Archives for the month of: December, 2013

Bowel resection, also called partial colectomy, for colorectal cancer removes the tumor and part of the colon or rectum on either side. The goal of bowel resection is to take out the part of the colon or rectum where the cancer is. Nearby lymph nodes are taken out and tested for cancer. Then healthy parts of the colon or rectum are sewn back together. Bowel resection is done either by opening the abdomen (open resection), or by laparoscopy. Recommended Related to Colorectal Cancer Overview Note: Separate PDQ summaries on Colorectal Cancer Screening; Colon Cancer Treatment; and Rectal Cancer Treatment are also available. Factors Associated With Increased Risk of Colorectal Cancer Excessive alcohol use Based on solid evidence from observational studies, excessive alcohol use is associated with an increased risk of colorectal cancer (CRC).[1,2,3] Magnitude of Effect: A pooled analysis of eight cohort studies estimated an adjusted relative risk (RR) of 1.41 (95%… to see what happens during this surgery. What To Expect After Surgery Bowel resection requires general anesthesia . You may stay in the hospital for 4 to 7 days or as long as 2 weeks after surgery. Sometimes the two parts of the colon or rectum cannot be reattached, so the surgeon performs a colostomy . This creates an opening, called a stoma, on the outside of the body for the stool, or feces, to pass through into a colostomy bag. Usually the colostomy is temporary, until the colon or rectum heals. If the lower part of the rectum has been removed, the colostomy is permanent. Most people who have colon cancer don’t need a colostomy.

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Surgery for Colon and Rectal Cancer

Abdominoperineal (AP) resection: For cancers in the lower part of the rectum, close to its outer connection to the anus, an abdominoperineal (AP) resection is done. For this the surgeon makes one cut in the belly (abdomen), and another in the area around the anus. Because the anus is removed, a colostomy is needed. A colostomy is an opening of the colon in the front of the abdomen. It is used as a way for the body to get rid of solid body waste (feces or stool). The usual hospital stay for an AP resection isfour to sevendays, depending on your overall health. Pelvic exenteration: If the rectal cancer is growing into nearby organs, more extensive surgery is needed. In a pelvic exenteration, the surgeon removes the rectum as well as nearby organs such as the bladder, prostate, or uterus if the cancer has spread to these organs. A colostomy is needed after this operation. If the bladder is removed, a urostomy (an opening to collect urine) is also needed. Side Effects of Colorectal Surgery Side effects of surgery depend on many things, such as the extent of the operation and a person’s general health before surgery. Most people will have at least some pain after the operation, but this can usually be controlled with medicines if needed.

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It appeared online in the journal Cancer on Dec. 16, 2013. Death Rates The latest Report includes mortality data through 2010, the most recent year for which complete data are available. It found that from 2001 through 2010, death rates for all cancers combined decreased by 1.8 percent per year among men and by 1.4 percent per year among women. Death rates among children 14 years of age and younger decreased by 1.9 percent per year. Death rates among men decreased for 11 of the 17 most common cancers (lung, prostate, colon and rectum, leukemia, non-Hodgkin lymphoma, esophagus, kidney, stomach, myeloma, oral cavity and pharynx, and larynx) and increased for melanoma of the skin, soft tissue cancers, and cancers of the pancreas and liver. During the same 10 year period, death rates among women decreased for 15 of the 18 most common cancers (lung, breast, colon and rectum, ovary, leukemia, non-Hodgkin lymphoma, brain, myeloma, kidney, stomach, cervix, bladder, esophagus, oral cavity and pharynx, and gallbladder) and increased for cancers of the uterus, pancreas, and liver. The Report found that lung cancer death rates for men dropped 1.9 percent per year during the period 1993-2005 and fell by 2.9 percent per year from 2005-2010. For women, rates declined 1.4 percent per year during the period 2004-2010, which was a turnaround from an increase of 0.3 percent per year during the period 1995-2004. These shifts have been attributed to many factors that have reduced the prevalence of cigarette smoking in the United States. Of particular note is the smaller drop in lung cancer death rates for women, most probably due to a later decline in cigarette smoking rates among females. The sustained fall in death rates for most cancers is an important indicator of our success in controlling this large set of complex diseases but is not as fast as wed like, said NCI Director Harold Varmus, M.D. In addition, the Report emphasizes the need to consider the entire health status of cancer patients since many have other significant medical conditions that may affect their survival. Incidence Rates Cancer incidence rates, which track new cases, can vary based on a number of factors and are considered an important measure of disease burden, whereas mortality is the primary measure of progress in cancer control.Incidence rates may presage changes in mortality outcomes however. During the period of 2001-2010, overall cancer incidence rates decreased by 0.6 percent per year among men, were stable among women, and increased by 0.8 percent per year among children (ages 0 through 14 years), continuing trends from recent Annual Reports. During the 2001-2010 time period, incidence rates decreased for six of the 17 most common cancers among men (prostate, lung, colon and rectum, stomach, larynx, and brain and other nervous systems) and increased for eight others (kidney, pancreas, liver, non-Hodgkin lymphoma, thyroid, leukemia, melanoma of the skin, and myeloma). Among women, incidence rates decreased for six of the 18 most common cancers (colon and rectum, bladder, cervix, oral cavity and pharynx, ovary, and stomach), and increased for eight others (thyroid, melanoma of the skin, kidney, pancreas, leukemia, liver, myeloma and uterus). Similar to death rates, the overall decrease in cancer incidence rates among men wasdriven in partby declines in lung cancer, mainly reflecting the success of tobacco control interventions, said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society.

