An Austrian psychotherapist specialising in counselling breast cancer patients was in Kuala Lumpur for a conference recently to explain the psychological issues involved in a woman who has breast cancer.
WOMEN who have had mastectomy go through a mire of complex feelings which people might not be aware of.
While doctors look into the physical treatment of cancer patients, clinical psychologists, psychotherapists or psychiatrists trained in cancer patient care play an important role in addressing their psycho-social needs and serve as a link between doctors and patients.
For women who are depressed after a mastectomy, the latter would sit down with them and counsel them, said Dr Gabriele Traun-Vogt, a psychotherapist specialising in breast cancer care from the Medical University of Vienna.
“It’s normal for them not to want sex after a mastectomy. That’s because the same organ that gives pleasure in a relationship is now a source of danger,” she explained.
“Breast cancer is also a serious disease but the symptoms are not easily seen.
“They feel that their bodies have let them down,” she said.
To begin to experience healing, patients should start having a positive approach to the scarred breast, she said.
“Touch and feel the part. This is a complex mental process. People need time to realise that it is normal to have problems and they should try to regain their sense of well-being.
“They need to realise that the breast is also the ‘hurting’ part of the body and a woman should touch it lightly again to have a good feeling towards the breast again,” said Gabrielle, who has been a clinical psychologist since she was 21 and has worked with women with breast cancer for nine years.
The action is important because there is a tendency for women to avoid looking at their scarred breasts or touch them, she said.
“By touching it, you are saying to yourself that you are not hating your body.
“Start loving that hurt part by putting some nice cream on it. Buy a nice bra so that you feel better,” she said.
Being able to accept herself makes it easier for a woman to get back to her relationship, which she was not able to while undergoing and coping with treatment.
“Women usually do not share their fears with their husbands because sex is such a taboo subject, and they don’t share with other women because they feel inadequate,” she said.
While psychotherapists counsel the patient, it’s important that friends and relatives provide a listening ear, she said.
“What they need is to express their feelings. They just want to feel cared for,” she said.
Besides contending with sexuality issues, a woman may still wish to consider having children and may wonder if she can conceive, and if she can, she may have fears about the cancer recurring or that she has a shorter life-span.
Her husband too may not want the risk of raising a child all by himself in the event that she dies.
To give advice, oncologists and clinical psychologists usually work together. The oncologists would give medical information such as the risk of cancer recurring and personal prognosis while the clinical psychologists may give some guidance on coming to a decision, said Gabriele.
A woman usually needs a year to get over the chemotherapy side-effects, and she needs to discuss with her partner on how much he wants to have a child and if anything should happen, would they want to take the risk?
The greatest challenge for Gabriele is seeing young women with young children dying of breast cancer.
Usually, even doctors do not know how to help them with their issues, she said.
Under such a situation, she said she would encourage the women to bring in their children to see her as well.
“The children should know what is going on. Six- or seven-year-olds know that their mother can die from cancer and fear that they will not see their mother anymore.
“It’s important to explain to them that their mother may live for months or years and will not die ‘instantly’. That’s because they watch television and may equate death as something instant,” she said.
“It is also important to explain to children that it is not their fault that their mother has cancer because they may think that they, in some magical way, cause their mother to be sick and die.
“It is important to explain to them that cancer is a disease and it’s no one’s fault,” she said.
An example of how an incident may trigger the child to think that way – a mother has been upset with the child, which is common, and she may have said, “You really make me sick,” and when she has cancer, the boy remembers what she said and think that it was his fault and suffer from guilt as a result.
It is important for Malaysia to establish a multidisciplinary approach in cancer patient care because it requires team work from surgeons, oncologists, nurses, clinical psychologists and social workers, said Gabriele, who conducted the “Workshop Establishing Psycho-Oncology in Malaysia” in conjunction with the International Survivorship and Supportive Care Conference in Cancer recently.
“If the surgeon sees that the woman needs more help psychologically, they should know whom to call,” she said.
Psycho-oncology addresses the psychological responses of patients to cancer at all stages, and that of their families and caregivers, as well as the psychological, behavioural and social factors that may influence the disease process, said Gabriele, who oversees 400 newly diagnosed breast cancer patients every year at the university.
Are counsellors not adequate in helping cancer patients?
