HELP THE CCAC HELP YOU AND IT WONT COST YOU A PENNY! www.dairygoodness.ca/getenough/app

The Dairy Farmers of Canada (DFC) have come up with a great fundraising campaign to help the Colorectal Cancer Association of Canada, Heart & Stroke and Osteoporosis. They have developed an App to promote healthy lifestyles and healthy food portions in accordance with the Canada Food Guide, with a fun way to track your own eating habits. elEach day you input and save your daily food servings from the 4 food groups the DFC will donate $1 to the charity of choice. So please choose the CCAC! With your participation by selecting the CCAC as a partner we can earn up to $50,000 to assist us in Colon Cancer Awareness, Education and Support programs. It’s a great way not only to ensure you are eating healthy, but to help us help the thousands of Canadians touched by the second biggest cancer killer in the country.


So please down load the Get Enough Helper for Apple and Android apps in the App Store and choose the CCAC as your charity. Help us help you and together we can save lives!



Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Aug 04, 2014 04:23 AM EDT

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption (Photo : Flickr)


A new study found that eating a type of resistant starch can help reduce the risk of colorectal cancer associated with red meat consumption.


Studies from around the world have suggested that high consumption of meat is linked to an increased risk of colon cancer. In all cases the worry is confined to red meat. A new study by researchers from Flinders University in Adelaide found that eating a type of resistant starch can help reduce the risk of colorectal cancer associated with red meat consumption.”Red meat and resistant starch have opposite effects on the colorectal cancer-promoting miRNAs, the miR-17-92 cluster,” said Karen J. Humphreys, a research associate at the Flinders Center for Innovation in Cancer at Flinders University, in a press release. “This finding supports consumption of resistant starch as a means of reducing the risk associated with a high red meat diet. Total meat consumption in the USA, European Union, and the developed world has continued to increase from the 1960s, and in some cases has nearly doubled.”

The study was conducted on 17 healthy males and six healthy females. All participants were aged between 50 and 75 years. They were put on a red meat or a red meat plus butyrate resistant starch diet for four weeks. After a four-week interval, the participants were made to switch diets. Researchers found that the participants that ate 300 g of lean meat daily for four weeks had a 30 percent increase in the levels of certain genetic molecules called miR-17-92 in their rectal tissue, and an associated increase in cell proliferation. However, those that ate 40 g of butyrate resistant starch per day along with red meat saw their miR-17-92 levels go down to baseline levels.

Resistant starch, unlike other starches, goes all the way through the small intestine without being digested at all. In this way, it is more like fiber, and in some cases is classified and labeled as fiber. Also, it is readily fermented by gut microbes to produce beneficial molecules called short-chain fatty acids, such as butyrate.

“Good examples of natural sources of resistant starch include bananas that are still slightly green, cooked and cooled potatoes [such as potato salad], whole grains, beans, chickpeas, and lentils. Scientists have also been working to modify grains such as maize so they contain higher levels of resistant starch,” said Humphreys.

Scientists have offered a number of explanations for the link between red meat and colon cancer. One theory blames heterocyclic amines (HCAs), chemicals produced when meat is cooked at high temperatures. HCAs may play a role, but since high levels can also be present in cooked chicken, this is unlikely to be the whole explanation. Preservatives have also been implicated in the case of processed meats; nitrates are a particular worry, since the body converts them to nitrosamines, which are carcinogenic.

Scientists from England have offered another explanation. Their investigation recruited healthy volunteers. The volunteers ate one of three test diets for a period of 15 to 21 days. The first diet contained about 14 ounces of red meat a day, always prepared to minimize HCA formation. The second diet was strictly vegetarian, and the third contained large amounts of both red meat and dietary fiber. Stool specimens from the 21 volunteers who consumed the high-meat diet contained high levels of N-nitroso compounds (NOCs), which are potentially cancer-causing chemicals. The 12 volunteers who ate vegetarian food excreted low levels of NOCs, and the 13 who ate meat and high-fiber diets produced intermediate amounts.

recent study also highlighted that consuming chilli peppers can reduce the risk of tumors associated with colorectal cancer. Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine. It is the third leading cause of cancer in males and fourth in females in the U.S. Risk factors for this disease include heredity, colon polyps, and long-standing ulcerative colitis. Most colorectal cancers develop from polyps.  Colon polyps and early cancer can have no symptoms. Therefore, regular screening is important.

