Cancer Helper

Regular, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against the development of actinic keratosis, a precancerous skin condition caused by long-term exposure to the sun, and squamous cell cancers (SCC) of the skin, according to a study conducted in subtropical Queensland, Australia.

Co-author Dr. David Whiteman, of the Queensland Institute of Medical Research in Brisbane, said he was not particularly surprised by the findings, noting that “previous findings from animal studies, from molecular studies of human skin cancers and findings from studies of other human…cancers all suggested that aspirin and NSAIDs may be negatively associated with risk of SCC of the skin. Our study was therefore designed to specifically test this hypothesis.”

The study, reported in the Journal of the American Academy of Dermatology, involved 86 individuals with SCC and 187 “control” subjects of the same age and sex who were randomly selected from the community.

The important findings, according to Whiteman, were that use of aspirin or NSAIDS, which include drugs like ibuprofen and naproxen, more than two times per week for more than five years was associated with about a 60-percent reduction in the risk of SCC of the skin. In addition, among subjects without SCC, current regular NSAIDs users had significantly lower counts of actinic keratoses than nonusers.

Whiteman stressed that these results require confirmation in other studies before any change to clinical practice could be advocated. “In particular, a randomized trial is required to definitively answer the question as to whether our observation reflects a real protective effect of NSAIDs, or whether the effect is due to other confounding factors,” he said.

“Perhaps in the future, there may be subgroups in the population at very high risk of skin cancer who might be advised to take NSAIDs to reduce their risk of skin cancer, Whiteman said.

However, the skin cancer prevention message is not altered by the current findings, Whiteman said. The prevention message used in Australia is: Stay out of the sun and Slip! Slop! Slap! (i.e., slip on a shirt, slop on sunscreen, and slap on a hat).”

Source: Journal of the American Academy of Dermatology, December 2005.

Betel quid chewing is a strong independent risk factor for pharyngeal cancer (cancer of the back of the throat), but not laryngeal cancer (cancer of the voice box), according to findings published in the International Journal of Cancer.

Chewing betel quid, which consists of betel leaf from the Piper betle vine, is popular in many parts of Asia. Betel quid is chewed for its stimulant effects, to satisfy hunger and as a social and cultural practice.

“The risks of betel quid chewing with or without tobacco, alcohol drinking and cigarette smoking have been well explored in the oral cavity but not in the pharynx and larynx,” Dr. Ying-Chin Ko, of National Health Research Institutes, Taiwan, and colleagues write.

The investigators therefore examined 148 men with pharyngeal cancer, 128 men with laryngeal cancer, and 255 men without either cancer who served as “controls.”

Betel quid chewing was significantly and independently associated with the risk of pharyngeal cancer, increasing the risk by nearly eight-fold. However, no significant association was observed between betel quid chewing and laryngeal cancer.

Those who consumed more than 20 quid a day or swallowed the betel quid juice had an even high risk — the investigators observed a synergistic effect of these risk factors for both pharyngeal and laryngeal cancer.

The quantity of exposure and the direct contact of the carcinogen to the mucus membrane appear to enhance the carcinogenic process, Ko and colleagues suggest. “Further studies to explore the associations between betel quid chewing and cancers of other sites of the digestive tract, for example, the esophagus and stomach, and the effects on other systems of humans are necessary.”

Source: International Journal of Cancer, December 2005.

Elevated blood levels of insulin do more than increase diabetes risk, they may also increase odds for pancreatic cancer.

New research found that male smokers with the highest post-fasting blood insulin levels had double the risk of pancreatic tumors.

“We had known that there was a pretty consistent association between diabetes and glucose intolerance and pancreatic cancer, but the reason for that association has been somewhat controversial,” explained study author Rachael Stolzenberg-Solomon, an investigator in the nutritional epidemiology branch at the National Cancer Institute. “Some people feel that diabetes is a risk factor for pancreatic cancer, while some clinicians think some cases of diabetes are the result of latent pancreatic cancer.”

This study’s findings, said Stolzenberg-Solomon, support the hypothesis that the high levels of insulin that occur during the early stages of diabetes may promote the growth of pancreatic cancer cells.

