Results of the ECHO (Eating habits CHanges in Oncologic patients) Survey: An Italian Cross-Sectional Multicentric Study to Explore Dietary Changes and Dietary Supplement Use, in Breast Cancer Survivors.

The role of a healthy diet in cancer prevention is well recognized. Recent data indicate that following the same advices can also improve cancer survivors' quality of life. Breast cancer (BC) patients are commonly concerned about diet and nutrition and frequently express the need to obtain health-related information and the will to change their diet and lifestyle. Hence, be aware of survivors' dietary changes and information needs is crucial for healthcare professionals to guide them toward optimal lifestyle choices. In order to investigate eating habits changes in a BC survivors' population, we conceived the cross-sectional multicentric study ECHO (Eating habits CHanges in Oncologic patients) Survey. Data were collected from 684 patients, diagnosed with invasive breast cancer, in order to investigate their changes in food consumption, use of supplements, or the beginning of a specific diet, after BC diagnosis. We also examined the sources of information used and if any modification in their diets was reported to the oncologist. We primarily observed that patients increased their consumption of vegetables, pulses, nuts, fruits, wholemeal bread/pasta, grains and fish; while decreasing red and processed meat, refined bread/pasta, baked good and animal fat consumption. Survivors also reported the use of dietary supplements, mainly vitamins, aimed at counteracting therapies' side effects. Changes in nutritional habits were often adopted without asking or informing the oncologist. Despite BC survivors made some positive changes in their nutritional habits, those modifications were mostly pursued by less than half of them, while the majority of patients consumed nutritional supplements after diagnosis. These results, as well as the failure to communicate with the physicians, reinforce the need to both improve the patient-healthcare professional relationship and to develop tailored nutrition counselling and intervention programs for cancer survivors.

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer.

The aim of this study was to assess the effect of adjuvant anastrozole, alone or associated with risedronate, on BMD and bone fracture risk in women more than 70 years old with hormone receptor-positive early breast cancer (EBC). In a group of 51 elderly women (aged 76.4 ± 5.0 years) considered for adjuvant aromatase inhibitors for EBC, 24 patients with T-scores ≥ -2 and no prevalent fractures received anastrozole 1 mg/day (group A), and 27 patients with T-scores < -2, or with T-scores ≥ -2 and prevalent fractures (group B), received anastrozole (1 mg/day) plus risedronate (35 mg/week). Both groups received supplementation with 1 g calcium carbonate and 800 IU vitamin D per day. Differences in BMD and frailty fractures were evaluated after 1 and 2 years. In group A, significant decreases in BMD were observed in the lumbar spine (Δ BMD, -0.030 ± 0.04 g/cm², P < 0.05), femoral neck (Δ BMD, -0.029 ± 0.05 g/cm², P < 0.05), and trochanter (Δ BMD, -0.026 ± 0.03 g/cm², P < 0.01) after 2 years. The greatest percent reduction in height (Hpr) emerged in the thoracic spine (3.6 ± 2.4%, P < 0.01), although only one incident vertebral fracture was observed. In group B, BMD increased in the lumbar spine (Δ BMD, 0.038 ± 0.04, P < 0.001), although no significant changes were seen in the hip regions. The decline in Hpr was negligible (about 1%). No incident fractures were observed at follow-up. In conclusion, anastrozole treatment for EBC in elderly women seems to have only mild negative effects on the femoral bone. Risedronate makes the use of anastrozole safer, even for osteopenic or osteoporotic elderly patients.

Rectal cancer neoadjuvant treatment in elderly patients.

BACKGROUND: The aim of the study was to evaluate the differences in terms of toxicity and feasibility of neoadjuvant 5-fluorouracil (5FU) continuous infusion (c.i.) or bolus in combination with pelvic radiotherapy (RT) in locally advanced rectal cancer "fit" or "vulnerable" elderly patients. A secondary endpoint was to identify any specific comorbidity that affected either effectiveness or morbidity of treatment. PATIENTS AND METHODS: From June 2000 to June 2005, 36 patients over 70 years of age out of a total of 88 consecutive elderly cases were retrospectively examined. Variables considered were age, gender, modality of 5FU administration and comorbidities (evaluated according to Cumulative Illness Rating Scale-Geriatric, CIRS-G). RESULTS: Median age was 74 years (range, 70-82) years and the male:female ratio, 22:14. Fourteen % of the patients healthy and 25% with slight comorbidities were considered "fit" and 61% "vulnerable". All the patients received the full course of RT. The mean number of chemotherapy weeks was 5.34 (range, 2-6); "vulnerable" patients did not experience higher toxicity compared to "fit" patients (p = 0.69). Eighty-nine % of the patients were operated without relevant postoperative complications. Thirteen out of 20 "vulnerable" and 10 out of 12 "fit" patients had a pathological downstaging of disease (p = 0.24). CONCLUSION: Selected elderly "vulnerable" patients with rectal cancer can receive the same neoadjuvant 5FU-based chemoradiotherapy (either bolus or c.i.) and undergo surgery as well as "fit" elderly patients, since tolerability and response rate seem to be similar in both categories of patients.

[Questionable methods in cancer therapy]. / Le terapie non convenzionali in oncologia.

Although alternative and complementary therapies are a well known, spread reality, and many alternative cancer cure were generally found ineffective in clinical trials, oncologists don't care of them. While some therapies, such as spiritual healing and relaxation, are low risk if they don't delay effective conventional methods, herbal remedies showed potential adverse reactions. Oncologists should be aware of these products and question patients on their use of them.