Natural Process in Colon Restrains Tumor Development

By: Andrew Carney
Thursday, December 10, 2015

A natural safety mechanism in the colon impedes development of adenomas, according to scientists at the Institute for Research in Biomedicine (IRB) in Barcelona, Spain.

The colon increases production of a molecule, bone morphogenetic protein (BMP), during adenoma formation in the colon. This molecule limits adenoma stem cells’ ability to renew themselves, which slows development of the precancerous lesions.

In a study published in Nature Cell Biology, the IRB scientists suggest that genetic variations in the population mean people have this safety mechanism to different degrees. Scientists see evidence for that in the genomic region where BMP production is regulated. Genomic differences linked to colon cancer susceptibility are in the same location.

Further studies based on the findings may help pinpoint populations at highest risk for colon cancer, researchers say.


Speeding Recovery from Colorectal Surgery

By implementing a process called enhanced recovery, researchers at Duke University Hospital reduced colorectal surgery patients’ average hospital stays from seven to five days and readmission rates by 50 percent.

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The process eliminates the usually prescribed bowel evacuation and extended fasting period prior to surgery and encourages patients to drink liquids and start moving soon after.

Patients in the study, results of which were published in Anesthesia & Analgesia, were given an epidural and non-opioid painkillers prior to surgery and received general anesthesia. They received non-steroidal anti-inflammatory drugs and, as needed, oral opioids after about 72 hours following surgery. In addition, they were urged to drink liquids and move about on the day of the procedure and for a minimum of six hours each day thereafter.

Enhanced recovery saved approximately $2,000 apiece for 85 percent of the patients and has been expanded to bladder, liver and pancreas procedures at the hospital.


Genes Linked to Consistent Route of Colon Cancer Metastasis

Scientists in Spain have identified genes linked to a predictable pattern of colon cancer metastasis to the liver and then the lung. The findings were published recently in Nature Cell Biology.

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A metastatic lesion must first exist in the liver for a lesion to occur in the lung, the researchers note. Metastasis from liver to lung begins when metastatic cells in the liver release PTHLH, a molecule that affects the cells of pulmonary blood vessels. The vessels, in turn, trigger remodeling processes that are further stimulated by the release of additional PTHLH as tumor cells migrate from the liver toward the lung. Gaps then form in the blood vessel walls, allowing metastatic cells to enter the lung.

While the path of metastasis from the colon to the lung via the liver is consistent, researchers point out that metastases to the lung do not occur among most colon cancer patients who develop metastases to the liver.