Obese Colon Cancer Survivors Face Poorer Prognosis
Colon cancer survivors who are moderately or severely obese face tougher survival odds following treatment compared with their normal-weight peers, a new study reveals.
The finding builds on prior research that established that being obese raises the risk for developing colon cancer in the first place.
“Previous studies have shown that obesity does influence the risk of developing colon cancer, but this study takes it one step further,” said study author Dr. Frank A. Sinicrope, a professor of medicine and oncology at the Mayo Clinic in Rochester, Minn. “Because now we know that if you’re obese, you have a higher risk of cancer recurrence or death for patients who have established colon cancer.”
Sinicrope and his colleagues, whose work was funded in part by the U.S. National Cancer Institute, report their findings in the March 15 issue of Clinical Cancer Research.
The American Cancer Society estimates that last year more than 106,000 Americans were newly diagnosed with colon cancer, while nearly 50,000 men and women died from the disease.
To explore a potential connection between obesity and colon cancer survival, the authors analyzed data concerning 4,381 men and women who had been diagnosed with either stage II or stage III colon cancer. All of the patients had undergone both surgical removal of their cancer and subsequent chemotherapy.
Based on body mass index (BMI), which is a measurement that takes into account weight and height, the researchers determined that approximately 20 percent of the patients were obese (above 30 on the BMI chart). Among that group, about seven in 10 patients were classified as “moderately obese” (BMI between 30 and 34.9), while slightly more than one-quarter were “very obese” (BMI of 35 and up).
About 37 percent of the patients were normal weight (BMI of 20 to 24.9), while a similar number were deemed overweight (BMI of 25 to 29.9). Six percent were classified as underweight (BMI under 20).
Tracking all the cancer survivors for an average of eight years, Sinicrope and his associates observed that 36 percent went on to experience cancer recurrence, while 42 percent ultimately died.
Furthermore, the researchers found that, taken as a group, being either moderately or very obese was associated on average with a 19 percent increase in the risk for death, when compared with normal-weight cancer patients.
Although the pool of underweight patients was considerably smaller, the researchers found that the underweight group also had a much poorer survival rate than normal-weight patients. And while overweight patients actually seemed to fare slightly better (by 6 percent) than normal-weight survivors, Sinicrope indicated that more sophisticated obesity measurements that take into account muscle-mass ratios (not revealed by BMI) could yield slightly different results.
Gender differences were also apparent.
With a patient pool that was more or less evenly divided between men and women, the authors found that taken on their own, the most severely obese men faced the highest risk for cancer recurrence and death — tagged as a 35 percent increase, relative to normal-weight patients.
However, women on the lowest end of the obesity scale were linked to a 24 percent increased risk for death — a risk that actually dropped down to 11 percent as obesity rose.
“For now, we don’t really have a clear explanation for why the moderately obese women did worse than the very obese women,” said Sinicrope. “Menopausal status and hormone replacement therapy — which could be protective against colon cancer — could both be factors. But we don’t know which women were pre- or postmenopausal and which were taking this medication.”
As for what general underlying cause accounts for the obesity-survival risk connection, Sinicrope said the question remains unanswered. But he speculated that the association might result from the presence of higher insulin and insulin-like growth-factor-1 hormone levels in obese patients.
“We know the obese patients have higher levels of both these hormones, which have been associated with both obesity and colon cancer risk in the past,” he noted. “So we think that could be playing a role in this risk.”
A number of variables could explain the findings, said Dr. Joseph Martz, chief of the division of colorectal surgery at Beth Israel Medical Center in New York City.
“Obesity is often associated with a higher likelihood for diabetes and other diseases, and overall secondary immune dysfunction. And since colon cancer is somewhat of an immune disease, that is going to be a driving factor,” he noted.
“There is also a good deal of data already regarding the supportive benefit of exercise and activity after colon cancer treatment in terms of prognosis,” Martz added. “So I think that goes along with the concept that obese individuals are less likely to be in shape. Also, there may be some inherent surgical limitations that could compromise the technical ability to achieve complete removal of the cancer and the potentially affected lymph node tissues when operating on an obese person. All of this may play a role.”
On a related front, a separate study published this week in the Journal of the National Cancer Institute provides fresh evidence that being obese does appear to be linked to a higher risk for colon cancer.
