Millions of Australians at risk of bowel cancer

By Alice Archer

More than 8 million Australians (almost one in three people) will be in the “crosshairs” of bowel cancer in just 10 years.

That’s the finding of a disturbing new report released on Monday by leading social demographer Bernard Salt, who says by 2026, 4.6 million baby boomers and 4 million Gen Xers “will be subjected to a bowel cancer lottery” purely because of their age.

“Bowel cancer attacks the middle-aged with progressive lethality, with rates leaping tenfold between the ages of 50 and 79,” he says.

The report examines the rising threat of bowel cancer in our ageing population. Developed by KPMG Demographics and commissioned by Bowel Cancer Australia, it reveals bowel cancer strikes hardest among rural communities, where the 50 to 79 age group comprise at least a third and up to half of the local population.
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“The analysis highlights how localised bowel cancer can be and demonstrates the need for public health programs to be based not only on age but also geography,” Bowel Cancer Australia chief executive Julien Wiggins said.

He says the federal government’s age-based national screening program had significant problems. Positive tests require further investigation by colonoscopy within 30 days, but the government’s response has been painfully slow and waiting times for tests are too long.

“Even before the program’s scheduled full implementation in 2020 – almost two decades after it was first piloted – colonoscopy waiting times in the public health system have exceeded recommended time frames.

“The reporting and publishing of colonoscopy waiting times on the My Hospitals website is long overdue,” Mr Wiggins said. “Bowel cancer patients require timely access to surgery, treatment and cancer support services. However, these are not always available locally, which can adversely impact patient outcomes.”

He says the frustrating aspect is that early detection saves lives. “The unique thing about bowel cancer is that you can catch it before it starts. The screening tests can detect blood in the stool that is invisible to the naked eye.”

Wiggins says he would love to see the “full implementation” of the screening brought forward as soon as possible so more lives can be saved. This would mean people are screened every two years from age 50.

Wiggins also wants to see far greater awareness of the disease that is Australia’s second biggest cancer killer.

“We all need to get over the yuck factor of talking about poo and pay more attention to our bowel health.”

paid more attention to her gut instinct so she would not have had to go through her ordeal.

“I had symptoms for two years before I was diagnosed in 2012,” says the Melbourne mother, who was 42 when her battle began.

Banse-Brown, of Carnegie, noticed blood in her stools, had bloating and felt “really tired”. After a year of suffering, she went to a doctor who told her she probably had haemorrhoids and not to worry.

“I went about my normal business for another year and when the symptoms didn’t go away I went back to the doctor and asked for a colonoscopy.”

Tests confirmed she had stage three cancer, requiring surgery to remove a large section of her bowel. She then underwent six months of “intensive chemotherapy”.

“My message to everyone is that you know your own body better than anyone. If you feel something’s not right, trust your instincts and talk to your doctor.”

 

Comments

What is missing from this Article? It mentions health programs  but  it does not mention Prevention. We need the government to invest more in education about preventing bowel cancer, which is associated by lifestyle and emotional factors. Excessive Alcohol intake, diet and nutrition,  and chronic unresolved stress, depression and anxiety can cause chronic inflammation in the digestive tract. Chronic inflammation affects our immune system’s ability to detect and destroy tumour cells and it also destroys our gut mucous  and healthy bacteria causing sensitivities to proteins and peptides we would normally be able to breakdown. Simply eating the recommended daily intake of green vegetables everyday can reduce our risk of bowel cancer and there are many other lifestyle choices we can make to reduce our risk, but equally important is being able to understand what is a healty bowel and what is not. Cancer is the most expensive condition you can get so it makes sense  the government does more to educate and empower people before they can cancer not invest more into screening which discourages people taking responsiblity for preventative health choices they can make today.

Source

http://www.smh.com.au/national/millions-of-australians-at-risk-of-bowel-cancer-20160320-gnmlzr.html#ixzz43V3GG58M  Follow us: @smh on Twitter | sydneymorningherald on Facebook


New Study: Type II diabetes patients overall cancer risk is 28% higher

 

A population-based cohort study of cancer in 32,247 type 2 diabetes mellitus (T2DM) patients.

•T2DM patients had an overall 28% significantly higher cancer risk.
•Particularly elevated risks were found for liver and pancreas carcinomas.

•T2DM patients with breast cancer had a lower 5-year survival probability than breast cancer patients without diabetes.