The findings appear in the Dec. 14 issue of the Journal of the American Medical Association.

More than 32,000 Americans will be diagnosed with pancreatic cancer this year and most will die because the disease is usually detected far too late, according to the American Cancer Society (ACS). Cigarette smoking is responsible for almost one in three cases of pancreatic cancer, according to the ACS.

Because many pancreatic cancers aren’t found until the later stages of the disease, the prognosis for this type of cancer is grim. Five-year survival rates range between 4 percent and 15 percent, depending on how far the disease has spread at the time of diagnosis.

The current research culled data from a large Finnish study on more than 29,000 male smokers aged between 50 and 69 years at the start of the study. From the pool of 29,000, the researchers found 169 cases of pancreatic cancer that occurred after the fifth year of follow-up.

One reason the researchers only looked at cancers that occurred after five years of follow-up was to better assess if early diabetes might be contributing to the cancer. They could assess this because they had blood samples from each man to measure glucose and insulin levels.

The researchers also randomly selected 400 men from the larger sample to act as controls.

Men with the highest levels of insulin in their blood and men with clinically diagnosed diabetes had double the risk of pancreatic cancer, compared to men with low levels of insulin and no history of diabetes. “This is the first study to show that insulin levels are increased with the risk of pancreatic cancer,” said Eric Jacobs, a senior epidemiologist for the American Cancer Society.

Jacobs was quick to point out, however, that insulin injected for the treatment of diabetes is not being implicated as a risk factor for pancreatic cancer in this study.

The suspected mechanism behind the increase in risk is that “pancreatic cells are exposed to a lot of insulin because insulin is produced in the pancreas. People with diabetes inject insulin into other locations, so the pancreatic cells aren??掳 exposed to as much insulin,” Jacobs explained. Both Stolzenberg-Solomon and Jacobs said that this study??? findings likely apply to women and nonsmokers as well.

The findings suggest that increasing levels of physical activity might help prevent pancreatic cancer, along with reducing your risk of diabetes and other serious illnesses, according to Jacobs.

“Exercising more can help reduce levels of insulin,” said Jacobs. “While our study needs to be confirmed, it has potentially important implications for nutrition and pancreatic cancer prevention strategies,” said Stolzenberg-Solomon.

“Lose weight, increase your physical activity and maybe make other changes to your diet, like eat less saturated fat. These changes impact other cancers and other chronic disease,” she said.

The U.S. government is starting one of the largest genetic research projects in history: the categorization of all genes involved in cancer.

The Cancer Genome Atlas, with a total final cost of at least $1 billion, will sort all of the hundreds of genes involved in turning healthy cells into carcinomas, potentially leading to more effective treatments, The Washington Post reported.

The National Cancer Institute will contribute half the cost of the $200 million pilot project, with the National Human Genome Research Institute funding the other half, the New York Times said.

By identifying all of the genetic errors that allow carcinomas to develop, scientists hope to be able to classify every cancer and identify which drugs will work and which ones will not, the Post said.

‘The future will look no more like the past than a butterfly resembles a caterpillar,’ NCI Director Andrew von Eschenbach told reporters, adding he sees cancer devolving soon from a killer disease to a ‘chronic, manageable condition.’

A new study has cast doubt on the belief that a high-fibre diet reduces the risk of bowel cancer.

While many people tuck into fibre-rich breakfast cereals in a bid to avoid cancer, scientific evidence of a preventative effect has been mixed.

So in an effort to tackle this uncertainty, a team from Harvard Medical School analysed 13 studies involving a total of more than 725,000 people.

There were 8,000 cases of cancer identified, but there appeared to be no correlation between the risk of developing the disease and eating high-fibre foods such as cereals, fruits, and vegetables.

‘Although high dietary fibre intake may not have a major effect on the risk of colorectal cancer, a diet high in dietary fibre from whole plant foods can be advised because this has been related to lower risks of other chronic conditions such as heart disease and diabetes,’ write the researchers, led by Dr Yikyung Park.

The team reports in the Journal of the American Medical Association (JAMA) that earlier contradictory studies yielded contrasting results depending on how evidence was collected.

