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Posted 7/14/2008 7:09 PM (GMT 0)
are there studies or evidence that Asacol prevents colon cancer or reduces the risk?

If so, can you post the link or article?

Thanks
Posted 7/14/2008 8:33 PM (GMT 0)
I have been told that asacol reduces the risk of colon cancer but don't know of any exact studies.
Posted 7/14/2008 8:56 PM (GMT 0)

Here are a few I found:

http://pt.wkhealth.com/pt/re/alpt/abstract.00001716-200002000-00001.htm;jsessionid=L78WvK0HZ837nPTLXQGLvqyb2p2FJj0ctJHbsf2lxS04vd2Z3rCF!-406629960!181195629!8091!-1

http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=DIG2006073001011

http://www.ferring.com/en/newsroom/pressreleases/2006/mesalazine_IBD.htm

Posted 7/14/2008 10:09 PM (GMT 0)

To my knowledge there is no definitive study that shows a causal relationship between Asacol use and a decreased incidence of colorectal cancer.  (P&G would love that.  Imagine every Baby Boomer on a low dose of Asacol.)

Instead, there are many studies that suggest that 5-ASAs may provide prophylaxis against colorectal cancer.  At any rate, the incidence of colorectal cancer (and colorectal cancer only) among patients with uc has gone down, and many studies have looked at 5-ASA compounds as the source of that benefit.  The careful studies also generally add that increased doctor visits and better surveillence may have a role in decreased colorectal cancer rates.

These studies notwithstanding, many foreign gastro associations commonly recommed prophylactic colectomy at the 20-25 year mark as the only true manner of reducing or eliminating a uc patient's colorectal cancer risk.

Hope this helps.

Posted 7/15/2008 5:55 AM (GMT 0)
It's strongly suspected that long-term use of 5-ASA ..not only Asacol...helps reduce the risk of cancer in UC patients.

Since UC starts at the rectum it'd be a good plus for the use of rectal meds rather than assuming it's just the oral 5ASA meds.

At the 18 year mark, all my biopsies were A++....unremarkable, which is actually a good thing. I also have primary sclerosing cholangitis (PSC) which increases my colon/liver cancer risk over and above just having UC.

I attribute my current state in (a large) part to faithful use of the 5ASA meds to treat flares and for maintenance since diagnosis over 19 years ago and heading into year 20, and there would be no reason for my doc to suggest surgery just in case unless biopsies stated so.
I also attribute the slow progression of PSC to keeping my colon nice and quiet as continually as possible.

I've only had c-scopes about every 3 years.

If a patient has chronic inflammation (with or without symptoms because not all show symptoms equalling the inflammation), I can see cancer risk increased just based on that fact. If one can use them, I would see it as some insurance.
For some UCers, 5-ASA isn't a possibility because of allergies and extreme side effects.

My perspective,
quincy
Posted 7/15/2008 1:37 PM (GMT 0)
That's interesting, Quincy. 

In a lot of the medical literature, PSC + UC is usually a pretty strong indication for prophylactic colectomy at 20 years.  As I understand the line of thought, the number of biopsies required to survey for cancer is too great to provide an accurate analysis of colonic health.  I think some reports recommend colonoscopy every six months at 25 years with PSC and UC.

I also have to wonder about reduced CRC rates.  If a patient has a colectomy due to high-grade dysplasia, does that count in reducing the CRC rate?  While technically accurate, it seems to juice the numbers.

(Completely off topic:  Have you seen "My Winnipeg"?  A couple of friends have recently recommended it.)

Posted 7/15/2008 2:05 PM (GMT 0)
Hi....I have 30 biopsies done and it's true I would think that not enough could ever be done to be totally unremarkable. I would think that visually something suspect would be biopsied for sure.

Statistics are wonky anyway.....who knows what they would include in the numbers, but I would suspect they don't include colectomies.

I would suspect that many who have PSC would die before needing a colectomy anyway ... or at least who would need liver transplant before the colectomy or whatever happens when both go. I would think it depends on the situation of the person and if one even knows they have PSC before the major symptoms hit. Lots of variables.

Definitely lots to chew on regarding what's right and what's not...I would suspect doing lots of research and dealing with flares and not ignoring maintenance meds is a good start.

