Crohn's and Cancer

[beautiful_disaster]

I've heard a lot about different Crohns treatments leading to different kinds of cancer. If you have Crohns, doesnt that normally mean you are goin to have cancer of your colon, so forth? I've heard remicade can give you lung cancer, so I mean basically cancer is inevitable here? So it's something to take into consideration, but need be, not to eliminate any kind of meds or treatment?? Sorry this is all just one big question. But I've heard a lot of rumors and have read a lot and was just curious on what your guy's intake of it all was?

 

[butt-eze]

Cancer is not a guarantee. However, our risk for colon cancer is greatly increased. Keeping flares under control and reducing scar tissue can help. But without a medication that works for you that is out of your control. Everyones view on cancer is different.
The healthiest people in the world can do everything to "prevent" cancer and end up developing it anyway.
I'm going to worry about one disease at a time.

 

[saidinstouch]

Actually our risk for cancer is not elevated statistically from those without cancer according to a lot of recent studies and discussions with various doctors. The persistant inflammation is indicated in leading to greater rates of cancer, but not proven and thus crohns itself does not truly increase our risk of cancer.

What is changed is the course of treatment. In normal people when precancerous lesions are found, they perform rounds of chemotherapy and attempt to save the colon, removing only the parts necessary. In patients with IBD, especially crohns and colitis, the entire colon in one surgery because the tendency is to develop cancer rapidly once it is discovered which is why we are supposed to receive colonoscopies so frequently and early on compared to the average person.

Remicade is not indicated in lung cancer, it is _potentially_ indicated for lymphomas, but that increased risk is minimal statistically meaning the reduced inflammation and health benefit greatly outweigh the risk for lymphoma. The slight increase is minimal at best and in many cases is considered to not truly exist except for the fact in relatively small samples from the trial one or two additional cases were observed.

Most of our treatments are fairly safe in the cancer causing department. I would be more worried about other long term effects like those caused by steroids and methotrexate. A healthy lifestyle and good maintenance therapy are the best way to go longterm. I hope this has cleared up some of your concern. It took attending a crohns conference and being told most of this information directly by doctors to really alleviate my concerns. You can also talk to your GI doctor and if they are well informed with the latest research, then you should hopefully get confirmation of this information or something very close.

P.S. when I say statistically small I mean it might be a 1-5% increase, but in general that is a very tiny increase and often the p-value associated with this result is not truly significant indicating the result could just as easily been random than something meaningful.

 

[Colt]

I'm curious to see a link for those studies. From what I've read 1 in 12 crohn's patients get colon cancer in their lifetime. I'm not sure of the normal rate but I doubt it's that high.

Also vegetarians get colon cancer at 25% of the rate meat eaters do. This is part of the reason I don't eat meat. Granted it doesn't really translate perfectly like this but that takes it from a 1 in 12 chance to a 1 in 48 chance.

 

[D Bergy]

Beware of statistics. You need to find the whole story before giving to much credence to them. Maybe meat eaters get colon cancer more often, but these type of statistics do not happen in a vacuum. It is difficult to get proper nutrition without meat in the diet. Quit often if you dig deeper you will find that vegetarians have an equally bad disease that comes from their eating habits.

I have also heard, but not verified that vegetarians have a shorter life expectancy then people who eat meat. Might be worth checking it out. If that is the case than it really does not matter if colon cancer is reduced, since something else is going to get you anyway.

I do not know the real facts in this case, but have found these type of studies lacking for the reasons outlined above.

Let me know if you find out some statistics on life expectancy.

Dan

 

[saidinstouch]

That is sort of what I was trying to get at. While there are statistics saying 90% of people with crohns (edit: do not) develop cancer, in general it isn't truly proven if we are at an elevated risk. With proper screening and maintenance we can avoid a lot of the risk, though even without flares we can still develop colon cancer. Because we don't live in a vacuum we cannot attribute the small increase in cancer to just the crohns and so it isn't something to worry about. There are enough conflicting studies to indicate that we should worry about a lot of other issues before cancer. As I said, the treatment is drastically changed because it saves lives and leads to less chance of relapse and death.

edit: forgot to add the words do not up there and that really changes the meaning there .

