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What the oncologist can learn from diabetes studies: Epidemiology, prevention, management, cure
1Scientific and Technology Pole, IRCCS MultiMedica, Milano, Italy.
Abstract:
Notwithstanding massive efforts and investment in improving cancer therapy, the limited progress made in reducing overall mortality has mostly been achieved through early diagnosis. Mortality rates for cardiovascular disease are in decline, a success attributable in large part to an active prevention approach coupled with identification of risk factors and biomarkers. Promising natural and synthetic molecules including numerous flavonoids have the potential to be used in diabetes care and in prevention of cardiovascular pathologies. These concepts should also be applied to cancer, the incidence of which continues to increase. In cancer chemoprevention low toxicity drugs or dietary constituents are used to prevent or delay onset of malignancy. Evidence is accumulating that cancer chemoprevention is a valuable weapon against human cancer. For example, doubling of fruit and fiber intake is associated with reduction of colorectal cancer whereas fat food consumption appears to increase malignant progression of certain tumors. Breast, colorectal and prostate cancer are the most suitable cancers for dietary prevention and scientists have strong data in these cancers at basic, translational, clinical and epidemiological levels, due to experimental evidence and the large EPIC study. Physical activity is also crucial. Yet, cancer chemoprevention research in oncology is largely underrepresented and lags far behind the efforts dedicated to therapy; it is important to close this gap. Few European phase III clinical trials are ongoing and systematic development of novel agents for cancer prevention is rare in Europe.
Insights
Cancer chemoprevention, using low-toxicity agents and lifestyle changes like increased fruit/fiber intake, shows promise in preventing cancers. More research and development are needed to match therapeutic efforts.
Area of Science:
- Oncology
- Preventive Medicine
- Nutritional Science
Background:
- Cancer therapy has seen limited progress in reducing mortality, with early diagnosis being the primary driver.
- Cardiovascular disease mortality is declining due to prevention and biomarker identification, a model applicable to cancer.
- Natural compounds like flavonoids show potential in managing diabetes and preventing cardiovascular diseases.
Purpose of the Study:
- To highlight the potential of cancer chemoprevention as a valuable strategy against increasing cancer incidence.
- To advocate for increased research and development in cancer chemoprevention, comparable to cancer therapy efforts.
- To emphasize the need to apply successful prevention models from cardiovascular disease to oncology.
Main Methods:
- Reviewing evidence for dietary constituents (fruits, fiber, fats) and physical activity in cancer prevention.
- Examining the role of low-toxicity drugs and natural molecules in chemoprevention.
- Analyzing data from epidemiological studies like the EPIC study and clinical trials.
Main Results:
- Increased fruit and fiber intake is linked to reduced colorectal cancer risk; high-fat diets may promote certain tumors.
- Breast, colorectal, and prostate cancers are identified as highly suitable for dietary prevention strategies.
- Evidence supports chemoprevention's value, yet research and clinical trials in Europe are significantly underrepresented.
Conclusions:
- Cancer chemoprevention, utilizing diet and lifestyle, offers a promising approach to combatting cancer.
- There is a critical need to bridge the gap between cancer prevention research and cancer therapy development.
- Systematic development of novel chemopreventive agents requires greater investment and focus, particularly in Europe.
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