Posts Tagged ‘colorectal cancer’

Can the Risk of Colorectal Cancer Among Obese People be Reduced?

Friday, January 22nd, 2016

logo1267406_mdA new study published in Cancer Research concluded that they have discovered the biological previously unfound connection of a long known association between obesity and an increased risk of colorectal cancer. They have also identified an approved drug that might prevent  the cancer in obese people.

In research they found that a high caloric diet turned off expression of a key hormone in the intestines, which lead to deactivation of a tumor suppressor pathway. Genetic replacement of that hormone turned the tumor suppressor back on and prevented cancer development even when mice continued to eat excess calories. The drug that was used was linaclotide (Linzess) that is structurally related to the hormone and may be a therapeutic approach to prevent colorectal cancer in obese patients. The researchers said “Our study suggests that colorectal cancer can be prevented in obese individuals with the use of hormone replacement therapy.”

In the study they used genetically engineered mice on different diets and found that obesity (either from excess fat or carbohydrate consumption. or both, is associated with loss of the hormone guanylin, that is produced in the intestine’s epithelium or cells lining the intestines. The hormones turn on its receptor guarylyl  cyclase (GUCY2C) that regulates processes underlying regeneration of the intestinal epithelium. “The lining of the intestines is very dynamic and continuously being replaced, and the GUCY2C contributes to the choreography of the key processes  needed for thus regeneration.”  Deactivation of the guanylin gene is common in colorectal cancers in both humans and animals and morbidly ovese patients echibit an 80% decrease in Guanylin gene expression compared to lean people.

In this study they found the consequence of that loss is that , and without the hormone, the receptor is silent. the guanylin  hormone receptor acts as a growth-controlling tumor suppressor happening early in the cancer development. “When the receptor is silenced, the epithelium becomes dysfunctional, setting up the conditions for cancer development.” The research demonstrates that obese mice, compared to lean mice, were much more likely to silence the hormone and its receptor, “We believe that if colorectal cancer is going to develop, it will be through this silencing mechanism-and that it will happen much more frequently in the obese.” This study demonstrates that if you can prevent hormone loss, you can also prevent tumor development and  a drug like guanylin, can activate GUCY2C tumor-suppressing receptors to prevent cancer in these patients.

Researchers have already started multi site clinical studies testing dose and side effects of linaclotide use in healthy volunteers.

 

Colorectal Patients have Speeded Recovery Time with New Care Approach.

Friday, May 15th, 2015

Colorectal Surgery Patients in Enhanced Recovery

A new research study published online as an “article in press” on the Journal of the American College of Surgeons website in advance of print publication concluded that patients who participated in an enhanced recovery program following colorectal surgery left the hospital sooner and had a significantly lower hospital costs than those following a traditional pattern of care. The focus of the enhanced recovery program is to speed patient’s recovery by reducing the body’s stress responses to a surgical procedure and promoting earlier return of bodily functions. In this study patient stays were trimmed by nearly two days, on average, compared to patients receiving traditional care and there was no increase in readmission’s in the first month following surgery. In addition, the rate of surgical site infections dropped by nearly 10 percent.

Enhanced recovery includes but goes beyond “fast tract surgery” in which there is minimal invasive techniques and encouragement of early mobilization and eating by patients.  Enhanced  recovery does away with traditional preoperative fasting and bowel-emptying preparation  whenever possible and instead allows clear fluids   up to two hours before surgery.  To prevent fluid retention, anesthesiologists reduce the amount of intravenous  fluids given during the procedure. Patients also receive fewer narcotic painkillers during and after surgery. By using alternative types of pain medications the length of hospital stay is shortened because the side effects of narcotics such as vomiting and constipation are reduced.

Researchers say the U.,S, hospitals have been slow to accept components of this pattern of care. For example, “The scientific evidence that it is safe for patients to drink clear fluids up to a few hours before anesthesia is more than 25 years old. It just took us that long to adopt.”

In this study data was used from patients undergoing elective major colorectal resection  at Duke between September 2006 and March 2013. Seven hundred eighty seven patients met study criteria and were divided into 3 groups based upon surgical care provided. Three hundred were in group one who received traditional care, 165 were in group 2 receiving the enhanced recovery program but did not receive the SSI (surgical site infection) bundle, and the third group that had both enhanced recovery program and SSI bundle.

