Diet, Exercie, and Recurrence/Prevention

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ASTEPHENS33
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Diet, Exercie, and Recurrence/Prevention

Postby ASTEPHENS33 » Sat Aug 25, 2018 2:47 pm

https://academic.oup.com/jnci/advance-a ... m=fulltext - I saw this article and thought it was really good. You probably have seen it. I know there is a correlation with good diet and exercise, but haven't seen such a thorough study before. Looks like it just came out.

Dr. Kimmie Ng of Harvard-affiliated Dana-Farber Cancer Institute was senior author of a recent study linking a low-insulin-load diet — fruits, vegetables, whole grains, and healthy protein and fats — to a dramatic drop in colorectal cancer recurrence.

The good news about this for me, is that it means as a patient I have some control

Koreysue
Posts: 21
Joined: Mon Apr 30, 2018 2:36 pm

Re: Diet, Exercie, and Recurrence/Prevention

Postby Koreysue » Sat Aug 25, 2018 3:15 pm

Awesome. Thanks for posting. Diet is so important, and this is a great reminder. You are right diet and excersize are things we have control over.
Take care,
Koreysue
Diagnosed: June 2017 stage 3 colon cancer
Sigmoid colon, 2 nodes affected
CEA at diagnosis: 6
Colectomy and folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
PET scan 8/20/18 clear (cea rise a mystery for now, doc said maybe all the smoke in my town from forest fires)

Utwo
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Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Diet, Exercie, and Recurrence/Prevention

Postby Utwo » Sat Aug 25, 2018 3:22 pm

ASTEPHENS33 wrote:https://academic.oup.com/jnci/advance-article-abstract/doi/10.1093/jnci/djy098/5038128?redirectedFrom=fulltext - I saw this article and thought it was really good.
...
The good news about this for me, is that it means as a patient I have some control
No it doesn't.
The quality of modern health science is so bad that you can't trust any single publication until its results were reproduced several times.
Personally I trust only meta-studies (reviews and summarization of many individual papers in the same area of science).
58 yo male at diagnosis: T1bN0M0, 0/15 nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 "prophylactic" laparoscopic right hemicolectomy - bleeding, leak, infection
06/2017 CT scan, colonoscopy OK; CEA = 1.6
A lot of funny stuff discovered by CT scans in liver, kidney, lungs, arteries, gallbladder and a lymph node

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O Stoma Mia
Posts: 1450
Joined: Sat Jun 22, 2013 6:29 am

Re: Diet, Exercie, and Recurrence/Prevention

Postby O Stoma Mia » Sun Aug 26, 2018 4:01 am

Utwo wrote:...The quality of modern health science is so bad that you can't trust any single publication until its results were reproduced several times.
Personally I trust only meta-studies (reviews and summarization of many individual papers in the same area of science).


boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Diet, Exercie, and Recurrence/Prevention

Postby boxhill » Sun Aug 26, 2018 9:20 am

As a person with T2 diabetes who normally follows a low carb diet--which BTW has to contain a low consumption of fruit limited largely to specific low-glycemic options, few grains of any type, and almost no root vegetables--I would love to know whether they have determined that the real issue is blood glucose levels, amount of insulin, or what.

Chemo has sent my BG levels through the roof. There is almost nothing I can do about it. I could add more exercise, and I have to do so. It is very frustrating.

BTW, Dr. Ng was the person my oncologist originally suggested I see at D-F, but it was impossible to get an appointment with her without delaying my chemo even longer. The person I did see was wonderful, though. :)
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

MissMolly
Posts: 561
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Location: Portland, Ore

Re: Diet, Exercie, and Recurrence/Prevention

Postby MissMolly » Sun Aug 26, 2018 10:43 pm

boxhill wrote:Chemo has sent my BG levels through the roof. There is almost nothing I can do about it. I could add more exercise, and I have to do so. It is very frustrating.


Boxhill:
Your highly elevated blood glucose levels are likely a direct effect of the glucocorticosteroid administered with chemotherapy (most commonly dexamethasone).

Steroid Induced Diabetes Mellitus (SIDM) refers to heightened BG levels and insulin resistance which is the result of long-term or high dose glucocorticosteoids in individuals with or without preexisting type 2 diabetes.

The dexamethasone you are receiving is compounding, or adding to, your existing type 2 diabetes.

Do not hesitate to discuss with your oncologist a dose reduction of dexamethasone, finding a balance of the benefits that dexamethasone provides (eases debilitating nausea and fatigue; eases inflammation; makes chemo infusion aftereffects more tolerable) while minimizing the cumulative effect of steroid induced diabetes mellitus given your existing type 2 diabetes.

I developed SIDM, myself, during a length hospitalization to stabilize my Addison’s disease. I was on 100 mg of Solu-Cortef IV a day x 3.5 weeks. I looked like a human football (grossly enlarged abdomen due to fluid retention associated with steroids) with stick arms and legs (muscle atrophy associated with steroids). People who take high dose glucocorticosteoids for auto-immune conditions (ex. Chron’s; ulcerative colitis) are similarly at risk for developing SIDM.

You may want to discuss insulin injections with your medical team if your BG levels remain highly elevated. Insulin injections would not be a permanent need but would support your pancreas and Beta cells to lower the physiological stress imposed by the dexamethasone you receive as a pre-med. SIDM almost often self-corrects once the glucorticosteroids are lowered or discontinued.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

mpbser
Posts: 474
Joined: Wed Apr 19, 2017 11:52 am

Re: Diet, Exercie, and Recurrence/Prevention

Postby mpbser » Mon Aug 27, 2018 3:33 pm

Thanks for sharing, ASTEPHENS33.

There must be a scientific basis for the NCCN Guidelines to recommend a plant-based diet and exercise and articles such as this one continue to drill down the data.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
Liver left hepatectomy seg 4 1/31/18
5/18 NED

NHMike
Posts: 1725
Joined: Fri Jul 21, 2017 3:43 am

Re: Diet, Exercie, and Recurrence/Prevention

Postby NHMike » Mon Aug 27, 2018 4:57 pm

boxhill wrote:As a person with T2 diabetes who normally follows a low carb diet--which BTW has to contain a low consumption of fruit limited largely to specific low-glycemic options, few grains of any type, and almost no root vegetables--I would love to know whether they have determined that the real issue is blood glucose levels, amount of insulin, or what.

Chemo has sent my BG levels through the roof. There is almost nothing I can do about it. I could add more exercise, and I have to do so. It is very frustrating.

BTW, Dr. Ng was the person my oncologist originally suggested I see at D-F, but it was impossible to get an appointment with her without delaying my chemo even longer. The person I did see was wonderful, though. :)


DFCI had a doctor that would offer nutritional advice - he would come around to various hospitals and give lectures on nutrition. He was a lab guy and an oncologist I think. He went to Yale to become head of oncology I think. So there are a few of those guys around.

DFCI intake is pretty hard to get through to. It took me two weeks to reach someone to schedule an appointment. Once you're in, though, it's pretty easy. I can imagine that some people are in high demand.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal


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