WEDNESDAY, Dec. 12 (HealthDay News) -- Many cancer patients endure unnecessary suffering when they resist treatment with morphine and other opioid painkillers because they believe the use of these drugs signifies imminent death, a new British study suggests.

"If we are to employ the range of available opioids in order to successfully manage pain caused by cancer, we must ensure that morphine does not remain inextricably linked with death. If this connection stays in place, then morphine will continue to be viewed as a comfort measure for the dying rather than a means of pain control for the living," study author Dr. Colette Reid, a consultant in palliative medicine at the Gloucester Royal Hospital, said in a prepared statement.

Publishing online Dec. 11 in the Annals of Oncology, Reid and her team interviewed 18 people, aged 55 to 82, with metastatic cancer who took part in a cancer pain management trial. A central theme of morphine as a last resort for dying patients emerged from the interviews.

"We found that patients with cancer who were offered morphine for pain relief interpreted this as a signal that their health professional thought they were dying, because opioids were interventions used only as a 'last resort.' Because participants themselves were not ready to die, they rejected morphine and other opioids as analgesics, despite the pain experienced as a consequence," the study authors wrote.

"Participants' descriptions of the role of professionals indicated that patients value professionals' confidence in opioids. Some patients may therefore become more frightened when offered a choice, since this indicates a lack of confidence in the opioid as an analgesic."

Reid noted that World Health Organization guidelines for the management of cancer pain state that severity of pain, not patient prognosis, should be the basis for making painkiller treatment decisions.

"So patients at all stages of cancer could have morphine if their pain is sufficient. In reality, the patients most likely to experience pain, and likely also to have the most severe pain, are those with metastatic disease, i.e., their cancer cannot be cured. These patients may yet have many months to live, but their quality of life is adversely affected by pain, since unrelieved pain leads to social isolation, loss of role and depressed mood," Reid said.

More information

The U.S. National Cancer Institute has more about cancer pain control.

TUESDAY, Dec. 11 (HealthDay News) -- A quarter-pound hamburger or a small pork chop eaten daily could put you at increased risk for a variety of cancers, U.S. government health researchers report.

The more red meat and processed meat you eat, the greater your risk, the researchers from the National Cancer Institute concluded.

"Red and processed meats have been associated with an elevated risk with colorectal cancer. We investigated whether this association was also evident for cancers at other anatomic sites," explained lead author Amanda Cross, an epidemiologist at the National Cancer Institute (NCI). "This is the largest study to look at the effect of red and processed meat on multiple cancer sites, including rarer cancers, such as laryngeal and liver cancer."

For the study, red meats included beef, pork and lamb. Processed meats included bacon, red-meat sausage, poultry sausage, luncheon meats, cold cuts, ham, regular hot dogs and low-fat hot dogs.

Cross and her team from the National Institutes of Health and the AARP analyzed health data from 500,000 people aged 50 to 71 who participated in the National Institutes of Health-AARP Diet and Health Study beginning in 1995-1996. They followed participants for about eight years, during which time they recorded 53,396 cases of cancer. In addition to meat consumption habits, the participants detailed other lifestyle choices such as smoking and exercise.

The team then grouped people into five categories according to their level of meat consumption.

"The highest category of red meat was those consuming the equivalent of a quarter pound hamburger or a small steak or a pork chop per day," said Cross, who added that the lowest category was equivalent to approximately three thin slices of ham or less per day.

For processed meat, the lowest category of consumption equated to no more than one slice of bacon a day, while the highest consumption category covered four slices a day.

The median consumption of red meat was 31.4 grams per 1,000 calories, which is about two and a half ounces of red meat a day for a person consuming the average 2,000-calorie diet.

Overall, the researchers found elevated risks for colorectal and lung cancer with high consumption of both meat types along with borderline higher risks for advanced prostate cancer. High red meat intake was also associated with increased risk of esophageal and liver and a borderline increased risk for laryngeal cancer. And high processed meat consumption also was associated with borderline increased risk for bladder cancer and myeloma, a kind of bone cancer.

In addition, both red meat and processed meat consumption were associated with increased pancreatic cancer risk in men, but not women.

And the research team noted an unexpected effect of red meat on endometrial cancer: the more red meat women consumed, the less likely they were to suffer from endometrial cancer.

