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Medical Edge Newspaper Column from Mayo Clinic

INULIN MAY HAVE ROLE TO PLAY IN CANCER PREVENTION

DEAR MAYO CLINIC: I’m starting to see foods labeled as containing something called “inulin,” which is supposed to help guard against colon cancer. What does this mean? Does it really help? — Charlotte, N.C.

ANSWER: Inulin (IN-yoo-lin) is a naturally occurring compound found in many plants. It is regularly used as a food ingredient — particularly in packaged foods — to increase fiber and replace fats.

Exciting preliminary evidence shows that inulin may have anticancer effects. Currently, the National Cancer Institute is funding a multicenter clinical trial — which will be coordinated by the Cancer Prevention Network — to examine inulin’s role in preventing colon cancer. Researchers will be comparing the cancer-preventing properties of inulin against other agents.

As with all cancers, the ultimate goal of physicians and researchers is to find a way to prevent the disease in the first place. Right now, physicians use screening and surveillance tests to attempt to prevent colorectal cancer. Chemoprevention is a different approach. It uses a combination of drugs and healthful foods with anticancer properties, and is quickly emerging as a complementary approach for high-risk patients.

While the results of the inulin study will not be known for several years, it is safe to say that following the dietary guidelines of the American Cancer Society is an excellent start toward improving or protecting colorectal health:

1. Choose most of the foods you eat from plant sources.
2. Eat five or more servings of fruits and vegetables each day.
3. Eat other foods from plant sources — breads, cereals, grain products, rice, pasta or beans — several times each day.
4. Limit your intake of high-fat foods, particularly from animal sources.
5. Choose low-fat foods.
6. Limit consumption of meats, especially high-fat meats.

Details on these guidelines can be found at www.cancer.org.

It’s critical to focus on preventing colon cancer — not just treating the disease. Colorectal cancer strikes about one in 18 people in the United States, but having a screening test can greatly reduce your risk for developing this disease. Hopefully, chemoprevention with compounds like inulin will provide additional colorectal cancer prevention benefits in the near future.

Paul Limburg, M.D., M.P.H, Gastroenterology, and Principal Investigator,
Cancer Prevention Network, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Cancer
Appointment Information
Cancer Prevention

DEAR MAYO CLINIC: What can you tell me about the new pill available to treat alcoholism? — Fort Wayne, Ind.

ANSWER: There are three medications approved by the U.S. Food and Drug Administration to treat alcohol dependence. But alcoholism is a complicated disease that requires multifaceted treatment. It can include counseling, education, inpatient and outpatient treatment, rehabilitation and support groups such as Alcoholics Anonymous. Medications can help, but they are only a small part of successful, comprehensive treatment.

Acamprosate (Campral) was approved by the FDA in July 2004. It was the first new drug approved for alcohol abuse in nearly a decade. It has been successfully used in Europe for some time.

While doctors aren’t sure how it works, acamprosate appears to decrease the desire to use alcohol in patients who have stopped drinking. It’s not effective for helping with alcohol withdrawal. Some common side effects are itchiness, abdominal pain, vomiting, nausea, diarrhea and skin rashes. Most of side effects are quite mild and well tolerated. Acamprosate is expected to be available in the United States by the end of the year.

Disulfiram (Antabuse) is an alcohol-sensitizing drug, and it can be a strong deterrent to drinking. A patient who takes this drug and drinks alcohol will have a severe reaction — flushing, vomiting and headache.

Naltrexone (ReVia) helps curb the desire for alcohol and decreases its pleasurable effects. Unlike disulfiram, naltrexone doesn’t make you feel sick soon after taking a drink.

Studies have been mixed on the effectiveness of these medications. Disulfiram works best when used in a monitored environment, where the patient comes in daily for medication. Naltrexone and acamprosate show promise in both monitored and non-monitored settings.

If you take any of these medications, you’ll need to work closely with your health care provider. Alcohol can damage the liver, and since naltrexone and disulfiram are broken down by the liver, your liver enzymes will need to be monitored regularly. Acamprosate is not extensively metabolized by the liver and can be managed with less frequent health care visits.

Donald Lewis, D.O., Outpatient Addiction Services, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Alcoholism
Appointment Information
More Information on Alcholism
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.