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Category: cancer

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Nice summary of cancer prevention advice. What it boils down to is that there is no magic bullet for cancer prevention (maybe the closest thing is to NOT smoke), but it's a lot of little things adding up (your lifestyle) that lowers the risk of cancer. From The Washington Post:

Looking for that fruit or vegetable that might prevent cancer?

Blueberries. Green tea. Tomatoes. And, oh, that cruciferous cauliflower. All make the lists of super foods that might help prevent cancer. Then there are the foods such as smoked meat and fried foods that supposedly might cause cancer. Such information is standard fare for TV doctors and Web sites, but most of us don’t know how to judge such claims. What sounds authoritative may not be. Only about half of the recommendations on two internationally syndicated TV medical talk shows were supported by scientific evidence, according to a recent study in the journal BMJ.

Of course, the blueberries we eat today are good for us. But nutrition’s role in cancer prevention is much more complex than a single dietary component: Evidence has mounted, for example, that lifestyle — diet, weight control and exercise — is vital in helping reduce risk. For now, experts endorse general dietary advice that is healthful for a variety of chronic diseases and conditions, rather than reductionist thinking that focuses on single foods or nutrients.

When you hear that a certain food helps prevent cancer, ask: Which cancer? “Cancer is multiple diseases,” said Marian Neuhouser, a nutritional epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle. Whereas cardiovascular disease might be broken down into several types, including myocardial infarction, stroke and peripheral vascular disease, she said, “for cancer, it’s really over 100 different diseases.” “Cancer is a very complex, very challenging disease to study whether you’re looking at it on the cell level or the clinical level or the epidemiologic and preventive level,” Willett said.

Researchers caution about overreacting to a single study. New findings come out every week, but “we never take any one study to be the answer to anything,” said Nancy Potischman, a nutritional epidemiologist at the National Cancer Institute. Only if the same results come up in multiple studies across multiple populations, “then you might think that, yes, this food might be important,” she said.

Tobacco use remains the leading preventable cause of cancer incidence and death worldwide. After tobacco, the lifestyle trio of diet, weight control and exercise may be linked to one-third to two-thirds of cancers. “They’re inseparable,” Neuhouser said. “You can have a great diet and you can have a healthy weight, but if you’re extremely sedentary then there’s a risk.”And there’s a strong link between excess weight and several kinds of cancer, including the esophagus, breast (after menopause), endometrium, colon and rectum, kidney, pancreas, thyroid, gallbladder, according to the NCI. 

Evidence mounts about how lifestyle may affect risk of cancer. In the largest study of its kind, nearly half a million Americans were evaluated for adherence to American Cancer Society cancer prevention guidelines that include smoking avoidance; a healthful, consistent weight; physical activity; limiting alcohol; and a diet emphasizing plants.

Those who followed the guidelines most closely had lowered risk of developing cancer (10 percent for men, 19 percent for women) and dying from cancer (25 percent for men, 24 percent for women) compared with those whose habits were least in line with the guidelines. Most striking was the reduction of overall risk of dying: 26 percent for men, 33 percent for women during the 14-year study period.

Fourteen types of cancer seemed affected by lifestyle behavior, most particularly gallbladder, endometrial, liver and colorectal. For men and women, a healthful weight and physical activity were the top factors in reduced deaths overall. Albert Einstein College of Medicine Researchers published this analysis online in January in the American Journal of Clinical Nutrition, based on data from a National Institutes of Health/AARP study.

Another approach to cancer and nutrition considers dietary patterns. “What we eat on any one day is not going to change our cancer risk, but it’s the pattern over the long term.” Neuhouser said. Several diets that emphasized fruit, vegetables, whole grains and plants or plant-based proteins were analyzed against information collected over more than 12 years from nearly 64,000 post-menopausal women in the Women’s Health Initiative Observational Study. Consuming a high-quality diet was associated with lower death rates from chronic diseases including cancer, as reported last year in the American Journal of Epidemiology.

The bacteria, viruses and other organisms that live in and on humans seem to play a bigger role in health and disease than was previously understood, Freudenheim said. How the countless microbes in such areas as the gut and the mouth might contribute to or prevent cancers is one of the open questions in the new area of study of the microbiome, which refers to the many organisms in the body, 10 percent of which are human and 90 percent nonhuman.

