Drug companies and cancer

The graph shows the annual number of cases of ...

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So….where are we now with new therapies that are actually saving lives for people with cancer?  As I have discussed before, have we seen any progress in the last ten years?  We have certainly advanced our knowledge of cancer and signaling pathways and have even come up with new strategies to target cancer.  Let me make a quick list of the things we have learned in the last ten to 15 years…

1.  We have now started looking for mutations in patients with certain kinds of cancer such as advanced melanoma (BRAF mutation V600E) as a means of identifying patients who should respond favorably to drugs that target those mutations.

2. Immunotherapy has potential to work (and does so in rare cases) but still not well against some cancers.   Antibody therapy is used against some cancers such as B cell cancer and even now in skin cancer with some success.  Things that help boost the immune system do show limited efficacy in some cancers. 

3.  Drug companies have developed some interesting other types of therapies that rely on dendritic cell vaccines and a few others.  A vaccine is a bit different from antibodies in that they are material that you can use that comes from the cancer cell itself or from a newly designed product (e.g. human dendritic cells given bits of tumor antigens) to patients to help them boost their anti cancer immunity.  These have limited effects and only work with certain patients and we can’t always anticipate who will benefit and who won’t.  Other approaches include the use of cancer RNA, DNA, cytokine stimulated dendritic cells, etc.  Only one drug in this class has been approved by the FDA so far and that is against very advanced protate cancer.

4. Small peptides (proteins) and other small molecules are being developed now that target various newly discovered cancer specific pathways (again we have learned a great deal about pathways in cancer that don’t exist in normal cells).  In melanoma (skin cancer) about 45 different cancer specific peptides have been identified (ones that the immune system recognizes and trials or pre clinical research is being conducted with many of them). 

5.  We have learned that treating cancers with drugs that target specific mutations (a classic example is Gleevec(R) that targets the BCR:ABL protein in a cancer called CML) have the potential of driving the cancer to become resistant to that drug (via further mutations).  This is somewhat similar to the anti-viral therapy for AIDS (HIV-1 disease).

  6.  We can sub-classify cancer better and stage it better.  It is not clear that this helps with treatment, but it certainly helps to give the patient individualized prognosis (e.g. give them with more accuracy his/her life expectancy with a cancer at a specific stage).  In some cases it does help to prolong life.

7.  Some drugs on the market can now be analyzed for long-term efficacies.  For example, for some drugs that have been used for 10 years or more for the same patient (same cancer) we can come up with better 10 year survival rates, etc.  This, of course, can be done on patients who were treated with a cancer therapy (even immunotherapy) ten years ago, even if the drug was stopped.  We can and have gotten better numbers now at longer term survival (perhaps in the future cure rates will be measured at longer time points than 5 years).

8.  Viral vaccines against papilloma virus for teens (females only) is going to revolutionize the HPV associated cancers.  These vaccines (initiated in many countries now) are going to reduce significantly the risk of getting certain cancer in women…the biggest of which is cervical cancer.  It will be interesting to see if the same can be done in the future for other viral associated cancers such as liver cancer (HCV or HBV), stomach cancer, and a few others (e.g. EBV and NPC). 

Anyhow, there is much we have learned (and this was not comprehensive).  However, it is not clear that we are truly extending the lives of many patients with cancer (better than we were ten years ago).  It seems that for advanced cancer patients we are in the same position as we were years ago.  Certainly for newly diagnosed cancers such as prostate cancer, we can do more now than ever to get most patients to continue to live cancer free lives.  We have a long way to go…we have got to find treatments that work for patients with cancers that have metastasized for example.  We have got to figure out how to keep costs low.  We have got to figure out how to do better screening or if screening is really necessary. Other avenues that are gaining interest are treatment that do not rely on “western medical” interventions.  This area will continue to grow.

Thanks for reading….please leave me comments!

Cancer made simple! 

Cancer treatments: traditional or not?

