You can do a lot to prevent colon and rectal cancer this year . . . and in the future.

Number One Resolution — Be screened for colorectal cancer if you are 50 or over, earlier if you are at higher risk.

In addition you can reduce your  colorectal cancer risk by:

• Exercising regularly.
• Keeping your weight normal.
• Eating less red meat, no processed meat at all, and mostly plant-based foods.
• Increasing the amount of fiber in your food.

Start on Monday, January 2, and review your progress toward better diet and exercise every Monday all year.  Research from leading public health schools for The Monday Campaigns shows that most people view Monday as a day for fresh starts.  They were most likely to begin exercising, start a diet, or stop smoking on Monday.

For the latest evidence on food, nutrition, and physical activity and their influence on colorectal cancer, read the World Cancer Research Fund’s Continuous Update Project focus on colorectal cancer.

Happy, healthy New Year!

Summer’s over. The black squirrels in the front yard are scurrying around hunting acorns and my inbox is full of neat nuggets of colorectal cancer news — and I don’t want to leave them buried all winter.

So here they are in brief.  You can check the links for more details.

Mixed Results Using Acupuncture for Radiation Nausea

The good news is that almost all patients felt they had less nausea after either real or sham acupuncture to manage nausea and vomiting during radiation therapy.  Nine out of ten wanted more treatments.

The sham procedure used non-penetrating needles just pressed against the skin, but neither the patients who got real acupuncture or those who got sham treatments knew which they received.

Ninety-five percent in the real acupuncture group and 96 percent in the sham acupuncture group believed that the treatment had been effective against nausea.  However, 70 percent of the real group and 62 percent of the sham group did experience nausea — for an average of 10 days for real treatments and 9 days for sham.

In addition, 25 percent of the real group and 28 percent of the sham group vomited.

So measured objectively, there was still significant nausea and whether or not acupuncture was “real” or just pretend, it made no measurable difference.

Dr. Anna Enblom from the Karolinska Institute in Stockholm said,

The beneficial effects seem not to come from the traditional acupuncture method, but probably from the patients’ positive expectations and the extra care that the treatment entails.

Read more in articles by Dr. Enblom and her colleagues in Annals of Oncology and earlier this year in PLoS ONE where acupuncture, both real and sham was compared to standard nausea care.  Dr. Enblom also was featured in a news release from the Karolinska Institute.

Why Research on Fruits and Veggies and Colorectal Cancer Risk is Confusing

More fruits?  More veggies? Less colon cancer? Less rectal cancer?

Doesn’t make a difference.  Makes a big difference.

Are you confused when you read media stories based on new research about the impact of diet on colon and rectal cancer?

It may be that different fruits and vegetables have different effects depending on where cancer develops — in the proximal colon (near the top), the distal colon (near the rectum), or the rectum itself.

The research team from the Western Australian Bowel Health Study compared fruit and vegetable intact between people who had been diagnosed with colon or rectal cancer and a similar group of cancer-free individuals. They specifically looked at where the cancer was in the colorectal tract.

While total intake of fruits and vegetables and total intake of vegetables did reduce distal cancer, neither had any impact on proximal or rectal cancer. Brassica vegetables like broccoli and cabbage reduced proximal colon cancer risk, while risk for distal cancer was significantly reduced by eating dark yellow vegetables and apples.

Rectal cancer risk was increased by drinking fruit juice.

The discovery of differences should impact future diet studies for reducing colorectal cancer risk. Epidemiologist and study author Professor Lin Fritschi, PhD explained.

Fruits and vegetables have been examined extensively in nutritional research in relation to CRC, however, their protective effect has been subject to debate, possibly because of different effects on different subsites of the large bowel.

It may be that some of the confusion about the relationship between diet and cancer risk is due to the fact that previous studies did not take site of the CRC into account. The replication of these findings in large prospective studies may help determine whether a higher intake of vegetables is a means for reducing the risk of distal CRC.

The study was reported in the October Journal of the American Dietetic Association.

The bottom line for people who want to reduce their risk of colon and rectal cancer is that eating fruit and vegetables does help prevent cancer in some parts of the colon and rectum, but doesn’t guarantee that cancer won’t occur.  Getting fruit from juice may not be the best choice because that does increase rectal cancer risk.

Even a Little More Exercise Helps

Although recommendations are for 150 minutes of exercise a week or 30 minutes a day to reduce risk of dying from cardiovascular disease or cancer, even less activity can increase life expectancy.

Following over 415,000 people in Taiwan over an average of 9 years, researchers found that even 15 minutes a day (92 minutes a week) of physical activity increased life expectancy three years compared to those people who had no exercise at all. The no exercise group had a 17% increased risk of dying compared to the low-exercise group.