The current study was published online in Cancer Prevention Research, a journal of the American Association for Cancer Research. The project was funded by the National Health and Medical Research Council of Australia, the Commonwealth Scientific and Industrial Research Organization (Preventative Health Flagship), and the Flinders Medical Center Foundation.


Gut Bacteria May Reveal Colon Cancer, Study Finds

Gut Bacteria May Reveal Colon Cancer, Study Finds

Test could be used in addition to current methods to better improve detection

By Robert Preidt

HealthDay Reporter

THURSDAY, Aug. 7, 2014 (HealthDay News) — Analyzing the composition of people’s collection of gut bacteria — also called the gut microbiome — can help improve identification of those who are at risk for, or already have, colon cancer, according to a new study.

Researchers collected stool samples from 30 healthy people, 30 people with precancerous intestinal polyps and 30 people with advanced colon or rectal cancerin order to assess the composition of their gut microbiomes.

 Each group had a different gut microbiome composition, according to the study published Aug. 7 in Cancer Prevention Research.

“If our results are confirmed in larger groups of people, adding gut microbiome analysis to other fecal tests may provide an improved, noninvasive way to screen for colorectal cancer,” study author Patrick Schloss, associate professor in the department of microbiology and immunology at the University of Michigan, said in a journal news release.

Adding analysis of gut microbiomes to assessment of age and race — known risk factors for precancerous polyps — led to a 4.5-fold improved prediction of precancerous polyps, the investigators found. Adding analysis of gut microbiomes to assessment of age, race and body mass index — known risk factors for invasive colorectal cancer — led to more than a fivefold improved prediction of the disease.

The researchers also found that analysis of gut microbiomes was better than fecal occult blood testing (a type of stool sample test) at distinguishing people with precancerous polyps from those with invasive cancer.

Assessing body mass index (a measurement based on height and weight), fecal occult blood test results and gut microbiomes together was even more effective at distinguishing patients with precancerous polyps from those with invasive colon and rectal cancer, the study revealed.

“Our data show that gut microbiome analysis has the potential to be a new tool to noninvasively screen for colorectal cancer,” Schloss said. “We don’t think that this would ever replace other colorectal cancer screening approaches, rather we see it as complementary.”

The Future of cancer treatment will be by genetic and molecular type. Are we ready?

Cancer should be classified by genetic and molecular type, say scientists

Friday 8 August 2014 – 3am PST
A research network in the US proposes that cancer should be classified according to genetic and molecular features rather than by the type of tissue in which the tumor arises. While more work is needed to confirm and build on findings that look set to rewrite oncology textbooks, the scientists say such a system would be better for patients because it would help tailor treatment to their individual needs.
Cancer cells
Researchers found that different types of cancerous tumors were molecularly and genetically similar, prompting them to challenge the existing system of classifying cancers.

Writing about their findings in the journal Cell, researchers from The Cancer Genome Atlas (TCGA) describe how they analyzed more than 3,500 tumors on multiple genomic technology platforms.

There have already been studies that suggestcancer should be defined by features at the genetic and molecular level. For example, Medical News Today recently reported another TCGA study that found four distinct molecular subtypes of stomach cancer.

But in this latest study – the largest genomic study of cancer – the researchers found even across tissue types (for instance, breast, bladder and kidney), what we currently regard as different cancers have tumors that are more similar at the molecular and genetic level than at the tissue level.

‘Disruptive’ study challenges existing system of classifying cancers

In explaining the impact of the findings, co-corresponding author Chris Benz, a professor at the Buck Institute for Research on Aging in Novato, CA, points out most of our tissues comprise many different types of epithelial and non-epithelial cells (epithelial cells being those that line cavities in the body and cover flat surfaces, while non-epithelial cells form other tissue types such as connective, muscle and nervous tissue), and:

“This disruptive genomic study not only challenges our existing system of classifying cancers based on tissue type, but also provides a massive new data resource for further exploration as well as a comprehensive list of the molecular features distinguishing each of the newly described cancer classes.”

He cites the example of bladder cancer, which they propose should be reclassified into several different types, each with distinct and different outcomes, to explain why patients can expect quite different results when treated with the same systemic therapy.