Diabetes mellitus (DM) is associated with an elevated risk of cancer. The aim of this study was to assess cancer risk and survival in individuals with type 2 DM (T2DM) in Friuli Venezia Giulia, Italy. A retrospective population-based cohort study of 32,247 T2DM patients aged 40–84 years was conducted through a record linkage of local healthcare databases and cancer registry for the period 2002–2009. Standardized incidence ratios (SIRs) with 95% confidence intervals (95%CIs) and 5-year survival probabilities after T2DM and cancer diagnosis were computed. The SIRs for all cancers (n = 2069) was 1.28 (95%CI: 1.23–1.34). The highest SIRs were observed for cancers of the liver, female genital organs, small intestine, and pancreas. After 3 years from T2DM diagnosis, a reduced risk of prostate cancer (SIR = 0.73, 95%CI: 0.54–0.96) was found in men aged 65–74 years, and a higher risk for breast cancer (SIR = 1.24, 95%CI: 1.00–1.52) was found among T2DM female patients. The overall 5-year survival after T2DM was 88.7%. Furthermore, T2DM appeared to have a negative effect on survival of women with breast cancer. This population-based study confirmed that T2DM patients are at increased risk of several cancers, and of premature death in women with breast cancer.

Source

doi:10.1016/j.canep.2016.01.011

Andrea Gini, Ettore Bidoli, Loris Zanier, Elena Clagnan, Giorgio Zanette, Michele Gobbato, Paolo De Paoli, Diego Serraino, Cancer among patients with type 2 diabetes mellitus: A population-based cohort study in northeastern Italy, Cancer Epidemiology, Volume 41, April 2016, Pages 80-87, ISSN 1877-7821,

 

 


IT’S ALL RELATIVE : How to understand cancer risk

Comment

This is a great article to remind us what risk really means when we talk about the probability of getting cancer.

Ian Olver, University of South Australia

Absolute risk is the risk of developing a cancer over a certain period of time.

Relative risk is the risk one group of people has of developing a cancer compared to the risk of another group.

 

The Conversation’s cancer map shows that the risk of bowel cancer is 10% higher for men and women who have one standard alcoholic drink every day, than for those who don’t drink any alcohol.

This is known as “relative risk” and does not mean you have a 10% chance of getting bowel cancer if you drink one drink per day.

As the map says, it means your risk of bowel cancer is 10% higher than the risk of someone who doesn’t drink any alcohol.

This 10% matters not only in relation to someone else, but also in relation to the absolute risk of getting the particular cancer in the first place. If the absolute risk is small, then a 10% increase still doesn’t make your chances of getting cancer very high.

For instance, a man living in Australia has an absolute risk of 10% of developing bowel cancer over his lifetime. If he drinks one beer every day and his risk of bowel cancer increases by 10%, then it only goes up to 11% overall – so not much higher than it was in the first place.

Absolute Risk

The absolute risk of cancer is the chance of developing a certain cancer over a specified period of time, say in one year or in five years.

That chance will change depending on different factors. The most important is a person’s age. Since most cancers are more common in older age groups, your absolute risk of cancer will be higher as you get older.

One measure of absolute risk is the lifetime risk, which is the absolute risk of a certain cancer over the period of someone’s life.

The graph below shows the risk for men and women who live in Australia getting certain cancers before the age of 85.

Women who have genetic changes in the BRCA1 or BRCA2 genes have around a 60% absolute lifetime risk of developing breast cancer. This absolute risk is high.

But this risk is over a whole lifetime, so a woman with altered BRCA genes who ends up developing breast cancer may not do so until she is in her 70s or 80s.

Relative risk

 

Relative risk compares the risk of cancer in one group of people to that in another group.

The chance of a group with a common risk factor (such as obesity) developing cancer can be compared to the chance of another group of people with a healthy weight. This relative risk ratio will remain constant across the world. But absolute risk will vary depending on how common a cancer is in a particular region.

Relative risk may sometimes be quite high and lead people to believe the absolute risk of developing disease is higher than it actually is.

For instance, a woman from a Western country has a 2 in 100 chance (2% absolute lifetime risk) of developing cancer of the endometrium (lining of the uterus) by the age of 85.

If the woman is obese, her risk of endometrial cancer is twice that of a woman of ideal weight. That is, a relative risk of 2 or 100% greater chance of developing endometrial cancer than a woman who is not obese.

This 100% figure may sound like obese women have a very high risk of endometrial cancer. But, in fact, the risk is still quite low, since doubling the 2% population risk still only makes the absolute risk of endometrial cancer in obese women around 4%. This is still a low probability of cancer.

