Public health and cooperative group partnership: a colorectal cancer intervention. Semin Oncol Nurs. 2014;30:61-73. [PMID: 24559782 DOI: 10.1016/j.soncn.2013.12.010]

Effects of dual modified resistant indica rice starch on azoxymethane-induced incipient colon cancer in mice

In this study, the effects of different doses of dual modification-treated (DMT) indica rice resistant starch (IR-RS) on azoxymethane (AOM)-induced early colon cancer in mice were investigated. The investigated factors included body weight, gastrointestinal emptying rate, the number and morphology of aberrant crypt foci (ACFs) and the specific expressions of adenomatous polyposis coli (APC), B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax) and cytochrome c genes. The results demonstrated that DMT IR-RS controlled the increase in the body weights of the mice, increased the gastrointestinal emptying rates and reduced the numbers of ACFs and aberrant crypts. Reverse transcription-polymerase chain reaction revealed that DMT IR-RS promoted the expression of APC, Bax and cytochrome c and inhibited the expression of Bcl-2. These results demonstrate that a DMT IR-RS diet may induce apoptosis and has beneficial health effects in AOM-induced early colon cancer in mice.

Breast Cancer Survivorship Care: Targeting a Colorectal Cancer Education Intervention

Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC) is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups' questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02) and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003). The most cited barrier was the complexity of preparation for colonoscopy.

Pulmonary metastases of colorectal carcinoma: Clinical characteristics, metastatic features, therapeutic methods and prognosis

AIM: To explore the clinical characteristics, metastatic features, therapeutic methods and prognosis in patients with pulmonary metastases of colorectal carcinoma.

METHODS: The clinical data of 120 patients with pulmonary metastases of colorectal cancer were retrospectively analyzed. The clinical parameters of the patients, treatment methods and the factors affecting prognosis were analyzed.

RESULTS: In patients with pulmonary metastases of colorectal carcinoma, the 6-mo, 1-, 2-, 3-, and 5-year survival rates were 78%, 44%, 26%, 19% and 16%, respectively, with an overall median overall survival (OS) period of 18.0 mo. Pulmonary symptoms, sex, age, single or multiple pulmonary metastases, the presence or absence of liver metastases, mediastinal and/or hilar lymph node involvement were not significant prognostic factors of OS (P > 0.05). Univariate analysis showed that factors significantly predicting a poor prognosis included primary tumor site (P = 0.017), vessel invasion (P = 0.024) and high T stage (P = 0.008). However, none of these were prognostic factors on multivariate analysis. There was a trend of better survival in patients submitted to metastasectomy compared with those submitted to chemotherapy alone, although there was no statistical difference (median OS: 33.0 mo vs 18.0 mo, P = 0.128). Among 153 patients who underwent radical colorectal resection, 82 had pulmonary metastases in two years after surgery, with a median disease free interval (DFI) of 20.0 mo. The factors that affected DFI included primary tumor site, morphotype, differentiation degree, T stage and N stage (P < 0.05). T stage was an independent predictive factor of DFI (P = 0.019).

CONCLUSION: T stage is an independent predictor of DFI, showing that the tumor with strong ability of invasion tend to cause lung metastasis more commonly.