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Published on Leave a comment on High Doses of B Vitamins and Lung Cancer?

Image result for calcium rich foods, wikipediaAgain, another study finds that taking supplements is not always best for health. Many studies find that eating foods with vitamin "X" is beneficial, but taking high dose supplements may be linked to health problems (here, here, and here). Now a new study finds that long-term high dose supplementation with vitamins B6 and B12 is associated with a 30 to 40% higher lung cancer risk in men (compared to men who didn't take these supplements). Smokers had the greatest increase in risk. But interestingly, long-term use use of  vitamins B6, folate, and B12 was not associated with lung cancer risk among women.

Good food sources of vitamin B6 are: poultry, fish, organ meats, potatoes and other starchy vegetables, chickpeas, and fruit (but not citrus). Good food sources of B12 are:  Beef liver, clams, fish, meat, poultry, eggs, milk, and other dairy products.  Bottom line: if you take vitamin supplements (such as daily multi-vitamin supplements), take a "low-dose" one - one that aims for 100% of minimum daily requirements, but not mega-doses of vitamins.  From Medical Xpress:

Clear link between heavy vitamin B intake and lung cancer

New research suggests long-term, high-dose supplementation with vitamins B6 and B12—long touted by the vitamin industry for increasing energy and improving metabolism—is associated with a two- to four-fold increased lung cancer risk in men relative to non-users.

Risk was further elevated in male smokers taking more than 20 mg of B6 or 55 micrograms of B12 a day for 10 years. Male smokers taking B6 at this dose were three times more likely to develop lung cancer. Male smokers taking B12 at such doses were approximately four times more likely to develop the disease compared to non-users..... This is the first prospective, observational study to look at the effects of long-term high-dose B6/B12 supplement use and lung cancer risk. These supplements have been broadly thought to reduce cancer risk.

For this study, Theodore Brasky, PhD, of the OSUCCC - James, and colleagues analyzed data from more than 77,000 patients participants in the VITamins And Lifestyle (VITAL) cohort study, a long-term prospective observational study designed to evaluate vitamin and other mineral supplements in relation to cancer risk. All participants were aged between 50 and 76 were recruited in the state of Washington between the years 2000 and 2002. Upon enrolling in the study, participants reported information to researchers about B-vitamin usage over the past 10 years. This included dosage information.

Brasky notes these findings relate to doses that are well above those from taking a multivitamin every day for 10 years. "These are doses that can only be obtained from taking high-dose B vitamin supplements, and these supplements are many times the U.S. Recommended Dietary Allowance," he said. Two additional studies are underway at The OSUCCC - James to further evaluate high dose, long-term B6 and B12 supplementation and lung cancer risk. [Original study.]

Published on Leave a comment on Hair Dyes, Hair Relaxers, and Breast Cancer

There has long been concern over the chemicals in hair dyes and chemical hair straighteners or relaxers, and whether they are linked to various cancers. Studies have had mixed findings with regard to breast cancer, but a review paper concluded that there is evidence to support a role of hair product use in the risk of early onset breast cancer, especially in African-American women. Other studies found that long term users of dark hair dyes have a significantly increased risk of non-Hodgkin's lymphoma, multiple myeloma, and bladder cancer. 

A recent study done in the New York City and New Jersey area looked at both African-American women and white women and their use of various hair chemical products. They found that regularly chemically relaxing hair or dying hair dark brown or black is associated with an elevated risk of breast cancer in both African-American and white women. And women using both types of products had an even higher risk of breast cancer.From Medscape:

Dark Hair Dye and Chemical Relaxers Linked to Breast Cancer

African-American and white women who regularly chemically straighten their hair or dye it dark brown or black have an elevated risk of breast cancer, new research suggests. The study of 4,285 African-American and white women was the first to find a significant increase in breast cancer risk among black women who used dark shades of hair dye and white women who used chemical relaxers.

Black women who reported using dark hair dye had a 51 percent increased risk of breast cancer compared to black women who did not, while white women who reported using chemical relaxers had a 74 percent increased risk of breast cancer, the study found. The risk of breast cancer was even higher for white women who regularly dyed their hair dark shades and also used chemical relaxers, and it more than doubled for white dual users compared to white women who used neither dark dye nor chemical straighteners.

