Do You Want to Help Others?
I recently was notified about a research project that aims to investigate how the use of online support groups by people with health conditions affects their feelings about themselves and their illness and how this impacts their relationship with their health care provider.
You may wonder why I'm telling you about this. It's simply because I believe that by volunteering about 15 minutes of your time to complete an anonymous online questionnaire, you can help others. This is exactly the type of research we need to better understand how computer-savvy health care consumers in the 21st century are getting and using support and information. This is the type of research that will lead to the development of better online support groups and communities for us all. And the best part is that this can help us all become wiser health care consumers.
If you have a few minutes to spare, please take the survey and become a part of the future of better online experiences and better health care interactions for us all. Thank you!
Vitamin D-Lightful
If you get the feeling that you're reading and hearing a lot about vitamin D lately, you're not alone. This vitamin has been receiving quite a bit of press lately, and with good reason. The last few years have seen an explosion of research on this nutrient and the conclusions of these studies pretty much agree: vitamin D is very important for long-term health and most of us don't get nearly enough of it.
Want to reduce your risk of cancer? Get more D. Want to reduce your risk of heart disease? Get more D. Want to minimize your odds of getting multiple sclerosis, lupus, or other autoimmune conditions? Get more D. Want to better manage your asthma and other respiratory conditions? Again, get your vitamin D! It's the rare (OK, never) time that I say, "Everyone needs this supplement," but vitamin D is one nutrient for which I make an exception.
A study presented at the 2009 American Society of Clinical Oncology meeting now suggests this is true for individuals with cancer, especially those with gastrointestinal (GI) cancers.
For the vitamin D study, which included 98 people with colorectal cancer, the researchers reviewed medical charts of people treated for GI cancer between December 2007 and September 2009. They found that at baseline, nearly 90% of the patients had vitamin D deficiency. That's the bad news.
The good news is that the chart review also uncovered success. When the people with GI cancer were prescribed vitamin D supplements, most of them responded: Their blood levels of vitamin D increased markedly after 8-12 weeks of supplementation. The patients were given 50,000 IU (international units) of vitamin D, once per week, for a total of 8-12 weeks.
When blood levels of vitamin D were rechecked after supplementation, the rate of any vitamin D deficiency, including very mild deficiency, decreased from 91% to 57%. Cases of severe to moderate deficiency decreased from 72% to 13%.
Is D for Me?
Yes, but with caution. The 50,000 IU dose that was used to bring vitamin D levels up to normal are very, very high. These doses are safe, when taken short-term, under close medical supervision. Never supplement with 50,000 IU of vitamin D on your own. Work with your medical care team so that your blood levels can be checked and you can know your body is responding to the supplements as intended.
If you want to supplement with vitamin D for general good health and to make sure you are getting enough, it is safe to take up to 2,000 IU of vitamin D per day. Fortunately, vitamin D is inexpensive, so taking a supplement won't break the bank. A 30 day supply costs about $3 to $5. If you are in cancer treatment and you are concerned about your vitamin D levels, ask your doctor to be tested. A simple blood test will tell you whether you need higher doses of supplements to get yourself back up to normal.
Family History - You're Invited to The Conference
On August 24-26, 2009, the National Institutes of Health (NIH) will be holding a State-of-the-Science conference on how family history can be used to improve health and health care in the United States. The conference is being held at the NIH Natcher Conference Center in Bethesda, Maryland. And if Maryland isn't on your summer vacation agenda, you don't need to worry: You can participate in the conference online.
What does this have to do with me?
The NIH organized this meeting specifically to help a wide range of people, from health care providers and researchers to interested citizens, better understand and utilize family health history to manage risk of a variety of diseases, including cancer. Many cases of cancer, including colon cancer, are considered sporadic, meaning they are not related to genetics or family history. However, up to 25% of colon cancer cases occur in people with a family history of the disease or who have a known "cancer gene".
