2.8 Million Cancer Cases Worldwide Could Be Prevented

September 9, 2011 — Around 2.8 million cases of cancer worldwide are preventable, and are largely linked to diet, physical activity, and weight, according to the World Cancer Research Fund (WCRF).

"The policy of simply relying on identifying and treating these cases when they occur is simply not a sustainable solution" in any country, said Martin Wiseman, FRCP, FRCPath, project director at WCRF International. "We need to focus on preventing disease in the first place, so that we have the resources to detect and treat the cases that do occur."

"That's how high the stakes are," he explained. "If we continue down the same path and do nothing more — with people being less and less physically active and relying more and more on highly processed and energy-dense foods, the problem is only going to get worse."

Coming up with new solutions is not the main problem, Dr. Wiseman emphasized. "The problem is having the world implement what we already know."

"Once-in-a-Generation" Opportunity

In 2 weeks, there will be a "once-in-a-generation" opportunity to prevent a public health disaster, the WCRF announced at a press conference this week.

On September 19 and 20, the United Nations (UN) will hold the historic Summit on Non-Communicable Diseases (NCDs), which aims to raise the profile of NCDs and mobilize the international community to take action to reduce the global burden of NCDs. The summit will focus on the 4 most prominent NCDs: cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes.

"Globally, 2 of every 4 deaths are caused by NCDs," said Kate Allen, PhD, director of science and communications at WCRF International, during the press conference. "NCDs are a serious problem in all regions of the world, and affect high-, middle-, and low-income countries."

"Taken together," she continued, "these 4 diseases exact an enormous global health toll and have a similarly massive death toll. They are one of the biggest health challenges that the world faces today."

Unless something changes, Dr. Allen added, "the direction that all of these diseases is taking is up."

Dr. Allen pointed out that much is known about these 4 diseases, and they share a number of common risk factors, such as tobacco use, obesity, unhealthy diets, and physical inactivity. "This is potentially a very big opportunity, but it's only going to be an opportunity if something concrete comes out of the summit," she said.

Gathering Steam

Currently, 35 heads of state will be attending. The WCRF is calling on British prime minister David Cameron to attend the summit in person to demonstrate his commitment to tackling NCDs in the United Kingdom and the world. In addition, major cancer organizations have been stepping up the pressure to bring attention to the global cancer crisis and calling on world leaders to attend the upcoming summit.

The American Society of Clinical Oncology, the Union for International Cancer Control, and the American Cancer Society have all announced new efforts to respond to the cancer epidemic occurring in low- and middle-income countries.

The upcoming meeting is only the second UN summit of its kind to focus on a global health issue. The first high-level UN meeting was the HIV/AIDS summit in 2001, which ultimately led to the creation of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Prevention Is Key

The number of global cancers has increased by 20% in less than a decade. It is now estimated that there will be 12 million new cases a year, which is more than 4 times the annual 2.6 million new HIV infections. Of these cancer cases, an estimated 2.8 million are preventable, and are largely linked to diet, physical activity, and weight. That number is expected to rise dramatically over the next 10 years.

This is a "best guess, rather than an estimate," noted Dr. Wiseman, who pointed out the difficulty in estimating the overall number of cases of cancer globally and the proportion of those that are largely preventable. "The number is always going to be inexact," he said at the press conference. "But even if its not an exact number, I think we can be sure that it's in the right order of magnitude."

The 2.8 million was calculated using the findings of the preventability estimates — that about 25% of all cancer could be prevented in high-income countries and 20% in medium- and low-income countries.

But prevention is key in curtailing what UN secretary general Ban Ki-moon has referred to as a "public health emergency in slow motion."

Not Going Far Enough?

The statistics are sobering: 63% of all global deaths are due to NCDs, the majority of which are the 4 targeted disease conditions. And 80% of those deaths occur in low- and middle-income countries, said Cary Adams, chief executive officer of the Union for International Cancer Control.

