Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Temple researcher shows diabetes, blood pressure link to colon cancer recurrence, survival

20.12.2012
By all accounts, a combination of colon cancer, diabetes and high blood pressure can be a recipe for medical disaster.

Now, a new study led by a surgical oncologist and researcher at Temple University School of Medicine and Fox Chase Cancer Center has shown just how deadly this mix can be.

In a retrospective analysis of more than 36,000 patients with colon cancer, investigators showed that those with early stage disease and diabetes or high blood pressure – two components of metabolic syndrome – have a greater risk for the cancer returning after treatment and of dying compared to patients with colon cancer who do not have either condition.

"Although metabolic syndrome has been linked to colon cancer, the third leading cause of cancer death in the U.S., previous work looking at its effect on mortality has not adequately accounted for cancer stage or treatment," said senior author Nestor Esnaola, MD, MPH, MBA, Chief of the Division of Surgical Oncology, Professor of Vice-Chair of Clinical and Academic Affairs in the Department of Surgery at Temple University School of Medicine.

"Our results suggest that patients with early stage colon cancer who also have diabetes or hypertension may need to be followed more closely for recurrence and could potentially benefit from broader use of adjuvant chemotherapy." Dr. Esnaola and his team reported their findings December 20, 2012 in an early online publication in the journal CANCER.

Metabolic syndrome is a cluster of conditions that affects one in five American adults and which can include diabetes, obesity, high blood pressure, low levels of good cholesterol and high amounts of lipids in the blood.

To better understand the effect of metabolic syndrome on colon cancer outcomes, Dr. Esnaola and his team linked data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program, a large population-based database, to Medicare data from 1998 to 2006 on 36,079 patients with colon cancer, including 7,024 patients (19.5 percent) who were identified as having metabolic syndrome. They analyzed the effect of metabolic syndrome and its components on colon cancer recurrence and overall survival, controlling for various sociodemographic factors, tumor factors, other medical conditions and cancer treatment received.

"Metabolic syndrome as a whole had no apparent effect on colon cancer recurrence or survival," said Dr. Esnaola, who is also an attending surgeon at Fox Chase Cancer Center. "When we teased out and analyzed the effect of each of its components, however, the data told a different story."

The researchers found that among patients with early stage disease, patients with diabetes or high blood pressure had a significantly greater risk of cancer recurrence rate and death after treatment. For example, 47.7 percent of patients who did not have diabetes were still alive five years after diagnosis compared to only 41.3 percent of patients with diabetes. When the researchers looked more closely, they also found that cancer recurrence rates at five years were approximately 8 percent higher in patients with diabetes or hypertension.

In contrast, the analysis showed that patients with abnormally high levels of lipids in the blood had a lower risk of recurrence and death from colon cancer. Overall, 39 percent of patients with normal lipid levels were still alive after five years, compared to 52.7 percent of patients with abnormal levels. Cancer recurrence rates were approximately 11 percentage points lower in patients with abnormal lipid levels.

"Although we did not have data on medication for these patients, we suspect that the higher survival and lower recurrence rates observed in patients with high lipid levels in our study group were likely due to the protective effects of statins," Dr. Esnaola said. Statins are drugs that are widely used to lower cholesterol and lipid levels and have been shown to lower the risk of developing colon cancer in people.

"To our knowledge, this is the largest study to date controlling for cancer stage and treatment that has analyzed the effect of metabolic syndrome and its components on colon cancer recurrence and survival," said Dr. Esnaola. "The adverse effects of diabetes and hypertension in early stage patients and apparent protective effect of high blood lipids observed in our cohort suggest that when it comes to metabolic syndrome and cancer outcomes, the devil is in the details."

Dr. Esnaola currently is investigating the effect of metabolic syndrome and its components on other cancer types, and plans to confirm these results in a larger set of data that contains information on cancer stage, treatment and medication. "In the interim, our results underscore the need for clinical trials to define the true benefits of (the diabetes drug) metformin and statins in patients with early stage colon cancer," he said.

Other investigators contributing to this research include: Yang Yang and Baorui Liu, Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China; and Patrick D. Mauldin, Myla Ebeling, Thomas C. Hulsey, Melanie B. Thomas, and E. Ramsey Camp, Medical University of South Carolina, Charleston.

This research was supported in part by the Nanjing Drum Tower Hospital Health, Education, and Research Foundation.

About Temple Health

Temple Health refers to the health, education and research activities carried out by the affiliates of Temple University Health System and by Temple University School of Medicine.

Temple University Health System (TUHS) is a $1.4 billion academic health system dedicated to providing access to quality patient care and supporting excellence in medical education and research. The Health System consists of Temple University Hospital (TUH), ranked among the "Best Hospitals" in the region by U.S. News & World Report; TUH-Episcopal Campus; TUH-Northeastern Campus; Fox Chase Cancer Center, an NCI-designated comprehensive cancer center; Jeanes Hospital, a community-based hospital offering medical, surgical and emergency services; Temple Transport Team, a ground and air-ambulance company; and Temple Physicians, Inc., a network of community-based specialty and primary-care physician practices. TUHS is affiliated with Temple University School of Medicine.

Temple University School of Medicine (TUSM), established in 1901, is one of the nation's leading medical schools. Each year, the School of Medicine educates approximately 720 medical students and 140 graduate students. Based on its level of funding from the National Institutes of Health, Temple University School of Medicine is the second-highest ranked medical school in Philadelphia and the third-highest in the Commonwealth of Pennsylvania. According to U.S. News & World Report, TUSM is among the top 10 most applied-to medical schools in the nation.

Steven Benowitz | EurekAlert!
Further information:
http://www.temple.edu

More articles from Health and Medicine:

nachricht Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center

nachricht Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: The pyrenoid is a carbon-fixing liquid droplet

Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.

A warming planet

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Rainbow colors reveal cell history: Uncovering β-cell heterogeneity

22.09.2017 | Life Sciences

Penn first in world to treat patient with new radiation technology

22.09.2017 | Medical Engineering

Calculating quietness

22.09.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>