For the study, the scientists compared the DNA, RNA and proteins of 3,527 specimens of 12 different tumortypes by analyzing them with six different “platform technologies.” The results showed tumors were more likely to be molecularly and genetically similar based on their cell type of origin as opposed to their tissue type of origin.

One subtype of bladder cancer virtually identical to lung adenocarcinoma

For example, the study suggests there are at least three different subtypes of bladder cancer, one of which is almost identical to lung adenocarcinoma, and another that is similar to squamous cell cancers found in the head-and-neck and lungs.

The study also confirms known differences in subtypes of breast cancer but reveals a surprising finding in that basal-like breast cancers – also known as triple-negative breast cancer – are actually a class of their own. These cancers are very aggressive and more common in African-American and younger women.

Even though these basal-like cancers may arise in the breast, the study shows that at the molecular level they are more like ovarian cancers and cancers of squamous cell origin than other breast cancer subtypes.

The team says the findings suggest at least 1 in 10 cancer patients would receive a different classification of their cancer type under the new system. However, Prof. Benz believes this proportion will grow after the next round of analysis, which will look at more samples and tumor types.

He anticipates this will show over 20 types of tumor, based on classification by molecular and genetic features at the cell level:

“We’re just appreciating the tip of the iceberg when considering the potential of this multi-platform type of genomic analysis. It could be that as many as 30 or 50% of cancers need to be reclassified.”

He believes this study and future repeats will improve design of clinical trials by helping to identify patients more likely to respond to new treatments based on the genomic reclassification of their tumors. He notes:

“Although follow-up studies are needed to validate and refine this newly proposed cancer classification system, it will ultimately provide the biologic foundation for that era of personalized cancer treatment that patients and clinicians eagerly await.”

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Decoding Noncoding DNA’s Role in Colorectal Cancer

GEN News Highlights

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Jul 24, 2014

Decoding Noncoding DNA’s Role in Colorectal Cancer

  • Scientists have been alert to genetic drivers of cancer that are embedded in the transcriptome, which consists of DNA’s coding regions. Beyond the transcriptome, in the wider genome, lurk additional drivers. They are, most likely, elements that regulate gene expression—or rather, being faulty, dysregulate gene expression.

    Expanding the search for cancer drivers into the wider genome, effectively sifting through noncoding stretches of DNA, a team of scientists centered at the University of Geneva (UNIGE) performed an RNA sequencing analysis of 103 matched tumor and normal colon mucosa colorectal cancer (CRC) samples. According to the scientists, theirs was the first study of this scale to examine the noncoding genome of cancer patients.

    The UNIGE team and its collaborators described the study July 23 in Nature, in an article entitled, “Putative cis-regulatory drivers in colorectal cancer.” The scientists reported that they were able to identify two kinds of noncoding mutations that have an impact on the development of colorectal cancer.

    They found hereditary regulatory variants that are not active in healthy tissue, but are activated in tumors and seem to contribute to cancer progression. In addition, they identified effects of acquired mutations on the regulation of gene expression that affect the genesis and progression of colorectal tumors.

    In particular, the researchers detected 71 genes with significantly higher allele-specific expression (ASE) somatic event rates, which they defined as genes with allelic dysregulation (GADs), as well as 376 genes with tumor-specific germline cis-regulatory variants.

    “Both categories demonstrate characteristics that support their role as putative cancer drivers,” wrote the study’s authors. “This gives us access to putative noncoding somatic and germline CRC drivers on an unprecedented scale.”

    “In addition, tumor-specific cis-eQTLs [expression quantitative trait loci] reveal a new category of variants that are likely to contribute to cancer besides predisposing alleles and somatic mutations,” the authors continued. “It is likely that some of the predisposing variants discovered via GWAS are in fact germline drivers.”

    The head of the research team, Emmanouil Dermitzakis, Ph.D., Louis-Jeantet Professor of Genetics in UNIGE’s faculty of medicine , best generic online pharmacy , noted that the methodology used here to evaluate colorectal cancer could also be applied “to understand the genetic basis of all sorts of cancers.”

    “The elements responsible for the development and progression of cancers located in the noncoding genome are as important as those found in the coding regions of the genome,” added Halit Ongen, D.Phil., a postdoctoral researcher at UNIGE and the lead author of the study. “Therefore, analyzing genetic factors in our whole genome, and not only in the coding regions as it was done before, gives us a much more comprehensive knowledge of the genetics behind colorectal cancer.”