The study included adult women from New York and New Jersey, surveyed from 2002 through 2008, who had been diagnosed with breast cancer, plus women of similar age and race but without a history of cancer.....While the vast majority - 88 percent - of blacks had used chemicals to relax their hair, only 5 percent of whites reported using relaxers. For dark hair dye, the numbers flipped, though the differences were not as dramatic. While 58 percent of whites said they regularly dyed their hair dark shades, only 30 percent of blacks did.

The most striking results showed increased risk in the minority of black women who used dark hair dye and white women who used chemical relaxers. Black women who used chemical straighteners and white women who used dark hair dyes were also at higher risk for breast cancer, but that might have been due to chance. James-Todd said that because so many of the black women used chemical relaxers and so many of the white women used dark hair dye, links would have been hard to detect. There’s no reason to believe that chemical relaxers and hair dyes would increase the risk for women of one race and not of another, she said. 

Previous studies have shown that long-term users of dark dyes have a four-fold increased risk of fatal non-Hodgkin’s lymphoma and fatal multiple myeloma, the authors write. Prior research also has associated dark hair dye use with an increased risk of bladder cancer. A 2016 report from the U.S. Centers for Disease Control and Prevention found that breast cancer rates are generally similar for black and white women, at around 122 new cases for every 100,000 women per year, although black women with the disease are more likely to die from it.  [Original study.]

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Published on 2 Comments on Higher Cadmium Levels and Endometrial Cancer

Image result for lobster meal wikipedia A recent study provided evidence that higher levels of cadmium in women may increase the risk of endometrial cancer. Endometrial cancer is the fourth most common cancer in women, and it occurs primarily in postmenopausal women. Endometrial cancer is associated with estrogen exposure (for example, being obese, and also from external or environmental sources of estrogen).

Cadmium is a metal commonly found in foods such as kidneys, liver, and shellfish, but also tobacco (cigarette smoking). Cadmium is toxic, it accumulates in the body, it is an estrogen-mimicking chemical, and it is associated with several hormone-dependent cancers. The researchers found that a doubling of cadmium exposure (as compared to those with low levels) was associated with a 22% increased risk of endometrial cancer.  Bottom line: Go ahead and enjoy these foods, but try to eat foods with naturally high levels of cadmium in moderation - such as shellfish, kidneys, and liver. From Science Daily:

Increased endometrial cancer rates found in women with high levels of cadmium

More than 31,000 new cases of endometrial cancer are expected to be diagnosed in 2017. Through a five-year observational study recently published in PLOS One, researchers at the University of Missouri found that women with increased levels of cadmium -- a metal commonly found in foods such as kidneys, liver and shellfish as well as tobacco -- also had an increased risk of endometrial cancer. It's an observation the researchers hope could lead to new treatments or interventions to prevent the fourth most common cancer in women.

"Cadmium is an estrogen-mimicking chemical, meaning it imitates estrogen and its effects on the body," said lead author Jane McElroy, Ph.D., associate professor in the Department of Family and Community Medicine at the MU School of Medicine. "Endometrial cancer has been associated with estrogen exposure. Because cadmium mimics estrogen, it may lead to an increased growth of the endometrium, contributing to an increased risk of endometrial cancer."

The research team partnered with cancer registries in Missouri, Arkansas and Iowa to identify cases of endometrial cancer. The team enrolled 631 women with a history of endometrial cancer in the study and 879 women without a history of the cancer to serve as a control group. The participants were asked to complete a survey of more than 200 questions about risk factors potentially associated with endometrial cancer. Once they completed the questionnaire, participants were sent a kit to collect urine and saliva samples. Through tests conducted at the MU Research Reactor, the samples were analyzed for cadmium levels.

While more research is needed to better understand the risks associated with cadmium, researchers say there are steps individuals can take to limit their cadmium-associated cancer risks. "We all have cadmium present in our kidneys and livers, but smoking has been shown to more than double a person's cadmium exposure," McElroy said. "Also, we recommend being attentive to your diet, as certain foods such as shellfish, kidney and liver can contain high levels of cadmium. You don't necessarily need to cut these from your diet, but eat them in moderation. This is especially true if women have a predisposition to endometrial cancer, such as a family history, diabetes or obesity." [Original study.]

Published on Leave a comment on Exercise Linked To Lower Mortality After Prostate Cancer Diagnosis

Another reason exercise is good for you: A large study found that men who exercise after a diagnosis of prostate cancer (but which is not metastatic) had a lower risk of dying from prostate cancer - as compared to those men who don't exercise.