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Colon cancer survival rate increases with lymph node removal says UT


Anderson Cancer Center reveals that the disease could be arrested by removing lymph nodes. The findings of the study show that the more lymph nodes that are taken out of the patients body, the slower the colon cancer spread, and the higher the survival rate of those that contracted the disease. This development came after a survey of 17 different studies from around the world. The results were similar across the board. During a national clinical trial of 3,200 patients suffering from stage II colon cancer in the United States it was found that patients that had 20 or more lymph nodes taken out of their body had a 14 percent improvement in their survival rate when compared with those who had 11 or fewer lymph nodes removed. Studies of stage III colon cancer showed that as the disease progressed, so did the potential for survival through lymphadenectomy. If 40 or more nodes were removed, patients were 23 percent more likely to survive than those with just 11 or excised. Most of the studies were focused on stage II, but of those that examined more advanced cancer gave similar indications, often with ever increasing numbers of lymph node removal showing respectively positive results. Many cancer treatments are still in the dark ages, with a hack-and-slash, salt-the-earth mentality still pervading in the industry as even the most conservative oncologists often take a cut first stance. But it could be that for now, in the choice between rapid, aggressive surgical intervention to save a life and allowing a form of cancer as progressive and pervasive as colon cancer to kill a patient is barely one that can be debated. Watch the video below for an overview of colon cancer from MD Anderson: The study is an encouragement to doctors to include lymph node removal when operating on colon cancer . Currently this is only done in approximately 1/3rd of cases. Many doctors opt not to take the time to trace blood vessels nearest to the tumor back to the lymphatic nodes associated with them.

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Vitamin D Doubles Colon Cancer Survival Rates

cancer, vitamin D, colon, colon cancer, colorectal cancer

Mercola October 13 2009 Higher blood levels of vitamin D may double survival rates of colorectal cancer patients, according to a new study. People with the highest average levels of 25-hydroxyvitamin D had a cancer-specific mortality half that of people with the lowest average levels. Whats more, high levels of the vitamin were associated with an overall mortality level 40 percent lower than people with the lowest average levels. Knowledge of the link between vitamin D intake and protection from cancer dates from the 1940s, when Frank Apperly demonstrated a link between latitude and deaths from cancer, and suggested that sunlight gave a relative cancer immunity. Sources: British Journal of Cancer September 15, 2009; 101(6):916-23 Dr. Mercola’s Comments: Colon cancer is one of the most common causes of cancer death in the United States. According to the latest data from the CDC , more than 141,400 Americans were diagnosed with colon cancer in 2005, and more than 53,000 died from the disease that same year. Fortunately, it is also one of the few cancers that can be successfully treated if precancerous growths are found and removed early enough. Better yet, I believe colon cancer is completely preventable with certain lifestyle changes, of which vitamin D is a vital part. More Evidence Showing the Cancer-Busting Power of Vitamin D In this latest study, people with colon cancer who had the highest average levels of vitamin D had half the mortality rate of those with the lowest average levels, indicating that optimizing your vitamin D levels can improve your survival rate even if you already have the disease. These findings add to a veritable mountain of studies that have found vitamin D to generate astounding powers of protection against a wide variety of cancers. In fact, there are well over 800 studies showing vitamin Ds effectiveness for cancer prevention and treatment! One 2003 study in JAMA found that men who consumed higher amounts of vitamin D significantly reduced their risk of developing colon cancer. Another study dating back to 1989 studied more than 25,000 people for eight years and discovered that people with vitamin D levels of 33-41 ng/ml, which is not even close to a great vitamin D level, reduced their risk of colon cancer by a whopping 80 percent!

