This blog is all about current FDA approved drugs to treat the hepatitis C virus (HCV) with a focus on treating HCV according to genotype, using information extracted from peer-reviewed journals, liver meetings/conferences, and interactive learning activities.
Risk Of Developing Liver Cancer After HCV Treatment
This New Test Could Detect All Types of Cancer in Just Minutes
ABU SINA, LAURA G CARRASCOSA & MATT TRAU, THE CONVERSATION 5 DEC 2018
Researchers have developed a test that could be used to diagnose all cancers. It is based on a unique DNA signature that appears to be common across cancer types.
The test has yet to be conducted on humans, and clinical trials are needed before we know for sure if it can be used in the clinic.
Each cancer type, whether it be breast or bowel cancer, has different genetic and other features. A test that detects one cancer may not work on another.
Researchers have long been looking for a commonality among cancers to develop a diagnostic tool that could apply across all types.
Our research, published in the journal Nature Communications, has found that cancer DNA forms a unique structure when placed in water. The structure is the same in DNA from samples of breast, prostate and bowel cancers, as well as lymphoma.
We used this discovery to develop a test that can identify the cancerous DNA in less than ten minutes.
How our test works
Current detection of cancer requires a tissue biopsy – a surgical procedure to collect tissue from the patient's tumour. Researchers have been looking for a less invasive diagnostic test that can detect cancers at an earlier stage.
One possibility, still in development, is a liquid biopsy, testing for circulating cancer DNA in the blood.
Our test also uses circulating cancer DNA but involves a different detection method.
Nearly every cell in a person's body has the same DNA, but studies have found that cancer's progression causes this DNA to undergo considerable reprogramming.
This change is particularly evident in the distribution pattern of a tiny molecule called a methyl group, which decorates the DNA.
A normal cell DNA's distinct methyl pattern is crucial to regulating its machinery and maintaining its functions. It is also responsible for turning genes on and off. Altering this pattern is one of the ways cancer cells regulate their own proliferation.
This methyl patterning has been studied before. However, its effect in a solution (such as water) has never been explored.
Using transmission electron microscopy (a high-resolution microscope), we saw that cancerous DNA fragments folded into three-dimensional structures in water. These were different to what we saw with normal tissue DNA in the water.
In the lab, gold particles are commonly used to help detect biological molecules (such as DNA). This is because gold can affect molecular behaviour in a way that causes visible colour changes.
We discovered that cancerous DNA has a strong affinity towards gold, which means it strongly binds to the gold particles.
This finding directed us to develop a test that can detect cancerous DNA in blood and tissue. This requires a tiny amount of purified DNA to be mixed with some drops of gold particle solution.
By simply observing the colour change, it is possible to identify the cancerous DNA with the naked eye within five minutes.
The test also works for electrochemical detection – when the DNA is attached onto flat gold electrodes.
Since cancer DNA has higher affinity to gold, it provides a higher relative electrochemical current signal in comparison to normal DNA. This electrochemical method is highly sensitive and could also eventually be used as a diagnostic tool. Why this matters
For this test to work properly the DNA must be pure. So far we have tested more than 200 tissue and blood samples, with 90 percent accuracy. Accuracy is important to ensure there are fewer false positives – wrongly detecting cancer when there is none.
The types of cancers we tested included breast, prostate, bowel and lymphoma. We have not yet tested other cancers, but because the methylation pattern is similar across all cancers it is likely the DNA will respond in the same way.
It is a promising start, though further analysis with more samples is needed to prove its clinical use.
The next step is to do a large clinical study to understand how early a cancer can be detected based on this novel DNA signature. We are assessing the possibility to detect different cancer types from different body fluids from early to later stages of cancer.
We are also considering whether the test could help monitor treatment responses based on the abundance of DNA signatures in body fluid during treatment.
Updated Nov 12, 2018
Meeting Coverage @ infohep People with fatty liver disease are at greater risk for multiple cancers Liz Highleyman / 12 November 2018 People with non-alcoholic fatty liver disease (NAFLD) were found to have higher rates of cancer, with the greatest increase observed for gastrointestinal cancers, according to findings presented yesterday at the 2018 AASLD Liver
Fatty liver imposes 91% higher risk for cancer
Nov 11, 2018
“The risk of malignancy was higher in NAFLD vs. controls ... 91% higher than the general population when we take all cancers into account,” Alina M. Allen, MD, of Mayo Clinic, Rochester, Minn., said during her presentation. “Obesity is associated with a higher risk of cancer only in those with NAFLD and not in those without.”
View all updates on this blog (LINK), and recommended coverage elsewhere, (LINK)
Nonalcoholic Fatty Liver Disease Patients Have Higher Rates of All Non-Liver-Related Cancers
November 9, 2018
Data from a new study presented this week at The Liver Meeting® found that rates of malignancy occurring outside of the liver were higher in adults with nonalcoholic fatty liver disease than among adults across most types of cancers.
SAN FRANCISCO – Preliminary data from a new study presented this week at The Liver Meeting® – held by the American Association for the Study of Liver Diseases – found that rates of malignancy occurring outside of the liver were higher in adults with nonalcoholic fatty liver disease than among adults across most types of cancers.
Nonalcoholic fatty liver disease (commonly called NAFLD or fatty liver disease) is used to describe liver complications that arise from the buildup of excess fat in the liver. NAFLD is estimated to affect more than 80 million Americans.
Malignancy is among the most common causes of death in patients with NAFLD. To examine whether increased malignancy risk is similar across all types of cancers, researchers at the Mayo Clinic in Rochester, Minn. conducted a study to determine the rates of cancer diagnoses among NAFLD patients compared to other adults in the United States of similar age and sex.
“Population-based studies such as this one can offer important epidemiologic data regarding the important threats to the health of a community,” explains Alina M. Allen, MD, assistant professor of medicine, Mayo Clinic, and the study’s co-author. “While it is known that individuals with NAFLD are at higher risk to develop cancers, it was not clear which type of cancer and how much higher their risk is, in reference to the general population. Such data would enable appropriate counseling and could inform screening policies.”
The researchers identified 4,782 NAFLD patients and compared them to 14,441 age- and sex-matched controls living in Olmsted County, Minn., between 1997 and 2016 using the Rochester Epidemiology Project database. They calculated age- and sex-adjusted incidence ratios of common cancers per 100,000 person-years between these two patient groups. The median age of the NAFLD patients was 54, and 54 percent were women. Median follow-up time was eight years. Overall, 788 (16 percent) of NAFLD patients and 1,752 (12 percent) of controls were diagnosed with malignancies during the study’s timespan.
Rates of malignancy were higher for NAFLD compared to controls for most types of cancers. The increased malignancy rate for NAFLD patients was highest for liver cancer, followed by stomach cancer, pancreatic cancer, and uterine cancer. Overall, breast, prostate and colon cancers were the three most common malignancies among NAFLD patients.
“These data provide an important “hierarchical” overview of the top most important malignancy risks associated with NAFLD. Liver cancer had the highest increase in relative risk, and this was not a surprising finding,” says Dr. Allen. “However, the 2.5-fold higher risk of stomach and pancreatic cancer are novel data that the medical community should be aware of. Future studies should further examine this association to determine if screening methods should be implemented in this population.”
