New Developments in Fighting Colorectal Cancer

Many people feel colonoscopies are one of those things where the cure seems worse than the disease. It's not, of course, but it is one of the most invasive and, for many, uncomfortable preventative/diagnostic procedures people undergo. So there is good news on two fronts:

• Most people over age 75 should stop getting routine colon cancer tests, says the U.S. Preventive Services Task Force, a government health group; although other medical and cancer organizations disagree. The task force recommends a colonoscopy of the entire colon every 10 years for adults between 50 and 75, a sigmoidoscopy of the lower colon every 5 years, a stool blood test every three years, and an annual stool blood test. Their recommendations are based on studies indicating that although the risks of contracting colon cancer rise after age 75, the benefits of detecting and treating this cancer decline significantly.
• An x-ray alternative to the standard colonoscopy has proven as effective in spotting most cancers, concludes a recent federal study. Faster, cheaper and less intrusive, the test is expected to increase screening rates by 50%. Despite the fact that colorectal cancer is America's second biggest killer, many people don't get tested because they fear the test during which a doctor snakes a thin, flexible scope (a tube with a tiny camera attached) through the patient's rectum into the large intestine while visually checking a monitor for signs of polyps, abnormalities and possible cancer. The new method, called CT colonography, uses x-rays to perform a "virtual colonoscopy." Critics say the new test is better at ruling out cancer than detecting it and that patients who receive a negative result will still have to undergo a standard colonoscopy to verify results and remove growths. In comparative tests, the virtual colonoscopy detected knobby polyps equally as well as the traditional test but was less effective in detecting flat growths on the colon wall that are more likely to be cancerous. Concern was also expressed about x-ray radiation and false readings by radiologists. If you're interested in CT colonography, check with your insurance carrier first. Because this is a new procedure, it is not yet covered by all insurance companies. Coverage by Medicare is currently under review.

Virtual colonoscopy is most likely to be used as an initial screening tool. The test costs $300 to $800 compared to up to $3000 for a traditional colonoscopy. The unfortunate aspect is that both tests require complete colon cleansing, for many the worst part of the screening process. Despite cost or discomfort, don't ignore screen recommendations. Colorectal cancer claims 50,000 lives each year and can nearly always be eliminated when discovered early.

Cancer Gene Linked to American Indians

A genetic mutation that significantly increases the risk of colon, uterine and ovarian cancer was recently linked to American Indians by researchers. Previously, scientists had traced the American Founder Mutation, which can lead to Lynch syndrome, to a German couple who immigrated to the United States in 1727. About 32,000 Americans now carry the cancer-causing mutation, many of them in Kentucky and Ohio. "this is so prevalent in Ohio and Kentucky, it's terrible," said researcher Heather Hampel of Ohio State University.

In a study published in the journal Cancer Research, researchers from the Mayo Clinic, Creighton University and Ohio State University examined the history of 41 families in Kentucky, Ohio and Texas. Many families reported Cherokee heritage which led researchers to re-examine the German findings. More exact genetic research allowed them to trace the mutant gene to an American woman who generations later married into the German family. Despite aggressive testing, the mutation has not been found in Europe, seeming to validate the Indian origin supposition.

The mutation is easily detectable via a $300 genetic test. Knowing you are predisposed to these cancers, you and your doctors can be more vigilant in watching for cancer signs and more aggressive in treating cancer if it occurs. "Colon cancer is 100% preventable if you do colonoscopies early enough," Hampel said. Future research hopes to pin the mutant gene to a specific Indian tribe which could improve preventative measures.

"Bugs" in Your Food Can Keep You Healthy

It's the latest health craze: adding bugs to your food. Not the creepy, crawly kind! These "bugs" are probiotics, or "friendly" microscopic bacteria like those normally found in your digestive tract. Manufacturers are adding them to everything from yogurt to baby formula to help keep you healthy, not make you sick.

Promising to "regulate your digestive health" or "strengthen your body's defenses," major food manufactures like Kraft and Dannon are promoting a growing number of products that contain probiotics in an effort to capitalize on the burgeoning health food craze. Experts say the microbes are generally safe and might even be helpful, though more research is needed to verify the rather vague claims appearing on food labels. This week the National Institutes of Health is sponsoring a conference where scientists will discuss recent advances.

This year more than 150 probiotic and prebiotic (fiber and nutrient containing microbes that feed probiotic bacteria) products have been introduced in the U.S., compared to 100 in 2006 and just 40 in 2005. Current studies of probiotics suggest they may be beneficial in treating gastroenteritis, diarrhea and some allergic skin reactions.

