This week research explores how medical problems affect complications after colon surgery, higher risks for colorectal cancer in vegetarians, decreasing levels of Vitamin D in the United States, and how malnutrition is connected to emotional distress in patients with advanced cancer.
Other headlines include an FDA update on the oxycodone shortage and a story linking a Pilgrim family to thousands of descendents with inherited colorectal cancer.
Brief Research Reports
- Advanced age or obesity didn’t independently affect complications after surgery for colorectal cancer, but other medical problems did. Patients over 80 without other medical problems or those with high body mass index (BMI) had no greater risk of complications or death after colon resection. Patients over 80 and those with existing medical problems took longer to move around after surgery. Patients who were male, had comorbidities, or had rectal surgery spent longer in the hospital. All patients were part of an enhanced surgical recovery program in Europe. Paul Henry and his team published their study in the British Journal of Surgery February 2009.
- In a large diet study vegetarians had a lower risk of cancer overall, but a 39 percent increased risk of colorectal cancer. The European Prospective Investigation into Cancer and Nutrition-Oxford (EPIC-Oxford) followed nearly 64,000 people recruited in the United Kingdom during the 1990′s. Overall, the group had about three-fourths the expected rate of cancer compared to the general population and vegetarians had 11 percent fewer cancers. However, unexpectedly, vegetarians had a high rate of colorectal cancer compared to the meat-eaters. Timothy J. Key and his team from Oxford University report their study in the American Journal of Clinical Nutrition, March 11, 2009.
- Vitamin D levels are decreasing in the United States with more people having levels below 30 ng/ML, which is considered sufficient. Blood collected during the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994 had an average Vitamin D level of 30 ng/ML. By the time of NHANES collections between 2001 and 2004, average Vitamin D levels had fallen to 24. In addition, very low levels below 10 ng/ML had increased from 2 percent to 6 percent. Very low levels increased even more in blacks where they went from 9 percent to 29 percent. Lead author Dr. Adit A. Ginde writes, “Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency.” Read about his research in the Archives of Internal Medicine, March 23, 2009 and in an article in Science Daily, March 24, 2009.
- Advanced cancer patients who are malnourished are also more distressed. Dr. Shafia Amdouni at McGill University in Canada asked patients for information about their food intake, weight loss, and other aspects of nutrition as well as asking them to rate their level of distress on the “distress thermometer.” Those with the highest levels of distress also had the poorest nutritional status. The research team urges that advanced cancer patients be seen by a clinical nutritionist or dietician to prevent malnutrition and improve quality of life. Dr. Amdouni reported her results at the ESMO Symposium on Cancer and Nutrition in Zurich.
- FDA drug shortage update 3/25/09: Immediate release oxycodone in 5, 15, and 30 mg tablets remains in short supply due to product recalls by manufacturers. Other companies are working with the FDA to increase production to meet the need. FDA estimates that shortages will be resolved in about two months. Other oxycodone products, included extended release tablets and combinations, are not affected. Update information from the FDA
- A team at the University of Utah has traced an genetic mutation that causes colorectal cancer back 16 generations to a couple that arrived in the Massachusetts colony in 1630. Mr. and Mrs. George Fry came as pilgrims aboard the William and Mary, one of them carrying a gene for attenuated familial adenomatous polyposis (AFAP). Patients with AFAP develop up to 100 polyps in their colons which carry a high risk of becoming cancer unless found and removed. Using molecular methods, the Utah team found 15 families with an identical genetic mutation. They then used the Utah Population Database (UPDB) to trace the genealogy of a pioneer Utah family and another family from New York back to the Frys. They estimate that the couple may have thousands of descendents at risk. Deb Neklason, Ph.D., and colleagues explained their research at the National Meeting of the American Chemical Society in Salt Lake on March 25, 2009.