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There seems to be a battle between those who passionately believe in traditional (evidence based) medical treatment and those who believe in non traditional (less evidence and sometimes no science-based) treatments.  Usually people are polarized one way or the other.  I would love to get a nice dialogue with folks who support one or the other and what the reasons are.  So let me start off by getting some of the terms spelled out and trying to categorize various types of treatments.

Pharmaceutical versus naturaceuticals:  The former is chemical based products designed and manufactured by pharmaceutical companies while the later is non-chemical based natural products (of course they can be chemical in principal, but not made synthetically) or extracts from natural products (such as seaweed, plants, oils, etc.). .

Traditional versus non-traditional (alternative medicine).  This is the western defined definition…traditional refers to surgery, radiation and chemotherapy while non traditional refers to things outside of this.  Traditional methods requires clinicians while non traditional may not.  Examples of non traditional treatment include vitamin C therapy, coffee enema, vegetable soups, etc.

Western versus Eastern medicine:  This usually refers to drugs and treatments designed to be used in modern health care and include drugs dispensed by trained cancer doctors while the later refers to things such as traditional chinese medicine, indian healing and traditional indian herbs, etc.  These might be dispensed by trained TCM practitioners but often given by parents and relatives of patients.  Some of these have many years of experience behind them but often have limited scientific studies behind them.

There are many other classes of treatment that do not have such nice and neat categories.  For example, I have a colleague who promotes holistic healing using energy (eg. from ones own self or from other sources).  Others believe that psychotherapy can help and some fo the techniques used include hypnosis.  Others belive that specific diets can starve cancer cells while normal cells grow well.  I have another colleague who calls himself Doc (not to be confused with Dr.) who uses a technique that analyzes hair samples and helps to identify (again using some interesting energy source) the cancer a person has but more importantly the source of the illness (e.g he belive that cancer is a result of other imbalances of the body).  He then embarks on a treatment plant (diet and natural products and alignment techniques) that corrects the underlying deficiency in the body that cures the patient.  There are many other types of proposed therapies and this only scratches the surface.  I would love to hear from you…the reader as to any treatments that you know about, swear works, or have suspicion about.

Let me finish by discussing some things that people tend to criticise about these types of therapies.  First of all major criticisms about modern therapies such as pharmaceutical based drugs and treatments include the following: 1) They are too expensive, 2) They don’t work- well they only target the cancer cell but not the underlying conditions that made the cancer grow in the first place, 3) They are not natural and thus inherently toxic, 4) Drug companies are in cahoots with Doctors and hospitals to milk the customer (the cancer patient) for as much money as possible so these companies can get larger and richer and 5) These companies spend so much on making these drugs (hundreds of millions) that many of these drugs can’t fail and the investment is too big and thus the claims for their effectiveness are exaggerated.  Common criticisms of other therapies include: 1) They are not tested well and have almost no scientific or clinical evidence for efficacy, 2) People who say they work base their assumptions on the one or two people who claim that they work but ignore the hundreds of people who they don’t know who had witnessed no recovery using these methods, 3) The few people who say these methods work could have gotten better for reasons we don’t know, 4) Some of the natural products that people take can actually be toxic in large amounts (especially for the liver or kidney), 5) Like pharmaceutical companies, companies that sell these so-called natural products for cancer treatment are also very biased, hide negative data, and try to sell inexpensive natural products at high prices to make a profit and have no real care for the patient. 

Despite how you feel there are likely to be real pros and cons for any type of treatments that you use if you have cancer.  No one is likely to be able to provide you with the miracle cure.  The comfort level and the background fo the patient is always going to play an important role and education can never hurt.  So, please do comment on this and let me know what you think!  Would love to see an active discussion going?  What do you favor or disfavor and why?  Can you challenge the status quo?  Do you have stories to share of how you may have changed your views about treatments?

Thanks for reading….. Dr. C

Cancer made Simple




A word on cancer therapies

...of course, this was prior to the actual zap...

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I thought I might go over a few concepts of cancer therapies for those of you who are interested but might not have the background to make sense of some of it.

