Jewish World Review Jan. 10, 2003 / 7 Shevat, 5763
By Robert A. Wascher, M.D., F.A.C.S.
http://www.NewsAndOpinion.com |
The American Cancer Society estimates that nearly 14,000 new cases of
esophageal cancer will be diagnosed in the United States in 2003, the vast
majority of which will occur in men. Unfortunately, nearly 13,000 Americans
will die of this disease this year, as esophageal cancer generally spreads
to other sites in the body before it is diagnosed. In addition to male
gender, risk factors for esophageal cancer include tobacco abuse, heavy
alcohol consumption (and combined tobacco use and drinking, in particular),
chronic gastroesophageal reflux disease, and advancing age.
In view of the seriousness of this disease, the prevention of esophageal
cancer is of great importance. In the current issue of the journal
Gastroentereology is a review of research studies over the past 20 years
that addressed the effects of aspirin on the incidence of esophageal cancer.
This review, using a statistical method known as meta-analysis, identified a
protective effect against esophageal cancer with both continuous and
intermittent use of aspirin. The use of the aspirin-related class of drugs
referred to as nonsteroidal anti-inflammatory drugs (NSAIDs) also appeared
to confer protection against esophageal cancer. Intermittent use of these
medications resulted in an 18% reduction in esophageal cancer risk, while
regular or frequent intake of aspirin or NSAIDs reduced the risk of
esophagus cancer by 46%, An important observation was that aspirin and
NSAIDs appeared to protect against the development of both of the
predominant types of esophageal cancer (squamous cell carcinoma and
adenocarcinoma). The protective effects of these drugs were, in turn,
proportional to the frequency of their use.
This intriguing study offers encouraging evidence of an effective means of
preventing a very dismal disease. Of course, abstaining from tobacco and
excessive alcohol intake are important preventive measures as well. One bit
of caution here: check with your doctor before adding aspirin or NSAIDs to
your daily medication intake, as these drugs are all associated with an
increased risk of gastrointestinal bleeding and kidney disease.
THE IMPACT OF OBESITY ON LIFESPAN
The study identified significant differences in obesity-related premature
death across both gender and ethnic lines. Interestingly, younger obese
adults appeared to experience a greater shortening of their overall
lifespans than people who developed obesity later in life. White males
between the ages of 20 and 30 experienced a lifespan reduction of 13 years
if they were in the severe obesity BMI range, while young Caucasian women
with severe obesity experienced an average loss of 8 years. Based upon
these findings, severe obesity may result in the loss of more than 20% of
predicted lifespan for white males. Among black men and black women older
than 60, moderate obesity was not associated with a significant decrease in
lifespan. However, severe obesity in younger African Americans was
associated with an average lifespan reduction of 20 years for men and 5
years for women.
In summary, this study suggests that obesity, particularly during young
adulthood, is associated with a significant decrease in lifespan, especially
for males. Based upon this study, it is perhaps even more important that
younger adults, as opposed to middle-agers, adhere to that most common of
New Year's resolutions. Indeed, this study strongly suggests that the
presence of severe obesity during early adulthood poses a greater threat of
eventual obesity-related mortality than does the onset of obesity much later
in life.
In a related study, published in the current issue of the Annals of Internal
Medicine, life expectancy rates for overweight and obese participants in a
large long-term study of heart disease trends were evaluated. Approximately
3,500 participants in the renowned Framingham Heart study were assessed
between 1948 and 1990 in this study. Overweight men and women who were 40
years old at the onset of the study lost an average of about 3 years of
lifespan when compared to men and women of normal weight. Men who were
frankly obese at age 40 lost almost 6 years of lifespan, while women who
were obese at age 40 lost about 7 years of lifespan. Obese men and women
who also smoked fared even worse. When compared to the statistical impact
of smoking on lifespan, significant obesity during early adulthood was found
to cause comparable reductions in lifespan as did tobacco abuse.
Both of these studies indicate that significant obesity during early
adulthood substantially increases the risk of premature death later in life.
Eat less, exercise more... live longer.
HORMONES & BREAST CANCER
The authors used the National Cancer
Institute's annual cancer statistical summary to study breast cancer trends
between 1992 and 1998. They specifically looked at the differences in
breast cancer estrogen receptor (ER) and progesterone receptor (PR) status.