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Colorectal Cancer Market Analysis and 2019 Forecasts in New Research Report at

The nurses and staff were all amazed by my fast pain-free recovery. My incision was so tiny and the healing process was very quick. I was able to walk up and down the hall the next day. Last month, Valdez celebrated his 80th birthday with over 100 relatives at his party. He has lived in Humble for more than 13 years and has 7 children, 21 grandchildren, and 28 great-grandchildren. He and his whole family are huge advocates now for da Vinci surgery. Valdez says that he wakes up every morning with a smile on his face and he gives God praise every day for leading the best doctors down his path and providing him with the best nurses and hospital care. We are committed to staying on the cutting edge of technology in order to provide our patients with superior surgical services, said Melinda Stephenson, CEO at Kingwood Medical. Kossoys experience and expertise with performing a broad spectrum of inpatient, outpatient, and minimally invasive procedures such as this is a testament to our commitment to providing our community and our patients with the best surgeons and the best surgical solutions available in healthcare today. At Kingwood Medical Center, the da Vinci Robotic Surgical System is currently being used on complex minimally invasive surgical procedures including gynecologic, urologic, colorectal, and gall bladder procedures. The da Vinci Robotic System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables the surgeon to operate with small incisions instead of 6-to-12-inch incisions that are common in surgeries resulting in less pain, smaller scars, and faster recovery. Kossoy is the only surgeon in Northeast Houston using da Vinci surgery for treatment of colorectal cancers and diseases. Kossoy is board-certified by both the American Board of Surgery and by the American Board of Colon and Rectal Surgery. He completed medical school at the University of Missouri in Columbia and residencies at the University of Southern Alabama and the University of Iowa. He then completed a fellowship, specializing in colon and rectal surgery, at the University of Texas Houston. Kossoy serves as the current chief of staff of Kingwood Medical Center. To schedule an appointment with a physician who is currently using the da Vinci Surgical System, please call 1-800-258-5064.

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Colon cancer

Including a heat map comparing the drugs in terms of safety and efficacy. A comprehensive review of the pipeline for colorectal cancer therapies, including individual analysis of a number of late-stage pipeline drugs that are likely to enter the market during the forecast period. The pipeline is analyzed on the basis of phase distribution, molecule types, program types, mechanisms of action and molecular targets. Additional in-depth analysis of pipeline drug clinical trials by phase, trial size, trial duration and program failure rate for each molecule type, in addition to an in-depth analysis of clinical trial primary endpoints. Multi-scenario forecast data of the market to 2019, taking into account how the market may be affected by the introduction of new drugs, the expiry of key patents on current drugs and the changes in disease epidemiology across the key developed markets. Discussion of the drivers and barriers for market growth. In-depth analysis of all licensing and co-development deals that have occurred in the colorectal cancer market since 2006. Reasons to Buy Understand the role of mAbs in the treatment of colorectal cancer and their relation to chemotherapies and targeted small molecule therapies. Understand the vast scope of the pipeline, including which molecule types and mechanisms of action are prominent. Observe the trends in clinical trial duration and size amongst clinical phases and molecule types. Use the clinical trial failure rate analysis to assess the risk profiles of current and/or future developmental programs for colorectal cancer therapeutics.

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In general, treatments may include: Surgery (most often a to destroy cancerous tissue SURGERY Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection ) There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist. CHEMOTHERAPY Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 – 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients. Chemotherapy is also used to improve symptoms and prolong survival in patients with stage IV colon cancer. Irinotecan, oxaliplatin, capecitabine, and 5-fluorouracil are the three most commonly used drugs. Monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), bevacizumab (Avastin), and other drugs have been used alone or in combination with chemotherapy. You may receive just one type, or a combination of these drugs. RADIATION Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer. For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used.

