Gum Disease and Cancer Risk

dental exam oral cavity white male head and neck oropharynx

New data supports the need to further investigate an association between periodontal disease and cancer risk.

Background: Previous studies have found periodontal disease is a risk factor for breast, oral, and esophageal cancers. Case-control studies have shown a link between tooth loss and the risk for esophagus and stomach cancers.

The Study: Investigators examined periodontal disease information in 65,869 women ages 54 to 86 at 40 centers in the USA. Mean age 68 years. Most were non-Hispanic whites with some college education. Participants answered this question: “Has a dentist or dental hygienist ever told you that you had periodontal or gum disease?”

The Results: This large prospective cohort study shows that postmenopausal women with a history of periodontal disease, including those who have never smoked, are at significantly increased overall risk for cancer as well as site-specific cancers, including lung, breast, esophageal, gall bladder, and melanoma skin cancers.Although periodontal disease and cancer share important risk factors (such as increased risk with increasing age and increased in smokers), this study showed that after adjustment for age, the risk of periodontal disease history and cancer persists regardless of smoking history.

My Take: This study adds to a growing body of evidence from smaller studies that link periodontal disease to total cancer risk. Oral hygiene is important not only in preventing tooth loss, but may have important implications for prevention of systemic diseases, including cancer. I’m Dr. Michael Hunter.

Cancer Epidemiol Biomark Prev. Published online 01 Aug 2017.

Available Today: Your Breast Cancer app on Android (in Search, type Michael Hunter Your Breast Cancer … and voila!)

How Can You Reduce Your Risk of Getting Cancer?

Recent reports suggest that about 2 out of 3 cancers may be due to “bad luck.” Today, we focus on the other third: What can you do to reduce your risk of cancer?

What You Need to Know:

  • Maintaining a healthy body weight and being physically active had the greatest impact on overall risk of a cancer-related death. 
  • Restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal).

Background

  • As people make their resolutions for 2015, two new studies — which show that curbing alcohol consumption, adding more plant foods to the diet, and losing excess weight can help reduce the risk of developing cancer — serve as a reminder that a healthy lifestyle is important.
  • In 1997, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued cancer prevention guidelines for weight management, diet, and physical activity. These were updated in 2007 and are considered to be the most comprehensive scientific analysis of cancer prevention and causation ever undertaken. Specifically, the guidelines reported that excess body fat is associated with an increased cancer risk and that there is convincing evidence that the consumption of alcohol, red meat, and processed meat elevates cancer risk. Since that time, numerous studies have reported links between colorectal cancer risk and alcohol, between breast cancer mortality and obesity, between breast cancer relapse and obesity, and between breast cancer risk and red meat.

The Evidence: The first study, published online January 6 in Cancer Causes & Control, showed that eating a plant-based diet and limiting alcohol intake, both already included in various cancer prevention guidelines, could help cut the risk for obesity-related cancers (about a third of all of cancers). In a cohort of nearly 3000 adults, the researchers found that restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal). For individuals who consume starchy vegetables, such as corn, potatoes, and yams, sufficient consumption of nonstarchy legumes, fruits, and vegetables was associated with a reduction in the risk for colorectal cancer.

Pronounced Effect on Cancer Risk

In their study, Makarem and colleagues investigated whether the healthful behaviors outlined in the WCRF/AICR guidelines were associated with the risk for obesity-related cancers, in particular, breast, prostate, and colorectal cancer. Of the 2983 adults enrolled in the Framingham Offspring cohort from 1991 to 2008, the researchers identified 480 incident obesity-related cancers.

Data from food frequency questionnaires, anthropometric measures, and self-reported physical activity were used to develop a 7-component score based on recommendations for body fatness; physical activity; foods that promote weight gain; plant foods; animal foods; alcohol; and food preservation, processing, and preparation. The cohort was, on average, middle aged to older and overweight, but had a relatively high level of physical activity. The mean duration of follow-up was 11.5 years.

The overall score was not associated with obesity-related cancer risk after adjustment for confounders such as age, sex, smoking, energy, and pre-existing conditions (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.86 – 1.02). However, when the score components were considered separately, the researchers found that for every unit increment in the alcohol score (representing an improvement and more closely meeting the guideline recommendations), there was 29% lower risk for obesity-related cancers (HR, 0.71; 95 % CI, 0.51 – 0.99) and a 49% to 71% reduced risk for breast, prostate, and colorectal cancers.

Similarly, each unit increment in the subcomponent score for nonstarchy plant foods (fruits, vegetables, and legumes) for those who eat starchy vegetables was associated with a 66% lower risk for colorectal cancer (HR, 0.44; 95% CI, 0.22 – 0.88).