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Even though the researchers said this was a "preliminary study"(looking only at non-Hispanic whites), what was good was that results are based on a very large sample size. Coffee drinkers can definitely feel that they are doing something beneficial for their health. From Medical Xpress:

Coffee may be associated with a lower risk of malignant melanoma

Both epidemiological and pre-clinical studies have suggested that coffee consumption has a protective effect against non-melanoma skin cancers. However the protective effect for cutaneous melanoma (malignant and in situ) is less clear, according to a study published January 20 in the Journal of the National Cancer Institute.

To determine if there is an association between coffee consumption and risk of cutaneous melanoma, Erikka Loftfield, M.P.H., of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, and colleagues used data from the NIH-AARP Diet and Health Study. Information on coffee consumption was obtained from 447,357 non-Hispanic white subjects with a self-administered food-frequency questionnaire in 1995/1996, with a median follow-up of 10 years. 

Overall, the highest coffee intake was inversely associated with a risk of malignant melanoma, with a 20% lower risk for those who consumed 4 cups per day or more. There was also a trend toward more protection with higher intake, with the protective effect increasing from 1 or fewer cups to 4 or more. However, the effect was statistically significant for caffeinated but not decaffeinated coffee and only for protection against malignant melanoma but not melanoma in-situ, which may have a different etiology.

The researchers point out that the results are preliminary and may not be applicable to other populations, and therefore additional investigations of coffee intake are needed. 

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Think of incense burning as indoor air pollution, with some of the same chemicals and particulates as cigarettes. From Environmental Health Perspectives:

Ritual Risk: Incense Use and Cardiovascular Mortality

Numerous studies have examined exposures to indoor combustion products such as secondhand smoke and emissions from burning of solid fuels. However, only a few have examined incense burning as a potential health threat, even though incense is commonly used for religious and ritual purposes in China, Taiwan, Singapore, India, and Middle Eastern nations.1,2In this issue of EHP, investigators report an association between long-term incense use and increased cardiovascular mortality.1

The study used data from the Singapore Chinese Health Study, which enrolled a cohort of 63,257 Chinese adults aged 45–74 years between 1993 and 1998. The authors identified cardiovascular deaths of cohort members via a nationwide death registry, checking the registry yearly through 31 December 2011.

More than three-quarters of the participants reported currently using incense, and another 13% were former users. Most had used incense daily for at least 20 years, typically keeping it burning intermittently throughout the day. The authors estimated that current long-term incense users had a 12% increased risk of cardiovascular mortality compared with former and never users, including a 19% increased risk for stroke and a 10% increased risk for coronary heart disease.1

Previous studies reported concentrations of volatile organic compounds and particulate matter in incense emissions similar to those in cigarette smoke.3,4 Others showed that long-term exposure to incense smoke increased blood vessel inflammation and affected blood flow in rats.5 In vitro studies have indicated adverse impact to human coronary6 and lung cells.4 

 In contrast with outdoor air pollution, incense exposure may be easier for an individual to avoid, but Yeatts says education will be needed to help people understand the risks of these exposures, similar to educational campaigns about cigarette smoking.Koh published an earlier prospective study that found an association between incense use and upper respiratory cancer.7

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This would be a major shift in advice. Take note: they found the benefits outweighed the cons only in women starting from the age of 65 and above. From Science Daily:

Cons of regular low-dose aspirin to stave off serious illness in women outweigh pros

The pros of giving healthy women regular low-dose aspirin to stave off serious illness, such as cancer and heart disease, are outweighed by the cons, suggests a large study.

But the balance begins to shift with increasing age, and limiting this form of primary prevention to women aged 65 and above, was better than not taking aspirin at all, or treating women from the age of 45 onwards, say the researchers.

They base their findings on almost 30,000 healthy women, who were at least 45 years old and taking part in the Women's Health Study.Participants were randomly assigned to take either 100 mg of aspirin or a dummy tablet (placebo) every other day, to see whether aspirin curbed their risk of heart disease, stroke, and cancer.

Compared with placebo, regular aspirin was linked to a lower risk of heart disease, stroke, bowel cancer, and in some women, other cancers, but only marginally so.And this slight health gain was trumped by the prevalence of internal gastrointestinal bleeding, which affected two thirds of the women  taking the non-steroidal anti-inflammatory drug.

The risk of gastrointestinal bleeding rose with age, but so too did the drug's impact on lowering the risk of bowel cancer and cardiovascular disease, with the balance appearing to tip in favour of the drug for women aged 65 and above..The researchers calculated that over 15 years, 29 over-65s would need to be treated with aspirin to prevent one case of cancer or heart disease/stroke...But they conclude that blanket treatment "is ineffective or harmful in the majority of women with regard to the combined risk of cardiovascular disease, cancer and major gastrointestinal bleeding."

