Saving lives with colonoscopy: colorectal cancer mortality drops if you do it at least once in lifetime.

Flexible sigmoidoscopy offered at least once for men and women between 55 and 64 years has significant impact in colon cancer mortality.
Study involving more than 170,000 women and men selected a group invited for screening or control group. Primary outcome was incidence and mortality from colorectal cancer. Based on intention to treat analysis, the colorectal cancer incidence in intervention group reduced 23% and mortality by 31%. Using per-protocol analysis the reduction reached 33% and 43% for incidence and mortality, respectively.
These numbers are impressive and reinforce the role of colonoscopy now clearly associated with colorectal cancer mortality.

So, what to do?

If you are over 55 do it at least once, with long lasting benefits.

See article at The Lancet: http://ht.ly/1E6Fo

Do Breast Cancer Screening Saves Lives?

A recent study published at the British Medical Journal (march 2010) was unable to find any benefit associated with the breast cancer screening program on breast cancer mortality. There was no difference between screened and non screened areas considering breast cancer mortality eluding the idea that mammography for screening has no importance at all…ops!!!

Intriguingly, the study found a mortality decline of 1% per year in the screening areas and 2% decline in non-screening areas for the same 10 year period. For patients too old to be screened there was no difference in breast cancer mortality and for patients too young to benefit from screening (35-55 years old) the mortality declined 5% per year during 1997-2006 in screened and 6% in non-screened areas.

The study included all Danish women recorded in the Cancer Registry from 1971-2006. They used the population of Copenhagen as the screened population (that began in 1991) and all other areas as non-screened areas.

A previous study attributed to screening a reduction in 25% of breast cancer mortality in women living in Copenhagen. As the authors say “there are, however, substantial problems in using observational studies to estimate the effect of screening. For example, a decline in breast cancer mortality following the introduction of screening would not necessarily be caused by screening”. Actually, most benefit associated with recent breast cancer mortality reduction can be attributed to better and more effective treatment.

So what to do?

Well… I would keep the screening … all available data is too biased to be conclusive…

What we really know: Breast cancer mortality decline is clearly associated with our steady effort to diagnose and introduce effective treatment earlier. Today, virtually all women with breast cancer are candidate to adjuvant treatment…

See article: KJ Jørgensen, et al BMJ 2010;340:c1241 http://ht.ly/1DPq1
See different opinion from another study (at msnbc): http://ht.ly/1DPvl

Tamoxifen, raloxifen and breast cancer risk reduction

Presented at the AACR 2010’s Meeting, the NCI sponsored STAR (Study of Tamoxifen and Raloxifen) trial confirms the breast cancer development risk reduction in postmenopausal women considered at a higher risk. 19,000 women participated and tamoxifen and raloxifen reduced de incidence of invasive and noninvasive breast cancer. Raloxifen is safer (less side effects) but less effective than tamoxifen. See JNCI Cancer Bulletin: http://ow.ly/1BvRe

Bisphosphonates use reduces breast cancer risk?

Bisphosphonates use reduces breast cancer risk?

Another study identifies the risk reduction of breast cancer development in women using bisphosphonates for osteoporosis.

Its getting even more frequent the “incidental” finding of cancer risk reduction in studies using non steroid anti-inflammatory agents, bisphosphonates and statins. These findings are relevant clues about the role of inflammation and cancer development. There is a growing evidence that inflammation is pivotal in cancinogenesis… it´s the second post about it this week.

Follow the link from BJC: : http://ow.ly/1A0ed

Exercise reduces breast cancer mortality

Extracts from an article by GOVARDHANAN NAGAIAH, MD, HANNAH W. HAZARD, MD, JAME ABRAHAM, MD, FACP, at ONCOLOGY. Vol. 24 No. 4

"Obese patients are more likely to get breast cancer and also have a worse prognosis from the disease. Exercise appears to attenuate the physiologic processes that increase the incidence and mortality from breast cancer. The feasibility of increasing physical activity in patients with breast cancer has been studied, and the results are encouraging. Exercise has also been shown to decrease all-cause mortality in patients with breast cancer. This could be a reflection of the known benefits of exercise in decreasing cardiovascular mortality. With the current obesity epidemic, it is essential that oncologists discuss the beneficial effects of exercise and weight loss in improving overall survival in patients with breast cancer".

Exercise? How? How much?

3 to 5 hours per week, at 2-3 mph, or walk in a moderate/intense pace 9 to 12 miles per week.
A better option is to alternate walking with bicycling and swimming to protect your joints...
The best option is to be supported/supervised by a sport professional...

See the complete article: http://ow.ly/1zeqK

Sun exposure protects melanoma patients from recurrence?

Our regular diet provides few quantities of vitamin D and most of us depend on cutaneous synthesis from Sun exposure to obtain adequate volumes of vitamin D. Food supplements are not regularly consumed by most of us and deficiency of vitamin D – or suboptimal levels – are commonly found in healthy populations.
In a prospective cohort study published last year (where the information above came from), there was “a strong inverse correlation between serum vitamin D levels and Breslow thickness” (and indicator of “aggressiveness of melanoma”). Low levels of vitamin D also correlates to bone density and bone fractures, and this information also correlates with the risk of melanoma development…
Authors consider –for good – that the level of vitamin D can only be a marker for another causal relationship. They also have shown that vitamin D deficiency is common among patients with melanoma in UK (in another study) and may increase the risk of relapse from melanoma.

Question: Should a patient with diagnosed and treated melanoma go to the beach as medical recommendation and forget about “sun avoidance policy”?

That’s not the case. Vitamin D supplements are safer and may be a better option; until more information come in.

Question: Should everyone take vitamin D pills as supplements?

We are not sure about the optimal level of vitamin D (the ideal level correlates to the lowest parathyroid hormone level), but suboptimal levels are frequent in healthy people… and low bone density is common as well. Excessively high levels of vitamin D are toxic...

Clues…

The Institute of Medicine (http://www.iom.edu/) will release a report in ~May 2010 about vitamin D adequate daily intake. We will provide more info when it's "on air"...

The www.veganhealth.com, info about calcium and vitamin D: http://ow.ly/1z4gE.

The University of Michigan, info about calcium and vitamin D: http://ow.ly/1z4hT.

The cited article from the Journal of Clinical Oncology: Julia A. Newton-Bishop, Journal of Clinical Oncology, Vol 27, No 32 (November 10), 2009: pp. 5439-5444), where this info came from. http://ow.ly/1z5Tv.

Breast Cancer and Aspirin

Women treated for
early-stage breast cancer have a reduced risk of breast cancer death and risk of metastasis according to recent published trial from JCO [Journal of Clinical Oncology, Vol 28, No 9 (March 20), 2010: pp. 1467-1472].

The benefit is for women taking aspirin from 2 to 7 days a week...
Sounds that NSAIDs are protective drugs (with growing evidence) for cancer and dangerouus to our kidneys...
See the DocGuide press release: http://ow.ly/1xN9j
See article abstract at JCO: http://ow.ly/1xNtp

Prostate cancer and diet

Chicken with skin and eggs increase the risk of recurrence of prostate cancer in a recent report from CapSURE - study published at: http://bit.ly/cTmS9m.

Junk food is additive

Junk food is additive, see Nature: http://bit.ly/bYpRWU.
And obesity is associated with breast, colon, endometrium(uterus), kidney and esophagus cancer. The list is growing...

New Blog

Welcome,
This is my new blog.
You will find information about daily activity and cancer prevention and control...