Chlorhexidine mouthwash not recommended for chemotherapy mouth sores

Although daily use of a chlorhexidine mouthwash is sometimes recommended to prevent mouth sores (mucositis) caused by chemotherapy, a review of several studies reported in the European Journal of Cancer Care found the mouthwash no more effective than plain water or salt solution. In addition, patients complained of tooth discoloration and changes in taste after using it.

Nurse scientist C.M.J. Potting MSC, RN and colleagues at Radboud University Nijmegen Medical Center in the Netherlands concluded:

These results do not support the use of chlorhexidine mouthwash to prevent oral mucositis.

Potting et. al. European Journal of Cancer Care Volume 15, Number 5, December 2006, pp. 431-439

Posted by Kate Murphy on December 29th, 2006
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Obesity increases risk of recurrence and death after adjuvant treatment for colon cancer

Very obese patients are more likely to have their colon cancer return and to die of their disease according to a study published in the Journal of the National Cancer Institute.

Researchers from the National Surgical Adjuvant Breast and Bowel Project reviewed recurrences, new primary cancers, and deaths in stage II and III colon cancer patients who were treated with chemotherapy in NSABP clinical trials between 1989 and 1994. The study team followed patients for a median of 11 years after adjuvant treatment.

When they compared patients who were very obese (BMI at least 35 kg/m²) to those with normal body mass index, they found the very obese had a

• 40% greater chance of having their colon cancer return or having a second primary cancer
• 30% greater chance of dying, most often from colon cancer

Underweight patients, who had a BMI less than normal, were more than twice as likely to die during the follow-up period, but most of these deaths were from causes other than colon cancer.

James J. Dignam, PhD, and his colleagues concluded:

Among colon cancer patients, a BMI greater than 35.0 kg/m² at diagnosis was associated with an increased risk for recurrence of and death from colon cancer. Further studies are needed to determine pathways between obesity and recurrence risk and whether weight reduction or related interventions would improve prognosis. 

Dignam et. al. Journal of the National Cancer Institute, Vol. 98, No. 22, 1647-1654, November 15, 2006

Posted by Kate Murphy on December 28th, 2006
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As 2006 draws to a close, the fight for 2007 funding goes on….

Cancer funding at the Federal level has been flat in recent years. In other words, the actual dollar amount allocated to the National Cancer Institute (for cancer research) and Centers for Disease Control (for cancer control programs) hasn’t gone up or down in any significant way. However, when you factor in inflation, this actually means that cancer funding has been decreasing. As put by NCI Director Dr. Niederhuber in a recent meeting of the National Cancer Advisory Board:

“…because of the higher inflation index for biomedical research, flat budgets represent an actual 3 to 5.5 percent decrease (about $150M) in the operating budgets….”

To avoid this inflationary cut, the Senate voted in favor of an amendment offered by Senators Specter (R-PA) and Harkin (D-IA) which would put back $7 billion into the appropriation for Labor-HHS-Education, above President Bush’s budget request. You may remember that it’s Labor-HHS-Education that funds the National Cancer Institute.

Unfortunately for us, the 109th Congress went home for holiday break without completing the Labor-HHS-Education Appropriation bill, as Dusty talked about last week. To keep the federal government running, Congress passed what is called a Continuing Resolution (CR) which keeps the funding for 2007 at levels that were passed for 2006. This CR expires in mid-February 2007. It wasn’t a perfect solution, but at least the government is still running…for now.

In mid-December we got word from the incoming Democratic leadership that they weren’t going to try to get the funding bills passed AT ALL for FY07. They were just going to extend the CR through until the end of FY07. And just deal with figuring out funding for FY08. This is not good news.

But there is one ray of hope. The Democrats who oversee the committee that decides funding for things like cancer research have stipulated that the Congress may adjust some departments funding levels and “earmarks” based on the demonstration of “urgent need.” C3 sympathizes with this dilemma, but we are quite certain that cancer research, screening and education programs are a most “urgent need.”

We have joined with our partners at One Voice Against Cancer and other health-related organizations to make sure Congress sees our point of view. We have to be prepared yet again for a tough fight to fund colorectal cancer research and programs when 2007 rolls around. Be sure to sign up as a One Minute Advocate because we might be calling on you to help us in this effort.

In the meantime, allow me to extend my heartfelt wishes to you and all those you love for a truly joyous holiday season.

Posted by Carlea Bauman on December 21st, 2006
Posted in: Policy & Advocacy News | No Comments »

Medicare funding for screening colonoscopy increased early detection of colon cancer

Since Medicare approved coverage for screening colonoscopies, there has been

• a significant increase in the rate of colonoscopies in the Medicare population
• an increased possibility of being diagnosed with colorectal cancer at an early, highly curable stage I

Medicare began to provide reimbursement for people at high risk of colorectal cancer in 1998 and expanded coverage to everyone on Medicare in July of 2001. 

Researchers at the Yale University School of Medicine reviewed SEER (Surveillance, Epidemiology, and End Results) information for patients diagnosed with colon cancer between 1992 and 2002.  They also looked at a group of Medicare-eligible patients in the database who did not have colon cancer.  They examined rates of colonoscopy screening and stage at diagnosis for three periods of time:

• Period 1 –  no coverage (1992 to 1997)
• Period 2 — limited coverage (January 1998 - June 2001)
• Period 3 — full coverage (July 2001 - December 2002)

They found increasing rates of colonoscopy screening for people eligible for Medicare.  Rates tripled between the period when there was no coverage  and doubled again when reimbursement was extended to all patients.

• Period 1 — 285 colonoscopies/100,000 eligible people
• Period 2 –  889/100,000
• Period 3 — 1919/100,000

Separating people diagnosed with colon cancer into two groups:  early stage (stage 1) and all other stages (stages II-IV), they found an increasing percentage of patients diagnosed at an early stage.

• Period 1 — 22.5% of cancers were found at an early stage
• Period 2 — 25.5%
• Period 3 — 26.3%

The strongest association with early diagnosis was found in patients whose cancers were in the proximal colon (the first section of colon farthest from the rectum).  There was a very small association for distal tumors on the left side of the body.

Dr. Cary Gross and colleagues reported their results in the December 20, 2006 issue of the Journal of the American Medical Association.  They concluded,

Expansion of Medicare reimbursement to cover colon cancer screening was associated with an increased use of colonoscopy for Medicare beneficiaries, and for those who were diagnosed with colon cancer, an increased probability of being diagnosed at an early stage. The selective effect of the coverage change on proximal colon lesions suggests that increased use of whole-colon screening modalities such as colonoscopy may have played a pivotal role.

Gross et. al. JAMA. 2006;296:2815-2822

The Centers for Disease Control (CDC) has a fact sheet on colorectal cancer screening for people receiving Medicare.

Posted by Kate Murphy on December 20th, 2006
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People Living with Cancer December Bulletin

People Living with Cancer (PLWC) has published a new bulletin for December 2006.

Besides links to current cancer news, the PLWC Bulletin includes additions to the Patients Toolbox.  Of particular interest to people affect by colorectal cancer are:

• Colonoscopy — What to Expect
• Biopsy — What to Expect
• A listing of Telephone and E-Mail Cancer Helplines
• An updated article on Obesity and Cancer

Reader’s questions will be answered through December 31 in the Ask the Experts Series.  This month’s focus is Tips to Cope with Cancer Treatment.

The December Bulletin also has a link to the American Society of Clinical Oncology (ASCO) Clinical Care Advances 2006.

Posted by Kate Murphy on December 13th, 2006
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