High-dose Senna effectively used as a preparation for colonoscopy.

Gastroenterologists in Italy compared senna tablets to conventional PEG lavage as a preparation for screening colonoscopy.  They rated overall colon cleansing, cleansing of the right colon, safety, and patient acceptance in a randomized study reported in the December issue American Journal of Gastroenterology.

Outpatients who had been referred for elective colonoscopy were randomly prescribed either 24 tablets of 12 mg. senna, taken in two doses on the day prior to colonoscopy or standard 4 liter polyethylene glycol-electrolyte solution (PEG-ES).

The gastroenterologist who performed the colonoscopy did not know which preparation the individual patient had used and evaluated the quality of colon cleansing.  Patients answered questions about tolerance, discomfort, adverse events, and their ability to complete the entire preparation.

The quality of colon cleansing, overall tolerance of the prep technique, and compliance were significantly better with the senna group. 

• overall cleansing was excellent or goo in 90.6% of senna patients compared to 79.7% of PEG-ES.
• 7.3% of PEG-ES patients had to be rescheduled for another colonoscopy because of insufficient cleansing compared to 2.8% of those using senna.
• incidence of adverse events was similar in the two groups, but patients receiving senna had significantly less nausea and vomiting, although they reported more abdominal pain.

The study team, headed by Franco Radaelli, M.D.concluded:

An oral high dose of senna is a valid alternative to standard PEG-ES for outpatient colonoscopy preparation.

Posted by Kate Murphy on December 21st, 2005
Posted in: Research & Treatment News | No Comments »

Senate Likely to Vote on H.R. 3010 Tomorrow

Friday last week I wrote my two Senators (Lincoln and Pryor) to express my opposition to the conference report on H.R. 3010 which is the fiscal year 2006 Labor, Health and Human Services, and Education (Labor-HHS) Appropriations Bill. It does not adequately fund National Institutes of Health, National Cancer Institute, and Centers for Disease Control and Prevention (CDC) cancer programs.

Today I received an email from the health legislative assistant (health LA) to Senator Lincoln. Here is what the health LA said:

It’s good to hear from you. Sen. Lincoln is deeply disappointed in the conference report and plans to oppose it. It is likely that this will come up for a vote tomorrow. We appreciate hearing from you!

Some thoughts on this:

I’m glad the Senator is dissappointed in the conference report but I am espcially glad she plans to oppose it. It is easy to say your are dissappointed in legislation. More than her words of opposition I want her nay vote when the conference report comes to the Senate floor.

Since it looks like this will come up for a vote Wednesday, December 21 there is very little time left for constituents opposing H.R. 3010 to tell their Senators to vote against it. The Senate convines at 9 AM eastern (8 AM central, 7 AM mountian, 6 AM pacific) so if you want to make one last call you need to do it shortly after 9 AM eastern.

You can dial (202) 224-3121 which is the U.S. Senate switchboard. Tell the operator the name of your Senator and you will be connected. When the Senator’s office answers the phone tell them you have a message for your Senator reguarding the H.R. 3010 conference report (aka Fiscal Year 2006 Labor-HHS Apprproations Bill).

Say you want the Senator to vote no because the bill provides inadequate funding for NIH, NCI and CDC cancer programs. You need to tell them your name and address so the office will know you are a constituent.

The words “We appreciate hearing from you!” are not just a nice closing to the email. Our elected officials really do appreciate hearing from us constituents. This is especially so when we tell them what issue we are interested in, our link to the issue and exactly what we want the official to do.

Posted by Dusty Weaver on December 20th, 2005
Posted in: Policy & Advocacy News | No Comments »

Blood DNA screening test for colon cancer being developed

In a press release on December 19, 2005, [Epigenomics](http://www.epigenomics.com/en/Company/), a Berlin-based company, released results from three large clinical studies that demonstrated a positive correlation between changes in DNA in a blood test and colorectal cancer. Epigenomics is developing diagnostic tools that build on the relationship between DNA methylation and cancer.

Using an ordinary blood draw, the test detects abnormal patterns in methyl *tags* on the DNA of key genes that affect how cells divide. In cancer, very frequent increases or decreases in DNA methylation contribute to unchecked growth of cells into tumors.

In three independent studies, the molecular test developed by Epigenomics showed sensitivity of 51%, 65%, and 50% in identifying blood from people with colorectal cancer. The test was also highly specific — there were almost no false positive readings in blood from people who did not have cancer. Importantly, there was no difference in the stage of cancer. The test was as sensitive for early cancers as for more advanced ones. The test also identified colorectal cancers despite their location.

The new process studied blood samples from 600 colorectal cancer patients in all stages of the disease, 600 patients with medical conditions that might confuse test results, and 600 normal controls who had all had colonoscopy and were cancer-free.