So get out there and do something that gets you moving - and yes, walking is an exercise (Note: 1 mile = 20 minutes of walking, thus 3 miles = 1 hour).

In this study the average age at diagnosis was 71, but studies find that exercise has numerous benefits at all ages. Some doctors even think of exercise as "anticancer therapy" (here, here). Also, exercise has anti-inflammatory benefits, and current thinking is that chronic inflammation is linked to cancer.

The American Cancer Society in its cancer prevention guidelines recommends that adults should be physically active, and get at least 150 minutes of moderate physical activity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

From Medscape: Exercise Linked to Lower Mortality With Early Prostate Cancer

Men with nonmetastatic prostate cancer may have longer survival the more they exercise, a recent study suggests. For these men, regular moderate or vigorous physical activity was associated with 31 percent to 37 percent lower likelihood of death during the study, compared to more modest amounts of exercise.

“This confirms and expands on previous work that shows an inverse association between recreational physical activity after diagnosis and risk of prostate cancer-specific mortality,” said lead study author Ying Wang of the American Cancer Society in Atlanta, Georgia, in email to Reuters Health.

Wang and colleagues pulled data from a large, long-term study group established by the American Cancer Society in 1992, focusing on 7,000 men who were diagnosed with prostate cancer between 1992 and 2011. The average age at cancer diagnosis was 71, and there were 2,700 deaths through 2012, including 450 due to prostate cancer and 750 due to heart disease. The average time from diagnosis to death was about eight years for those who died from cancer and 10 years for those who died from other causes.

Men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Both before and after diagnosis, walking accounted for 73 percent of the physical activity that men did, followed by 10 percent for cycling and 5 percent for aerobic exercise, according to the report online now in European Urology.

Based on exercise levels before diagnosis, moderate to vigorous exercise, including walking, was linked to lower risk of death from prostate cancer, but only for men with lower-risk tumors. But after the diagnosis, the same levels of exercise were linked to lower risk of death from prostate cancer for all men, although the apparent benefit of walking was no longer statistically meaningful. [Original study.]

Published on Leave a comment on Vitamin D, Breast Cancer, and Melanoma

Two more studies found that higher levels of vitamin D in the blood are associated with better health outcomes - one study found a lower risk of breast cancer, especially among postmenopausal women, and in the other - better outcomes after a metastatic melanoma diagnosis.

The breast cancer study suggested that a fairly high blood level of vitamin D (25(OH)D serum level>38.0 ng/mL) was associated with a lower risk of breast cancer. But overall they found that women supplementing with vitamin D (more than 4 times a week) at any dose had a lower risk of breast cancer over a 5 year period than those not supplementing with vitamin D. From Environmental Health Perspectives:

Serum Vitamin D and Risk of Breast Cancer within Five Years

Vitamin D is an environmental and dietary agent with known anticarcinogenic effects, but protection against breast cancer has not been established. We evaluated the association between baseline serum 25-hydroxyvitamin D [25(OH)D] levels, supplemental vitamin D use, and breast cancer incidence over the subsequent 5 y of follow-up. From 2003-2009, the Sister Study enrolled 50,884 U.S. women 35-74 y old who had a sister with breast cancer but had never had breast cancer themselves. Using liquid chromatography-mass spectrometry, we measured 25(OH)D in serum samples from 1,611 women who later developed breast cancer and from 1,843 randomly selected cohort participants.

We found that 25(OH)D levels were associated with a 21% lower breast cancer hazard (highest versus lowest quartile). Analysis of the first 5 y of follow-up for all 50,884 Sister Study participants showed that self-reported vitamin D supplementation was associated with an 11% lower hazard. These associations were particularly strong among postmenopausal women.

In this cohort of women with elevated risk, high serum 25(OH)D levels and regular vitamin D supplement use were associated with lower rates of incident, postmenopausal breast cancer over 5 y of follow-up. These results may help to establish clinical benchmarks for 25(OH)D levels; in addition, they support the hypothesis that vitamin D supplementation is useful in breast cancer prevention.