Results showed each intervention improved surgical outcomes in different ways. Those receiving enhanced recovery stayed in the hospital 1.7 days less than those receiving traditional care.  In addition, the average cost for colorectal surgical admissions fell from $31,926 before the enhanced recovery program was initiated to an inflation-adjusted $22,044 three years after it started.  The group having both enhanced recovery and the SSI bundle had a decreased rate of superficial wound infections: 6.3 percent vs 16.1 percent in the enhanced recovery only group. The rates of sepsis, a life-threatening infection, also were lower, 1.8 vs 11.2 percent. The SSI bundle included among other measures, keeping the patients temperature normal during the post op period, removing the bandages within 2 days of the operation, and washing the incision daily for one week with antiseptic solution.  Researchers concluded ” The enhanced recovery program and the SST bundle together have profoundly altered the practice of colorectal surgery at our institution and improved the quality of care.”

Does Fitness Level Influence Risk of Cancer and Death in Men?

Wednesday, April 1st, 2015

Does Fitness Level Influence Risk of Cancer and Death in Men

A new study published in the online JAMA Oncology concluded that men with a high fitness level in midlife seem to be at lower risk for lung and colorectal cancer, but not prostate cancer. In addition, a higher fitness level may also predict aa lower risk of death if they are diagnosed with cancer when they are older.

The purpose of the study was to look at the association between midlife cardiorespiratory fitness (CRF) and the incidence of cancer and survival at age 65 or older. The study included 13,949 men who had a baseline fitness exam where CRF was measured in a treadmill test between 1971 and 2009. Lung cancer, prostate and colorectal cancers were assessed on this group using medicare data between 1999 and 2009. during an average surveillance period of 6.5 years for the men, 1310 developed prostate cancer, 200 lung cancer, and 181 developed colorectal cancer.  Results showed that high CRF in midlife was associated with a 55 percent lower risk of lung cancer, and a 44 percent lower risk of colorectal cancer compared to men with low CRF. However, this association was not seen between high CRF and lower prostate cancer risk. Researchers also found that high CRF in midlife was associated with a 32 percent lower risk of cancer death among men who developed lung, colorectal or prostate cancer at age 65 compared with men who had alow CRF.  In addition, high CRF in midlife was associated with a 68 percent reduction in cardiovascular disease death (CVD) compared with low CRF among men who developed cancer.  Further research is needed to determine specific levels of CRF necessary toi prevent site specific cancer.

A gene variant increases colorectal cancer risk from eating processed meat.

Friday, April 25th, 2014

logo1267406_mdResearchers in a new study in PLOS Genetics reported that a common gene variant that affects one in 3 people seems to increase the risk of colorectal cancer from the consumption of processed meat. Data from over 9,200 patients with colorectal cancer and over 9,100 controls were pooled. Over 2 million variants were analyzed to find those associated with the consumption of meat, fiber, fruits and vegetables and found a significant interaction between the variant rs4143094 and processed meat consumption. This variant was found on the same chromosome 10 region of another gene that was previously linked to several forms of cancer. Colorectal cancer is a multi-factor disease process that has both genetic caused and lifestyle factors including diet. About 30 known genetic susceptibility alleles for colorectal cancer have been identified but the effect of specific foods on the activities of the genes has not been found. The researchers said “The possibility that genetic variants may modify an individual’s risk for disease based on diet has not been thoroughly investigated but represents an important new insight into disease development.”  They further said”Diet is a modifiable risk factor for colorectal cancer. Our study is the first to understand whether some individuals are at higher or lower risk based on their genomic profile.  This information helps us better understand the biology and maybe in the future lead to targeted prevention strategies.”

Does radiation therapy for cervical cancer increase your risk of later colorectal cancer?

Wednesday, April 23rd, 2014

logo1267406_mdIn a recent study published online in the journal Medical Oncology researchers found that young women treated with radiation for cervical cancer had a higher incidence of secondary colorectal cancer later in life than women who were not treated with radiation therapy. As a result they recommended earlier colorectal cancer screening for this group than earlier recommended starting at about 8 years after treatment instead of waiting until age 50.

Researchers analyzed data on over 64,500 cervical cancer cases collected between 1973 and 2009. Among cervical cancer survivors studied, colon, rectum, and anus tumors were found to be two to four times more frequent in the group treated with radiation than in the group not treated with radiation. The rate of colorectal cancer in the group receiving radiation for cervical cancer varied by time and began about 8 years after treatment and increased over time until after 35 years they were 3 to 4 times more like to develop colorectal cancer than women who had not had radiation.