Editor’s note: This press release contains updated data that is not reflected in the published abstract but will be presented at The Liver Meeting®.
Dr. Allen will present these findings at AASLD’s press conference in Room 312-314 at the George R. Moscone Convention Center in San Francisco on Saturday, November 10 from 4:00 PM – 5:30 PM. The study entitled “The Incidence of Extrahepatic Malignancies in Nonalcoholic Fatty Liver Disease(NAFLD)” will be presented on Sunday, November 11 at 8:30 AM in Room 24/25. The corresponding abstract (number 0031) can be found in the journal, HEPATOLOGY
AASLD is the leading organization of clinicians and researchers committed to preventing and curing liver disease. The work of our members has laid the foundation for the development of drugs used to treat patients with viral hepatitis. Access to care and support of liver disease research are at the center of AASLD’s advocacy efforts. Read the press release and additional information about AASLD are available online at www.aasld.org.
Study Suggests Risk of Cancer Death Increases With Each Generation of Latinos Born in the United States By Jo Cavallo Posted: 11/5/2018 3:30:12 PM
Last Updated: 11/5/2018 3:30:12 PM
Key Points
Latinos in the United States experience an increased risk of cancer death with each generation born in the United States.
The highest cancer death rate occurred among third-generation U.S.-born Latinos, followed by second-generation Latinos with one or both parents born in Mexico. The lowest cancer death rate occurred among first-generation immigrants.
The risk of dying from certain cancers, including lung, colorectal and liver cancers, was significantly higher among third-generation U.S.-born Latinos compared with the first-generation Mexico-born immigrants
According to the U.S. Census Bureau, as of July 2016, the Hispanic population in the United States had grown to 57.5 million, making people of Hispanic origin the nation’s largest ethnic or racial minority group. Studies have shown that U.S.-born Latinos have a higher incidence of cancer than foreign-born Latinos. To better understand the influence that acculturation and environmental factors have on cancer risks in Latinos in the United States, Setiawan et al launched a large observational study examining the cancer mortality patterns across first-generation immigrants and second- and third-generation U.S.-born Mexican Americans.
How to Find a Cancer Doctor
Cancer changes your life and the lives of those around you. Finding the right cancer doctor (called an oncologist) and treatment facility is an important step to getting the treatment and support you need.
Doctors specialize in different types of cancer and treatment methods. It’s important for you to find a doctor with experience treating your type of cancer. You also need to feel good about the doctor you choose. You’ll be working with this person closely as you make decisions about your treatment.
Your primary care doctor can suggest cancer specialists. Or, you may be able to get a recommendation from a friend or family member. Also, your local hospital should be able to provide you with a list of specialists who practice there.
You can check with your local or state medical society, which may maintain a list of doctors in each specialty of cancer care. A nearby medical school may be able to suggest cancer specialists as well.
NIH’s Finding Health Care Services webpage provides a list of several online directories to cancer specialists. Visit www.cancer.gov/about-cancer/managing-care/services to find this and other cancer resources.
American Cancer Society
Cancer Help Line 800.227.2345 Choosing a Doctor and a Hospital
When you learn you have cancer, you want to make sure you get the best possible medical care and treatment. Choosing your doctor and treatment center will be one of the most important decisions you’ll make. There are many excellent cancer care centers in the United States, but how do you know where to look? Continue reading...
American Medical Association DoctorFinder
DoctorFinder provides you with basic professional information on virtually every licensed physician in the United States. This includes more than 814,000 doctors.
American Society of Clinical Oncology (ASCO) Find a Cancer Doctor
This international medical society represents cancer specialists in clinical research and patient care. They provide an oncologist directory, which is a database of ASCO members called - Find a Cancer Doctor. The Find an Oncologist Database is made available by ASCO as an informational resource for patients and caregivers. The database includes the names of physicians and other health professionals from certain ASCO membership categories who have given their permission to be identified publicly. Inclusion in the database is not an endorsement or a warranty by ASCO of the physicians or other health professionals in the database or the care they provide.
Liver Cancer
This is Cancer.Net’s Guide to Liver Cancer.
Use the menu to choose the Overview/Introduction section to get started. Or, you can choose another section to learn more about a specific question you have. Each guide is reviewed by experts on the Cancer.Net Editorial Board, which is composed of medical, surgical, radiation, gynecologic, and pediatric oncologists, oncology nurses, physician assistants, social workers, and patient advocates. Continue reading.....
Cancer.Net Video:
Choosing an Oncologist, with John Sweetenham, MD
Watch this patient education video to learn more about types of oncologists, sources to help find an oncologist, what to consider at your first appointment, and more with Drs. Shelby Terstriep and Jyoti Patel.
Today is World Cancer Day
Did you know chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) is the most common risk factor for liver cancer? The only way to know your status is to get tested for hepatitis B and C, take a 5 minute Hepatitis Risk Assessment developed by the CDC and get a personalized report.
Free registration may be required to view article
Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD
Hepatitis C is an infection caused by the hepatitis C virus (HCV) that attacks the liver and leads to inflammation. The World Health Organization (WHO) estimates about 71 million people globally have chronic hepatitis C, with approximately 399,000 dying from this infection as primarily due to cirrhosis and hepatocellular carcinoma. Continue reading........
Alejandro Forner, MD, MD Alejandro Forner
Published: 04 January 2018
DOI: http://dx.doi.org/10.1016/S0140-6736(18)30010-2
Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour ≤5 cm or up to three nodules ≤3 cm). Image-guided ablation is the most frequently used therapeutic strategy, but its efficacy is limited by the size of the tumour and its localisation. Chemoembolisation has survival benefit in asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread. Finally, sorafenib, lenvatinib, which is non-inferior to sorafenib, and regorafenib increase survival and are the standard treatments in advanced hepatocellular carcinoma. This Seminar summarises the scientific evidence that supports the current recommendations for clinical practice, and discusses the areas in which more research is needed....
Full-text article
Downloaded & shared by @HenryEChangvia Twitter.
View Article: https://jumpshare.com/v/La5WS4Mn8Uwpi927nbeU
November 2017
Alan Franciscus
Did you know that people who were treated with direct-acting antiviral (DAA) medications….
*Were significantly less likely to die than the people who were untreated.
*Had at least a 20% decrease in liver fibrosis after 24-weeks of the completion of DAA therapy
*Experienced a 71% reduction in liver cancer risk after being cured with a DAA medication.
The studies on this blog looked at treatment with DAAs to find out if curing hepatitis C (HCV) with DAAs improved HCV disease progression and reduced the risk of liver cancer.
Direct-acting antiviral treatment for hepatitis C did not correlate with an increased risk for hepatocellular carcinoma in a large cohort study of both treated and untreated patients with or without cirrhosis. Those with incident HCC after DAA treatment had higher risk factors at baseline. “There was no increased risk for HCC as a result of having received DAA therapy whatsoever,” Raymond T. Chung, PhD, director of Hepatology and Liver Center at Massachusetts General Hospital, told Healio Gastroenterology and Liver Disease. “The risk was related to their preexisting likelihood of developing HCC. The fact that HCC developed post-DAA, we think, is more likely to be an accident of timing than the idea that it's related to receipt of DAA — these persons were at risk for HCC whether they received DAAs or not.”
Deaths from liver cancer nearly double since the 1990s, new figures reveal Feb 1, 2018
Over the past two decades, deaths caused by liver cancer have increased by 80% , making it one of the fastest-growing causes of cancer deaths worldwide.
According to the Global Burden of Disease Study, the most comprehensive worldwide observational epidemiological study to date, 830,000 people died as a result of the disease in 2016 compared to 464,000 people in 1990. This makes liver cancer the second leading cause of cancer deaths worldwide, after lung cancer.
Primary liver cancer, the most prevalent liver cancer worldwide, can be attributed to heavy drinking and other lifestyle choices but is most commonly caused by long-term infection with the hepatitis B or hepatitis C virus. These viruses are a major public health challenge, affecting over 325 million people, worldwide.
Globally, two out of three liver cancer deaths are caused by hepatitis B or C. The Western Pacific and South East Asia regions record the largest numbers of people living with the viruses and also some of the highest cases of liver cancer deaths globally. In China alone, over 260,000 liver cancer deaths caused by hepatitis B and C were recorded in 2016, accounting for a third of the global liver cancer death toll.
According to the findings, the hepatitis C virus was responsible for 160,000 liver deaths in 2016. The USA was amongst the top three countries with the highest numbers, alongside Japan and China.
The American Cancer Society suggests this is because of the high rate of hepatitis C infection among baby boomers (born between 1945 through 1965), of which prevalence is approximately 2.6%, a rate 6-fold greater than that of other adults in the USA. Highly-effective cures for hepatitis C do exist which can halt progression to liver cancer, however only 3 of the 71 million people living with the virus globally, have accessed these life-saving treatments in the last two years.
The study also found that 350,000 liver cancer deaths were caused by the hepatitis B virus, of which China and India accounted for 80% of these. The high majority of these deaths could have been prevented if people received the hepatitis B vaccination after birth. Today, only 52% of countries provide the hepatitis B birth dose vaccine to newborns.
"What many people don't realise is the correlation between the sharp increase in liver cancer deaths and the hepatitis B and C viruses", said Michael Ninburg, President of the World Hepatitis Alliance. "The rise in deaths is ultimately a result of poor vaccination coverage, lack of routine testing and inadequate access to effective treatment".
"Ahead of World Cancer Day, we are asking people go get tested for hepatitis B and C because that is a first vital step in prevention", said Raquel Peck, CEO of the World Hepatitis Alliance. "Together, we can stop cancer in its tracks". http://www.worldhepatitisalliance.org/
Global cancer survival rates improve, but wide gaps remain Last Updated: 2018-01-31 By Kate Kelland
LONDON (Reuters) - Cancer patients' survival prospects are improving, even for some of the deadliest types such as lung cancer, but there are huge disparities between countries, particularly for children, according to a study published on Wednesday.
In the most up-to-date study of cancer survival trends - between 2010 and 2014 - covering countries that are home to two-thirds of the world's people, researchers found some significant progress, but also wide variations.
While brain tumor survival in children has improved in many countries, the study showed that for children diagnosed as recently as 2014, five-year survival is twice as high in Denmark and Sweden, at around 80%, as it is in Mexico and Brazil, at less than 40%.
This gap was most likely due to variations in the availability and quality of cancer diagnosis and treatment services, the researchers said.
The US Centers for Disease Control and Prevention released a new report on cancer and obesity last week, highlighting that cancers associated with overweight and obesity, including thyroid, liver, kidney, and ovarian cancer, constitute 40% of cancers diagnosed in the USA, with over 630 000 diagnoses in 2014 alone....
CDC Telebriefing: New Vital Signs Report – Why is the overall cancer rate declining, while cancer rates associated with overweight and obesity are on the rise?
Tuesday, October 3, 2017
Please Note: This transcript is not edited and may contain errors.
OPERATOR: Good afternoon and thank you for standing by. As a reminder, today’s conference call is being recorded. If you have any objections, please disconnect at this time. Your lines have been placed in listen only mode until the Q&A session of today’s conference. At that time, you may press star followed by the number one to ask a question. I would now like to turn the conference over to your moderator, Kathy Harben. Thank you, you may begin.
KATHY HARBEN: Thank you, Michelle. Thank you, everyone, for joining us today for the release of a new CDC Vital Signs. We are joined today by CDC’s deputy director, Dr. Anne Schuchat, as well as, Dr. Lisa Richardson, who is director of CDC’s Division of Cancer Prevention and Control.
ANNE SCHUCHAT: Good afternoon, everyone, and thanks for joining us today. CDC provides for the common defense of the country against health threats. Each month in our vital signs report, we focus on a disease from the front lines and give you information to help stop it. Today’s report contains new information about national cancer trends and focuses in on trends in those cancers associated with obesity and overweight. Let’s start with the good news. We have made great strides in overall cancer since the 1990s. As a nation, we’re now better at preventing and treating some cancers. Improvements in early detection through screening have helped drive down cancer rates. Between 2005 and 2014, the incidence of cancers not associated with overweight or obesity decreased 13%. But today’s report shows in some types of cancers, we are going in the wrong direction. As we’ve highlighted before, we are seeing the effects of obesity and overweight on many chronic conditions. Today’s vital signs report highlights how the growing prevalence of obesity and overweight is affecting cancers as well. This may be surprising to many Americans, since awareness of some cancers being associated with obesity and overweight is not yet widespread. Research shows that being overweight or having obesity is associated with at least 13 types of cancer. Today’s report looked carefully at trends in the rates of specific cancers, comparing the ones that are associated with obesity and overweight with the ones that are not, and looking closely at colorectal cancer, which is associated with obesity but also has a very effective screening intervention that can address precancers. Our study shows that cancers not associated with obesity and overweight are going down. Colorectal cancer is going down, but the rates of most of the cancers associated with obesity or overweight has increased over the past decades. They’re up 7%. We’ve noticed these cancers are increasing particularly among middle-aged adults, people between the ages of 50 and 74. These are important results, and may be harbingers of even greater challenges in the years to come. Tackling obesity is difficult. Many of us struggle with our weight. We’ve heard for a long time that people who are obese or overweight are more likely to suffer from heart disease, strokes, and diabetes. But more than half of Americans are not aware that excess weight can increase the risk of many cancers. And unfortunately, two out of three Americans are either overweight or obese. It’s easier to prevent overweight and obesity than it is to reverse it and the science is still catching up on whether and how much losing weight can lower a person’s risk of some cancers. We do know that even modest weight loss can help when it comes to lowering the risk of other chronic diseases like diabetes and heart disease. The trends we’re reporting today are concerning. The first step to addressing a risk is to be aware of it. There are many good reasons to strive for healthy weight. Now you can add reducing your risk for cancer to the list. The obesity epidemic is a complex and major public health challenge that requires comprehensive efforts. People can eat healthy, be physically active, and get recommended cancer screening. I’m going to turn things over now to Dr. Lisa Richardson, who will share the detailed findings from the report.