The first sentence in the melanoma study lays out what is widely known: "Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma." Studies show that the relationship between vitamin D, sunlight exposure, and melanoma is complicated in a number of ways, including: sun exposure may be associated with increased survival in patients with melanoma. which may mean that vitamin D has a protective role in patients with melanoma. Several studies suggest that vitamin D may delay melanoma recurrence and improve overall prognosis. The study also found that metastatic melanoma patients with vitamin D deficiency who are unable to or don't raise their vitamin D blood levels (25(OH)D3) have a worse outcome compared to those who are are able to markedly increase (by greater than >20 ng/mL) their 25(OH)D3 levels. From Oncotarget:

Vitamin D deficiency is associated with a worse prognosis in metastatic melanoma

Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma. A retrospective, single-center study of individuals diagnosed with melanoma from January 2007 through June 2013 who had a vitamin D (25(OH)D3) level measured within one year of diagnosis was performed to determine whether vitamin D deficiency and repletion are associated with melanoma outcome.

A total of 409 individuals diagnosed with histopathology-confirmed melanoma who had an ever measured serum 25(OH)D3 level were identified. 252 individuals with a 25(OH)D3 level recorded within one year after diagnosis were included in the study .... A worse melanoma prognosis was associated with vitamin D deficiency, higher stage, ulceration, and higher mitotic rate. In patients with stage IV metastatic melanoma, vitamin D deficiency was associated with significantly worse melanoma-specific mortality. Patients with metastatic melanoma who were initially vitamin D deficient and subsequently had a decrease or ≤20 ng/mL increase in their 25(OH)D3 concentration had significantly worse outcomes compared to non-deficient patients who had a >20 ng/mL increase. Our results suggest that initial vitamin D deficiency and insufficient repletion is associated with a worse prognosis in patients with metastatic melanoma.

Published on Leave a comment on Drinking Coffee May Reduce Risk of Death

Once again several studies found health benefits associated with drinking coffee daily - this time "reduced risk of death" in 2 studies, and in one study a reduced risk of gallbladder cancer.

Just keep in mind that the studies found associations, but did not establish that drinking coffee caused X (reduced risk of death) - so perhaps coffee drinkers differ in some still unknown way from non-coffee drinkers. But...so many studies are piling up showing an association with health benefits that it looks likely that it is actually the coffee causing the benefits. Both decaffeinated and regular coffee seem beneficial, and it doesn't matter how it is prepared (e.g., espresso, drip, cappuccino). (Earlier posts about coffee - here, here, here)

In the one study higher consumption of coffee was associated with a lower risk of death from heart disease, cancer, stroke, diabetes, and kidney disease in African Americans, Japanese Americans, Latinos, and whites. People who consumed a cup of coffee a day (decaffeinated or regular) were 12 percent less likely to die compared to those who didn't drink coffee, and those who drank two to three cups a day had an 18 percent reduced chance of death.

The conclusion of the other study of over half million adults in 10 European countries was similar: coffee drinking was associated with lower risk for death from "all causes", especially from circulatory diseases and diseases related to the digestive tract. This association held up among all the countries. The highest levels of consumption  group (3 cups or more of coffee per day)  had the lowest risk of death - as compared to those drinking none or less than 1 cup of coffee per day. However, the one negative result from drinking more than 3 cups of coffee daily was an increase in risk for ovarian cancer mortality in women (but only when compared to coffee non-drinkers).

From STAT News: Drink coffee? It won’t hurt you, and may reduce your risk of an early death

Good news, coffee drinkers: A couple of massive new studies that looked at hundreds of thousands of people for about 16 years finds that a few cups of coffee a day won’t hurt you and could lower your risk of dying prematurely. The studies reinforce previous findings that drinking an 8-ounce cup of joe (or three) won’t hurt you, but the authors of the new works and other experts say caveats abound.

Murphy told STAT his is the largest study on coffee and mortality to date. In the study, researchers with the WHO’s International Agency for Research on Cancer and Imperial College London tracked 521,000 adults from 10 European countries who self-reported their coffee consumption over an average of 16 years.... In investigating more than 40,000 deaths from this group, the team found that participants who fell into the highest 25 percent of coffee consumers had a lower risk of death due to any cause compared to non-coffee drinkers. They saw a reduced risk of early death by diseases related to the digestive and circulatory systems. The researchers also discovered a link between higher coffee consumption and lower risk of early death by lung cancer in men. And they also looked at suicide — completed suicides were lower for coffee drinkers, but only in men. [Original study.]

