Lifestyle Matters: Dietary Factors Influence Ovarian Cancer Survival Rates

University of Illinois at Chicago researchers identify relationship between healthy eating and prolonged ovarian cancer survival

UIC researchers find that consumption of cruciferous & yellow vegetables provide an ovarian cancer survival advantage

Therese A. Dolecek, Ph.D., M.S., R.D., Research Associate Professor of Epidemiology, Division of Epidemiology & Biostatistics, Institute for Health Research & Policy, School of Public Health, University of Illinois at Chicago

A study published in the March 2010 issue of the Journal of the American Dietetic Association (JADA), is among the first to evaluate possible diet associations with ovarian cancer survival. Researchers from the University of Illinois at Chicago (UIC) determined that there is a strong relationship between healthy eating and prolonged survival.

The subjects included 351 women diagnosed with epithelial ovarian cancer between 1994 to 1998, who participated in a previous case-control study. The original study collected demographic, clinico-pathologic, and lifestyle-related variables including diet. Each subject completed a food frequency questionnaire (FFQ) in which they were asked to report their usual dietary intake during the three to five year period prior to their diagnosis.

To translate the diet estimates in a meaningful way, the FFQ items were assigned to the major food groups reflected in the Dietary Guidelines for Americans 2005 (DGA), including fruits, vegetables, grains, meats, dairy, fats and oils, sweets, and alcohol. Grains, meats, and dairy were further subdivided into “suggested” and “other” groups. The “suggested” subdivisions included healthier food choices, whereas the “other” subdivisions contained less desirable selections.

The researchers found that higher total fruit and vegetable consumption, and higher vegetable consumption alone led to a survival advantage. A subgroup analyses revealed that only yellow and cruciferous vegetables (e.g., broccoli, kale, cauliflower, bok choy) significantly increased survival advantage. At five years, 75% of the women who ate less than one serving a week of yellow vegetables were alive, compared to about 82% of those who had three or more servings of yellow vegetables a week.  Likewise, a statistically significant improvement in survival was observed for the healthier grains.

Higher intakes of less-healthy meats — specifically the red and cured/processed meats subgroups — were associated with a survival disadvantage. Notably, the researchers found a 3-fold increased risk of dying for those women who ate four or more servings of red meat a week compared to those who ate less than one serving per week over the 11-year study period.

A survival disadvantage was also observed in connection with consumption of the milk (dairy – all types) subgroup. Women who had seven or more servings of milk of any type per week were two times as likely to die during the study period as those who had none.  The researchers stress that the milk finding should be interpreted cautiously, because it may have something to do with the fact that some women are genetically predisposed.

Therese A. Dolecek, Ph.D., M.S., R.D., Research Associate Professor of Epidemiology, Division of Epidemiology and Biostatistics, Institute for Health Research and Policy, School of Public Health, UIC, and a member of the Cancer Control and Population Science Research Program at the UIC Cancer Center, and her colleagues state the following in the article:

The study findings suggest that food patterns three to five years prior to a diagnosis of epithelial ovarian cancer have the potential to influence survival time. The pre-diagnosis food patterns observed to afford a survival advantage after an epithelial ovarian cancer diagnosis reflect characteristics commonly found in plant-based or low fat diets. These diets generally contain high levels of constituents that would be expected to protect against cancer and minimize ingestion of known carcinogens found in foods.

In an interview with WebMD.com, Dr. Dolecek said:  “To pinpoint exactly how much survival [was lengthened] is not possible. It varies from person to person.”  Many factors affect survival, such as the stage of the cancer at diagnosis and the woman’s age.

Cynthia A. Thomson, Ph.D., M.S., R.D., Associate Professor, Nutritional Sciences, Univ. of Arizona, Tucson

David S. Alberts, M.D., Director, Arizona Cancer Center, Tucson, Arizona

In an editorial commentary in the same JADA issue, Cynthia A. Thomson, Ph.D., M.S., R.D., Associate Professor, Nutritional Sciences, University of Arizona, Tucson, and David S. Alberts, M.D., Director, Arizona Cancer Center, Tucson, write the following:

The authors provide new evidence that dietary factors, particularly total fruit and vegetable, red and processed meat and milk intakes, may influence ovarian cancer survival. These findings corroborate earlier work by Nagle et. al. and are among only a select few studies of dietary associations with ovarian cancer recurrence and/or prognosis despite a significant and growing body of literature suggesting diet may influence ovarian cancer risk.

About The Journal of the American Dietetic Association

As the official journal of the American Dietetic Association (www.eatright.org), the Journal of the American Dietetic Association (JADA) (www.adajournal.org) is the premier source for the practice and science of food, nutrition and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. JADA focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, food service systems, leadership and management and dietetics education.

About The American Dietetic Association

The American Dietetic Association (ADA) (www.eatright.org) is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.

Sources:

UA Research Team Designing Holographic Imaging System For Ovarian Cancer

University of Arizona researchers Jennifer Barton and Ray Kostuk have received a five-year, $2.4 million grant from the National Institutes of Health to build the instrument that they hope will one day be used to monitor women at high risk for ovarian cancer.