In these situations, the lack of a standardized way for health care providers to collect, and for patients to provide, a family health history, can contribute to people being diagnosed later, when disease is more advanced and harder to treat. This is where the NIH State-of-the-Science conference steps in, to fill in the gaps and to improve health care delivery. If you have a family history of colon cancer, or any other disease, or even if you're just interested in this topic, be sure to take advantage of this free, open-to-the-public conference, either in person, or through the internet.
The Wrong Direction
As someone who cares deeply about cancer prevention, news today that obesity rates continue to climb in both adults and children is disheartening. Quite simply, as a country, we are going in the wrong direction with obesity and overweight. When it comes to colon cancer, the ever-increasing obesity rates are especially problematic. If even one colon cancer case can be prevented by raising awareness of the strong connection between obesity and this disease, then it's worth it to me to continue writing and blogging about this important topic.
As mentioned in my June 18th blog, obesity and overweight are among the most important, modifiable risk factors for colon cancer. Modifiable means something that we can control with the choices we make everyday.
Each and every one of us, by making better food choices, walking instead of sitting, biking instead of driving, and making a whole host of other health decisions, can control our own body weight and reduce our own risk of colon cancer. We can help reduce the rates of colon cancer in our country too, by addressing our collective struggles with overweight and obesity.
I've mentioned this previously as well: Health experts estimate that about 30% of all colon cancer cases in the United States are directly due to people having a body mass index (BMI) greater than 22.5 kilograms per meter squared (kg/m2).Using our BMI calculator, you'll quickly see that a BMI of 22.5 is not particularly high. In other words, you have to be pretty fit and thin to maintain a BMI of 22.5. For a woman, a BMI of 22.5 translates into being 5'4" (64 inches) tall and weighing about 131 pounds. For a man, a BMI of 22.5 translates into being 5'11" (71 inches) tall and weighing about 161 pounds.
As you read this, you may be thinking, "who actually has a BMI of 22.5?" In a small bit of self-disclosure, I'll admit my BMI is about 21.2 kg/m2. And I don't say this to "brag", because in fact, at one point in my adult life, at 5' 4" tall and about 170 pounds, my BMI was an unhealthy 28.9 kg/m2!When I talk to people about a healthy diet and regular exercise, I sometimes receive feedback that I must be "lucky" and must be "naturally thin". Phew, I wish that were the case. In reality, I think about maintaining my weight each and every day. It's a lot of work, but my health is worth it. Reducing my own risk of colon and other cancers, as well as heart disease, diabetes and more, is worth it. I'm worth it and SO ARE YOU!
Since this is a blog about colon cancer, I don't want to get too side tracked talking about weight management, but I encourage everyone to think about how important it is to avoid being overweight or obese in order to reduce colon cancer risk. Other than regular colon cancer screening, nothing is more important for reducing colon cancer risk than staying at a healthy body weight.
And even if you never reach a BMI of 22.5, every single pound that you lose and keep off will improve your health. Even 5 or 10 pounds can markedly improve health! Take a moment to peruse the About.com Weight Loss website, where you'll find news, information, and tons of great ideas you can incorporate into your life today, to put you on the path to a healthy weight and lower colon cancer risk.
Remember, anyone can learn (and it does take learning!) how to live more healthfully, despite the fact that we live in a society that is designed to make us "fat". Between the advertisements; the cheap, tasty junk food available at every turn; the lack of communities being designed in a way that allows for walking and biking; and our hectic, cram-too-much-into-every-moment lifestyles, it's no surprise that close to 70% of us are overweight or obese. But investing in your health is worth the effort! I've been there (overweight). I understand your pain. I know you can live healthier too.
Metastatic Colon Cancer - The Outlook Brightens
For a person with metastatic colon cancer, which is colon cancer that has spread beyond the colon to other parts of the body, the situation may feel hopeless and overwhelming. But a recently published review of survival rates after metastatic colon cancer diagnosis brings new hope that this disease can be more effectively managed with newer treatment options. The results of this review, published in the Journal of Clinical Oncology online May 26, 2009, indicate that in the period from 1990 through 2006, the length of survival after metastatic colon cancer diagnosis has improved dramatically.
