Cancer Watch - May-June 2004

Originally published in May-June 2004 icon

Cancer Watch eye

Bacteria cancer link

Alistair Lax, professor of cellular microbiology at King’s College, London has confirmed what ICON has been telling you for 18 months. Professor Lax cites helicobacter pylon as the prime suspect in stomach cancer. His figures indicated that one in three people may be carriers, and he went on to suggest other cancers may be eventually linked to bacteria in the body. He specifically mentioned renal, stomach and bowel cancers but said that, since bacteria produced toxins and could be found universally in the body, other cancers may have bacteria as a causal factor.

Night goggles for brain tumour surgeons?

M D Anderson Cancer Centre researchers have suggested that near-infrared optical imagery, based on night goggle technology, can show up tumour margins more easily and thus help surgeons become more accurate in removing tumours. Dr Shi Ke presented results of an imaging probe that showed up small brain tumours.

3-D Pictures of tumours

A new scanner giving 3-D pictures has been combined with radiotherapy in a trial at Christie Hospital, Manchester. Professor Chris Moore said, "For the first time the system lets us see what we want to hit with our treatment in real time". Professor Ann Barrett added that, "The advantage of having an on-line imaging system is that it can instantaneously correct for any movement and ensure that you are still treating what you intend to treat".

Macmillan campaign

MP’s rallied behind Macmillan in April 2004 and called on the Government to review how the NHS spends its money on cancer services. A motion has been tabled by Labour MP Dr lan Gibson, Conservatives John Baron and Tony Baldry and Sandra Gidley, a LibDem, calling on the Government to formally respond to Macmillan’s ideas following a survey completed last November. The survey showed a lack of transparency, widespread inconsistency, poor investment and inadequate meaningful patient involvement.

Antibiotics linked to cancer?

The Journal of the American Medical Association (Feb 18, 2004; 29 1:827-35) has reported a recent study of 10,000 women. Those who took antibiotics for more than 500 days in a 17 year period held more than twice the risk of breast cancer as women who had taken none. Women who had taken just one dose of antibiotics, statistically increased their risk by 1.5 times.

The study was only recorded for breast cancer but obviously it would be interesting for prostate and other cancers. The likely explanation might involve the action of antibiotics in destroying good bacteria in the stomach. (In my e-newsletter we have mentioned that good bacteria keep helicobacter pylon in check. The bacterium is linked to lowered levels of B-12 in the blood). It could also be simply a case of women who get more infections have weaker immune systems and may be more prone to cancer. The study followed up on original findings in Finland in 2000 where the first connection was made.

US Government advises lower salt levels than FSA

In my book The Tree of Life, I advocate a maximum of 1 gm of sodium per day. Sodium excess is known to displace potassium from the power stations in cells, causing a lowering of oxygen in the cell’s biochemistry, a more acid environment and general toxicity. The FSA when we wrote to them advocated 6 gms of "salt" per day - which we feel is too much. Now the US Institute of Medicine has concluded that the amount required by a 19-50 year old for maintaining health is just 1.5 gms of sodium per day. They have revised their figure down from 2.4 gms.

Stress hormones may help spread ovarian cancer

MD Anderson Cancer Centre researchers have shown how norepinephrine and epinephrine (that’s stress hormones to you and me) can cause ovarian cancer cells to proliferate in vitro laboratory experiments. Doctor Anil Sood presented his paper at the American Psychosomatic Society in March. Research has previously shown that "stress" hormone can affect the immune systems of cancer patients and link to cancer progression in some. However no link has ever previously been established at the cellular level.

Sood and his team have shown that stress hormones increase levels of vascular endothelial growth factor (VEGF). This is important in driving cancer growth. A number of other cancers have been found to have large numbers of ’stress receptor’ sites - Sood says, "cancer cells will do whatever works to their advantage". In an earlier study, Sood and his team found women with greater distress and less social support have higher levels of VEGF.

Vitamin D and breast cancer

According to The Scotsman (March 23, 2004) low levels of vitamin D in the blood are linked with increased breast cancer risk. A recent study has shown that vitamin D plays a protective role. ICON in February covered vitamin D extensively - it is atypical of vitamins in that the human body does actually make it. Sunlight on our subcutaneous cholesterol levels make cholocalciferol the precursor of vitamin D. If you don’t get enough sunlight, try fish oils (preferably dioxin free). Laboratory tests (Shokravi et al 1995) have shown vitamin D inhibits the growth of new blood vessels essential to tumour growth.

Bladder cancer and low vitamin E

In a study with 1000 people, of whom 468 were newly diagnosed with bladder cancer, researchers at M D Anderson Cancer Centre found that alpha-tocopherol vitamin E significantly reduced the risk of bladder cancer. Dr Wu told the American Association of Cancer Research in March that high intake of alpha-tocopherol vitamin E is linked to a 42 per cent reduced risk. The study continues. Foods richest in alpha-tocopherol include nuts like almonds, fruits and vegetables especially red and green peppers, spinach and greens, seeds (for example, sunflower seeds) and vegetable oils like safflower. Although previous research has made a link with bladder cancer and vitamin F - it did not specify the type.