New molecular features of colorectal cancer and five colon cancer subtypes are identified with proteomics

Researchers report first large-scale integrated proteomic and genomic analysis of a human cancer: Identification of new molecular features of colorectal cancer

Investigators who analyzed 95 human colorectal tumor samples have determined how gene alterations identified in previous analyses of the same samples are expressed at the protein level. The integration of proteomic and genomic data, or proteogenomics, provides a more comprehensive view of the biological features that drive cancer than genomic analysis alone and may help identify the most important targets for cancer detection and intervention. The results of this study appeared online July 20, 2014, in Nature.

The colorectal study produced several key findings:

  • Measurements of messenger RNA abundance did not reliably predict protein abundance. The investigators were not surprised by this discordance, because many regulatory controls lie between RNA and protein expression. However, it did demonstrate that RNA analyses do not necessarily give a correct indication of protein levels.
  • Most of the focal amplifications (increased amounts of certain chromosome segments) observed in the earlier genomic analyses of the same tumors did not result in corresponding elevations in protein level. Proteomic analyses identified a few amplifications that had dramatic effects on protein levels and may represent potentially important targets for diagnosis or therapeutic intervention.
  • Proteomics identified five colon cancer subtypes, including classifications that could not be derived from genomic data. Protein expression signatures for one of the subtypes indicated molecular characteristics associated with highly aggressive tumors with poor clinical outcome.

These findings, by Clinical Proteomic Tumor Analysis Consortium (CPTAC) investigators, including Henry Rodriguez, Ph.D., director of the Office of Cancer Clinical Proteomics Research, NCI, and Daniel C. Liebler, Ph.D., Vanderbilt University School of Medicine, Nashville, were made possible because of genomic analyses that were done on the same tumors in 2012 by The Cancer Genome Atlas (TCGA) Research Network. The CPTAC study provided a clear demonstration of how proteomics can be used to help understand how genomic abnormalities drive cancer.

Interesting new Trial for Stage lll resected CRC FOLFOX and CELEBREX®

Redefining Adjuvant Therapy for Stage III Resected Colon Cancer

Name of the Trial

Oxaliplatin, Leucovorin Calcium, and Fluorouracil with or without Celecoxib in Treating Patients with Stage III Colon Cancer Previously Treated with Surgery (CALGB-80702). See the protocol summary.

Principal Investigator

Dr. Jeffrey A. Meyerhardt, Alliance for Clinical Trials in Oncology

Dr. Jeffrey A. Meyerhardt

Dr. Jeffrey A. Meyerhardt

Why This Trial Is Important

Despite improvements in treatment, approximately 30 percent of patients with resected (surgically removed) stage III colon cancer still experience arecurrence. Accordingly, clinical trials of new interventions are needed to find better ways of preventing the cancer from returning. In this trial, patients with resected stage III colon cancer are being randomly assigned to receive a type of chemotherapy called FOLFOX for either 3 months or 6 months and to take either an aspirin-like pill called celecoxib (Celebrex®) or a matching placebo pill for 3 years.

“We’re really trying to answer two questions with this study: first, does adding celecoxib to chemotherapy following surgery provide any benefit over the chemotherapy alone, and second, does a shorter course of FOLFOX work as well as the standard 6-month course?” said Dr. Meyerhardt, the study’s lead investigator.

Resection of the tumor is the cornerstone of treatment for colon cancer that has not spread to other parts of the body. For early-stage disease, surgery alone may be sufficient to eradicate the cancer, but for more advanced stage III colon cancer, the use of chemotherapy after surgery (adjuvant chemotherapy) may help prevent or delay the return of cancer and prolong the lives of patients.

Currently, a 6-month course of adjuvant FOLFOX is considered standard treatment for resected stage III colon cancer. FOLFOX combines fluorouracil and leucovorin, drugs first approved decades ago, withoxaliplatin, a relatively newer platinum-based drug. Clinical trials have demonstrated that this combination extends disease-free survival and overall survival better than adjuvant fluorouracil and leucovorin alone.