Surgery: If surgery for the cancer can be done it will.  Surgery is often curative (long-term survival with the cancer or with the complete absence of the cancer).  Surgery refers to the complete removal of the tumor and it is usually performed when the cancer is well-defined (like a solid tumor) and works well with cancers that are caught early. Some cancers are small but located in areas that the surgeon may not have access to (like parts of the brain stem, parts of the spinal column, or even near some major arteries, etc.).  If the surgery might end up killing the patients, then it is not performed.  If the patient is very old or has heart conditions, the surgery for cancer removal might not be performed as well.

Radiation therapy:  high energy frequencies that are directed at the cancer with hopes of ‘burning it off’ and causing the tumor and surrounding tissue to die.  Better and better forms of radiation therapy are available in some centers that allow for more accurate focusing on the beam of energy to the tumor and not the healthy tissue.  Not all cancers are radio-sensitive.  Radiation has several side effects and too much radiation damage can also lead to cancer down the road….so killing one cancer but inducing another is not a good idea.  Sometimes the addition of radiation therapy to surgery can help kill off any remaining cells that were not removed during the operation.  Many times radiation is not a one time deal, but must be performed numerous times and the patient must come back to the hospital for all the cycles.

Chemotherapy:  There are many kinds.  In essence, they are drugs that kill cells that rapidly divide.  Cancer cells rapidly divide and thus are usually very sensitive to this form of therapy.  Many types of chemotherapies are used against many types of cancers including solid and liquid cancers (or blood cancers).  These types of agents can kill cells directly, poison them so they can’t make DNA, stop them from cycling (a terms used to describe the process of cell division), starve them from nutrients, or prevent their DNA repair machinery from working, etc.  These agents have a lot of side effects as they almost always target other cells that divide in your body in addition to the cancer cells.  For example, they target hair follicles (and the hair will fall out) or they hit the cells lining the gut which turn over quickly and cause patients to vomit severely sometimes.  Some patients can be on several of these drugs at a time and often they are combined with surgery and/or radiation therapy.  These are not fun to take, but in some cases they do help to reduce the cancer to a very small size and allow patients to live longer.  However, many people who get treatment with chemotherapy do see their cancers come back after some time and thus it is not curative in most cases.

Transplantation:  One can have the entire organ transplanted if it has cancer or one can get a type of blood transplant know as a hematopoetic cell transplant.   In the latter case, the patients own bone marrow is killed off using drugs and radiation and then a new bone marrow from another person is given to them.  It is a horrific procedure that used to kill many patients and sometimes still does.  However, it can be curative and the patient can live cancer free for the rest of his/her life in some cases.  There are a lot of complicated things that the doctor must do before performing this kind of procedure and the younger the patient is the better.  For some childhood blood cancer, this procedure has been short of a miracle.  It is best used when cancer of the immune system are detected.  This procedure can cost hundreds of thousands of dollars in some countries and is very dangerous.

Immunotherapy: This is a newer type of therapy and refers to any product of the immune system that is given to patient to help them fight off their cancer.  For example, a potentially curative form of this therapy works for a type of skin cancer and renal cell carcinoma.  The drug is IL-2 a cytokine or protein mediator that helps activate T cells and these cells then look for and kill the cancer.  However, only 10-15% of patients respond to this drug well and most patients do not and subsequently die of their disease.  High-dose IL-2 therapy is also very toxic.  Another form of this therapy is being used now (just recently developed) on advanced skin cancer and uses another immune molecule called CTLA-4.  Blocking this protein seems to enhance T cells to kill the patients own cancer cells.  Again, this only works well in a small fraction of people with this type of skin cancer.  Many other forms of this therapy are being tested now and it is hoped that this is one way that some cancers may be cured in the future, but honestly we are quite far from that at the moment.  These drugs cost a huge amount and are not very well tolerated by many patients (too many side effects).  They also try to use the patients of immune system and thus can cause other damage in many cases.