 

[Kev]

I do NOT have much to add to this in the way of statistics, scientific studies, anything along those lines... I just think there are some things we need to be aware of.

frinstance, I would ASSume finding a potentially 'interesting' polyp in a pristine GI tract as opposed to 'ours' is probably balanced in favour of the former.. But you do have to take into account we have doctors, scopes, tests, all of that.. looking for issues just like this... whereas those pitiable folks with pristine GI tracts... how often do they get their plumbing examined? Probably only when there's a problem.. I also think that some of the meds we are on have some connection, some link to a small 'known' increased risk of developing specific cancers... BUT, again, if our doctors are doing their job, and we co-operate, it should be something that we are routinely screened/checked/tested for, n'est pas? I dont' think the prescence of this disease predetermines us for cancer..
AND that a fatalistic point of view that we are likely going to die from cancer is not a benefit... or a boon.. Sorry to break the news to you folks, but we are ALL going to die of something, sometime. I wouldn't waste time lookin for a cure

 

[jed]

i was very afraid of reading all the statistics on this, but it turns out i was reading the info inncorrectly.

when i saw it say "crohns people have 50% more chance of colon cancer ", i read it as we have a 50% chance of getting it.

however, it actualy meant, we have 50% more chance than a normal person. so if a normal person has a 1 in 500 chance of colon cancer, then we have a 1 in 250 chance. so its not all that much more.

(fyi, i know the numbers and percentages i used are wrong, they were just easy round numbers to do an example with.)

 

[BWS1982]

yeah I know what you were trying to say Jed. It's 1 in 500 for example, and then 50% more is actually 1.5 in 500, or about 1 in 333.3....

 

[Colt]

Beware of statistics. You need to find the whole story before giving to much credence to them. Maybe meat eaters get colon cancer more often, but these type of statistics do not happen in a vacuum. It is difficult to get proper nutrition without meat in the diet. Quit often if you dig deeper you will find that vegetarians have an equally bad disease that comes from their eating habits.

I have also heard, but not verified that vegetarians have a shorter life expectancy then people who eat meat. Might be worth checking it out. If that is the case than it really does not matter if colon cancer is reduced, since something else is going to get you anyway.

I do not know the real facts in this case, but have found these type of studies lacking for the reasons outlined above.

Let me know if you find out some statistics on life expectancy.

Dan

Completely untrue. There's not one thing vegetarians have a deficiency in. Even without considering supplements like a multi-vitamin.

Protein? Your average vegetarian gets more protein than your average meat eater. Vegetarians also get a healthier mix of protein types. What Vegetarians get less of (and it's the main nutritional difference) is fat. While a beef hamburger may have 25% fat and 75% protein, a vegie burger has 0-5% fat, 5-10% carbohydrates, and 90-95% protein.

Iron? 12.8% of your daily recommended iron for a hamburger. 10% for a vegie burger. Spinach is 5%. Broccoli is 4%. Tofu is 9%. Peanut butter is 3%. Bread is 4%. A small bowl of total cereal in the morning will give you a whopping 124% of your daily Iron.

All of this has far fewer calories too. Vegetarians after a few years have an extremely low incidence of obesity which is pretty much the #1 killer. The low fat intake reduces the incidence of everything from heart disease to diabetes and colon cancer, and it helps with digestive problems like crohn's.

The only studies that have supposedly shown vegetarians have problems or have a lower life expectancy than meat eaters use the following proposition: People who have (Insert vitamin/nutrient here) deficiency have this life expectancy. The problem here is that it has nothing to do with vegetarians. They make absolutely no connection to vegetarians even having such deficiencies. Yes, if you have a calcium deficiency you will have weaker bones. That does not mean vegetarians have weaker bones because there's nothing that says vegetarians get less calcium.

On the other hand here's a link (http://www.veganhealth.org/articles/research) providing the results cumulated from the 4 largest studies on the matter before 1999 showing a 15% reduction in mortality for vegetarians. 18% for fish vegetarians (which is what I am). And that's before anyone knew what we know now about nutrition and before we had the supplements and meat alternatives that we do today. The things available to vegetarians today are completely different from 10 years ago.

