Obesity and Cancer Risk

 

Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”


OBESITY AND CANCER RISK

We have become the heaviest people in the history of our species, with two-thirds of Americans officially classified as overweight, and one of every three of us tipping the scales into the “obese” range.  For too many of us, day after day, we load our bodies with more fat- and calorie-packed foods than our bodies can utilize.  Surrounded by effort-saving devices that have drastically reduced the amount of food-derived energy that our bodies can reasonably metabolize, a majority of Americans are becoming progressively heavier and heavier.  Moreover, obesity now affects a shocking percentage of children and adolescents in our society, and it is no longer uncommon to see children and teenagers with obesity-related diseases, previously seen only in adults, like diabetes, arthritis, high blood pressure, gallstones, and cardiovascular disease.

In addition to chronic illnesses that have long been associated with obesity, it has become increasingly clear that the risk of multiple different types of cancer is also increased by obesity.  Now, a newly published public health study, which appears in a forthcoming issue of The Lancet Oncology, underscores the disturbing extent to which excess weight increases our risks of several different common types of cancer.

In this huge public health study, more than 400,000 patient volunteers from Asia, Australia, and New Zealand were followed for an average of 4 years.  When obese study volunteers (BMI of 30 or higher) were compared with volunteers of normal weight (BMI less than 25), the obese volunteers were found to have a 21 percent higher risk of death due to cancer.  The risk of dying of certain specific types of cancer were even higher among the obese volunteers, including a 50 percent increased risk of death due to colon cancer, a 68 percent increased risk of death due to rectal cancer, a 63 percent increased risk of death due to breast cancer (in postmenopausal women), a 162 percent increase in the risk of dying of ovarian cancer, a 321 percent increase in the risk of death due to cancer of the cervix, a 45 percent increase in the risk of death due to prostate cancer, and a 66 percent increase in the risk of dying from leukemia.

The findings of this enormous public health study are worrisome, to say the least, and reflect the very serious impact that obesity has on our risk of developing cancer, and the risk of dying from cancer.

Obesity is a growing public health problem in the United States and, increasingly, around the world; and the list of chronic, major illnesses associated with obesity continues to expand (along with our collective waistlines).  If you are overweight or obese, then please consult with your physician for advice on how best to lose your excess weight.  Meanwhile, sharply reduce your intake of high-calorie and high-fat foods, and begin a responsible and consistent exercise program, under your physician’s supervision. 

 

For a more detailed discussion of the scientific links between obesity and cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in August of this year. 



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg



I and the staff of Weekly Health Update would like to take this opportunity to thank the more than 100,000 new and returning readers who visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



 

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Vitamin D Reduces Risk of Cognitive Decline & Dementia

 

Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”


VITAMIN D REDUCES RISK OF COGNITIVE DECLINE & DEMENTIA

Regular readers of this column are already well aware of the preventive effects of Vitamin D with respect to falls in the elderly, certain cancers, and cardiovascular disease.  (My new book, “A Cancer Prevention Guide for the Human Race,” which is scheduled to be published in August, 2010, contains an exciting and comprehensive update on the role of Vitamin D in cancer prevention.)  Now, a newly published research study, which appears in the current issue of the Archives of Internal Medicine, has linked low Vitamin D levels in the blood with an increased risk of cognitive decline and dementia in adults over the age of 65.

A total of 858 adults at or over the age of 65 participated in this prospective public health study, which was conducted over a period of 7 years.  All of these study volunteers underwent extensive evaluation of their cognitive function, using validated, standardized tests, when they entered into the study.  All patients also underwent testing of their blood for Vitamin D levels.  This extensive evaluation and testing was then repeated every 3 years during the course of this important clinical research study.

The results of this study indicated that patient volunteers with low Vitamin D levels in the blood (less than 25 nmol/liter), when compared with volunteers with normal blood levels of Vitamin D (75 nmol/liter, or higher), experienced significant declines in their intellectual function over the course of this study.  Indeed, the patient volunteers with decreased Vitamin D levels in their blood were as much as 60 percent more likely to experience progressive cognitive decline or dementia over the relatively brief duration of this study, when compared with the patients who had normal levels of Vitamin D in their blood! 

The results of this study are very similar to the findings of a similar study, which has just been published in the journal Neurology.  In this particular study, an inadequate level of Vitamin D in the blood of elderly men and women was associated with a significantly increased risk of cognitive decline and dementia from all causes, including Alzheimer’s disease and stroke.  Moreover, abnormalities of the brain, as detected by MRI scans, were also more commonly observed in patients who were deficient in Vitamin D.

Vitamin D deficiency is very common in older men and women.  An estimated 80 percent of people over the age of 65 have inadequate levels of Vitamin D in their blood, while as many as 45 percent of older men and women also have severe Vitamin D deficiency.

 

The results of these two studies strongly suggest that adequate levels of Vitamin D in the blood may be associated with a significantly reduced risk of aging-associated cognitive decline and dementia in older men and women, in addition to improving muscle strength, decreasing the risk of certain cancers, and decreasing the risk of cardiovascular disease. 

