Prostate-Shrinking Medicines
​and Cancer

DEAR DR. ROACH: I’ve had low-grade prostate cancer for several years and am presently on “active surveillance.” My PSAs have been high but steady, running around 7.8 to 9.2. I have a greatly enlarged prostate, which I believe contributes to the high PSA numbers.

I would like your opinion regarding finasteride (Proscar), as I am considering taking it. I see one of its side effects is that it increases the risk of developing a very serious form of prostate cancer. Since I already have this cancer, am I at an increased risk of mine growing more aggressive? — D.N.W.

ANSWER: A 2013 study showed that although finasteride reduced the overall risk of prostate cancer from 15% to 10% in men followed up to 18 years on finasteride, there was a small increase in high-grade, aggressive prostate cancer, from 3% to 3.5%. However, there was no increased risk of prostate cancer death among treated men.

Several follow-up studies have suggested that the apparent small increase in aggressive prostate cancers reflected an easier ability to find these cancers, since finasteride shrinks prostate tissue, making it easier to both biopsy and read the results. My view is that the apparent increase in aggressive prostate cancer is unlikely to represent a real danger in taking finasteride. There is no evidence to suggest that finasteride would change the behavior of an existing tumor.
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                                     • • •

DEAR DR. ROACH: I have breast cancer and am being recommended anastrozole. Can you tell me the side effects, both short term and long term? — Anon.

ANSWER: Anastrozole is an inhibitor of the enzyme aromatase, which converts androgens made in the adrenal gland to estrogens. Anastrozole thus has the effect of dramatically reducing estrogen levels in the blood. For women with estrogen-sensitive tumors, this means less stimulus for the tumors to grow. Aromatase inhibitors like anastrozole have had a significant effect on improving cure rates and survival in women with estrogen receptor-positive breast cancer.

Aromatase inhibitors have been used for over 20 years; however, that’s still not long enough for a comprehensive understanding of long-term effects. There are short-term effects, and these limit the ability of some women to tolerate their use for the five years they are usually prescribed. About a third of women do not complete the course.

The most common reason I see for women stopping anastrozole is the musculoskeletal pain that often accompanies it. Symptoms can be severe in up to a third of women, but regular exercise and anti-inflammatory drugs are effective in reducing
these symptoms.

There are sexual side effects for many women. The loss of estrogen due to anastrozole can cause vaginal dryness, which may lead to painful intercourse. This can be treated with lubricants, and most data suggests that low-dose vaginal estrogen is both safe and effective, although I recommend an individualized discussion with her oncologist before a woman takes that.

Fatigue, forgetfulness and poor sleep are often reported by women on anastrozole. Bone loss (osteopenia and osteoporosis) is more common in women on anastrozole. Nonpharmacologic strategies include regular exercise, calcium and vitamin D, and smoking cessation. However, many women need medical therapy if the bone density becomes dangerously low despite this.

While there are certainly downsides to taking anastrozole, they need to be balanced against the improved survival rates in women who take them compared with other treatments.

Dr. Roach regrets that he is unable to answer
​individual questions, but will incorporate them 
in the column whenever possible. 
Readers may email questions to ToYourGoodHealth@med.cornell.edu. 

© 2020 North America Synd., Inc.
All Rights Reserved

Time to Spill the Beans

If you have dry or canned beans in your pantry, you have the start to an easy, budget-friendly meal. Beans are high in iron, zinc, potassium, folate, and fiber, nutrients missing in the diet of many Americans. Beans are readily available and an inexpensive source of protein. It’s recommended that adults eat at least 1½ cups of beans per week. They come in many sizes and varieties including kidney beans, pinto beans, black beans, garbanzo beans (chickpeas), black-eyed peas, split peas, and lentils. There is a type of bean to please everyone! 

One of the easiest ways to prepare dried beans is in the slow cooker. Simply rinse beans and remove any small stones, dirt pieces, or withered beans. Then, combine 1 pound of dried beans (2 cups) with 8 cups of water in the slow cooker. Lastly, cook on low for 6-8 hours (or overnight), until beans are soft. 

Slow Cooker Mexican Chicken Soup
Serving Size: 1½ cups 
Serves: 8

Ingredients:
2 cans diced tomatoes
¾ cup dried black beans, rinsed
1 bag (16 ounces) frozen corn, thawed
2 cups water
1 teaspoon chili powder
¼ teaspoon pepper
1 pound skinless boneless chicken breast, thawed

Optional - Baked tortilla chips, chili flakes, chopped cilantro, jalapenos, lime, chopped avocado, light sour cream, salsa, or shredded cheese

Directions: 
Add all ingredients to the slow cooker. Cook for 4 to 6 hours on high heat or 8 to 10 hours on low. 

Remove chicken right before serving. Shred using two forks. Stir shredded chicken into soup. 

Serve with choice of optional ingredients.

Nutrition information per serving: 210 calories,
3g total fat, 0g saturated fat, 0g trans-fat, 35mg cholesterol, 270mg sodium, 28g total carbohydrate,
6g fiber, 4g sugar, 19g protein

​This recipe is courtesy of ISU Extension and Outreach’s Spend Smart. Eat Smart. website. For more information, recipes, and videos, visit spendsmart.extension.iastate.edu

Ed’s Story—Everyone With ALS Counts

Because learning more about ALS is an important step in the battle to defeat it, the National ALS Registry gathers confidential health information from people who are living with the disease to learn more about what causes ALS, possibly leading to better treatments.