"Our findings for colorectal cancer are consistent with the recommendations from the recently published World Cancer Research Fund and American Institute for Cancer Research to limit consumption of red meats, such as beef, pork and lamb," said Cross. "Our study also suggests that individuals consuming high quantities of red meat may be at an elevated risk for esophageal, liver and lung cancer."

There are several possible routes by which red and processed meats may contribute to cancer, the NCI researchers said. Meats are a source of saturated fat and iron, both of which have been linked to cancer, and also the source of several compounds that are known to affect cell development, they added.

Cooking at high temperatures might also contribute to cancer risk, Cross added.

"Heterocyclic amines and polycyclic aromatic hydrocarbons are formed when meats are cooked well-done by high temperature cooking methods, such as barbecuing," she said.

The study, published in the December 2007 issue of the online journal PLoS Medicine, brought a mixed response from experts in the field.

"This adds to the body of knowledge that supports recommendations that to reduce the risk of colon cancer, you should reduce your consumption of red and processed meats," said Colleen Doyle, director of nutrition and physical activity for the American Cancer Society. "It also adds to the smaller amount of research tying red and processed meats to other types of cancer risk. The American Cancer Society recommends reducing red and processed meat consumption to reduce the risk of prostate cancer."

"We really see this study that it further illustrates the complexity and challenges of understanding research related to diet and cancer. They also could have said red meat is protective of endometrial cancer. The challenges of looking at diet and cancer are just vast," said Mary K. Young, vice president for nutrition with the National Cattlemen's Beef Association. She noted that the researchers did not ask how food was prepared, which she said could have affected the health outcomes.

Doyle and Young, both dietitians, agreed that diet can play a critical role in health.

"One of the most important things people can do to lower their risk of chronic disease, including cancer, is maintain a healthy weight," added Young, who recommended that people follow national dietary guidelines, watch their serving sizes and stay physically active.

People worrying about cancer and diet should take a balanced approach, said Doyle. " No one food is going to put our cancer risk over the top. If you are someone who eats steak or pork or lamb or salami or hot dogs, etc., on a regular basis and/or in large portion sizes, I would probably suggest you look for healthier protein sources to include in your diet," she added. The American Cancer Society recommends that people eat lots of fruits, vegetables and whole grains with some lean proteins to prevent cancer.

Research released last summer in the e Journal of the National Cancer Institute suggested that choline, found in many red meat and dairy products, may contribute to the growth of polyps that lead to colon cancer.

And another study, released in the Aug. 17 Journal of the American Medical Association, showed that colon cancer patients who eat a diet rich in fruits, vegetables, poultry and fish can significantly lower the risk of their cancer returning. In contrast, those patients whose self-reported diet included high intakes of meat, fat, refined grains and dessert were more than three times more likely to see their colon cancer return.

"If I were a cancer survivor," Doyle said, the new research "would make me stand up and take notice."

More information

To learn more about how diet and physical activity choices can help prevent cancer visit the American Cancer Society's Food and Fitness guide  .

SUNDAY, Dec. 9 (HealthDay News) -- Danish researchers are reporting what appears to be a cure for a rare type of lymphoma that has been regarded as incurable until now.

A complex regimen that included immunochemotherapy produced a five-year, event-free survival rate of better than 60 percent in 159 people with mantle cell lymphoma, physicians at the Rigshospitalet in Copenhagen reported Sunday at the American Society of Hematology annual meeting, in Atlanta.

The cancer was treated with six cycles of immunochemotherapy, aimed at arousing the immune system, followed by high-dose chemotherapy with stem cell support. Of the 114 people who completed treatment, 72 percent were disease-free at five years.

The report is an outstanding example of the better long-term survival rates for various kinds of blood cancers such as lymphomas being reported at the meeting, said Dr. Jane Winter, a professor of hematology and oncology at Northwestern University in Chicago.

"All kinds of things are happening," Winter said. "These are exciting times for us all."

The advances being made "really represent a variety of different kind of approaches," Winter said, with no one thread running through the variety of trials being reported.

One piece of research represents something of a challenge to standard chemotherapy by successfully using high doses of steroids for multiple myeloma, said study author Dr. S. Vincent Rajkumar, a professor of medicine at the Mayo Clinic in Rochester, Minn.

"There is a different philosophy in this trial," Rajkumar explained. "Less can be more. For years, we have used the highest possible dose of steroids for multiple myeloma, but they have been a source of major morbidity for patients. This is the first trial in which the intensity of steroids that are used has been studied in a randomized way."