 

Not everyone should take large doses of Vitamin D, however, as the unmonitored use of this potent hormone-like vitamin can cause dangerous elevations in the level of calcium in the blood, as well as calcifications in the soft tissues of the body, kidney failure, pancreatitis, and gastrointestinal ulcers.  (Prior to starting Vitamin D supplements, you should certainly discuss the risks and benefits of Vitamin D supplementation with your physician.)

 

To learn more about the critical role of Vitamin D and the risk of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the August of this year. 



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg



I and the staff of Weekly Health Update would like to take this opportunity to thank the more than 100,000 new and returning readers who visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



 

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All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk

 

Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”


ALL FORMS OF HORMONE REPLACEMENT THERAPY (HRT) INCREASE BREAST CANCER RISK

One of the most common questions that I am asked is if there are any safe forms of hormone replacement therapy (HRT) for women who are experiencing severe symptoms associated with menopause.  Since the release of the preliminary results of the pivotal Women’s Health Initiative study, in 2002, which clearly showed that standard combination HRT (containing the two primary female sex hormones) was associated with a significant increase in the risk of developing breast cancer, a number of alternative “safer” forms of HRT have been proposed.  These alternative forms of HRT have included transdermal estrogen patches (which are placed on the skin) and other forms of “bioidentical” HRT hormones. 

Advocates of transdermal estrogen patches note that the adverse effects of estrogen-based HRT pills on cholesterol, as well as their association with an increased risk of life-threatening blood clots, may be lower with transdermal patches when compared to oral HRT medications. 

Proponents of “bioidentical” HRT, in which the active ingredient is the same chemical form of estrogen (estradiol) that is manufactured in the ovaries prior to menopause, have also made abundant health-related claims for this form of  HRT when compared to the more commonly prescribed cocktail of mixed forms of estrogen derived from the urine of pregnant mares.  Unfortunately, there is almost no solid clinical research evidence available to support these claims that “bioidentical” HRT is safer, or more effective, than the more commonly prescribed “conjugated equine estrogens.”  (Within the estrogen-sensitive cells of a woman’s body, estrogen receptors really don’t care much whether estrogen-like hormones come from horse urine or from the human form of estrogen; nor do they care whether or not estrogen-like hormones enter the body in the form of a pill versus being absorbed into the bloodstream through a transdermal patch.)

As the Women’s Health Initiative study’s breast cancer risk findings were far more robust for the combination HRT pill that has been commonly prescribed for menopausal women (because estrogen-alone HRT increases the risk of uterine cancer, as well…), many patients, and their doctors, have held out the hope that low-dose estrogen-only HRT might be a safer alternative to traditional combination HRT.  However, a recently published research paper from the enormous European EPIC public health study casts serious doubt about the assumption that alternative forms of HRT are safe from the standpoint of breast cancer risk.

This research paper, which has been published in the International Journal of Cancer, is an update of the huge European Prospective Investigation into Cancer and Nutrition (EPIC) study, in which 134,744 postmenopausal women throughout Europe were evaluated.  After nearly 9 years of follow-up, on average, 4,312 new cases of breast cancer were diagnosed within this extremely large group of patient volunteers. 

When compared to women who had never used HRT, the women who were currently using combination HRT during the course of this clinical study experienced a 77 percent increase in the relative risk of developing breast cancer (similar to what has been shown in the Women’s Health Initiative study, and in other similar prospective clinical research studies).  However, the greater contribution of this study to our understanding of the risks of HRT was the finding that estrogen-only HRT also increased the risk of breast cancer, as there was a 42 percent increase in the relative risk of breast cancer among the women who were taking various forms of estrogen-only HRT.  Moreover, this increased breast cancer risk among users of estrogen-only HRT was the same for both oral and transdermal forms of estrogen-only HRT.

The results of this giant, multi-national prospective public health study are of great importance, as it is many times larger than most of the studies that have preceded it, including the Women’s Health Initiative study.  These results from the ongoing EPIC study emphasize the point that I have made to patients for almost two decades, now:  The biology of the receptors in cells that respond to estrogen, and other estrogen-like molecules, has been well understood for decades now.  Any substance that stimulates these estrogen receptors automatically sets off a cascade of biochemical reactions with the same end biological result.  We have long known that prolonged exposure to estrogen (whether from a woman’s own ovaries, or from HRT medications) increases the risk of breast and uterine cancer, and also increases the risk of blood clots, gallstones, and other serious illnesses.  (More recent data has also implicated combination HRT in the development of cardiovascular disease and dementia in women.)

Based upon the findings of this very large prospective public health study, my advice to women remains the same as it has been for almost 20 years.  If you are going through menopause, do not use HRT medications.  If you are already using HRT medications, then ask your doctor to help in weaning you off of them.  If you are one of the approximately 3 to 5 percent of postmenopausal women who have unbearably severe hot flashes, or other severe symptoms of menopause, and you are currently using some form of HRT medication, then work with your doctor to reduce the dose of your HRT medicine to the lowest possible level that adequately treats your symptoms.