Unfortunately, many drugs, including the ones used in this trial, cause side effects. In some cases, these side effects can be severe. One of the most common and serious side effects associated with oxaliplatin is peripheral neuropathy, an often painful “tingling” or numbing sensation in the feet or hands. The likelihood of developing peripheral neuropathy increases with each dose of FOLFOX. This and other side effects can be so severe that patients stop treatment before completing the full 6 months of chemotherapy.

In an effort to limit the toxicity associated with adjuvant FOLFOX, this trial will determine whether a 3-month course of treatment is as good as a 6-month course in delaying or preventing a recurrence of colon cancer. In addition, patients will be monitored to determine whether the shorter course of treatment reduces side effects such as peripheral neuropathy.

EnlargeThe random assignment schema for this trial

Graphic showing the random assignment schema for this trial.

This trial also tests celecoxib’s ability to help prevent or delay cancer recurrence. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that blocks the activity of a protein thought to play a role in cancer growth. A number of large observational studies have shown that people who regularly take aspirin or other NSAIDs may be at reduced risk of developing colon cancer. These findings have led to studies of aspirin and NSAIDs as prevention agents for colon cancer.

The NCI-sponsored Adenoma Prevention with Celecoxib (APC) trial, in particular, tested celecoxib’s ability to prevent colon polyps in people who had them removed during a previous colonoscopy and found that the drug did reduce the recurrence of polyps. Most, if not all, cases of colorectal cancer begin as polyps in the colon or rectum. These findings encouraged researchers to test celecoxib as an adjuvant therapy for resected colon cancer.

However, cardiac toxicity is a concern with all NSAIDS, including celecoxib. Previous studies have identified a daily dose of 400 milligrams as the safest dose for celecoxib, and doctors have learned a great deal about which patients are at greater risk of heart complications. This trial is recruiting patients who will be at the least risk for cardiac problems and is using the safest dosage of celecoxib.

“For celecoxib to be incorporated into clinical practice for colon cancer, we need to have a randomized controlled trial to make sure there aren’t other factors leading to the associations we’ve observed,” said Dr. Meyerhardt.

“We’ve enrolled 1,700 patients since 2010 and we haven’t seen any disturbing trends with either cardiac toxicity or with the shorter course of chemotherapy,” he explained. “So we’re hopeful that we can reach our goal of 2,500 patients in order to definitively settle these questions.”

For More Information

See the lists of eligibility criteria and trial contact information or call the NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). The toll-free call is confidential.

Ottawa Hospital hopes diagnosis lab will aid cancer treatment: This is the future for target therapy

The Ottawa Hospital is hoping a new diagnostic centre for identifying cancers that could be treated through less invasive means will be open by the fall.


The hospital says it has raised half the $3 million it needs to open its own Molecular Oncology Diagnostics Laboratory.


Currently cancer patients in Ottawa who want to know if their particular disease could be treated with a targeted therapy instead of a one-size-fits all treatment like chemotherapy have to wait months before their samples can be assessed at labs in Toronto.


The Ottawa Hospital, which treated 24,000 cancer patients last year, said having a lab here in the city could cut the wait time for results to days instead of months.


The head of the new lab, Dr. Bryan Lo, said targeted treatments, if available, are far preferable to other options.


“When a cancer is discovered we’ll really be characterizing genetically this cancer to try to determine if we can apply some of these newer targeted therapies. Therapies that are much less toxic and with fewer side effects,” said Lo.


Jenn Miriguay, 37, has been living with cancer for five years and has gone through an arsenal of treatments, including chemotherapy, and lived through the side effects.


“It’s an all-hazards approach, you throw everything at it that you can and hope and pray that it works,” she said.


Dr. Brian Lo, Ottawa HospitalDr. Brian Lo said targeted treatments can be less toxic than broad-spectrum treatments such as chemotherapy. (CBC)

She said the new diagnosis centre has raised her hopes there will be an alternative way to treat her disease.


“The kids aren’t going to have a grumpy mommy all the time, my husband’s going to have a wife who wants to actively participate in life,” she said.


The clinic, when it opens, will focus on analyzing samples from patients with breast, lung, melanoma and colorectal cancers, the four most common types of cancers for which targeted therapies are available.

The hospital hopes within a year of opening it will then be able to accept samples from all cancer patients.

Are Provinces taking too long to approve potentially life-saving cancer drugs in your opinion? Tell us what you think about these delays,.