Cancer doesn't run in my family, so there's some plusses to it...should have at least something positive since I have enough other inherited crapola. I'll take functioning well as a good sign all is working OK.

No, haven't seen "My Winnipeg" yet. Very artsy I hear....but thanks for the recommendation. I'll consider it.

q
Posted 7/15/2008 4:29 PM (GMT 0)
My gastroenterologist put me back on the Asacol last year as maintenace stating that there were findings that it was a cancer preventative.
Posted 7/15/2008 6:01 PM (GMT 0)
I hear you, Quincy. What's "right" is always so situation dependant with chronic illness. . . What's best at the time??? (Which sometimes scares me.)

In the end, probably better to do whatever it takes to keep inflammation down since it's likely the reduction of inflammation rather than the drugs that reduces the risk, among other possibilties. All about healthy livin'. . . . At least you have genetics on your side. My peoples tend to live forever, but when they die it's almost always colon cancer. Always something to chew on.

Have you heard of chromo-colonoscopy? (I think that's what it's called.) It uses a dye to check for lesions and I think it's being tested for uc. Might help with early cancer detection. If I'm not mistaken, water infusion colonoscopy rather than insufflation seems to have some benefit in CRC detection too.

"Artsy" may be an understatement. "Saddest Music in the World" was so artsy I just couldn't sit through it.
Posted 7/16/2008 6:05 AM (GMT 0)
Definitely scary that colon cancer runs in your family. That puts you in a higher stat bracket than I'm in I would suspect. I did a quick search on the chromocolonoscopy...interesting stuff but it seems it's more in the early stages of diagnostics? if I'm "reading" it correctly. Doing the spray dye makes sense if it detects the type of cells that are cancerous or soon to be cancerous. Very promising and hoping it'll be a tool all the docs can use to diagnose and treat very early. That'would be great.

I know of one girl whose father died of colon cancer. His mom died of it as well....and he hid his symptoms from everyone until it was too late. After he died, all the family (his children, his siblings and their children had to have c-scopes for early detection of that specific precancer...and his daughter had the cells..out came her colon. Sometimes there are preventative measures that can be lifesaving.

My genetics aren't really on my side regarding other stuff, but cancer isn't one of them at least....but that doesn't make it a guarantee. Like I said...just functioning (and wanting to wake up in the morning) is a huge plus for me..haha.

Regarding the artsy term for the movie....maybe I was a bit reserved in stating it...yes, maybe nauseating would be a better term..the "guy" is on another planet. I checked out a few trailers on YouTube...uh, I'll pass, even if it is about Winnipeg..lol! ugh.

I'll ask my doc about the chromocolonoscopy when I see him in September. The time is flying quickly. Best start making my list....

Be well,
quincy
Posted 7/16/2008 11:52 PM (GMT 0)
The sun comes up every morning. That's one thing we can all count on. I certainly look forward to it.

I'm pretty sure chromocolonoscopy is still early. Even in non-uc people the flat lesions that often lead to colon cancer are difficult to detect. (And current research indicates many more people have these lesions than was previously thought.) These lesions are common in uc folks, more common than a polyp that goes wrong, and finding them is important in a uc colonoscopy but -- as I understand it -- more difficult given the possibility of inflammation etc. One way to attempt to find them is to take tons of biopsies. (I think some suggest upward of 90 samples.) The chromocolonoscopy uses an indigo dye to heighten the contrast between the regular colon and these lesions and is supposed to make them easier to locate.

Some friends suggested "My Winnepeg" because I live in a pretty dysfunctional city where a healthy appreciation for the absurd is a necessary coping mechanism. There's a fine line between nauseating and sublime -- perhaps that is where artsy lies.
Posted 7/17/2008 7:45 AM (GMT 0)
Yeah, maybe so..lol! We're heading up the dysfunctional scale as we speak...unfortunately.

Artsy according to the dictionary means informal. Hmmm..interesting.
Seems the definition is lacking compared to what artsy usually seems to portray. I like your description better ;-)

Thanks for the insight.
q
Posted 7/17/2008 2:56 PM (GMT 0)
Glad you liked it.
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