Targeted or Individualized therapy:  This is a large and new area of development in the anti-cancer arena.  Here patient as well as cancer specific molecules are attacked by certain drugs that recognize them.  The most well-known example of this is a drug called Gleevec(Tm) that is used for the treatment of a blood cancer called CML.  It targets a very specific cancer protein that only affects the CML cancer cell.  The drug basically poisons this cancer protein and kills the cancer cell.  It needs to be taken for life and can be very expensive.  The other problem is that about 15% of all patients develop resistance to the drug (or rather the cancer cell changes before it is all killed and starts to make a protein that does not bind the drug). A very new example is used with some success against advanced skin cancer to target a very common mutation in a protein that is essential for the cancer cell to grow.  So a drug is used to bind to that very specific mutation (50% of all patients with advanced skin cancers have this mutation present) can block this survival factor for the cancer cell and it is then killed.  Many new proteins are being targeted such as those that cancer cells use to get blood supply, allow the cancer to move to different areas in the body, and so on.  In all the cases, these drugs are aimed at blocking these things that the cancer cell need to survive.  In many cases, these are unique to the cancer cells and not to the normal cells in the body.

Unique category:  The last type of therapy I wish to discuss is a rare but successful type of anti cancer drug known as a vaccine immunization type.  For bladder cancer there is a drug that is injected into the area of the bladder…the drug is actually the same thing that is used to vaccinate children and some adults for tuberculosis: BCG.  Intrathecal BCG (or intravesical) works very well in about 50-60% of patients with early stage bladder cancer. It works by stimulating the immune response against the cancer, but besides that we do not know much about the mechanism.  It is one of the most successful drug therapies used today for cancer….but no one really understands it and it does not seem to work well against other cancers.

There are other examples, but the most common ones have been mentioned.  I hope you have found this information useful.  I kept it general and vague intentionally.  I know that some of you may be looking for more specific information and want more detail.  Do ask me if you want more information or do check out some of the additional resources that I have one my web page.

Thanks D C – Cancer Made Simple

Skin cancer treatment part II

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In my last blog I talked about the new drug Vemurafenib that treats advanced skin cancer by targeting mutations found in roughly 50% of cancer patients with this disease.  There is also a new drug that is likely to get FDA approval for the same cancer.  New data came out for this drug a few days ago from phase three clinical trials. 

This is a different kind of drug altogether than the very specific inhibitor of the mutated BRAF mutation.  This new drug called Ipilimumab is an antibody.  That means it is a protein that binds to other proteins and is made by B cells.  Antibodies are natural, but this one is man-made.  It targets the immune system in the patient.  T cells in your body are usually helpful in killing cells that are infected and cells that become cancerous.  However, as cancer cells are part of us, T cells are not very efficient at killing them.  Even if they do, cancer cells can evade killing by shedding the target that the T cell needs to kill it or by suppressing the killing T cell when it tries to attack the cancer cell.  This new drug is an antibody that binds to something on the T cell called CTLA4.  CTLA4 is a natural inhibitor that the immune system uses to shut down T cell activity.  This new antibody blocks this protein on the surface of the T cell and helps to keep the T cell active so that it can kill the cancer cell. 

This drug given in combination with the chemotherapy agent Dacarbazine improves 3 year survival from 12% (with the chemo drug alone) to 20%.   Overall survival went from 9 to 11 months; an added two month advantage.  However, if you look at the data in the journal that reported the trial the number of patients who were living at 48 months was about 10% of the total who were enrolled into this trial.  That 10% is exactly the same for the chemo alone group as it is for the chemo plus new antibody therapy group.  So, patients do get to live an additional two months, but don’t do any better in the long-term. 

This is a huge problem.  Do we encourage patients to take this VERY expensive drug and get there hopes up even if it does no good in the long run?  There are no cures here.  There are no long-term benefits here.  There is an additional few months (for only some of the patients).  I don’t know the answer here, but I do know that after millions of dollars this clinical trial and drug will not help that many patients.  The phase four clinical trials will start soon and the FDA will most likely approve this drug as they will the Vemurafenib, but for patients metastatic melanoma is still a killer. 