However, the research team — led by Peter T. Campbell of the epidemiology research program at the American Cancer Society — also found that the obesity-survival link does not seem to hold for all tumors, but only for those that are so-called “microsatellite stable.” Obese patients who had this common type of tumor had lower five-year survival rates than obese patients with “microsatellite-high” tumors, suggesting that obesity has a varying impact on prognosis, depending on the kind of colon cancer at hand. By Alan Mozes, Yahoo Daily News
Kept Weight Off
Some people along with the so-called health enthusiasts really don’t believe that death begins in the colon. But according to a coroner, autopsies often reveal colons that are plugged up to 80% with waste material. Well, you don’t even know that as of now, you could be plugging your colon with years of waste & poison. The colon is like a sewerage system, but because of neglect and abuse it’ll probably becomes a filthy place. And towards that development, colon cleansers have been one of the most popular health supplements sold on the market today.
Be that as it may, however, be extra careful in choosing your desired colon cleanse as different companies have been flooding the market and often advertised as the best colon cleanser available. Though it may be quite difficult for you to find out which product really produces the promised results, hence, many users of colon cleanse say that since they used the product, they stopped gaining weight, felt loss bloated and consistently kept weight off all while feeling less irritability.
Lactose Intolerance Proof Cow’s Milk Not For Humans
GOT MILK? WELL, IF YOU HAVE, then a number of health advocates and scientists would say you’ve likely got health problems, too.
Doctors Neil Nedley and David de Rose, authors of “Proof Positive,” relate how, several years ago, a large US humanitarian shipment of powdered milk backfired as widespread cases of cramping and diarrhea—the classic symptoms of lactose intolerance—were reported in various South American communities that received and consumed the milk.
Physiologically, after infancy, many individuals lose their ability to digest simple sugar, or lactose, that cow’s milk is rich in. They develop an insufficiency of the enzyme lactase that is needed to break down lactose into two simple sugars so that it can be absorbed properly by the body. The result is that undigested lactose travels to the large intestine where bacteria break this sugar down, producing anything from gas, to cramps, to diarrhea. Lactose intolerance appears to be the main factor in as many as a third of cases of recurrent abdominal pain in children.
Well over half the world’s population is lactose intolerant. Some races tend to lose the lactase enzyme earlier in life than others.
Nutrition biochemist T. Colin Campbell, which co-authored “The China Study” with son Thomas Jr., wrote in a chapter on autoimmune disease how cow’s milk may cause Type 1 diabetes, one of the most devastating diseases that can befall a child. The ability of cow’s milk protein to initiate Type 1 diabetes is well documented. The possible initiation of this disease, he wrote, goes like this:
• An infant is not nursed long enough with its own mother’s milk, and is fed cow’s milk protein, perhaps as an infant formula.
• The (infant milk formula) reaches the small intestine, where it is digested down to its amino acid parts.
• For some infants, cow’s milk is not fully digested, and small amino acid chains or fragments of the original protein remain in the intestine
• These incompletely digested protein fragments may be absorbed into the blood.
• The immune system recognizes these fragments as foreign invaders and goes about destroying them.
• Unfortunately, some of the fragments look exactly the same as the cells of the pancreas that are responsible for making insulin.
• The immune system loses its ability to distinguish between the cow’s milk protein fragments and the pancreatic cells, and destroys them both, thereby eliminating the child’s ability to produce insulin.
• The infant becomes a Type 1 diabetic, and remains so for the rest of his or her life.
Contrary to numerous milk advertisements championing the product as loaded with calcium, Nedley and DeRose further said cow’s milk results in just a low absorption of calcium by the body. They cited various studies that show:
1. Only 25 percent of the calcium in cow’s milk is absorbed by the body
2. Human milk, although containing less than half the calcium of cow’s milk, is a better source of calcium because of its high absorption qualities.
3. Kale, turnip greens or sesame seeds are better sources of calcium for the same reason.
Major childhood health concerns related to drinking cow’s milk are the higher risk of developing allergies, iron deficiency anemia, lowered intelligence, milk sensitivities, early atherosclerosis, juvenile diabetes, acne, rheumatoid arthritis, dental decay and infectious diseases.
The milk sensitivity disorders could include chronic fatigue, tension headache, musculoskeletal pain, hyperactivity, bed wetting, aggravation of allergies and congestion and asthma and other respiratory diseases.
Nona D. Andaya-Castillo, International Board Lactation Consultant of the Breastfeeding Clinic Philippines, stressed that breastmilk is the only perfect food for infants and the only perfect milk for children. The World Health Organization and Unicef recommend that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health and should receive nutritionally adequate and safe complementary foods, while breastfeeding should continue beyond two years.
Andaya-Castillo has consistently exposed cases of contamination of dairy products that have occurred here and abroad, which has even prompted employees of a multinational company that produced infant milk formulas to give her a top secret and voluminous documentation of the sale of contaminated milk by their company.