Be careful not to confuse relative risk with absolute risk and remember the time-frames over which absolute risk can apply

It’s all relative: how to understand cancer risk


A Great tool to see how you can reduce your risk of cancer

Less than 10% cancers are genetic,which means 90% are due to epigenetic factors.  We know some of the reasons why people get cancer later in life and these can be easy to change. This is a great online tool to show you how some of the lifestyle choices you make can increase or decrease cancer risk.

https://theconversation.com/interactive-body-map-what-really-gives-you-cancer-52427


Traditional Chinese Medicine Significantly Improves Quality of Life in Lung Cancer Patients

Traditional herbal medicine as an adjuvant treatment for non-small-cell lung cancer: A systematic review and meta-analysis

Introduction

Non-small-cell lung cancer (NSCLC) is one of the most common cancers and the leading cause of cancer-related deaths. In East Asia, traditional herbal medicine (THM) is commonly used in clinical settings for the treatment of cancer. Therefore, the aim of the present review was to systematically assess the efficacy of THM with varied components for the treatment of NSCLC.
Methods

This study identified randomized controlled trials (RCTs) that evaluated the effectiveness of combined THM and chemotherapy (CTx) in searches of English, Chinese, Japanese, and Korean language databases.
Results

This meta-analysis systematically reviewed 27 RCTs involving 2382 patients and found that THM improved the quality of life (QoL) significantly for patients with NSCLC. Improvement in QoL was seen in 19 studies using the Karnofsky Performance Status score, three studies using the Eastern Cooperative Oncology Group scale, three studies using the Functional Assessment of Cancer Therapy-Lung scale, and six studies using the European Organization for Research and Treatment of Cancer.
Conclusions

The pooled results of this systematic review and meta-analysis suggest that THM significantly improved the QoL for patients with NSCLC.

Comments

There is extensive evidence that Traditional Chinese Herbs not only reduces side effects of Chemotherapy but they enhance the chemo agent effects by regulating cell multi-drug resistance factors. TCM herbs also reduce the side effects of radiotherapy helping relieve exhaustion, pain and digestive problems as well as improve recovery.

In China more than 90% of breast Cancer patients choose to use TCM as an adjunct and their QoL outcomes are significantly better than those who choose only conventional treatment. Unfortunately here in Australia and Western civilisation the use of TCM in cancer treatment protocols is much less common, but it is I believe it is slowly changing due to  studies like this that help to convince Oncologists and patients that Chinese Herbs are safe and useful in oncology clinic.

doi:10.1016/j.eujim.2015.08.005


Silymarin (Milk Thistle) can revoke liver enzyme changes during chemotherapy of breast cancer with Taxanes

doi:10.1016/j.eujim.2015.10.012

Introduction

Drug associated liver injury is common and anticancer agents have been associated with inducing liver dysfunction, too. The present study was designed to evaluate the effect of silymarin (Milk Thistle) in reducing the hepatic side effects of taxane when used in chemotherapy of breast cancer.
Methods

This study was conducted on 99 patients with invasive breast carcinoma receiving chemotherapy contained adriamycin, epirubicin, cyclophosphamide, docetaxel, and paclitaxel. The patients were randomized into 2 groups and given silymarin 70 mg PO three times daily or placebo during their treatment course. The patients were assessed by liver function tests (LFT) after each dose of taxane and results were analyzed statistically.
Results

The patients had mild rises in serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminases (SGPT), and bilirubin in both groups during the study. However, the changes were less notable in the study group. The differences were statistically significant for rises in SGOT and SGPT (23.3 ± 2.3 vs. 1.7 ± 1.5 for SGOT and 27.8 ± 0.6 vs. 23.7 ± 0.3 for SGPT in the control and case groups respectively).
Conclusion

There was a rise in some of the LFT indices after the chemotherapy, with more than 2-fold rise in SGOT, SGPT, and bilirubin which indicated liver injury. The addition of silymarin alleviated these effects considerably.

Comments

Silymarin has been used around the world for centuries as a liver tonic. It protects the liver and restores liver function. It is still used extensively today by complimentary medicine practitioners and Integrative Medical Doctors.  It is encouraging to see that Silymarin can benefit breast cancer patients during Chemotherapy treatment and  Silymarin does not show any significant effect on CYP450 enzymes which makes it ideal for use with Chemo agents


European Code against Cancer – 12 ways to reduce your cancer risk

Among the 504.6 million inhabitants of the member states of the European Union (EU28), there are annually 2.64 million new cancer cases and 1.28 million deaths from cancer. It is estimated that this cancer burden could be reduced by up to one half if scientific knowledge on causes of cancer could be translated into successful prevention. The Code is a preventive tool aimed to reduce the cancer burden by informing people how to avoid or reduce carcinogenic exposures, adopt behaviours to reduce the cancer risk, or to participate in organised intervention programmes. The Code should also form a base to guide national health policies in cancer prevention.