While not as sensitive as colonoscopy, the new test is more sensitive and more specific than *fecal occult blood testing (FOBT)* which is used for screening large groups of people for colorectal cancer by searching for hidden blood in stool.

In their press releast, the company wrote:

Epigenomics believes that this diagnostic, which works by interpreting changes in DNA methylation, has the potential to support large-scale, general population colorectal cancer screening since early detection of colorectal cancer significantly improves treatment outcome. The test targets asymptomatic men and women over the age of 50 who are recommended to take an early detection test for colorectal cancer on a regular basis.

The current test is based on a single marker. The company believes that additional markers may make it more sensitive and that standardizing the way blood samples are handled may also improve it.

Epigenomics is working in collaboration with Roche Diagnostics to develop and market the blood test.

Additional information about the test is in the *Seattle Times* and the *Houston Chronicle*. Epigenomics has a subsidary in Seattle.

Posted by Kate Murphy on December 19th, 2005
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Analysis of 13 studies shows no correlation between high or low fiber diets and colorectal cancer

Although previous studies of fiber in diet and colorectal cancer have been inconsistent, when scientists pooled study results and adjusted for other known colorectal cancer risk factors, they found that eating large amount of high-fiber food did not reduce the chance of getting colorectal cancer.

In an analysis reported in the [December 14, 2005 issue of the *Journal of the American Medical Association*](http://jama.ama-assn.org/cgi/content/full/294/22/2849) the **Pooling Project** combined results of 13 prospective studies of diet and cancer. Follow-up varied from 6 to 20 years for individual studies. During that time 8,081 cases of colorectal cancer were found among participants.

Initially, the combined studies showed a 16% reduction in risk for colorectal cancer between the people who ate the most fiber and those who ate the least. This reduction remained steady when the researchers adjusted for *known colorectal risk factors* such as physical activity, family history, age, body mass index (BMI), smoking, and total daily calories. The analysis also included use of hormone replacement therapy, contraceptives, and daily multivitamins.

In a second analysis, *dietary folate* was added to the first group of colorectal cancer risk factors, and the relationship between high and low fiber diets weakened somewhat.

Finally, the statisticians added diets high in *red meat, total milk consumption, and alcohol use* to their analyses and found only a weak, not statistically significant, relationship between dietary fiber and colorectal cancer.

When the team looked at the effect of dietary fiber on individual risk factors such as age, smoking, body mass index, use of alcohol, or red meat consumption, they also found no difference in risk for colorectal cancer.

Fiber in European diets most often came from grains, while fruits and vegetables were more common in North America. However, there was no difference in risks based on fiber intake between Europeans and North Americans.

Although the research did not find a relationship between dietary fiber and colorectal cancer, in their conclusion, the Pooling Project team reminded consumers that fiber has been shown to reduce the risk of heart disease and diabetes and is still important in choosing foods.

In conclusion, we did not find support for a linear inverse association between dietary fiber intake and risk of colorectal cancer in a pooled analysis of 13 prospective cohort studies. Although high dietary fiber intake may not have a major effect on the risk of colorectal cancer, a diet high in dietary fiber 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.

Posted by Kate Murphy on December 16th, 2005
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Two immune-stimulating hormones can be safely used together in cancer treatment

In a phase I trial, a research team at Ohio State University Cancer Center safely added interleukin-12 (IL-12), an immune system stimulating hormone, to interferon, another immune system protein, to treat cancers that were not responding to radiation or chemotherapy. The research included some patients with metastatic colorectal cancer.

In addition, using the two drugs in sequence enabled the doctors to use a lower dose of interferon, reducing its toxicity. Together the side effects of the two treatments were safe for patients.

William E. Carson III, M.D. led the study. He wrote,

“Our findings were encouraging. They indicate that we can safely administer IL-12 in combination with interferon, that it enhances the action of interferon in some patients with advanced cancer, and that it can be an effective way to stimulate the immune system.”

“We were initially concerned that the addition of IL-12 might increase that toxicity. Instead, we found that the two drugs can be used together without additional side effects.”

Gregory B. Lesinski, a researcher in the [Human Cancer Genetics Program](http://www.cancergenetics.med.ohio-state.edu/) at Ohio State wrote,

““We hope that the IL-12 will allow us to use lower doses of interferon in patients, which should result in fewer side effects and potentially a longer use of interferon, giving the immune system more time to fight the tumor.”

Results of the study were published in the [December 1, 2005 issue of the *Journal of Clinical Oncology.*](http://www.jco.org/cgi/content/abstract/23/34/8835)

Posted by Kate Murphy on December 12th, 2005
Posted in: Research & Treatment News | No Comments »