April 2011 (issue 2)
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This issue aims to highlight topical research news, relevant recent announcements and products which add to our understanding of lifestyle and cancer. As well as performing our own studies, we screen the world literature for recent studies which show how lifestyle can reduce the risk of cancer, improve well-being during and after treatments and reduce the risk of relapse.
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Contents of this issue
Lifestyle research in the news
Turning the lights off at night! - As well as saving money reduces cancer risk
research group from Israel recently published a study of 1,679 women in
the journal "Chronobiology International". They
found that artificial light at night, specifically in the
bedroom, increases the risk for breast cancer especially if exposure was for
long periods of time. The research believe that the carcinogenic effect
of leaving the lights on at night is because it interferes with
the bodies melatonin production which, in turn, modulates endogenous estrogen levels.
They advise turning off all artificial light bulbs at night and avoiding
exposure to other sources from mobile phones, computer screens and TV's.
These findings supports previous reports that night shift workers who have an exposure to light at night have a higher incidence of cancer. This largely applies to night shift workers in factories, hospitals and restaurants. These studies also postulate a disruption of normal circadian rhythm upsets the excretion of melatonin. The hormone produced by the pituitary gland in the head has an influence on oestrogens and growth hormones.
Although, these trials are well conducted they are still only what is called retrospective so not all cancer experts are convinced (see counter arguements in
Sun creams actually help reduce cancer risk
After years of scientific debate, a study published the January 2011 edition of the prestigious Journal of Clinical Oncology showed that sun tan creams actually do reduce the risk of skin cancer. Previously there was a suspicion that creams prevent burning but not the UV damage to DNA which actually causes cancer. In fact , some scientist even suggest that they could actually increase the risk by allowing individuals to stay in the sun for longer.
In this study, 1,621 adults were randomized to regular sunscreen use or to discretionary use, which included no use at all. Researchers found that regular application of sunscreen with a sun protection factor of 15 or more during a five-year treatment period. There were particularly advised apply the cream to the face, neck hand and shoulders. They found that this advice reduced the incidence of new primary melanomas during a subsequent 10-year follow-up period. (Link to Medscape). Despite this reassurance it is still advisable to take care in the sun - see safe sun exposure
Vitamin A&E with mineral supplement increase the risk of skin cancer (The SU.VI.MAX study)
It has long been known that vitamin and mineral deficiencies can reduce immunity and ability to deal with environmental carcinogens. This leads to an increased risk of cancer. These studies suggest that if an individual in the west takes a vitamin and mineral supplement it could reduce the risk of cancer. A study from France, however, compared supplementation with Vitamin A, C & E with selenium and zinc against placebo. After 7.5 years the incidence of skin cancers including melanoma were actually higher in the supplementation group. Fortunately a study published in the EJC (2010, 46, 3316-3322) showed that stopping the supplements reduced the risk in the normal levels within 5 years. The fundamental design problem of this and other similar trials is that they did not measure baseline levels of these vitamins and mineral before the start. So although some people may benefit others, with a normal level to start with would end you taking them in excess. This study further confirms the importance of measuring your micro-nutrient levels before considering supplements - see micronutrient testing
Calcium, Vitamin D Supplementation May Reduce Risk of Melanoma In High-Risk Women.
study described above suggested that some supplements increase the risk of
cancer. However, this does not apply to all supplements - calcium and vitamin D
according a a well conducted study appears to have a protective effect. The
study presented in January 2011 in the USA involved 36,282 postmenopausal
women who were randomised to either vitamin D and calcium supplements or placebo
and then followed them for seven years (know as the WHI trial).
This sub-study looked specifically at women who had a history of non-melanoma skin cancer such as rodent ulcer (BCC). In this women who were at a high risk of developing another skin cancer, who taking calcium and vitamin D supplementation had a reduced risk of developing melanoma (the most serious type of skin cancer. The dose of supplementation was either 400 IU of vitamin D3 along with 1,000 mg of calcium or a placebo. The risk of melanoma was almost 55% (HR = 0.43; P = 038) lower in the Vit D and calcium group compared to placebo.
The study further confirms that supplements can be both good and bad and the most reliable way to to ensure you have the most benefit from them is to measure your baseline micro-nutrient levels first
Pomegranate Extract May Slow Prostate Cancer Progression.