Antibody therapies that boost the immune system are a nice way to look to the future.  Immunotherapy has never worked well (high dose IL-2, a cytokine that boosts T cells has shown some limited but impressive results in a few cancers) and is usually highly toxic or has many undesired and often lethal side effects.  In this study, the side effects of the anti-CTLA4 therapy is quite high…liver toxicity was observed at a high rate.  The cost for immunotherapies is exceedingly high.  In clinical trials it is provided free to the patients, but when the drug is approved by the FDA patients will now have to pay tens of thousands of dollars for this. 

I don’t mean to sound so ‘all doom and gloom’, but this is what we are up against.  Cancer therapy is making baby steps for these aggressive cancers.  Despite spending hundreds of millions of dollars, these ‘so called’ blockbuster drugs are lackluster at best.  I sure do hope research will prevail and we are able to significantly prolong the life of cancer patients. 

Thanks for reading.  Please leave any comments here or visit Cancer Made SImple for more information.

Dr C

Skin cancer: new treatments????

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You might have noticed….or not, that the newspapers have been talking about a new promising set of drugs for advanced skin cancer.  From reading these reports, it seems like huge advances in treatment have been found.  They way the researchers who sponsored the studies are talking, it makes it seem as if a miracle has occurred.  I think this is unfortunate, as in my opinion (thinking about this from the patient’s point of view) this is a tiny advance and not so earth shattering. 

So, what’s the fuss.  First of all, primary skin cancer is treatable and can even be cured if it is caught early.  However, advanced melanoma that has metastasized (or moved to another location) is very difficult to treat and is in no way curable.  The standard form of therapy relies on a drug called Dacarbazine, a form of chemotherapy that interferes with DNA synthesis, that is needed by rapidly dividing cancer cells.  The problem with this drug is that it only works for about 10% of patients who have advanced melanoma and has little to no overall survival benefits.  The drug also does not target cancer cells per say but any dividing cell and is thus not very specific.  As more and more was learned about melanoma and indeed other cancers, more specific drugs were developed. 

It was discovered that roughly 50% of patients with this deadly form of skin cancer carry a very specific mutation in a gene called BRAF which as a protein controls a very important signaling pathway that controls growth in all cells.  Under normal circumstances, the protein is off and only turned on for a very specific amount of time when necessary.  The mutation that patients have (V600E) keeps the protein in an open and an ‘always-on’ position.  This new information allowed scientists to develop a new drug that targets this specific mutation in the protein BRAF.  The drug binds the protein when it is in the ‘on’ position and prevents it from binding to other proteins, and thus making it act as it is ‘off’ (another way of looking at it is to say that it inhibits the function of this mutated protein).  Early experiments in the laboratory showed very nice results that blocked the cancer cells from surviving.  Animal studies (mostly mice and rats) also looked promising at controlling the injected human cancer cells from growing into large tumors.  Then, small-scale clinical trial studies were performed (small numbers of patients) to look at safety issues as well dose and tumor-shrinking  properties of the new drug.  These also looked promising and allowed the drug companies (Roche/Daiichi Sankyo) to initiate bigger clinical trials.  This is what is now being reported.

The median survival for patients with late stage advanced melanoma is about 8 to 18 months on average.  Somewhere between 7-12% of patients respond (e.g. tumor shrinks) to the chemotherapy drug alone as treatment.  But, the overall survival following treatment is often no better than patients who get no chemotherapy. The addition of this new drug called Vemurafenib (PLX4032) to the standard chemotherapy seemed to produce better results than the chemotherapy alone.  The results so far from a phase III clinical trials with about 675 patients showed that 84% of patients surviving after six months with the combination drug treatment while only 64% surviving after 6 months with the single drug alone (the standard chemotherapy).  So, in general the new drug when added to the existing drug seems to increase the interm overall survival rates (only assessed at 6 months) and increase what is called the progression free survival of patients.  Progression free refers to the fact that the cancer does not get worse and in some cases gets better (tumor shrinks, there is less metastasis, or there is less organ failure for example due to the cancer).  In fact, since the 6 months survival data was considered to be good, patients were allowed to cross-over.  That means that those patients who were getting the chemotherapy drug alone were allowed (after the first six months) to switch to the new drug and the standard chemotherapy. 

