Digestive Health Archive

Increasingly, doctors are turning to prevention for this hard-to treat cancer.

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Ovarian cancer is a challenging foe. It's often found at an advanced stage when it's difficult to treat.

In recent years, researchers have learned that many cases of ovarian cancer don't even start in the ovaries. "It turns out that ovarian cancer is a bit of a misnomer. We think a portion of ovarian cancers actually arise from cells in the fallopian tubes," says Shelley Tworoger, adjunct associate professor of epidemiology at Harvard Medical School and associate center director of population science at the Moffitt Cancer Center.

Bleeding indicates cancer only in a small percentage of cases, even though endometrial cancers are on the rise in American women.

You've gone through menopause and you thought your periods were a thing of the past — but suddenly, you're bleeding again, more than a year after your last period.

Should you be concerned?

The good news according to an analysis published in JAMA Internal Medicine, is that most likely your bleeding is caused by a noncancerous condition, such as vaginal atrophy, uterine fibroids, or polyps. But the study also reinforces the idea that postmenopausal bleeding should always be checked out by your doctor to rule out endometrial cancer, a cancer of the uterine lining, says Dr. Ross Berkowitz, William H. Baker Professor of Gynecology at Harvard Medical School.

Intestinal infection known as C. diff can spread through spores and cause diarrhea

Why would you get an intestinal infection, like C. diff, from treating a different illness with antibiotics?

When you're admitted to a hospital, you expect to receive tests and treatments that will make you feel better. When you get antibiotics in the hospital, you expect that the drugs will treat or prevent infection. But it doesn't always work that way. A distressing number of patients acquire infections while they are in the hospital. And antibiotic therapy can actually increase the odds of coming down with a hospital-acquired infection, particularly when the cause is a bacterium named Clostridium difficile. Although doctors are working hard to control intestinal infections caused by the bug commonly (if not fondly) known as C. diff, the problem is rapidly becoming more common, more serious, and harder to treat.

Research we're watching

Need another reason to make your oral health a priority? Researchers at Harvard's T.H. Chan School of Public Health found that people with a history of gum disease also have a higher risk of stomach and esophageal cancers. They outlined their work in a letter published online in July 2020 by the journal Gut.

The researchers looked at two large studies involving a total of nearly 150,000 men and women. They found that during the studies' follow-up periods, which ranged from 22 to 28 years, people who had gum disease had a 43% higher risk of developing esophageal cancer and a 52% higher risk of developing stomach cancer compared with people whose gums were healthier. The authors proposed some ideas as to what was driving increased risk, such as greater exposure to oral bacteria or harmful substances produced by those bacteria. The authors said more study is needed to confirm their results.

News briefs

Having gum disease increases your risk for many health problems other than tooth loss, such as heart disease. To add to the list, a study from Harvard summarized in a letter published online July 20, 2020, by the journal Gut suggests that the microbes camping out between your teeth and gums may affect your risk for cancers of the stomach and esophagus. Harvard scientists analyzed health data from two large studies that included almost 150,000 men and women. In up to 28 years of follow-up, people with a history of periodontal (gum) disease were 43% more likely to develop esophageal cancer and 52% more likely to develop gastric (stomach) cancer compared with people whose gums were healthier. The risk was even higher in those with gum disease severe enough to cause tooth loss. The study is observational and doesn't prove that gum disease causes cancer, but it could mean that someday doctors will include a look at your gum health when assessing your overall risk. Fortunately, it's easy to prevent gum disease. The American Dental Association recommends that you brush your teeth twice per day, floss at least once per day, and get a dental exam and cleaning regularly.

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In the journals

Greater amounts of physical activity during the day are associated with lower risk of dying from cancer, according to a study published online June 18, 2020, by JAMA Oncology.

The study involved about 8,000 people, average age 70, who did not have a cancer diagnosis. Each wore an accelerometer on the hip during waking hours for a week to collect movement data.

Constant burping can be annoying — and embarrassing! But there are some simple steps that can help you squelch belching. The key is to reduce the amount of air you swallow.

Start by looking at some simple habits. Two of the biggest culprits behind swallowing too much air are chewing gum and smoking. Drop these habits and you'll be gulping less air — and quitting smoking has even more important health benefits! If you wear dentures, make sure they fit snugly. And avoid "high-air" foods and beverages like carbonated beverages and whipped desserts. After eating, consider taking a stroll rather than plunking down in front of the TV. Staying upright and moving helps your stomach empty and relieves bloated feelings. When it's time to go to bed, try sleeping on your stomach or right side to aid in the escape of gas and alleviate fullness.

The US Preventive Services Task Force has updated its lung cancer screening guidelines, to open up the screening to a wider range of people based on their age and smoking history, with the goal of detecting more cancers and reducing deaths.

Research we're watching

Move your body more and skip the alcohol to reduce your risk of cancer, says the American Cancer Society in its new cancer prevention guidelines. The updated recommendations, published online June 9, 2020, by CA: A Cancer Journal for Clinicians, also recommend cutting down on sugar and red meat, based on a review of the most recent scientific evidence.

Specifically, the new guidelines say that instead of exercising moderately for 150 minutes a week or doing 75 minutes of vigorous activity, adults should try to squeeze in 150 to 300 minutes of moderate activity or 75 to 150 minutes of vigorous activity — and that the higher number should be the target. As for diet, people interested in reducing their risk of cancer should aim to eat more plants, including whole (not refined) grains and at least two-and-a-half cups of colorful fruits and vegetables each day, and less sugar and meat (specifically limiting processed and red meat whenever possible). In the past, the ACS recommended moderate alcohol intake, but the new guideline says it's better to avoid alcohol altogether if possible. People who do drink should still stick to the previous recommended limits: no more than one drink a day for women and two drinks a day for men.

Blood testing to detect early cancer may be closer to reality than ever before.

When it comes to most cancers, the sooner they're found, the better. "Identifying cancer in its earlier stages offers improved chances for treating it before it can grow and spread," says Dr. Brian Wolpin, director of the Gastrointestinal Cancer Center at Harvard-affiliated Dana-Farber Cancer Institute.

Unfortunately, there are not reliable tools to screen for most cancers. Examples of effective screening tests that do exist now include colonoscopies that look for polyps and early colorectal cancers, as well as imaging tests like mammograms for early signs of breast cancer and chest CT scans for localized lung cancer among former or current smokers.