Higher selenium levels associated with reduced bladder cancer risk
In a meta-analysis reported in the September, 2010 issue of Cancer Epidemiology, Biomarkers & Prevention, researchers from the Spanish National Cancer Research Center and the U.S. National Cancer Institute conclude that the mineral selenium may have a protective effect against bladder cancer, one of the most common types of cancer worldwide.
Núria Malats, MD, PhD and colleagues analyzed data from 7 epidemiologic studies that reported the association between bladder cancer incidence and selenium levels measured in blood, serum, nails, hair or saliva. The studies included a total of 1,910 bladder cancer patients and 17,339 controls or cohort members who did not have the disease.
The researchers found a 39 percent lower risk of bladder cancer in those with high versus low selenium levels. The protective effect extended mainly to women, who are at lower risk of developing the disease than men.
"Selenium may exert anticarcinogenic effects mainly through selenoproteins, although the specific mechanisms are not yet fully known," the authors write. "Aberrant expression patterns of glutathione peroxidases and selenoprotein P, found in colorectal cancer, show that the antioxidant properties of selenoenzymes are relevant in carcinogenesis and tumor progression, particularly by scavenging reactive oxygen species and diminishing further oxidative damage."
They add that selenium also affects apoptosis (programmed cell death), DNA repair, and carcinogen metabolism.
"The lower the levels of selenium, the higher the risk of developing bladder cancer," observed Dr Malats, who is the leader of the Genetic and Molecular Epidemiology Group at the Spanish National Cancer Research Center's Human Cancer Genetics Program. "Although our results suggest a beneficial effect of high selenium intake for bladder cancer risk, more studies are needed to confirm these findings before an enforcement of high selenium intake is recommended."
"These findings provide a valuable lead for what to do next to understand if there is a role for selenium supplementation in bladder cancer prevention," Cancer Epidemiology, Biomarkers & Prevention Editorial Board Member Elizabeth A. Platz, ScD, MPH concurred.
Surgery places an enormous physical stress upon the body. There is considerable scientific evidence supporting that surgeries that are less invasive—and therefore less traumatic—pose less risk of metastasis, compared to more invasive and traumatic surgery. Laparoscopic surgery is one type of minimally invasive surgery, in which operations in the abdomen, pelvis, and other regions are performed through small incisions, as compared to the much larger incisions needed in traditional “open” surgeries.
A study published in The Lancet compared laparoscopic to open surgery to remove part of the colon (colectomy) in patients with colon cancer. In contrast to the group receiving traditional open surgery, the laparoscopic surgery group had a 61% decreased risk of cancer recurrence coupled with a 62% decreased risk of death from colon cancer. The surgeons concluded that laparoscopic colectomy is more effective than open colectomy for treatment of colon cancer as assessed by tumor recurrence and cancer-related survival. A long-term follow-up of these patients (median time 95 months) reported a 56% decreased risk of death from colon cancer for laparoscopic surgery as compared to traditional open surgery. Another comparison of laparoscopic surgery to open surgery for colon cancer reported a five-year survival rate of 64.1% for the laparoscopic group, and a five-year survival rate of 58.5% for the group receiving open surgery.
Minimally invasive surgery has produced substantial improvements in survival for those with lung cancer. Video-assisted thoracoscopic surgery (VATS), a minimally invasive surgery, was compared to traditional open surgery for removing lung tumors (lobectomy). The five-year survival from lung cancer was 97% in the VATS group. This greatly contrasts the 79% five-year survival in the open surgery group.
Commenting on the use of minimally invasive surgery for lung cancer, surgeons at Cedars-Sinai Medical Center stated that minimally invasive surgery for lung cancer “… can be performed safely with proven advantages over conventional thoracotomy [chest surgery] for lobectomy: smaller incisions, decreased postoperative pain,…decreased blood loss, better preservation of pulmonary function, and earlier return to normal activities… the evidence in the literature is mounting that VATS may offer reduced rates of complications and better survival.”
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