UPDATES FROM THE AACR ANNUAL MEETING

Folate supplementation is a difficult issue.  Given before colorectal cancer begins to develop when colon tissues are normal, it seems to reduce risk for cancer.  However, once precancerous changes in polyps are underway, folic acid increases the development of colorectal cancer.

To complicate the issue, folic acid is added to food in the United States to prevent birth defects and is included in many multivitamin preparations. So Americans may be exposed to high levels of folate.

Research with rats and their pups reported  by Karen Sie at the 2008 annual meeting of the American Association for Cancer Research explored both folate supplements during pregnancy and folate supplemention in the offspring.

When rats were fed folate supplements during their pregnancy, their pups had a reduced rate of colon cancer.  Pups whose mothers did not receive supplements had almost three times the risk of getting colorectal cancer.

However, rat pups whose mothers did not receive supplements and who were fed folate-enriched chow themselves developed more colorectal cancers and larger cancers.

Karen Sie, from the University of Toronto, who conducted the experiments said,

The potential long-term benefits and adverse effects of the drastically increased folate status in North American populations needs to be closely monitored. It is critical to determine safe and effective doses and timing of folic acid intervention for colorectal cancer prevention.

Video appears courtesy of MedPage Today.

UPDATES FROM THE AACR ANNUAL MEETING

Combining a very low dose of oral difluoromethylornithine (DFMO) and the NSAID sulindac (Clinoril) once a day signficantly decreased new colon polyps (adenomas) for patients with a history of polyps.  After three years the two drugs reduced all new polyps by 70 percent, advanced adenomas by 92 percent, and multiple adenomas by 95 percent.

The results were so striking that the study was closed early so that all participants could benefit from the new intervention.

In the study, 375 patients who had at least one polyps removed within the past five years, were randomly assigned to the two-drug chemoprevention treatment or a placebo.  After three years, they had repeat colonoscopies to look for new polyps.

Researchers found many fewer new polyps in treated patients compared to those who received placebos:

• 41.1% of placebo patients had new polyps compared to 12.3% of the treated group.
• 8.5% placebo group had advanced adenomas compared to less than 1 percent of those receiving DFMO and sulindac.
• For patients who previously had more than one polyp, treatment reduced new adenomas from 13.2 percent to less than 1 percent.

Side effects, including gastrointestinal problems, hearing loss, cardiovascular problems, or need for hospitalization, were not different between the two groups.

Frank Meyskens, MD, director of the Cancer Center at the University of California at Irvine who headed the study team said,

There is a great hope that we will be able to prevent colon cancer effectively using this method. We had not been able to do this before due to the high toxicity of available therapies. Difluoromethylornithine is a targeted agent that represents a new treatment paradigm,

DFMO inhibits the development of polyamines in the lining of the colon, chemicals that trigger cell division and growth.  At high doses it can cause hearing problems, but there was no hearing loss noticed during the trial.

Originally developed as a potential cancer treatment, DFMO is now used to treat one form of African sleeping sickness.

Sulindac is a non-steroidal anti-inflammatory drug that is used to treat arthritis pain and to prevent colon polyps in patients with familial adenomatous polyposis (FAP).  It is thought to prevent polyps by reducing inflammation in the colon.

Dr. Meyskens pointed out that people recovering from colon cancer might also benefit from treatment with DFMO and sulindac to prevent new polyps that could lead to a second cancer.

Patients who have been shown to have advanced adenomas are probably the largest group that will be helped. Another group consists of those who have been cured of colon cancer, because about 35% will go on to have another colon cancer, so they are a good target.

SOURCE:  AACR 2008 Annual Meeting Abstract: Marked efficacy of difluoromethylornithine plus sulindac in reducing recurrent colorectal adenomas in patients with prior adenomas: results of a randomized, placebo-controlled double-blind phase III trial: Abstract LB-142

Dr. Meysken’s audio presentations with slides at the 2008 annual meeting of the American Association for Cancer Research.

The mission of the Kentucky Colon Cancer Prevention Project (C2P2) is “to eliminate preventable colon cancer death and suffering by increasing screening rates.” On Wednesday, April 2 C2P2 came closer to achieving this when the Kentucky Senate passed the Kentucky Colon Cancer Screening Act (HB 415) with a 38 to 0 vote. The House passed the bill February 26 with a 94 to 0 vote.