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Patients with final stage colon cancer (also known as stage IV colon cancer) have the lowest survival rate among colon cancer patients. Pain Patients with final stage colon cancer may experience pain in the bone, as the cancer has spread to the bone. Patients may experience pain in the back or in the rib. Pain tends to be localized and continuous. In some cases, patients may suffer from bone fracture due to metastatic colon cancer in the bone. If the cancer has spread to the brain, patients may experience severe headache, blurred vision, dizziness, confusion and disorientation. Computed tomography (CT) or magnetic resonance imaging (MRI) can be used to scan the brain and to determine the extent of the tumor in the head. Jaundice (yellowing of skin), fever, loss of appetite, swelling of the leg or abdominal pain may indicate that the liver has been affected. You Might Also Like Herbal Remedies for Weight Loss Patients with final stage colon cancer may experience losing weight of 10 percent or more, according to a 2004 review published in “Family Practice.” Weight loss is also an indication of metastatic cancer in the liver. Shortness of Breath Shortness of breath is an indication that the cancer has spread to the lung. Other indications of metastatic colon cancer in the lung include chest pain, cough and cough producing bloody sputum. Other Symptoms Patients may observe bubbles in the urine (pneumateria). This is the sign that the cancer affects the bladder. Patients with final stage colon cancer might also have symptoms that are common to colon cancer, such as rectal bleeding, constipation, fatigue, anemia, obstruction and diarrhea, according to a 2004 review published in “American Journal of Gastroenterology.” Roughly 50 to 70 percent of colon cancer patients experience rectal bleeding and changes in bowel habit. These symptoms are fairly common even among healthy people. However, if you are older than 50, you should consult your physician about colon cancer testing if these symptoms persist for long time.

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Avastin Shows No Benefit for Earlier Colon Cancer: Study

Symptom Checker: Your Guide to Symptoms & Signs: Pinpoint Your Pain

The new trial was set up to see whether the drug could also help patients with earlier-stage cancer, explained lead researcher Dr. Carmen Allegra, chief of hematology and oncology at the University of Florida, in Gainesville. He and his colleagues found no evidence that the expensive drug — priced at around $5,000 per month — kept patients in remission longer or lengthened their lives. Doctors not involved in the study said it added to evidence that Avastin is of no use to patients with earlier-stage, curable colon cancer. “I think it’s time to move on,” said Dr. Jennifer Obel, a medical oncologist with the NorthShore University Health System in suburban Chicago. The study, reported online Dec. 10 in the Journal of Clinical Oncology, included 2,673 patients who’d had surgery for stage 2 or stage 3 colon cancer — meaning the tumor was either confined to the colon or had spread no farther than the lymph nodes. All of the patients were getting “adjuvant,” or follow-up, chemotherapy to hopefully take care of any remaining tumor cells and cut the odds of a recurrence. Allegra’s team randomly assigned half of the patients to receive six months of standard chemotherapy — a three-drug regimen of fluorouracil, leucovorin and oxaliplatin. The other half received that therapy, plus Avastin for one year.

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Colorectal cancer screening knowledge, attitudes and behavioural intention among Indigenous Western Australians

Enabling Cookies in Internet Explorer 7, 8, 9 + Open the Internet Browser Click Tools (or “gear” icon at top right hand corner) > Internet Options > Privacy > Advanced Check Override automatic cookie handling For First-party Cookies and Third-party Cookies click Accept Click OK and OK Click Tools > Options > Privacy Select Privacy > Content settings Check ‘Allow local data to be set (recommended)’ Click ‘Done’ Under ‘History’ select Firefox will: ‘Use custom settings for history’ Check ‘Accept cookies from sites’ and then check ‘Accept third-party cookies’ Click OK Enabling Cookies in Google Chrome Open the Google Chrome browser Chrome > Preferences Click ‘Show advanced settings’ at the bottom. Under Privacy select ‘Content settings’ Under ‘Cookies’ select ‘Allow local data to be set (recommended)’ Click ‘OK’ Under ‘Block cookies’ check ‘Never’ Enabling Cookies in Mobile Safari (iPhone, iPad) Go to the Home screen by pressing the Home button or by unlocking your phone/iPad Select the Settings icon. Select Safari from the settings menu. Select ‘accept cookies’ from the safari menu. Select ‘from visited’ from the accept cookies menu. Press the home button to return the the iPhone home screen. Select the Safari icon to return to Safari. Before the cookie settings change will take effect, Safari must restart. To restart Safari press and hold the Home button (for around five seconds) until the iPhone/iPad display goes blank and the home screen appears. Select the Safari icon to return to Safari.