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Much discussion about the link between gut bacteria and liver cancer, as well as the link between inflammation and cancer. Gut microbiome imbalances can cause health harms.

Bottom line: Try to improve your gut microbiome by eating a diet rich in fruits, vegetables, seeds, nuts, legumes, and whole grains.

From the Dec.4, 2014 issue of Nature: Microbiome: The bacterial tightrope

Imbalances in gut bacteria have been implicated in the progression from liver disease to cancer. The team's research, published last year, suggests that gut bacteria — which are part of the microbiome of bacteria and other microorganisms that live in and on the body — can play a crucial part in liver-cancer progression.

There are trillions of microorganisms in the human microbiome — they outnumber their host's cells by around ten to one — and their exact role in health and disease is only now starting to be explored. Studies have found that people with non-alcoholic fatty liver disease have a different composition of bacteria in their gut from healthy individuals2, 3

 Instead, she sees an emerging picture of liver disease and cancer as a process in which various factors — including a high-fat diet, alcoholism, genetic susceptibility and the microbiome — can each contribute to the progression from minor to severe liver damage, and from severe liver damage to cancer.

Flavell's research suggests that the liver has an important role in immune surveillance and helps to maintain bacterial balance in the gut. Specialized cells in the liver and intestines monitor the microbiome by keeping tabs on bacterial by-products as they pass through. These cells can detect infections and help to fight them.

But they can also pick up on subtler changes in the bacterial populations in the gut. When certain types of bacteria become too numerous — a state called dysbiosis — the immune system becomes activated and triggers inflammation, although at a lower level than it would for an infection... Now, research is emerging that suggests that dysbiosis and the immune reaction it provokes can even contribute to cancer.

He thinks that at least part of this mechanism involves disruption in the balance of the various species of bacteria in the gut. An out-of-balance microbiome promotes a constant state of inflammation, which can contribute to cancer progression, Schwabe says. This aligns with the picture that is emerging of cancer, in general, as an inflammatory process: the same immune reactions that help the body to fight infection and disease can also promote unchecked cell growth.

Some of the earliest research on the human microbiome, published in 2006, demonstrated that the balance of gut bacteria in obese people is different from that in people of healthy weight. In particular, obese people tend to have greater numbers of the bacteria that produce DCA (deoxycholic acid) and other secondary bile acids.

This line of research points to the microbiome as one potential link between obesity and liver-cancer risk . And, much like Schwabe's work, Hara's results indicate that several factors converge to promote cancer: in this case, bacteria, diet and carcinogen exposure. Here, too, the ability to stave off the disease seems to depend on maintaining the appropriate microbial balance. Overweight mice and people have a different composition of gut microbiota from their lighter counterparts, and they have higher levels of DCA, too.

However, not everyone is convinced that individual bacterial species are to blame. Some researchers point out that dysbiosis, and therefore cancer risk, involves multiple strains of bacteria. And the bacterial mix can vary from person to person, meaning it is unlikely that scientists can pin all responsibility on a single species.

Others are looking for ways to promote the growth of healthy bacterial strains rather than target the bad ones....There is also some early clinical evidence that specially formulated probiotics — cocktails of good bacteria — can bump the microbiome back into balance. Hylemon and his colleagues gave people with cirrhosis a probiotic containing Lactobacillus bacteria and found that their blood markers of inflammation decreased along with their cognitive dysfunction (a common symptom of cirrhosis)6. Although the study was not designed to evaluate cancer risk, it does show that delivering bacteria to the gut can have positive therapeutic effects on the liver.

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Great reasons to eat walnuts. Yes, this study was done in mice, but it (as supported by other research) should also apply to humans.From Medical Xpress:

'Tis the season to indulge in walnuts

Researchers at UC Davis and other institutions have found that diets rich in whole walnuts or walnut oil slowed prostate cancer growth in mice. In addition, both walnuts and walnut oil reduced cholesterol and increased insulin sensitivity. The walnut diet also reduced levels of the hormone IGF-1, which had been previously implicated in both prostate and breast cancer. The study was published online in the Journal of Medicinal Food. 

Davis and colleagues have been investigating the impact of walnuts on health for some time. A previous study found that walnuts reduced prostate tumor size in mice; however, there were questions about which parts of the nuts generated these benefits. 

In the current study, researchers used a mixture of fats with virtually the same fatty acid content as walnuts as their control diet. The mice were fed whole walnuts, walnut oil or the walnut-like fat for 18 weeks. The results replicated those from the previous study. While the walnuts and walnut oil reduced cholesterol and slowed prostate cancer growth, in contrast, the walnut-like fat did not have these effects, confirming that other nut components caused the improvements - not the omega-3s.

While the study does not pinpoint which combination of compounds in walnuts slows cancer growth, it did rule out fiber, zinc, magnesium and selenium. In addition, the research demonstrated that walnuts modulate several mechanisms associated with cancer growth.

"The energy effects from decreasing IGF-1 seem to muck up the works so the cancer can't grow as fast as it normally would," Davis said. "Also, reducing cholesterol means cancer cells may not get enough of it to allow these cells to grow quickly." In addition, the research showed increases in both adiponectin and the tumor suppressor PSP94, as well as reduced levels of COX-2, all markers for reduced prostate cancer risk.

Although results in mice don't always translate to humans, Davis said his results suggest the benefits of incorporating walnuts into a healthy diet. Other research, such as the PREDIMED human study, which assessed the Mediterranean diet, also found that eating walnuts reduced cancer mortality.

Still, Davis recommends caution in diet modification. "In our study the mice were eating the equivalent of 2.6 ounces of walnuts," he said. "You need to realize that 2.6 ounces of walnuts is about 482 calories. That's not insignificant, but it's better than eating a serving of supersized fries, which has 610 calories. In addition to the cancer benefit, we think you also get cardiovascular benefits that other walnut research has demonstrated.

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Read the labels on personal care products, and do NOT buy those with triclosan! (See earlier posts for other reasons to avoid triclosan.) From Science Daily:

The 'dirty' side of soap: Triclosan, a common antimicrobial in personal hygiene products, causes liver fibrosis and cancer in mice

Triclosan is an antimicrobial commonly found in soaps, shampoos, toothpastes and many other household items. Despite its widespread use, researchers report potentially serious consequences of long-term exposure to the chemical.The study, published Nov. 17 by Proceedings of the National Academy of Sciences, shows that triclosan causes liver fibrosis and cancer in laboratory mice through molecular mechanisms that are also relevant in humans.

"Triclosan's increasing detection in environmental samples and its increasingly broad use in consumer products may overcome its moderate benefit and present a very real risk of liver toxicity for people, as it does in mice, particularly when combined with other compounds with similar action," said Robert H. Tukey, PhD, professor in the departments of Chemistry and Biochemistry and Pharmacology. 

Tukey, Hammock and their teams, including Mei-Fei Yueh, PhD, found that triclosan disrupted liver integrity and compromised liver function in mouse models. Mice exposed to triclosan for six months (roughly equivalent to 18 human years) were more susceptible to chemical-induced liver tumors. Their tumors were also larger and more frequent than in mice not exposed to triclosan.

The study suggests triclosan may do its damage by interfering with the constitutive androstane receptor, a protein responsible for detoxifying (clearing away) foreign chemicals in the body. To compensate for this stress, liver cells proliferate and turn fibrotic over time. Repeated triclosan exposure and continued liver fibrosis eventually promote tumor formation.

Triclosan is perhaps the most ubiquitous consumer antibacterial. Studies have found traces in 97 percent of breast milk samples from lactating women and in the urine of nearly 75 percent of people tested. Triclosan is also common in the environment: It is one of the seven most frequently detected compounds in streams across the United States.

More about this study plus a discussion about the FDA's lack of action. From The Atlantic:

The Ingredient to Avoid in Soap

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This article describes results of a research review showing cancer prevention benefits from eating fatty fish and fish oil. From Science News:

Marked benefits found for cancer prevention with a higher intake of fatty fish

A new research review will once again have people asking for a second helping of wild Alaskan salmon at the dinner table. While several other studies have recently challenged the long-held belief of the benefits of a diet high in omega-3 fatty acids, this new study cites compelling evidence that eating the right kinds of fatty fish, in the right quantity, and prepared the right way, can in fact help prevent the body’s development of adenocarcinomas, a common type of cancerous tumor. A high proportion of the cancers arising in the breast, prostate, pancreas, colon, and the rest of the gastrointestinal tracts are adenocarcinomas.