Those that asked both healthy people and patients with bowel cancer to report on their diets in retrospect seemed to reveal a link between high-fibre diets and a reduced cancer risk.

But studies that recorded people’s diets from the outset and then waited to see who developed the disease did not find a link.

However, the JAMA study has not succeeded in entirely dismissing the argument that chewing through high-fibre food is beneficial.

Factors related to lifestyle and demographics may actually affect the reliability of prostate cancer screening according to research by Seattle-based Fred Hutchinson Cancer Research Center.

The study, appearing in the online version of the journal Cancer, shows that changes in concentration of prostrate specific antigen (PSA) otherwise known as PSA velocity is affected by factors like race, age or diet. Such PSA levels could easily be misinterpreted as signs of cancer.

Reviewing data on PSA and PSA velocity pertaining to 3,341 cancer-free menthe researchers found a relationship between PSA test results and specific lifestyle or demographic factors. Despite age and body mass index (BMI) being statistically significant, they had little influence in the interpretation of PSA test results.

The study found that PSA velocity decreased with aging in men and increased as their diets became richer with high calorie foods. Also PSA velocity in blacks was found to be twice as that of whites on an average and those who used high-dose calcium supplements had lower PSA values. Men who gained weight also enjoyed PSA results while those who lost weight had higher PSA results. These factors seemed to work in a manner to affect the end values of the test, making clinical interpretation of PSA velocity difficult if not biased.

Dr. Alan Kristal, lead scientist in the study opined that reliance on the PSA velocity tests could cause unnecessary biopsies besides trauma for many. Kristal said, “This is not going to be the solution. It’s not going to save the whole screening process from the problems of PSA”. The PSA velocity test was developed in an effort to improve the reliability of the commonly used PSA test that is known to have its drawbacks.

The most lethal cancer in men, prostate cancer has over 232000 new cases reported every year in the United States alone, one percent of whom will die as a result. Experts believe that annual prostate-cancer screenings from the age of 50 may help reduce the fatalities by early detection and treatment. The current methods of screening available include a rectal exam besides a PSA test that identifies from the concentration of antigen in the bloodstream.

However, several studies have questioned the reliability of PSA. One recent study done by “The Hutch” in 2004 showed that nearly 3 out of 20 men between 62 and 91 years with normal PSA tests were later diagnosed with prostate cancer. At that point in time some physicians believed that PSA velocity tests provided better reliability. Give that PSA values were affected by aging they believed that PSA readings over time could point out to increases that were abnormal. The new study by Kristal and his team now points to there being multiple factors that affect the PSA velocity and the difficulty in interpreting which factor affected the test results.

This difficulty in interpreting PSA tests is exactly what 63-year old Melvyn Raider has experienced. Raider thought that doing the tests could catch a cancer early and began doing them in his 50s. Raider with three abnormal tests in five years underwent biopsies three times as a result extracting four, eight and finally 14 samples. Raider who teaches at Wayne State University said, “There’s probably not much prostate left after all those samples”. With the biopsies yielding negative results for malignancy Raider says, “I’m out of the woods for a while. But if this same pattern continues, I’ll be back where I started”.

For years, Americans have been dutifully eating fiber ??鈥?lots and lots of fiber ??鈥?in the belief that it might protect them from a leading killer: colon cancer.

But now new data shows that while fiber-rich foods are healthy, there is no evidence to prove they prevent colon cancer, CBS News medical correspondent Elizabeth Kaledin reports.

“We have no diet at the present time that we can categorically say it will prevent cancer,” says Dr. Moshe Shike of the Memorial Sloan-Kettering Cancer Center.

The study is significant because it looked at the diets of a huge number of people ??鈥?725,628 men and women.

Among them, there were 8,081 cases of colorectal cancer, leading researchers to conclude dietary fiber was not protective.

But besides the numbers, there’s a bigger lesson to be learned according to Shike, a gastroenterologist.

He believes Americans are under the illusion that one healthy food or behavior can undo other poor health habits.

Fiber has been on the list of “rescue” foods for a long time, but Shike warns, “There is not one vegetable, there is not one chemical or phytochemical.”

