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Like to eat meat? Consider this unappetizing truth: When you gulp down a nice juicy steak or hamburger, you are contributing to tumor-fueling inflammation in your body.In fact, eating a diet rich in red meat has long been linked to a host of ills including an increased risk of several types of cancer. But what is it about meat consumption that could impact cancer growth? Now scientists at the University of California, San Diego School of Medicine, have found a mechanism that explains how eating red meat, as well as milk, could spur the growth of malignancies. The new study, headed by Ajit Varki, M.D., suggests that inflammation resulting from a molecule introduced through eating these foods could make cancer grow. The research is set for upcoming publication in the Proceedings of the National Academy of Sciences (PNAS).Dr.Varki, UC San Diego School of Medicine distinguished professor of medicine and cellular and molecular medicine and co-director of the UCSD Glycobiology Research and Training Center, and his research team studied a non-human glycan, or sugar molecule, known as N-glycolylneuraminic acid (Neu5Gc). Although this molecule is not produced naturally in the human body, it’s incorporated into human tissues if you eat red meat. The body then develops antibodies against Neu5Gc – and this immune response could potentially trigger a low-grade chronic inflammation, spurring the growth of cancer. In a statement prepared for the media, Dr. Varki explained it has been recognized by scientists for some time that chronic inflammation can stimulate cancer progression."We've shown that tumor tissues contain much more Neu5Gc than is usually found in normal human tissues. We therefore surmised that Neu5Gc must somehow benefit tumors,” Dr. Varki said in the press statement. So the scientists came up with this hypothesis: The fact that Neu5Gc accumulates in human tumors despite circulating anti-Neu5Gc antibodies suggests a low-grade, chronic inflammation has developed, and caused the tumor to grow. To test this idea, the researchers worked with specially bred mice. The animals lacked the Neu5Gc molecule , just as humans do before they eat red meat and the molecule is absorbed into their bodies, and they had tumors.Anti-Neu5Gc antibodies were given to half of the mice . In those animals, the antibodies induced inflammation and their cancers started growing faster. In the control group comprised of mice that were not treated with antibodies, their tumor growth was far less aggressive.Building on previous research that has shown that humans who take non-steroidal anti-inflammatory drugs (commonly known as NSAIDs) have a reduced risk of cancer, the researchers tried giving NSAIDs to the mice with cancerous tumors fueled by anti-Neu5Gc antibodies. The result? The anti-inflammatory treatment blocked the effect of the Neu5Gc antibodies and the tumors became smaller."Taken together, our data indicate that chronic inflammation results from interaction of Neu5Gc accumulated in our bodies from eating red meat with the antibodies that circulate as an immune response to this non-human molecule – and this may contribute to cancer risk," Varki said in the media statement.For anyone interested in reducing inflammation through natural, non-drug methods, here are seven top strategies to incorporate into your lifestyle:1. Stop eating meat and dairy products.2. Concentrate on a Mediterranean flavored style of eating with lots of fruits, vegetables, whole grains , olive oils and nuts. Research has shown these foods lower inflammation levels.3. Don’t smoke and avoid those who do – second hand smoke can contribute to inflammation.4. Know your oils. Avoid all inflammation-causing trans-fats, hydrogenated and partially hydrogenated oils as well as saturated animal fats. Instead, add inflammation-fighting omega-3 oils like flaxseed, canola and walnut oil to your diet.5. Lose weight if you need to. Research has shown that a waist that measures over 40 inches in a man or over 35 inches in a woman is a sign of probable high inflammation.6. Don’t skimp on sleep. Previous studies have concluded less than six hours of sleep can result in inflammation .7. De-stress. Try yoga, meditation, walking and other forms of exercise. Staying continually stressed out means your body is releasing excess, inflammation-promoting stress hormones . Schedule a minimum of 20 minutes a day to let your worries go.

