Experts Highlight Inroads to Preventing Cancer

(HealthDay News) -- Scientists looking at everyday factors that influence cancer risk are finding important new clues that could affect cancer prevention strategies.

"Many of us believe that prevention is better than trying to identify drugs for people after they get cancer," said Dr. Peter Shields, deputy director of the Lombardi Comprehensive Cancer Center and interim chairman of the Department of Medicine at Georgetown University Medical Center in Washington, D.C. "As we understand risk factors better, it may be possible to personalize cancer prevention."

Shields moderated a Monday teleconference highlighting cancer prevention-related findings that are being presented at the annual meeting of the American Association for Cancer Research, in Denver.

One study found that two common gene variants do not protect individuals from the ill effects of smoking.

In the study, smoking boosted the odds for the two most common types of colorectal polyps: adenomas and hyperplastic polyps, although the association was stronger in the latter.

People who had smoked a pack of cigarettes a day for a year had a 68 percent increased risk for adenomas but a 238 percent increased risk for hyperplastic polyps. Those still smoking had the same risk for adenomas as former smokers but a more than threefold increased risk for the second type of polyp.

Polyps can be precursors to colon cancer, but if they're detected early, the disease can often be prevented.

There was also a slight though not statistically significant risk from "charred" (well done) meat.

"Susceptibility to smoking did not vary by this gene, and everyone needs to be concerned [about the risk of smoking]," said Andrea N. Burnett-Hartman, a doctoral student at the Fred Hutchinson Cancer Research Center in Seattle.

"This gene is not going to protect you from the carcinogenic effects of smoking, at least in colorectal tissue," she said. In terms of meat consumption, she added that "everything in moderation" remains a good rule.

Another study found that specific genetic variations in the cox-1 and cox-2 genes indicate different risks for colorectal cancer. This might help determine who would benefit from the cancer-prevention benefits of nonsteroidal anti-inflammatory drugs (NSAIDs).

Although NSAIDs, including aspirin and cox-2 inhibitors, have been shown to reduce the risk of colorectal cancer, that benefit may be nullified by an increased risk of heart disease seen in some cox-2 inhibitors such as Vioxx, which was removed from the market.

Other findings being presented at the society's meeting include:

• A tool that looks simultaneously at several genetic variants and family history might more accurately predict who is at risk for prostate cancer and who could benefit from more aggressive prevention efforts. Men who had at least 15 of the gene variants included in the tool were found to have a 34 percent increased risk of developing prostate cancer in a 20-year span, or 45 percent increased risk if they had a family history of the disease. But without the combination of genetic information, their risk would have been estimated at only 13 percent.
• Rats born to mothers who had been given folic acid supplementation during and after pregnancy were found to have experienced changes in DNA methylation in both the liver and the colon. DNA methylation is a process whereby genes can be turned off or on. Folic acid is recommended before and during pregnancy to prevent neural tube defects in babies. Folic acid intake in North America has soared since these recommendations were implemented in 1998.
• Abnormal collections of cells were found in the blood of 38 percent of people with chronic lymphocytic leukemia (CLL) as early as 10 years before their diagnosis -- something that could be a clue in the so-far fruitless search for causes of the disease. "Apparently, these cells are cranking out proteins years before people get CLL," said Dr. Neil Caporaso, a section chief at the U.S. National Cancer Institute. "We can try to understand what causes people to get these abnormalities and, more importantly, what causes somebody to progress from having relatively benign protein abnormalities to developing leukemia. We can search for environmental agents and genes that could cause this next step."

More information
The American Cancer Society has more on preventing cancer.

Cancer Deaths Take Heavy Financial Toll

(HealthDay News) -- In pure economic terms of productivity lost and the expense of care-giving, cancer deaths cost the United States $232.4 billion in 2000 and will cost $308 billion in 2020, a new report finds.

But another way of measuring that toll includes the human element of years of life lost -- and that model placed the cost of cancer mortality at $960.7 billion in 2000 and projects it to reach $1.472 trillion in 2020.

Those two estimates appear in side-by-side papers published online Dec. 9 in the Journal of the National Cancer Institute. While the numbers differ widely, they are alike in one major respect, said Cathy J. Bradley, a professor of health administration at Virginia Commonwealth University and the Massey Cancer Center in Richmond, Va., and lead author of one of the reports.

"In both cases, the percentage of cost caused by lung cancer was about the same," Bradley said. "Lung cancer accounts for between a quarter and a third of the value of life lost."

The assessment made by Bradley and her colleagues used what is called the human capital approach, which looks strictly at money not earned or money spent because of cancer deaths. Lost productivity cost the country $115.8 billion in 2000. Adding in the cost of care-giving and lost household duties, as well as the loss of regular wage-earning jobs, more than doubled the total of that reckoning.

Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute, and lead author of the second paper, said her "calculation was based on willingness to pay. How much would an individual be willing to pay for an extra year of life?"

Estimates of that figure can vary, depending on the country. The Canadian government, for instance, has set the value of an added year of life at $50,000, a figure it uses to determine whether the national health program will pay for drug treatment, Bradley said. Her report used previous U.S. studies to set the value of an added year of life at $150,000. That estimate led to the $960.7 billion cost for the year 2000.

"Both of these methods are used in the medical literature," Yabroff said. "We thought it would be useful to compare them."

Large as the costs are, they reflect a decrease in the incidence of cancer in the United States. A report issued earlier this month said the rate for all cancers among men and women had dropped 0.8 percent a year between 1999 and 2005 -- a 1.8 percent a year decline for men and a 0.6 percent annual decline for women.

The human capital approach places a higher value on some people than others, Bradley added. For example, "Certain diseases inflict a lower cost because they affect older people more," she said. "Men tend to be valued higher than women, men in their middle years higher than men at the beginning of their career."

The findings could be used to affect cancer spending priorities, Bradley said.

"Policy makers have to decide if we focus on working-age individuals, if we focus on prevention or treatment," she said. "If you get people to stop smoking, 40 years later you see the cost of lung cancer come down. Or perhaps right now you would want to make an impact on treatment."



The assessment of cost is important because "it puts a dollar value on the fact that many people die of cancer at a younger age," Yabroff said.

"But," Bradley added, "you can argue that people are worth more than the wages they earn."

More information
The American Cancer Society has statistics on U.S. cancer deaths.

Health Tip: Maintain a Healthy Lifestyle

(HealthDay News) -- No one knows precisely why people get cancer, and there's no surefire cure.

But if you maintain a healthy lifestyle, you can help reduce your risk. Here are some suggestions, courtesy of AARP:

• Eat a healthy diet, including plenty of whole grains, fruits and vegetables. Limit intake of red meat, saturated fats, smoked and salt-cured foods, and foods preserved with nitrates.


• Get regular exercise of 30 minutes or more at least five days a week.


• Maintain a healthy body weight.


• If you drink alcohol, do so in moderation.


• Wear sunscreen and avoid prolonged exposure to direct sun during the midday hours.


• Get screened for cancers for which you may be most susceptible.

Melanomas on Scalp and Neck More Deadly

(HealthDay News) -- The most deadly melanoma skin cancers occur on the scalp and neck, says a University of North Carolina at Chapel Hill (UNC) study.

Researchers analyzed 51,704 melanoma cases in the United States and found that patients with scalp or neck melanomas died at 1.84 times the rate of patients with melanoma elsewhere on the body, including the face or ears.

The five-year survival rate for patients with scalp-neck melanomas was 83 percent, compared with 92 percent for patients with melanomas at other sites. The 10-year survival rate was 76 percent for scalp-neck melanomas and 89 percent for other melanomas.

The findings confirm that melanoma patient survival rates differ depending on where the cancer first appeared, the researchers said. The study was published in the April issue of the Archives of Dermatology.

Doctors need to pay close attention to the scalp when examining patients for signs of skin cancer, said senior author Dr. Nancy Thomas, an associate professor of dermatology in the UNC School of Medicine and a member of the UNC Lineberger Comprehensive Cancer Center.

"Only 6 percent of melanoma patients present with the disease on the scalp or neck, but those patients account for 10 percent of melanoma deaths. That's why we need to take extra time to look at the scalp during full-skin examinations," Thomas said in a prepared statement.

There has been debate about whether scalp and neck melanoma is more deadly primarily because it's diagnosed later than melanomas in other locations, but this study indicates that the presence of melanoma on the scalp or neck is, in itself, an indicator of poorer patient prognosis.

"We think there's something different about scalp and neck melanomas. This gives us directions for research to look at tumor cell types in those areas at the molecular level and to see if there are differences. I'm interested in identifying the mutations that drive malignancy," Thomas said.

The patients included in study were non-Hispanic white adults in nine states who were first diagnosed with invasive melanoma between 1992 and 2003. Patients with scalp-neck melanomas were more likely to be male and were an average age of 59 years, compared to 55 years for those with other melanomas.

Scalp-neck melanomas were thicker (0.8 millimeters) than other melanomas (0.6 millimeters) and more likely to be ulcerated. The study also found that lymph node involvement was more common in cases of scalp-neck melanomas.

More information
The American Academy of Family Physicians has more about melanoma.

Melanoma and skin cancer is usually a concern for adults who have basked in the sun for years. However, as Nancy Johnson reports, young children are also at risk as cases of melanoma in children has doubled in recent years. This medical segment focuses on the warning signs of Melanoma and ways to reduce risk.