LISA RICHARDSON: Thank you, Dr. Schuchat. For this Vital Signs report, we analyzed data from the United States Cancer Statistics database to calculate cancer rates associated with being overweight and having obesity in 2014 and trends from 2005 to 2014. We looked at the 13 types of cancer classified by the International Agency for Research on Cancer as having enough evidence to support being associated with excess body fat. These include cancers of the thyroid, gallbladder, upper stomach, liver, pancreas, kidneys, ovaries, uterus, colon and rectum, breast in post-menopausal women, myeloma, a cancer of blood cells, meningioma, cancer in the brain and spinal cord, and a type of cancer of the esophagus. In 2014, 13 cancers associated with overweight and obesity made up 40% of all cancers diagnosed. Around 55% of cancers in men and 24% of — sorry, in more men, and 24% of cancers in men were associated with overweight and obesity. The fact that endometrial, ovarian, and post-menopausal breast cancers accounted for 42% new cases in 2014 reflects the fact that these cancers occur among females. However, among cancers that affect both males and females, incidence rates were higher among males. For the time period studied, new cancer rates for all cancers associated with overweight and obesity are down, but the decrease varied widely by age group. Colorectal cancer had the second largest decrease in rate of new cases during the study period. Increased colorectal cancer screening, which prevents colon cancer, most likely accounts for this decline. It’s important to note, though, that when we took colorectal cancer out of the equation, we found cancers associated with overweight and obesity went up in all age groups except people age 75 or older. These findings are concerning and it will take the cooperation and coordination of many more organizations to help more people nationwide get to or maintain a healthy weight. On a federal level, CDC supports comprehensive cancer control programs in all 50 states, the District of Columbia, 8 tribes and 7 territories. Our programs focus on cancer prevention, education, screening, quality of cancer care, and survivorship. Our programs work with partners in the community that are already doing some of the following activities. Schools are providing healthy food options and quality physical education. Health care providers can screen for and educate patients about the dangers of overweight and obesity. Workplaces are encouraging physical activity and offering healthy food options in vending machines. Planners are building parks, gardens, and roads that are safe for all types of transportation to share including walking. Planners are being — sorry, encouraging families to be physically active is part of the equation as well. Maintaining a healthy weight and reducing overweight and obesity in adults and children can help reduce the risk and burden of cancer. We’re still learning how losing weight can decrease the risk of some cancers in people who weigh more than recommended. Losing weight also lowers the risk for high blood pressure, diabetes, heart disease, stroke, and other chronic conditions. The bottom line is it will take everyone working together to reduce cancer associated with overweight and obesity. Thank you. I will now turn it back to the moderator.
KATHY HARBEN: Thank you, Dr. Richardson. Michelle, we’re now ready for questions.
OPERATOR: Thank you. At this time if you would like to ask a question, you may press star one. To withdraw your question, you may press star two. Again, star one if you do have any questions. Jessica Glenza, from The Guardian, you may go ahead.
JESSICA GLENZA: Hello. Thank you so much for holding this call. My question is whether rates of obesity linked cancer now rival that of tobacco linked cancer since the CDC has said that tobacco-linked cancers account for 40% of overall cancer diagnoses in the United States.
ANNE SCHUCHAT: Thank you for that question. We could actually get you more information subsequently, but one thing I would like to clarify, when we say obesity associated cancers, some of those cancers are also actually associated with tobacco. It’s different to say something is associated with obesity and overweight than to say that that is the cause. We know that there are different levels of causation, and of course, tobacco has been pretty clearly shown to be the cause of several types of cancer. So, I think the specific numbers involved of adding up all the tobacco-associated cancers and whether those tally greater numbers than all of the current obesity-associated cancers is something that folks can do after the call. I do want to caution that our finding is looking at the 13 types of cancers that are considered associated to obesity and overweight, not that are necessarily all causally related to obesity and overweight. Next question.
OPERATOR: Thank you. Our next question comes from Laurie McGinley from The Washington Post. You may go ahead.
LAURIE MCGINLEY: Yes, thanks very much for taking my question. I’m interested in what you think the mechanisms are of the link here, whether it has to do with inflammation or if there is some explanation or if people don’t really know what the explanation is. And also, you mentioned that not losing weight, it’s not clear whether it would reduce the risk. Why would that be, that not losing weight would not necessarily reduce your risk? Thank you.
ANNE SCHUCHAT: Let me start — this is Dr. Schuchat, then I’ll let Dr. Richardson fill in more details. There are multiple mechanisms considered to be likely biological underpinnings for a link between overweight and obesity and cancer, including the endocrine changes that occur, as well as inflammatory mechanisms that can sometimes be turned on by some of those endocrinological changes that occur with overweight and obesity. In terms of the reversal, we know that it’s possible for some things. You know if you quit smoking for several years, your risk can reduce. The question is really whether the mechanisms that are turned on in the presence of overweight and obesity can be reversed, or whether the cancer process is already far enough along. That’s the high level answer. But let me let Dr. Richardson go into more details about the specific mechanisms.
LISA RICHARDSON: This is Dr. Richardson. Dr. Schuchat is exactly right. For some cancers, the endocrine mechanism, especially estrogen, is very prominent for blood cancer and endometrial cancer. As you stated, inflammation is extremely important in causing carcinogenesis or generating cancer in the first place. Regarding losing weight, the current evidence is the biomarkers, the inflammatory marker that we look for, are decreased when we lose weight about the evidence is still not there about whether it would reduce the risk for developing cancer completely. There is promising research that was published this year in the Journal of Clinical Oncology from the women’s health initiative looking at intention weight loss. In that study, women who lost weight of ten pounds or more did lower their risk of developing endometrial cancer. The evidence is early but promising.
ANNE SCHUCHAT: Thanks. Next question, please.
OPERATOR: Thank you. Mike Stobbe, from the Associated Press. You may go ahead.
MIKE STOBBE: Thank you for taking my call. Just a variation of the earliest one. Could you say in the clearest possible way, does obesity cause cancer, yes or no? Or what’s the most plainspoken statement you can make to answer that question?
ANNE SCHUCHAT: Obesity and overweight are associated with a higher risk of many types of cancers. Our report found an increase in a number of types of cancers associated with obesity and overweight at a period where the prevalence of obesity and overweight has increased substantially in the middle ages. So our report has indirect evidence that this greater evidence of obesity is starting potentially to show up in our cancer statistics. The evidence for a link between obesity and overweight and cancer is considered strong by the international association of research on cancer. And that consortium group has essentially identified 13 types of cancers that are associated with overweight and obesity. So it’s not exactly the same as what we say about tobacco and cancer. But the mounting evidence points to this association and the trends that we’re seeing are an indirect emphasis that there are important general changes going on. Next question?
MIKE STOBBE: Thank you.
ANNE SCHUCHAT: I’m sorry, did you have a follow-up, mike?
MIKE STOBBE: I was just wondering, are there other possible explanations for some of the trends that were noted in some of these cancers besides the fact that these categories of cancer are associated with obesity?