The impact of NCDs goes far beyond being a health issue, he emphasized. "They have far-reaching social, economic, development, and human rights implications."

Hardest hit are the most socially vulnerable and economically disadvantaged people, and most people living in low- and middle-income countries pay for healthcare out of pocket. "Every year an estimated 100 million people are pushed into poverty because they have to pay for health services," said Mr. Adams.

NCDs are also a significant barrier to achieving the UN millennium goals in 2015, particularly the targets related to health, education, and gender equality. One half of those who die from NCDs are in their productive years, so the economic consequences and social cost in terms of productivity are considerable, he noted at the press conference.

Although the upcoming summit will bring attention to the issue of NCDs, "not everything we wanted is covered in the current draft," Mr. Adams pointed out. "The document lacks text with specific targets, including no overall goal for reducing preventable deaths. Our generation is sending a message to future generations that we don't have a goal to help them."

"It would be good to see governments commit to reducing preventable deaths by 25% by 2025," he said. "This is a target that [the World Health Organization] believes can be achieved."

The current language on additional resources for NCDs is weak in some areas, with no commitments to increase the proportion of development assistance devoted to health outcomes, he added.

Mr. Adams emphasized that, despite some of the disappointments, a great deal of progress has been made. The summit, however, is only the first step. "We view the UN summit as a start point, and not an end," he said.

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High BMI Linked to More Deaths in Nonsmoking Black Women

September 8, 2011 — Overweight and obesity, and large waist circumference without obesity, are associated with increased all-cause mortality risk in black women who had never smoked, according to the results of aprospective study reported in the September 8 issue of the New England Journal of Medicine.

"Recent pooled analyses show an increased risk of death with increasing levels of the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 25.0 or higher in populations of European ancestry, a weaker association among East Asians, and no association of an increased BMI with an increased risk of death among South Asians," write Deborah A. Boggs, ScD, from the Slone Epidemiology Center at Boston University in Boston, Massachusetts, and colleagues. "The limited data available on blacks indicate that the risk of death is increased only at very high levels of BMI (≥35.0)."

Using follow-up data from 1995 through 2008 in the Black Women's Health Study, the investigators prospectively examined the association of BMI and waist circumference with mortality risk among 51,695 black women who were 21 to 69 years old at study enrollment, and who had no history of cancer or cardiovascular disease. Multivariable proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

During follow-up, 1773 women died, including 770 of 33,916 women who had never smoked. Mortality risk among nonsmokers was lowest for a BMI of 20.0 to 24.9 kg/m² and rose as the BMI increased above this range. When a BMI of 22.5 to 24.9 kg/m² was used as a reference category, the HR was 1.12 (95% CI, 0.87 - 1.44) for a BMI of 25.0 to 27.4 kg/m², 1.31 (95% CI, 1.01 - 1.72) for a BMI of 27.5 to 29.9 kg/m², 1.27 (95% CI, 0.99 - 1.64) for a BMI of 30.0 to 34.9 kg/m², 1.51 (95% CI, 1.13 - 2.02) for a BMI of 35.0 to 39.9 kg/m², and 2.19 (95% CI, 1.62 - 2.95) for a BMI of 40.0 to 49.9 kg/m² (P < .001 for trend).

Among women with a BMI of less than 30.0 kg/m², a large waist circumference was associated with greater risk for all-cause mortality.

"The risk of death from any cause among black women increased with an increasing BMI of 25.0 or higher, which is similar to the pattern observed among whites," the study authors write. "Waist circumference appeared to be associated with an increased risk of death only among nonobese women."

Limitations of this study include use of self-reported measures of body size and unknown generalizability to men.

"For both BMI and waist circumference, the positive association with the risk of death was stronger for deaths from cardiovascular disease than for deaths from cancer or other causes," the study authors conclude. "Weaker associations were observed among current and former smokers than among women who had never smoked, even after adjustment for pack-years of smoking."