They usually refer more serious cases such as those suffering from severe anxiety, sleeping disorders, depression, and the danger of suicide to clinical psychologists, psychotherapists or psychiatrists trained in cancer patient, she said.
“If you are able to solve the problem in the beginning, it’ll be easier for the patients later,” she said.
In Malaysia, the field of psycho-oncology is almost unheard and in Europe, it is a relatively new discipline.
Psycho-oncology started in Austria 15 years ago and in Britain 20 years ago as the result of the patients’ rights movement. Patients want to be involved in the decision-making process and have options, said Gabriele.
“If you want to be a centre of excellence in health and medical care, international standards and guidelines require psychological support for the treatment of cancer,” she said.
thestar.com.my
Saturday, August 25, 2007
Studying cancer
How goes cancer research? In a nutshell, it’s going well, slowly, but surely.
WHY can’t we cure cancer when we could even land man on the moon back in 1969?
Inevitably, I get asked this question at every cocktail party when I introduce myself as an oncologist. The other common question is “What’s new in cancer treatment?” The somewhat more verbose and erudite will ask “What progress has there been lately in cancer research and treatment?”
Before I answer all these questions, let us get one thing clear. Cancer is not one disease. The word “cancer” encompasses about a hundred different entities.
Basic cancer research – molecular biology, biochemistry, cancer genomics and proteomics – attempts to tease out the similarities and differences amongst all these entities.
Based on this basic research, clinical cancer research is carried out. It usually entails testing out new treatments, eg a new drug, on patients with a certain cancer.
We have new drugs (sunitinib, sorafenib) to prolong the lives of patients with metastatic renal cell carcinoma (kidney cancer that has spread widely in the body).
These drugs are different from the drugs (cisplatinum, vinorelbine) used to improve cure rates in patients who have undergone surgery for early lung cancer.
So, a suitable response to the question “Why can’t we cure cancer” is “Which subset of cancer are you speaking of?”.
For many subsets of cancer, cure is possible. For many others, lives are prolonged with meaning and dignity. For a small subset, we have done less well, but good palliation is always possible.
Sixty years ago, breast cancer was treated with surgery alone. To all intents, women were not given additional treatment (adjuvant treatment in medical parlance) after surgery. At least 80% of patients relapsed and eventually died of advanced metastatic disease.
Forty-five years ago, the first chemotherapy trials were started with CMF, an acronym for the three-drug combination of cyclophosphamide, methotrexate and 5-Fluorouracil.
Tamoxifen, an anti-oestrogenic drug, was introduced for early breast cancer almost 30 years ago. With these early developments in the chemical treatment of early breast cancer, only 50% of patients relapsed.
The 1980s and 1990s saw more chemotherapy agents which were effective in this setting ie early breast cancer. Doxorubicin, paclitaxel and docetaxel produced more cures.
A new class of hormonal therapy with greater efficacy and less side effects, the aromatase inhibitors (anastrozole, letrozole, exemestane), was introduced around the late 1990s.
In the early 2000s, trastuzumab, a highly effective targeted therapy (it targets tumours in 20% of women whose breast cancer expresses the HER2 receptor) was introduced.
Today, the overall relapse rate for early breast cancer is down to 30%!
Of course, each subset of early breast cancer patients will experience a different relapse rate. This only goes to reinforce the fact that cancer is a very heterogeneous disease.
We divide up all cancers into small groups and we divide up these groups again into smaller groups – subsets of subsets if you like. And then we treat each subset differently and achieve different rates of success.
The whole point of taking you through in detail the last 60 years of research and treatment in early breast cancer is to show that it is not an overnight business.
To some, 60 years is a long wait for a 50% gain. The impatient ones would like to see all cancer patients (all subsets, all stages, all scenarios) completely cured today.
In reality, scientific cancer research (a subset of all scientific research) is a slow, laborious, intellectually honest endeavour. It starts with hypothesis generation: based on all we know of this subset of cancer and based on the theoretical actions of the new drug, will it work?
We conduct Phase I trials, then phase II trials and finally the phase III randomised clinical trials. But wait, there is more. Findings of the phase III trials are presented and finally published in a peer-reviewed journal. This new drug will eventually be accepted by the mainstream oncological community and it becomes a new standard of treatment. It takes about 20 years for a drug to get from the “bench to the bed”.