News from the European Breast Cancer Conference

The Netherlands Organisation for Scientific Research has produced a new model for tumour development that treats tumours henceforth as an integrated part of the body in which they grow. (Ed: At last!!!) And the model links calorie intake to growth rate of tumours and allows for age of patient, since children’s cancers grow faster.

Mammograms only 67 per cent effective - at best

JDr van der Horst, a radiologist in the Netherlands screening programme presented his findings to the 4th European Breast Cancer Conference in Hamburg in March.

He is concerned that changing lifestyle patterns have resulted in many post-menopausal women having breast tissue more akin to that of younger women. He stated that "this makes it harder for mammograms to pick up tumours or early signs of breast cancer and may lead to unnecessary biopsies." He was addressing a meeting of screening specialists.

His research took a random sample of 2000 from 54,000 women, who are screened every two years in Holland. The research classified the tissue as dense if more than a quarter of the tissue was dense. Otherwise it was classified as lucent. The research found that 25 per cent of 50-69 year olds and 17 per cent of 65-69 year olds had dense breasts.

They then looked at cancer rates, comparing total cancers with those detected by the mammograms, i.e. the ability of the mammogram to actually detect a cancer. In the lucent group it was 67 per cent. In the dense group it was 59 per cent. Asked if HRT were a contributing factor, Dr van der Horst said it was unlikely as HRT use in Holland has never been over 15 per cent. He noted that women who have given birth have more lucent breasts than those who haven’t.

Meanwhile at the same conference:

Professor Lars Holmberg from Sweden concluded that older breast cancer patients have a worse prognosis than younger. Whilst the population of Europe ages, he noted that 25 per cent of all breast cancer cases occurs in the over 75 age group. "Of course older people can’t take the really tough treatments - they are just not robust enough", he said, "but increasingly we believe that doctors just don’t try hard enough to find suitable treatments for this group".

PhD Student Britta Weigelt told the same conference that, contrary to what had been previously thought, any primary breast cancer cell was capable of producing secondary cells, which would then spread to other parts of the body. Her group found that even distant metastases had a similar genetic code to the original.

Report on Exemestane

Dr Robert Paridaens reported on the world’s only phase III trial to compare tamoxifen with a newer hormone treatment Exemestane. He said it was, "safe, superior and lengthens progression-free survival". (Ed - We caution readers to note that the trial involved 382 patients in 81 centres in 25 countries over a limited time period and the word "safe" is that of Dr Paridaens not this magazine’s - see below, Dr Piccart).

The majority of cancers in post-menopausal women rely on female hormones to grow. Exemestane is a steroidal Aromatase inhibitor, which permanently inactivates Aromatase, the enzyme that converts the building blocks - androgens - into oestrogen.

During the trial 7.4 per cent of women responded completely (compared with 3% per cent on Tamoxifen), and 36.8 per cent partially (compared with 26.6 per cent on Tamoxifen). The average progression-free period increased from 6.7 months to 10.9 months. The trial was paid for by Pfizer.

Meanwhile Dr Martine Piccart, head of chemotherapy at the Institute Jules Bordet. Belgium, urged researchers to stop reporting prematurely on breast cancer drug trials. She was worried about questions remaining unanswered about side effects or long-term efficacy (Ed: Hear, hear!). She particularly pointed to the fact that in the long-term, risks of Tamoxifen linked endometrial cancer and blood clots might have been more apparent. Now with Aromatase inhibitors she was worried about osteoporosis and bone fractures.

Even in the above Exemestane trial - led by Professor Charles Coombes of Imperial College London - the report was premature with only 90 per cent of completed trials recorded. Dr Piccart stressed that long-term effects for Aromatase were unclear in terms of cardiovascular health, bone density, signal function and quality of life.

Equally no one as yet knows what the optimal treatment strategy is, and what role Aromatase inhibitors and tamoxifen might play. In another presentation, Dr Michael Untch noted that using chemotherapy before surgery meant that 15-30 per cent more breast cancer patients could conserve their breast. He noted that 80 per cent of hormonally responsive cancers shrink and that possible spread caused by surgery was also limited.

Perhaps the final word on this conference should come from the rival conference - the 26th San Antonio Breast Cancer Symposium (3-6th December 2003). In fact the quote comes from the British contingent. Professor Ian Smith of the Royal Marsden said, "Aromatase inhibitors are arguably the biggest advance in breast cancer over the last ten years and likely to reduce mortality even further". Nigel Bundred of South Manchester University Hospital said that studies presented at the symposium, show Tamoxifen is an anachronism that won’t survive.

Cancer Watch - November-December 2004
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