ANNE SCHUCHAT: Yes, and in particular, I think one of the simplest ones to think about is the trend in liver cancer. We saw an important increase in liver cancer between 2005 and 2014. But we know of a number of factors that are associated with liver cancer besides obesity and overweight. Of course, we’re talking a lot about Hepatitis C here as something that’s become quite a bit more common. So I think with liver cancer, there are a number of factors. Hepatitis C and Hepatitis B are both associated with liver cancer, as is fatty liver, which can result from alcohol problems and can also result from overweight and obesity. So I think that gives you an example of the complexity of each of these cancer statistics. I think the importance of today’s report is when we step back and we lump together all of the types of cancers that are associated with overweight and obesity, we saw a direction upwards. And when we looked at all of the other cancers except for colorectal cancer, we saw a direction downwards. That’s not a smoking gun. But that is a note of caution for us. And that’s one of the reasons that we’re trying to bring broader attention to awareness that at this point, obesity and overweight have been associated with a number of types of cancers. Most of us hadn’t heard of that, and that’s one of the things we’re trying to alert the public about. Next question.
OPERATOR: Thank you. Leigh Ann Winick from CBS News. You may go ahead.
LEIGH ANN WINICK: Thank you. I’m wondering and you mentioned in your introduction that about half of Americans are not aware of this association. What does that point to as far as a directive to primary care physicians and other public health officials? What might you be suggesting?
ANNE SCHUCHAT: You know, awareness is the beginning. And certainly we know that people hearing from their doctors or nurses take information differently than when they hear it from the general public or the media. So we do think it’s important for us to get the word out and for clinicians to get the word out with their patients about the potential health effects of overweight and obesity. We know that there’s lots of challenges with maintaining a healthy weight, but that it’s an important thing each of us can do. We know that there can be challenges with having enough physical activity in our daily schedules. But it’s an important thing to do. We do urge clinicians to talk with their patients about how to maintain a healthy weight. And if they are overweight or obese, what kinds of steps they might take to work on that. Next question.
OPERATOR: Thank you. Once again, as a reminder, you may press star one if you would like to ask a question. Our next question comes from Tom Corwin with Augusta Chronicles. You may go ahead.
TOM CORWIN: Thanks for taking my question. I see you have the 13 cancers listed here. One that’s not on the list is prostate cancer. I’m curious whether that was looked at in this report or not.
ANNE SCHUCHAT: Dr. Richardson can answer that one.
LISA RICHARDSON: No, prostate cancer was not reviewed in the most recent report, no. The report, it was not looked at.
TOM CORWIN: Okay. Thank you.
ANNE SCHUCHAT: Okay. Next question.
OPERATOR: Our next question comes from Rachel Bergman with the American Public Health Association. You may go ahead.
RACHEL BERGMAN: Yes, hi, thanks.
ANNE SCHUCHAT: It’s hard for us to hear you, could you try to speak closer to the microphone, please.
RACHEL BERGMAN: Is this any better?
ANNE SCHUCHAT: Just a little bit.
RACHEL BERGMAN: I apologize. I’ll try to speak up. You spoke a little bit about the disparate incidence between males and females with these cancers. Can you talk about other disparities you saw in other population groups?
ANNE SCHUCHAT: Right. Thank you. We did see that the increases were more pronounced in the middle-aged adults than in adults over 75 — or 75 and over. So that was — the trends were, you know, increasing in that middle-aged population. That was an important factor. You know, in terms of the direction that things were going rather than the individual risk. When we look at age in general, of course, cancer rates are higher in the oldest of age groups. But when we looked at the trend in the obesity and overweight associated cancers, we saw it was increasing in those younger age groups and not in the group that was 75 and over. There of course have been some racial and ethnic differences in the incidence of cancers in general, and there are as well in the incidence of obesity and overweight-related cancers, some geographic differences. But I think the important — most important of the differences that we found was that this age group of middle-aged adults, who probably are the cohort that has really experienced this increase in the prevalence of obesity and overweight in America, that that’s the group where obesity and overweight-related cancers, associated cancers, have been increasing, rather than in the oldest age group.
ANNE SCHUCHAT: Next question.
OPERATOR: Once again, if you do have any questions or comments, you may press star one. Again, that is star one if you would like to ask a question.
KATHY HARBEN: Michelle, this is Kathy Harben, the operator. If anyone else has questions, they’re welcome to call us at 404-639-3286. Or they can e-mail us at media@cdc.gov. I would like to thank Dr.’s Schuchat and Richardson for joining us today. We will post a transcript of this call later. And again, if you have other questions, please contact us by phone or e-mail. Thank you very much.
OPERATOR: And thank you. This concludes today’s conference call. You may go ahead and disconnect at this time.
The cancer diagnoses are divided almost equally among men (51%) and women (49%). Just more than half (53%) of all new cases are cancers of the breast, prostate, lung, and bowel.
Five-year survival rates range from more than 80% for breast cancer, prostate cancer, melanoma of the skin, Hodgkin's lymphoma, and thyroid and testicular cancer to fewer than 15% for lung and liver cancer and 6% to 7% for mesothelioma and pancreatic cancer. Continue reading...
CANCER DIAGNOSIS NOW AS COMMON A 'LIFE MILESTONE' AS MARRIAGE OR GETTING A DEGREE 10 July 2017 Being diagnosed with cancer is now one of the most common life-changing events in people’s lives, Macmillan wants the public to be better informed about the reality of cancer diagnosis and treatment
There are more new cases of cancer each year than marriages in the UK, according to a new report from Macmillan Cancer Support.
The report, The C-Word: How we react to cancer today, reveals being diagnosed with cancer is one of the most common life-changing events in people’s lives. New analysis reveals: Cancer is more common than new marriages: Latest figures show there are over 70,000 more new cases of cancer each year in UK than new marriages[i].
Cancer is more common than women having their first child: Latest figures show there are almost 50,000 more new cases of cancer each in year in England and Wales than women giving birth to their first child[ii].
Cancer is as common as graduating: Latest figures show there are a similar number of undergraduate degrees awarded each year in the UK[iii], compared with new cases of cancer.
Cancer affects many people at the “prime” of their life: More than 1.2 million people have been diagnosed with cancer under the age of 65 in the past 10 years, including more than 340,000 diagnosed in their 20s, 30s and 40s[iv].
Cancer is the most feared disease
Macmillan’s research reveals that while receiving a cancer diagnosis is an increasingly common life event, it is the disease people most fear getting (37%), ahead of Alzheimer’s (27%), stroke (7%), depression (4%), heart disease (4%) or multiple sclerosis (2%)[v].
For one in 10 people in the UK (10%), cancer is their biggest fear of all, ahead of losing a loved one, their own death or even terrorism[vi].
However, Macmillan’s report highlights that people’s perceptions and fears around cancer can be unhelpful in supporting them to understand their choices when they are diagnosed. When they were first told they had cancer, one in three people (34%) say they were in a daze and couldn’t take anything in[vii].
We all need to be better prepared and informed about cancer
As one in two people will get cancer at some point in their lives[viii] and more and more people are living longer after cancer[ix], Macmillan wants the public to have a better understanding of the reality of a cancer diagnosis.