Xeloda® and Eloxatin® Evaluated in Esophageal and Gastric Cancers



According to the results of a Phase III clinical trial published in the New England Journal of Medicine, it may be possible to replace 5-FU (5-fluorouracil) with Xeloda® (capecitabine) and to replace cisplatin (Platinol®) with Eloxatin® (oxaliplatin) in the treatment of advanced esophageal and gastric cancers.
For patients with advanced cancer of the esophagus, stomach, or esophagogastric junction (area where the esophagus joins the stomach), chemotherapy has been shown to improve survival. Chemotherapy drugs that are commonly used for these cancers include cisplatin and 5-FU.
Xeloda is an oral chemotherapy drug that offers a more convenient approach to treatment than 5-FU. Xeloda is currently approved for certain patients with breast and colorectal cancers. Eloxatin is also approved for colorectal cancer, and appears to offer advantages over cisplatin in this setting.
To explore the role of Xeloda and Eloxatin in advanced esophageal and gastric cancers, researchers conducted a Phase III clinical trial. The study enrolled 1,002 patients with locally advanced (inoperable) or metastatic cancer of the esophagus, esophagogastric junction, or stomach.
Patients were assigned to one of four treatment groups:
ECF (Ellence® (epirubicin), cisplatin, and 5-FU)
ECX (Ellence, cisplatin, and Xeloda)
EOF (Ellence, Eloxatin, and 5-FU)
EOX (Ellence, Eloxatin, and Xeloda)
One-year survival was 37.7% for ECF, 40.8% for ECX, 40.4% for EOF, and 46.8% for EOX.
Progression-free survival and response rates did not differ significantly across treatment groups. Overall survival was longer with EOX than with ECF.
Toxic effects of Xeloda and 5-FU were similar. Compared to cisplatin, Eloxatin was less likely to cause grade 3 or 4 neutropenia, hair loss, kidney problems, and blood clots, but slightly more likely to cause grade 3 or 4 diarrhea and neuropathy.
The researchers conclude that Xeloda is as effective as 5-FU and that Eloxatin is as effective as cisplatin. Xeloda and Eloxatin may be able to replace 5-FU and cisplatin in the treatment of advanced esophageal and gastric cancers.
Reference: Cunningham D, Starling N, Rao S et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. New England Journal of Medicine.

Esophageal Cancer Can Tolerate Chemoradiotherapy


Chemoradiotherapy (CRT) is an effective treatment and does not present major toxicity for elderly patients with esophageal cancer, according to the results of a study released in an early online publication of the November issue of the British Journal of Cancer.[1]
The esophagus is a tube that carries food from the mouth to the stomach. Esophageal cancer is relatively uncommon, but is one of the most aggressive and deadly forms of cancer. It is the eighth most common cancer, but the sixth cause of cancer death worldwide. Standard treatment for esophageal cancer may include chemotherapy, radiation therapy, and/or surgery.
Historically, treatment of elderly patients with esophageal cancer has been challenging because it is believed that the elderly cannot tolerate the side effects associated with treatment. However, there is very little data regarding the outcomes and side effects associated with CRT in elderly patients with locally advanced esophageal cancer.
Researchers in the UK conducted a study in 109 patients over the age of 70 with locally advanced esophageal cancer. The patients received CRT, consisting of radiation plus cisplatin-based chemotherapy. In this study, 38.5% of patients received the planned treatment, while 53.2% required a dose adjustment. Severe side effects (grade 3) occurred in 23.8% of patients, with 16.5% of patients being hospitalized.
Six to eight weeks after completing CRT, patients underwent endoscopy (examination of the esophagus through a long, lighted tube) and computed tomography scan (a series of detailed pictures of areas inside the body taken from different angles). The results indicated that 57.8% of patients experienced a complete response (total disappearance of cancer in response to treatment) and the two-year survival was 35.5%
The researchers concluded that CRT was an effective treatment for elderly patients, with no major side effects. In addition, they noted that their results showed that CRT in elderly patients produced similar response rates and overall survival as typically reported in younger patients treated with the same regimen