In a second study of 180,000 people tracked for an average of 16 years, University of Southern California investigators found drinking one to six cups of coffee per week led to a decreased risk of early death. The study was focused on non-white populations, andtheir findings proved consistent for coffee drinkers across racial and ethnic groups. One of the USC study’s senior authors, V. Wendy Setiawan... said coffee consumption may be linked a lower risk of early death for people with heart disease, cancer, chronic lower respiratory disease, stroke, and kidney disease.Drink one cup per day, and the risk of dying early from those diseases decreases by 12 percent, she said. [Original study.]

This 2016 study is from Medscape: Coffee Consumption and Risk of Gallbladder Cancer in a Prospective Study

Evidence indicates that coffee consumption may reduce the risk of gallstone disease, which is strongly associated with increased risk of gallbladder cancer. The association between coffee consumption and gallbladder cancer incidence was examined in a prospective cohort study of 72,680 Swedish adults (aged 45 − 83 years) who were free of cancer and reported their coffee consumption at baseline.....  In conclusion, coffee consumption was observed to be associated with a reduced risk of gallbladder cancer. A potential protective association between coffee consumption and risk of gallbladder cancer may be mediated via reduced gallstone formation or through other mechanisms such as reduction of oxidative damage and inflammation and regulation of DNA repair, phase II enzymatic activity, apoptosis, angiogenesis, and metastasis.

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Published on 1 Comment on Is Coffee From Lightly Roasted Coffee Beans Best For Health?

Should the results of this study determine what kind of coffee one drinks? Does it really make a difference? Eh...Not for me (because all coffee seems to be beneficial), but it might for you.

Studies show that daily drinking of coffee appears to have health benefits. Studies have linked coffee consumption with lower rates of cancer (here and here), cardiovascular disease, and diabetes. Coffee contains beneficial chemicals (such as caffeine and chlorogenic acid) that are antioxidant and anti-inflammatory, and could help fight chronic inflammatory diseases. It turns out that how much coffee beans are roasted changes how much chlorogenic acid they contain, but the amount of caffeine basically stays the same among the different roasting levels.

Researchers in Korea compared the caffeine and chlorogenic acid components of Arabica coffee beans at different roasting levels: Light, Medium, City, and French roast. They then tested various protective antioxidant and anti-inflammatory properties of the different coffee extracts in various "cell models" (meaning in the lab, not on real people). They found that chlorogenic acid levels were higher in light roasted coffee extract than the other roasted groups, and also light roasted coffee extract had the highest antioxidant activity. The results found that increasing degrees of roasting reduced antioxidant and anti-inflammatory activities.

From the Journal of Medicinal Food: Cellular Antioxidant and Anti-Inflammatory Effects of Coffee Extracts with Different Roasting Levels

During roasting, major changes occur in the composition and physiological effects of coffee beans. In this study, in vitro antioxidant effects and anti-inflammatory effects of Coffea arabica green coffee extracts were investigated at different roasting levels corresponding to Light, Medium, City, and French roast. Total caffeine did not show huge difference according to roasting level, but total chlorogenic acid contents were higher in light roasted coffee extract than other roasted groups. In addition, light roasted coffee extract had the highest antioxidant activity.... The expression of mRNA for tumor necrosis factor-alpha and interleukin-6 was decreased in cells treated with the coffee extracts and the expression decreased with increasing roasting levels. These data suggest that coffee has physiological antioxidant and anti-inflammatory activities and these effects are negatively correlated with roasting levels in the cell models.

Coffee is one of the most popular beverages worldwide. Increasing consumption of coffee is related to the pleasing taste and aroma, as well as its physiological effects. Coffee is proposed to exert beneficial effects against cancer, cardiovascular disease, obesity, and diabetes. Coffee contains phenolic compounds such as caffeic acid, chlorogenic acid, ferulic acid, vanillic acid, and other phytochemicals. The quality of coffee is significantly related to the roasting process.... During roasting, there are numerous changes in coffee bean compound profiles and the aroma is increased. Major changes in coffee bean composition occur during roasting as a result of the Maillard reaction..... Roasting markedly affects chlorogenic acid, leading to hydrolysis of chlorogenic acid. New compounds are formed during the roasting process; one of these is melanoidin. Its formation might alter the overall antioxidant capacity of coffee beans after roasting.

Coffee is a rich source of antioxidants that may contribute to prevention of oxidative stress-related diseases. The antioxidant properties of coffee may reflect the presence of both phenolic and nonphenolic bioactive compounds, such as caffeine and chlorogenic acids. Previous studies have shown that coffee has protective effects against oxidation and DNA damage in human cell models and has been shown to possess an in vitro antioxidant activity that lessens lipid peroxidation and neoplastic activity. 