The National Cancer Institute supported this study. Disclosure forms provided by the authors are available with the full text of the original article.

N Engl J Med. 2011;365:901-908.

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Lemons and Cancer (Helpful Tips)

Lemons and Cancer Useful info that may help someone ...  LISTEN UP FOLKS:  This is something that we should all take seriously – just had a recent test myself that sent shivers up my spine – or near by – Even doctors are now saying that there is value in trying “LEMON” So, a tablespoon of "real lemon" (the concentrate in a bottle) in a glass of water every morning. What can it  hurt?  Subject: A must-read- The surprising benefits of lemon! I remain perplexed! ================================ Institute of Health Sciences, 819 N. L.L.C. Charles Street Baltimore , MD 1201. This is the latest in medicine, effective for cancer! Read carefully & you be the judge. Lemon (Citrus) is a miraculous product to kill cancer cells. It is 10,000 times stronger than chemotherapy. Why do we not know about that? Because there are laboratories interested in making a synthetic version that will bring them huge profits. You can now help a friend in need by letting him/her know that lemon juice is beneficial in preventing the disease. Its taste is pleasant and it does not produce the horrific effects of chemotherapy. How many people will die while this closely guarded secret is kept, so as not to jeopardize the beneficial multimillionaires large corporations? As you know, the lemon tree is known for its varieties of lemons and limes. You can eat the fruit in different ways: you can eat the pulp, juice press, prepare drinks, sorbets, pastries, etc... It is credited with many virtues, but the most interesting is the effect it produces on cysts and tumors. This plant is a proven remedy against cancers of all types. Some say it is very useful in all variants of cancer. It is considered also as an anti microbial spectrum against bacterial infections and fungi, effective against internal parasites and worms, it regulates blood pressure which is too high and an antidepressant, combats stress and nervous disorders. The source of this information is fascinating: it comes from one of the largest drug manufacturers in the world, says that after more than 20 laboratory tests since 1970, the extracts revealed that: It destroys the malignant cells in 12 cancers, including colon, breast, prostate, lung and pancreas ... The compounds of this tree showed 10,000 times better than the product Adriamycin, a drug normally used chemotherapeutic in the world, slowing the growth of cancer cells. And what is even more astonishing: this type of therapy with lemon extract only destroys malignant cancer cells and it does not affect healthy cells. Institute of Health Sciences, 819 N. L.L.C. Cause Street , Baltimore , MD1201SEND TO EVERYONE ... Please! ! ! ! !

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Walking Intervention Helps Patients With Diabetes and PAD

September 6, 2011 — A home-based walking intervention improves walking speed and quality of life in people with diabetes and peripheral arterial disease (PAD), according to new research findings.

Tracie C. Collins, MD, MPH, with the Department of Medicine, at the University of Minnesota, in Minneapolis, and colleagues reported their findings online August 26 in Diabetes Care.

According to the researchers, the benefits of supervised walking therapy in PAD have been documented but have limited generalizability because of patient selection, variable methods to measure disease, and the impracticality of hospital-based programs.

The current study sought to evaluate patients with PAD and diabetes participating in a home-based walking program. The primary outcome was a 6-month change in maximal treadmill walking distance vs attention control.

A total of 145 participants, of which 100 were men, and who had diabetes and PAD, were randomly assigned to receive an intervention for 6 months directed towards levels of readiness. The intervention consisted of a 1-on-1 interaction with the research coordinator at baseline. Walking training, weekly group walking classes with an instructor, and biweekly telephone calls for 6 months were also included.

The remaining participants were randomly assigned to a "control" intervention that consisted of twice-monthly telephone calls with the research coordinator. Both groups also watched a 7-minute educational video about PAD.

No significant difference was observed between groups in treadmill walking distance during the course of the 6-month program. However, among secondary outcomes, average walking speed scores increased by 5.7 units for the intervention group but decreased by 1.9 units in the control group (P = .03).