Taking a pomegranate pill a day may help slow the progression of prostate cancer according to preliminary research presented at the American Society of Clinical Oncology Genitourinary Cancer Symposium Meeting. The study involved 92 men with cancer that had not spread beyond the prostate. All men had rising prostate-specific antigen (PSA) levels before they started taking the pomegranate extract At baseline, the men's PSA levels were doubling on average every 12 months. The researchers found that for the men in the group taking pomegranate capsules for at least six months, their PSA doubling time extended to 19 months. The researchers attributed the anticancer effect to antioxidants in pomegranates. There were some side effects in men who took three of the one-gram pomegranate extract capsules daily. Fourteen percent suffered mild to moderate diarrhea compared to those who only took one pill. The design of this study was very similar to one involving 113 men published from Bedford and Addenbrooke's Hospitals 3 years ago which showed that 40% had a prolongation of doubling time following lifestyle and dietary maneuvers. Both studies are open to criticism because they lack a placebo control and therefore our lifestyle research team are designing a double blind randomised trial of an antioxidant rich food supplement and will compare it against an inactive placebo in men with prostate cancer. For our study we have not only picked pomegranate but three other foods which also demonstrated activity in prostate cancer (Green tea, broccoli and turmeric). There concept being that patients receive a broad spectrum of antioxidants from foods of different sources which may improve the effect and avoid sided effects or overdose of one particular food source.
Dogs help fight Colon Cancer
New research published in February 2011 reports that a dog trained to sniff out colorectal cancer was almost as accurate as a colonoscopy. The study published in the journal GUT described how a Labrador retriever was at least 95 percent as accurate as colonoscopy when smelling breath samples, and 98-percent accurate when sniffing stool samples. The dog picked 37 out of 38 stool tests. In contrast, a fecal occult blood test to screen for cancer at early stages is accurate in only one in 10 cases, the study authors noted. The samples came from 48 people with confirmed colorectal cancer and 258 volunteers with no cancer. The dog's sense of smell was especially effective in early-stage cancer; and the canine could discern polyps from malignancies, which colonoscopy can't.
Maybe dogs in screening centres would be a feasible cost effective option. More likely, the research will prompt further investigation to develop cancer detection tests based on odor materials. In another study looking at exercise levels post cancer dog owners had significantly greater exercise levels that non dog owners - so dogs now have a role in preventing and detecting cancers!
Anti-Stress techniques improve immunity and recovery from surgery
Helping men cope with the stress of prostate cancer surgery before the
operation has been shown to improve their immunity and speed up both their physical and psychological
recovery. The new research study, published
this month in the journal Psychosomatic Medicine, evaluated 159 with
early stage prostate cancer who were scheduled for radical prostatectomy, which is the
surgical removal of the prostate gland. The surgery itself is highly successful at
eliminating the cancer but takes a physical and mental toll, often leaving
men impotent and incontinent for weeks, months or longer. Two thirds of the men in the study received routine
care or “supportive care (they had access to psychologists one to
two weeks before surgery). A third received stress management
training. These men met with a psychologist for support but also learned
deep breathing and guided-imagery techniques to help cope with the stress of
surgery. They were led through a mental imagery exercise so they understood
everything that would be happening to them as they were taken into surgery
and recovery. They also were given booster sessions the morning of the
operation and two days after surgery as well as a guide and audiotapes so
they could practice on their own.
Two days after surgery, the men who had received stress management had a measurably stronger immune response, based on higher levels of natural killer cell function and circulating pro-inflammatory cytokines, which affect the healing process. More research is needed to determine if the boost in immune function that occurs with stress management techniques has a meaningful effect on a man’s immediate recovery after surgery. However, the research did show that men who learned stress management reported better physical functioning a year after surgery.
A study published in the Archives of Internal Medicine in Feb 2011 showed that patients yho are told to exercise, eat healthily and loose weight are much more likely to acknowledge a weight problem and change their lifestyle. The reports also showed that when a doctor tells a patient that he or she is obese, the patient may be more likely to admit that they have a weight problem and then take steps to do something about it.
The researcher examining data derived from National Health and Nutrition Examination Survey. Those participants that were told by their doctors that they were overweight were eight times more likely to perceive themselves this way, compared with patients who were not informed of their weight status. In addition, overweight patients were eight times more likely and obese patients five times more likely to state that they wanted to lose weight, and more than twice as likely to have tried to shed pounds if their physician had talked to them about the issue. This research highlights the importance of the whole medical team being involved in providing lifestyle advice for patients and their relatives and that this advice is not just left to a non-specific leaflet or patients searching for advise themselves on the internet.
