This week we have research information about an ingredient in licorice that reduces the development of colon polyps and colorectal cancer and a review of the effects of Avastin® (bevacizumab) given with chemotherapy before surgery to remove liver mets.
There are links to a digital edition of CR Magazine, video blogs by Dr. John Marshall from Georgetown University, and information about changes to Medicare Advantage plans in 2010 to simplify choices and ensure that the sickest Medicare beneficiaries are not discriminated against. We also report FDA warnings to manufacturers of some unapproved narcotic drugs to stop manufacturing and distributing them.
- An ingredient in licorice, glycyrrhizic acid, which makes it taste sweet, blocks an enzyme that leads to inflammation and the development of colon polyps and colorectal cancer. The enzyme, 11βHSD2, was increased in colon polyps in both mice and humans and correlated with the amount of COX-2 and COX-2 activity. COX-2 is known to be important in both inflammation in the colon and the development of colorectal cancer. Other inhibitors of COX-2 have serious cardiovascular side effects, but side effects of the licorice compound didn’t appear in the treated mice. Licorice has been used for centuries to treat ailments from coughs to constipation. It does have side effects, including reduced blood potassium and high blood pressure. Vanderbilt-Ingram Cancer Center, where the research is being conducted, has more information. The entire article by Ming-Zhi Zhang and colleagues appeared in the Journal of Clinical Investigation on March 23, 2009.
- Avastin® (bevacizumab) protected patients with liver metastases from one type of liver damage from chemotherapy before surgery to remove liver tumors. However, it had no effect on response rate to chemo with FOLFOX or XELOX. Avastin reduced the severity of sinusoidal obstruction syndrome, a condition where veins in the liver become blocked. It had no effect on two other kinds of liver damage that are sometimes associated with chemotherapy before liver surgery: hepatic steatosis where fat builds up in liver cells and fibrosis, an accumulation of scar tissue. Austrian researchers report the results of studying liver specimens after surgery for colorectal cancer in the European Journal of Surgical Oncology, May 2009.
- A free preview of the digital edition of CR Magazine can be read online, just as it appears in print. The winter edition includes stories about cancer clusters, how to talk to your kids about cancer, and a profile of Jack Benny, who died of pancreatic cancer. The digital edition can be searched and its text enlarged for individual preferences, or you can page through it just like a magazine.
- Dr. John Marshall, oncologist at Lombardi Comprehensive Cancer Center at Georgetown University, muses about the power of words in a Medscape video blog. Realizing that there is a ripple effect of the one or two sentences that oncologists may give patients when test results are revealed that extends to family, friends, and neighbors, Dr. Marshall said, “Slowed me down.” He says that results need to be communicated “carefully, thoughtfully, and lovingly.” Dr. Marshall, who is a member of the C3 Medical Review Network, has a regular video blog on Medscape Today Marshall on Oncology.
- The Food and Drug Administration has told several manufacturers of narcotic pain drugs containing morphine, hydromorphone, and oxycodone to stop making and distributing the products because they have not been approved by the FDA. The warnings do not include all morphine, hydromorphone, or oxycodone formulations — just those without FDA approval. Unapproved opiate drugs include high concentration oral solutions of morphine and a number of extended release tablets of morphine, hydromorphone, and oxycodone. There is no recall of the drugs that are currently on pharmacy shelves, but patients need to be aware that the pain medicine they are using may not meet FDA standards. A complete list of recalled medicines is on the FDA website, along with answers to questions consumers might have about the action.
- The Centers for Medicare and Medicaid Services (CMS) has tightened rules for Medicare Advantage insurance plans for 2010 to simplify choices for seniors and make sure that Medicare beneficiaries with serious illness are not discriminated against. Plans could offer no more than 3 options in any one market eliminating many plans that are almost duplicates of one another. Cost-sharing (co-pays and deductibles) for health services needed by very ill patients, including those with cancer, could not exceed that of original Medicare. Out-of-pocket costs would be capped at $3,400.