The charity has released the report to coincide with the launch of its major new advertising campaign, Life with cancer, which Macmillan hopes will remove some of the fear around diagnosis and highlight the support that is available for people living with cancer today. The charity believes that life with cancer is still life and that people should have the right support in place to help them live it as normally as possible.
A positive new approach to cancer awareness, the campaign reflects the insight that 85% of people with cancer don’t want to be defined by the disease[x]. The series of recently released adverts, show that cancer doesn’t have to change who you are with an important message: life with cancer is still life.
Macmillan’s research shows that nine in ten (90%) people living with cancer say they are still living their lives as normally as they can[xi].
The charity believes that being as prepared as possible, knowing what to expect during and after treatment and being told what support is available from the moment of diagnosis, can support people to continue to live their lives.
Lynda Thomas, chief executive of Macmillan Cancer Support, says:
“Being told you have cancer changes your life, and it can leave people feeling as if they’ve been thrust into the unknown, bewildered and unprepared.
“But as more and more people are being diagnosed with cancer, it’s important that we are all better informed about what to expect if we do one day we receive this shocking news.
“Cancer is almost always life-changing, but it isn’t always life-ending. Life with cancer is still life – you’re still a dad, a sister, a grandparent, a friend. Macmillan has supported millions from the point of diagnosis, throughout their treatment and into the future. From our experience, we believe that living well with cancer begins at diagnosis. People should come away from those first appointments feeling informed about their choices and knowing what support is available.”
Jane Ives, 49, a mum of two from Hampshire, was diagnosed with breast cancer in 2014. She says:
“Getting a diagnosis of cancer was probably the single most terrifying thing that has happened to me. My biggest fear by far was not seeing my children fully grow up. Not being there for those milestones in their lives – their graduations, their weddings maybe. But here I am three years on and in a few weeks I will be at my eldest’s graduation, which will be a huge moment for both of us. While the fear never quite leaves you – you realise life goes on after cancer and you appreciate the here and now.”
Macmillan’s new report, The C-Word: How we react to cancer today, explores what it’s like to receive a cancer diagnosis in 2017, how our fears and preconceptions affect us in the moment we’re told, and how each of us can be prepared for the news. This is essential in helping people to live their best possible life with cancer.
Cancer rates among patients with hepatitis C are increased compared to those not infected
Researchers suggest an extrahepatic manifestation of hepatitis C may be an increased risk of cancer
April 24, 2015, Vienna , Austria: Results announced today at The International Liver CongressTM 2015 show that cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort. The researchers suggest an extrahepatic manifestation of HCV may be an increased risk of cancer.
The aim of the study was to describe the rates of all cancers in the cohort of HCV patients compared to the non-HCV population. Known cancer types associated with hepatitis C include non-Hodgkin's lymphoma, renal and prostate cancers, as well as liver cancer.
A retrospective study at Kaiser Permanente, Southern California, USA, was conducted. The study authors recorded all cancer diagnoses in patients over 18 years of age with or without HCV during 2008-2012. Within the timeframe of the study 145,210 patient years were included in the HCV cohort, and 13,948,826 patient years were included in the non-HCV cohort.
In the HCV cohort there were 2,213 cancer diagnoses (1,524/100,000) during the 5-year period and 1,654 cancer diagnoses when liver cancer was excluded (1,139/100,000). In the non-HCV cohort there were 84,419 cancer diagnoses (605/100,000) during the same 5-year period and 83,795 (601/100,000) when liver cancer was excluded. When all cancers are considered the rate is 2.5 times higher in the HCV cohort; when liver cancers are excluded, the rate is still almost 2 times higher.
Lisa Nyberg, MD, MPH, Kaiser Permanente, Southern California, senior author of the study, explains: "The results suggest that cancer rates are increased in the cohort of hepatitis C patients versus the non-hepatitis C patients, both including and excluding liver cancers. These findings certainly point to the suggestion that hepatitis C may be associated with an increased risk of cancer. However, the findings must be interpreted with caution, as the study also showed that confounding factors such as alcohol abuse, tobacco, obesity, and diabetes modified the results."
Dr Laurent Castera, Vice-Secretary, European Association for the Study of the Liver, commented: "This data adds to the evidence bank linking hepatitis C with an increased risk of cancer, and highlights that there is still a long way to go in order to fully understand this complex and devastating disease."
###
About The International Liver Congress™
This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Specialists share research studies and findings, and discuss the hottest topics related to liver disease. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. 2015 is a very special year for EASL and the hepatology community as they will celebrate the 50th annual meeting. The International Liver Congress™ takes place from April 22-26, 2015, Vienna, Austria.
U.S. cancer incidence, mortality largely stable or decreasing
BY ANDREW M. SEAMAN
There are areas of concern, Sherman told Reuters Health in a phone interview.
For example, liver cancers are increasing, likely due to an increase in hepatitis C infections that goes back decades.
“A couple decades ago, the rate of hepatitis C infections increased and that in turn is being reflected in liver cancer rates,” Sherman said. Fortunately, two of the biggest risk factors for liver cancer are hepatitis C infection and alcohol abuse, which are preventable and treatable, she said.
(Reuters Health) – - The rate of people being diagnosed or killed by cancer in the U.S. is stable or decreasing for men and women, according to a new report.
“For the main cancers, it’s really pretty much good news, incidence and mortality is decreasing,” said Recinda Sherman, an author of the new report from the North American Association of Central Cancer Registries (NAACCR) in Springfield, Illinois.
A highlight of the report is that for the first time it breaks breast cancer into specific groups based on how it responds to hormones, said Ahmedin Jemal, vice president of surveillance and health service research at the American Cancer Society (ACS).
Published on Feb 14, 2014 - Foxnewstest·
More than 30 million people in the U.S. have liver disease. Plus, cases of hepatitis C, non-alcoholic fatty liver disease and liver cancer are on the rise. Dr. Manny sits down with Dr. Nikolaos Pyrsopolous to clear up some myths, and give healthy liver tips
In the new study, the researchers first used the iKnife to analyse tissue samples collected from 302 surgery patients, recording the characteristics of thousands of cancerous and non-cancerous tissues, including brain, lung, breast, stomach, colon and liver tumours to create a reference library. The iKnife works by matching its readings during surgery to the reference library to determine what type of tissue is being cut, giving a result in less than three seconds. The technology was then transferred to the operating theatre to perform real-time analysis during surgery. In all 91 tests, the tissue type identified by the iKnife matched the post-operative diagnosis based on traditional methods.
"Intelligent knife" tells surgeon if tissue is cancerous
Scientists have developed an "intelligent knife" that can tell surgeons immediately whether the tissue they are cutting is cancerous or not.
In the first study to test the invention in the operating theatre, the “iKnife” diagnosed tissue samples from 91 patients with 100 per cent accuracy, instantly providing information that normally takes up to half an hour to reveal using laboratory tests.
In cancers involving solid tumours, removal of the cancer in surgery is generally the best hope for treatment. The surgeon normally takes out the tumour with a margin of healthy tissue. However, it is often impossible to tell by sight which tissue is cancerous. One in five breast cancer patients who have surgery require a second operation to fully remove the cancer. In cases of uncertainty, the removed tissue is sent to a lab for examination while the patient remains under general anaesthetic.
