Low survival rates in non-Hodgkin's lymphoma patients attributed to lifestyle factors
A new study completed by researchers from the Mayo Clinic in collaboration with six other institutions in the United States found that patients with non-Hodgkin's lymphoma smoked and absorbed alcohol who or were obese prior to their cancer than the Diagnosis had a lower overall survival compared to patients who did not have these risk factors. This association was held after the representation of clinical and demographic factors, and also considering only deaths due to this kind of lymphoma.
"We don't know why this is the case, but suggest that alcohol may have different impacts on developing against surviving non-Hodgkin's lymphoma, and this justifies more research"
For example, non-Hodgkin's lymphoma patients with a 20 plus year history of smoking have never had a risk of death 76 percent higher compared to smokers; Patients who absorbed more than 43 grams of alcohol per week had a 55 percent higher risk of death compared to non-drinkers; and obese patients (defined as body mass index of 30 or higher) had a death risk of 32 percent higher compared to patients with normal weight for their height.
While smoking and obesity had already proven to increase the risk of developing non-Hodgkin's lymphoma, this is the first study of the United States to look at their role on survival after being diagnosed with non-Hodgkin's lymphoma, The researchers say. For alcohol, they found that use was associated with lower survival, which is opposite to the effect to develop non-Hodgkin's lymphoma, where alcohol appears at more low risk.
These discoveries, published in the online edition of March 30 of cancer, mirror findings found in three smaller studies, according to the principal investigator of the study, James Cerhan, M.D., Ph.D., a Mayo cancer epidemiologist. These are the first data of North American patients, and the only study to simultaneously look at each of the three lifestyle factors, he says.
"This now raises the hypothesis that changing these behaviors after the diagnosis could improve survival, but from this must be tested in a clinical study," he says. At the same time, patients in active treatment should discuss all lifestyle changes with their health care providers. Long-term survivors outside of treatment should consider the general public health recommendations that do recommend smoking cessation, moderate or no alcohol consumption, and reach a normal weight. »
Non-Hodgkin's lymphoma is a cancer of the immune system. This is the fifth most classic cause of cancer, and the most common hematologic malignancy in the United States.
In this study, information from 1,286 patients of non-Hodgkin's lymphoma was collected from 1998 to 2000. Patients were identified from population-based cancer registries in Michigan, Iowa, California, and Washington, and they were interviewed shortly after the diagnosis. Participants were invited to record their height and weigh the year before they were diagnosed, and half of the participants were also asked for information on the history of drinking and smoking.
Until 2007, 442 patients (34 percent) had died, including 144 of 420 patients with large diffuse B lymphocyte lymphoma and 93 of patients with follicular lymphoma, the two most common subtypes of non Hodgkin.
Of the 471 patients who provided information about smoking history, 34 percent were former smokers and 19 percent were current smokers at the time of diagnosis. The researchers predicted that the old and current smoking in these patients was associated with a risk of death approximately 50 percent higher. Also lower survival was related to a longer smoking time and larger numbers of the cigarettes smoked per day.
But there was a piece of good news. "It is important to note that patients who had to quit smoking 20 years or more before diagnosis had no higher risk of death than patients who had never smoked," Mr. Cerhan said.
of 458 patients with data on alcohol consumption, 49 percent absorbed alcohol one year before diagnosis, and median intake was 43.1 grams per week (about 3.3 cans of beer, 4.6 glasses of wine, or 2.7 bites Weekly mud). Researchers found an increased risk of 55 per cent of death among those who never drank more than 43 grams per week compared to drinkers. On the other hand, patients who drank 43 grams or less a week had a risk of death as compared to non-drinkers.
Mr. Cerhan notes that the association between drinking and survival is the opposite of what has been found for the development of non-Hodgkin's lymphoma. There, alcohol consumption appears to be at a lower risk of non-Hodgkin's lymphoma. "We don't know why this is the case, but suggest that alcohol may have different impacts on developing against surviving non-Hodgkin's lymphoma, and this justifies more research," he says.
Of the 1,189 who provided usable data about their height and weight, about 5 percent were of insufficient weight, 31 percent were normal weight, 39 percent were overly heavy, and 26 percent were classified as obese. After adjusting to clinical and demographic factors, obese patients had a death risk of 32 percent higher compared to normal weight patients; The risk of death for patients with overweight was assimilated to that for normal weights patients.
Even given these results for lifestyle factors, the most intense predictive factors of results in non-Hodgkin's lymphoma remain age and clinical measures that include deliveries such as cancer stage, number of lymph nodes Lymphatics that are affected, and some biochemical measures, Mr. Cerhan said.
The study had limitations, such as the initial data was designed to investigate at risk of developing non-Hodgkin's lymphoma and, in this study, these questionnaires were used to assess the impact of the same factors on survival. "This raises the concern that people may have changed their behaviour after diagnosis, and we would have missed these changes," Mr. Cerhan said. However, it notes that such an amendment would most likely polarise the study to find no association with lifestyle factors.
"First of all, we haven't answered the question of whether changing these factors after the diagnosis influences survival," he says. "Which is better done with a clinical test."
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