The 12 recommendations are:

not smoking or using other tobacco products;
avoiding second-hand smoke;
being a healthy body weight;
encouraging physical activity;
having a healthy diet;
limiting alcohol consumption, with not drinking alcohol being better for cancer prevention;
avoiding too much exposure to ultraviolet radiation;
avoiding cancer-causing agents at the workplace;
reducing exposure to high levels of radon; encouraging breastfeeding;
limiting the use of hormone replacement therapy;
participating in organised vaccination programmes against hepatitis B for newborns and human papillomavirus for girls;
and participating in organised screening programmes for bowel cancer, breast cancer, and cervical cancer.

You can read the open access paper here

http://www.sciencedirect.com/science/article/pii/S1877782115000764?np=y
http://dx.doi.org/10.1016/j.canep.2015.05.009.


Radiotherapy for DCIS – Does it prolong life?

Treatment for Ductal carcinoma in situ (DCIS) has been criticised for being excessive with unnecessary mastectomies and conventional therapy including chemo and radiotherapy. This criticism stems from  knowledge that 50% of women with DCIS do not end up having invasive cancer and in some instances the lump will vanish within 6 months without any intervention. However for the remaining women DICS remains. Common treatment includes a lumpectomy, followed by radiotherapy and / or chemotherapy.   This study finds that radiotherapy treatment after initial diagnosis does not prolong mortality at the 10 year period. This suggest a women with DCIS  will live just as long if she does not have radiotherapy. However radiotherapy die reduce risk of a ipsilateral invasive recurrence at 10 years.

Importance  Women with ductal carcinoma in situ (DCIS), or stage 0 breast cancer, often experience a second primary breast cancer (DCIS or invasive), and some ultimately die of breast cancer.

Objective  To estimate the 10- and 20-year mortality from breast cancer following a diagnosis of DCIS and to establish whether the mortality rate is influenced by age at diagnosis, ethnicity, and initial treatment received.

Design, Setting, and Participants  Observational study of women who received a diagnosis of DCIS from 1988 to 2011 in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Age at diagnosis, race/ethnicity, pathologic features, date of second primary breast cancer, cause of death, and survival were abstracted for 108 196 women. Their risk of dying of breast cancer was compared with that of women in the general population. Cox proportional hazards analysis was performed to estimate the hazard ratio (HR) for death from DCIS by age at diagnosis, clinical features, ethnicity, and treatment.

Main Outcomes and Measures  Ten- and 20-year breast cancer–specific mortality.

Results  Among the 108 196 women with DCIS, the mean (range) age at diagnosis of DCIS was 53.8 (15-69) years and the mean (range) duration of follow-up was 7.5 (0-23.9) years. At 20 years, the breast cancer–specific mortality was 3.3% (95% CI, 3.0%-3.6%) overall and was higher for women who received a diagnosis before age 35 years compared with older women (7.8% vs 3.2%; HR, 2.58 [95% CI, 1.85-3.60]; P < .001) and for blacks compared with non-Hispanic whites (7.0% vs 3.0%; HR, 2.55 [95% CI, 2.17-3.01]; P < .001). The risk of dying of breast cancer increased after experience of an ipsilateral invasive breast cancer (HR, 18.1 [95% CI, 14.0-23.6]; P < .001). A total of 517 patients died of breast cancer following a DCIS diagnosis (mean follow-up, 7.5 [range, 0-23.9] years) without experiencing an in-breast invasive cancer prior to death. Among patients who received lumpectomy, radiotherapy was associated with a reduction in the risk of ipsilateral invasive recurrence at 10 years (2.5% vs 4.9%; adjusted HR, 0.47 [95% CI, 0.42-0.53];P < .001) but not of breast cancer–specific mortality at 10 years (0.8% vs 0.9%; HR, 0.86 [95% CI, 0.67-1.10]; P = .22).

Conclusions and Relevance  Important risk factors for death from breast cancer following a DCIS diagnosis include age at diagnosis and black ethnicity. The risk of death increases after a diagnosis of an ipsilateral second primary invasive breast cancer, but prevention of these recurrences by radiotherapy does not diminish breast cancer mortality at 10 years.


Mastectomy and Breast-Conserving Therapy Confer Equivalent Outcomes in Young Women With Early-Stage Breast Cancer

A recent study has shown that mastectomy and breast conserving therapy (BCT) consisting of lumpectomy and radiotherapy (RT) have equivalent survival outcomes for young women with early-stage breast cancer (Clin Breast Cancer [published online ahead of print April 2, 2015]. doi: 10.1016/j.clbc.2015.03.012).

The BCT group had a 10-year breast cancer-specific survival (BCSS) rate of 87.7% and an overall survival (OS) rate of 85.9% compared with rates of 85.4% and 83.5%, respectively, in the mastectomy-only group (P5.009 and .01, respectively, for BCSS and OS). In an analysis of patients from both treatment groups combined, those aged 35 to 39 years had significantly better 10-year BCSS and OS rates (88% and 84%, respectively) compared with patients aged 20 to 34 years (86% and 82%, respectively).

When stratified by stage of disease (I, IIA, and IIB), there were no differences noted with regard to BCSS,
OS, or non-BCSS between the 2 treatment groups..  When the patients were stratified by
disease stage and age, the only group among whom a difference in treatment (BCT vs mastectomy without RT) was found to influence survival was those patients aged 20 to 34 years with stage IIB disease. In this group of patients, those undergoing mastectomy only had a significantly inferior 10-year BCSS and OS rate versus the BCT group (P5.004 and .002 for BCSS and OS, respectively).

Our study, along with prior data, provides convincing evidence that BCT is a safe and effective alternative for patients with early-stage breast cancer, even in patients under the age of 40,” says lead author Jason Ye, MD, chief resident of radiation oncology at Weill Cornell. Medical Center in New York City.“This is in contrast to the current trend of an increase in the rate of mastectomies.”

These findings are of interest because there is a trend in the United States for young women to undergo a mastectomy over BCT. A recent registry study of women with breast cancer who were aged younger than 46 years demonstrated that between 2003 and 2010, treatment with lumpectomy decreased from 61% to 49%, whereas the rate of bilateral mastectomy increased from 9% to 24%, and the unilateral mastectomy rate remained steady (J Am Coll Surg. 2014;219:19-28).


Acupuncture for Xerostomia in Patients with Cancer: An Update

Background: Xerostomia (dry mouth) is a common side-effect of cancer treatment following radiotherapy, especially in patients with head-and-neck (HN) cancer. Objective: The purpose of this review was to evaluate evidence related to acupuncture for xerostomia in patients with HN cancer.

Materials and Methods: Embase, Medline, Cochrane (all databases), PubMed, and Scopus were searched from inception through December 2014 for studies published in English that were randomized controlled trials (RCTs) evaluating acupuncture to treat and/or prevent xerostomia in patients with cancer. A usual-care and/or placebo comparison group was required for inclusion. Risk of bias (ROB) was rated as low, high, or unclear according to Cochrane criteria. Outcomes and treatment parameters were summarized.

Results: Of 184 articles identified, 136 duplicates were omitted, leaving 48 publications that were screened. Thirty-nine studies were excluded because they were not prospective RCTs of acupuncture in patients with cancer, and three studies did not involve needle insertion into acupuncture points. Six studies met all inclusion criteria. Four investigated acupuncture to treat xerostomia, and two investigated acupuncture to prevent xerostomia. Of the six included trials, four reported significant between-group differences in favor of real acupuncture, and two reported significant within-group differences only. No studies were rated as low ROB, either because of low statistical power or a lack of blinding.

Conclusions: Acupuncture may be a helpful adjunct to cancer care for treatment and/or prevention of xerostomia in patients with HN cancer, but studies to date have been limited by small sample size and/or lack of blinding. Large phase III trials are currently underway.

Comments: 

The Acupuncture points used and the number of sessions  varied considerably in studies. Some studies combined common acupuncture points with ear points. The retention period was fairly consistent across studies with minimum 20 minutes and maximum 30 minutes. Some studies had 3 sessions a week during radiotherapy and others only 1. There are promising results across these studies that prove acupuncture can help increase salivary flow rate and relieving symptoms of dry mouth as well as improving QoL for patients. However the results are inconsistent due to differences in trial design and measurements used. Never the less the review  is a positive outcome for acupuncture as a beneficial adjunct treatment for dry mouth.