The iKnife is based on electrosurgery, a technology invented in the 1920s that is commonly used today. Electrosurgical knives use an electrical current to rapidly heat tissue, cutting through it while minimising blood loss. In doing so, they vaporise the tissue, creating smoke that is normally sucked away by extraction systems.
We believe it has the potential to reduce tumour recurrence rates and enable more patients to survive. – Dr Zoltan Takats
The inventor of the iKnife, Dr Zoltan Takats of Imperial College London, realised that this smoke would be a rich source of biological information. To create the iKnife, he connected an electrosurgical knife to a mass spectrometer, an analytical instrument used to identify what chemicals are present in a sample. Different types of cell produce thousands of metabolites in different concentrations, so the profile of chemicals in a biological sample can reveal information about the state of that tissue.
In the new study, the researchers first used the iKnife to analyse tissue samples collected from 302 surgery patients, recording the characteristics of thousands of cancerous and non-cancerous tissues, including brain, lung, breast, stomach, colon and liver tumours to create a reference library. The iKnife works by matching its readings during surgery to the reference library to determine what type of tissue is being cut, giving a result in less than three seconds.
The technology was then transferred to the operating theatre to perform real-time analysis during surgery. In all 91 tests, the tissue type identified by the iKnife matched the post-operative diagnosis based on traditional methods.
While the iKnife was being tested, surgeons were unable to see the results of its readings. The researchers hope to carry out a clinical trial to see whether giving surgeons access to the iKnife’s analysis can improve patients’ outcomes.
“These results provide compelling evidence that the iKnife can be applied in a wide range of cancer surgery procedures,” Dr Takats said. “It provides a result almost instantly, allowing surgeons to carry out procedures with a level of accuracy that hasn’t been possible before. We believe it has the potential to reduce tumour recurrence rates and enable more patients to survive.”
Although the current study focussed on cancer diagnosis, Dr Takats says the iKnife can identify many other features, such as tissue with an inadequate blood supply, or types of bacteria present in the tissue. He has also carried out experiments using it to distinguish horsemeat from beef.
Professor Jeremy Nicholson, Head of the Department of Surgery and Cancer at Imperial College London, who co-authored the study, said: “The iKnife is one manifestation of several advanced chemical profiling technologies developed in our labs that are contributing to surgical decision-making and real-time diagnostics. These methods are part of a new framework of patient journey optimisation that we are building at Imperial to help doctors diagnose disease, select the best treatments, and monitor individual patients’ progress as part our personalised healthcare plan.”
Lord Darzi, Professor of Surgery at Imperial College London, who also co-authored the study, said: “In cancer surgery, you want to take out as little healthy tissue as possible, but you have to ensure that you remove all of the cancer. There is a real need for technology that can help the surgeon determine which tissue to cut out and which to leave in. This study shows that the iKnife has the potential to do this, and the impact on cancer surgery could be enormous.”
Lord Howe, Health Minister, said: “We want to be among the best countries in the world at treating cancer and know that new technologies have the potential to save lives. The iKnife could reduce the need for people needing secondary operations for cancer and improve accuracy, and I’m delighted we could support the work of researchers at Imperial College London. This project shows once again how Government funding is putting the UK at the forefront of world-leading health research.”
Reference
J. Balog et al. ‘Intraoperative tissue identification using rapid evaporative ionization mass spectrometry.’ Sci. Transl. Med. 5, 194ra93 (2013).
October 8, 2012
Type 2 diabetes can increase the risk for hepatocellular carcinoma and other malignancies in patients with chronic HCV, according to recent results.
In a retrospective cohort study, researchers observed the incidence of malignancies during a mean follow-up of 8.1 years among 4,302 Japanese patients with chronic HCV who had undergone prior interferon [IFN] therapy. All participants had no malignancies, had received IFN therapy between 1 month and 1 year and were aged 30 to 80 years at enrollment.
Malignancy occurred in 606 patients, including 393 incidents of HCC, which had cumulative development rates of 4.3%, 10.5% ,19.7% and 28% after 5, 10, 15 and 20 years, respectively. Other malignancies — including stomach, colon, lung, pancreatic, prostate and breast cancers — had cumulative development rates of 2.4%, 5.1%, 9.8% and 18% for 5, 10, 15 and 20 years, respectively.
Factors associated with HCC development included the presence of cirrhosis (n=433 patients, HR=5.01; 95% CI, 3.92-6.40), a lack of sustained virological response during interferon therapy (n=2,402 patients; HR=4.93; 95% CI, 3.53-6.89) and type 2 diabetes (T2DM) (n=267 patients; HR=1.73; 95% CI, 1.30-2.30). Investigators noted that the risk for HCC decreased among patients with diabetes and mean HbA1c levels less than 7.0% (HR=0.56; 95% CI, 0.33-0.89).
The presence of non-HCC malignancies was associated with advanced age (HR=2.19, 1.84-2.62 for every 10-year increase), heavier smoking (20 or more pack-years) (HR=1.89, 1.41-2.53 compared to fewer than 20 pack-years) and T2DM (HR=1.70, 1.14-2.53). In particular, T2DM was significantly associated with pancreatic cancer (HR=3.75, 1.02-13.88), and also had a tendency to increase the risk for gastric cancer (HR=2.29, 0.95-5.52) (95% CI for all).
“The present study shows several findings with regard to the development incidence and predictive factors for total malignancies after IFN therapy for HCV patients,” the researchers wrote. “T2DM causes an approximately 1.7-fold enhancement in the development of HCC and malignancies other than HCC after IFN therapy. Additionally, in T2DM patients, maintaining mean HbA1c levels of [less than] 7.0% during follow-up reduced the development of HCC.”
In new study published in PNAS, scientists found that nanoparticles, produced from chemicals in tea, reduced tumors by 80 percent.
July 16, 2012
Currently, large doses of chemotherapy are required when treating certain forms of cancer, resulting in toxic side effects. The chemicals enter the body and work to destroy or shrink the tumor, but also harm vital organs and drastically affect bodily functions. Now, University of Missouri scientists have found a more efficient way of targeting prostate tumors by using gold nanoparticles and a compound found in tea leaves.
This new treatment would require doses that are thousands of times smaller than chemotherapy and do not travel through the body inflicting damage to healthy areas. The study is being published in the Proceedings of the National Academy of Science. Full Story
Older men and women who
took supplements of B vitamins,
or omega-3 fatty acids,
or both for approximately 5
years were no less likely to develop
cancer than people who
took placebo, a randomized
clinical trial has shown.
“This study does not support
dietary use of B vitamins
or omega-3 fatty acids for cancer
prevention,” wrote Valentina
A. Andreeva, Ph.D., and her
associates in the Archives of
Internal Medicine (2012;172:
540-7).
The B vitamins have been
proposed for preventing cancer
because deficiency of these nutrients
is thought to affect
DNA methylation, which in
turn modulates cell differentiation
and chromosomal stability.
Similarly, omega-3 fatty
acids have been suggested as
chemoprevention because they
may restrict tumor cell proliferation,
and they modulate inflammation
and immunity.
However, research regarding
both types of supplements has
yielded inconclusive results.