Healthy Body Weight and Exercise Reduce Mortality

The second study, published online January 7 in the American Journal of Clinical Nutrition, reported similar results. Researchers found that greater adherence to the cancer prevention guidelines of the American Cancer Society (ACS) was associated with a reduction not only in cancer incidence, but also in cancer mortality and total mortality.

The ACS guidelines recommend that individuals avoid smoking, achieve and maintain a healthy weight, be physically active, and eat a healthy diet that emphasizes plant foods. In their study, Geoffrey Kabat, PhD, senior epidemiologist in the Department of Epidemiology & Population Health at the Albert Einstein College of Medicine in Bronx, New York, and colleagues report that maintaining a healthy body weight and being physically active had the greatest impact on overall mortality for both men and women.

The researchers used data from the NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults who were 50 to 71 years of age in 1995 and 1996, when they enrolled in the study. They were followed for a median of 10.5 years for cancer incidence, 12.6 years for cancer mortality, and 13.6 years for total mortality.

During the study period, there were 73,784 cases of cancer, 16,193 cancer deaths, and 81,433 deaths from any cause. The patients were stratified by how closely they adhered to ACS guidelines, and adherence to the guidelines was associated with a reduced risk for all cancers combined. When the highest level of adherence was compared with the lowest level, the hazard ratio was 0.90 for men and 0.81 for women.

In addition, increased adherence was associated with a reduction in risk for 14 of 25 specific cancers. Reduction in the risk for gallbladder cancer was 65% in men and women combined, for endometrial cancer was 60%, for liver cancer was 48% in men, for colon cancer was 48% in men and 35% in women, and for rectal cancer was 40% in men and 36% in women.

My Take: These results add to the existing evidence on the potential role of limiting alcohol intake and increasing the intake of plant foods in influencing cancer risk. Dietary advice on cancer should focus on encouraging the consumption of a plant-based diet providing abundant non-starchy fruits, vegetables, and legumes, and restricting alcohol, if consumed at all, to the recommended levels. Try to stick to the ACS Guidelines, as the closer you follow them, the greater the benefit in cancer risk-reduction. Finally, exercise and don’t use tobacco. I’m Dr. Michael Hunter.

References: Cancer Causes Control. Published online January 6, 2015. Abstract; Am J Clin Nutr. Published online January 7, 2015. Abstract; http://www.medscape.com/viewarticle/837976#vp_2

Obesity-related Cancers on the Rise Worldwide

What You Need to Know: A quarter of all obesity-related cancers worldwide in 2012 were attributable to the rising average body mass index (BMI) in the population since 1982, and were therefore “realistically avoidable”.
 
The Study: Using data from a number of sources including the GLOBOCAN database of cancer incidence and mortality for 184 countries, Arnold and colleagues created a model to estimate the fraction of cancers associated with excess bodyweight in countries and regions worldwide in 2012, and the proportion that could be attributed to increasing BMI since 1982.
  • Obesity-related cancer is a greater problem for women than men, largely due to endometrial (womb/uterus) and post-menopausal breast cancers. In men, excess weight was responsible for 1.9% or 136,000 new cancers in 2012, and in women it was 5.4% or 345,000 new cases.
  • Post-menopausal breast, endometrial, and colon cancers were responsible for almost three-quarters of the obesity-related cancer burden in women (almost 250,000 cases), while in men colon and kidney cancers accounted for over two-thirds of all obesity-related cancers (nearly 90,000 cases).
  • In developed (very high human development index; HDI) countries, around 8% of cancers in women and 3% in men were associated with excess bodyweight, compared with just 1.5% of cancers in women and about 0.3% of cancers in men in developing countries (low HDI).
  • North America contributed by far the most cases with 111,000 cancers — equivalent to almost a quarter (23%) of all new obesity-related cancers globally — and sub-Saharan Africa contributed the least (7300 cancers or 1.5%). Within Europe, the burden was largest in eastern Europe, accounting for over a third of the total European cases due to excess BMI (66,000 cancers).

The proportion of obesity-related cancers varied widely between countries. In men, it was particularly high in the Czech Republic (5.5% of the country’s new cancer cases in 2012), Jordan and Argentina (4.5%), and in the UK and Malta (4.4%). In women, it was strikingly high in Barbados (12.7%), followed by the Czech Republic (12%) and Puerto Rico (11.6%). It was lowest in both sexes in countries within sub-Saharan Africa (less than 2% in men and below 4% in women).

The global prevalence of obesity in adults has doubled since 1980. If this trend continues it will certainly boost the future burden of cancer, particularly in South America and North Africa, where the largest increases in the rate of obesity have been seen over the last 30 years.” I’m Dr. Michael Hunter.