If you want to cite the Adventist Studies that people incorrectly say show a lower life expectancy for vegetarians, they covered a population who are only 29% vegetarian and in 1976-1988 they lived 2.87 years longer than non-Adventists. They have other differences like not smoking or drinking though so the Adventists can pretty much be ignored when compared to the general public for any one specific thing.

My wife is actually studying to be a nutritionist and nutritionists usually hold vegetarians in high regards.

 

[Kev]

Oh, I love this sort of controversy. I think folks on either side of the equation could wile away the rest of their lives in point/counterpoint, comparing studies till the cows came home (and why wouldn't the cows come home with no meateaters around)... BUT... All of the vegetarians I know have serious health ailments. That is a relatively small sample, and I'm not using it as a solid argument for/against. I point it out simply as an anecdotal anomaly. I think the argument whether vegetarians live longer or shorter, worse or better, than non vegatarians is a waste of time. WHY? Simply because one is comparing a group WHO stringently (more or less) watch what they eat; against a group of dubious interest in what they consume. Most 'meat' eaters don't eat a healthy well balanced diet. I'm speculating, but I propose that if one confined a study to those who kept to a strictly vegatarian diet and those who ate a strictly well balanced diet, the latter would surpass the former .. all things being equal. It's a totally unprovable stance... My only real points of argument are that humans were /are omnivores.. that is our genetically engineered pre-disposition, AND the 'equipment' we have evolved with was designed/intended/evolved to just that purpose. AND.. That a diet that is not well balanced... too many veggies N not enuff meat... OR vice versa.. SIMPLY cannot by logic compete against one that derives the best of both from the nutritional sources available to us. The studies that talk about the risk of meat consumption WERE talking about the typical over consumption of red meat... fatty red meat.. AND you know that if someone doesn't concern themselves about red meat, it's fat content, then its highly probable they aren't going to concern themselves about its preparation.

That's basically what I structure my stance on in this unwinable argument. The observation of the 'human animal' (which we are) N pure, simple, honest logic!

 

[BWS1982]

I completely agree with what Kev said. There's healthy meat eaters, and then there's the classic McDonalds lover who thrives on the worst meat has to offer. At the top of my game, my cholesterol was around 110 at a "150 grams of meat protein/day" state, and it comes down to a simple matter of what meat you're talking about. It's like comparing alcohol drinkers: you have a vodka alcoholic on one side and the 3 red wines/week drinker....it's all about the content/quality.

To the point of protein intake, not true with the amino's, plant proteins are known for not containing all the amino's in their profiles, a complete protein is a more effective protein. 1 gram from peanuts or tofu isn't the same as 1 gram from something like an egg white or chicken breast. There's many aminos that a vegetarian can often miss out on if one isn't careful (although I'd guess that Colt is more learned on the subject than most vegetarians)...just like all fat isn't the same, not all protein is the same. There are plenty of massive bodybuilders who naturally get their diet sans meat, so I still respect the potentials, but it's more work and more difficult and I honestly believe that good meats in a diet are the best route, but that's my opinion.

I also agree there's too many studies like Kev said for one to win, as soon as one is placed on the table, 2 more are placed by the other party, and then 3 more are placed by the first party....nonsensical waste of time. To each his/her own.

Also, to the point of nutritionists holding meat eaters to a high esteem, that's not always the case, but if they do, I'd have to point out the old "low fat is king" mantra that ruled the 1990's health scene, it's still thriving in many circles, but it's not so cut and dry.

"Intelligence, research, moderation, and fitness.....the other other other white meat"

 

[D Bergy]

I don't know which is healthier, so I will go by my instincts on this one.

We apparently have an intestinal tract that is better for plant material, and yet we have eyes on the front of our head like a predator. It is difficult for me to believe that we are not supposed to eat meat since we have some characteristics of predators. It is almost certain that people have always had meat in their diet since crop farming is a relatively new thing. In cold climates, meat was the only food available in winter, to our ancestors. Ethnic back round probably plays a role in this also.

I guess I will eat as an omnivore and try to keep a healthy balance. I think it is better to eat less red meat and more fish.

Who knows for sure?