No wonder then that alternative cancer treatment (or under another guise, traditional and complementary medicine) is so attractive to so many. It meets many unmet needs with so little hassle. There is no need to trawl through all the available data and scientific methodologies.
Nothing is obvious in science. Nothing is taken for granted. No leaps of faith and no extrapolations here.
Trastuzumab was initially shown to work very well in advanced breast cancer. A 50% response rate was obtained and lives were prolonged.
By simple deduction, trastuzumab should work even better in early breast cancer where the tumour load is much smaller. Yet four randomised clinical trials were conducted at the cost of US1.2bil (RM4.08bil) to see if this drug will also work in early breast cancer. The findings of these trials have now conclusively proven that trastuzumab works very well in early breast cancer.
What of the next 60 years of scientific research in cancer?
Expect more and watch this space carefully. But don’t look for that quick unproven fix offered at every dark street corner.
thestar.com.my
WHY can’t we cure cancer when we could even land man on the moon back in 1969?
Inevitably, I get asked this question at every cocktail party when I introduce myself as an oncologist. The other common question is “What’s new in cancer treatment?” The somewhat more verbose and erudite will ask “What progress has there been lately in cancer research and treatment?”
Before I answer all these questions, let us get one thing clear. Cancer is not one disease. The word “cancer” encompasses about a hundred different entities.
Basic cancer research – molecular biology, biochemistry, cancer genomics and proteomics – attempts to tease out the similarities and differences amongst all these entities.
Based on this basic research, clinical cancer research is carried out. It usually entails testing out new treatments, eg a new drug, on patients with a certain cancer.
We have new drugs (sunitinib, sorafenib) to prolong the lives of patients with metastatic renal cell carcinoma (kidney cancer that has spread widely in the body).
These drugs are different from the drugs (cisplatinum, vinorelbine) used to improve cure rates in patients who have undergone surgery for early lung cancer.
So, a suitable response to the question “Why can’t we cure cancer” is “Which subset of cancer are you speaking of?”.
For many subsets of cancer, cure is possible. For many others, lives are prolonged with meaning and dignity. For a small subset, we have done less well, but good palliation is always possible.
Sixty years ago, breast cancer was treated with surgery alone. To all intents, women were not given additional treatment (adjuvant treatment in medical parlance) after surgery. At least 80% of patients relapsed and eventually died of advanced metastatic disease.
Forty-five years ago, the first chemotherapy trials were started with CMF, an acronym for the three-drug combination of cyclophosphamide, methotrexate and 5-Fluorouracil.
Tamoxifen, an anti-oestrogenic drug, was introduced for early breast cancer almost 30 years ago. With these early developments in the chemical treatment of early breast cancer, only 50% of patients relapsed.
The 1980s and 1990s saw more chemotherapy agents which were effective in this setting ie early breast cancer. Doxorubicin, paclitaxel and docetaxel produced more cures.
A new class of hormonal therapy with greater efficacy and less side effects, the aromatase inhibitors (anastrozole, letrozole, exemestane), was introduced around the late 1990s.
In the early 2000s, trastuzumab, a highly effective targeted therapy (it targets tumours in 20% of women whose breast cancer expresses the HER2 receptor) was introduced.
Today, the overall relapse rate for early breast cancer is down to 30%!
Of course, each subset of early breast cancer patients will experience a different relapse rate. This only goes to reinforce the fact that cancer is a very heterogeneous disease.
We divide up all cancers into small groups and we divide up these groups again into smaller groups – subsets of subsets if you like. And then we treat each subset differently and achieve different rates of success.
The whole point of taking you through in detail the last 60 years of research and treatment in early breast cancer is to show that it is not an overnight business.
To some, 60 years is a long wait for a 50% gain. The impatient ones would like to see all cancer patients (all subsets, all stages, all scenarios) completely cured today.
In reality, scientific cancer research (a subset of all scientific research) is a slow, laborious, intellectually honest endeavour. It starts with hypothesis generation: based on all we know of this subset of cancer and based on the theoretical actions of the new drug, will it work?
We conduct Phase I trials, then phase II trials and finally the phase III randomised clinical trials. But wait, there is more. Findings of the phase III trials are presented and finally published in a peer-reviewed journal. This new drug will eventually be accepted by the mainstream oncological community and it becomes a new standard of treatment. It takes about 20 years for a drug to get from the “bench to the bed”.