In the intervention group, the mental health quality-of-life subscale score also increased by 3.2 and decreased by 2.4 units in the control group (P = .01).

"These results suggest that home-based walking holds promise for improving walking speed and quality of life in people with DM [diabetes mellitus] and PAD," Dr. Collins and colleagues conclude.

According to the researchers, their study is the "first large-scale walking intervention trial in PAD to use home-based walking versus an attention control." They add that "such a program may improve walking speed and quality of life in this high-risk population."

The study was supported by the American Diabetes Association. The study authors have disclosed no relevant financial relationships.

Diabetes Care. Published online August 26, 2011.

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Multiple Lifestyle Factors Contribute to Diabetes Risk

September 6, 2011 — Collectively, lifestyle factors, including not smoking, regular physical activity, healthy diet, moderate alcohol consumption, and normal body weight, are associated with a substantially decreased risk of developing diabetes, according to new research findings.

Jared P. Reis, PhD, from the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, and colleagues reported their findingsin the September 6 issue of the Annals of Internal Medicine.

According to the researchers, several risk factors have each been associated with a lower risk for diabetes; however, only limited data support a combined effect of lifestyle factors on diabetes risk.

"Our objective was to examine how combinations of several lifestyle risk factors relate to the 11-year risk for incident diabetes in a large prospective cohort study of adults aged 50 to 71 years," Dr. Reis and colleagues write.

In a population-based prospective cohort study, the researchers analyzed data from the National Institutes of Health–American Association of Retired Persons Diet and Health Study, including 114,996 men and 92,483 women aged 50 to 71 years. Participants were recruited from 1995 to 1996, and at the time, they had no evidence of heart disease, cancer, or diabetes.

The study involved a comprehensive survey of demographic characteristics and lifestyle factors. These included factors such as dietary intake, body weight and height, physical activity, smoking, and alcohol consumption at the beginning of the study (1995 - 1996). Participants were classified into low-risk and non–low risk groups for each lifestyle factor. Physician-diagnosed diabetes was identified in a follow-up survey conducted in 2004 to 2006.

Of the men and women, 9.6% and 7.5%, respectively, developed incident diabetes during the study period. For each additional lifestyle factor in the low-risk group, the risk of developing diabetes was reduced by 31% (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.68 - 0.71) for men and 39% (OR, 0.61; 95% CI, 0.60 - 0.63) for women.

When participants had 4 low-risk factors (diet score, physical activity level, smoking status, and alcohol use), the risk was reduced both for men (OR, 0.61; 95% CI, 0.56 - 0.66) and for women (OR, 0.43; 95% CI, 0.34 - 0.55). If participants were also at an optimal weight, the risk was further reduced both for men (OR, 0.28; 95% CI, 0.23 - 0.34) and for women (OR, 0.16; 95% CI, 0.10 - 0.24).

No difference was observed based on extent of adiposity or family history of diabetes.

Study limitations include its observational design with possible residual bias, the measurement of lifestyle risk factors only at baseline, and a reliance on self-report of diabetes diagnosis.

"[W]e found that a low-risk profile that incorporated 5 lifestyle factors was strongly associated with a lower risk for new-onset diabetes among older adults," Dr. Reis and colleagues concluded. "Each additional factor in the low-risk category was associated with a substantial reduction in risk for diabetes."

According to the researchers, the combined influence of these factors had a slightly stronger association with a lower risk for diabetes among women. In addition, the findings indicate that "overweight and obese adults may benefit from adopting other low-risk lifestyle behaviors."

The National Institutes of Health–American Association of Retired Persons Diet and Health Study was supported by the Intramural Research Program of the National Institutes of Health. The authors have disclosed no relevant financial relationships.