Caffeine is the major component in coffee extract and has antioxidant property. Chlorogenic acid is another well-known efficient antioxidant in coffee extract; it was highest in Light roast coffee extract and highest with low roasting temperature and lowest in Dark roasted extract. Carbohydrates, protein, and chlorogenic acid are all decreased in coffee during the roasting process.... Caffeine contents showed no differences among roasting levels, but chlorogenic acid content decreased as roasting degree increased..... The effect of coffee roasting on the antioxidant properties of coffee extracts was investigated in several earlier studies; antioxidant capacity decreased in Dark roast coffee. The antioxidant property of coffee extracts prepared with different roasting levels was also determined in this study. The best antioxidant activity was evident in Light roast coffee extract and the lowest in French roast coffee.

Published on Leave a comment on Can Cancer Immunotherapy Make Some Cancers Grow?

T-Cells and cancer Everyone has heard about the miraculous stories of recovery from cancer using immunotherapy. Immunotherapy involves giving the sick person substances which stimulate the person's own immune system to battle the cancer. And when it works, it's wonderful. But...there's another side - a dark side of the harms from these treatments - that is rarely discussed, and why we should be very careful going forward.

Here are two articles that do point out the problems - such as in some people the immunotherapy actually accelerates the cancer being treated (called "hyperprogression of tumors"). Studies suggest that these people share certain genetic characteristics or they are over the age of 65. In general, many patients undergoing immunotherapy have side-effects, some even developing life-threatening ones, from the treatments. Also, most patients do not respond to the immunotherapy treatments, for reasons that remain largely unknown. Obviously more studies are needed. Remember, this field is in its infancy.

Excerpts from Bob Tedeschi's article, from STAT: Cancer researchers worry immunotherapy may hasten growth of tumors in some patients

For doctors at the University of California, San Diego, it was seemingly a no-lose proposition: A 73-year-old patient’s bladder cancer was slowly progressing but he was generally stable and strong. He seemed like the ideal candidate for an immunotherapy drug, atezolizumab, or Tecentriq, that had just been approved to treat bladder cancer patients. Doctors started the patient on the drug in June. It was a spectacular failure: Within six weeks, he was removed from the drug, and he died two months later.

In a troubling phenomenon that researchers have observed in a number of cases recently, thetreatment appeared not only to fail to thwart the man’s cancer, but to unleash its full fury. It seemed to make the tumor grow faster. The patient’s case was one of a handful described last week in the journal Clinical Cancer Research. Of the 155 cases studied, eight patients who had been fairly stable before immunotherapy treatment declined rapidly, failing the therapy within two months. Six saw their tumors enter a hyperactive phase, where the tumors grew by between 53 percent and 258 percent.

“There’s some phenomenon here that seems to be true, and I think we cannot just give this therapy randomly to the patient,” the author of the study, Dr. Shumei Kato, an oncologist at UC San Diego, said in an interview with STAT. “We need to select who’s going to be on it.” .... But similar findings were published last year by cancer researchers at the Gustave Roussy Institute in France. These results were considered controversial by some, since they hadn’t been widely confirmed by other oncologists.

In the latest Clinical Cancer Research findings, those who experienced the hyperprogression of tumors, as the phenomenon is known, shared specific genetic characteristics. In all six patients with so-called amplifications in the MDM2 gene family, and two of 10 patients with alterations in the EGFR gene, the anti-PD-1 or anti-PD-L1 immunotherapies quickly failed, and the patients’ cancers progressed rapidly. ....Doctors who prescribe immunotherapies may be able to identify at-risk patients by submitting tumors for genetic testing, Kato and his coauthors suggested.

The findings published last year by the Gustave Roussy team also appeared in Clinical Cancer Research. In that study, of 131 patients, 12 patients, or 9 percent, showed hyperprogressive growth after taking anti-PD-1 or anti-PD-L1 immunotherapies. The lead author of that study, Stephane Champiat, acknowledged that the research so far raises more questions than it answers. ... Champiat suggested factors that could be associated with the effect. In his study’s patients, for instance, those who were older than 65 showed hyperprogressive growth at twice the rate of younger patients.