Ok, now for the bad news.  What are the limitations of this study.  Well, for starters for the 50% or so fo the patients without mutations are not going to be suitable for this drug.  The second point it perhaps even more troubling, the study was in essence stopped after six months due to cross-over as was explained above.  So, although the drug seemed to increase survival rates (not overall long-term survival) by about 60% or so at six months, we have absolutely no clue what will happen to patients with this new drug after one year or more.  Finally, the tumor is not gone…there is no data on this but we can be fairly certain that this is not curative and the tumor is not completely eradicated.  9.9999 time out of ten the tumor shrinks (or the number of metastases decrease, etc.) but come back.  Tumor shrinkage which often leads to increased survival benefits are very often temporary, when the tumor regrows after therapy is stopped or when the tumor develops resistance it comes back with a vengeance.  So, what often happens is that hundreds of millions of dollars are spent on the development of new anti-cancer drugs (personalized cancer drugs that hit a very specific kind of mutation found only a some patients but not others)  that show limited amount of response at first but result in very little long-term overall survival.  In fact, it is very common that new drugs provide only a few additional months of survival and that overall benefits affect only 10-20% of patients (not including the fact that half of all patients can’t even take this drug). 

Please note that I am not against an additional few months of life for patients that have advanced skin cancer.  I know that any additional time is welcome by patients.  However, that does not make for a successful drug in my opinion.  Cancer patients and the public are not thinking to themselves, I hope that new drugs that are developed and cost me tens of thousands of dollars a year give me an additional month or two to live.  They want a cure or they at least want a long life with limited complications of the cancer.  That is real to them.  Even if that is not realistic for most advanced cancers, scientist and clinicans need to be very aware of that.  They need to temper their enthusiams and be real abou what the data actually says.  News reports should state the limitations of the drugs and state the cost of the drug in terms of development and in terms of what it will cost a patient.  These overenthuistic statement by the scientist/clinicans in the papers are misleading at best and discouraging at worst. 

Comment/suggestion…they are welcome!

Dr. C   Cancer Made Simple



Cancer terms defined

metaphase showing one part of the mitosis divi...

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As I write more and more blog entries…it occurs to me that many of you reading these and other cancer related information may be thrown off from time to time with the technical terms that many of us use without thinking.  One of the primary reasons I started writing this blog is that I hope to reach out to the scientific and non-scientific community.  Scientists spend a huge amount of time hidden in their labs, reading highly technical journal articles, and then trying to publish highly specialized articles that are not reaching out to the majority of people out there.  I hope to do that less and reach out to more…more often.

So here are some common terms that you will see when you read,view, or hear cancer information.

Cancer:  A set of over 200 different disorders that arise from uncontrolled cell growth and usually form tumors

Blood cancer A large number of highly different cancers that arise from uncontrolled cell growth of blood cells (such as T and B cells) that are circulating on the body and may or may not form solid tumors.

Metastasis:  The term referrers to the state of cancer in which cells from a primary cancer have moved from its original location to that of another location.  For example, a breast cancer tumor cell that has moved from the area of the breast to the bone.  The newly targeted bone cancer is actually part of the breast cancer that has metastasized (either from the blood or from the lymph nodes).  The metastatic cancer is usually much more difficult to treat than the original primary tumor.

Clinical Trials:  A set of human trials used to measure safety or efficacy of a new drug against cancer or a new combination of drugs or an old drug being studied on a new disease.  There are four types and they get more and more expensive as you go up.  All  drugs must go through all four of these and if they succeed at each step are likely to be approved by the Food and Drug Administration.