Between 1990 and 1997, the researchers noted that the median, overall length of survival held steady at 14.2 months. However, in the following years, median survival improved notably, to 18 months from 1998 to 2000, and then to 18.6 months from 2001 to 2003. The overall median length of survival improved most dramatically, to 29.2 months, for patients diagnosed with metastatic colon cancer from 2004 to 2006. Also encouraging is that the 5-year survival rate more than doubled from 9.1% in the early years of the study to 19.2% for patients diagnosed in 2001 to 2003. The improvements in survival are due to a combination of more effective chemotherapy medications and surgery to remove colon tumors that have spread to the liver.
Years of Life
The bottom line is that even after receiving an original diagnosis of metastatic colon cancer, good treatment can allow patients to live meaningful lives for years, rather than weeks and months. This may seem like small comfort to someone facing a diagnosis of metastatic colon cancer, but it points toward the day when metastatic colon cancer may become a chronic, manageable condition, rather than a life-shortening disease.
If you've been diagnosed with metastatic colon cancer, be sure you talk to your doctor about all of the treatment options you should consider. New research breakthroughs are being made daily and you may even want to find out if a clinical trial is right for you. Be sure to discuss the pros and cons of clinical trials with your health care team.
Turning Science Fiction into Science
It sounds like the stuff of science fiction...a tiny device implanted in your body that provides a way to continuously monitor your blood, looking for clues as to what's going on with your health, and in particular, what's going on during cancer treatment. But if researchers at the Massachusetts Institute of Technology (MIT) have their way, this may become reality within a few years.
In their study Implantable diagnostic device for cancer monitoring, published in the research journal Biosensors & Bioelectronics, the MIT researchers describe how they created and implanted a tiny, five millimeter device which successfully monitored a chemical produced by some tumors, in mice with cancer. This type of technology has the potential to revolutionize cancer care, improve outcomes, and save lives.
Currently, techniques that are used to track cancer in the body, such as a biopsy, PET scan, or MRI, only reveal what a tumor is doing after it has spread. After spreading, most cancers become very difficult to treat and nearly impossible to cure.
An implanted device that monitors cancer in real time can provide information on whether a tumor is growing, spreading, responding to treatment by shrinking, or perhaps is about to spread to other areas of the body (metastasize). This would allow doctors to better treat patients, for example by changing treatment plans or medications for people whose tumors are not responding the their current therapies.
The research team notes that the goal is to improve the technology so that the implanted device can monitor a variety of substances, such as various tumor markers, levels of chemotherapy in the body and near the tumor, oxygen levels, acidity (pH), and hormones.
We'll be following this exciting research closely. And as the technology continues to develop and eventually become available in cancer clinics, we'll be sure to update you on it!
B3 May Be Key to Upping Neutrophils
As many people with cancer know, when your immune system bounces back after each treatment cycle, this is a good thing. And while some decrease in immune function during chemotherapy is expected, in certain cases, immunity is so seriously affected that people have to take a break from treatments.
Also unfortunate is that severe declines in immune function put people at high risk for infections. This complicates treatment, decreases quality of life, sometimes requires hospitalization, and generally is something doctors want to prevent in their patients. Medications that increase immune cell counts are an option, but some people cannot take these medications and others react poorly to them.
For all of these reasons, cancer researchers continue to seek safe ways to help patients maintain good immune function throughout treatment. A study published in the February 2009 issue of Nature Medicine offers new hope that a safe way to improve immunity in cancer patients may be available soon.
This study details, for the first time, how vitamin B3, also called niacin, can improve the ability of the body to make new immune cells known as neutrophils. In addition to this finding, the researchers discovered that giving high doses of vitamin B3 significantly increases neutrophil count in healthy people. The vitamin B3 doses used in the study ranged from 10 to 20 milligrams per kilogram of body weight per day (mg/kg/day).
