Weekend Links: Methotrexate Safe In Long Run, Mouse Model, Fecal Transplants, and Crohn Cancer Risk

Methotrexate Safe In Long Run 
A study shows that methotrexate is safe for Crohn's patients in the long run (and also beneficial). 63% of patients saw benefits after 1 year, which decreased to 47% at 2 years, and at 5 years only 20% of patients saw benefits.

New Mouse Model To Study Crohn's disease 

Researchers at McMaster University in Canada are using mice that have e-coli in them to study how inflammation affects the mice.

Crohn's Cancer Risk

In a study done in Norway the mortality and cause of death was looked at in Crohn's patients. The study looked over a 20 year period after patients were initially diagnosed with Crohn's. The study found no significant difference between Crohn's patients and regular people (about 14% of Crohn's patients died as opposed to 13% of the control group). 

FDA Backing Off Fecal Transplants

In a wise move by the FDA it said this past week it would no longer need agency approval before performing fecal transplants. I am glad to see the FDA did something wise for once. I estimated over regulating fecal transplants would have let thousands of people die and left even tens of thousands or more people in pain.

Colon Cancer and Crohn's: How You Can Reduce Your Risk

One of the things I hear is that Crohn’s patients are at greater risk of getting colon cancer. Me being the researcher I am decided to do some research to see what the causes of colon cancer are and if anything can be done to prevent it.

This study puts the risk of getting colon cancer at 7% for Crohn’s patients after having the disease for 20 years. The risk was greater for patients who get it younger than 25. However, this meta-analysis (combined multiple studies) at least for ulcerative colitis found a non significant increase in risk over time for colon cancer.  This study shows that ulcerative colitis and Crohn’s only account for 1-2% of all cases of colon cancer however accounts for 15% of the deaths related to inflammatory bowel disease. 5-ASA’s do seem to help reduce the risk. This study which studied patients from 1940-2001 showed that there as only a slight increase in the risk of getting colon cancer for Crohn’s patients (6 patients got colon cancer vs. 3.2 that were expected).

So what can we do to reduce the risk of colon cancer? I am glad you asked because I did some research and found in this study (in men) cutting back on red meat, eating beef, pork, or lamb less than 5 or more times per week. Poultry, fish, dairy products, and vegetable fat can slightly reduce the risk of colon cancer.  This New England Journal of Medicine article that studied woman found that woman should avoid eating animal fat because it increased the risk of colon cancer and substitute fish and chicken for meats high in fat. This study showed that low physical activity in a physical job can lead to an increase risk in colon cancer.

A company called Exact Sciences is trying to create a better screening for colon cancer. The test is known as Cologuard and could hit the market by 2014 if the FDA approves it according to this Barron’s article.  If you get a colonoscopy done and precancerous growths are caught early enough they can be removed during the colonoscopy. The problem is that more than 50% of colon cancers are diagnosed in the late stages when death increases dramatically.  The test is pretty easy and just requires a stool sample that is sent to a lab to see if it has precancerous growths. The cost may cost $300 which is still much more than stool-based blood tests.

On the drug side the FDA just recently approved a drug called Stivarga which helps for people that have the cancer spread to other parts of their body. The drug extended life almost 6 and half months.

The policy recommendations for reducing risk of colon cancer are avoid meat (eat chicken or fish instead), work out, get a colonoscopy, and if something is wrong talk to your doctor for early detection and you should reduce your risk of getting colon cancer.