Do You Know of the Connection Between Obesity and Cancer Risk?

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I just read a provocative headline from Cancer Research UK: Three in four folks in the United Kingdom don’t know obesity causes cancer. Looking by cancer type, 69 percent did not know that there is a connection between obesity and breast cancer, 53 percent did not link pancreas cancer with being overweight, and 40 percent didn’t connect obesity and bowel cancer.

My Take: After smoking, being overweight or obese is the single biggest preventable cause of cancer. Being overweight or obese has been associated with at least ten cancer types, including breast bowel, uterus, and esophagus cancer. For most of us, cancer is not at the front of our minds when thinking about obesity, and I think we need to do a better job of educating the public. I’m Dr. Michael Hunter.

 

http://www.cancerresearchuk.org/sites/default/files/tipping_the_scales_-_cruk_full_report11.pdf

 

 

In Prostate Cancer, Regular Walking May Boost Quality of Life

What You Need to Know: Engaging in a regular walking regimen can improve well-being for men with prostate cancer.

The Study: In the new study, a team led by Siobhan Phillips, Ph.D., of the Northwestern University Feinberg School of Medicine in Chicago, tracked outcomes for 51,529 early-stage prostate cancer survivors in the United States, who completed a survey about their quality of life.

  • Many of the men reported having urinary and bowel problems, erectile dysfunction, and other sexual function problems, as well as weight gain, fatigue, and depression.
  • The men also provided information about the average amount of time per week they spent walking, jogging, running, cycling, swimming, and playing sports.

Results: Three hours of “casual” walking per week boosted the men’s health-related quality of life by reducing fatigue, depression, and weight issues. Walking at a faster pace for 90 minutes a week provided similar benefits, the team found.

My Take: You don’t have to engage in high-impact, vigorous activities to improve your quality of life after a prostate cancer diagnosis. Just keep moving. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Reference: Phillips, Siobhan M., et al. “Physical activity, sedentary behavior, and health-related quality of life in prostate cancer survivors in the health professionals follow-up study.” Journal of Cancer Survivorship. DOI: 10.1007/s11764-015-0426-2. April 16, 2015.

Lethal Metastatic Prostate Cancer May Spread from Other Sites

What You Need to Know: Multiple targeted therapies may be needed to combat metastatic prostate cancer because metastasis may be spread from multiple tumor clones according to a new study. “{The findings} are eye-opening,” said study investigator William Isaacs, PhD, who is a professor of urology at the Johns Hopkins Brady Urological Institute and a member of The Johns Hopkins Kimmel Cancer Center in Baltimore, MD. “It emphasizes the aspects that these cancers are evolving at an almost continual rate.”

The Study: Using whole-genome sequencing, Dr. Isaacs and colleagues characterized multiple metastases arising from prostate tumors in 10 men with metastatic castration-resistant prostate cancer (mCRPC). The team analyzed the subclonal architecture of prostate cancer cells and found that:

  •  Metastasis-to-metastasis spread was found to be common through de novo monoclonal seeding of daughter metastases.
  • Researchers found a transfer of multiple tumor clones between metastatic sites in 5 of the 10 patients.

The researchers believe that a new view of mCRPC is now emerging that tumor cells share a common heritage but subclones develop metastatic potential. The data suggest clonal diversification may occur in part as a necessity to bypass androgen deprivation therapy (ADT) and subsequently drive distinct subclones onto a convergent path of therapeutic resistance.

My Take: Whole-genome sequencing on the samples showed that even though a single cell begins the metastatic process, the disease becomes very heterogeneous as it spreads throughout the body over time. These new findings support the notion that treatments for metastatic cancers should include a combination of therapies that target a variety of genetic pathways.  The idea that metastatic tumors can seed and establish other metastatic tumors in patients is different from traditional theories that the primary tumor is solely responsible for disseminating cancer cells with metastatic potential. To me, this work is beautiful, pointing to a new way to see and manage metastatic cancer. I’m Dr. Michael Hunter.

Reference: Gundem G, Van Loo P, Kremeyer B, et al. The evolutionary history of lethal metastatic prostate cancer. Nature. 2015;520(7547):353-357.

Omega-3 Fatty Acids for the Control of Breast Cancer Medicine–Induced Musculoskeletal Pain

Purpose Musculoskeletal symptoms are the most common adverse effects of aromatase inhibitors (AIs) and can result in decreased quality of life and discontinuation of therapy. Omega-3 fatty acids (O3-FAs) can be effective in decreasing arthralgia resulting from rheumatologic conditions and reducing serum triglycerides.

Patients and Methods Women with early-stage breast cancer receiving an AI who had a worst joint pain/stiffness score ≥ 5 of 10 using the Brief Pain Inventory–Short Form (BPI-SF) were randomly assigned to receive either O3-FAs 3.3 g or placebo (soybean/corn oil) daily for 24 weeks. Clinically significant change was defined as ≥ 2-point drop from baseline. Patients also completed quality-of-life (Functional Assessment of Cancer Therapy–Endocrine Symptoms) and additional pain/stiffness assessments at baseline and weeks 6, 12, and 24. Serial fasting blood was collected for lipid analysis.

Results Compared with baseline, the mean observed BPI-SF score decreased by 1.74 points at 12 weeks and 2.22 points at 24 weeks with O3-FAs and by 1.49 and 1.81 points, respectively, with placebo. Adjusting for the baseline score, osteoarthritis, and taxane use, 12-week BPI-SF scores did not differ by arm (P = .58). Triglyceride levels decreased in patients receiving O3-FA treatment and remained the same for those receiving placebo (P = .01). No between-group differences were seen for HDL, LDL, or C-reactive protein.

Conclusion There was a substantial (> 50%) and sustained improvement in AI arthralgia for both O3-FAs and placebo but no meaningful difference between the groups.

My Take: A strong illustration of the power of a placebo. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Reference: Published online before print May 4, 2015, doi: 10.1200/JCO.2014.59.5595 JCO May 4, 2015 JCO.2014.59.5595                                   

 

Low Sunlight Exposure and Higher Risk for Pancreatic Cancer

What You Need to Know: People living in countries with low levels of sunlight have a substantially increased risk for pancreatic cancer, even after taking into account a number of factors associated with the disease. Researchers found that low exposure to ultraviolet B (UVB) irradiance, which is related to both latitude and the degree of cloud cover, was associated with a six-fold increased risk for pancreatic cancer.

The Study: Investigators obtained age-standardized pancreatic cancer incidence rates for 172 countries from the International Agency for Research on Cancer’s GLOBOCAN 2008 database.

  • Data on energy intake from animal sources and alcohol consumption were obtained from the United Nations Food and Agriculture Organization, and the World Health Organization provided information on the prevalence of obesity, the sex-specific smoking prevalence, and per capita health expenditure.
  • Crucially, data from the NASAs International Satellite Cloud Climatology Project, which pertain to geographical variations in solar irradiance, allowed estimated UVB irradiance levels to be corrected for percentage cloud cover, inasmuch as heavy cloud cover does not transmit UVB.

Results: Overall, there was a higher incidence rate of pancreatic cancer with lower cloud-adjusted UVB irradiance, such that residents of countries with low UVB irradiance were approximately six times more likely to have incident pancreatic cancer than those living in countries with high UVB irradiance (P < .0001 for males and females).

The associations remained significant after taking into account per capita health expenditure, the geographical distribution, and factors known to be associated with pancreatic cancer, such as diabetes, obesity, alcohol consumption, and smoking. Interestingly, consumption of animal protein was positively associated pancreatic cancer in both sexes (P = .0190 in males; P = .0156 in females).

My Take: Given the strong association between UVB irradiance and pancreatic cancer risk, what about using vitamin D in an attempt to prevent or even treat pancreatic e cancer? There are a number of ongoing studies in both animal and human models on whether pancreatic cancer can be treated with vitamin D. Moderate doses of vitamin D seem reasonable as both a potential risk-reduction agent for a dreadful disease, and for consideration among those with pancreas cancer. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Reference: American Society of Breast Surgeons (ASBS) 16th Annual Meeting. Presented April 30, 2015.