Rajkumar and his colleagues used varying doses of the steroid dexamethasone along with lenalidomide, an agent that can modify and regulate action of the immune system, to treat 445 people with multiple myeloma. One-year survival was higher in the group getting lower doses of the steroid, "96 percent survival at one year, the highest reported in any study," he said. A reduction in damaging side effects was one reason for the improvement, he added.

The approach is potentially applicable to other cancers, Rajkumar said. "As more and more drugs enter the picture, that kind of examination has to go on," he said. "As new drugs come along, can we adjust the dosage down?"

However, a study of 1,196 people treated for advanced Hodgkin's lymphoma at the University of Cologne in Germany indicated that high-dose treatment can sometimes be more effective. Patients treated with higher doses of varying chemotherapy regimens had better 10-year overall survival rates.

In another advance reported at the meeting, successful use of a form of radio-immunotherapy, using an anti-lymphoma antibody coupled with a radioactive isotope, against various forms of non-Hodgkin's lymphoma was reported by physicians at University Medical Center Utrecht, the Netherlands.

A single infusion of the combination treatment tiuxetan, prolonged by two years the time period for which there were no signs or symptoms of the cancer. Some 60,000 new cases of non-Hodgkin's lymphoma are reported in the United States each year.

And physicians from the Hospital Avicenne in Paris reported that a new drug, azacitidine, was more effective than standard chemotherapy at prolonging survival among 358 patients with high-risk myelodysplastic syndromes (MDS), which currently have no cure other than bone marrow transplantation.

More information

Learn about lymphoma from the Lymphoma Research Foundation  .

MONDAY, Dec. 10 (HealthDay News) -- The majority of Americans in Medicare aren't getting screened for colorectal cancer, a major killer, even though the screening is free, a new study finds.

In fact, the percentage of enrollees in Medicare, the federal health insurance program for older Americans, getting screening tests such as colonoscopies has declined since the program began paying for them, the study said.

An assessment of 153,469 Medicare members identified in 1998 found that 29.2 percent of them were screened for colorectal cancer between 1991 and 1997, when Medicare began paying for screening tests. Only 25.4 were screened between 1998 and 2004, after screening was covered by Medicare, the study found.

Failure to get those tests costs lives, said study author Dr. Gregory Cooper, interim chief of gastroenterology at University Hospitals Case Medical Center in Cleveland.

"We know that the survival curve is strongly related to the state at which the cancer is diagnosed," he said. "For the mostly fairly healthy people in this cohort, early detection would bring a benefit."

Colorectal cancer is the third leading cause of cancer deaths in the United States. The American Cancer Society estimates that 147,000 new cases will be diagnosed in this country this year, with 57,000 deaths.

The new study, published online Dec. 10 in the journal Cancer, looked at a variety of screening tests. They included barium enemas, methods of detecting fecal blood, and colonoscopy, which is regarded as the most definitive test. By detecting polyps before they become malignant, a colonoscopy can help prevent cancer. Colonoscopies are recommended every 10 years for adults, starting at age 50.

The public, doctors and the Medicare system itself are all responsible in different ways for failures to screen for colorectal cancer, said Dr. Otis W. Brawley, chief medical officer of the American Cancer Society.

"Many physicians do not have a preventive mindset as yet," Brawley said. "People go to the doctor overwhelmingly because they are hurt and have a medical problem. No one goes to the doctor with a preventive intention."

Medicare does allow for an initial patient visit with a new doctor, "but it is designed to be all discussion, not for physical examinations," Brawley said. "During that discussion, they [patients] may be told that they have this benefit, but it is up to them to ask for it."

And there's something about colorectal cancer that makes people shy away from discussing it, Brawley said.

"Prostate cancer screening has not been shown to save lives, and people ask for it," he said. "Colon cancer screening has been shown to save lives, and people don't ask for it."

The ultimate responsibility lies with the patient, Cooper said. "If the physician doesn't bring it up, often the patient has to remind them," he said.

The new study findings are troubling, in light of research published in the Journal of the American Medical Association last December that found that since Medicare began paying for colon-cancer screenings, more patients' tumors are being diagnosed at an early, more curable stage.

The new findings also don't reflect a federal report released in March that found that national goals for colorectal cancer screenings are on target with the Healthy People 2010 initiative.

More information

Colorectal cancer screening is explained by the U.S. National Cancer Institute.