No wonder then that alternative cancer treatment (or under another guise, traditional and complementary medicine) is so attractive to so many. It meets many unmet needs with so little hassle. There is no need to trawl through all the available data and scientific methodologies.
Nothing is obvious in science. Nothing is taken for granted. No leaps of faith and no extrapolations here.
Trastuzumab was initially shown to work very well in advanced breast cancer. A 50% response rate was obtained and lives were prolonged.
By simple deduction, trastuzumab should work even better in early breast cancer where the tumour load is much smaller. Yet four randomised clinical trials were conducted at the cost of US1.2bil (RM4.08bil) to see if this drug will also work in early breast cancer. The findings of these trials have now conclusively proven that trastuzumab works very well in early breast cancer.
What of the next 60 years of scientific research in cancer?
Expect more and watch this space carefully. But don’t look for that quick unproven fix offered at every dark street corner.
thestar.com.my
Experts push NHS to use US-style cancer care
LIKE many other British cancer sufferers before him, Rob Ellert travelled to one of America’s leading hospitals to give himself a better chance of survival.
Now in remission, he is so determined that National Health Service patients should no longer die unnecessarily that he has enlisted Lord Darzi, the health minister, to transfer best practice across the Atlantic. He has also set up a charity to promote American-style cancer treatment in Britain.
Ellert, a 61-year-old businessman, is part of a movement demanding a wholesale overhaul of NHS treatment of the disease. It is led by Professor Karol Sikora and Dr Maurice Slevin, two world-leading cancer experts who are based in Britain. They have set out the reforms needed by the NHS.
Figures published last week in the journal The Lancet Oncology showed that survival rates in this country are among the lowest in Europe, on a par with Poland.
Sikora, a former chief of the World Health Organisation cancer unit and now medical director of CancerPartnersUK, a private company, has taken senior Department of Health (DoH) officials on a tour of American cancer centres in the hope that they will bring back ideas to boost British survival rates.
He and Slevin, a consultant at the London Oncology Clinic, a private centre, have devised an action plan which they argue can be implemented within existing NHS budgets:
- NHS patients must be referred to a consultant within 24 hours of a GP suspecting cancer. At present, urgent cases are referred within 14 days, but many NHS cancer patients do not see a specialist for several weeks
- Scans and biopsies to determine how far a cancer has spread should be carried out within three days. At present, NHS patients can wait months.
- Surgery, radiotherapy or chemotherapy should begin within one week of diagnosis. At present, NHS patients can wait two months for treatment.
- Patients should be monitored weekly by a consultant during treatment to detect immediately if it is not working.
- Patients should be given wider access to powerful new medicines.
- Patients should receive the correct amount of radiotherapy at the correct time. A shortage of radiotherapy in Britain means that NHS patients face long delays and may not receive the correct amount of radiation.
- Patients should be treated in the evenings and at weekends to cut queues. In the NHS, expensive equipment is often switched off after 5pm.
Although the NHS has seen some improvements since the introduction of its cancer plan in 2000, experts believe that its targets are not sufficiently ambitious.
Sikora said: “There should be no delays for cancer treatment. A 62-day wait in the NHS is laughable. Patients can be waiting weeks for scans and months for radiotherapy. In Europe and the US this would all happen within 24 to 48 hours.”
Anni Matthews, 53, who is fighting breast cancer, was told by British doctors in February 2003 that she would be lucky to live until the Christmas of that year. Matthews, a former property company director, increased her chances of survival by travelling to the Dana-Farber Cancer Institute in Boston, Massachu-setts, where her treatment was helped by new “wonder drugs”.
Matthews said: “The Food and Drug Administration [FDA] is known to be very pernickety about licensing new drugs due to fears of legal action. If the FDA approves a new cancer drug, why is there such a delay before it is available to British patients?”
The DoH said: “Last November we announced that we were developing a cancer reform strategy . . . We expect to publish the strategy by the end of the year.”
www.timesonline.co.uk
Now in remission, he is so determined that National Health Service patients should no longer die unnecessarily that he has enlisted Lord Darzi, the health minister, to transfer best practice across the Atlantic. He has also set up a charity to promote American-style cancer treatment in Britain.
