Red meat causes changes in bowel cells which may affect DNA

Scientists are studying the cells in the colon linings of volunteers to try to understand the effect of diet on the development of colorectal cancer.  In a study reported in the February 1, 2005 edition of Cancer Research volunteers were fed one of three carefully controlled diets:  high in red meat, high in fiber and red meat, or vegetarian. 

Stool specimens were collected and tested for NOC (N-nitrosocompounds), a substance associated with red meat consumption and an increased risk of colorectal cancer.  Cells in stool shed from the colon lining were tested for changes in DNA.

High red meat diets showed the greatest amount of NOC, as well as the most cell changes compared to vegetarian diets. High fiber-high meat diets showed intermediate changes, leading to the conclusion that fiber may modify the effect of red meat.

The scientists theorized that if DNA changes caused by consumption of red meat are not repaired, they may lead to the first changes in the process of developing colorectal cancer.

An article from Reuters explains the research.

Posted by Kate Murphy on February 6th, 2006
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PLWC Live Chat: Gastrointestinal Cancers: Scientific News for Patients

Richard Schilsky M.D. will discuss the latest scientific information for patients with colorectal cancer on the People Living With Cancer web site January 26th. The chat will address:

• How to recognize symptoms of gastrointestinal cancer.
• The latest screening and prevention efforts.
• New treatment strategies.
• Treatment for advanced cancer.
• How to manage the side effects of treatment.

There is no cost for the chat which can be joined by going to the PLWC site.

• Gastrointestinal Cancers: Scientific News for Patients
• Richard Schilsky M.D.
• January 26, 2005
• 2:00 – 3:00 p.m. EST

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Posted by Kate Murphy on January 19th, 2006
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Surgery to reduce the risk of cancer in women with Lynch Syndrome

Women with the genetic mutation that causes hereditary colorectal cancer — hereditary non-polyposis colon cancer or Lynch syndrome — are also at increased risk for endometrial and ovarian cancer.  Research reported in the January 19, 2005, issue of the New England Journal of Medicine found that hysterectomy and removing the ovaries reduced the incidence of gynecological cancers in these high-risk women.

Researchers, led by Dr. Karen Lu at M.D. Anderson Cancer Center, identified 315 women who had inherited a mutated gene for Lynch syndrome.  They then matched those who had undergone prophylactic hysterectomy or prophylactic removal of both ovaries with mutation-positive women who had not had protective surgery.  Over the time of the study, no one who had had prophylatic surgery developed endometrial, ovarian, or peritoneal cancer.  However, among the controls 69 women (33%) were diagnosed with endometrial cancer and 12 (5%) with ovarian cancer.

The research team concluded:

These findings suggest that prophylactic hysterectomy with bilateral salpingo-oophorectomy is an effective strategy for preventing endometrial and ovarian cancer in women with the Lynch syndrome

Lynch Syndrome was first identified by Henry T. Lynch M.D, who is one of the authors of the NEJM article. Also called hereditary non-polyposis colon cancer, a mutated gene directly inherited from a parent increases the lifetime risk of colon cancer to about 80%.  In addition, there is an increased risk of related cancers including endometrial (40% to 60%) and ovarian (10% to 12%).  There is also higher risk of other cancers of the gastrointestinal tract, pancreas, brain, and kidney.

Lynch syndrome is more frequently diagnosed at a young age than non-inherited colon cancer and is associated with a strong family history of colorectal and related cancers.  Diagnosis depends on a identifying one of the mutated mismatch repair genes that fail to repair damaged DNA and allow cells to develop into cancer.

A Lynch syndrome mutation is suspected when

• There are at least 3 directly related family members with colon or a related cancer.
• Cancer occurs in at least 2 generations.
• At least 1 individual is diagnosed under the age of 50.

However, not all colorectal cancer patients with a Lynch syndrome mutation will fit this criteria.  Some researchers are now recommending that people diagnosed with colorectal cancer under the age of 50 have their tumors tested for microsatellite instability, a change in genetic appearance, to screen for possible Lynch syndrome.

Read more about the study on Medpage Today.  Reuters.

Posted by Kate Murphy on January 18th, 2006
Posted in: Research & Treatment News | 1 Comment »

Analysis of sentinel nodes fail to predict positive lymph nodes in colon cancer

Cancer cells in the regional lymph nodes that drain directly from the colon are important to staging colon cancer and estimating the risk of recurrence after surgery.  Sentinel nodes are the first nodes leading from the tumor.  In other cancers, particularly breast cancer, examining the sentinel node reliably predicts whether or not cancer has spread to the remaining nodes.

Researchers from the Cancer and Leukemia Group B identified and removed both sentinel nodes and non-sentinel regional lymph nodes during surgery to remove primary colon cancers.  They injected a blue dye into the tumor and observed its flow to identify the sentinel node.

However, it was not possible to use the sentinel node to predict whether cancer cells (micrometastatic disease) was present in other nearby lymph nodes.  Sentinel nodes failed to predict further positive nodes in 13 of  24 (54%) of node-positive patients. 

Writing in the Journal of Clinical Oncology published early online on January 17, 2005, the team concluded:

By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.  

Posted by Kate Murphy on January 18th, 2006
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Medicare prescription insurers told to provide a 30-day supply of drugs to avert coverage emergency

The federal administration has told Medicare Part D insurers that they must provide a 30–day supply of any drug a beneficiary was taking prior to the changes in the law which occurred on January 1, according to reports in the New York Times.  The new directive also says that low-income patients cannot be charged a co-pay more than $2 for a generic drug or $5 for a name-brand one.

Over 42 million elderly and disabled Medicare recipients became eligible for prescription coverage on January 1, 2005 as part of a new Medicare Part D program.  Six million low-income participants, whose prescriptions were previously covered by Medicaid, were automatically switched to the new Medicare coverage.  However, hundreds of thousands of dual-eligible people were being told incorrectly that they had to pay the $250 deductible required of higher-income participants as well as significantly higher co-pays.  Pharmacists have been spending hours on the telephone trying to verify eligibility for the low-income program or find which insurance company had been assigned to a particular individual.

In addition, some higher-income people who had signed up for one of the many Medicare Part D insurance plans found that they were not on the federal computerized list of subscribers system when they tried to refill prescriptions at their pharmacies.

About 20 states including California, New York, Pennsylvania, Ohio, and all New England have adopted emergency procedures to continue coverage of prescription drugs for low-income people previously on Medicaid.  Some have declared public health emergencies.

More stories about emergency coverage on Bloomberg,com and in the Los Angeles Times.

To compare Medicare prescription plans or enroll in one, you can visit Medicare’s web site.

Posted by Kate Murphy on January 16th, 2006
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