DFCI research
In an effort to advance knowledge about this preventable disease, Dana-Farber scientists are studying the value of dietary changes and chemoprevention.
Charles Fuchs, MD, MPH
The people most concerned about prevention are not the general population, says Fuchs, but those who have already had one or more polyps or colon cancer. And because there is not much data on how effective lifestyle changes are at this stage in the cancer process, Fuchs is heading a study of 1,300 colon cancer patients who have been treated with surgery and chemotherapy.
Participants are filling out questionnaires about the lifestyle changes they've made since their experience with cancer. At the end of three-and-a-half years, scientists will compare cancer recurrence rates for those who adopted healthful changes and those who didn't.
Another ongoing study, by Karen Emmons, PhD, of DFCI's Department of Adult Oncology, looks at the effectiveness of behavior-change counseling for people who have had precancerous polyps removed. Immediately after a polyp's removal comes a "teachable moment" when patients are open to living more healthfully, notes Emmons. Each patient receives personalized written materials and phone calls from a counselor who suggests lifestyle changes, such as increasing exercise, eating more fruits and vegetables, taking multivitamins, and controlling weight.
"I still see too many patients with colon cancer that has spread to other parts of the body, and there's no excuse for it."
— Monica Bertagnolli, MD
Meanwhile, Monica Bertagnolli, MD, a Brigham and Women's surgeon who is a also a member of the CGO, is heading an international, multi-center trial comparing the effect of Celebrex, a relatively new NSAID known as a Cox-2 inhibitor, against a placebo (an inactive pill) in thousands of people who have had colon polyps removed. Celebrex has already been approved for preventing recurrences in patients with a rare genetic condition (familial adenomatous polyposis) who are extremely prone to developing polyps.
Patients in the study will receive either Celebrex or a placebo twice a day for three years. Since many of the volunteers will already be taking small doses of aspirin to prevent heart disease, the trial will also measure the effects of Celebrex, aspirin, and a combination of the two compared to the placebo. The National Cancer Institute and Pharmacia/Pfizer, which produces Celebrex for relief of arthritis symptoms, are jointly sponsoring the study.
If the new study finds Celebrex works in people with sporadic colon polyps, the drug might be recommended for all those who have had polyps removed. Looking ahead, the medication — which has few side effects — may someday be taken by anyone who is concerned about colon cancer.
Bertagnolli and her colleagues are adamant about the value of screening for the disease. "I still see too many patients with colon cancer that has spread to other parts of the body, and there's no excuse for it," says Bertagnolli. "I don't think we're effectively getting out the message about screening. We need to keep working to make people aware of the risks of the disease and the benefits of early detection."