Dan

 

[Kev]

Well, we have canines and incisors... so a veggie diet would have caused dental problems for our ancient forebears... and we only have one stomach, not multiple stomachs N digestive chambers.. And I've always held that we should listen to our 'bodies'.. which makes me ponder all the vegetarian meat substitutes, which I do eat... meatless hamburgers, meatless hotdogs, meatless pepperoni, meatless ground round... meatless chicken burgers N stips

Wellll, obviously there's a major market amongst vegetarians for the 'taste' of meat... which leads me to speculate their bodies are trying to tell em something

 

[Wiles]

I think the perfect diet will vary from person to person. Both my sisters were vegetarian and it worked well for one, but not the other. I know I couldn't handle a veggie diet. At the best of times a lot of veggies don't digest well for me, and at the worst of times they cause me much discomfort.

 

[BWS1982]

Well, we have canines and incisors... so a veggie diet would have caused dental problems for our ancient forebears... and we only have one stomach, not multiple stomachs N digestive chambers.. And I've always held that we should listen to our 'bodies'.. which makes me ponder all the vegetarian meat substitutes, which I do eat... meatless hamburgers, meatless hotdogs, meatless pepperoni, meatless ground round... meatless chicken burgers N stips

Wellll, obviously there's a major market amongst vegetarians for the 'taste' of meat... which leads me to speculate their bodies are trying to tell em something

Good point.

 

[Colt]

First off, I'm not an ethical vegetarian. I don't have any more or less moral problem eating a cow or a cake. I'm not going to argue that people that eat meat are bad. it's perfectly possible to have a healthy diet including meat. I even eat seafood which has the benefit of almost no fat, high omega-3s, etc. It's just a lot easier to do without because there aren't so many bad options and you don't have to have the rest of your diet be completely crazy and strict to compensate for the bad qualities of the meat. I'd like to point out the annoying thing where everyone things that vegetarians eat nothing but vegetables though. Most vegetarians don't really each much more. The vegetarian diet consists of the grains and dairy as much as a meat eater's.

The thing is that we don't have the same food access as we used to. Sure in Mongolia 1000 years ago there was practically 0 fruits, grains or vegetables available (it's still pretty much that way with what they have domestically) and everyone ate a diet of almost 100% meat and dairy. Now we have access to any type of food from anywhere on the planet and we have engineered foods (don't fall into the natural fallacy. Bread is engineered too) that haven't even existed until the very recent past. Before the 1950s it wasn't even possible for many people to get a balanced diet. Meat or not. Our new found access to the best foods from the entire world give us the ability to eat healthier than we ever have. There are reasons we are vastly more healthy than we used to be just 100 years ago.

Today we have access to things that make meat no longer a necessary evil. People can get everything meat has to offer (complete proteins and fat) easily with no trouble from many, many other things. All of the proteins are available in non-meat items. If you eat beans and rice (one of thousands of combinations) you've gotten a complete protein. Not only do you get every single type of protein there is in that combination but eating them separately makes them more absorbable so eating beans and rice means more protein makes it into your blood stream and it's more easily used by your body than if you ate that same combination of proteins in meat.

Again, there's nothing in meat that can not be easily found in a typical lazy vegetarian diet. Nutrition all breaks down into it's parts like matter breaks down to atoms. A nitrogen atom is still a nitrogen atom regardless of if I got it out of the air or out of the ground. Just the same as a protein is the same regardless of if I got it out of a cow's ass or a cow's milk.

 

[Kev]

Well, I'm not sure whether it is possible to get all one's essentials readily from just a strictly vegetarian source UNLESS it was processed so we could properly absorb it.. And, even if theoretically, or even practically, it was possible.. is it the 'best' source? Like, if protein is a protein is a protein... why is krill oil better than fish oil?
Or, why is Omega 3 from 'cold' water fish better than warm water, shallow living fish? And, if Omega 3 (just as an example) is available from veggie only sources (is it?), then for a veggie diet to match an omnivore diet, the availabilty or 'ease' of getting it from krill or fish has to be some sort of misconstruence of the facts... It's things like this that make me question whether a vegan diet is superior, or even equal to an omnivore diet. I'm not saying that its impossible to live on a strictly vegetarian diet... and I believe it is healthier than a 'typical' diet.. but I believe, logically, a well balanced healthy diet HAS to be the 'BEST'.
Else a vegetarian diet would be put forward as the best case diet for everyone by the medical profession. And I've seen absolutely no evidence of them doing so... nor any 'real' reasons for them not to. It certainly isn't a populist vote, it isn't easy to get folks to adopt a healthy balanced diet... Does that make sense?