“These whistleblowers helped the Department of Health to win the case filed against it by milk companies when it was trying to strengthen laws that protect breastfeeding to protect parents from unethical marketing tactics such as issuing false health and nutritional claims,” Andaya said. By Tessa Salazar, PDI
Arthritis Too Is A Lifestyle Disease
Diabetes and hypertension are not the only lifestyle diseases, but possibly the most high profile. Arthritis is also a lifestyle disease, orthopaedicians insist.
While degenerative arthritis is essentially wear and tear of the joints, more manifest in the knees in India, it is also true that those affected are not necessarily people over 65 years.
Mrs. Al Saeed Nada Ali Kadhim is only 54. But she was suffering from Rheumatoid Arthritis which affected both her knees for the last 20 years. For two years now, she has not been able to walk. At Apollo Speciality Hospital, surgeons put in a new generation Ceramic Coated Knee that will now ease her pain.
Even younger is Anjana Devi, 50, from Vijayawada. She too has benefitted from a ceramic joint and is now able to walk. “With these patients, conventional metal total knee replacement was not possible due to their relative youth. The advantage with the ceramic knee is that it would last twice as long as the conventional device,” says Vijay C.Bose, joint reconstructive surgeon, Apollo Speciality Hospital. “Arthritis is also a lifestyle disease. All of us, if we live to a 100, may develop arthritis, that is normal, as it is wear and tear. However, a lot of people are developing the condition much earlier, it is more common now,” Dr. Bose explained
Prithvi Mohandas, consultant hip surgeon, MIOT Hospitals, says a lot of young males with Ankylosing Spondylitis, a chronic inflammatory autoimmune disease, are reporting early these days. “It is very common in India, occurs among 16-17 year old males and initially manifests as early morning stiffness. The natural progression is low back pain and stiffness of joints, really crippling movements,” he explains. However, if picked up early, it can be easily treated with a bunch of drugs. “Weight is a certain factor in degenerative arthritis,” Dr. Bose says. The heavier you are, the greater the wear and tear. Avoid becoming overweight and obese, the aggravating factors such as stress and make sure you get adequate exercise, complimented by a healthy diet, he advices.
“ Suppose you have an auto immune joint disease, once cartilage wear and tear has set in, it will damage the joint. The idea, therefore is to prevent the joint from becoming stiff, with exercises, and avoid putting on weight” Dr. Prithvi says. Kannan Pugazhendhi, sports physician, adds that most people ignore the fact that muscular strength provides integrity for the joint. “We can avoid arthritic manifestations by increasing muscular strength, especially for the lower body.” “The biggest misconception is that the knee will wear out with exercise. Exercise will strengthen the muscles, all you have to do is choose the right kind of terrain – non concrete surfaces, including beach sands,” Dr. Pugazhendi explains. By Ramya Kannan, The Hindu
Diabetes Study Seeks Clues in Dolphins
Researchers Find that Dolphins Use Diabetes-Like State to Control Blood Sugar – Here’s a neat dolphin trick that doesn’t involve jumping through hoops. While dolphins sleep overnight (with half their brains and one eye at a time), they begin to show signs of the kind of insulin resistance that marks type 2 diabetes in humans. But when they wake up and have their breakfast, they switch back to their normal state.
A research team led by Stephanie Venn-Watson announced the findings at the American Association for the Advancement of Science meeting in San Diego, and said that dolphins’ apparent ability to switch insulin resistance on and off could lead to better understanding of the disease in humans.
Insulin helps people control their levels of blood sugar, and the resistance to it inherent in type 2 diabetes means those levels can get way too high.
The dolphins, though, switch on this temporary insulin resistance to their advantage, boosting blood sugar levels overnight. “Bottlenose dolphins have large brains that need sugar,” Dr Venn-Watson explained. Since their diet is very low in sugar, “it works to their advantage to have a condition that keeps blood sugar in the body… to keep the brain well fed”
However, while dolphins can turn this resistance off once they start their day and revert to a normal state, they can have metabolic problems similar to diabetes, too. For 21 weeks, Venn-Watson and her colleagues measured insulin levels in six dolphins two hours after the animals ate. One dolphin that had especially high insulin levels compared to others, also had a 10-year history of iron overload, or hemochromatosis. Iron overload is associated with type 2 diabetes in people, Venn-Watson noted.
No other animal has symptoms relating to diabetes so similar to humans, and the connection between the two species is probably our big, glucose-demanding brains. So, Venn-Watson says, studying them could help researchers figure out how to confront insulin resistance in humans: “There is no desire to make a dolphin a lab animal, but what we can do is compare their genes with human genes and look for evidence of a genetic switch” By Andrew Moseman, CBS News