Guidelines Do Not Recommend Endoscopy for GERD

The American Gastroenterological Association (AGA) has released a medical position statement that recommends against using endoscopy for the screening of patients with gastroesophageal reflux disease (GERD). These results were recently published in the journal Gastroenterology.
GERD, also referred to as heartburn, is a condition in which the acidic contents of the stomach back up into the esophagus (the tube that connects the throat to the stomach). GERD may be responsible for the irritation of tissues of the esophagus, a condition referred to as Barrett’s esophagus. Ultimately, chronic GERD and Barrett's esophagus may be associated with an increased risk of esophageal cancer.
The AGA is a medical association comprised of physicians that specialize in gastroenterological disorders, which include conditions of the esophagus, such as GERD and esophageal cancer. Researchers have been evaluating ways in which to screen for esophageal cancer so that the disease may be caught and treated early, in its most curable stages.
Members of the AGA recently evaluated data involving patients with GERD and screening for esophageal cancer, including the use of endoscopy. Endoscopy is a procedure in which a lighted tube is advanced through the mouth, esophagus and stomach. The data evaluated was obtained from literature searches regarding screening practices and outcomes among patients with GERD.
Overall, no survival was demonstrated among patients undergoing screening endoscopy.
The majority of patients diagnosed with esophageal cancer had not received a prior diagnosis of GERD. As a result, the AGA concluded that screening endoscopy is not a necessary precaution for individuals with GERD. Guidelines for the management of GERD consisted mainly of pharmaceutical drugs, surgery and/or lifestyle modification.
Patients with GERD should speak with their physician regarding their individual risks and benefits of screening and treatment for their condition, as guideline recommendations are not tailored to the individual.
Reference: Hiltz S, et al American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease. Gastroenterology

Confirms Increased Incidence of Adenocarcinoma of the Esophagus in White Americans


Researchers from the National Institutes of Health have reported that between 1975 and 2004, the incidence of adenocarcinoma of the esophagus increased by 463% in White males and 335% in White females. The details of this study appeared in an early online publication in the Journal of the National Cancer Institute on August 11, 2008.
The esophagus is the tube that connects the back of the mouth to the stomach. Esophageal cancer is relatively common and is very deadly. It 1998 there were approximately 12,300 new cases of esophageal cancer diagnosed in the United States and nearly 12,000 esophageal cancer deaths, making esophageal cancer one of the most deadly of all cancers. Most cancers of the upper two-thirds of the esophagus arise from a type of cell called squamous cells. Cancers of the lower esophagus most often arise from cells called columnar epithelium and are referred to as adenocarcinomas of the esophagus.
In the recent past, squamous cell cancers made up more than 80% of all esophageal cancers. Over the past two decades, there has been a dramatic increase in the incidence of adenocarcinomas, which now account for one-third to one-half of all esophageal cancers. Thus, the recent increase in the overall incidence of esophageal cancer is almost entirely due to the increase in adenocarcinomas.
Environmental factors such as smoking, drinking, and obesity have long been known to be associated with an increased incidence of gastric and esophageal cancers. It is also well recognized that gastroesophageal reflux plays a role in causing esophageal cancer.
The current study is the best documentation of the increased incidence of adenocarcinomas of the esophagus. Using data from the Surveillance, Epidemiology, and End Results (SEER) program, these authors compared the incidence of adenocarcinoma of the esophagus in the 1975-1979 period with the most recent data from 2000-2004.
Between 1975 and 2004 the incidence increased 463% among White males and 335% among White females.
The incidence rose in all age and stage groups and was not due to increased surveillance.
The researchers concluded that the incidence of esophageal cancer has risen significantly over the past 30 years, specifically adenocarcinoma of the esophagus. Although the exact causes of the increased incidence are unclear, a significant factor may be the increasing obesity of the U.S. population

According to an article recently published in the journal Gut, individuals who are obese and have frequent symptoms of acid reflux have a significantly increased risk of developing esophageal cancer compared with the general population.
The esophagus is the tube through which food and liquid travel from the back of the throat to the stomach. There is a muscular ring at the bottom of the esophagus (the point where the esophagus and stomach meet) that allows material to pass into the stomach. This muscular ring also stops stomach acid from coming back into the esophagus. This muscle, however, does not entirely close in some individuals, resulting in acid coming back into the esophagus; this condition is referred to as acid reflux or gastro-esophageal reflux. It is thought that acid reflux may increase the risk of developing esophageal cancer as stomach acid damages the lining of the esophagus.
Researchers from Australia recently explored the relationship between obesity, acid reflux, and the risk of esophageal cancer. This study included approximately 700 individuals with esophageal cancer who were compared with 1,580 individuals who did not have esophageal cancer.
Individuals who were obese and had frequent symptoms of acid reflux had more than a 16-fold increase in the risk of developing esophageal cancer compared with individuals who were either obese without symptoms of acid reflux or those with symptoms of acid reflux who were not obese.
Obesity itself was associated with a significantly increased risk of developing esophageal cancer in all patients, but males and patients under 50 years of age had the greatest risks of esophageal cancer associated with obesity.
Acid reflux itself was also significantly associated with an increased risk of developing esophageal cancer.
The researchers concluded: “From a clinical perspective, these data suggest that patients with obesity and frequent symptoms of gastro-oesophageal reflux are at especially increased risk of [esophageal cancer].”
Patients who are obese and have frequent symptoms of acid reflux may wish to speak with their physician regarding screening for esophageal cancer.
Reference: Whiteman D, Sadeghi S, Pandeya N. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57:173-180.