Ellert, a 61-year-old businessman, is part of a movement demanding a wholesale overhaul of NHS treatment of the disease. It is led by Professor Karol Sikora and Dr Maurice Slevin, two world-leading cancer experts who are based in Britain. They have set out the reforms needed by the NHS.
Figures published last week in the journal The Lancet Oncology showed that survival rates in this country are among the lowest in Europe, on a par with Poland.
Sikora, a former chief of the World Health Organisation cancer unit and now medical director of CancerPartnersUK, a private company, has taken senior Department of Health (DoH) officials on a tour of American cancer centres in the hope that they will bring back ideas to boost British survival rates.
He and Slevin, a consultant at the London Oncology Clinic, a private centre, have devised an action plan which they argue can be implemented within existing NHS budgets:
- NHS patients must be referred to a consultant within 24 hours of a GP suspecting cancer. At present, urgent cases are referred within 14 days, but many NHS cancer patients do not see a specialist for several weeks
- Scans and biopsies to determine how far a cancer has spread should be carried out within three days. At present, NHS patients can wait months.
- Surgery, radiotherapy or chemotherapy should begin within one week of diagnosis. At present, NHS patients can wait two months for treatment.
- Patients should be monitored weekly by a consultant during treatment to detect immediately if it is not working.
- Patients should be given wider access to powerful new medicines.
- Patients should receive the correct amount of radiotherapy at the correct time. A shortage of radiotherapy in Britain means that NHS patients face long delays and may not receive the correct amount of radiation.
- Patients should be treated in the evenings and at weekends to cut queues. In the NHS, expensive equipment is often switched off after 5pm.
Although the NHS has seen some improvements since the introduction of its cancer plan in 2000, experts believe that its targets are not sufficiently ambitious.
Sikora said: “There should be no delays for cancer treatment. A 62-day wait in the NHS is laughable. Patients can be waiting weeks for scans and months for radiotherapy. In Europe and the US this would all happen within 24 to 48 hours.”
Anni Matthews, 53, who is fighting breast cancer, was told by British doctors in February 2003 that she would be lucky to live until the Christmas of that year. Matthews, a former property company director, increased her chances of survival by travelling to the Dana-Farber Cancer Institute in Boston, Massachu-setts, where her treatment was helped by new “wonder drugs”.
Matthews said: “The Food and Drug Administration [FDA] is known to be very pernickety about licensing new drugs due to fears of legal action. If the FDA approves a new cancer drug, why is there such a delay before it is available to British patients?”
The DoH said: “Last November we announced that we were developing a cancer reform strategy . . . We expect to publish the strategy by the end of the year.”
www.timesonline.co.uk
Talcum powder 'poses cancer risk to women'
The practice of discreetly puffing underwear with a dab of talcum powder may be increasing women's risk of ovarian cancer.
Research shows that women who use talc have a 17 per cent higher risk of getting the cancer. Researchers say using a small amount of talc in the pelvic area may lead to it reaching the ovaries and increasing the risk of the most common gynaecological cancer in the UK, with more than 4,000 deaths a year.
In the research, published in the International Journal of Cancer this week, data on more than 3,000 women was compared. "We confirmed a statistically significant increase in ovarian cancer risk associated with use of talc in the pelvic region," say the researchers, who are from hospitals and centres taking part in the Australian Ovarian Cancer Study Group.
The increased risk was specifically related to talc use in the pelvic region. Use on other body sites showed no association. "This suggests that use of only a small amount of talc may be required for some talc to reach the ovaries and increase risk of cancer," says the report.
It's not clear how talc could trigger the cancer. One theory is it may be carcinogenic to the covering layer of the ovaries when it get through the vagina, uterus and fallopian tubes to the ovary.
news.independent.co.uk
Research shows that women who use talc have a 17 per cent higher risk of getting the cancer. Researchers say using a small amount of talc in the pelvic area may lead to it reaching the ovaries and increasing the risk of the most common gynaecological cancer in the UK, with more than 4,000 deaths a year.
In the research, published in the International Journal of Cancer this week, data on more than 3,000 women was compared. "We confirmed a statistically significant increase in ovarian cancer risk associated with use of talc in the pelvic region," say the researchers, who are from hospitals and centres taking part in the Australian Ovarian Cancer Study Group.
