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The News You NeedTaxol
Improves Survival in Advanced Breast Cancer
Women with metastatic breast cancer have better survival rates and fewer side effects
when treated with Taxol (paclitaxel), instead of a standard chemotherapy combination of
cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP), according to a
study conducted at the Sydney Cancer Center in Sydney, Australia. In women receiving each
regimen as first-line treatment for advanced cancer, two-year survival was 20 percent in
the CMFP group versus 39 percent in the Taxol group. The Taxol group also had fewer side
effects, primarily hair loss, nerve symptoms, and joint and muscle pains. The CMFP group
suffered nausea and vomiting, loss of white blood cells and platelets, and other symptoms.
Bishop JF, Dewar J, Toner GC, et al. Initial paclitaxel improves outcome
compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic
breast cancer. J Clin Oncol 1999;17:2355.
Folic Acid Cuts Alcohol-Related Breast
Cancer Risk
Alcohol is known to increase risk of breast and colon cancer, presumably by blocking
the DNA repair actions of the B-vitamin folic acid. New data suggest that women who drink
alcohol can counteract some of this increased risk by getting more folic acid through diet
or supplements. The Harvard Nurses' Health Study, following 88,818 women from 1980 to
1996, found that breast cancer risk was 24 percent higher for those consuming 15 grams of
alcohol or more per day, compared to nondrinkers. However, daily consumption of 600
milligrams of folic acid returned the risk to the level of nondrinkers.
A 12-ounce beer contains 12.8 grams of ethanol. A 4-ounce glass of wine contains 11.0
grams of ethanol. A 1.5-ounce shot of 80-proof liquor contains 14.0 grams of ethanol.
Here are some great folic acid sources (micrograms per 1-cup cooked serving):
asparagus176, black beans256, broccoli108, chick peas282,
blackeyed peas356, lentils358, navy beans255, pinto beans294, and
spinach262.
Zhang S, Hunter DJ, Hankinson SE, et al. A prospective study of folate intake
and the risk of breast cancer. JAMA 1999;281:1632-7.
Low-Potency
Estrogen Pills Linked to Cancer
Low-potency estrogens, such as estriol used orally or in vaginal creams, have been
prescribed to many women to relieve symptoms of vaginal atrophy and dryness, particularly
in Europe. It has never been clear whether these estrogens are safer than the
higher-potency formulations, such as estradiol and conjugated estrogens (Premarin) that
are often used to treat hot flashes and night sweats. High-potency estrogens are known to
increase risk of uterine cancer unless accompanied by a progestin. They also increase
breast cancer risk regardless of whether progestins are added.
In a case-control study at Stockholm's Karolinska Institute including 789 women with
uterine (endometrial) cancer and 3,368 controls, oral low-potency estrogens were linked to
cancer risk, just as stronger estrogens are. Women using low-potency estrogen pills had
double the cancer risk of women who had never used them, and triple the risk if they used
them for five years or longer. Risk quickly dropped with discontinuation of use. Vaginal
application was not associated with cancer risk. However, this result does not apply to
vaginal use of more potent estrogens.
Weiderpass E, Baron JA, Adami HO, et al. Low-potency oestrogen and risk of
endometrial cancer: a case-control study. Lancet 1999;353:1824-8.
Screening
Helps Younger Women
Many studies
have shown benefits of mammography only for women over 50. Two new British studies,
however, indicate there may be a benefit for younger women as well. The U.K. Trial of
Early Detection of Breast Cancer found a 27 percent reduction in breast-cancer mortality
among those attending screening centers, with similar benefits for women aged 45 to 49
compared to older women. A University of Edinburgh study arrived at a similar conclusion,
finding a 21 percent reduction in breast-cancer mortality. The bad news is that
approximately three-quarters of breast cancer mortality risk remained despite screening,
highlighting the need for prevention measures rather than relying solely on cancer
detection.
UK Trial of Early Detection of Breast Cancer group. 16-year mortality from
breast cancer in the UK Trial of Early Detection of Breast Cancer. Lancet
1999;353:1909-14.
Alexander FE, Anderson TJ, Brown HK, et al. 14 years of follow-up from the
Edinburgh randomised trial of breast-cancer screening. Lancet 1999;353:1903-8.
© 1999, PHOTODISC
DES Dangers May Extend to Grandchildren
Diethylstilbestrol
(DES), a drug for preventing miscarriages, was prescribed to an estimated 4.8 million
pregnant women from the mid-1940s to 1971 before being linked to vaginal and cervical
cancer in their exposed children. At a recent conference on DES sponsored by the U.S.
Department of Health and Human Services, researchers reported two new concerns. First,
cancers may not appear until women reach their 40s, 50s, and 60s. In addition, because DES
given during pregnancy affects not only the fetus but also the tiny eggs developing within
the fetus' ovaries, risk may extend to the treated women's grandchildren.
© 1999, PHOTODISC
What Is It
about Those Vegetarians?
It's the fiber! It's the beta-carotene! No, it's the phytoestrogens! Scientists have
been trying to figure out why vegetarians have only about half the cancer risk of
meat-eaters. The latest plant supernutrient, beta-sitosterol, was lauded at the Federation
of American Societies of Experimental Biology by University of Buffalo nutrition
researcher Atif Awad, Ph.D. Beta-sitosterol was shown to inhibit the growth of breast
cancer cells in the test tube, cutting the number of cancer cells by 66 percent compared
to control cell cultures. Dr. Awad had previously found that beta-sitosterol inhibited
prostate cancer cell growth but did so by a different mechanism, inhibiting an enzyme
called PP2A, which is involved in cell growth.
Don't Thank
Fiber; Blame Meat and Milk
The very low rate of colon cancer among blacks in South Africa compared to whites is
probably not due to a high fiber intake but rather to a very low intake of animal
products, according to a recent study in the American Journal of Gastroenterology.
Colon cancer affects only 1 in 100,000 South African blacks and is 17 times more common
among whites. The cornmeal-based diet common among South African blacks is not
particularly high in fiber and is low in calcium. According to Stephen J.D. O'Keefe and
colleagues at the University of Capetown, the healthfulness of the diet comes from the
absence of "aggressive" factors such as animal protein and fat. Osteoporosis,
which is also linked to diets rich in animal protein, is also extremely rare among South
African blacks.
O'Keefe SJ, Kidd M, Espitalier-Noel G, Owira P. Rarity of colon cancer in
Africans is associated with low animal product consumption, not fiber. Am J Gastroenterol
1999;94:1373-80.
Herbal
Prostate Cancer Treatment Proves Its Worth
A mixture of Chinese herbs called PC-SPES has emerged from clinical testing to show
benefit against prostate cancer. The mixture includes saw palmetto, which is commonly used
to shrink an enlarged prostate, along with seven other herbs prepared by a southern
California company. Its name comes from the words "prostate cancer" and the
Latin word for "hope."
The treatment reduced the prostate-specific antigen (PSA) level, a blood marker
commonly used as an index of cancer activity, in all 27 men whose cancer had never been
treated by hormones and in 19 of 34 men whose cancers had grown resistant to ongoing
hormone treatments. The study was conducted by Eric Small and colleagues at the University
of California at San Francisco.
Meanwhile, high-fat diets were again linked to increased risk of benign prostate
enlargement, according to a new study conducted in Athens, Greece. Higher intakes of
butter and margarine increased risk, while fruit decreased risk.
Lagiou P, Wuu J, Trichopoulou A, Hsieh CC, Adami HO, Trichopoulos D. Diet and
benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. |