The authors first cite evidence that the recently-demonstrated ability of daily low-dose aspirin to decrease risk for adenocarcinomas is attributable to its ability to modestly decrease the activity of cyclooxygenase-2 (cox-2), an enzyme which contributes importantly to the genesis and progression of adenocarcinomas. They then propose that an ample dietary intake of omega-3 fats -- the type prominent in fatty fish -- could also be expected to oppose cox-2 activity, and thereby reduce risk for adenocarcinomas.

The authors emphasize that it is not only the amount of fish consumed daily, but also the nature of this fish, and how it is preserved or cooked, that can have a major impact on the potential of dietary fish to lower cancer risk. "An easy way to see the benefit of omega-3 is to look at Italy," Dr. DiNicolantonio said. "The staple oil used in cooking and as a salad dressing in Italy is olive oil, which is quite low in omega-6. Meanwhile, fish -- high in omega-3 -- is a staple food in the Italian diet, and this fish is rarely salt-preserved or fried. In Italians studies, subjects who consumed fish at least twice weekly as compared to those who ate fish less than once a week, were found to be at a significantly lower risk for a number of cancers, including ovarian, endometrial, pharyngeal, esophageal, gastric, colonic, rectal, and pancreatic."

The authors also focus on several recent studies in which regular consumption of fish oil is correlated with lower subsequent cancer risk. These studies have reported lower risks for colorectal, breast, and advanced prostate cancer in those taking such supplements. And a recent study from the University of Washington, which estimated total omega-3 intakes of its subjects from both fish and from supplements, found that a high omega-3 intake was associated with a 23 percent reduction in total cancer mortality. Indeed, mortality from all causes was significantly lower in those with higher omega-3 intakes. The authors also noted that cox-2 is significantly expressed in pre-malignant and early stage adenocarcinomas, but expression is sometimes lost as cancers mature. This may be why cox-2 inhibition (via increased omega-3 intake) seems to have greater potential for cancer prevention, than for cancer therapy.

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The latest results on this hotly debated subject. The researchers suggest that people instead use "hands free phones with the loud speaker feature". From Medscape:

Long-Term Cell Phone Use Linked to Brain Tumor Risk

Long-term use of both mobile and cordless phones is associated with an increased risk for glioma, the most common type of brain tumor, the latest research on the subject concludes.

The new study shows that the risk for glioma was tripled among those using a wireless phone for more than 25 years and that the risk was also greater for those who had started using mobile or cordless phones before age 20 years.

The recent worldwide increase in use of wireless communications has resulted in greater exposure to radio frequency electromagnetic fields (RF-EMF). The brain is the main target of RF-EMF when these phones are used, with the highest exposure being on the same side of the brain where the phone is placed.

The analysis included 1498 cases of malignant brain tumors; the mean age was 52 years. Most patients (92%) had a diagnosis of glioma, and just over half of the gliomas (50.3%) were the most malignant variety — astrocytoma  grade IV (glioblastoma multiforme). Also included were 3530 controls, with a mean age of 54 years.

The analysis showed an increased risk for glioma associated with use for more than 1 year of both mobile and cordless phones after adjustment for age at diagnosis, sex, socioeconomic index, and year of diagnosis. The highest risk was for those with the longest latency for mobile phone use over 25 years.

The risk was increased the more that wireless phones were used. The odds ratios steadily rose with increasing hours of use...Further, the risk was highest among participants who first used a mobile phone (odds ratio, 1.8) or cordless phone (odds ratio, 2.3) before age 20 years, although the number of cases and controls was relatively small.

As Dr Hardell explained, children and adolescents are more exposed to RF-EMF than adults because of their thinner skull bone and smaller head and the higher conductivity in their brain tissue. The brain is still developing up to about the age of 20 and until that time it is relatively vulnerable, he said.

There was a higher risk for third-generation (3G) mobile phone use compared with other types, but this was based on short latency and rather low numbers of exposed participants, said the authors. 3G universal global telecommunications system mobile phones emit wide band microwave signals, which "hypothetically" may result in higher biological effects compared to other signals, they write. 

Numerous studies have looked at the link between use of wireless phones and brain tumors. Studies by Dr Hardell and his colleagues dating back to the late 1990s have found a connection with mobile and cordless phones. But the INTERPHONE study (Int J Epidemiol 2011;39:675-694; Cancer Epidemiol 2011;32:453-464) failed to find strong evidence that mobile phones increase the risk for brain tumors.