To put this into perspective, this means a 175 pound person would take between approximately 800 and 1,600 mg of vitamin B3 per day. The safe upper limit for niacin is set at 35 mg per day, so these doses are very high. On a positive note, high doses of niacin, up to several thousand mg per day, are given as a cholesterol treatment medication, so we know it can be used safely.
Should You Take B3?
For now, you should not take high doses of vitamin B3 (niacin) without first talking to your doctor. Niacin can cause liver problems and in someone who's already taking cancer medications that tax the liver, this may be a very bad combination. Furthermore, we don't know how high doses of niacin will interact with or affect cancer treatment medications.
The Bottom Line
If you have had to take frequent breaks from your treatment due to poor immunity or your immune system just isn't bouncing back the way it should, ask your doctor what to do about this. You may be prescribed medications to improve immune function. As well, under proper medical supervision, it may be OK to try niacin as a way to improve neutrophil count. However, only you and your doctor, working together, can determine if the possible benefits of this approach outweigh the risks.
Avoid Meating Your Way To Overweight and Colon Cancer
Among the most important risk factors for colon cancer are overweight and obesity. And by most important, I mean something that is modifiable (can be controlled by the choices we make everyday) and that contributes a lot to the burden of colon cancer in this country. In fact, health experts estimate that about 30% of all colon cancer cases in the United States are directly due to people having a body mass index (BMI) greater than 22.5 kilograms per meter squared (kg/m2).
Using our BMI calculator, you'll quickly see that a BMI of 22.5 is not particularly high. In other words, you have to be pretty fit and thin to maintain a BMI of 22.5. For a woman, a BMI of 22.5 translates into being 5'4" (64 inches) tall and weighing about 131 pounds. For a man, a BMI of 22.5 translates into being 5'11" (71 inches) tall and weighing about 161 pounds.
What does this have to do with meat?
When we're talking about obesity, why focus on meat? Because the connection between meat eating and obesity just got stronger. A study published in the June 2009 issue of International Journal of Obesity provides support for the notion that the biggest meat-eaters have the biggest bellies. Researchers found that people in the United States who eat the most meat have a roughly 50% higher risk of being obese compared with people who eat the least meat. As well, these heavy-duty meat eaters have a 33% higher risk of central obesity, which means carrying fat around the mid-section and belly areas. This is particularly bad news, because fat around the middle of the body increases risk of colon cancer and other chronic diseases such as diabetes and heart disease much more than fat in the butt and thighs. Finally, major meat-eaters consume on average, about 700 more calories per day than people who eat meat the least often.
The Bottom Line
What this study tells us is that eating a lot of meat may be a fast-track to being overweight or obese. And knowing that being above a healthy body weight is a major risk factor for colon cancer should give us all incentive to cut back on both our meat-eating and our body size. You certainly don't need to swear off all meat, but making some healthy choices can allow you to enjoy your favorite foods, but keep yourself healthy too. A few tips to accomplish these goals include:
- Consider red meat a treat that you enjoy no more than one to two times per week.
- Also consider high-fat processed meats, such as bacon and sausage a treat that you eat no more than once per week.
- In place of red meat, try leaner options including skinless chicken breast, turkey, fish, and non-animal options such as beans, tofu, or tempeh.
- As you decrease the meat in your diet, fill up your plate with more vegetables, fruit, and beans. Not only are these foods natural cancer-fighters, but they also fill you up with fewer calories than high-fat meats.
- When you do enjoy red meat, opt for leaner cuts, such as round steak, shoulder steak, strip steak, tenderloin steak, T-bone steak, and 95% (or more) lean ground beef. Trim off visible fat. These options provide 10 or fewer grams of total fat, 4 to 5 or fewer grams of saturated fat, and no more than 95 milligrams of cholesterol for a 3.5 ounce serving.
Want Better Health? Get Out of the Car!
A recent news article has drawn attention to one of the most important reasons why many Americans fail to get even a minimal amount of physical activity into their daily lives: Our car-driven lifestyles. You may be wondering why a website dedicated to colon cancer would be discussing this issue, but the connection between these two things, colon cancer and cars, may be closer than you think.