 

For more information on HRT and cancer, please click on the following links to my previous columns on this topic:

Hormone Replacement Therapy (HRT) & Ovarian Cancer

Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

To learn more about the critical role of hormone replacement medications and the risk of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year.



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg



I and the staff of Weekly Health Update would like to take this opportunity to thank the more than 100,000 new and returning readers who visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



 

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Irritable Bowel Syndrome: Cause Discovered?

 

Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”


IRRITABLE BOWEL SYNDROME: CAUSE DISCOVERED?

Irritable bowel syndrome (IBS) is a poorly understood cluster of gastrointestinal (GI) tract symptoms that typically includes varying degrees of abdominal bloating and crampy pain, diarrhea, constipation, and the frequent discharge of mucus-like stools from the rectum.  At any one time, an estimated 10 to 20 percent of all Americans chronically experience one or more of these intestinal symptoms.  In most patients with IBS, these symptoms begin in childhood.  In the United States, and in most other Western countries, IBS is at least 3 times more common in women than in men although, interestingly, in Southeast Asia, men are 2 to 3 times more commonly afflicted with IBS.

Numerous theories about the cause(s) of IBS have been proposed, but none have been definitively proven to cause this common syndrome, thus far.  Because the precise cause(s) of IBS has not yet been determined, there is no specific medical test available to diagnose this condition.  Likewise, there is no specific treatment available for IBS, although fiber supplements and careful attention to dietary “triggers” are often helpful.  Moreover, as IBS is frequently associated with chronic depression and/or anxiety, the use of some types of antidepressant medications has also been associated with an improvement in IBS symptoms.

Among the numerous proposed causes of IBS, an excess of a powerful hormone and neurotransmitter, serotonin, within the GI tract has been the focus of considerable research, lately.  (Serotonin is also commonly known as 5-HT, which is an abbreviated form of serotonin’s chemical name.) 

Serotonin has been shown to have multiple functions within the human body.  Decreased serotonin levels in the brain have been associated with both depression and anxiety, which explains why the most commonly used antidepressant medications, the selective serotonin reuptake inhibitors (SSRIs), are used to treat both chronic depression and anxiety.  (Commonly prescribed SSRIs include Prozac, Paxil, Zoloft, Lexapro and Celexa, among others.)  Because more than 95 percent of the body’s serotonin is found in the GI tract, SSRI drugs also have a profound effect on GI tract function, in addition to their effects on brain serotonin levels.  Indeed, previous observations that certain SSRI antidepressant medications worsen cramping and diarrhea in patients with diarrhea-predominant IBS have at least suggested that serotonin in the GI tract may play an important role in this common form of IBS.

Another serotonin-related disease that is associated with severe abdominal cramping and diarrhea is carcinoid syndrome.  In this relatively rare condition, serotonin-secreting carcinoid tumors of the GI tract cause profuse, watery diarrhea in affected patients after these tumors spread to the liver.

Based upon these apparent clinical links between IBS and serotonin (and for diarrhea-predominant IBS, in particular), additional research into the metabolism of serotonin in the GI tract of IBS sufferers is sorely needed.  Fortunately, a newly published research study, which appears in the current issue of the journal Gastroenterology, sheds further light on the potential link between serotonin and at least some forms of IBS.

In this novel clinical research study, 98 children with chronic GI tract symptoms were evaluated.  Twelve of these children presented with chronic symptoms suggestive of IBS.  Endoscopic GI tract biopsies were performed on these 12 children, and the results of these biopsies were compared with similar biopsies performed on other age-matched children who were undergoing endoscopy for reasons other than IBS symptoms.

When compared with the biopsy results on the “control” children without IBS symptoms, the children with IBS symptoms were found to have significantly elevated levels of serotonin (5-HT) in the mucosal cells lining their GI tract.  At the same time, the children with IBS symptoms were also found to have lower levels of a protein that is responsible for removing serotonin from the GI tract (serotonin transporter protein, or SERT) when compared to the children without IBS symptoms.  Therefore, these two findings, in children with chronic IBS symptoms, further and strongly suggest that an excess of serotonin in the gut may be associated with classic IBS symptoms.

In view of the varying degrees of diarrhea and constipation (and other IBS-associated symptoms) observed among individual patients considered to have IBS, it is highly likely that this syndrome has more than just one cause.  However, the biopsy-proven excess of serotonin in the GI tracts of the 12 children in this study with chronic IBS symptoms is a powerful indication that the abnormal regulation and metabolism of GI tract serotonin likely plays an important (if not causative) role in many, if not most, cases of this chronic and very common GI affliction.  The data from this powerful little clinical study also supports the continued development and clinical testing of serotonin/5-HT blocking (antagonist) agents in patients with diarrhea-predominant IBS.

 

For additional information on IBS, please see my previous column on this topic:

Irritable Bowel Syndrome (IBS), Diet & Fiber

 

 

To learn more about the critical role of diet in the prevention of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the summer of this year. 



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link: 


http://www.youtube.com/watch?v=7-Tdv7XW0qg



I and the staff of Weekly Health Update would like to take this opportunity to thank the more than 100,000 new and returning readers who visit our premier global health information website every month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



 

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