Ann Intern Med. 2011;155:292-299. Abstract

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World Health Organization: Cell Phones May Cause Cancer

The World Health Organization announced today that cell phones pose a significant risk of causing cancer. Cell phones are now labeled under "carcinogenic hazard," just like lead and chloroform. You can download the full WHO report here. Since cell phones are a relatively new technology, the study warns it could take years before the long-term effects are truly known. From the announcement: ...one study of past cell phone use (up to the year 2004), showed a 40% increased risk for gliomas in the highest category of heavy users (reported average: 30 minutes per day over a 10‐year period). Those results, among others analyzed by WHO, were enough to earn cell phones a "2b classification," meaning there is some risk for cancer. Here's the full report, embedded below: موبائل فون سے دماغ کے سرطان کا خطرہ ہے:عالمی ادارہ صحت کی رپورٹ عالمی ادارہ صحت کے مطابق دنیا بھر میں تقریباً پانچ ارب ایسے افرادجو دن میں چار گھنٹے تک موبائل فون کا استعمال کرتے ہیں،جس سے دماغ میں سرطان زدہ رسولی پیدا ہونے کے خدشات بڑھ جاتے ہیں۔  رپورٹ کے حوالے میں بہت سے سائنس دانوں نے عالمی ادارہ صحت کے اِس بیان کی تائید کی ہے، تا ہم ان کا کہنا ہے کہ عالمی ادارہ صحت نے صحت پردیگر آلات کے اثرات کے بارے میں کچھ نہیں کہا۔موبائل فون کے ماہرین کا کہنا ہے کہ موبائل فون سے جوشعائیں نکلتی ہیں وہ بہت دراز اورسخت ہوتی ہیں جِس کو ہمارا دماغ برداشت نہیں کرسکتا۔اِن ویوز سے نہ صرف سرطان کے خدشات بڑھ جاتے ہیں بلکہ اِس کےاثرات انسان کے تمام خلیوں پر ہوتے ہیں۔ کچھ ماہرینِ صحت کاخیال ہے کہ اِس کے اثرات بڑے پیمانے پر دیکھے جا سکتے ہیں۔ نیشنل انسٹی ٹیوٹ سے منسلک ماہرین کا سیل فون کے استعمال سے دماغ پر اثرات کے بارے میں کہنا ہے کہ ان کی تحقیق سےثابت ہوا ہے کہ انسان کا دماغ سیل فون سے نکلنے والی شعائوں کے بارے میں بہت حساس ہے،خاص طور پر جب اس کو سر کے قریب رکھاجائے۔ سیل فون کے استعمال کے بارے میں والدین کو مشورہ دیتے ہوئے ڈاکٹروں کا کہنا ہے کہ بچوں اور نوجوانوں کی حوصلہ افزائی کی جائے کہ وہ سیل فون کو سر کے قریب نہ لائیں، بلکہ سپیکر یا پھر ہیڈ فون کااستعمال کریں اور سیل کو تکیے کے نیچے بلکل نہ رکھیں۔تاہم، بہت سے ماہرین کے مطابق ، سیل فون اور دماغ کے کینسر کے تعلق کے بارے میں سامنے آنے والے حقائق کافی نہیں ہیں اور ابھی مزید تحقیق کی ضرورت  ہے۔

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'Brain Fitness' Program Improves Memory

September 1, 2011 — A combination of brain exercises and healthy lifestyle changes can improve memory performance in healthy elderly adults, new research suggests.

In a sample study of 115 participants from 2 live-in retirement communities, those who underwent a new educational program (that included memory training, physical activity, stress reduction, and better diet) showed significant improvements on a variety of measures after just 6 weeks, including word recognition and recall.

"I was very pleased with these significant results in a sample that was not huge," senior study author Gary Small, MD, professor of aging at the University of California–Los Angeles (UCLA) and director of the UCLA Longevity Center, told Medscape Medical News.

Dr. Gary Small

He noted that the investigators wanted to test whether this intervention improved both objective and subjective memory performance.

"Subjective memory is a person's self-perception of how they're doing, and objective is how well they do on a pen-and-paper test. It was gratifying to see that this program seemed to be helping people in day-to-day memory challenges."