The increased risk was specifically related to talc use in the pelvic region. Use on other body sites showed no association. "This suggests that use of only a small amount of talc may be required for some talc to reach the ovaries and increase risk of cancer," says the report.
It's not clear how talc could trigger the cancer. One theory is it may be carcinogenic to the covering layer of the ovaries when it get through the vagina, uterus and fallopian tubes to the ovary.
news.independent.co.uk
Eating healthy fruit, vegetables won't stop cancer
FRUIT and vegetables provide no protection against cancer, according to latest Australian research that has shocked nutritionists.
In a discovery that turns conventional advice on its head, experts have admitted there is "zero evidence'' that eating fruit and vegetables can help people avoid a disease that kills nearly 40,000 Australians every year.
Research presented for the first time at last week's CSIRO Prospects for Cancer Prevention Symposium shows that what people eat is far less important in cancer prevention than previously believed.
Instead, the three prime risk factors driving up Australian cancer rates have been identified as obesity, drinking too much alcohol and smoking.
Staying within a healthy body weight range was found to be more important than following particular nutritional guidelines.
This means a slim person who doesn't eat enough fruit and vegetables would probably have a lower risk of developing cancer than someone who is overweight but eats the recommended daily amount of fruit and vegetables.
The findings emerged from the Cancer Council's Melbourne Collaborative Cohort Study, an ongoing research project involving 42,000 Australians who have been monitored since 1990.
Revealed exclusively to The Sunday Telegraph, they challenge widespread belief in the power of juices and vegetable-based ``anti-cancer'' diets to avoid or fight various types of the disease.
Dr Peter Clifton, director of the CSIRO's Nutrition Clinic, told The Sunday Telegraph there was ``zero evidence'' that eating fruit and vegetables could protect against cancer.
Heart disease is Australia's biggest killer, so fruit and vegetables are still regarded as important in maintaining health.
Professor Dallas English, of the Cancer Council of Victoria, told the symposium that despite decades of research, there was no convincing evidence on how Australians could modify their diet to reduce the risk of cancer.
``The most important thing about diet is limiting energy (kilojoule) intake so people don't become overweight or obese, because this has emerged as a risk factor for a number of cancers, including breast, prostate, bowel and endometrial (uterus),'' he said.
The link between eating red meat and bowel cancer was ``weak'' and the Cancer Council supported guidelines advising people to eat red meat three or four times a week, Professor English said.
His advice comes after Health Minister Tony Abbott last week backed a report, funded by Meat & Livestock Australia, on the dietary role of red meat.
Surprisingly, fibre was deemed to have no significant benefit in avoiding bowel cancer _ although calcium was associated with a 20 per cent reduced risk.
Likewise, a high intake of fat, considered a prime culprit since the 1970s, was found to have only a ``modest'' link to breast cancer.
Smoking caused one in five cancer deaths, while regularly drinking too much alcohol boosted the risk of several cancers including breast and bowel, Professor English said.
He and Dr Clifton acknowledged that eating fruit and vegetables might help people avoid obesity, as they were lower in kilojoules than other foods.
``The risk of every type of cancer is increased by obesity,'' Dr Clifton added.
Both experts predict a surge in cancer as a result of Australia's obesity epidemic, but say exercise can play a vital role in cutting cancer rates, potentially halving the risk of some cancers.
Sydney mother Tauri Smart, 29, said the findings ``take the pressure off'' meal preparation.
She and her husband try to eat healthily and want to set a good example for their daughters Poppy, 3, and Sadie, six weeks.
``I've always tried to push fruit and vegetables, and have a vegetarian meal at least once a week,'' Ms Smart said. ``Being able to have meat makes it easier.''
Nutritionist Dr Rosemary Stanton cast doubt on the findings and suggested the study could be flawed.
www.news.com.au
In a discovery that turns conventional advice on its head, experts have admitted there is "zero evidence'' that eating fruit and vegetables can help people avoid a disease that kills nearly 40,000 Australians every year.
Research presented for the first time at last week's CSIRO Prospects for Cancer Prevention Symposium shows that what people eat is far less important in cancer prevention than previously believed.
Instead, the three prime risk factors driving up Australian cancer rates have been identified as obesity, drinking too much alcohol and smoking.
Staying within a healthy body weight range was found to be more important than following particular nutritional guidelines.
This means a slim person who doesn't eat enough fruit and vegetables would probably have a lower risk of developing cancer than someone who is overweight but eats the recommended daily amount of fruit and vegetables.
The findings emerged from the Cancer Council's Melbourne Collaborative Cohort Study, an ongoing research project involving 42,000 Australians who have been monitored since 1990.
Revealed exclusively to The Sunday Telegraph, they challenge widespread belief in the power of juices and vegetable-based ``anti-cancer'' diets to avoid or fight various types of the disease.
Dr Peter Clifton, director of the CSIRO's Nutrition Clinic, told The Sunday Telegraph there was ``zero evidence'' that eating fruit and vegetables could protect against cancer.
Heart disease is Australia's biggest killer, so fruit and vegetables are still regarded as important in maintaining health.
Professor Dallas English, of the Cancer Council of Victoria, told the symposium that despite decades of research, there was no convincing evidence on how Australians could modify their diet to reduce the risk of cancer.
``The most important thing about diet is limiting energy (kilojoule) intake so people don't become overweight or obese, because this has emerged as a risk factor for a number of cancers, including breast, prostate, bowel and endometrial (uterus),'' he said.
The link between eating red meat and bowel cancer was ``weak'' and the Cancer Council supported guidelines advising people to eat red meat three or four times a week, Professor English said.
His advice comes after Health Minister Tony Abbott last week backed a report, funded by Meat & Livestock Australia, on the dietary role of red meat.
Surprisingly, fibre was deemed to have no significant benefit in avoiding bowel cancer _ although calcium was associated with a 20 per cent reduced risk.
Likewise, a high intake of fat, considered a prime culprit since the 1970s, was found to have only a ``modest'' link to breast cancer.
Smoking caused one in five cancer deaths, while regularly drinking too much alcohol boosted the risk of several cancers including breast and bowel, Professor English said.
He and Dr Clifton acknowledged that eating fruit and vegetables might help people avoid obesity, as they were lower in kilojoules than other foods.
``The risk of every type of cancer is increased by obesity,'' Dr Clifton added.
Both experts predict a surge in cancer as a result of Australia's obesity epidemic, but say exercise can play a vital role in cutting cancer rates, potentially halving the risk of some cancers.
Sydney mother Tauri Smart, 29, said the findings ``take the pressure off'' meal preparation.
She and her husband try to eat healthily and want to set a good example for their daughters Poppy, 3, and Sadie, six weeks.
``I've always tried to push fruit and vegetables, and have a vegetarian meal at least once a week,'' Ms Smart said. ``Being able to have meat makes it easier.''
Nutritionist Dr Rosemary Stanton cast doubt on the findings and suggested the study could be flawed.
www.news.com.au
Cancer's New Pitch
Sept. 3, 2007 issue - Two summers ago a group of Philadelphia-area women who were preparing for the Breast Cancer 3-Day charity walk met to decide their team name. Kelly Rooney, then a 42-year-old with five children and stage-three breast cancer, tossed out an idea: how about "Save 2nd Base," a playful allusion to that quaint high-school system in which the bases signify the progression from kissing to sex? Rooney designed a T shirt, drawing two baseballs at breast level above the slogan. By the time of the fund-raiser Rooney was too sick to walk, but her teammates wore the shirts—and many spectators commented on how much they loved the idea. So Rooney's sister Erin O'Brien Dugery and friend Kelly Day spent close to $10,000 to trademark the Save 2nd Base tagline and began selling the T shirts online and in boutiques (total sales so far: 1,000). "We can't keep them in stock—they're catching on like fire," says Jen Dailey at People People, a boutique in Stone Harbor, N.J. The women selling the shirts have pledged that after they earn back the money they've invested, 50 percent of profits will go to a breast cancer foundation set up in memory of Rooney, who died last summer.
The 2nd Base shirts aren't the only edgy brand of breast-cancer apparel out there. Since 2004, Los Angeles designer Julie Fikse has sold more than 80,000 shirts carrying variations on the message "Save the Ta-Tas"—and donated $80,000 of her profits to breast-cancer charities. Both slogans garner mostly chuckles and enthusiasm, though a few people have reacted negatively, criticizing them as too crude. (To counter that, Dugery and Day launched a more demure line carrying the slogan "S2B.")
