Red Wine Cuts Risk For Aggressive Prostate Cancer

Drinking a glass of red wine a day may cut a man's risk of prostate cancer in half, and the protective effect appears to be strongest against the most aggressive forms of the disease, according to a new study reported in The International Journal of Cancer.

"We found that men who consumed four or more glasses of red wine per week reduced their risk of prostate cancer by 50 percent," says Dr. Janet L. Stanford and colleagues at the Fred Hutchinson Cancer Research Center.

"Among men who consumed four or more four-ounce glasses of red wine per week, we saw about a 60 percent lower incidence of the more aggressive types of prostate cancer," says Dr. Stanford, senior author of the study. "The more clinically aggressive prostate cancer is where the strongest reduction in risk was observed."

Red Wine Stands Out Over White

Dr. Stanford found no significant effects - positive nor negative - associated with the consumption of beer or hard liquor and no consistent risk reduction with white wine, which suggests that there must be a beneficial compound in red wine that other types of alcohol lack.

That compound, Dr. Stanford believes, may be an antioxidant called resveratrol, which is abundant in the skins of red grapes but much less so in the skins of white grapes.

The compound is also found in peanuts and raspberries and is available as a dietary supplement, which has been suggested to protect against cardiovascular disease.

Lab studies indicate that resveratrol influences a variety of biological pathways that are important in cancer development.

As an antioxidant, it helps sweep dangerous, cancer-causing free radicals from the body. As a potent anti-inflammatory agent, it blocks certain enzymes that promote tumor development.

The compound also reduces cell proliferation, curtailing the number of cell divisions that could lead to cancer or the continued growth of cancer cells.

It also enhances apoptosis, or programmed cell death, which helps rid the body of cancerous cells. It may act as an estrogen, reducing levels of circulating male hormones such as testosterone that fuel the growth of prostate cancer.

While the researchers found that the risk of prostate cancer decreased 6 percent for every glass of red wine consumed per week, Dr. Stanford is quick to point out that research shows the law of diminishing returns comes into play when consumption increases beyond moderation.

"From a public-health standpoint, it's difficult to recommend any alcohol consumption given the risks associated with heavy consumption, from increased overall cancer risk to accidental injury and social problems," she notes.

"But for men who already are consuming alcohol, I think the results of this study suggest that modest consumption of red wine - four to eight 4-ounce drinks per week - is the level at which you might receive benefit," Dr. Stanford explains. "Clearly other studies show that more than that may have adverse effects on health."

Thorough Study Covers Many Qualities

For the study, the researchers interviewed 753 newly diagnosed Seattle-area prostate-cancer patients as well as 703 healthy controls who served as a comparison group.

Detailed information about tumor aggressiveness (such as tumor grade and disease stage) was obtained through the National Cancer Institute's Seattle-Puget Sound Surveillance, Epidemiology, and End Results cancer registry.

"Even though this study is based on relatively small numbers, the results are very intriguing and suggest that the potential beneficial effect of red wine and resveratrol would be very important, because it's the more aggressive forms of prostate cancer that are most important to prevent," she comments.

A particular strength of the study, Dr. Stanford says, is that the participants were relatively young, ranging in age from 40 to 64, and the majority were under 60.

"By focusing on men under age 65, whose incidence of prostate cancer is much lower than that of older men, we can tease out the effect of a particular environmental exposure on cancer risk, such as wine consumption, more easily than if we were looking at men across the entire age range," she says.

This is particularly true when studying complex diseases such as prostate cancer in which numerous genetic and environmental factors are thought to play a role over an individual's lifetime.

Another strength of the study is that in addition to being surveyed about lifetime alcohol consumption, participants were asked about a variety of other risk factors for prostate cancer, such as diet, family history of cancer, screening for prostate cancer, and tobacco use, all of which were taken into account and adjusted for when analyzing the data.

While the majority of studies to date have assessed the effects of overall alcohol use on prostate-cancer risk, fewer studies have attempted to compare the effects of wine versus beer versus hard liquor, and only one previous study has compared the impact of red versus white wine on prostate-cancer risk, says Dr. Stanford.

"One of the reasons we wanted to do this study is because overall, most of the scientific literature - around 17 studies to date - haven't shown a consistent relationship between alcohol consumption and prostate cancer," Dr. Stanford says.

"Some have shown an increase, some a decrease, and most no association whatsoever," she remarks. "Part of the problem, we believe, is that few of the studies have attempted to sort out the effects of different types of alcohol intake over a man's lifetime."

Always consult your physician for more information.

November 2004

Red Wine Cuts Risk For Aggressive Prostate Cancer

Red Wine Stands Out Over White

Thorough Study Covers Many Qualities

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African-American Men and Prostate Cancer Screening

African-American men in the US are more likely than Caucasian men to be diagnosed with advanced prostate cancer and have a two-fold greater risk of dying from it.

However, they are significantly less likely to be screened for prostate cancer, according to a study in the Archives of Internal Medicine.

In a study involving more than 67,000 men age 65 years and older, the researchers found that blacks were 35 percent less likely than whites to undergo prostate-specific antigen (PSA) testing.

"The level of racial disparity in the use of PSA screening is quite unsettling," says Dr. Timothy Gilligan, a genitourinary oncologist at Dana-Farber Cancer Institute and the article's lead author.

"While some physicians question the effectiveness of PSA as a screening test, there is no reason its availability should differ according to a man's race," Dr. Gilligan says. "Indeed, because blacks are at higher risk of dying from prostate cancer, they stand to benefit the most from screening."

Prostate cancer is the second leading cause of cancer death in men in the US.

The American Cancer Society estimates that nearly 30,000 men will die from the disease this year and that 230,000 cases of prostate cancer will be diagnosed.

While the prostate cancer mortality rate for African Americans has declined a little during the past decade, it is still more than double the rate for other races and ethnicities. Prostate cancer also tends to be detected in African Americans at a younger age and at a more advanced stage than in Caucasians.

The researchers' findings were derived from claims 67,245 New Jersey residents filed with Medicare, Medicaid, and the New Jersey Pharmaceutical Assistance to the Aged and Disabled program from 1991 through 1996.

Men who were previously diagnosed with prostate cancer were excluded from the study. To overcome the limitations of previous studies that looked at racial disparities, the researchers accounted for differences in age, socioeconomic status, use of health care services, and presence of other diseases and medical conditions - factors that are known to impact the use of primary and preventive care services.

While the study established there is a racial disparity in prostate cancer screening use, it did not identify its causes or its impact.

The researchers note that potential contributing factors could include racial differences in access to care and education levels, patient preferences, and care provider recommendations.

Always consult your physician for more information.

Online Resources

American Cancer Society

American Prostate Society

American Urological Society

Centers for Disease Control and Prevention (CDC)

Healthfinder, US Department of Health and Human Services (HHS)

National Cancer Institute Prostate Cancer Information

National Institutes of Health (NIH)

NIH 4Women.Gov on Men's Health

National Library of Medicine

National Prostate Cancer Coalition

Prostate Cancer Foundation