The Act will establish a colon cancer screening program within the Kentucky Department of Public Health to provide screening services to uninsured individuals age 50 to 64 and others at high risk. A sample letter C2P2 encouraged constituents to send to their legislators said HB 415 will:

“…ensure that all Kentuckians will be educated as to the need for this cancer screening. It will assist and navigate the uninsured to seek the screening necessary to save lives.”

The letter went on to make the economic point that the very expensive cost for late stage colon and rectal cancer treatment can be greatly reduced with adequate screening. To support this C2P2 listed the following points made by Dr. Tom Tucker on November 19 in testimony presented to the Interim Joint Health & Welfare Committee:

• Approximately half (1378) of all colon cancer cases are diagnosed with late stage disease each year in Kentucky.
• It costs an average of $30,000 to treat each case of early stage colon cancer and an average of $120,000 to treat each case of late stage colon cancer. This is $90,000 more in direct treatment costs for each case of late stage colon cancer.
• If just 200 more new cases of colon cancer were diagnosed at an early stage rather than a late stage each year for the next five years, there will be a savings of $90 million in direct treatment costs.

Angela Champion, C2P2 Executive Director said, “Our efforts will continue to make sure that this legislation will result in a funded statewide screening and education program.”

C3: Colorectal Cancer Coalition gives a pat on the back to all the people who made this possible and urges constituents to contact their Kentucky Legislators and thank them for passing this bill.

Go here to read more about HR 415 and to see how your Kentucky Legislators voted.

Go here to read an op-ed piece authored by Alan Stein in favor of HB 415 published in the Lexington (Kentucky) Herald-Leader.

Go here to learn more about the Kentucky Colon Cancer Prevention Project.

Marilia Sardinha, C3 Advocate and Steering Committee Member played a vital role in the passing of LD 2109, An Act Relating to Insurance Coverage for Colorectal Cancer Early Detection.

“It was an honor to be a part of it and to know how it will help so many people”, said Marilia. Earlier in the year Marilia was asked by the local chapter of the America Cancer Society to testify during a hearing on the bill.

The Governor of Maine, John E. Baldacci, signed the bill into law on March 26th. The bill requires health insurance policies issued or renewed after Jan. 1, 2009, to provide coverage for colorectal cancer screenings. “We know that the five-year survival rate for those who detected their colon cancer early is 90 percent, but only 39 percent of colon cancers are diagnosed at this stage,” Governor Baldacci said. “That’s why this bill is so important.”

C3 would like to thank Marilia along with the bill’s sponsor, Rep. Edward Mazurek (D-Rockland), for all of their hard work.

Click here to read LD 2109

Image of Marilia with Maine Governor John E. Baldacci used with permission.

Olympus Cameras for a Cause will donate 10 percent of the proceeds from its consumer products sold through the eBay Giving Works auction to C3: Colorectal Cancer Coalition and the Entertainment Industry Foundation’s National Colorectal Cancer Research Alliance (EIF’s NCCRA), to benefit advocacy and research to defeat colorectal cancer.

Go to the Olympus Auctions store on eBay to find point and shoot digital cameras, 35mm film cameras, digital SLR cameras, camera accessories, digital voice recorders and much more.  Your purchase, direct from Olympus, will help the fight against colorectal cancer.

Olympus is a leader in both medical imaging products and consumer electronics, producing

• Gastrointestinal endoscopes, accessories, and minimally invasive surgical products.
• Advanced clinical and research microscopes.
• Lab automation systems, chemistry-immuno and blood bank analyzers and reagents.
• Digital cameras and voice recorders.

Olympus colonoscopes and other medical equipment are important in the prevention and treatment of colorectal cancer.

All cameras purchased from Olympus on eBay will be shipped with information about colorectal cancer screening.  F. Mark Gumz, President of Olympus America pointed out,

At Olympus, we believe it is our responsibility to help educate, inform and create awareness about colorectal cancer,. Our hope is that through our many Olympus initiatives, we will increase awareness and facilitate discussions about the disease.

In hearing about the Olympus support  C3 President Carlea Bauman said,

C3: Colorectal Cancer Coalition is grateful to Olympus for supporting our efforts to fight colorectal cancer through research, empowerment and access. We hope to one day make colorectal cancer no more deadly than the common cold – and we will only accomplish that through an increased commitment to ending this terrible disease. We applaud Olympus’ efforts to raise awareness, and raise the bar.

Colorectal Cancer is Preventable, Treatable, and Beatable