 

[BWS1982]

Like I said Colt, it comes down to informativeness of the person in question. In your case you're learned compared to most when it comes to nutrition, so of course you can get the full spectrum of aminos. But I disagree with your "easily" choice of wording. Certain aminos are harder to come by (glutamine for example is very plentiful, whereas something like tryptophan or Isoleucine are a bit rarer).

One has to know what aminos are in all the foods so they can get a complete spectrum and even focus on certain ones due to unique properties (like Arginine's NO2 properties), without meat, it requires some research (most people in civilized nations don't have a clue what they're putting in their mouth, vegan or otherwise) and you can see in my post above that I say yes it's possible but much more work.

Remember also to the point that "meat eaters" also eat grains etc...so they get a greater array of protein profiles IMO, because they get the ones you speak of (beans and rice) plus the ones from meats (preferably lean). I agree with some of your points but disagree with others, and in this case I think it comes down too much to a point of who you're talking about, not what diet one is talking about. For example, I could find many vegetarians I know who don't care about getting all the nutrients meat would offer them otherwise. An ex-coworker and a current coworker both scoffed at the thought of even focusing on protein consumption (the latter is an avid weightlifter who comes to me for advice, and a he's a good friend)....so again my point still is about who you're speaking of. Like I said above you're a learned/informed individual in such matters, whereas there are many "lazy" meat eaters with their diets, and some (albeit fewer) lazy Veggies too, who neglect to makes sure they get what they should. I honestly believe that an intelligent vegetarian will be about as healthy as an intelligent meat eater when you break it down, as they both will make sure to focus on the good, and limit the bad.

I think your choice to include fish is probably one of the best kinds of "vegetarians" due to fish being probably the healthiest/most beneficial "meat" there is, but I think when it really comes to it, it's about who is in question, not what diet is in question. So in conclusion, several things: Vegetarianism is more work, being judicial about meat choices is second nature to me, and staying active (when not flaring) helps immensely, and finally, meat tastes damn good. I don't feel sinful or unhealthy about my diet as I know how it was constructed and what it consists of, and what it has the propensity to lack. I feel optimally healthy when I make a meal of spinach, chicken breast, egg whites, and an orange (a typical non-flaring bodybuilding meal of mine), and if one was to substitute that chicken and egg whites and they know what they're doing, I'm sure they'll feel optimally healthy too.

 

[Kev]

Well, I live on the coast. Fished since I was a kid. Worked on my uncles fishing boats.. recall when the harbours were teeming with sword fishing boats.. They are gone the way of the dodo. Mercury contamination. The levels of mercury in albacore means one has to watch how much they ingest. I don't know how many other 'wild' species of fish are on the mercury, or other contaminants, hot sheet..

Then there's farmed fish. fish farming abounds in the area.. problem is, that is in decline too. Problems include parasites from growing in close proximity, and infections (again, proximity plays a role, but it is also thought that 'farmed' varieties aren't as robust as wild varieties.. nod to Darwin and survival of the fittest).. Then there's the anti-biotic controversy.. fish farming, to stem off the parasites N infections, LOAD their farmed fish with anti-biotics. and it remains.

I eat fish. I love fish.. I recall the days vividly before I became allergic to shell fish.. And I recall the days BEFORE my low fat diet when I would readily eat all fish (w/o shells, of course). I wonder as I write this, in relation to another post, whether it was the adoption of a Westernized diet, hi in fats, and contaminants or anti-biotics in fish, a staple of their diet. COMBINED, that led to the 'increase' in IBD in Japan. Anyway, I think the days of a simple yes or no to food intake is behind one AFTER you develop IBD. Of course, thats just my 'gut' talking, ok?