Obesity and lack of physical exercise increase risk of colorectal cancer death

Colorectal cancer patients who had little physical activity and excess abdominal fat  prior to their diagnosis were more likely to die of the disease.  A study of patients in Australia found that body fat, waist circumference, and exercise patterns were all related to risk of death from colorectal cancer.

Researchers reviewed information from nearly 42,000 people enrolled in the Melbourne Collaborative Cohort Study from 1990 through 1994.  When individuals entered the study, their body measurements and exercise activity were recorded.

Between 1994 and 2002, there were 526 cases of colorectal cancer in the cohort, including 181 deaths from the disease.  Analyzing the deaths 5 1/2 years after diagnosis and the information about body fat and exercise obtained at the beginning of the study, the research team found:

• Non-exercisers were 27% more likely to die of colorectal cancer.
• The greatest exercise impact was for stage II and III cancers, where exercise reduced the risk of death in half.
• Obesity increased the risk of death by 1/3, particularly when fat was located around the waist.

Dr. A.M.M. Hayden and colleagues at the Monash Medical School in Melbourne, Australia reported the results of their study in the January, 2006 issue of GUT. They concluded:

Increased central adiposity and a lack of regular physical activity prior to the diagnosis of colorectal cancer is associated with poorer overall and disease specific survival.

Posted by Kate Murphy on December 31st, 2005
Posted in: Research & Treatment News | No Comments »

Magnetic Resonance colonography effective finding cancers and polyps larger than 5 mm

German researchers compared dark lumen magnetic resonance imaging to conventional optical colonoscopy in 92 patients referred for a non-screening colonoscopy.  After standard pre-colonoscopy colon cleansing, patients received MR imaging followed immediately by colonoscopy.

47% of patients had normal conventional colonoscopies with no polyps found.  For the other 53%, there were 107 polyps discovered:  82 adenomas, 25 hyperplastic polyps, and 7 carcinomas.  MR colonography found all of the adenomas over 10 millimeters in size and 84% of those 6 to 9 millimeters.  On a per patient basis, MR colonography was 93% accurate (89% sensitive in finding polyps, 96% specific in not identifying false positive results) when polyps of all sizes were considered.

Patients were prepared for the MR test by having their colons filled with approximately 2 liters of tap water, and IV contrast was used.

Dirk Hartmann M.D. and his colleagues reported the results of their study online before print in Radiology, November 22, 2005.  They concluded,

 Dark-lumen MR colonography is a promising modality with high accuracy for detecting colorectal polyps larger than 5 mm in diameter.

Use of CT colonoscopy (so-called virtual colonoscopy) is controversial in Europe where questions of radiation concern both patients and environmental groups.  During the 2005 RSNA several papers addressed the use of dark lumen magnetic resonance colonography as a non-invasive alternative to both optical colonoscopy and CT-colonography. 

Posted by Kate Murphy on December 27th, 2005
Posted in: Research & Treatment News | No Comments »

Heartburn medications are risk factor for c. difficile infection

Heartburn medications that reduce stomach acidity may contribute to  Clostridium difficile infections that occur outside of hospitals. So-called community-acquired infections are much less common than those found in hospitals and appear to have a different pattern according to research in the December 21, 2005 issue of the Journal of the American Medical Association.

Researchers found that patients who were taking a proton pump inhibitor such as Nexium™, Prilosec™ or Protonix™ were three times more likely to have a C.difficile infection than study participants who were not.  H2–receptor antagonists including Tagamet™, Zantec™, and Pepcid™ doubled risk for C.difficile.  There was also a moderate increase in risk among patients taking NSAIDs — non-steroidal anti-inflammatory drugs.

Using a United Kingdom database, the research team found 1672 cases of C. difficile among patients registered in community practices.  Among them was a subset of patients with community-acquired infections.  Since C.difficile is ordinarily considered a hospital-acquired infection, it was a surprise that 70% of the patients had not been hospitalized in the year prior to their infection and 50% of them had not had antibiotic treatment within the past three months.  The patients with C.difficile were matched to controls in the practices without the disease.

The team concluded:

“The use of acid-suppressive therapy, particularly proton pump inhibitors, is associated with an increased risk of community-acquired C difficile. The unexpected increase in risk with non-steroidal anti-inflammatory drug use should be investigated further.”

In a news release from McGill University where the research was done, Dr. Sandra Dial said,

 ”We believe drugs that reduce gastric acidity provide a more hospitable environment within which C. difficile bacteria can colonize.”

Dr. Dial and the research team at McGill compared rates of community-acquired c.difficile in  the United Kingdom General Practice Research Database (GPRD over ten years.  In discussing the increased incidence, Dr. Dial said,

 ”In 1994 there was less than one C. difficile case per 100,000 people in the database, By 2004, this number had increased exponentially to 22 cases per 100,000”

Clostridium difficile, also known as C. difficile, is a bacterial microbe that can cause an infection of the bowel. The usual symptoms are diarrhea, fever and abdominal pain.  Careful hand washing is key to preventing its spread.