The expression of these sex hormone receptors on breast cancer cells is
associated with a generally more favorable prognosis than breast cancers
which lack these receptors. The ER and PR status of breast cancer tumors
may also say something about the mechanisms involved in breast cancer
development, as different cancer development pathways may be involved for
tumors as a function of their hormone receptor status.
The study determined that the percentage of breast cancers containing ER
and/or PR increased during the study period. At the same time, the overall
incidence of breast cancers that did not express ER and PR remained steady.
The authors, therefore, conclude that the increase in breast cancer
incidence during the study period arose primarily due to an increase in
tumors that were positive for ER and/or PR. As hormonal factors are thought
to play a relatively greater role in ER-positive and PR-positive breast
cancers, this study provides some evidence for a hormonal basis, at least in
part, for the sustained increase in the incidence of breast cancer in the
United States.
A DRINK TO YOUR HEALTH!
More than 38,000 male health
professionals participated in this study for an average off 12 years, and
all study participants were free of cardiovascular disease and cancer at the
beginning of the study. Their consumption of beer, red wine, white wine and
liquor was individually evaluated, and the incidence of heart attacks in
this population was assessed.
Men who consumed alcohol 3-4 days per week experienced a 32% decrease in
their risk of heart attack when compared to men who drank alcohol less than
once per week. Consumption of alcohol 4-5 times per week translated into a
36% reduction in the risk of heart attack, and alcohol consumption with
meals was equally effective as alcohol consumed without food. This benefit
held up for all of the alcoholic beverages studied.
This study offers strong evidence linking moderate alcohol intake with
protection against cardiovascular disease, at least in males. Remember, of
course, to drink alcohol responsibly.
JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at
the John Wayne Cancer Institute in Santa Monica, CA.
Comment by clicking here.
Can Aspirin Prevent Esophageal Cancer?
By now, almost everyone knows that Americans face a virtual epidemic of
obesity. Most of us also know that this condition is associated with an
increase in the risk of high blood pressure, cardiovascular disease,
diabetes, and premature death. A new study in the current issue of the
Journal of the American Medical Association looks at the association between
various levels of obesity and lifespan. The study's authors used government
databases to correlate age at death with a measure of obesity known as body
mass index (BMI). The authors then compared average age at death for
various degrees of obesity.
The incidence of breast cancer increased approximately 0.5% per year between
1987 and 1998. The cause-or causes-for this sustained increase in breast
cancer cases has been the subject of a great deal of debate. In the current
issue of the Journal of Clinical Oncology is a report that sheds additional
light on this worrisome trend.
Moderate alcohol intake has been shown to reduce the risk of cardiovascular
disease and stroke, while heavy drinking is associated with an increased
risk of liver disease, cancer and dementia. A study in this week's New
England Journal of Medicine looked at the association between alcohol intake
and the risk of cardiovascular disease.
01/06/03:"The Pill" for Males?; Obesity & Diabetes Trends in the United States; Binge Drinking in the United States; One Less Reason to be Depressed; Liver Failure: Trends
12/20/02: Citrus Pectin & Cancer; Echinacea & the Common Cold; Update on High Blood Pressure Treatment
12/06/02: Calcium Intake & Prostate Cancer Risk; Alcohol Consumption & Risk of Breast Cancer; Reducing Blood Transfusions in Critically Ill Patients
12/06/02: Alcohol, Tamoxifen & Carotid Artery Wall Thickness; Coffee & Gallstones?; Irritable Bowel Syndrome Update; Statins: More Good News
11/22/02:Alcohol, HRT & the risk of breast cancer; hormone replacement therapy: more bad news; new vaccines may eliminate cervical cancer; more
11/15/02: The Effects of Diet & Exercise on Blood Pressure & Health; Growth Hormone & Sex Steroid Supplements & the Elderly; C-Reactive Protein & Cardiovascular Disease Risk
11/08/02: More Good News About Statin Drugs; Hormone replacement Therapy (HRT) & Alzheimer's Disease; A Role for Antibiotics in the Treatment of Vascular Disease?; more
11/01/02: Digoxin & gender; driving & degenerative disc disease; Coenzyme Q10 & Parkinson's Disease; Ginseng & erections; Viagra & stroke
10/25/02: Aspirin & coronary artery bypass surgery; glucosamine sulfate & progression of knee arthritis; hospital nurse staffing & patient mortality
10/18/02: Motor Vehicle Exhaust Pollution & Mortality; CT Scans, C-Reactive Protein & Heart Disease; Antiperspirant Use & the Risk of Breast Cancer; Atomic Bomb Radiation Exposure Update; more
10/04/02: Antioxidants & the Risk of Stomach Cancer; Best Way to Diagnose Appendicitis?; Coronary Artery Disease: Stent or Surgery?