Diet, Exercise Decrease Risk of Breast Cancer

While science offers no guarantees, multiple research studies suggests you can lower your risk of getting breast cancer by taking a few simple defensive measures:

• Eat more fruits and veggies. Five servings (3 or more cups) daily are recommended. Plants contain substances that protect cells the from damage that can lead to cancer growth. Cruciferous vegetables like broccoli, cauliflower, brussels sprouts and cabbage contain particularly potent cancer fighters. So stock up next time you're at the store and Go Green to stay in the Pink!
• Eat less fat. Diets high in fat usually include more calories and cause weight gain. Studies on connections between fat and cancer have been inconclusive to date, but weight gain, particularly after menopause, is strongly associated with increased cancer risk.
• Drink less alcohol. The use of alcohol has been clearly linked to an increased risk of breast cancer. One drink a day increases your risk only slightly over non-drinkers, but risk escalates quickly as alcohol consumption increases. (Remember, one drink = 5 oz. wine, 12 oz. beer or 1 oz. liquor. Those giant margaritas you love at your favorite Mexican restaurant, each of those can count as 2 to 3 drinks!)
• Add soy. There are no definitive studies on the merits of soy as a cancer deterrent, but Asian women who eat soy all their lives have a significantly lower incidence of breast cancer. Researchers suspect that benefits are greater if soy is a part of your diet from a young age, as opposed to being added to your diet after menopause. At any rate, soy is a healthy food, so it sure can't hurt to add it to your diet, and it might help.
• Exercise. There is growing evidence that regular exercise (30 minutes, 3 times or more a week) reduces breast cancer risk. In fact, exercise is a crucial element of good health and can significantly reduce your risk of other diseases such as heart attack, stroke and diabetes. One thing to remember, it's cumulative exercise time that counts. Ten minutes three times a day is just as good as 30 minutes once a day. So get out there and get moving!
• Enjoy your coffee. Thank heavens caffeine doesn't increase your risk of breast cancer. So you don't have to feel guilty when you sit down with that well-earned cup of java after a day of healthy eating and exercise.

Noninvasive X-ray Exam Could Replace Colonoscopy

When you reach 50 (and sometimes sooner), doctors want to do all kinds of invasive things to your body. Sure, it keeps you safe and healthy and it's the smart thing to do, but that doesn't make it any more pleasant when you're lying on a cold, hard exam table in one of those drafty paper gowns.

For many people, the annual colonoscopy to check for polyps and colon cancer is one of the least pleasant exams required. Those dreaded scope exams may soon be replaced by a noninvasive x-ray called a virtual colonoscopy or CT colonography.

Two fairly large studies have both shown that as a diagnostic tool the experimental x-ray technique is as accurate in detecting potentially cancerous growths as the invasive scope exam -- and it's faster and cheaper. The x-ray exam can determine which patients require a colonoscopy for polyp removal. In one study only 8% of the participants required a follow-up colonoscopy.

Unfortunately, x-ray exams still require the patient to drink laxatives to purge the bowel so growths can be seen. For many of us, that's the worst part! This is a test you don't want to avoid though. Colon cancer is the second-leading cause of cancer deaths in America. An estimated 52,000 people will die of colon cancer this year.

Colon exams are recommended every 10 years beginning at age 50, more often if polyps are found. The new x-ray exams are already being offered by some hospitals and cost about $1200, less than half the cost of a traditional colonoscopy which generally runs about $3300 (most insurers pay 40%). Still considered experimental, the x-ray technique is not covered by many insurance companies. That is expected to change once the technique is endorsed by cancer screening guidelines.

Cancer Breakthroughs for Women

A diagnosis of cancer is not the death-knell it was in our parents' day, but it is still the second leading cause of death in women. Only heart disease is more deadly. This year 680,000 women will be diagnosed with cancer and 270,000 will die. The 10 most common types of cancer in women are:

1. Breast
2. Lung
3. Colon/rectum
4. Uterus/cervix
5. Urinary tract
6. Lymphoma
7. Melanoma
8. Thyroid
9. Ovary
10. Leukemia

Today there is plenty of hope on the horizon. Five-year survival rates are up significantly. Nearly 90% of the women who contract breast cancer are still alive five years after diagnosis. The survival rate for uterine/cervical cancer is 73%; 66% for kidney cancer and 65% for colon cancer.