“The message is that we need to adopt an overall healthy diet,” he says.

Fiber is part of a healthy diet. Guidelines suggest we eat 25 to 30 grams a day. An apple is about 5 grams. A cup of baked beans is 19.

But right now the only thing known to prevent colon cancer is that colonoscopy. And that is the problem because only about 40 percent of Americans get a regular colonoscopy.

If you’re 50 or over, the recommendation is that you have one every few years. So, Kaledin concludes, it seems most people think eating a big bowl of cereal is a lot easier and just as healthy ??鈥?they would be wrong about that.

Drinking two or more cups of tea per day may dramatically cut the risk of ovarian cancer, a Swedish study of more than 61,000 women has found.

The findings by researchers at the Karolinska Institute in Stockholm were based on a look back at the habits and long-term health of the women, according to the report published in the Archives of Internal Medicine yesterday.

Of the women recruited for the study that began in 1987, two-thirds reported drinking tea. When it concluded at the end of 2004, 301 participants had developed ovarian cancer, a particularly deadly form of the disease.

“We observed a 46 per cent lower risk of ovarian cancer in women who drank two or more cups of tea per day compared with non-drinkers,” study authors Susanna Larsson and Alicja Wolk wrote.

“Each additional cup of tea per day was associated with an 18 per cent lower risk of ovarian cancer.”

Black and green teas are believed to contain antioxidants that help ward off the cell mutation that leads to cancer. The researchers cautioned that additional studies were needed to confirm their findings.

Ovarian cancer will be diagnosed in about 22,000 United States women this year and 80 per cent of cases are not detected till the cancer has spread. That means more than 16,000 US women will die of ovarian cancer in 2005, the American Cancer Society says.

Patients over 50 make up the bulk of those diagnosed with cancer. Yet these patients are often considered too old and frail for potentially lifesaving treatments such as bone-marrow transplants, says John Pagel, a blood cancer specialist at the Fred Hutchinson Cancer Research Center in Seattle.

“If we could get enough therapy into people, we could cure them,” says Pagel, who presented early results of experimental treatments Monday at the annual meeting of the American Society of Hematology in Atlanta.

Pagel and others are experimenting with methods that “target” cancer cells more precisely. His team focused on patients 50 and older who had either acute myeloid leukemia or high-risk myelodysplastic syndrome, a condition that often leads to cancer. Other Seattle researchers presented a study of patients over 60 with lymphoma, a cancer of the lymph nodes.

Instead of exposing the body to a wide beam of radiation, which can injure vital organs, scientists in each case attached radioactive particles to man-made versions of immune system proteins called antibodies, says Ajay Gopal of the University of Washington in Seattle. The antibodies were engineered to stick only to the types of white blood cells that are afflicted by these cancers.

That brings radiation directly to tumor cells but mostly spares other parts of the body, Gopal says.

Because doctors targeted cancerous tissue, they were able to give much stronger doses, Gopal says. In his study, 56% of patients are alive after three years. In Pagel’s study, about 55% are alive after about 10 months. Without treatment, all of the patients were expected to die from their disease, Pagel says.

Doctors didn’t compare the new treatments with other therapies, so they can’t say that the new strategies are superior, says Thomas Shea, director of bone-marrow transplantation at the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill, who did not work on the study. Although larger studies are needed to confirm the findings, Shea says, they are encouraging. “Not only can older patients tolerate these treatments well, but they had a good response.”

Federal health officials Tuesday launched the biggest genetic research project since the landmark mapping of the human genome–an ambitious effort to categorize all the hundreds of molecular glitches that turn normal healthy cells into cancers.

The Cancer Genome Atlas, whose total cost could reach $1 billion or more, will for the first time direct the full force of sophisticated genetic technologies to the thorough understanding of a single disease, one that eventually strikes nearly half of all Americans.

Leaders of the National Institutes of Health, which will administer the project through grants and contracts, predicted it would revolutionize the diagnosis, treatment and prevention of cancer, which will kill 564,000 Americans this year.

NIH’s National Human Genome Research Institute and the National Cancer Institute will provide $100 million for a three-year pilot project to test the project’s feasibility.