09/27/02: Breast Feeding & the Risk of Asthma; HMOs & Quality of Care Scores; Red Wine & Vascular Disease
09/20/02: Dietary Folate & the Risk of Colorectal Cancer; Risks Associated with Smoking after Heart Attacks; BRCA1 Gene Mutation & the Risk of Breast & Non-breast Cancers; Breast Tissue Density & Inheritance
09/13/02: Dairy Products, Calcium, Vitamin D & the Risk of Breast Cancer; Efficacy of Nonprescription Smoking Cessation Aids; A Nutty Approach to Heart Disease Prevention; Update on Prostate Cancer
09/06/02: C-Reactive Protein & Estrogen Replacement Therapy; Walking Women & Cardiovascular Disease; Physical Activity Among Teenaged Girls
08/30/02: Babbling babies & brain function; homocysteine levels, vitamins & coronary artery disease; St. John's Wort & chemotherapy
08/16/02: A New Weapon Against Anthrax?; cataracts & motor vehicle accidents; gingko biloba takes a hit; air pollution & heart function during exercise; breast cancer genes & the estimated risk of breast cancer
08/09/02: Botulinum Toxin & Post-Stroke Spasticity; Intestinal Hormone Kills Appetite; Bone Marrow Cells Improve Blood Flow in Vascular Disease; Effectiveness of Restraining Orders on Domestic Violence
08/02/02: Mammography Saves Lives!; Obesity & the Risk of Heart Failure; High Sugar Diets & the Risk of Colon Cancer; Abuse During Childhood & Possible Effects of Genes on Antisocial Behaviors
07/26/02: Cancer: Nature vs. Nurture; Cardiorespiratory Fitness & Inflammation; Kidney Transplants from Cadaver Donors; Aircraft Cabin Air Recirculation & the Common Cold
07/19/02: PCBs & the Gender of Babies; Breastfeeding & the Risk of Breast Cancer; More Bad News About Hormone replacement Therapy
07/12/02: A cancer surgeon's perspective on hormone replacement therapy
07/08/02: Hormone replacement therapy & the risk of disease; more good news about statins; antioxidant vitamins & disease prevention; more
06/28/02: Antioxidants & the Risk of Alzheimer's Disease; Effects of Exercise on the Hearts of Patients with Mild Hypertension; Statins reduce cardiac events following angioplasty; more
06/21/02: Sex & violence and Advertising: Do Advertisers Get What they Pay For?; Don't Drink the Water (or the Salsa Either!); Vasectomy & Prostate Cancer Risk; Update on Smoking & Disease
06/14/02: Young Men, Obesity & Heart Disease; Breastfeeding & Obesity; Irritable Bowel Syndrome & rectal pain threshold; more data on cox-2 inhibitors & cancer; more
06/07/02: New coronary artery stent reduces risk of restenosis; possible cause of Parkinson's Disease identified; more
05/31/02: New biological insights into obesity & weight loss; broccoli kills cancer-causing stomach bug; anti-inflammatory drugs and the risk of heart attack
05/24/02: Molecular detection of tumor cells in the blood & prognosis; Cox-2 & breast/lung cancers; BRCA2 gene mutations & the risk of breast cancer; breast density & the risk of breast cancer
05/19/02: Moderate alcohol intake and blood sugar levels; more good news for tea drinkers; blood potassium levels & the risk of cardiovascular disease; ethnic differences in diabetic complications
05/10/02: Tea drinkers and the risk of death following heart attack; duration of breastfeeding & adult intelligence; abdominal aortic aneurysms: surgery or observation?
05/03/02: Risk of adverse drug reactions from newly released medications; preoperative beta-blockers may reduce heart bypass deaths; shape-shifting plastics may alter surgical practice; weight loss
supplement may cause liver damage
04/26/02: Angry young men & risk of premature cardiovascular disease; stay-at-home dads & risk of
cardiovascular disease; more on the effects of statins; dairy consumption and the risk of
pre-diabetes; smallpox vaccine: good to the last drop?