Can a Simple At Home Test Detect Colorectal Cancer?

Wednesday, February 12th, 2014

logo1267406_mdA new study in the Annals of internal Medicine reported that a simgle stool sample collected by patients at home and sent to a lab for analysis  will detect 79 percent of colorectal cancers. The researchers said “We know the FIT is easy to use, and now we also know this tool is a great tool for assessing which patients have cancer and which patients don’t.” The test has been recommended since 2008 but many people still do not know about it. And unlike other older stool tests, it does not require people to restrict their diets or to stop taking medications. The test detects small amounts of blood in the stool and those who test positive are more likely to have colorectal cancer and need to be followed up with a colonoscopy.

The evidence review for FIT . showed the test was quite sensitive and on average, detects 79 percent, or about 4 or 5 cancers with only one round of testing. It was also quite specific, on average, identifying 94 percent of those who did not have cancer who actually did not have cancer. For comparison, the at home test for fecal occult blood (FOBT) detects only about 13 to 50 percent of cancers after a single round of testing. This test also required three stool samples and also had dietary and medication restrictions.  For the FIT three stool specimens do not detect better than one. Nineteen studies were reviewed.

Is Grape Seed Effective for Aggressive Colorectal Cancer?

Wednesday, January 23rd, 2013

logo1267406_mdA recent research study published in the journal Cancer Letters concluded that the more advanced colorectal cancer cells are the more  great seed extract( GSE) inhibits their growth and survival and leaves healthy cells alone. Researchers said “We’ve known for quite a while that the bio active compounds in grape seed extract selectively target many types of cancer cells.  This study shows that many of the same mutations that allow colorectal cancer cells to metastasize and survive traditional therapies make them especially sensitive to treatment with GSE.

The study was done on colorectal cancer cell lines representing various stages of the disease. While it generally takes more chemotherapy to kill A Stage IV cancer cell than a stage II cancer cell, the reverse was found with grape seed extract. “It requires less than half the concentration of GSE to suppress cancer growth  and kill 50 percent stage IV cells than it did to achieve similar results in the stage II cells. ”  They said further “A colorectal cell can have upwards of 11,000 genetic mutations–differences from the DNA of healthy cells. Traditional chemo therapies may only target a specific mutation and as cancer progresses more mutations occur.  In contract, the many bio active compounds of GSE are able to target multiple mutations. The more mutations a cancer presents, the more effective GSE is in Targeting them.  The research is ongoing and more results will be available in the future.

Research Finds Link Between Inflammation, Bacterial Communities and Cancer.

Friday, August 24th, 2012

A new study published online in the journal Science concluded that a significant disturbance in the human body can profoundly alter the makeup of an otherwise stable microbial community coexisting within it and that changes in the internal ecology can result in unexpected and drastic consequences for human health. In a series of experiments using mice prone to intestinal inflammation the researchers found that inflammation caused simplification in diverse communities of gut microbes and allowed a new bacterial population  to establish a foothold. These pathogens then may damage host cells increasing the risk of developing colorectal cancer. Bacteria taxa often invading the disturbed intestinal ecosystem were E.Coli and related bacteria. By putting E. coli bacteria in mice raised in a sterile environment the researchers found that the presence of  E. coli promoted  tumor formation but when the region of the E. coli genome responsible for DNA damage was removed the ability of the E. coli to cause tumors was significantly decreased.  Researchers also found an E. coli variant with the suspected genes in a high percentage of human patients with colorectal cancer and irritable bowel disease.

There first study looked at determining a clear connection between the physiological condition of intestinal inflammation and a subsequent change in microbial communities in the gut. They used mice that are genetically prone to inflammation because they lack the gene that suppresses the inflammation response. The researchers compared bacterial communities in the inflamed gut of this group of mice with those bacteria  in healthy field mice. They found the diversity of different kinds of bacteria was lower in the mice with genetically facilitated inflammation but there was little difference in the microbial diversity between those that had inflammation and those that had cancer and this indicated that inflammation was the critical factor affecting microbe populations. They said ” A shift in the microbial community is associated with inflammation.” “It is interesting that the microbial community is actually  changing with the disease state, which indicates that it is either responding to or contributing to the disease state.”