My Take: Currently used gene signatures (including MammaPrint and OncoType DX) are associated with the probability of distant disease recurrence and are in clinical use as prognosticators. These signatures are primarily driven by genes reflecting the amount of cancer cell proliferation and the presence (or absence) or hormone receptors in the tumor. Now we have the exciting promise of adding in characteristics of the tumor microenvironment to offer better prognoses. I think this approach represents a fundamental change in how we approach 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.

 

 

Journal Reference:

  1. Melina Arnold, Nirmala Pandeya, Graham Byrnes, Andrew G Renehan, Gretchen A Stevens, Majid Ezzati, Jacques Ferlay, J Jaime Miranda, Isabelle Romieu, Rajesh Dikshit, David Forman, Isabelle Soerjomataram. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. The Lancet Oncology, 2014; DOI: 10.1016/S1470-2045(14)71123-4

Is Soy Detrimental for Women with Breast Cancer?

What You Need to Know: Two weeks of soy supplementation was enough to increase expression of genes related to tumor proliferation.  Women with breast cancer should probably not take soy supplements, and should eat soy foods, such as tofu and tempeh, only in moderation.

The Study: Jacqueline Bromberg, M.D., Ph.D., a breast cancer specialist at the Memorial Sloan Kettering Cancer Center in New York City, and colleagues randomly assigned 140 women with newly diagnosed, early-stage breast cancer to one of two groups. In one, women took a soy protein supplement every day for anywhere from one to four weeks; those in the other group were given milk powder as a comparison. The women were premenopausal or just past menopause. The soy supplement — a powder added to water or juice — was the equivalent of about four cups of soy milk a day. Women in the study typically used it for two weeks.

Results: Researchers found that about 20 percent of the women using soy developed high blood concentrations of genistein, a soy phytoestrogen. Among those women, some showed heightened activity in certain genes that promote breast tumor growth and spread.

“This study doesn’t tell us anything about whether soy raises the risk of developing breast cancer,” said Bromberg who also noted there was no evidence of “tumor proliferation” in women with revved-up gene activity, but the study may have been too short to detect such an effect. “All we can say is that two weeks of soy supplementation was enough to increase expression of genes related to tumor proliferation.” But to be safe, she said, women with breast cancer should probably not take soy supplements, and should eat soy foods, such as tofu and tempeh, only in moderation.

My Take: There are conflicting reports on the impact of soy on breast carcinogenesis. This study examines the effects of soy supplementation on breast cancer-related genes and pathways. While the study proves little, it seems prudent (for those with a history of breast cancer) to avoid soy supplements, and to consume soy-based foods in moderation. 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.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

References: 1. Jacqueline Bromberg, M.D., Ph.D., physician/scientist, Memorial Sloan Kettering Cancer Center, New York City; V. Craig Jordan, Ph.D., D.Sc., scientific director, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C.; Sept. 4, 2014 Journal of the National Cancer Institute; 2.  http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/soy-a-friend-or-foe-of-breast-cancer-691425.html

Some Cancers More Likely Among Taller Women

What You Need to Know:  A new study has found an increased risk for certain types of cancers in taller women.

Background: While obesity has long been named as a risk factor for cancer, a new study published in Cancer Epidemiology, Biomarkers & Prevention that adjusts for various factors including age and weight, has found an increased risk for certain types of cancers in taller women.

The Evidence: The study, which included 20,298 postmenopausal women, found that for every 10-centimeter (3.94 inches) increase in height, there was a 13% increase in the risk of developing certain cancers, including, breast, colon, endometrium, kidney, ovary, rectum, thyroid, multiple myeloma and melanoma. The most surprising finding for researchers was that weight seems to be a lower risk factor than previously assumed.

“We did examine variation in risk and there was no variation of levels of risk by weight,” says senior author Thomas Rohan, PhD, MD, chairman and professor of the department of epidemiology and population health at Albert Einstein College of Medicine.

Since you can’t really do anything about your height, what does this mean to tall women? Nothing specifically, says Dr. Rohan. He says the purpose of the study was not to make clinical recommendations and there was no thought of cancer screening or diagnosis implied in the study. Rather, the researchers were merely to try to add to the existing research into the biology of cancer development.

“We have been aware of some reports in the literature about the link between cancer and height, and we thought we could make a contribution to that research,” says Dr. Rohan.

In other words, don’t try to stunt your daughter’s growth so that her cancer risk is reduced when she is in her 70s.