04/19/02: Change your sex by drinking water?; Anti-inflammatory RXs may reduce growth of breast cancer cells; radiation treatment reduces repeat narrowing of bypass grafts
04/05/02: Fish & Omega-3 fatty acid consumption and cardiac health; news briefs
04/05/02: Can coffee reduce your risk of tooth decay?; exercise & blood pressure; a single high-fat meal reduces coronary artery function
04/01/02: Pre-diabetes: a newly defined category of
health risk; teen television viewing and subsequent
aggressive behavior; the benefits of strength training
in the elderly; more ...
03/22/02: Bacteria, antibiotics & heart disease; mammograms: the debate continues; calcium & the risk of colon cancer ... and more
03/15/02: Mammography debate continues; statins & fracture risk; physical fitness & the risk of death; other intriguing findings
03/08/02: Blows to the chest & sudden cardiac death; air quality & the risk of lung cancer; tomatoes and your prostate
03/01/02: Diet & the risk of ovarian cancer; lifetime risk of developing high blood pressure; Osteoporosis prevention with a once-a-year injection?
02/26/02: The continuing controversy regarding screening mammography
02/22/02: Lowering body temperature after heart attack improves outcome; A silver lining for the chronically sleep-deprived?
02/15/02: Hormone replacement therapy & the risk of breast cancer; use it or lose it: Alzheimer's disease
& cognitive stimulation; stress, divorce & death; child daycare, infections & parental guilt
02/08/02: Possible breakthrough in early cancer diagnosis; mammography: the controversy continues; CPR techniques revisited
02/01/02: Antibiotics in livestock feed & human disease; genetic detection of early colon cancer in the stool; genetic analysis of breast cancers may help decide treatment
01/25/02: Drug increases lifespan (if you're a fly...); workplace attitudes and smoking cessation; effects
of inadequate sleep on surgeons
01/18/02: Lifelong effects of premature birth; smokers under the knife; aspirin and cardiovascular health
01/11/02: Estrogen levels in the blood & breast cancer risk; Heart attack: sex and survival; dangerous lettuce invaders
01/09/02: Cancer & aging: Two sides of the same coin?
01/04/02: Vitamin a & the risk of hip fracture in postmenopausal women; ovarian cancer risk and oral contraceptives
12/28/01:
Magnetic Resonance Imaging (MRI) detects
coronary artery disease; new development in
obesity research; adverse childhood experiences &
the risk of suicide attempts
12/21/01: Vaccination of children controls hepatitis a in the community; a possible cure for sickle cell disease; leptin and the risk of heart attacks
12/14/01: Chernobyl and the Risk of Thyroid Cancer in hildren; children & obesity; gastroesophageal reflux disease update
12/07/01: Update on school shootings; new implantable heart-assist device approved for further evaluation; prevention of fungal infections in pre-term babies
11/30/01: Flu vaccination in asthmatics; low-tar cigarettes are not less harmful; beans and your heart
11/21/01: Modified smallpox vaccine may reduce risk of cervical cancer; New approach to breast cancer diagnosis; New non-invasive prenatal diagnostic test for down's syndrome
11/16/01: Cholesterol-lowering drugs reduce risk of heart attack; supplemental radiation therapy reduces risk of breast cancer recurrence; brains of women may answer age-old questions
11/09/01: Bio-warfare (redux); my gray matter is bigger than yours; mad elk disease?
11/02/01: Making sense of bio-warfare
10/26/01: The impact of mammography on deaths due to breast cancer; diet & exercise may slow cancer cell growth; antidepressants and the risk of heart disease
10/19/01: New insights into autism; the wiley appendix
10/12/01: More bad news about obesity links to other diseases…Hey dad, can I borrow the car keys?
10/05/01: California leads nation in reduction of tobacco-related disease; exercise as an antidepressant?
09/25/01: Advances in the detection of breast cancer; primary care physician awareness of peripheral arterial disease; arsenic in the water
09/17/01: In perspective
09/12/01: Genes may hold secret to long life; men and women: cognitive function in the elderly; physical activity, obesity and the risk of pancreatic cancer
09/05/01: English milk cows prefer Beethoven and Simon & Garfunkel over
Bananarama; new prostate cancer prevention study: looking for a few good men; exercise & diet can help prevent diabetes
08/28/01: Arthritis drugs may be linked with increased risk of heart disease; errors in blood clotting tests can be fatal; infant soy formula not associated with reproductive side effects