Provinces taking too long to approve potentially life-saving cancer drugs: study


Author of the study, Nigel Rawson says while the organization is doing its job, provinces are not required to take up the recommendations.
Christina Commisso

Christina Commisso, CTVNews.ca Writer

Published Thursday, July 17, 2014 10:02AM EDT
Last Updated Thursday, July 17, 2014 10:44AM EDT

Canada’s two-tiered process of approving potentially life-saving oncology drugs is preventing cancer patients in some provinces from accessing medication that’s readily available in other parts of the country, according to a new study.

The study, released by conservative think-tank Fraser Institute on Thursday, looks at the effectiveness of the pan-Canadian Oncology Drug Review (pCODR), which was established in 2010 to recommend new cancer drugs to all the provinces and territories, except Quebec.

While pCODR recommends drugs for approval, provinces are not required to accept their recommendations. The result is certain cancer drugs are covered by provincial health care plans in some provinces, but not others.

Canada AM: Cancer drug delays

Nigel Rawson appears on Canada AM, Thursday, July 17, 2014.

“For negative recommendations, the provinces generally agree. For recommendations that are favourable, for provinces it’s sort of a ‘maybe,’ or whenever (the provinces) can actually afford to fund these drugs,” study author Nigel Rawson told CTV’s Canada AM on Thursday.

Rawson said, in many cases, the key factor keeping drugs from being approved is cost.

“They are expensive because they are (used) for difficult cancers or cancers that are late-stage,” he said. “There are often not a lot of patients projected for these drugs, and they take a long while to develop.”

The study also found that, while the pCODR’s aims to take between five and eight months to review a drug, some reviews take up to 10 months.  It could then take a province up to a year to conduct their own review of the drug before deciding whether it will be covered.

The average time between a pCODR recommendation and provincial approval is the longest in Newfoundland and Labrador, where it was measured at 366 days. The average time spans in the other provinces:

  • New Brunswick, 339 days
  • Prince Edward Island, 309 days
  • Manitoba, 249 days
  • Nova Scotia, 218 days
  • British Columbia, 197 days
  • Alberta, 183 days
  • Saskatchewan, 154 days
  • Ontario, 150 days

“A lot of these patients, they’re projected life expectancy isn’t too great,” Rawson pointed out.

The study referenced the struggle of an Ontario mother suffering from late-stage brain cancer who lobbied the provincial government to fund a cancer drug that could have prolonged her life.

Kimm Fletcher, a 41-year-old mother of two, went public with her fight to have the province help cover the cost of Avastin — a cancer drug that’s covered for brain cancer treatment in Manitoba, British Columbia and Saskatchewan.

In Ontario, however, the drug is only covered for patients with colon cancer.

Fletcher died of cancer earlier this year.

Rawson said many cancer patients are forced to turn to donations from family and friends to pay for unfunded drugs, while others forego the treatment all together.

The study recommends some ways to improve the current system.

Rawson recommends that provinces make a commitment to accept a “reasonable proportion” of these drugs.

“The pCODR has provided positive recommendations for just over 80 per cent of these products,” he said. “It would be appropriate, in my opinion, for the provinces to make a commitment to take a high proportion of these products within a reasonable amount of time — like 120 days.”

Rawson added that the drug approval process in Canada is fragmented, as Ottawa is responsible for looking at the safety and efficacy of the drug, while the provinces look at the drug’s cost-effectiveness and makes the ultimate decision on whether it will be funded.

“The alternative is to take a national approach to providing funding for these drugs,” he said. “That’s more ideal, but more difficult.”

In a statement to CTV News, the pCODR says it welcomes the Fraser Institute assessment.

Read more: http://www.ctvnews.ca/health/provinces-taking-too-long-to-approve-potentially-life-saving-cancer-drugs-study-1.1918021#ixzz387GMeJjt

Study Links Heavy Use of Antibiotics To Risk for Colorectal Cancer by Kate O’Rourke

Study Links Heavy Use of Antibiotics To Risk for Colorectal Cancer

by Kate O’Rourke



Chicago—The use of certain antibiotics is associated with an increased risk for colorectal cancer, according to a case–control study involving roughly 100,000 patients.

