WEDNESDAY, Feb. 13 (HealthDay News) -- One of the largest studies of its kind concludes that most older men with early prostate cancer do not shorten their survival odds if they adopt a "wait-and-see" approach to the disease.

In fact, most such patients will die of other causes or they simply won't develop any complications from the cancer, the researchers found.

"Many elderly men with lower risk cancer may do well with conservative management," concluded study author Grace Lu-Yau, a cancer epidemiologist at the Cancer Institute of New Jersey, and an associate professor at UMDNJ-Robert Wood Johnson Medical School and School of Public Health.

"Each patient facing a treatment decision has to ask himself what is the potential survival benefit of various treatments and the potential side effects of various treatments, then compare this potential risk of side effects with the potential risk of cancer complications if the cancer is left untreated -- and ask themselves which treatment option is their personal preference," Lu-Yau said.

She presented the findings to reporters at a special teleconference Tuesday, part of the 2008 Genitourinary Cancers Symposium taking place in San Francisco.

The question of whether to treat or not treat prostate cancer has long absorbed experts.

Although one in six men in the United States will be diagnosed with prostate cancer in their lifetime, many of the malignancies are slow-growing, and there is currently no reliable way to identify which men will benefit from treatment. Better knowledge of the natural history of the disease (i.e., what happens without any treatment) would help guide treatment decisions, Lu-Yau said.

This study is one of the first to look at the natural history of prostate cancer since PSA (prostate-specific antigen) blood testing has become commonplace. PSA tests can detect a prostate cancer six to 13 years earlier than previous methods.

Lu-Yau and her colleagues looked at data on more than 9,000 men with Stage I or II prostate cancer diagnosed between 1992 and 2002 who did not undergo treatment. The mean age of participants was 77 years.

Seventy-two percent of these men died of other causes or didn't have enough cancer progression to warrant surgery or radiation, the researchers found. For the remaining 2,675 men who did receive treatment, the median time between diagnosis and start of therapy was more than 10 years.

Not surprisingly, men with less aggressive disease survived longer than those with more aggressive tumors.

"For elderly men with localized prostate cancer, the potential survival benefit for treatment is most likely modest, therefore it is very critical to weigh the risk of having side effects of various treatments with the risk of developing cancer-related complications down the road," Lu-Yau said. "The majority of patients will die of other causes or remain alive without significant major complications."

A second study presented at the conference found that giving salvage radiation therapy (SRT) to men whose PSA levels rise after having their prostate removed can reduce their risk of dying from the cancer by more than 60 percent.

SRT is typically given only after a recurrence, not after an initial diagnosis of prostate cancer, noted study lead author Dr. Bruce Trock, associate professor of urology, epidemiology, oncology and environmental health sciences at Johns Hopkins University School of Medicine in Baltimore. Existing studies have either not been large enough or long enough in duration to determine if SRT prolongs survival.

In this retrospective analysis of 635 men who had experienced a recurrence after having their prostate removed, 62 percent of those who did not receive any salvage therapy were still alive after 10 years, versus 86 percent of those who received SRT and 82 percent of those who received SRT plus hormone therapy.

Men whose PSA doubling time (the amount of time it took for PSA levels to double from when in first becomes detectable) was six months or less had the greatest benefit.

"If another study was able to replicate our data, it could lead to clinical trial that would eventually support a way to determine who should get immediate adjuvant radiation and who could wait until the time of recurrence to have SRT," Trock said. "The question is, could a benefit be achieved in some of these men if you waited to see whether they recurred or not?"

More information

There's more on prostate cancer at U.S. National Cancer institute.

FRIDAY, Feb. 8 (HealthDay News) -- If you're a video game "widow," science might now be able to tell you why.

New research from Stanford scientists shows that the part of the brain associated with reward and addiction was more activated in males than in females when both genders played a game whose object was to acquire more territory.

In other words, the game was more rewarding for males, who were therefore more motivated to succeed.

The findings could have implications beyond the video screen and console, offering insights into what motivates human behavior.

"It's my sense that the results really do open a fascinating realm of future investigations," said Dr. Kathryn J. Kotrla, chairwoman of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine in Round Rock. "These investigations allow one to visualize literally the reward that different individuals experience."

"It would be fascinating either to determine what motivates women more than men or, within a specific gender, to look at the range of motivations and rewards for different variables," she added. "The study itself is looking at gaining territory but one could imagine studies that dealt with attachment or caring for others, so it really opens the door to a wide range of extremely interesting questions about human motivation."

According to background information in the study, which was recently published online in the Journal of Psychiatric Research, more than 230 million video and computer games were sold in 2005.

"Forty percent of Americans play video games, and men are two to three times more likely to feel addicted," said study author Dr. Fumiko Hoeft, senior research scientist at Stanford University School of Medicine. "It seems like an international phenomenon, but no one has looked at how the brain responds."

For the study, 22 Stanford undergraduates (half of them men and half women) were recruited to play a video game designed by the study authors. The game purposely dealt with territoriality, as men are known to be more territorial than women, Hoeft said.

Half the space on the screen "belonged" to the player; the other half showed balls coming toward the player's space. Clicking on the balls before they hit the dividing wall resulted in a space gain. But if the balls hit the wall, the player lost space.

Participants were not told that the object of the game was to gain more space but all quickly caught on.

Although both genders clicked on the same number of balls, men quickly acquired more space than women, apparently because men were better at identifying which balls (those closest to the wall) would give them the most space if clicked.

While playing the game, the participants were hooked up to functional MRI, which shows which parts of the brain are activated at different times. All participants showed activation in the mesocorticolimbic center of the brain, which is typically associated with reward and addiction. But the male brains showed much more activation in this area.

"Women and men showed activity in the reward circuitry, which overlaps with addiction circuitry," Hoeft explained. "Men activated those regions more than women, and the brain regions moved together more than women."

When participants played a video game that had no territorial aspect, there was no difference in men's and women's brain activation. "It's linked to the reward of more space," Hoeft said.

According to the study authors, most computer games that males like to play involve territory and aggression, explaining why men seem more likely to get hooked.

More information

The National Institute on Media and the Family   has more on "taming the video game tiger."

THURSDAY, Jan. 31 (HealthDay News) -- Consumption of sugar-sweetened soft drinks and fructose is strongly associated with increased risk of gout in men, a new study says.

Gout, caused by excess uric acid in the blood, is a joint disease that causes extreme pain and swelling. Cases of gout, which is most common in men, have doubled in the United States over the past few decades.

In this study, published in BMJ Online First, researchers looked at more than 46,000 men, aged 40 and older, with no history of gout. Information on the men's food and beverage intake was collected at the start of the study, and details about their weight, medication use and medical conditions were recorded every two years during the 12-year study.

During that time, 755 of the men were diagnosed with gout. The risk was much higher in men who drank five to six servings of sugar-sweetened soft drinks per week and was 85 percent higher in those who drank two or more of the beverages a day, compared to those who had less than one serving per month.

The increased risk was independent of other gout risk factors such as body-mass index, age, diuretic use, high blood pressure, alcohol intake and dietary habits. Diet soft drinks did not increase gout risk.

The study also found that fruit juice and fructose-rich fruits such as apples and oranges were associated with increased gout risk. But the researchers said this higher risk of gout needs to be balanced against the many health benefits provided by fresh fruits and vegetables.

More information

The American Academy of Family Physicians has more about gout  .