Lead researcher Geoffrey Kabat, PhD, MS, a senior epidemiologist at Albert Einstein College of Medicine, noted that cancer is a result of processes having to do with growth, so hormones or other growth factors that influence height may also influence long-term cancer risk. The study also notes that height should not be thought of as a risk factor, but rather as a marker for exposures that may influence cancer risk. In other words, there are so many things that effect growth, that it’s almost beyond anyone’s ability to control.

The take-home message is not to panic, but to just appreciate one more small step in the ongoing quest to try to figure out exactly what makes cancer tick. 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.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: http://www.prevention.com/health/health-concerns/scary-link-between-height-and-cancer-risk

 

 

Exercise Lowers Chances of Getting Breast Cancer

What You Need to Know: Postmenopausal women who in the past 4 years who have undertaken regular physical activity (equivalent to at least 4 hours walking per week) had a lower risk for invasive breast cancer.

The Study: Fournier and colleagues analyzed data from biennial questionnaires completed by 59,308 postmenopausal women who were enrolled in E3N, the French component of the European Prospective Investigation Into Cancer and Nutrition (EPIC) study. The mean duration of follow-up was 8.5 years, during which time 2,155 women were found to have a first primary invasive breast cancer.

Results: Postmenopausal women who in the previous 4 years had undertaken 12 or more MET-h (metabolic equivalent task-hours; roughly equivalent to at least 4 hours walking per week) had a 10% decreased risk of invasive breast cancer compared with women who were less active. 

My Take: It is not necessary to engage in vigorous or very frequent exercise; even walking 30 minutes per day seems beneficial. Keep moving, as you may reduce your own risk of cancer, diabetes, high blood pressure, heart attack, stroke, or even dementia! 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.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Cancer Epidemiology, Biomarkers & Prevention 2014; doi:10.1158/1055-9965.EPI-14-0150.

 

Sitting Too Long? You May Increase Your Risk of Cancer

African American young woman

What You Need to Know: If you’re spending a lot of time sitting every day, either in front of the TV or at work, you may be at higher risk for developing certain types of cancer, according to new research published this week in the Journal of the National Cancer Institute.

The Evidence: The study found an additional two hours a day of sedentary behavior was linked to an 8% increase in colon cancer risk, a 10% increase in endometrial cancer risk and a 6% increase in risk for lung cancer. It did not find the same connection for breast, rectum, ovary and prostate cancers or for non-Hodgkin lymphoma.

  • Researchers came to these conclusions by analyzing 43 existing studies – that included more than 4 million study participants and 68,936 cancer cases – to measure the relationship between hours spent sitting and certain types of cancers.
  • It’s important to note that while the study identifies a link between sedentary behavior and an increased risk for certain cancers, the research doesn’t prove cause and effect.

“Does sitting in front of the TV cause colon cancer? No,” said Dr. Martin Heslin, chief of surgical oncology at the University of Alabama at Birmingham. “But the recommendations (of the study) are awesome.” Heslin, who was not involved in the research, says that in addition to sedentary behavior, several factors can increase your risk of cancer, including drinking or smoking too much, being obese and having a genetic predisposition.

 

It’s nearly impossible to say that any one of these factors causes someone to get a specific cancer, he says, but these are the behaviors we can control to help reduce our risk.

“You can affect TV time by turning it off,” said Heslin, though he acknowledges it’s not so easy to turn off work if you’re stuck in an office all day.

In that case, Heslin suggests looking for opportunities to leave your desk, such as standing up while working or taking a walk, to reduce the number of hours you spend sitting down.

“If I ever have the opportunity to design (a meeting room), I’m putting a waist-high table in the room, and no chairs,” Heslin said.

According to an editorial accompanying the study, organizations such as the American Cancer Society and the UK Department of Public Health address the need to reduce hours spent sitting, but do not offer any quantitative recommendations or strategies to help people improve. Daniela Schmid, one of the study’s co-authors and a faculty member in the University of Regensburg’s department of epidemiology and preventive medicine, hopes to change that.

“The findings of our study may encourage public health efforts to expand physical activity recommendations to reduce time spent in sedentary behavior,” Schmid said.

Previous studies support the findings in Schmid’s study. A 2012 study conducted by the National Institutes of Health concluded that sitting for several hours a day is bad for you, even if you are physically active. Researchers found even exercising at least 150 minutes each week – the generally accepted public health guideline for physical activity – can’t reverse the negative effects of sitting down for hours. In that study, sitting increased an individual’s risk for major chronic diseases such as Type 2 diabetes, cardiovascular disease, and breast and colon cancers.

My Take: If you sit regularly, get up periodically (even if that means every 20-30 minutes for a few minutes). In addition, aim for a minimum of 150 minutes per week of the equivalent of a brisk walk (for example, 30 minutes daily for five times per week). 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.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: CNN Health, 16 June 2014