Macmillan exercise and cancer expert advisory committee - Inaugural meeting Jan 2011.
Twenty experts in the field of exercise and cancer gathered from across the UK for the inaugural meeting in Macmillan HQ in January this year. Chaired by Professor Robert Thomas and the group discussed practical ways to improve the level of exercise among cancer patients during and after treatments. Amongst a range to useful suggestions, the group agreed to support the design of a new national exercise information manual which could be individualized to match the needs, wishes, abilities of local facilities of patients across the UK. To read the full rationale, aims and objectives of the group - click here or to contact the project lead Jo Foster - click here
Is there a link between lifestyle and radiotherapy side effects - A major UK study started
Macmillan Cancer relief have sponsored the
Worlds first study evaluating the
links between lifestyle and pelvic radiotherapy late side effects. Co-ordinated
from the Primrose research Unit Bedford Hospital, the study involves
400 men who have received radiotherapy for prostate cancer over a 10 year
period, between 2000-2010 at Addenbrooke's Hospital, Cambridge University. The level of late side effects are being measured using the validated
Vaisey (rectal toxicity) questionnaire; the NCI symptom check list for urinary
symptoms and erectile function. Men's weight, height and smoking habits are
recorded together with a measure of the physical activity using the General
Practitioner Physical Activity Questionnaire (GPPAQ).
The data will be analyzed independently by the bio-statistical department at Cranfield University and the results presented at the next Macmillan late effects conference.
This study should help professionals guide and advise men on the optimal lifestyle to help reduce their risks of side effects during and after radiotherapy read a summary of the study protocol
Lifestyle and Cancer - the facts is now available on Amazon Kindle
Following the success of the first edition a completely revised second edition has been launched in 2011. The fully colour illustrated book is still available to order online but now it has also been reformatted for the benefit of Kindle users.
This second, 2011, edition has been extensively re-written with evidence from the latest high quality research from around the world which has demonstrated how diet, exercise and other lifestyle changes can; help avoid cancer especially if you have a family history or genetic risk; help you cope with treatments side effects; reduce the risks of complications of cancer treatments; slow the rate of progression of cancer and help prevent your cancer relapsing. What some of the 5000 readers of the first edition have said:
"This book has been fundamental in providing well needed support; arming my mother with the tools to win her own personal marathon" Paula Radcliffe.
"This book stands out from the crowd - it sorts out the wheat from the Chaff. My lifestyle bible, it helped me to recover earlier with more confidence" Cecilia Nicholson journalist and survivor.
The Primrose Oncology Research Unit "National Patient Safety Award"
Oncology lifestyle research team together with Karen Hanscobme from the Bedfordshire Primary Care
Trust have been selected for the finals of the National Patient safety awards.
The judges commented that they were impressed that the team had also made considerable effects to evaluate the scheme and ensure exercise levels, attendance to the local gyms and patient satisfaction had actually increased. This award follows on from the good news, announced in July 2010, that the government representative body SkillsActive gave the legal go-ahead for exercise professionals within the UK’s network of municipal leisure centres to be trained in cancer rehabilitation. Professor Thomas had been leading a group consisting of national charities and oncology colleagues to write the minimal standards for future training courses which now has an internationally recognized official level 4 qualification.
Guest article of the issue
Chapped lips and cold sores during chemotherapy - the effectiveness of lip salves.
Thomas RJ and Williams M.. The Primrose Oncology
Lifestyle Research Unit,
Objectives;This study evaluated the prevalence and severity of chapped lips and cold sores during chemotherapy, and the perceived effectiveness of self-medicated lip salves.
Methods;One hundred and five consecutive patients receiving chemotherapy where given a specifically designed questionnaire between 2nd July and 31st October 2008, at the Primrose Oncology Unit, Bedford Hospital.
Results;One hundred (95%) were returned. Twenty eight percent reported regular sore lips before chemotherapy as opposed to 69% during chemotherapy. Sixty six percent of these used lip salves, but 82% of these reported little or no benefit. Of these, eighty three percent used petroleum-based creams, and of these, 9% reported that they were helpful. Seventeen used natural oil-based creams, and of these, 63% reported that they were helpful. Patients were 2.5 times more likely to have cold sores if they had chapped lips.
Conclusion;As the incidence of chapped and sore lips more than doubles during chemotherapy, preventative lifestyle advice has been included in our patient information leaflets and website (see prevent sore lips lifestyle advice). This survey suggests a potential association between chapping and cold sores so it is even more important to protect the lips if there is a history of cold sores. The patients evaluated in this study clearly perceived that natural oil-based creams gave them more relief than petroleum based creams.