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As bowel cancer knowledge score was significantly related to perceived self-efficacy, perceived susceptibility and having participated in screening in the past in bivariate analyses, all of these variables could not be included in the same logistic regression model. Thus, two logistic regressions were performed one excluding these three variables and another including them, but excluding the knowledge variable. Marital status was almost significantly related to knowledge (p = 0.054) and initially retained in both models, however was subsequently removed from model 1 as it caused unstable odds ratios and wide confidence intervals. Thus, the first model included 12 of the 26 variables and the second included 10. A backward step-wise approach using the default enter method in SPSS was utilised, removing variables from the model that were non-significant until only variables with a p <0.05 remained in the model. Results Socio-demographic characteristics A total of 93 participants were recruited for this study (Table 2 ). Females were over-represented with less than 25% of respondents being male. The majority (47.8%) were in the 45-54 year age group, around half (52.7%) were married or living in de-facto relationships, 44% had either completed senior high school or a post-school qualification, and over half (56.7%) were unemployed or not working. Most respondents were enrolled with Medicare but only 17% had private health insurance. English was the primary language spoken at home for most (92.4%), with 28% rating their English reading ability as poor-fair. Table 2. Socio-demographic characteristics, subjective health status, healthcare seeking behaviour, cancer experience and screening history of study participants Health-care seeking behaviour, cancer experience and screening history Over 80% had a regular GP and had seen a doctor within the past 12 months (Table 2 ). Half (50%) reported having participated in any cancer screening in the past 2 years, and 15% had undergone a colonoscopy. Only 5.6% (5/90) of respondents reported ever having done a FOBT/bowel screening test. Awareness and knowledge of bowel cancer and FOBT bowel cancer screening General awareness The majority (78%; 72/92) of respondents reported having heard of bowel cancer, although of those, only 15% (11/72) could give a correct description of any aspect of bowel cancer (for example, cancer of the bowel or digestive system). Less than a third were aware of what polyps were (29%, 25/86) and only 19 of the 25 (76%) who said they knew what a polyp was, were able to describe it correctly.

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What Causes, Prevents Colon Polyps

Lieberman’s study was a detailed analysis of how various dietary, lifestyle, and genetic factors influenced the development of these colon polyps, which often lead to colorectal cancers that kill some 55,000 Americans each year. None of the 3,100 veterans enrolled — almost all men — had any signs of colon polyps or cancer when the three-year study began, but being between ages 50 and 75, they were at a statistically higher risk of colon cancer. They participated in the study at 13 VA centers across the U.S., but their levels of sun exposure were not measured. Most of the body’s vitamin D comes from sunlight on bare skin, and getting about 10 minutes a day of sunscreen-free sun exposure when weather permits can absorb some 20,000 IUs of vitamin D, says Holick. “This can be stored in fat layers,” he says. But during winter months, he recommends taking a daily multivitamin, along with a separate 400 IU vitamin D supplement to lower risk of colon and other cancers. Avoid Smoking, Red Meat As expected, Lieberman’s study also confirms previous research that being overweight, alcohol consumption, or frequently consuming fatty meats can boost risk. Men having beef, pork, or lamb more than four times a week were nearly three times as likely to develop polyps. But the big surprise was in the risk caused by smoking. Being a current smoker doubled the risk of these polyps — more than having a parent or sibling with colon cancer, which upped risk by 70%. Lieberman’s theory: Smoking stimulates the overgrowth of cells in the lining of the colon, as it’s been shown to do in other organs. “In past studies, smoking was found to have a smaller or marginal effect, but we found it was profound — never before was the risk higher than a high-degree relative with colon cancer,” Lieberman tells WebMD. “This provides yet another reason to not smoke.”