Hologram of Human Ovary

Human ovary image captured with the use of the prototype holographic imaging system the team developed. (Photo: Univ. of Arizona News)

Hologram of An Orange

For comparison, an onion is imaged with the use of the prototype system the team developed. (Photo: Univ. of Arizona News)

Two University of Arizona [UA] researchers have formed a research team to design, build and evaluate two versions of an ovarian cancer medical imaging and screening instrument that will use holographic components in a new type of optical microscope.

Raymond Kostuk and Jennifer Barton have secured a five-year, $2.4 million grant from the National Institutes of Health to build the instrument that they hope will one day be used to monitor women at high risk for ovarian cancer. Kostuk is the Kenneth Von Behren Professor of Electrical and Computer Engineering and professor of optical sciences. Barton heads the UA department of biomedical engineering and is assistant director of the BIO5 Institute.

The system is unique in that it will for the first time project multiple spatial images from different depths within a tissue sample and simultaneously provide spectral information from optical markers in order to better identify cancerous cells.

This combined spectral spatial imaging technique shows potential to be much more effective in identifying cancerous tissue sites than by separately using spatial or spectral information.

The grant was issued following the successful two-year development of a prototype system the team built. It tests the validity of using holographic technology for subsurface imaging without having to perform surgery and take tissue samples.

According to the National Institutes of Health, there is, to date, no single effective screening test for ovarian cancer, so ovarian cancer is rarely diagnosed in its early stages. The result is that in more than 50 percent of women with ovarian cancer are diagnosed in the late stages of the disease when the cancer has already advanced.

  • About 76 percent percent of women with ovarian cancer survive one year after diagnosis.
  • About 45 percent live longer than 5 years after diagnosis.

Barton said ovarian cancer provides a compelling case to test holographic imaging and its efficacy in detecting cancers. At the present time the preferred treatment is surgery, which is also often needed to diagnose ovarian cancer. The procedure includes taking tissue samples, which may threaten the woman’s ability to have children in the future.

Jennifer Barton, UA

Jennifer Barton, Professor & Chair, Department of Biomedical Engineering; Assistant Director, BIO5 Institute. (Photo: Univ of Arizona News)

“Ovarian cancer has no symptoms until it is highly advanced making the five-year prognosis extremely poor. Those at high risk – with a family history of ovarian cancer or those who carry genetic mutations in the BRCA1 and BRCA2 genes, which normally help protect against both breast and ovarian cancer – may be counseled to have their ovaries removed through laparoscopic surgery,” Barton said. “Now imagine if you are an 18-year-old woman who has this history – ovaries are an important part of your overall health. They produce hormones you need over and above the notion that you would need your ovaries should you want to have children in the future.”

Thus, new technology capable of reliably diagnosing ovarian cancer in earlier stages could reduce the morbidity, high mortality and economic impact of this disease.

The system will work like a high-powered microscope that can be used to study tissue samples already removed. In addition, an endoscopic version is in the design stage to safely scan the ovaries for cancer during laparoscopic screenings in high-risk women, or as an adjunct to other laparoscopic procedures in all women.

The team will work with Dr. Kenneth D. Hatch, president of the Society of Pelvic Surgeons, and a professor of obstetrics and gynecology and director of female pelvic medicine and reconstructive surgery at the UA College of Medicine.

Through Hatch and a partnership with his patients who consent, Barton and Kostuk will be able to identify abnormal spatial and spectral markers of cancerous ovarian tissue.

Ray Kostuk

Ray Kostuk, Kenneth Von Behren Professor of Electrical and Computer Engineering & Professor of Optical Sciences, University of Arizona (Photo: Univ. of Arizona News)

The new imaging system will be tested on high-risk patients who are willing to participate and provide some future benefit to other patients who find themselves in a similar situation, Barton said.

Kostuk and Barton’s aim is to design the imaging system so that it is easy to use, requiring very little training, and also be cost effective.

“The system will image like an MRI or a CT scan but with much higher resolution than an ultrasonic image and will be a lot less expensive than an MRI. As an additional benefit no radiation will be used or exposed to sensitive ovary areas during the cancer screenings,” Kostuk said.

During the past 25 years Kostuk has researched different aspects of holography and holographic materials for use as optical elements.

The holographic imaging system being designed combines an optical technique that creates images capable of detecting subtle tissue microstructure changes. Together with fluorescence spectroscopy methods, the system has demonstrated capability for early cancer detection.

Another member of the team, UA research professor Marek Romanowski, with the UA department of biomedical engineering and the BIO5 Institute, is working on the development of targeted fluorescent dyes that will be used on tissue samples to identify or confirm suspected cancerous areas shown in the spatial image.

The multidisciplinary approach to the design of the hologram-based imaging system is a testament to the complexity of treating cancers.

“One of the advantages of being part of the UA is the ability to interact collaboratively with people in other disciplines,” Kotuk said. “Jennifer is a wonderful colleague who can identify important medical applications for new techniques and is able to bridge the gap between traditional engineering and medicine. Her skill and knowledge is critical to the success of the program,” he said.

“To solve the really interesting problems of today, no one person has all the expertise needed,” Barton added.

Sources: