Colon Cancer News has been a bit thin on the ground recently . . . Your reporter has been overwhelmed with illness and holidays. Watch for bigger and better posts in January 2003.

Having a primary care physician is a key element in screening colonoscopy (American Journal of Gastroenterology) A study of outpatients at the Mayo Clinic who had never been screened for colon cancer and those who had revealed that:more screened patients had a primary care provide (80% of never screened vs 95% of screened)

Screened patients were more likely to have had prior screening mammography (87% of non-screened women vs. 95% screened women)
Never-screened patients had less understanding of the incidence and treatment outcomes of colon cancer.

Both groups ranked the four most commonly reported deterrents to screening colonoscopy similarly: volume of bowel preparation, adequate pain control, no recommendation from primary physician, and embarrassment equally.

The study questionnaires were analyzed by Gavin C. Harewood M.D. a , Maurits J. Wiersema M.D. a * and L. Joseph Melton III M.D. from the Mayo Clinic in Rochester, MN and published in Volume 97, Issue 12 of The American Journal of Gastroenterology.

Read the abstract here.

Quality of life differences between laparoscopically assisted colectomy and open colectomy for colon cancer are not as great as previously assumed -- (Medscape Today) December 5, 2002

Results from a randomized trial comparing laparascopic assisted colectomy (LAC) with traditional open colectomy (OC) in 578 patients in 37 centers showed only a small difference in quality of life after surgery. QOL assessments were completed at 2 days, 2 weeks, and 2 months post surgery. The only statistically significant difference was in the global rating scale score at 2 weeks postsurgery (76.9 for the LAC group vs 74.4 for the open colectomy group

LAC patients spent slightly less time on both IV and oral pain medication (mean, 3.2 vs 4.0 days for IV analgesics and mean, 1.9 vs 2.2 days for oral analgesics. Median hospital stay was slightly shorter at 5.6 days for LAC versus 6.4 days for OC.

Alan P. Venook, MD writes an editorial in JAMA accompanying the research article. He points out that the randomized trial results were somewhat different that earlier Phase II trials. He speculates that one reason might be that the post-surgical care in the trial was carefully controlled. Patient controlled analgesia, epidurals, and aggressive diet advancement were all part of the trial design.

Venook suggests that the lack of QOL differences may be in the better post-surgical care in the OC arm, care that is not always provided by more conservative surgeons.

LAC is more expensive and requires special equipment and more operating room time.

Both the study authors and Dr. Vernook conclude that QOL differences are not sufficient to call for replacement of open colectomy with LAC until additional studies of recurrence and survival are completed.

The full article appears in:

Weeks JC, Nelson H, Gelber S, et al.
JAMA. 2002;287:321-328.

Read the abstract here on MedScape.

Is there really an anti-cancer diet? WASHINGTON (AP) December 3, 2002 -- The National Cancer Institute is recruiting 32,000 men to study the effect of selenium and Vitamin E in preventing prostate cancer. However, the researchers expect to find that not every individual will benefit from dietary change.

John Milner, one of the study leaders, says, "In five years, we'll have a lot of information on how your gene profiles influence your response to different foods."

Links between genetics and metabolism of various foods may help show why the evidence for nutritional benefit of foods like brocolli, tomatoes with olive oil, and garlic appear to reduce cancer risk in some groups and not in others. To this point much of the research on food and cancer has been done in animal models or by asking people to remember what they ate. The prostate study is prospective -- risk will be assessed five years after supplemental selenium and vitamin E programs begin.

Read the article on CNN.com