Oncologists studying this phenomenon said it could complicate treatment strategies, becausesome patients who receive immunotherapies can exhibit what’s known as “pseudo-progression,” in which tumor scans reveal apparent growth. In reality, however, the scans are instead showing areas where the cancer is being attacked by armies of immune cells. Roughly 10 percent of melanoma patients on immunotherapies, for instance, experience this phenomenon.

Jimmy Carter is perhaps the best-known immunotherapy success story. But most patients do not respond to the immunotherapy treatments, for reasons that remain largely unknown. In a study by Prasad and Dr. Nathan Gay, also of Oregon Health and Science University, nearly 70 percent of Americans die from forms of cancer for which there is no immunotherapy option, and for the rest who do qualify forimmunotherapy, only 26 percent actually see their tumors shrink.

And while immunotherapies typically include less intrusive side effects than chemotherapy, those side effects, when they happen, can be life-threatening. Researchers have reported cases in which immunotherapies attacked vital organs, including the colon, liver, lungs, kidney, and pancreas, with some patients experiencing acute, rapid-onset diabetes after receiving the treatments. But in those cases, the treatments were at least attacking the cancer. Such reports didn’t raise the specter of these treatments possibly working on the cancer’s behalf to shift it into overdrive.

 T-Cells and cancer A group of killer T cells (green and red) surrounds a cancer cell (blue, center). Credit: NIH.

From Health News Review: Cancer immunotherapy: more reason for concern?

Immunotherapy for cancer — which basically involves manipulating our immune system to attack cancer cells — is ever so slowly creeping toward the scrutiny phase. This slow crawl is something we reported on four months ago. With few exceptions, like this deep dive by the New York Times (the Cell Wars series ), we found many journalists completely overlooked the harms (some life-threatening) of this oft-vaunted treatment.

Published on Leave a comment on Is It Possible That Eating Nuts May Prevent Colon Cancer Recurrence?

Amazing study results - if true - about some health benefits of eating nuts. Just tree nuts, not peanuts (which are actually a legume). Researchers at the Dana-Farber Cancer Institute in Boston found that colon cancer survivors who ate at least two ounces (57 grams) of tree nuts a week were 42% less likely to have their cancer return or a 53% lower chance of dying from their cancer than those who did not eat nuts. One ounce or a handful of nuts is considered a serving, but two ounces of nuts is about 48 almonds, or 36 cashews, or 96 shelled pistachios, or 38 pecan halves, or 28 walnut halves, or 42 hazelnuts.

The benefits of eating tree nuts was so surprising and so big, that the researchers caution that the study needs to be repeated (and improved) to make sure. The problem is that the study was observational, and so can't say a definite cause and effect. Perhaps people eating the tree nuts may also be doing some other protective behavior - thus there is just an association. So can't say for sure, but....the studies are adding up that eating nuts is linked with all sorts of health benefits. From STAT:

Can cashews keep colon cancer patients alive? Study says yes — but cautions abound

Surprising new research scheduled to be unveiled at a major cancer meeting next month suggests that cashews and other tree nuts might be as effective as some of oncology’s most effective treatments at keeping colon cancer from recurring after treatment — and even keeping patients from dying. If the benefit is real, a daily handful or two of cashews (cost: less than $1) could work as well as standard chemotherapy (cost: thousands of dollars). But the reported benefit comes with a big “if.”

Although the study is from a respected clinical trial, this finding was not from the original research but, instead, an add-on. The original trial randomly assigned colon cancer patients to either of two drug treatments. Later, researchers looked at cancer survivors who simply went about their lives, doing as they pleased, and tried to evaluate whether eating nuts was associated with better outcomes.In that kind of observational study, it’s not possible to say whether a given behavior — in this case, eating nuts — caused an outcome, or was instead simply associated with the true cause.

Even the study’s lead author was cautious. “This is the first study to show an association between nut consumption and cancer outcomes,” said Dr. Temidayo Fadelu of Dana-Farber Cancer Institute. “When you see an association that is more dramatic than you expect, you have to repeat [the study] in another [group of patients]. … There could be underlying confounders that we didn’t control for.” In other words, people who eat tree nuts, such as pecans, almonds, and walnuts, might be different from people who do not, something called “healthy patient bias.” They “might be more health-conscious,” said Shah. They might be wealthier, or better connected to the health care system, or have healthier habits in general. Any of those attributes might help patients survive colon cancer.