Lead author Karen Miller, PhD, associate clinical professor at the Semel Institute for Neuroscience and Human Behavior at UCLA, said in a release that "it was exciting" to see the subjects' participation, as well as their improvements in the memory fitness program.

"The study demonstrates that it's never too late to learn new skills to enhance one's life," added Dr. Miller.

The study was published online July 14 in the American Journal of Geriatric Psychiatry.

Emphasizing a "Healthy Brain"

"Despite the effectiveness of memory training interventions in clinical trials, few community-based programs exist, and their effects have not been systematically tested," write the investigators.

The new memory training program, which was created by Dr. Small and Dr. Miller, uses a standardized curriculum consisting of brain exercises for association and visual imagery, education on a "healthy brain diet" and stress reduction, physical activity, and even assigned memory exercises to be performed at home.

The investigators have previously offered this program in a number of settings, including the UCLA campus and senior centers. However, this is the first time it was offered in a retirement living community, which made participation easier because "users did not have to drive to a class off-site," said Dr. Small.

"Our group tends to study memory training and healthy lifestyle techniques from the point of view of first developing a program that we think is user friendly and then testing it out. However, many times there's the approach where a scientific study is done first. So a program may be proven to be effective or not, but the question is: Will people use it? And will it be adaptable to a lot of communities?" he said.

For the study, 115 residents of 2 continuing-care communities in Maryland older than 62 years (mean age, 80.9 years; 79% women; 98% white) who had slight memory complaints but no diagnosis of dementia were enrolled and tested for memory performance.

After testing, participants were randomly assigned either to undergo the memory fitness program, consisting of 12 twice-weekly, hour-long sessions (15 - 20 per class), or to be placed on a waiting list for the program and considered study controls.

Objective cognitive measures during the pretesting phase, as well as at baseline and at study's end, assessed changes in immediate and in delayed verbal memory, retention of verbal information, memory recognition, and verbal fluency.

Subjective measures evaluated domains of memory self-awareness, including frequency and severity of forgetting, mnemonics use, and retrospective functioning.

Generalizeable Results?

Results showed that the patients who underwent the memory fitness program showed significant improvements postintervention on recognition memory for word pairs (P < .001) and retention of verbal list learning (P < .01).

In addition, their retrospective functioning scores increased (P < .0001), "indicating a belief in having a better memory," write the investigators.

"These findings indicate that a 6-week healthy lifestyle program can improve both encoding and recalling of new verbal information as well as self-perception of memory ability in older adults," they write, noting that it may be generalizable to a real-world setting.

"As a community-based educational intervention, the program has the potential to meet the community's need for an affordable and sustainable memory program over time."

John Parrish, PhD, executive director of the Erickson Foundation, which oversees the retirement communities used in this study, said in a release that the foundation is now offering the program in all 16 of their communities across the country.

"The study suggests that the memory fitness program may be a cost-effective means of addressing some memory-related concerns of healthy older adults," he said.

Dr. Small said that he hopes that clinicians will see from this study and others that mild, age-related memory complaints can improve with specific training.

"There are a lot of ways to learn memory techniques. I think physicians should first ask people about their memory concerns and then try to refer them to get some help," he said.

"It's important to empower people and teach them about healthy brain lifestyle. Although there's no absolute proof that you can prevent Alzheimer's disease, we know that physical exercise and healthy diet can prevent diabetes, which is itself a major risk factor for Alzheimer's. So it all seems to tie together."

The study was supported by the Fran and Ray Stark Foundation Fund for Alzheimer's Disease Research, the Judith Olenick Elgart Fund for Research on Brain Aging, and the Parlow-Solomon Professorship. Dr. Small reports having served as a consultant and/or having received lecture and stock options in Dakim, Inc. and is author of the forthcoming book, The Alzheimer's Prevention Program. Dr. Miller and one other study author report having received grant support from Dakim.

Am J Geriatr Psychiatry. Published online July 14, 2011. Abstract

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