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If you want even more protection, add a 10-minute walk on sunny days without wearing sunscreen . So suggest the results of the one of the largest and most comprehensive studies to date on factors that raise and lower the risk of colon cancer . In this new report, vitamin D shines — it’s associated with a one-third reduced risk of serious colon polyps that often lead to cancer in men getting at least 645 IUs of this nutrient each day. “That’s what you’ll find in a multivitamin supplement and a small glass of milk,” says lead investigator David A. Lieberman, MD, chief of gastroenterology at the Portland VA Medical Center. “Other vitamins also seem to have a protective effect, but our study suggests a stronger protective effect from vitamin D.” That’s because vitamin D keeps cells from over-proliferating and multiplying too quickly. “Cells in the lining of the colon are constantly turning over and reproducing,” Lieberman tells WebMD. “A drug that could prevent that, theoretically, could prevent cell mutations that can lead to cancer.” A similar protective effect — about one-third reduced risk of these polyps — was noted in men who took a daily aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Just over 4 grams of cereal fiber a day, which is less than one-quarter ounce, also offered the same degree of protection. –> The Value of Vitamin D Taking a multivitamin — most of which contain 400 IUs of vitamin D — was associated with reducing polyp risk by about 25%. These multivitamins also contain adequate amounts of calcium, folate, vitamin E, and selenium, which Lieberman also found to help lower polyp risk, “but not as much as vitamin D,” he says. In order to get the full protective effect of vitamin D — at 645 IU — add a small glass of milk daily to the multivitamin. That doesn’t surprise Michael Holick, MD, PhD, director of the Vitamin D Research Lab at Boston University Medical Center and considered by many to be the nation’s leading authority on vitamin D. He was not involved in Lieberman’s research, which is published in this week’s Journal of the American Medical Association. “In 1941, the very first edition of the medical journal Cancer Research included a study showing that people who lived in New Hampshire, Massachusetts, Vermont, and other higher-latitude states had a higher risk of dying from all types of cancer than people in Alabama, the Carolinas, and other sunnier states,” Holick tells WebMD.

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Most adults under 50 unlikely need colorectal screening

In the years 1992 to 1995, the rate was 6.9. They did the study again in the years of 2002 to 2005 and those numbers had risen to 8.8, which mean a 28 percent increase. They did the same sturdy with Latinos. The increase was 33 percent for men, but not statistically significant for women. There was no increase for African-Americans, but unfortunately, this group of 20 to 49-year-old men and women has a higher risk. Their numbers are 12.7 and 10.8 cases per 100,000. Reasons for the Increase Among Young Adults Researchers believe the reasons for the increase in colorectal cancer in the younger generation are from changes in the American lifestyle. Diets that consist of a high intake of red and processed meat and diets that are low in milk and calcium have been liked as the possible cause. As a nation, many of the young eat hamburgers and sodas at fast-food places. The result is not only a rise in cancer, but also a rise in obesity and low physical activity. The American Cancer Society recommends that people eat plenty of fruits, vegetables, and whole grains. Exercise should be done for at least 30 minutes for five days a week. This will help protect against cancer, but in not a 100 percent protection against a person having colorectal cancer. Screening Usually Not Considered When Patient is Below Age 50 For most people under the age of 50, screening for colorectal cancer is generally not done. Doctors do the screening only when the patient has a family history, chronic inflammatory bowel disease or a predisposing genetic condition. Since they don’t screen most patients below 50, this gives the benign polyps time to turn into invasive cancer.