As a consequence of this study, our research team are planning a double-blind, randomised study comparing a natural oil-based cream (Nature-Medical lip balm) against a petroleum-based control.
Anti-oxidant focus - the benefits of broccoli
Biologists at Britain’s Institute of Food Research recently published a study which showed that the healthy chemicals found in broccoli can prevent pre-cancerous cells in the prostate progressing to more aggressive cancers. They found that just a few more portions of broccoli each week sparks hundreds of genetic changes, activating some genes that fight cancer and switching off others that fuel them.
In their study, they split into two groups of 24 men with pre-cancerous lesions and had them eat four extra servings of either broccoli or peas each week for a year.
The researchers then took tissue samples over the course of the study and found that men who ate broccoli showed hundreds of changes in the genes known to play a role in fighting cancer. They believe the benefit would likely be the same in other cruciferous vegetables that contain a compound called isothiocyanate, including brussel sprouts, cauliflower, cabbage, rocket or arugula, watercress and horse radish. Broccoli, however, has a particularly powerful type of the compound called sulforaphane glucosinate which the researchers think gives the green vegetable an extra cancer-fighting kick. The broccoli eaters showed about 400 to 500 of the positive genetic changes, with men carrying a gene called GSTM1 enjoying the most benefit. About half the population have this gene.
The researchers did not track the men long enough to see who got cancer but it is a very logical conclusion that increasing broccoli intake daily portions each week can make a big difference. Furthermore it is also likely that these vegetables work the same way in other parts of the body and probably protect people against a whole range of cancers.
A study from Queensland Australia analysed over a thousand men and women who had been treated for skin cancer – a common occurrence in fair-skinned migrants to hot climates. They estimated their intake of dietary antioxidants via interviews and questionnaires over the next eight years. The results showed there was a significantly lower rate of subsequent skin cancers in those who had a high level of dietary antioxidants compared to those who did not. This was particularly associated with foods which contained lutein and xeaxanthin found commonly in broccoli and leafy green vegetables. Unfortunately, for those who do not have the time to prepare broccoli every, the process of drying broccoli and putting it into a tablet preserves the antioxidant content. So, unlike the vitamin supplement mentioned above a whole food supplement is likely to be beneficial - see Pomi-t
Recipe of the issue
Quinoa feta asparagus salad
Ingredients (for 3-4 people)
In a pan add two tablespoons of extra virgin cold pressed olive oil and 2 cups of quinoa. Gently fry for 1 minute then add 3 cups hot water, half a tea spoon of bouillon. Then heat to simmer for 15 minutes.
In the mean time on a wok or large frying pan, add one chopped medium sized onion with 2 tablespoons of olive oil. Salt and pepper to flavour. Cook for 1 minute then add 10 asparagus spears and a half cup of peas. Gentry fry for a further 5 minutes then add 3 chopped tomatoes and fry for a further 1 minute.
When both components are ready, mix together in the wok (frying pan) adding a handful of fresh feta cheese at the same time stirring together.
Serve on a rich bed of spinach leaves or rocket salad with plain bio-yogurt and chili sources as a garnish.
To add a bit of variety flakes of preserved smoked mackerel for an extra super food boost.
Totally yummy and leaves you feeling healthy and revived.
of the issue
There is so much I do not know
The problem seems not to be in dying.
Just when you begin to master your mood
Hardly a ripple will be made
There is hope that a vestige will remain,
My life was not always correct or wise,
Up and down, there is no other way,
From my parents' lessons, I am strong
Each second is precious and a treasure
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and chapped lips are uncomfortably and unsightly. This distressing
symptom is common following exposure to sun, wind, after a period of
stress, dehydration or during chemotherapy and afterwards. There is
evidence that natural oil based creams are better than petroleum based
creams (read paper).
It is also idea for moisturizing and soothing the nail bed to prevent and
treat cracked skin around the cuticles.
after Cancer - the facts
the sell-out first edition
this book has been extensively re-written with even more evidence from
two more years of international research and feedback from readers from
over 5000 sales of the first edition.
It is up-to-date, topical and relevant to the stresses of modern day life - You now can be even more confident the book explains the reasons why foods, personal habits and environmental factors can increase or decrease the risks of cancer and other major illnesses and help you recover stronger from cancer treatments.
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