Proton pump inhibitors include:

•  Prilosec™ (omeprazole)
•  Prevacid™ (lansoprazole)
•  Aciphex™ (rabeprazole)   
•  Protonix™ (pantoprazole)
• Nexium™ (esomeprazole)

H2–receptor antagonists include:

• Tagamet™ (Cimetidine)
• Zantac™  (Ranitidine) 
• Pepcid™ (Famotidine)
• Axid™ (Nizatidine)

McGill University researchers have recently sequenced the genome of the antibiotic-resistant strain of C.difficile that has caused the epidemics of hospital-based intestinal infections in the United States and Canada.

Posted by Kate Murphy on December 26th, 2005
Posted in: Research & Treatment News | No Comments »

Season’s Greetings from Kate

In this season of light and joy, I wish all of you health, happiness, and something nice in your stocking.  Writing these posts has been a special blessing for me over the past few months, and I am thankful that C3 – Colorectal Cancer Coalition has made this space available.  I’m looking forward to the coming year with many new posts full of  more effective treatments and even better ways to ease the difficulties of living with colorectal cancer.

So much is on the horizon.  There is real hope that we can end the death and suffering from this disease.  Prevention is becoming a stronger possibility as screening methods improve and awareness that screening prevents colorectal cancer grows..  Treatment of early stage disease is making even more cures possible.  And survival times in advanced colorectal cancer has doubled with current therapy.

Enjoy the coming days.  Eat cookies, walk in the snow (or the sunshine), buy a bone for the dog, hug the children, sing even if you can’t carry a tune.  Tonight many candles on my mantle will be lit and shining for all of you.

Love from me and Santa.

Kate

Posted by Kate Murphy on December 24th, 2005
Posted in: Research & Treatment News | 3 Comments »

Senate Passes Labor-HHS FY2006 Appropriations Bill

Wednesday, December 21 the Senate passed by unanimous consent the Labor, Health and Human Services, Education and related agencies (Labor-HHS) Fiscal Year (FY) 2006 Appropriations Bill (HR 3010). This is the bill which provides funding for the National Institutes of Health (NIH), National Cancer Institutes (NCI), Center for Disease Control and Prevention (CDC) among other agencies of interest to the cancer community.

The bill increased the NIH budget by $253 million (0.89%) over FY 2005 making it one of the few agencies in the massive $142.5 billion Labor-HHS bill to receive an increase. This is well under the $1 billion increase in the original Senate version of the bill and conderably less than the $1.7 billion increase recommended by One Voice Against Cancer.

While we are fortunate NIH received an increase, albeit at an unacceptable one, Congress also approved a one percent across-the-board cut to all discretionary domestic programs. This will wipe out the modest gain NIH received and turn the increase into a decrease.

Nancy Roach, President of C3, said this about the NIH funding in the Labor-HHS bill:

“The bottom line is that NIH is now facing its first cut in funding in more than 35 years. I don’t know when we will understand the specific impact of this action on NCI funding.”

While we must wait for specifics from NIH and other agencies on how this bill will impact their cancer-related programs an article published in the December 6, 2005 edition of the NCI Cancer Bulletin provides a hint at what will happen. Here is a quote from the article:

“In the interim, and as discussed at the NIH Director’s Advisory Committee meeting on December 1, noncompeting research grant awards will be made at a level of approximately 80 percent of the previously committed level. Upward adjustments to these levels will be considered after the final 2006 budget level is established. Competing renewal awards also are being made at approximately 80 percent of current levels until more definitive budget information is available. NCI leadership has advised that recipients continue to monitor their expenditures carefully during this period.”

While we do need to wait for official word from NIH it looks like there will be a 20 percent cut in the funding level of noncompeting research grant awards. One thing is for sure with the small increase removed by a larger across-the-board cut there will be less money for research and other activities.

While I am upset that Congress passed these funding levels I am perhaps more mad at the way the Senate did it. As I mentioned at the start of this post the Senate adopted the bill by unanimous consent. This is a procedure in which a motion can pass if no one present objects. This differs from a roll call vote when each Senator’s name is called and the Senator must say “yea” or “nay” on the motion.

Since the Senate passed the Labor-HHS approriations bill by unanimous consent there is no public record of whether or not each Senator supported or opposed the bill, thus we constituents have no way of knowing how our Senators would have voted. I want to know why the Senate did not go on record with this vote. I know time is short and they wanted to go home for the end-of-year recess but bills like this are too important not to go on record with a roll call vote.

Nancy ended her email with this:

“I watched this on CSPAN2 last night - not a very cheerful event. The only positive note is that it could have been much worse - the initial iterations included larger hard cuts to NIH. Constituent pressure made the difference, so thank you all for your efforts, and stay tuned for next year.”

Those of you who contacted your Senators and Representatives about the Labor-HHS Appropriations Bill did have an effect. It did not pass the House the first time through and was having a rough time in the Senate.

You made a difference one person at a time.

Posted by Dusty Weaver on December 22nd, 2005
Posted in: Policy & Advocacy News | 3 Comments »