parkinson's disease

Common drugs appear linked to bouts of ill-timed sleeping.

* THE QUESTION Sudden, uncontrollable sleepiness at inappropriate times -- dozing off while driving or talking with friends -- is not normally associated with Parkinson's disease, a nervous system disorder characterized by trembling, stiffness, difficulty walking and balance problems. Might the drugs commonly taken to control these symptoms be related to such sleep episodes?

* THIS STUDY analyzed medical data on 929 people with Parkinson's, 22 percent of whom reported having at least one attack of irresistible sleepiness during the six months before being interviewed for the study. Those who took drugs called dopamine agonists -- including pramipexole (Mirapex), ropinirole (Requip) and pergolide (Permax) -- were nearly three times more likely to have had sleep attacks at inappropriate times than were people who took other drugs for the disease. For these three drugs, higher doses produced more severe attacks. Compared only with people who took levodopa, a classic Parkinson's drug, those who took dopamine agonists were twice as likely to have sleep attacks.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People taking medication for Parkinson's. About a half-million Americans have the disease, which is more common after age 60. No cure has been found for Parkinson's; rather, treatments focus on making its symptoms more tolerable.

* CAVEATS Some of the data for the study stemmed from people's recollections of their sleep attacks. The study was funded by a grant from Pharmacia Corp. (since acquired by Pfizer).

* FIND THIS STUDY August issue of Archives of Neurology; abstract available online at www.archneurol.com.

* LEARN MORE ABOUT Parkinson's disease at www.ninds.nih.gov/disorders and www.michaeljfox.org/parkinsons.

prostate cancer

Major changes in diet, lifestyle may stem cancer's spread.

* THE QUESTION Men diagnosed with prostate cancer often vow to change their diet and lifestyle in hopes of keeping the disease in check. For those who follow through, do the changes make a difference?

* THIS STUDY involved 93 men with prostate cancer that had been detected at an early stage and not considered likely to spread. The men chose not to have surgery, radiation or chemotherapy. They were randomly assigned to dramatically change their diet and lifestyle or to make no changes. The group that changed ate a vegan diet (mostly fruit, vegetables, legumes and whole grains) supplemented with soy, fish oil and vitamins E and C; walked 30 minutes a day, six days a week; practiced an hour a day of yoga-based stress management (stretching, breathing and relaxation exercises); and participated in a support group one hour a week. After a year, levels of prostate-specific antigen (PSA), a blood component that indicates the presence of cancer, had decreased 4 percent in those who had made the diet/lifestyle changes and increased 6 percent in the others. The greater the change, the lower the PSA level. In that year, six men in the group that had made no changes underwent traditional prostate cancer treatment because their PSA levels had increased or their cancer had spread, compared with no one in the group that had changed diet and lifestyle.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Men with early stage prostate cancer. This disease is the most common cancer affecting men and is diagnosed in more than 230,000 Americans each year.

* CAVEATS Three men in the change group withdrew early in the study, saying the regimen was too difficult to follow. The study did not determine whether particular diet and lifestyle changes were more effective than others. Some experts have described the relative change in PSA levels as modest; the authors contend that the differences would have been more substantial had the six men in the no-change group not received treatment before the study ended. They also emphasized that an increasing PSA predicts spread of the disease, regardless of the relative differences. A longer study would be required to tell if the changes would affect life expectancy.

* FIND THIS STUDY September issue of the Journal of Urology; abstract available online at www.jurology.com.

* LEARN MORE ABOUT prostate cancer at http:// familydoctor.org and www.prostatecancerfoundation.org.

-- Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.