Efficacy:  The effectiveness of a drug or treatment for cancer.  How well does it treat the disease.  There are many ways to measure this and some of the terms that are used are:  progression free survival (PS), overall survival (OS), Partial Response (PR) and others. 

Cure:  Oncologists’ definition:  The clinical absence of the cancer in question for five (sometimes ten) years is often referred to as the cure rate.  Pateints’ definition:  The complete absence of the disease for life.  This is difficult to achieve for many cancers and only a few can be said to permanently cured.  success stories are mostly found in some childhood blood cancer and a few adult cancers. 

Chemotherapy:  Chemical agents that are used to target pathways in the cancer cells that are essential for its survival but often affect normal cells as well.  For example, many chemotherapuetic agents target the proliferative capacity of the cancer cell and thus stop its division.  However, other cells that divide quickly can also be affected such as hair follicles and gut epithelial cells (thus hair loss and diarrhea are common side effects).

 Bone marrow transplant:  A very complicated medical procedure where the bone marrow from a donor is removed and placed inside a sick patient (recipient) that has been treated with radiation to “kill” off his own bone marrow in hopes that the donors cells will replace the recipient.  The objective is to either remove the cancer (if it is located in the bone marrow of the recipient) and replace it with healthy new bone marrow or to use the new bone marrow to fight off the cancer in the patient.  This procedure is complex, has many side effects, and works only for some types of cancers. 

That is a good start for now.  Please do let me know if there other terms you have heard but don’t really understand of if you wish to have some clarification of any of the above definitions.  Please do visit cancer made simple for more information and resources.

Thanks Dr. C

Cancer made simple!

Red meat….love it or leave it?

A large tray of meat

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For red meat lovers out there…this is definitely not your day.  The now more definitive report that links red meat to certain cancers is fairly strong and may spell ‘well-done’ to those of you who love to see your steaks moving before they are cooked.  Probably nothing is going to make you give up red meat but perhaps reading this blog and the new report from the World Cancer Research fund will inspire you to consider reducing your red meat intake.

Here is the scoop on red meat and bowel cancer.  It turns out that the evidence (although still pretty associative) is fairly overwhelming; that red meats such as pork, beef, or lamb in addition to ham and salami are quite harmful when looking at the risk of bowel related cancers.  UK scientist as well as groups from other countries have looked at over 24 independent papers in addition to 260 plus general papers on diet, excercise and lifestyles and their impact on cancer.  The overall data when just looking at the red meat portion of those studies is that, substantial data now more accurately links red meat consumption to increased risk in bowel related cancer.  This means that each study itself may not be significant, but after 2007 where the controversial findings were reported, enough additional material continues to support the hypothesis.  Thus, enough papers exist now that really make this red meat-cancer danger hypothesis more likely to be true.

It is actually not all bad news, as the cancer group recommended that one can eat red meats but that he/she should reduce that consumption to no more than 70g/day on average.  This is a reasonable amount for most of us as it equals to about 2 regular burgers or one lamb chop.  However, those who eat red meats twice a day would need to consider cutting down substantially.  In addition to reducing the red meat intake and eliminating processed meats such as salami and processed ham, the reduction in bowel cancer is seen better with those who take increased amounts of fiber with their meals.  So, to make things better one could reduce the meat component of their meal and replace it with a higher fiber substitute such as whole wheat, fruits or even vegetables.  The estimates are that out of the 36K people who develop bowel cancer in the UK a year, about half of them could be cancer free if they were able to adhere to these recommendations.

Again, this is not proof that says…”hey red meat causes cancer.”  But, it goes along way in saying, hey “if you eat large amounts of processed meats and red meats every week, you will increase your risk in developing bowel cancer.”  Again, as I have mentioned time and time again, the doctors can try to help you once you get cancer (surgery if possible, radiation or chemotherapy), but you too, have a role to play in your own health.  The reduction of red meats in your life is certainly not impossible.  It is a lifestyle choice.

ps.s the cancer we most talk about when we say bowel cancer is colon or rectal  cancer or colorectal cancer.

Thank you for reading: Dr. C

Cancer made simple