There are many proactive steps you can take to minimize your risk of contracting cancer. Prevention magazine suggests nine ways to combat cancer.

1. Get the new vaccine Gardasil to protect yourself from cervical cancer. Currently approved for women age 9 to 26, clinical trails are now being conducted to determine effectiveness on older women. Drug companies soon hope to gain FDA approval to vaccinate women up to age 55.
2. Avoid hormone replacement therapy (HRT) when you can or use the lowest dose possible. Research has proved a direct link between HRT and breast cancer.
3. Get plenty of vitamin D. Numerous studies indicate that vitamin
   D fights cancer, possibly cutting the risk of getting any cancer by 60%. Two to three times a week for 5 to 15 minutes spend time in the sunshine without sunscreen. The short exposure shouldn't increase your risk of skin cancer doctors say. But if you're concerned, take your vitamin D in tablet form. Researchers recommend 1,100 IU per day.
4. Use chemotherapy only when truly necessary. A new tool called Oncotype DX tests tumor genes to predict whether a breast cancer patient will benefit from chemo in addition to hormone therapy. A test by Loyola University Health System found 23% of women who would have been recommended for chemotherapy didn't need it.
5. DNA researchers are discovering more genes that increase cancer susceptibility. In the not too distant future, they expect to develop tests that will determine an individual's amount of cancer risk.
6. Use drugs that target your cancer. Herceptin reduces breast cancer recurrence rates by an amazing 50% for HER-2 positive cancer. The drug uses an antibody to seek out and destroy HER-2 cancer cells. The FDA has just approved the treatment for all HER-2 positive cancer, not just breast cancer.
7. Lung cancer kills more women than any other cancer. The 5-year survival rate is only 16%. New, less-invasive surgery techniques make treatment easier and recovery faster. Video-assisted thoracoscopic (VATS) surgery requires only a small incision between the ribs and sends you home in about 3 days.
8. Learn to identify possible ovarian cancer symptoms: pelvic pain, prolonged bloating, urinary problems, loss of appetite or feeling full quickly. Women who experience these symptoms probably don't have cancer, but it pays to be proactive, so see your doctor promptly. More women die from ovarian cancer because it is discovered too late. A simple blood test for the protein CA-125 can detect the presence of cancer.
9. Ask about new radiation treatments. Many women choose to have a mastectomy instead of the less drastic lumpectomy to avoid radiation treatments. Typically, treatments are given for five days a week for five weeks. A new study shows three weeks of radiation is enough to get the job done. A five-day radiation treatment using temporary insertion of radioactive pellets at the tumor site is also being studied.

Warning Signs of Ovarian Cancer May Save Lives

Cancer experts have identified a set of symptoms that may indicate ovarian cancer. Women who experience these symptoms are urged to contact their doctor. This is the first time the medical community has recognized that the disease may cause symptoms in its early stages in some women. Ovarian cancer has long been seen as a silent killer, exhibiting no symptoms until the disease was extremely advanced.

If you experience any of these symptoms daily for two to three weeks, contact your doctor:

• bloating
• pelvic or abdominal pain
• difficulty eating or feeling full quickly
• frequent or urgent need to urinate

This year 22,430 new cases of ovarian cancer and 15,280 deaths are expected in the US. It is hoped that recognition of the symptoms will lead to earlier diagnosis and save lives. If you experience the above symptoms, don't panic, but do call your doctor. It may not be cancer as other problems exhibit the same symptoms. In fact, my niece experienced these symptoms and after a stress-filled week of tests and doctor visits was diagnosed with a benign ovarian cyst (thank heavens). Better safe than sorry.

Genetic Research Holds Hope for Pancreatic Cancer Patients

There is hope on the horizon for pancreatic cancer patients. A particularly deadly cancer, patients generally die within two years. New research by Ohio State University scientists has revealed tiny genes that may lead to better ways of treating pancreatic cancer.

Called microRNAs, the genes take on a different look in a cancerous pancreas when compared to a healthy organ. In addition to developing treatment protocols, it is hoped that further research will enable physicians to more accurately predict how long a cancer patient will live.

The findings are preliminary and more study is needed, but treatment "is not decades away, but probably years away," said Dr. Mark Bloomston, the OSU surgeon leading the study.

In the US this year more than 33,000 people will die of pancreatic cancer and 37,00 new cases will be diagnosed, according to the American Cancer Society. Genetic research is on the cutting edge of new approaches to understanding and treating cancer and holds great hope for the future.