As Americans, our dependence on cars for all transportation needs may be convenient, but it's not doing our health any favors. Health experts say that as a baseline, we all should get a minimum of 10,000 steps per day, which translates into about 5 miles of walking. This might sound like a lot, but most people can reach this goal without ever hitting the gym. All the steps we take as we go about a typical day, including walking our child to catch the bus, walking to get the mail, walking the dog, walking around work, and walking across parking lots and stores add up. But when we insert the most American of inventions, the car, into all of our daily activities, the daily steps we take can fall as low as 1,000.
Why Should I Care?
You may wonder why anyone concerned with colon cancer should care about this issue. The reason? There is a very solid connection between the amount of exercise we get and our risk of colon cancer. The less we get, the higher our risk of colon cancer. As well, less physical activity means higher risk of obesity, which is a leading cause of colon and other cancers.
If you've already had colon cancer, you may figure that this connection between exercise and colon cancer risk isn't important for you. After all, it's too late, right? WRONG! Leading health experts have studied this very issue and have found that without a doubt, those who exercise the most after a colon cancer diagnosis have the best survival. Even for people who have never exercised a day in their lives, adding exercise after colon cancer can reduce the risk of getting colon cancer again by as much as 50%!
Moving Toward Better Health
The most important thing to keep in mind about exercise is that it's never too late. Even after a colon cancer diagnosis, the more you move, the healthier you will be. Also important to remember is that in most cases, the biggest benefit from adding exercise comes from increasing from doing absolutely nothing, to doing at least a little physical activity each day. You don't need to run a marathon, you simply need to get those steps in each and every day.
I know we've all heard the standard advice about exercise - park in the spot furthest from the store, walk on your lunch hour, get an exercise buddy, etc. While this is good advice, most of these points are nothing new. What is new, however, is the mounting evidence that in terms of colon cancer prevention and prevention of recurrence (getting colon cancer again), nothing beats exercise. You can't change your gender, your genetics, or your past medical history, but you can change your health behaviors, including how much exercise you get each day.
Instead of dwelling on using exercise to lose weight or get ready for an event such as a wedding or class reunion (it's OK to admit, we all want to look good), think of exercise as your gateway to health and a long, fulfilling life.
Screening the Relatives
Among relatives of those diagnosed with colon cancer, denial is a very common feeling. Relatives of loved ones who are diagnosed with colon cancer often have feelings including:
- I'm really sad about this, but I'm sure it's not going to happen to me.
- It's horrible that my brother (or another relative) is so unlucky to have been diagnosed with colon cancer.
- It's a good thing I'm healthy and don't have to worry about cancer, so I can help my loved one.
At first glance, a 70% screening rate may seem pretty good, but given that colon cancer can run in families, it is likely that every first degree relative of a person with colon cancer should be screened for this disease. As well, the most effective screening method, colonoscopy, may be preferable over other, less effective screening methods, such as fecal occult blood testing.
What may be most interesting are the reasons why relatives of people diagnosed with colon cancer aren't screened themselves. Not feeling that they themselves are at risk for colon cancer, as well as worry and fear about cancer turned out to be important barriers to relatives seeking colon cancer screening. This is unfortunate, because when caught early, with routine screening, colon cancer is a highly treatable disease with a very high survival rate. Waiting to be screened until symptoms appear can greatly reduce survival after colon cancer.
Your Action Plan
If you have a relative who's been diagnosed with colon cancer, talk to your doctor about being screened for colon cancer yourself. And even though nobody looks forward to a colonoscopy, there are plenty of practical steps you can take to make this test easier. Be sure you mention your family history of colon cancer to your doctor and ask what an effective screening plan for you should look like.
You may need a baseline colonoscopy, to make sure everything looks good and to remove any pre-cancerous growths if they are found. This may be followed up with other tests at regular intervals, to keep yourself healthy and colon cancer free. Even though it's scary to contemplate cancer, not dealing with this issue is far scarier when it comes to your long-term health and well-being.