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The finding supports current cancer screening guidelines recommending adults in general undergo screening colonoscopies starting at age 50. The new study, published in the September issue of the journal Clinical Gastroenterology and Hepatology, also showed that white patients more often had adenomas on the left side of the colon, whereas African Americans had lesions more often on the right side. The take-home lesson, Giardiello says, is that screening and diagnostic evaluations of African Americans should include a colonoscopy rather than a sigmoidoscopy, because the latter evaluates only part of the colon. The Hopkins study assessed the “natural history” and occurrence of colorectal polyps by reviewing records of 3,558 autopsies performed at The Johns Hopkins Hospital between 1985 and 2004 on patients aged 20 to 89. The review, called an “epidemiologic necropsy,” categorized patients by sex, race and 10-year age groups, then compared the prevalence and location of adenomas between younger adults (ages 20 to 49) and older adults (ages 50 to 89). The review identified a low but increasing prevalence ofcolorectal adenomas — from 1.72 percent to 3.59 percent from the third to the fifth decade of life, with the presence of adenomas sharply increasing after age 50. Prevalence ranged from 10 to 12 percent from the sixth to ninth decade of life. “Our study affirmed that the greatest increase in prevalence was in older adults, abruptly starting in the sixth decade,” says Francis M. Giardiello, M.D., professor of medicine, oncology and pathology, who directed the research. The average number of adenomas spotted in most young adults was one. In older adults, the average number of adenomas ranged from 1.6 to 1.9. Most polyps detected in colorectal screenings qualify as adenomas, but there are also lower-risk lesions called “hyperplastic” which are not thought to lead to cancer, the researchers note. The researchers found that in young adults, adenomas were slightly more prevalent in men than in women and in whites than in blacks. In older adults, the prevalence of adenomas also was greater in men than in women, but greater in blacks than in whites. In addition, the study found that in both younger and older adults, the overall prevalence of left-sided adenomas was higher than right-sided adenomas.

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Folic acid may hike, not cut, colon polyp risk

EXCLUSIVE: Marcheline Bertrand, French actress and mother of Angelina Jolie, has died of cancer

Joel Mason, an expert on folate and cancer prevention at Tufts University in Boston who was not involved in the new study. Right now it would not be appropriate to blindly go forth and further increase the levels of folic acid without better understanding the potential risks, Mason said. And whether we continue folic acid fortification should be an open debate over the next few years. Mason said he believes folic acid someday may earn a role in cancer prevention, perhaps at smaller doses than given in the study. No cancer rate difference Cancer patients should discuss taking vitamins with their doctors, and anyone over 50 who takes vitamins should have a colorectal screening test, said Cornelia Ulrich of Seattles Fred Hutchinson Cancer Research Center, who co-wrote an accompanying editorial. Older individuals often have abnormalities in the colon and folic acid may promote their growth, Ulrich said. Researchers did not see any real difference in rates of colon cancer, just in the precancerous colon growths. Some of the participants also took aspirin as part of the study. The aspirin seemed to protect the colon against the harms of folic acid. The study was not designed to look at prostate cancer, but more men who took folic acid developed prostate cancer than did the other men (7.3 percent vs. 2.8 percent). Grants from the National Institutes of Health funded the study. Some of the researchers reported financial ties to drug companies, such as consulting work and research support.

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In a new analysis, American Cancer Society researchers led by Rebecca L. Siegel, M.P.H., looked at trends in colorectal cancer incidence rates between 1992 and 2005 among young adults (ages 20 to 49) by sex, race/ethnicity, age, stage at diagnosis, and anatomic subsite. The study found that among individuals ages 20 to 49, incidence rates of colorectal cancer increased 1.5 percent per year in men and 1.6 percent per year in women from 1992 to 2005. Among non-Hispanic Whites, rates increased for both men and women in each 10-year age grouping (20-29, 30-39, and 40-49 years) and for every stage of diagnosis. They found the largest annual percent increase in colorectal cancer incidence was in the youngest age group (20-29 years), in whom incidence rates rose by 5.2% per year in men and 5.6% per year in women. They say the rises are due to an increase in left-sided tumors, particularly in the rectum. The researchers address several possibilities for the rise, including rising rates of obesity, which is a major risk factor for colorectal cancer. Dietary factors may also come into play. The researchers note that between the late 1970s and the mid-1990s, fast-food consumption in the United States increased 5-fold among children and 3-fold among adults. A diet high in fast food is associated with both greater meat consumption and reduced milk consumption. Increased consumption of red and processed meat has been shown to increase risk of cancers of the distal colon and rectum, while milk and calcium consumption have shown a protective effect against the subsites in which the rise in incidence was most prominent. They say it is plausible that the emergence of unfavorable dietary patterns in children and young adults over the past three decades may have contributed to the increase in CRC among young adults observed in the study.

