your life, you can work on being more open to new and unplanned experiences.

If you get an invitation for any activity, event, or sport, don’t say no to it. Getting to indulge in more social activities will help you create new memories and experience new thrills in life.

 

3.    Bring a Furry Friend in Life

A boring life can easily distance you from fun. To embrace joy in life, having a furry company can do wonders. You can cherish love and warmth and have little moments of joy with a furry one.

If you don’t have a furry companion, you’re majorly missing joy. It’s time for you to look for the best puppy-selling company, such as Fou Fou Puppie’s website, to bring a cute puppy into your life.

 

4.    Practice Mindfulness

Practicing mindfulness will help you to live the present to the fullest. As most people worry more about their future, it makes them overlook the current joys of life.

What you can consider best to bring fun to your life is practicing mindfulness for at least 2 minutes. Let go of all the thoughts that pop into your head and focus on the positive aspects of living.

 

5.    Participate More in Fun Activities

There should be no excuse for having fun in life as there are many low-cost fun activities for the community that you can explore to have fun. It can be simple, but it prevents you from living a boring and less-inspiring life.

For example, you can call your group of friends to have coffee together and share more laughter, or you can go to the movies to unwind yourself. These activities will not cost you a fortune and allow you to make the most out of your day, week, and month.

 

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