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Harvard Health Letters
Harvard Health Letters
About 12 million Americans are cancer survivors, and the number is almost certainly going to increase because of early detection, better treatment, and an aging population. After the first encounter with the disease and the ordeal of treatment, attention swivels to what can be done to prevent a second one.
As many as a third of cancer survivors start taking vitamin and mineral supplements. But should they?
Two
Until that research is done, we must go by the results of studies of long-term supplement use and how it correlates with advanced or fatal cases of cancer. Those findings can't separate out the pre- and post-diagnosis effects of supplements, but as the
VITAMIN D IS A CONTENDER
The most encouraging news out of Giovannucci and Chan's review is that vitamin D is a prospect for lowering cancer recurrence. Vitamin D is generated in skin exposed to the ultraviolet B (UVB) part of the light spectrum, and people in higher latitudes with less exposure to UVB light from the sun have higher rates of fatal colon, breast, and ovarian cancer.
Moreover, the association is stronger for mortality than incidence, suggesting that vitamin D might have effects late in the disease process. Several threads of experimental evidence point to vitamin D having anticancer activity, and some animal experiments suggest particularly strong effects on metastasis -- cancer's spread from one part of the body to another.
Studies of lung, breast, and colon cancer patients help make the case for D: High levels of the vitamin in the blood of the patients in those studies were associated with lower rates of death and cancer coming back.
The research done so far doesn't prove that vitamin D supplements will reduce colon cancer recurrence. And vitamins have disappointed so many times now that enthusiasm must be tempered. Still, as the
NOT SO PROMISING
The glass looks to be half empty -- or even worse -- for other vitamins. The antioxidant vitamins -- vitamin C, vitamin E -- don't seem to have broad anticancer effects, and beta carotene, a form of vitamin A, seems to increase the risk of lung cancer in smokers. Giovannucci and Chan hold out some flickering hope for vitamin E perhaps reducing the risk of advanced or fatal prostate cancer in smokers.
Folate may have a split personality, reducing the risk of precancerous colon polyps, but once they have developed, raising the risk of the polyps becoming full-fledged colon cancer. The
That advice may be at odds with the
ASPIRIN: A DEFINITE MAYBE
In contrast to the wavering enthusiasm for vitamins, with the notable exception of D, things are looking up for aspirin, according to Giovannucci and Chan. They describe the evidence for aspirin reducing the risk of colon cancer recurrence as "compelling" and point to results from a randomized trial that showed a daily 325-mg dose of aspirin reduced the recurrence by 35 percent among about 500 patients who had been treated for early-stage colon cancer.
Another feather in the aspirin cap: Results in 2009 from a study led by Chan that linked a regular aspirin habit after a colon cancer diagnosis to a lowering of risk for dying from the disease.
Other types of cancer seem susceptible to aspirin's influence, too. A different group of
So how is it that aspirin, the humble pain reliever, might keep cancer at bay? Aspirin inhibits the COX-2 enzyme. In addition to catalyzing inflammatory processes that are part of pain, COX-2 is involved in others that influence cell growth and therefore the development of cancer. By blocking COX-2, aspirin may have the ability to steer wayward cells away from a cancerous fate and, if the current findings hold up, maybe it can do the same for some cancer survivors.
Giovannucci and Chan envision a day when cancers might be tested for their COX-2 status so doctors and patients would know if taking an aspirin is worth it. -- Harvard Health Letter
Available at Amazon.com:
Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder
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Health - Keeping Cancer From Coming Back: Should Survivors Take Supplements?