ANN ARBOR, Mich - The rapidly climbing obesity rates in the United States have created a higher risk of esophageal cancer linked to reflux disease. And this has some surgeons wondering if a currently popular procedure to remove the esophagus is as safe in obese patients.According to a new study at the University of Michigan Health System, obese patients who underwent a procedure called transhiatal esophagectomy primarily for esophageal cancer had outcomes similar to their lean counterparts. "The type of patient who currently develops esophageal cancer has changed dramatically in the last 20 years. Esophageal cancer used to be primarily squamous cell carcinoma found in people who drank alcohol and smoked excessively. In association with the horrendous epidemic of obesity in this country, we have seen a 350 percent increase of adenocarcinoma over the last 30 years. This is related to more gastroesophageal reflux and Barrett’s esophagus in these patients," says Mark Orringer, M.D., John Alexander Distinguished Professor of Surgery at the U-M Medical School.Orringer and lead study author Christopher Scipione, a U-M medical student, will present the study results Tuesday, Jan. 30, at the Society of Thoracic Surgeons 43rd annual meeting in San Diego.Adenocarcinoma of the esophagus is often the result of chronic reflux disease. When acid continuously backs up into the esophagus, it wears down the natural lining. This can cause a condition called Barrett’s esophagus in which the body replaces the normal esophageal lining with one similar to that found in the intestines. People who develop Barrett’s are at a higher risk of developing adenocarcinoma.Transhiatal esophagectomy, or THE, is an operation in which most of the esophagus is removed without the need to open the chest, and swallowing is restored by pulling the stomach to the neck and connecting it there to the remaining esophagus. THE is used to treat esophageal cancer and Barrettآ’s esophagus with severe precancerous changes. It was originally developed at the University of Michigan as a surgical alternative to removing the esophagus by going through the chest, a much more difficult operation for the patient. The researchers sought to determine if THE is a safe procedure for the growing number of obese patients requiring esophageal surgery. They pulled the records of 133 profoundly obese patients who had this surgery at U-M between 1977 and 2006. Profound obesity was defined as a body mass index of 35 or more. Those 133 patients were matched to a randomly selected control group of non-obese patients undergoing the same procedure. Both groups were matched for factors including gender, age, year of operation and pre-existing medical conditions.After comparing measures such as hospital length of stay, infection and mortality, the researchers found both groups had comparable outcomes. This suggests the THE procedure is safe to perform in obese patients. The study authors stress, however, that the results may be influenced by the high volume of patients U-M surgeons see for this procedure. U-M surgeons perform 120 to 150 transhiatal esophagectomies each year and have completed more than 2,000 of these procedures in total. Because the procedure in obese patients is more demanding on surgeons, the results may not be the same in hospitals that see relatively few patients in need of an esophagectomy."Profoundly obese patients undergoing a THE at a high-volume center can have surprisingly and acceptably low morbidity and mortality rates, similar to those of non-obese individuals matched for co-morbidities," says Orringer, head of the U-M Section of Thoracic Surgery and co-director of the Thoracic Oncology Program at the U-M Comprehensive Cancer Center.Currently about 85 percent of esophageal cancers removed in this country are adenocarcinomas, most related to obesity and reflux disease, and 15 percent are squamous cell carcinomas, typically due to smoking or alcohol consumption. Two decades ago, those numbers were reversed."Reflux is an extraordinarily common problem now, and it’s because we’re a fat society. If heartburn is persistent or chronic, patients should have a thorough exam and endoscopy to see if they have developed Barrett’s esophagus, which carries an increased risk of cancer and signals the need for close surveillance with periodic endoscopies and biopsies," Orringer says.About 14,500 people will develop esophageal cancer this year. For more information on this disease, contact Cancer AnswerLine at 800-865-1125 or visit