The researchers did not find an association with eating peanuts. Only tree nuts seemed to matter, to an eye-popping degree. Of 826 patients, those who reported having two or more servings per week (as 19 percent did) had a 46 percent lower risk of their cancer returning and a 53 percent lower risk of dying than those who said they did not eat tree nuts.

The study is an outgrowth of a famous clinical trial that began in 1999, testing chemotherapies in 1,264 patients with stage 3 colon cancer (meaning it had spread to lymph nodes but not to distant sites like the liver and lungs). Some patients filled out questionnaires about diet and lifestyle, once while receiving chemotherapy and again six months after treatment ended. 

Fadelu and his colleagues studied nut consumption because that has been associated with lower mortality, mostly because of a reduced risk of cardiovascular disease. “We definitely think something is going on,” with tree nuts providing a biological benefit, Fadelu said. For one thing, they decrease insulin resistance, “a potential mechanism” by which they might keep colon cancer from recurring, he said.

Published on Leave a comment on Living In More Polluted Counties Linked To Higher Cancer Rates

This is a thought-provoking study that looked at environmental quality and cancer incidence in counties throughout the US. The researchers found that the more polluted the county, the higher the cancer incidence. An increase in cancer rates was associated with poorer air quality and the "built environment" (such as major highways). They correctly point out that many things together can contribute to cancer occurring - and this is why looking at how polluted the air, water, etc. together is important.

They looked at the most common causes of cancer death in both men (lung, prostate, and colorectal cancer), and women (lung, breast, and colorectal cancer). They found that prostate and breast cancer demonstrated the strongest associations with poor environmental quality. [Original study.]

The researchers point out that about half of cancers are thought to have a genetic component, but therefore the other half have environmental causes. Other studies already find that environmental exposures (e.g., pesticides, diesel exhaust) are linked to various cancers. But this study was an attempt to look at interactions of various things in the environment with rates of cancer - because we all are exposed to a number of things simultaneously wherever we live, not just to exposures to one thing. Thus this study looked at associations in rates of cancer. 

Of course there is also a lifestyle contribution to many cancers that wasn't looked at here (nutrition, alcohol use, exercise). They also pointed out that many counties in the US are large and encompass both very polluted and non-polluted areas - and that those counties should be broken up into smaller geographic areas when studied. [More air pollution studies.] From Science Daily:

Poor overall environmental quality linked to elevated cancer rates

Nationwide, counties with the poorest quality across five domains -- air, water, land, the built environment and sociodemographic -- had the highest incidence of cancer, according to a new study published in the journal Cancer. Poor air quality and factors of the built environment -- such as the presence of major highways and the availability of public transit and housing -- -- were the most strongly associated with high cancer rates, while water quality and land pollution had no measurable effect.

Previous research has shown that genetics can be blamed for only about half of all cancers, suggesting that exposure to environmental toxins or socioeconomic factors may also play a role. "Most research has focused on single environmental factors like air pollution or toxins in water," said Jyotsna Jagai, research assistant professor of environmental and occupational health in the University of Illinois at Chicago School of Public Health and lead author of the study. "But these single factors don't paint a comprehensive picture of what a person is exposed to in their environment -- and may not be as helpful in predicting cancer risk, which is impacted by multiple factors including the air you breathe, the water you drink, the neighborhood you live in, and your exposure to myriad toxins, chemicals and pollutants."

To investigate the effects of overall environmental quality, the researchers looked at hundreds of variables, including air and water pollution, pesticide and radon levels, neighborhood safety, access to health services and healthy food, presence of heavily-trafficked highways and roads, and sociodemographic factors, such as poverty. Jagai and her colleagues used the U.S. EPA's Environmental Quality Index, a county-level measure incorporating more than 200 of these environmental variables and obtained cancer incidence rates from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program State Cancer Profiles. Cancer data were available for 85 percent of the 3,142 U.S. counties.

The average age-adjusted rate for all types of cancer was 451 cases per 100,000 people. Counties with poor environmental quality had higher incidence of cancer -- on average, 39 more cases per 100,000 people -- than counties with high environmental quality. Increased rates were seen for both males and females, and prostate and breast cancer demonstrated the strongest association with poor environmental quality.

The researchers found that high levels of air pollution, poor quality in the built environment and high levels of sociodemographic risk factors were most strongly associated with increased cancer rates in men and women. The strongest associations were seen in urban areas, especially for the air and built environment domains. Breast and prostate cancer were most strongly associated with poor air quality.