Screening tools help guide patients to physicians who can find cancer in it's early stages

A recent study published in the Annals of Internal Medicine reported that colonoscopy risks may outweigh the benefits for some patients over the age of 85.   Elderly patients with a medical history of stroke, diabetes, heart failure and atrial fibrillation are encouraged to consider alternatives such as the fecal occult blood test.  These less invasive tests minimize risks which may be present during a colonoscopy such as bleeding colon perforation and heart problems.

“Somebody who is older and not in great health might benefit from a fecal occult blood test, and if the result is positive then a colonoscopy may be needed,” said lead researcher Joan L. Warren in a HealthDay interview.  Colonscopy is considered the “gold standard” for the detection and prevention of colon cancer.  If polyps are detected during the procedure they can be removed.  Warren goes on to say “overall, the risks from colonoscopy are quite low, however, there are some groups of people for whom the risk was significantly elevated.”

For more information on colon cancer and a list of screening tests, visit the Colon Cancer Coalition website at GetYourRearInGear.com

Source: University of Minnesota Medical Center Fairview Health Update

A new study published in the Archives of Internal Medicine indicates that important test results including cholesterol blood work, mammograms, Pap smears and screening tests for colon cancer are not always shared with patients.  According to an Associated Press report, “the first study of its kind finds doctors failed to inform patients of abnormal cancer screenings and other test results 1 out of 14 times.”

“Our goal is not to indict physicians.  It’s about working smarter and getting processes in place.” said researcher Dr. Daniel Dunham who was interviewed for the report.  In many cases, medical offices had no system in place for informing patients of test results.  Offices with computer based systems fared worse in many cases than those without.

Both Dunham and fellow researcher Dr. Lawrence Casalino explained that the test results in question were those in which “any doctor would agree patients should be informed.”  Physicians were also given an opportunity to explain when medical charts did not indicate that patients had been contacted with information about potentially harmful medical test results.

The study underscores the importance of patient involvement and self-advocacy.  “If you’ve had a test, whether it be blood test or some kind of X-ray or ultrasound, don’t assume because you haven’t heard from your physician that the result is normal,” Casalino said.

At least 50% of the Western population develops a colorectal tumor by the age of 70, and about 1 in 10 of these individuals, progress to malignancy. As a result, colorectal cancer is the second leading cause of cancer death in the United States and first when smoking-related cancers are excluded (1).

It is estimated that more than half of all new cancers and cancer deaths worldwide are potentially preventable by altering lifestyle. Of course excessive alcohol, smoking, and obesity are the most common causes but certain cancers are also related to infectious agents, such as hepatitis B (HBV), human immunodeficiency virus (HIV), human papilloma virus (HPV), and helicobacter pylori (H. pylori). They could be prevented through known interventions such as vaccines, antibiotics, improved sanitation, and education. Some cancers (colorectal and cervix) can be avoided by detection and removal of pre-cancerous lesions through regular screening examinations by a health care professional.

Colorectal cancer is one of the most preventable. There are several things you can do to avoid this type of cancer:

• Avoid high levels of animal fats, eating more fish, chicken and vegetables (2).
• Try to eat 40% of your diet as vegetables and no, fries and ketchup are not included. Particularly, stop eating preserved meats; bacon, sausages and ham are at the top of the list of things to avoid. Also don’t burn your steak.
• Cut back on simple carbohydrates, high simple sugar like sucrose and high fructose corn syrup as well as refined white flour. Rough and tough carbohydrates or low GI are the best (3). The roughage from the box many foods come in is better than the refines foods within.
• Keeping your blood sugar down is a key to avoiding colorectal cancers (4).
• Lastly, many experts suggest vegetables high in certain compounds are helpful, try eating more cruciferous vegetables and more sulphur containing vegetables like garlic and onions (5). Loosening weight and being fit will benefit you in a number of ways, including lower tumor rates (6).

While much has been written about the genetics of cancer, genes are not destiny; at most it’s only 15% of all colorectal cancers are attributable to genes (1). Its what is turned on or off that counts, its what you do with your genes not what your genes do to you.

Some herbs are also found useful. Natural anti-inflammatory compounds abound in the herbal world and are found in green tea, the spices turmeric and rosemary, feverfew and others (7).

References:
1) Cell, Vol. 87, 159–170, October 18, 1996
2) American Journal of Epidemiology Vol. 109, No. 2: 132-144
3) International Journal of Cancer. Volume 32 Issue 1, Pages 1 – 5
4) JNCI Journal of the National Cancer Institute 1999 91(13):1147-115
5) Cancer Causes and Control. Volume 2, Number 6 / November, 1991
6) Journal of the National Cancer Institute, Vol. 82, No. 11, 915-926, June 6, 1990
7) J. Nutr. 131:3034S-3036S, November 2001

“Women who got the most calcium from food and supplements had a lower risk of all cancer and a 23% lower risk of cancers of the digestive system than those who got the least.”

The recommended daily allowance of calcium increases for adults as they age.  The National Institutes of Health Office of Dietary Supplements recommends 1200 mg/day for adults over the age of 51 and 1000 mg/day for those between 19 and 50 years of age.  While  supplements have become increasingly popular, “most Americans should consider their intake of calcium from all foods including fortified ones before adding supplements to their diet to help avoid the risk of reaching levels at or near the tolerable upper limit for calcium (2500 mg)”, according to the agency.

Calcium rich foods can be found in almost any aisle of the grocery store.  If dairy products rich in calcium are not your favorite foods, consider adding green leafy vegetables to your diet.  One cup of cooked spinach provides 300 mg of calcium, the same amount provided by an 8 oz glass of skim milk.  Ready-to-eat cereals are another great source.  Fortified cereals can provide anywhere from 236 to 1043 milligrams of calcium.  A more complete list of calcium rich foods, along with tips for improving the body’s ability to absorb this important nutrient can be found on the Dietary Supplement Fact Sheet provided by the National Institutes of Health.

January 29, 2009

Researchers led by Drs. Lillian Maggio-Price and Brian Iritani at The University of Washington found that mice that lack the immune inhibitory molecule Smad3 are acutely sensitive to both bacterially-induced inflammation and cancer. They report these findings in the January 2009 issue of The American Journal of Pathology.

Bacteria contribute to the development of certain cancers, in some measure, by stimulating chronic inflammation. Absence of a molecule that inhibits inflammation, Smad3, may therefore increase susceptibility to colon cancer.

To examine whether Smad3 signaling contributes to development of colon cancer, Maggio-Price et al examined mice deficient in Smad3 that lack of adaptive immune responses. They found that these mice are acutely sensitive to bacterially-induced inflammation and cancer due to both deficient T regulatory cell function and increased expression of proinflammatory cytokines. Through increased expression of both pro-oncogenic and anti-apoptotic proteins, epithelial cells in colonic tissues underwent both enhanced proliferation and survival.

“That the inflammatory response to microorganisms is a key event in these results reveals important ‘tumor-suppressive’ functions for Smad3 in T effector cells, T regulatory cells, and intestinal epithelial cells, all of which may normally limit the development of colon cancer in response to bacterial inflammation,” explains the groups led by Dr. Maggio-Price and Dr. Iritani.