According to specialists, bowel cancer patients may avoid the need for colostomy bags if they are first treated by having an expandable tube inserted at the site of their blockage.
The new approach, presented at this year’s American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago – the worlds’ biggest cancer conference – showed that the tube, or stent, cut the risk of complications from surgery.
Experts said colostomy bags, to collect faeces, often frightened patients.
Globally, nearly 1.4 million cases of bowel cancer are diagnosed each year.
This unplanned surgery has a much higher risk of complications compared with routine surgery.
The patient is often in worse health, the swelling caused by the blockage can mean keyhole surgery is not possible so more invasive surgery is needed and there may not be a colorectal specialist surgeon on hand.
The death rate goes up from 2% for planned surgery to 12% in emergency bowel cancer surgery.
After removing the tumor and surrounding bowel, surgeons are also less likely to be able to re-plumb the bowels.
One part of the colon is often hugely distended and the other collapsing in on itself. If it cannot be put back together properly, the risk of needing a colostomy bag soars.
A trial on 250 patients was organized by Cancer Research UK. Half were treated with conventional surgery, but the others had a novel procedure to unblock the bowels.
Surgeons used an endoscope to find the precise location of the blockage and then positioned a stent at the site of obstruction.
When inserted, the tube is just 3mm in diameter. But over 48 hours it expands in response to body heat until it reaches 2.5cm in diameter, creating a new clear passageway through the intestines.
The tumor is then removed once the bowels have healed and the patient has recovered from the blockage.
There was no difference in survival rates between the procedures, but the difference in the need for a colostomy bag was stark.
In the emergency patients, 69% needed a bag to rid their bodies of faeces.
In those treated with the stent, the figure was 45%, according to data presented at the ASCO Annual Meeting.
Prof. James Hill, who led the trial at Central Manchester University Hospitals, said: “Traditionally doctors have worried that unblocking the bowel in this way could increase the chance of cancer spreading, but our early results don’t show this.
“We’re also pleased to see that this could be a way of reducing the risk of patients needing a colostomy bag after their surgery, which is a huge improvement to patients’ day-to-day lives.
“These are early results and we’ll need to follow up our work for three years in full to find out if this technique affects survival and end-of-life care for bowel cancer patients.”
According to a World Health Organization (WHO) report, processed meats – such as bacon, hot dogs, sausages and ham – do cause cancer.
The WHO’s report said 50g of processed meat a day – less than two slices of bacon – increased the chance of developing colorectal cancer by 18%.
Meanwhile, the health agency said red meats were “probably carcinogenic” but there was limited evidence.
The WHO did stress that meat also had health benefits.
Processed meat is meat that has been modified to increase its shelf-life or alter its taste – such as by smoking, curing or adding salt or preservatives.
It is these additions which could be increasing the risk of cancer. High temperature cooking, such as on a barbeque, can also create carcinogenic chemicals.
The WHO has come to the conclusion on the advice of its International Agency for Research on Cancer, which assesses the best available scientific evidence.
The International Agency for Research has now placed processed meat in the same category as plutonium, but also alcohol as they definitely do cause cancer.
However, this does not mean they are equally dangerous. A bacon sandwich is not as bad as smoking.
“For an individual, the risk of developing colorectal [bowel] cancer because of their consumption of processed meat remains small, but this risk increases with the amount of meat consumed,” Dr. Kurt Straif from the WHO said.
Estimates suggest 34,000 deaths from cancer every year could be down to diets high in processed meat.
That is in contrast to one million deaths from cancer caused by smoking and 600,000 attributed to alcohol each year.
Red meat does have nutritional value too and is a major source of iron, zinc and vitamin B12.
However, the WHO said there was limited evidence that 100g of red meat a day increased the risk of cancer by 17%.
The WHO said its findings were important for helping countries give balanced dietary advice.
The World Health Organization (WHO) is to reveal whether some meats should be classed as carcinogens.
The International Agency for Research on Cancer, which is part of the WHO, has been reviewing evidence on whether red and processed meats increase the risk of bowel and other cancers.
According to experts, eating a lot of red and processed meat probably increases the risk of bowel cancer.
However, red meat can be part of a healthy diet.