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Rectal Cancer Rate Increasing in Young Adults

Together, rectal and rectosigmoid cancers appeared to have started to climb in incidence starting in 1984. The rate of increase was identical between males and females and was seen in both black and white populations. Although uncommon, cancer of the rectum and anus gained significant attention with the death of American actress Farrah Fawcett in 2009 after a three-year battle with anal cancer. Anal cancer is rare compared to rectal cancer; the American Cancer Society estimates 39,670 new cases of rectal cancer and 5,260 new cases of anal cancer in 2010. Current guidelines for colorectal cancer screening from the American College of Gastroenterology recommend that screening begin at age 50 for average-risk individuals and at age 45 years for African Americans, who are at higher risk. An earlier start for screening is suggested only for those with a positive family history of colorectal cancer or certain types of polyps. Although the researchers offered no clear explanation for the changing incidence of rectal cancers and didn’t recommend a change to screening guidelines, they warned physicians to take symptoms seriously in younger patients. “Patients presenting with rectal bleeding or other alarming signs or symptoms should be evaluated with this finding in mind,” they wrote. “Although colonoscopy may not be warranted, we suggest that flexible sigmoidoscopy, at a minimum, should be performed in this setting to rule out rectal or rectosigmoid cancer.” — This embed didnt make it to copy for story id = 11463628. — This embed didnt make it to copy for story id = 11463628. — This embed didnt make it to copy for story id = 11463628. — This embed didnt make it to copy for story id = 11463628. — This embed didnt make it to copy for story id = 11463628.

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The study is the first of its kind to find a positive link between the disease and a diet high in foods that contain a lot of sugar and fat. Researchers looked at risk factors including diet, levels of physical activity and smoking in a large Scottish study. A team from the University of Edinburgh examined more than 170 foods. These included fruit, vegetables, fish and meat, as well as high-energy snack foods like chocolates, nuts and crisps and fruit drinks including fruit squash. Scientists reported links with some established risk factors of colorectal cancer such as family history of cancer, physical activity and smoking. They also identified new factors including high intake of high energy snacks and sugar-sweetened drinks. The study which used data from the Scottish Colorectal Cancer Study carried out in 2012, builds on previous research into the link between bowel cancer and diet. Those studies identified two distinct eating patterns one, high in fruit, vegetables and other healthy foods and the other known as the western pattern, which is high in meat, fat and sugar. The healthy dietary pattern was found to be associated with a decreased colorectal cancer risk, while the western dietary pattern was found to be associated with an increased risk. Dr Evropi Theodoratou, of the University of Edinburgh’s School of Molecular, Genetic and Population Health Sciences, said: “What we have found is very interesting and it merits further investigation using large population studies. While the positive associations between a diet high in sugar and fat and colorectal cancer do not automatically imply ’cause and effect’, it is important to take on board what we’ve found especially as people in industrialised countries are consuming more of these foods.” The study is published in the European Journal of Cancer Prevention. Provided by University of Edinburgh

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Gut microbes influence colon cancer risk

It’s not just the microbiome, it’s not just the inflammation, it’s both.” For their study, the researchers induced colorectal tumors in a group of mice, then transferred their feces and bedding to a group of germ-free mice (mice eat their droppings, so this was an easy way to inoculate the germ-free group with a new microbiome). Meanwhile, another group of germ-free mice were similarly inoculated with a new microbiome from healthy mice. Both sets of mice were then induced to develop colorectal tumors, with stark results: the mice that had received a microbiome from the tumor-ridden mice had more than twice as many colon tumors as the mice inoculated with a healthy microbiome. The researchers also inoculated normal mice with gut bacteria from the tumor-ridden mice. One half of this group received antiobiotics before and after inoculation, while the other half received no antibiotics . When induced to develop tumors, the half that had been given antibiotics had fewer, smaller tumors. This second experiment suggests specific populations of microbes are involved in tumor formation, so in a final phase of the study, the team set out to identify them. They discovered that the guts of the tumor-ridden mice contained more bacteria in the genera Bacteroides, Odoribacter and Akkermansia, and fewer in the Prevotellaceae and Porphyromonadaceae families. Gut bacteria imbalance and inflammation ‘feed forward’ Prof. Schloss says they see the process as a “feed-forward” system, where the inflammation changes the balance of the gut bacteria, and the gut bacteria induce inflammation: “They make each other worse to the point that you have higher rates of tumor formation.” The team is now investigating which bacteria are and are not associated with tumor formation. Prof.

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