20 Yr anal cancer survivor

Intensive Chemotherapy and Radiation Therapy Combo May Improve Outcomes for Persons with Cancer of the Anus
Persons who have cancers of the anus that have spread to the nearby lymph nodes or are large in size may require more aggressive therapy than individuals with smaller cancers. Now, researchers say that chemotherapy with fluorouracil and cisplatin, followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin, may help preserve bowel function and improve survival for persons with this type of disease.

Cancer of the anus, the opening at the end of the rectum, is an uncommon cancer. Depending on the stage of disease (extent of disease at diagnosis) and other factors, cancer of the anus may be treated with surgery, chemotherapy, and/or radiation therapy. Persons who have surgery for anal cancer sometimes need a colostomy, an opening created from the skin to the bowel to help dispose of waste; however, a colostomy is usually temporary. Persons who have anal cancer that can be operated upon are often treated with surgery followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Seventy percent of these individuals are cured and maintain bowel functioning. However, persons with anal cancers that are large in size or have spread to the lymph nodes, do not respond as well to the standard therapies and need more aggressive treatment.

Researchers from the Cancer and Acute Leukemia Group B conducted a study with the hope of improving survival rates and preserving bowel function for persons with cancer of the anal canal that were large in size or had spread to the lymph nodes. Forty-five patients first received chemotherapy with fluorouracil and cisplatin. They then received a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Thirty-six patients had a complete response to the therapy. After an average of 21 months, 78% of the patients were alive and 67% were free from any signs and symptoms of cancer. Fifty-six percent of those who were alive were without a colostomy.

The researchers concluded that this more aggressive combination of chemotherapy and radiation therapy appears to result in better survival and better preservation of bowel functioning than the standard regimens for persons with more advanced anal cancer. Persons with this type of disease may wish to talk with their doctor about the risks and benefits of receiving intensive chemotherapy with radiation therapy or of participating in a clinical trial in which other promising new therapies are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute ( cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com ( www.411cancer.com). ( Proceedings of the American Society of Clinical Oncology Thirty-Fifth Annual Meeting, Vol 18, Abstract 909, pp 237a, 1999)

There are 19 doctors who are panel members of the National Comprehensive Cancer Network (NCCN) for Anal Cancer (from Johns Hopkns to Duke University--in several regional states) Two are from the Lurie Cancer Center of Northwestern University Chicago. One of these doctors is my radiologist, Dr. Krystyna Kiel. She recommended 200 mg of Selenium after a study showed usage over 10 years was associated with fewer recurrences of rectal/colon and lung cancers.

Below is the article and sites:

Selenium May Reduce Risk of Developing Lung, Colorectal, and Prostate Cancers
The essential dietary nutrient, selenium, may help reduce the risk of developing cancers of the lung, colon, rectum, and prostrate, as well as reduce the number of deaths in persons who have certain types of cancer, according to preliminary research findings.

It is believed that cancer is caused by a number of factors, making prevention of the disease a challenge. Few cases of cancer have a causative association as clear as the one between smoking and lung cancer. However, ongoing research continues to elucidate characteristics or exposures that may increase the chance of developing different types of cancers ( risk factors) as well as characteristics or exposures that may reduce the chance of developing those cancers ( protective factors). Recently, much attention has been given to the potential protective effects of various dietary supplements and nutrients, including selenium.

Selenium is a nutrient that is essential to the human body. A component of a number of the body’s enzymes, selenium is found predominantly in foods but also in water and air. Several scientific reports have shown an increased risk of developing certain cancers when the diet does not contain enough selenium. Similarly, some clinical studies have shown that selenium supplements in the diet may reduce the risk of developing some cancers. The side effects of most forms of selenium are low; however, certain forms (such as selenious acid) can be fatal if ingested. Excessive exposure to selenium, often characterized by a garlic odor on the breath, can result in chronic selenium poisoning. Further investigation of the potential protective effect of selenium from some types of cancer is ongoing.

Researchers from several centers in the United States conducted a study to determine whether the use of selenium supplements would result in a reduced risk of developing cancer or a recurrence (return) of cancer in 1312 persons who had a history of basal cell or squamous cell cancer of the skin. The researchers assigned the patients to receive either 200 micrograms of selenium per day or a placebo. The findings showed that the selenium did not have any impact on whether the patients developed the skin cancer again. However, the selenium was associated with fewer cancer-related deaths. Of the group receiving placebo, 57 persons died of cancer; of the group receiving selenium, 29 persons died of cancer. Of the cancers that were diagnosed, 119 were in the placebo group and 77 were in the selenium group. Cancers that were shown to be reduced in the selenium group included lung, colorectal, and prostate cancers. Because of these favorable results showing reductions in the incidence of lung, colorectal, and prostate cancers and the reduction in deaths from cancer, this study was stopped early.

The researchers concluded that the protective effects of selenium shown here appear promising; however, further studies are needed to confirm these findings. ( Journal of the American Medical Society, Vol 276, No 24, pp 1957-1963)

http://www.researchforacure.com/cancernews.aspx?section=cancernews&id=16980

http://64.233.161.104/search?q=cache:M5ocwUEiOvAJ:www.news.cornell.edu/releases/Jan97/selenium.ssl.html+selenium+studies+on+cancer&hl=en&ie=UTF-8

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Andrea