Dr. Andreeva and her colleagues
studied the issue using
data from a randomized clinical
trial of cardiovascular disease.
In that trial, 2,501 patients
aged 45-80 years who had had
an acute myocardial infarction,
unstable angina, or ischemic
stroke during the preceding
year were randomly assigned
to one of four supplementation
groups and followed for a
mean of 5 years for recurrent
cardiovascular disease–related
events.
The B vitamin and omega-3
fatty acid supplements were
not found to affect cardiovascular
disease recurrence in that
trial. Dr. Andreeva, of the nutritional
epidemiology research
unit, University of
Paris, and associates performed
a secondary analysis to
assess incident cancers in these
study subjects.
The 1,987 men
and 514 women had a mean
age of 61 years at baseline.
The first group took the B
vitamins 5-methyltetrahydrofolate
(0.56 mg), pyridoxine
HCl (vitamin B6, 3 mg), and
cyanocobalamin (vitamin B12,
0.02 mg); the second group
took eicosapentaenoic and docosahexaenoic
acids (600 mg);
the third group took both
types of supplement; and the
fourth group took placebos.
Treatment adherence was
judged to be high, based on
subjects’ self-report and on
their increased blood levels of
both types of nutrients.
During follow-up, 174 subjects
(7%) developed an incident
primary cancer.
The 145 men
with cancer included 50 with
prostate cancer, 22 with lung
cancer, and others with bladder
(16 cases), colorectal (13 cases),
or other (44 cases) malignancies.
Twenty-nine women developed
breast (9 cases), lung (4
cases), colorectal (3 cases), or
other (13) malignancies.
Neither B vitamins nor
omega-3 fatty acids affected
the incidence of cancer, the investigators
said. Among men,
74 who took B vitamins developed
cancer, compared with
71 in the comparison groups,
a nonsignificant difference.
Similarly, 72 men who took
fatty-acid supplements developed
cancer, compared with
73 in the comparison groups,
also a nonsignificant difference.
Among women, 20 who
took B vitamins and 9 in the
comparison groups developed
cancer, a difference of borderline
significance.
And 21 who
took fatty acid supplements
developed cancer, compared
with 8 in the comparison
groups. This difference was
significant, but the low number
of cancer cases in women
“resulted in unstable and
equivocal risk estimates,” the
researchers said.
The study was supported by
Candia, Danone, Merck Eprova
AG, Pierre Fabre Laboratories,
Roche Laboratories,
Sodexo, Unilever, the French
National Research Agency, and
the French Ministry of Health.
The investigators had no relevant
financial disclosures. ■
New MIT study offers comprehensive look at chemical and genetic changes that occur as inflammation progresses to cancer.
Anne Trafton, MIT News Office
One of the biggest risk factors for liver, colon or stomach cancer is chronic inflammation of those organs, often caused by viral or bacterial infections. A new study from MIT offers the most comprehensive look yet at how such infections provoke tissues into becoming cancerous.
Endoscopic biopsy showing granulomatous inflammation of the colon in a case of Crohn's disease. Image: wikipedia/nephron
The study, which is appearing in the online edition of Proceedings of the National Academy of Sciences the week of June 11, tracked a variety of genetic and chemical changes in the livers and colons of mice infected with Helicobacter hepaticus, a bacterium similar to Helicobacter pylori, which causes stomach ulcers and cancer in humans.
The findings could help researchers develop ways to predict the health consequences of chronic inflammation, and design drugs to halt such inflammation.
“If you understand the mechanism, then you can design interventions,” says Peter Dedon, an MIT professor of biological engineering. “For example, what if we develop ways to block or interrupt the toxic effects of the chronic inflammation?”
Dedon is one of four senior authors of the paper, along with Steven Tannenbaum, a professor of biological engineering and chemistry; James Fox, a professor of biological engineering and director of the Department of Comparative Medicine; and Gerald Wogan, a professor of biological engineering and chemistry. Lead author is Aswin Mangerich, a former MIT postdoc now at the University of Konstanz in Germany.
Too much of a good thing
For the past 30 years, Tannenbaum has led a group of MIT researchers dedicated to studying the link between chronic inflammation and cancer. Inflammation is the body’s normal reaction to any kind of infection or damage, but when it goes on for too long, tissues can be damaged.
When the body’s immune system detects pathogens or cell damage, it activates an influx of cells called macrophages and neutrophils. These cells’ job is to engulf bacteria, dead cells and debris: proteins, nucleic acids and other molecules released by dead or damaged cells. As part of this process, the cells produce highly reactive chemicals that help degrade the bacteria.
“In doing this, in engulfing the bacteria and dumping these reactive chemicals on them, the chemicals also diffuse out into the tissue, and that’s where the problem comes in,” Dedon says.
If sustained over a long period, that inflammation can eventually lead to cancer. A recent study published in the journal The Lancet found that infections account for about 16 percent of new cancer cases worldwide.
Widespread damage
In the new MIT study, the researchers analyzed mice that were infected with H. hepaticus, which causes them to develop a condition similar to inflammatory bowel disease in humans. Over the course of 20 weeks, the mice developed chronic infections of the liver and colon, with some of the mice developing colon cancer.
Throughout the 20-week period, the researchers measured about a dozen different types of damage to DNA, RNA and proteins. They also examined tissue damage and measured which genes were turned on and off as the infection progressed. One of their key findings was that the liver and colon responded differently to infection.
In the colon, but not the liver, neutrophils secreted hypochlorous acid (also found in household bleach), which significantly damages proteins, DNA and RNA by adding a chlorine atom to them. The hypochlorous acid is meant to kill bacteria, but it also leaks into surrounding tissue and damages the epithelial cells of the colon.
The researchers found that levels of one of the chlorine-damage products in DNA and RNA, chlorocytosine, correlated well with the severity of the inflammation, which could allow them to predict the risk of chronic inflammation in patients with infections of the colon, liver or stomach. Tannenbaum recently identified another chlorine-damage product in proteins: chlorotyrosine, which correlates with inflammation. While these results point to an important role for neutrophils in inflammation and cancer, “we don’t know yet if we can predict the risk for cancer from these damaged molecules,” Dedon says.
Another difference the researchers found between the colon and the liver was that DNA repair systems became more active in the liver but less active in the colon, even though both were experiencing DNA damage. “It’s possible that we have kind of a double whammy [in the colon]. You have this bacterium that suppresses DNA repair, at the same time that you have all this DNA damage happening in the tissue as a result of the immune response to the bacterium,” Dedon says.
The researchers also identified several previously unknown types of damage to DNA in mice and humans, one of which involves oxidation of guanine, a building block of DNA, to two new products, spiroiminodihydantoin and guanidinohydanotoin.
James Swenberg, a professor of environmental sciences and engineering at the University of North Carolina School of Public Health, says the “comprehensive and innovative” study should help researchers better understand many types of cancer. “I can’t remember ever seeing a paper that brought so many aspects of research to the table in one report,” says Swenberg, who was not involved in the study.
In future studies, the MIT team plans to investigate the mechanisms of cancer development in more detail, including looking at why cells experience an increase in some types of DNA damage but not others.
The research was funded by the National Cancer Institute.