After an initial 15 minutes every day (low-volume exercise) every additional 15 minutes of daily exercise decreased risk of dying from any cause by 4% and dying from cancer by1%.

Dr Chi Pang Wen MD from the National Health Research Institutes in Zhunan, Taiwan reported study results in the October 1, 2011 issue of The Lancet.

Will you help answer a question about how to help colon cancer survivors  increase their physical activity?

You’ll learn more about colon cancer and may be randomly assigned to a special interactive program that is designed to help recovering colon cancer patients develop a healthy lifestyle.

The Survivorship Comprehensive Health Enhancement Support System (CHESS) study is available in centers in Wisconsin, Texas, North Carolina, and Connecticut.  To be part of the research, you need to have completed treatment for stage I, II, or III colon cancer within the past 12 months. 

Evidence has shown that exercise can reduce risk of recurrence for people with colon cancer, but some people may have trouble returning to their pre-cancer activity or improving on old habits.  The CHESS study will test a new intervention that may help those folks.

If you are a colon cancer survivor — or are close to finishing your treatment — get more information or join the study by calling a program director:

• University of Wisconsin Carbone Cancer Center in Madison — 1-800-361-5481
• University of Texas MD Anderson Cancer Center in Houston — 1-877-554-6061
• University of North Carolina Lineberger Cancer Center in Chapel Hill — 1-877-404-7255
• Helen and Harry Gray Cancer Center at Hartford Hospital, Connecticut — 1-860-545-4681

Survivorship CHESS is designed to help colon cancer patients develop

• competence in gathering information making decisions, and learning about behaviors they are trying to change.
• social support systems to help deal with their cancer experience.
• autonomy that comes when they regain a sense of control over their lives.
• ways to adopt or maintain healthy lifestyle behaviors and improve their quality of life.

During the study:

A new interactive cancer communication system (ICCS) called Survivorship Comprehensive Health Enhancement Support System (CHESS) will be developed and tested to promote lifestyle change among colon cancer survivors. The study will test the efficacy of Survivorship CHESS to help newly diagnosed colon cancer survivors increase their physical activity, decrease distress, and improve quality of life.

The study is funded by the National Cancer Institute and headed by David Gustafson, PhD., University of Wisconsin-Madison & Deborah Mayer, PhD., University of North Carolina.  More information from ClinicalTrials.Gov.

Think twice about that second holiday cookie

Just in time for holiday indulging, a Danish study of 55,000 middle-aged men and women monitored for an average of 10 years showed a clear association between healthy lifestyle and a lower risk of developing colorectal cancer, according to a study published in a recent British Medical Journal.

“Colorectal cancer is predominantly a disease of Westernized countries, indicating that components of a Western lifestyle may contribute to risk,” researchers wrote in the journal. Yet only three prospective studies had been done—in which people without cancer were monitored over a period of time to see who developed colorectal cancer, and how lifestyle actions compared in those who did and didn’t develop it. And the three previous studies used different lifestyle factors. This study was one of the first to study the impact of five basic healthy behaviors, rather than just one.

“Our study reveals…that even modest differences in lifestyle might have a substantial impact on colorectal cancer risk,” concluded the researchers at the Institute for Cancer Epidemiology in Denmark.

Using internationally accepted health recommendations, the study found that most Danes in the study followed 4 of the 5 healthy behaviors:

• 80% were physically active at least 30 minutes daily
• 76% had a waist circumference indicating recommended weight
• 64% were nonsmokers
• 59% drank alcohol within recommended limits (fewer than 7 drinks per week for women; fewer than 14 drinks per week for men).

But lest you think the Danes have it all over Americans, only 2% followed dietary recommendations (eating at least 600 grams fruits and vegetables, eating less than 500 grams of red or processed meat per week and getting less than 30% of calories from fat.)

“If all participants had followed merely one additional recommendation, we estimate that 13% of the cases of colorectal cancer (that ensued in the next 10 years) might have been prevented,” the researchers said. “Furthermore, we estimate that 23% of the colorectal cancers in the cohort [studied] were associated with lack of adherence to the recommendations for the 5 lifestyle factors,” they concluded.

So there you have it.

For the holidays and especially beginning with a brand new year:

Be even moderately active 30 minutes a day (walking briskly counts)

Lose weight

Drink moderately

Don’t smoke

And perhaps most importantly, relax and enjoy the holidays!