(NAPS)—Amyotrophic lateral sclerosis (ALS) is a fatal neurological disease that attacks the nerve cells. It first gained national attention as Lou Gehrig’s disease, named after the famous baseball player who was diagnosed with ALS in 1939. To date, the cause of ALS is unknown, and there is still no known cure. The disease strikes quickly, usually leading to death within 2–5 years of diagnosis. But every person with ALS has an individual story, and understanding these stories will help researchers ultimately piece together clues about the disease. 

Ed Tessaro was diagnosed with ALS in 2009. As he learned to cope with this diagnosis, he reflects, “I’ve never considered myself a victim of the disease, because I believe in my heart all of us have a wheelchair. In my case, it’s quite literal, but with everything that goes on in my life, I realize that every family has had a crisis.” One of the things that helps him and others with ALS is reaching out for community support and resources. “The ongoing struggle is to encourage newly diagnosed people to come in and talk about their condition. I want to help people learn about the National ALS Registry, clinical trials, and other resources that can provide support and hope.” 

The National ALS Registry helps gather information from those who are living with this disease. Researchers from all around the world can access the Registry data to help scientists learn more about what causes this disease. Everyone’s story is different, and everyone’s piece of the puzzle is essential. The Registry has found that more than 16,000 people with ALS live in the United States. It is important to include as many people as possible living with the disease to get the most accurate information. When patients join, it helps give researchers more information. This could lead to a better understanding of the causes of ALS, because learning more about the disease is one step further in the battle to defeat it.

If you or someone you care about has ALS, consider learning more about the National ALS Registry by visiting: www.cdc.gov/als.

• Five ways to keep yourself from turning up the thermostat this winter: Put on a sweater; have a nice bowl of soup or stew; wear slippers or thick nonskid socks, grab a comfy blanket; snuggle up with someone special.

• “If you bathe in a tub, try rubbing on bath oil before getting in the tub. You will get greater coverage and more moisturizing power from your bath oil. And at this time of year, who doesn’t need that?” — M.E. in Washington

• “To keep light bulbs from sticking in the socket, apply petroleum jelly to the base of the bulb before screwing it into the fixture.” — B.D. in Virginia

• Here’s an oldie but a goodie: Add a few drops of water to votive cups before adding a candle. The wax will float on the water, and when the candle burns down, it won’t get stuck in the votive glass.

• “Burned rice? No problem. While it’s still hot, carefully remove to a new pot any rice not browned or blackened. Then top it with a single slice of white bread. Allow it to sit for several minutes under a tightly fitted lid. The burned smell is absorbed by the bread, and the rice is fit to eat.” — M.U. in Michigan

• “Recycle in the new year by using wrapping supplies to help store your holiday decorations. The cardboard tube from gift wrap can be cut into smaller pieces, which you can wrap strands of tree or house lights around. Boxes can be put to use to hold ornaments or other decorations, and ribbon and bows that are still in good condition can be tucked away for re-use next year.” — E.F. in Oregon

• “Resolutions are a great idea, and, like a lot of people, last year I resolved to exercise more often. I keep a stationary bike in my living room, and I use it while I watch my favorite programs on television. It has helped me lose 8 pounds, and I feel much better. This year, I am going to resolve to volunteer to help others.” — I.N. in Nebraska

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​© 2020 King Features Synd., Inc.

Hot White Chocolate

A touch of almond extract gives this comforting winter-warmer a deliciously nutty aroma.

1 quart milk
3 ounces white chocolate, finely chopped*
1 tablespoon sugar
2 teaspoons vanilla extract
1/4 teaspoon almond extract

1. In 2-quart saucepan, heat milk to simmering over medium heat.

2. With wire whisk, stir in white chocolate, sugar, and vanilla and almond extracts. Heat mixture 3 minutes or until chocolate melts, stirring occasionally. Pour into warm mugs to serve. Serves 4.

* Or use one 3-ounce Swiss confectionery bar, or one-half 6-ounce package white baking bar.

• Each serving: About 290 calories, 15g total fat (10g saturated), 37mg cholesterol, 140mg sodium, 27g total carbohydrate, 10g protein.

For thousands of triple-tested recipes, visit our website at www.goodhousekeeping.com/food-recipes/.
© 2020 Hearst Communications, Inc.
All rights reserved

Chocolate Chip Peanut Butter Cookies

What’s a holiday without a few holiday goodies — not too festive, that’s what! This ultra-easy cookie should brighten things up.

1/2 cup cold water
1 1/2 cups nonfat dry milk powder
Granular sugar substitute to equal 1/2 cup sugar, suitable for baking
3/4 cup reduced-fat peanut butter
2 teaspoons vanilla extract
2 cups reduced-fat baking mix
1/4 cup mini-chocolate chips

1. Place cold water in a 2-cup glass measuring cup. Stir in dry milk powder until mixture makes a smooth paste. Cover and microwave on HIGH (100% power) for 45 to 60 seconds or until mixture is very hot but not to the boiling point. Add sugar substitute. Mix well to combine. Cover and refrigerate for at least 2 hours. (What you’ve just made is fat-free and sugar-free sweetened condensed milk!)

2. When ready to make cookies, preheat oven to 375 F. In a large bowl, combine cooled milk mixture, peanut butter and vanilla extract. Add baking mix. Mix well to combine. Stir in chocolate chips. Shape into 36 (1-inch) balls. Place balls on an ungreased baking sheet. Flatten each ball with a fork.

3. Bake for 6 to 8 minutes. Remove cookies from baking sheets and cool on wire racks. Makes 12 (3 cookies each) servings.

• Each serving equals: About 203 calories, 7g fat,
8g protein, 27g carb., 349mg sodium, 1g fiber;
Diabetic Exchanges: 1 1/2 Starch, 1 Meat, 1 Fat.

© 2020 King Features Syndicate, Inc.

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