Red meat includes beef, lamb, and pork. It looks darker in color than white meat, like poultry, because of higher levels of hemoglobin and myoglobin, the iron and oxygen-binding proteins you find in blood and muscle.
Processed meat is not fresh meat, in other words something has been done to it to extend its shelf life or change its taste such as smoking, curing or adding salt or preservatives.
Processed meat includes bacon, sausages, salami and ham. Simply putting fresh meat through a mincer does not make it processed
Meat is a good source of protein, B vitamins and minerals such as iron and zinc.
Expert scientists’ advice is to consume healthier meat or meat products, such as lean cuts and lean mince, and cut down on processed meat.
Since 1971, more than 900 agents, including lifestyle factors and chemicals, have been evaluated by expert scientists for the International Agency for Research on Cancer.
More than 400 have been identified as carcinogenic, probably carcinogenic, or possibly carcinogenic to humans.
Bacon, ham and sausages are set to be classed alongside cigarettes, arsenic and asbestos as cancer-causing by global health experts.
A new study suggests that teenage obesity is linked to a greater risk of bowel cancer later in life.
The study, published in the journal Gut, followed 239,658 Swedish men for 35 years. The young men were conscripted into the military aged 16 to 20 years old.
The analysis, led by Orebro University Hospital in Sweden and Harvard University, showed overweight teenagers went on to have twice the risk of bowel cancer. The figures were even higher in obese teens.
Teenage boys who become very obese may double their risk of getting bowel cancer by the time they are in their 50s.
The study and researchers were funded by the National Cancer Institute, Harvard School of Public Health, Örebro University and the UK Economic and Social Research Council (ESRC).
The World Cancer Research Fund said the link between obesity and cancer was “strong”.
Bowel cancer is the third most common cancer in the world, with nearly 1.4 million new cases each year.
Processed red meat and abdominal fat have been linked to the disease.
The overwhelming majority of participants were a normal weight, but 6.5% were overweight and 1% were obese.
There were 855 cases of colorectal cancer in the study.
However, the results showed not all weights were affected equally.
Those who were obese were 2.38 times more likely to have developed a bowel tumor.
The study said: “Late adolescence marks the transition from childhood to adulthood and is a period of accelerated growth, especially among men, thus this period may represent a critical window.
“It is important that we understand the role of exposures in childhood and adolescence in the development of colorectal cancer.
“In fact, the strong association observed between adolescent obesity and early-to-mid-life colorectal cancer [CRC], coupled with the increasing prevalence of adolescent obesity, may shed light on the increase in colorectal cancer incidence among young adults.”
Being obese and having long-lasting (chronic) signs of inflammation in the body as an adult have been linked to increased bowel cancer risk. Adolescents with “high” levels of inflammation were more likely to develop bowel cancer than those with “low” levels.
The marker (or sign) of inflammation the researchers had information on was the erythrocyte (red blood cell) sedimentation rate, or ESR. This measurement increases when there is inflammation.
However, few of the studies have assessed the effect of obesity in adolescence specifically, and none have been said to look at the impact of inflammation in adolescence.
The researchers concluded that, “late-adolescent BMI and inflammation, as measured by ESR, may be independently associated with future CRC risk”.
Taking aspirin every day can reduce the chance of developing or dying from bowel and stomach cancers, a Queen Mary University of London research team reports in the Annals of Oncology.
Scientists examined some 200 studies investigating the benefits and harms of taking aspirin – an area of continuing medical debate.
They found the drug reduced the number of cases and deaths from bowel, stomach and esophageal cancer by some 30-40%.
There was weaker and more variable evidence that the drug reduced deaths from breast, prostate and lung cancer too.
And the study found people needed to take the drug for at least five years to see any benefits.
Prof. Jack Cuzick, at Queen Mary University of London, who led the research, urged all healthy people aged 50 and above to consider taking a small dose (75mg) of the drug every day for a decade.
Taking aspirin every day can reduce the chance of developing or dying from bowel and stomach cancers
Researchers predicted if 1,000 individuals aged 60 took the drug for 10 years, a further decade later there would be:
16 fewer deaths from cancer
One fewer death from heart attack
Two extra deaths from bleeding
Prof. Jack Cuzick, who has been taking aspirin for four years, said: “Whilst there are some serious side-effects that can’t be ignored, taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement.”