Next they studied whether or not there was a relationship between E. coli and colorectal cancer. For this they raised sterile (bacteria free) mice that were genetically prone to inflammation  and inoculated each mouse with either E. coli variant (NC lOl) or Enterococcus faecalis, another common gut bacteria.  Both groups of the inflammation prone mice developed severe gut inflammation (colitis) but of significance, 80 percent of the E. coli infected mice also developed cxolorectal cancer, while the other group remained cancer-free. The researchers said it was the presence of the  E. coli in an inflammed environment that lead to the cancer rather than the inflammation itself.

Next they wanted to know what was it in the E. coli that caused cancer. Knowing that some strains of E.coli have a set of genes known as “the pks island” that have been implicated in pathways causing DNA damage, they innoculated mice with a modified NC lOl  E. coli that lacked the pks island and the mice still developed inflammation but  had a dramatically  reduced rate of tumors. Researchers concluded that host-microbial interactions that allow E. coli to cause inflammation are distinct from the interactions that cause the inflammation to progress to cancer.

Their next step was to look at human subjects to see if there was an association of pks containing bacteria with colorectal cancer. Subjects included 24 healthy people, 35 people with irritable bowel disease (including inflammation) , and 21 with colorectal cancer.  Researchers said “Remarkably, we found the bug with pks in only 5 out of 24 controls (29% in healthy people), but if you look at people with inflammatory bowel disease, the bug and pks were present in 14 out of 35 (40%), and with people with colorectal cancer it was 15 out of 21 (66.7%).”  “These are exciting results because they suggest there may be a direct link between changes in tyhe gut microbiome and the progression from inflammation to cancer.”

Does Childhood Obesity Increase the Risk of Adult Cancer?

Friday, August 3rd, 2012

New research published in the journal of Cancer Epidemiology. Biomarkers and Prevention and Obesity concluded that obesity in adolescents has a direct link to the incidence of urothelial (bladder and urinary tract) and colorectal cancers in adulthood when obesity is defined as a Body Mass Index (BMI) in the 85th percentile and above. This group of adolescent has a 1.42% greater chance (50% higher risk) of developing urothelial or colorectal cancer in adulthood than those beneath it.

Researchers conducted a longitudinal study of 1.1 million males in the Israel Defense Force using health information collected by the army for a follow-up period of 18 years. When controlled for factors such as year of birth and education, the researchers discovered a clear link between childhood BMI and those diagnosed with urothelial or colorectal cancer later in life. Although at this time the researchers have only found a link between childhood  BMI and these types of cancer later in life they believe further research may find a wider range of cancers including pancreatic cancer which they are currently researching. Further research will evaluate whether or not obesity is a direct risk factor for cancer or a confounding factor for a genetic variation and whether or not a successful weight loss program can reduce a child’s risk of developing urothelial and colorectal cancer in adulthood.

Is Your Risk of Colorectal Cancer Reduced by Eating Fruit and Vegetables?

Friday, December 16th, 2011

A recent research study published in the Journal of The American Dietetic Association concluded that the effects of consuming fruit and vegetables seem to differ depending on the site of origin. Within the proximal and distal colon and that brassica vegetables such as Brussels sprouts, cabbage, cauliflower, and broccoli are associated with a decreased risk of these cancer. However, a lower risk of distal colon cancer was associated with eating more apples, and at the same time an increase of rectal cancer was found to occur with the consumption of fruit juices. The researchers acknowledged the earlier research on diet and colorectal cancer research that was contradictory and believe these results were related to not considering the site of the colorectaL cancer. In a case controlled study, the researchers explored the link between fruit and vegetables and cancers in three different parts of the bowel: proximal colon cancer, distal colon cancer, and rectal cancer. There were 918 subjects with a confirmed colorectal diagnosis and 1021 controls with no history of colorectal cancer. Extensive medical and nutritional questionaires were completed and all participants were assigned a socioecomic status depending upon their address.
Results showed that the consumption of brassica vegetables were associated with a reduced incidence of proximal colon cancer, and both fruit and vegetables seemed to reduce the risk of distal colon cancer. Distal colon cancer risk was significantly reduced with the intake of dark yellow vegetables and apples, but there was an increase risk of rectal cancer associated with the consumption of fruit juice. There was no risk of proximal colon cancer or rectal cancer associated with intakes of total fruit and vegetables. total vegetables or total fruit.