Cancer secondary prevention: Difference between revisions
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and in the general population.<ref>{{cite journal |author=Baron J, Sandler R, Bresalier R, Quan H, Riddell R, Lanas A, Bolognese J, Oxenius B, Horgan K, Loftus S, Morton D |title=A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas |journal=Gastroenterology |volume=131 |issue=6 |pages=1674-82 |year=2006 |pmid=17087947}}</ref><ref>{{cite journal |author=Bertagnolli M, Eagle C, Zauber A, Redston M, Solomon S, Kim K, Tang J, Rosenstein R, Wittes J, Corle D, Hess T, Woloj G, Boisserie F, Anderson W, Viner J, Bagheri D, Burn J, Chung D, Dewar T, Foley T, Hoffman N, Macrae F, Pruitt R, Saltzman J, Salzberg B, Sylwestrowicz T, Gordon G, Hawk E |title=Celecoxib for the prevention of sporadic colorectal adenomas |journal=N Engl J Med |volume=355 |issue=9 |pages=873-84 |year=2006 |pmid=16943400}}</ref> | and in the general population.<ref>{{cite journal |author=Baron J, Sandler R, Bresalier R, Quan H, Riddell R, Lanas A, Bolognese J, Oxenius B, Horgan K, Loftus S, Morton D |title=A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas |journal=Gastroenterology |volume=131 |issue=6 |pages=1674-82 |year=2006 |pmid=17087947}}</ref><ref>{{cite journal |author=Bertagnolli M, Eagle C, Zauber A, Redston M, Solomon S, Kim K, Tang J, Rosenstein R, Wittes J, Corle D, Hess T, Woloj G, Boisserie F, Anderson W, Viner J, Bagheri D, Burn J, Chung D, Dewar T, Foley T, Hoffman N, Macrae F, Pruitt R, Saltzman J, Salzberg B, Sylwestrowicz T, Gordon G, Hawk E |title=Celecoxib for the prevention of sporadic colorectal adenomas |journal=N Engl J Med |volume=355 |issue=9 |pages=873-84 |year=2006 |pmid=16943400}}</ref> | ||
In both groups, there were significant reductions in [[colon polyp]] [[incidence (epidemiology)|incidence]], but this came at the price of increased cardiovascular toxicity. | In both groups, there were significant reductions in [[colon polyp]] [[incidence (epidemiology)|incidence]], but this came at the price of increased cardiovascular toxicity. | ||
===Diet=== | |||
A 2005 [[secondary prevention]] study showed that consumption of a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time.<ref name="Ornish">{{cite journal | author = Ornish D et al. | title = Intensive lifestyle changes may affect the progression of prostate cancer | journal = The Journal of Urology | volume = 174 | issue = 3 | pages = 1065-9; discussion 1069-70 | year = 2005 | id = PMID 16094059}}</ref> | |||
These results were amplified by a 2006 study in which over 2,400 women were studied, half randomly assigned to a normal diet, the other half assigned to a diet containing less than 20% calories from fat. The women on the low fat diet were found to have a markedly lower risk of breast cancer recurrence, in the interim report of December, 2006.<ref>{{cite journal |author=Chlebowski RT, Blackburn GL, Thomson CA, ''et al'' |title=Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study |journal=J. Natl. Cancer Inst. |volume=98 |issue=24 |pages=1767-76 |year=2006 |pmid=17179478 |doi=10.1093/jnci/djj494}}</ref> | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Secondary Prevention
Chemoprevention
The concept that medications could be used to prevent cancer is an attractive one, and many high-quality clinical trials support the use of such chemoprevention in defined circumstances.
Daily use of tamoxifen, a selective estrogen receptor modulator (SERM), typically for 5 years, has been demonstrated to reduce the risk of developing breast cancer in high-risk women by about 50%. A recent study reported that the selective estrogen receptor modulator raloxifene has similar benefits to tamoxifen in preventing breast cancer in high-risk women, with a more favorable side effect profile.[1]
Raloxifene is a SERM like tamoxifen; it has been shown (in the STAR trial) to reduce the risk of breast cancer in high-risk women equally as well as tamoxifen. In this trial, which studied almost 20,000 women, raloxifene had fewer side effects than tamoxifen, though it did permit more DCIS to form.[1]
Finasteride, a 5-alpha-reductase inhibitor, has been shown to lower the risk of prostate cancer, though it seems to mostly prevent low-grade tumors.[2] The effect of COX-2 inhibitors such as rofecoxib and celecoxib upon the risk of colon polyps have been studied in familial adenomatous polyposis patients[3] and in the general population.[4][5] In both groups, there were significant reductions in colon polyp incidence, but this came at the price of increased cardiovascular toxicity.
Diet
A 2005 secondary prevention study showed that consumption of a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time.[6] These results were amplified by a 2006 study in which over 2,400 women were studied, half randomly assigned to a normal diet, the other half assigned to a diet containing less than 20% calories from fat. The women on the low fat diet were found to have a markedly lower risk of breast cancer recurrence, in the interim report of December, 2006.[7]
References
- ↑ 1.0 1.1 Vogel V, Costantino J, Wickerham D, Cronin W, Cecchini R, Atkins J, Bevers T, Fehrenbacher L, Pajon E, Wade J, Robidoux A, Margolese R, James J, Lippman S, Runowicz C, Ganz P, Reis S, McCaskill-Stevens W, Ford L, Jordan V, Wolmark N (2006). "Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial". JAMA. 295 (23): 2727–41. PMID 16754727.
- ↑ Thompson I, Goodman P, Tangen C, Lucia M, Miller G, Ford L, Lieber M, Cespedes R, Atkins J, Lippman S, Carlin S, Ryan A, Szczepanek C, Crowley J, Coltman C (2003). "The influence of finasteride on the development of prostate cancer". N Engl J Med. 349 (3): 215–24. PMID 12824459.
- ↑ Hallak A, Alon-Baron L, Shamir R, Moshkowitz M, Bulvik B, Brazowski E, Halpern Z, Arber N (2003). "Rofecoxib reduces polyp recurrence in familial polyposis". Dig Dis Sci. 48 (10): 1998–2002. PMID 14627347.
- ↑ Baron J, Sandler R, Bresalier R, Quan H, Riddell R, Lanas A, Bolognese J, Oxenius B, Horgan K, Loftus S, Morton D (2006). "A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas". Gastroenterology. 131 (6): 1674–82. PMID 17087947.
- ↑ Bertagnolli M, Eagle C, Zauber A, Redston M, Solomon S, Kim K, Tang J, Rosenstein R, Wittes J, Corle D, Hess T, Woloj G, Boisserie F, Anderson W, Viner J, Bagheri D, Burn J, Chung D, Dewar T, Foley T, Hoffman N, Macrae F, Pruitt R, Saltzman J, Salzberg B, Sylwestrowicz T, Gordon G, Hawk E (2006). "Celecoxib for the prevention of sporadic colorectal adenomas". N Engl J Med. 355 (9): 873–84. PMID 16943400.
- ↑ Ornish D; et al. (2005). "Intensive lifestyle changes may affect the progression of prostate cancer". The Journal of Urology. 174 (3): 1065–9, discussion 1069-70. PMID 16094059.
- ↑ Chlebowski RT, Blackburn GL, Thomson CA; et al. (2006). "Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study". J. Natl. Cancer Inst. 98 (24): 1767–76. doi:10.1093/jnci/djj494. PMID 17179478.