Most people under 60 understand what "second base" means, but the motto creates occasional confusion: Dailey recalls watching an American teenager use pantomime to explain the concept to a Japanese foreign-exchange student, and Dailey had to provide a definition for her sixtysomething mother. But usually, "when someone reads it, they get it, they start laughing," says Dugery, co-owner of the company behind the shirts. And in the face of a devastating disease, a little laughter can feel like a home run.
www.msnbc.msn.com
The 2nd Base shirts aren't the only edgy brand of breast-cancer apparel out there. Since 2004, Los Angeles designer Julie Fikse has sold more than 80,000 shirts carrying variations on the message "Save the Ta-Tas"—and donated $80,000 of her profits to breast-cancer charities. Both slogans garner mostly chuckles and enthusiasm, though a few people have reacted negatively, criticizing them as too crude. (To counter that, Dugery and Day launched a more demure line carrying the slogan "S2B.")
Most people under 60 understand what "second base" means, but the motto creates occasional confusion: Dailey recalls watching an American teenager use pantomime to explain the concept to a Japanese foreign-exchange student, and Dailey had to provide a definition for her sixtysomething mother. But usually, "when someone reads it, they get it, they start laughing," says Dugery, co-owner of the company behind the shirts. And in the face of a devastating disease, a little laughter can feel like a home run.
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Cancer fight gets a boost
Sun Media -- Cancer researchers at the University of Manitoba have landed some major funding from the federal government under a program intended to award funds to the best of the best.
Two of the seven projects being funded across Canada as part of a five-year, $10.1 million initiative will take place here in Manitoba.
Each project will receive about $300,000 a year for five years.
"This is huge," said Donna Turner, an epidemiologist with CancerCare Manitoba who will work on both Manitoba projects. "This is a big coup for Manitoba."
All the projects, funded by the Canadian Institutes of Health Research, focus not on clinical research seeking a cure, but on the care received by cancer patients, both in terms of access and quality. The projects were selected by CIHR via a peer-review process that aimed to choose the most promising projects based on "scientific excellence," ensuring that only the cream of the crop were chosen.
One of the two Manitoba-based projects will look at patterns of cancer incidence, risk factors and care within aboriginal populations in the province.
"One of the things we've never been able to do is separate out what's happening with cancer in our aboriginal populations," said Turner. "We think, based on what other jurisdictions like Ontario have found, that cancer is probably on the rise (among aboriginal people)."
The project should produce a cancer control strategy specific to First Nations.
The second Manitoba project will focus on the role of primary health care providers like family doctors and nurse practitioners in screening for colorectal cancer, as well as their role following treatment.
Led by Alan Katz, an associate professor of family medicine at the U of M, the research team will try to determine how primary health care providers can help improve screening for a form of cancer with high death rates often linked with late detection.
The project will also examine the best way to transfer some of the post-treatment care back from the cancer specialists to the primary care providers.
winnipegsun.com
Two of the seven projects being funded across Canada as part of a five-year, $10.1 million initiative will take place here in Manitoba.
Each project will receive about $300,000 a year for five years.
"This is huge," said Donna Turner, an epidemiologist with CancerCare Manitoba who will work on both Manitoba projects. "This is a big coup for Manitoba."
All the projects, funded by the Canadian Institutes of Health Research, focus not on clinical research seeking a cure, but on the care received by cancer patients, both in terms of access and quality. The projects were selected by CIHR via a peer-review process that aimed to choose the most promising projects based on "scientific excellence," ensuring that only the cream of the crop were chosen.
One of the two Manitoba-based projects will look at patterns of cancer incidence, risk factors and care within aboriginal populations in the province.
"One of the things we've never been able to do is separate out what's happening with cancer in our aboriginal populations," said Turner. "We think, based on what other jurisdictions like Ontario have found, that cancer is probably on the rise (among aboriginal people)."
The project should produce a cancer control strategy specific to First Nations.
The second Manitoba project will focus on the role of primary health care providers like family doctors and nurse practitioners in screening for colorectal cancer, as well as their role following treatment.
Led by Alan Katz, an associate professor of family medicine at the U of M, the research team will try to determine how primary health care providers can help improve screening for a form of cancer with high death rates often linked with late detection.
The project will also examine the best way to transfer some of the post-treatment care back from the cancer specialists to the primary care providers.
winnipegsun.com
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