In addition, a large prospective study (Int J Epidemiol 2013;42:792-802) found that mobile phone use was not associated with increased incidence of glioma or of meningioma or non–central nervous system cancers in middle-aged British women.

Pathophysiology. Published online October 28, 2014. Abstract

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This recent scientific (and yes, technical) article discusses the tantalizing promise of treating cancer, especially melanoma, with infections and certain vaccines. Much discussion of how two vaccines that are already out there may prevent some cancers such as melanoma and leukemia (vaccination with Bacille Calmette-Guerin (BCG) of newborns and vaccination with the yellow fever 17D vaccine of adults).This recent article is a further development on what was discussed in the last post (Injecting a person with a bacterial extract - called Coley's toxins or Coley toxins - to cause an infection, and so treat cancer). From BioMed Central:

The biography of the immune system and the control of cancer: from St Peregrine to contemporary vaccination strategies

In 1875 Campbell de Morgan, a surgeon at the Middlesex Hospital in London, reported that regressions and remissions of cancers sometimes occurred after post-operative infections, particularly the streptococcal infection erysipelas...

Campbell de Morgan’s observation that remissions sometimes occurred after post-operative streptococcal infections inspired some workers to undertake the risky procedure of deliberately inducing erysipelas in cancer patients. Subsequently, an American surgeon, William Coley, developed bacteria-free extracts of streptococci and other bacteria (“Coley toxins”) and reported their successful use in the therapy of cancers, especially sarcomas, between 1881 and 1936 . Unfortunately Coley, a mild mannered and unassuming gentleman, did not adhere to rigorous scientific protocols in his studies and he was marginalized by forceful personalities advocating radiotherapy. Notwithstanding, an analysis of his results with cancer deemed inoperable undertaken in 1994 revealed a remission rate of 64% and a five-year survival rate of 44%, results equal to or better than those with modern therapies [14]. 

It is also now appreciated that chronic inflammation is an essential element of cancers and it has indeed been termed ‘the other half of the tumour’ [37]. The normal healing process relies on inflammation, collagen production, angiogenesis and cell proliferation and, in a description of the similarities between tumour stroma formation and wound healing, tumours have been referred to as “wounds that do not heal” [38], 

The relationship between infection, and associated inflammation, and cancer is a complex and paradoxical one and there are several well described examples of cancer being the direct consequence of infection [41]. Around 2 million of the 12.7 million new cancer cases worldwide in 2008 (16.1%) were assumed to be related to infection, principally Helicobacter pylori, hepatitis viruses, and the human papilloma virus, with a higher proportion in developing countries (22.9%) than in developed ones (7.4%) [42]. The large majority of cases of cancer, especially those in the developed nations, are therefore not caused by infection – on the contrary, there is growing evidence that a history of certain infections and environmental exposure to certain populations of micro-organisms, as well as some types of vaccination, may induce patterns of immune reactivity that reduce the risk of at least some cancers. 

A study of an adult population in Italy demonstrated an association between a history of common childhood infectious diseases (measles, chickenpox, rubella, mumps and pertussis) and the risk of developing chronic lymphatic leukaemia (CLL), with a strong inverse relationship between the risk of CLL and the number of infections (p = 0.002) [47]. 

In the 1990s Kölmel and colleagues established a working group – Febrile Infections and Melanoma (FEBIM) – within the European Organization for Research and Treatment of Cancer (EORTC). Based on a pilot study [79] this group undertook a series of studies to establish the relationship between the risk for developing melanoma and a history of, initially, infectious diseases [80], and, subsequently, also of vaccinations [81,82].

In the first report of the FEBIM group a significant level of protection against melanoma in those with a history of certain severe infections (sepsis, Staph. aureus infection, pneumonia, pulmonary tuberculosis) with fever of over 38.5°C was demonstrated [80]. It should, however, be noted that these apparently melanoma-protective infectious diseases have become rare in the industrialized nations. 

It is claimed that, as a result of recent observational studies, measures for prevention of some malignancies such as melanoma and certain forms of leukaemia are already at hand: vaccination with Bacille Calmette-Guérin (BCG) of new-borns and vaccination with the yellow fever 17D (YFV) vaccine of adults. While the evidence of their benefit for prevention of malignancies requires substantiation, the observations that vaccinations with BCG and/or vaccinia early in life improved the outcome of patients after surgical therapy of melanoma are of practical relevance as the survival advantage conferred by prior vaccination is greater than any contemporary adjuvant therapy.