Multivitamin use doesn’t impact colon cancer outcomes

BOSTON–Patients with colon cancer who used multivitamins during and after being treated with post-surgical chemotherapy did not reduce the risk of the cancer returning or their dying from it, according to researchers at Dana-Farber Cancer Institute.

In a study of patients with stage III colon cancer — characterized as cancer in the large bowel area with some cancer cells in a few nearby lymph nodes — the researchers found that while multivitamin use had no beneficial effect on patients’ outcomes, it also did not have a detrimental effect. The findings are reported online in the Journal of Clinical Oncology and later will be published in a print edition.

Kimmie Ng, MD, MPH, the paper’s first author and a gastrointestinal oncologist at Dana-Farber, said that despite conflicting evidence on the efficacy of multivitamins to reduce cancer risk and death, studies suggest that approximately 30 percent of Americans take multivitamins to prevent and treat chronic diseases such as cancer. Among cancer survivors, between 26 and 77 percent report using multivitamins.

“With such a high proportion of cancer patients utilizing multivitamin supplements in the belief that it will help them fight their cancer, we felt it was important to really examine the data to see what impact multivitamins had on cancer recurrence and survival,” said Ng.

The researchers used two questionnaires to track multivitamin use during and after chemotherapy. Of the 1,038 patients who completed the first survey, nearly half (518) responded they used multivitamins while receiving chemotherapy. Of the 810 cancer-free patients who completed the second survey six months after chemotherapy, more than half (416) reported multivitamin use.

Ng and her colleagues found no statistically significant differences in the rates of disease-free survival (the study’s primary endpoint), recurrence-free survival, or overall survival between those who used multivitamins and those who didn’t.

They also determined that an array of factors, including socio-economic status, household income, multivitamin and individual vitamin dosage, and consistency of multivitamin use did not impact their findings.

However, they did find a small beneficial association between age and weight and the use of multivitamins while receiving chemotherapy. Those 60 and younger experienced some survival benefit, as did obese patients. There were no benefits for either subgroup when the multivitamins were taken after chemotherapy was completed. Ng said additional studies are needed to confirm their findings and to investigate whether there were other factors that influenced the outcomes.

“This study adds to a growing body of research that questions the purported benefit of multivitamin use, and it underscores the need to investigate the use of individual vitamins, such as vitamin D, which may, in fact, provide real benefit,” said Charles Fuchs, MD, director of gastrointestinal oncology at Dana-Farber and the paper’s senior author. He noted that the average multivitamin typically contains only a small to modest amount of vitamin D.

The study was funded in part by the National Cancer Institute and by an American Society of Clinical Oncology Young Investigator Award.

In addition to Ng and Fuchs, the other authors are Jeffrey A. Meyerhardt, MD, MPH, Jennifer Chan, MD, and Robert J. Mayer, MD, Dana-Farber; Donna Niedzwiecki, PhD, and Donna R. Hollis, BS, Duke University; Leonard Saltz, MD, Memorial Sloane Kettering Cancer Center; Al B. Benson, III, MD, Lurie Comprehensive Cancer Center, Chicago; Paul L. Schaefer, MD, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, MD, Hôpital du Sácre-Coeur de Montréal; Alexander Hantel, MD, Edward Cancer Center, Naperville, IL; and Richard M. Goldberg, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, N.C.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute. It provides adult cancer care with Brigham and Women’s Hospital as Dana-Farber/Brigham and Women’s Cancer Center and it provides pediatric care with Children’s Hospital Boston as Dana-Farber/Children’s Hospital Cancer Center. Dana-Farber is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding.

2 COMMENTS

  1. To help protect yourself and your loved ones from the disease, follow these ten colon cancer prevention tips.
    1. Go to a doctor if you have any colon cancer symptoms.

    Usually, colon cancer doesn’t have any symptoms. However, in the later stages, symptoms may include thin stools, cramping, unexplained weight loss, and bloody stools.

    2. If you’re 50 or older, schedule a colon cancer screening.

    Then actually go to the appointment. More than 90 percent of people diagnosed with colon cancer are 50 or older and the average age of diagnosis is 64. Research indicates that by age 50, one in four people has polyps (colon cancer precursors). Getting screened is an excellent colon cancer prevention method.

    3. Eat a balanced diet.

    Diets high in fat and cholesterol (especially from animal sources) have been linked to increased colon cancer risk. Cholbuster and High-fiber diets however, have shown a protective effect.

    4. Maintain a healthy weight.

    All other things equal, obese men seem to be more at risk for colon cancer than obese women. Also, certain body types seem to influence risk more than others. Studies indicate that extra fat in the waist (an apple shape) increases colon cancer risk more than extra fat in the thighs or hips (a pear shape).

    5. Maintain an active lifestyle.

    Research indicates that exercising can reduce colon cancer risk by as much as 40 percent. Exercise also tends to reduce the incidence of other risk factors for colon cancer, like obesity and diabetes.

    6. Consider genetic counseling.

    People who carry genetic mutations linked to hereditary colon cancer are the most likely to develop the disease. If someone in your family has FAP or HNPCC, or if you’re of Ashkenazi Jewish descent, you should seriously consider adding genetic counseling to your colon cancer prevention plan.

    7. Learn your family medical history.

    Did you know your family medical history can impact your chances of developing colon cancer? When discussing colon cancer prevention with your doctor, remember to mention if family members have had polyps or colon cancer. Other cancers (such as stomach, liver, and bone) may also be relevant.

    8. Talk to a doctor about your personal medical history.

    As you may have guessed, discussing your own medical history is extremely important when it comes to colon cancer prevention. Sometimes we feel like doctors aren’t interested in what we have to say, so we try to answer their questions as quickly and succinctly as possible. But it’s alright – and advisable – to talk about your health history. Of particular concern are polyps, certain cancers, and chronic inflammation of the bowel – all of which can increase the risk of developing colon cancer.

    9. Don’t smoke.

    Yes, it’s a risk factor for colon cancer too. Smoking increases your risk for two main reasons. First, inhaled or swallowed tobacco smoke transports carcinogens to the colon. Second, tobacco use appears to increase polyp size.

    10. Reduce radiation exposure.

    Is radiation really relevant to colon cancer prevention? The short answer is yes. According to the U.S. Department of Health and Human Services, colon cancer has been caused by doses of about 1,000 millisieverts. So, what the heck is a millisievert and how do you keep from racking up 1,000 of them?

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