Antibiotics may reduce overall bacterial diversity, which can have substantial consequences on the functional stability of microbiota in the colon. Previously, research in mice and humans has suggested that tumor tissues from colon cancers have lower levels of microbial diversity and enrichment of certain bacterial strains (PLoS One 2011;6:e20447;Gastroenterology 2014;146:1534-1546).

“The study suggests that long-term and repeated antibiotic exposure might increase colorectal cancer risk,” said Ben Boursi, MD, a medical oncologist from the Integrated Cancer Prevention Center in Tel Aviv Sourasky Medical Center, in Israel, who led the study. Dr. Boursi’s group presented its findings at the 2014 annual meeting of the American Society of Clinical Oncology (abstract 1599).

The researchers evaluated the association between the type, timing, cumulative duration and intensity of antibiotic exposure and colorectal cancer (CRC) risk, using data from the Health Improvement Network. This population-representative electronic medical records database in the United Kingdom contains information on 11.7 million patients, with follow-up as long as 18 years.

The investigators identified cases of CRC, excluding patients with a known family history of CRC or inflammatory bowel disease and those who were diagnosed with CRC before the age of 40 years. These patients were matched with up to four controls based on age, sex, practice site and duration of follow-up.

Dr. Boursi and his colleagues controlled for known risk factors for CRC, including obesity, diabetes, smoking, alcohol consumption, chronic use of aspirin and nonsteroidal anti-inflammatory drugs, as well as previous screening colonoscopies.

Table. Multivariable Analysis of Number of Penicillin Courses and Colorectal Cancer Risk
Courses of Penicillin (n) Cases N=20,990 (%) Controls N=82,054 (%) Adjusted Odds Ratio (95% CI?, P Value)
1-5 8,926 (42.5) 33,320 (40.6) 1.10 (1.06-1.14; <0.0001)
5-10 2,057 (9.8) 7,360 (9.0) 1.14 (1.08-1.21; <0.0001)
>10 913 (4.4) 3,096 (3.8) 1.2 (1.11-1.31; <0.0001)
CI, confidence interval

The risk for developing CRC was increased by 6% in patients first exposed to penicillin more than one year prior to diagnosis (P=0.002), and remained statistically significant for patients who used penicillin more than 10 years before a diagnosis of cancer, with an odds ratio (OR) of 1.11. The risk increased significantly with the number of exposures to penicillin, with ORs ranging from 1.10 for one to five courses, to 1.2 for more than 10 courses (P<0.0001). The adjusted risk increase associated with each additional antibiotic course per year was 4% on average (P=0.008).

“This is the first study that has looked at whether or not, from an epidemiological standpoint, there is an association between antibiotic use, which is a very common exposure in the population, and colorectal cancer,” said Yu-Xiao Yang, MD, assistant professor of medicine and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, in Philadelphia, and senior researcher on the study.

According to Dr. Yang, the differences in effect likely show that “different antibiotics behave differently on different bacterial populations.” Future studies could try to find the mechanism by which antibiotics could be influencing cancer incidence.

“There are certain bacteria that might promote a pro-inflammatory environment,” Dr. Yang said. “Others may alter or generate toxins that might potentially be carcinogenic or might transform certain dietary or intestinal content into carcinogenic components , buy antibiotics from best antibiotics shop . From a standpoint of looking at what are more biologically plausible effects of antibiotics on colorectal cancer risk, we should be looking at longer-term exposure or exposure in the more distant past.”

Richard Peek, MD, director of the Division of Gastroenterology at Vanderbilt University Medical Center, in Nashville, Tenn., who was not involved with the study, called the research significant.

“This is a very large study evaluating the effect of past exposure to multiple antibiotics on colorectal cancer risk. It is hypothesis-generating, and provides a framework for more detailed mechanistic studies to be performed that can determine the cause of this effect,” Dr. Peek toldGastroenterology & Endoscopy News. “This study adds to the growing body of literature supporting the role of the microbiota on diseases that develop within the gastrointestinal tract. It would be helpful to discern whether particular combinations of antibiotics exert a synergistic effect on cancer risk.”

Dr. Peek added that “the opportunity to enhance the diversity of the microbiome may be a strategy that can raise the threshold for malignant transformation. However, this requires much more detailed study.”

Drs. Boursi, Peek and Yang reported no relevant financial conflicts of interest.