They found benefits continued even when people stopped taking the drug, but say it is unclear exactly how long people should use it for.
As the risk of internal bleeding rises as an individual gets older, they suggest a cut-off point of 10 years.
There is still uncertainty whether other doses of the drug could offer more protection.
Aspirin’s well known possible side-effects include bleeding in the stomach and the brain.
Experts warn anyone at high risk of bleeding, including people with blood disorders who take blood thinning medication, or are frequent smokers or drinkers, are more likely to suffer these side-effects.
They recommend anyone considering daily medication should speak to their doctors to discuss individual risks.
Exactly how aspirin protects against cancer is unknown. Scientists suggest it may reduce inflammation or act on blood cells that would otherwise encourage the spread of the disease.
US researchers have uncovered how bacteria may set off a chain reaction leading to bowel cancer.
Fusobacteria, commonly found in the mouth, cause overactive immune responses and turn on cancer growth genes, two studies reveal.
The microbes had been linked with colorectal cancer before but it was not known whether they were directly involved in tumor growth.
The early findings are published in the journal Cell Host & Microbe.
In addition to potential new treatments, the discovery could lead to better early diagnosis and prevention, experts hope.
The first study, carried out by Harvard Medical School researchers, showed that fusobacteria was present in high numbers in adenomas – a benign bowel growth that can become cancerous over time.
Fusobacteria, commonly found in the mouth, cause overactive immune responses and turn on cancer growth genes
The same researchers also did tests in mice showing that the bacteria speeded up the formation of colorectal tumors by attracting special immune cells that invade and set off an inflammatory response which can lead to cancer.
The second study, carried out by researchers at Case Western Reserve University, showed that fusobacteria had a molecule on their surface which enabled them to attach to and invade human colorectal cancer cells.
The molecule – FadA – then switches on cancer growth genes and stimulates inflammatory responses to promote tumor formation.
A synthetic compound which blocked FadA was found to completely halt the process, raising the possibility it could one day be used as a preventive treatment.
The Case Western team also confirmed that FadA levels were much higher in tissues from patients with adenomas and colorectal cancer compared with healthy individuals.
Dr. Wendy Garrett, lead author of Harvard study, said: “Fusobacteria may provide not only a new way to group or describe colon cancers but also, more importantly, a new perspective on how to target pathways to halt tumour growth and spread.”
She added that in the future the presence of the bacteria in a tumour may be used to guide treatment decisions.
Prof. Yiping Han who carried out the second study added: “We have proven there is an infectious component to colorectal cancer.
“We have shown that FadA is a marker that can be used for the early diagnosis of colorectal cancer and identified potential therapeutic targets to treat or prevent this common and debilitating disease.”
British researchers believe they have explained why some families are incredibly vulnerable to bowel cancer.
They have found two genes, which are passed from parent to child, that greatly increase the risk of a tumor forming.
The study, published in Nature Genetics, analyzed DNA from 20 people with a strong family history.
The findings could be used to develop a test to judge someone’s risk of the disease.
One of the people who took part in the study, Joe Wiegand from Hampshire, was diagnosed with bowel cancer when he was 28. Most of his colon had to be removed.
British researchers believe they have explained why some families are incredibly vulnerable to bowel cancer
“There’s a very strong history of bowel cancer in my family – my dad’s mother and sister both had it, my dad was diagnosed with it at 43 and a few cousins have had bowel cancers and brain tumors.
“It’s clear that something’s going on in our family.”
The researchers looked at the genetic code of 20 people and found faults in two genes could increase the chance of developing the cancer.
Lead researcher, Prof. Ian Tomlinson from the University of Oxford, said: “There are some families where large numbers of relatives develop bowel cancer, but who don’t have any of the known gene faults that raise the risk of developing the disease.
“These two faults are rare, but if you inherit them your chance of bowel cancer is high.”
He said that, in the short-term, the findings could be used to work out which people had a high risk of developing bowel cancer and, in families with a high incidence of the cancer, to work out which people were at risk and needed more regular screening.
He said it was “conceivable” that specific therapies could be designed to overcome these mutations in the future.
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