Traditionally, people getting cancer treatments were told to rest and avoid exertion, to save their strength during treatment. But more experts now say that the best way to get through treatment, and possibly the best way to beat cancer, is to stay as physically active as possible.

The American College of Sports Medicine has revised its national recommendations, saying that cancer patients and survivors should strive for the same goal as everyone–about 150 minutes a week of moderate aerobic exercise, along with resistance training and stretching.

The panel does caution that workout plans must be adapted to each person’s condition and treatment. For example, some cancer treatments make bones more brittle, which will require exercise that place less stress on them. And immunosuppressed patients must avoid exercise in groups of people.

But the expert panel cited research showing that aerobic activity reduces fatigue, and loss of both muscle and bone mass. Exercise also can calm fear and restore a sense of control.

And the most important benefit, emerging evidence shows, may be a better chance of survival: Treatments can be more effective when the body can better withstand the effects of chemotherapy and radiation. Dr. Eleanor Walker, lead author of an ongoing study of exercise in cancer patients in Detroit, says her research is “potentially showing that even if you don’t start your exercise training until you’ve received your diagnosis, it can still be of some help. And if you’re in a healthier state before you get a [cancer] diagnosis, you’re going to do better because your body is in better shape and you have reserves…”

Source: HealthDay News

Today is National Start Walking Day.  Not only can regular walking reduce risk for heart disease, it can be part of an exercise program to prevent colorectal cancer and support survivorship.

Thirty minutes of walking at a moderate pace has been shown to reduce risk of getting colorectal cancer.  Plus exercise after surgery for stage III colon cancer reduced the chances of its coming back.

The National Heart, Lung, and Blood Institute suggests starting slow by walking for 30 minutes three days a week.

All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. This regimen can be adapted to other forms of physical activity, but walking is particularly attractive because of its safety and accessibility.

They also point out that you can combine several short periods of exercise during the day.

Start walking!

Recent studies have clearly shown that diet is directly associated with the risk of tumor recurrence. People who eat primarily a Western diet are significantly at higher risk than those patients whose diet has less red meat, processed sugar, desserts, and French fries. You can change your diet and reduce your risk of tumor recurrence.

You can change not only what you eat, but also how much you exercise. Daily exercise, such as walking for one hour, can reduce your risk by 50 percent — more than any chemotherapy can. For patients who are obese, weight loss will not only reduce risk for diabetes or heart disease but also decrease your risk of colon cancer.

Exercise, diet, and weight loss go along with significant changes in your body. Our immune response and reaction to stress, response to inflammation and tumor will all change the better shape our bodies are in. Every environmental change will impact the biology in our bodies. We need to strengthen our bodies to fight off the cancer. These studies show clearly that diet and exercise can easily do that.

Other data also show that taking aspirin every day can reduce the risk also by 50 percent.

All this is in your power. Please discuss these with your oncologist. In my own practice we stress the point of weight loss and exercise as well as diet.

To collect all this information I set up my blogs (go and check out the former blogs on Revolution Health). I did not want to stress out my patients writing down all this information for them, so I created these blogs where that they can go to anytime  and check out what to eat, what exercise to do, what supplements may help,whether to drink alcohol or not, whether to have sex or not . . .

Only 15 percent of people responding to the Health Information National Trends Survey listed physical activity as one way to reduce the chances of getting colon cancer.

Least aware of exercise’s value in reducing risk were

• People over 50
• Those with less education
• Individuals who thought physical activity recommendations were confusing
• People who said they didn’t look for information about cancer
• Those with less information about colon cancer
• Less physically active individuals

Writing in Patient Education and Counseling, researchers at Fox Chase and Memorial Sloan Kettering cancer centers recommended,

Health care providers should routinely inform their patients that engaging in regular physical activity greatly reduces the risk of developing colon cancer.

SOURCE: Coups et al., Patient Education and Counseling, Volume 72, Number 2, August 2008.

More than 400 colon and rectal cancer survivors in Canada answered questions about their exercise, quality of life, and fatigue.  Those who were exercising at the level recommended by guidelines reported significantly better quality of life.  They also had less fatigue.

Even after adjusting for various medical and demographic factors, exercise still made an impact of both how tired survivors felt and how they perceived their overall quality of life.

Carolyn Peddle and her team in Edmonton, Alberta wrote,

Colorectal cancer survivors meeting public health exercise guidelines reported significantly and meaningfully better quality of life and fatigue scores than colorectal cancer survivors who did not meet guidelines. Prospective observational studies and randomized, controlled trials are needed to further assess the causal nature of these relationships.

SOURCE: Peddle et al., Diseases of the Colon and Rectum, published online June 7, 2008.