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Mother & Son		Importance of Registries		Helping Others
Research Update		Code of Silence		Patient Advocacy
Patient Perspective

Answering Your Questions About:
• New Treatments • Fiber • Calcium
Are there any new treatments for colorectal cancer? I’ve heard about the possibility of a vaccine.
As a matter of fact, there have been some promising research developments in the treatment of colorectal cancer. Traditionally, patients with colon cancer that has advanced into the lymph nodes or metastasized (spread into other organs) are given chemotherapy to improve their chances of survival and decrease their rate of cancer recurrence. A recently completed study in Europe demonstrated a survival benefit in those patients who were given a colon cancer vaccine. Patients with stage II or III colon cancer (cancer that had spread through the bowel wall or into the lymph nodes) were operated on and given either a vaccine made from colon cancer cells or no additional treatment. There was a 42 to 44 percent reduction in recurrence of colon cancer and a benefit of survival in patients receiving the vaccination.

The vaccine had very few side effects and researchers foresee the vaccine as potentially becoming a standard treatment for patients with stage II colon cancer.

I’ve always read and heard that fiber helps prevent colorectal cancer. Recently though, I read a newspaper article that said a study disproved this claim. What’s the truth?
I believe the study that you are referring to involved a group of nurses in whom there was no decrease in the rates of colorectal cancer between those reporting high fiber intake, compared with those with lower fiber intake. Exactly why these results emerged is unclear. However, there are many studies about the use of fiber that support its relationship to a decreased risk of colorectal polyps and cancer. The interest in dietary fiber was sparked by observations of the significantly reduced rate of polyps and cancer in populations whose diets are chock full of fiber, such as legumes, fruits and vegetables. In addition, those populations also had less obesity and a decreased risk of heart disease. Because of the abundance of other data that support the protective benefits of fiber against colorectal cancer, among other diseases, I strongly recommend a high fiber, low fat diet to all my patients.

Is it true that calcium can prevent the type of polyps that eventually lead to colorectal cancer?
Yes. Researchers at the Cleveland Clinic helped discover this finding, which was recently published in the New England Journal of Medicine. Patients with adenomas, the type of polyp that can lead to colorectal cancer, participated in a three-year study. In the study, patients had all polyps removed and took either 1200 mg of elemental calcium or an inactive pill, called a placebo. After three years, the patients who took the calcium were found to have a significant decrease in the recurrence of polyps, by 25 percent. These results are very encouraging. We are currently studying the long-term effects of calcium on these patients in order to determine the mechanism by which calcium prevented the recurrence of adenomas. See additional article about a Cleveland Clinic patient who took part in the calcium study.

Questions were answered by Carol Burke, M.D., Department of Gastroenterology.