In a recent conversation between Dr. John L. Marshall, MD, Professor of Medicine; Chief, Division of Hematology-Oncology and Director of Clinical Research at the Lombardi Compresensive Cancer Center (Georgetown University), and Thomas Weber, MD Professor of Surgery (State University of New York Health Sciences), they discuss the alarming increase of colorectal cancer among young adults, featured in the Medscape TV series Not on Anyone’s Radar: Colorectal Cancer in Young Adults.
Why is colorectal cancer increasing among young adults?
Dr. Marshall: This generation is not really feeding their microbiome.When I was a kid, I was told to go out and play in the yard, make a mud pie, and eat it. That’s what we did. I don’t know how much of this is that we have whitewashed our microbiome and somehow that is affecting it. (Dr. Marshall)
Dr. Weber: I think you’re exactly right. It’s very important to keep in mind that it’s unlikely for the human genome to have that kind of plasticity. It has not changed that much over this period of time. I think it’s definitely some sort of environmental interaction. Diet is an extremely important possibility. How it impacts the biome is extremely important.
There has been some exciting comparative work by Dr O’Keefe at the University of Pittsburgh that looked at diet among native Africans and African Americans, and demonstrated changes in the microbiome that actually influenced the chemical composition. Of course, with the American diet, there was a much higher ratio of chemicals that are proinflammatory and procarcinogenic.The positive message out of all of this is that if we increase our understanding of these phenomena, we can improve the situation. We can have an impact. We can make it better. If we improve our diets, if we do risk-stratification, if we educate our providers and consumers about what the symptoms and signs are, we can save a lot of lives.
- Diet is extremely important. How it impacts the biome is extremely important.
- With the American diet there is a much higher ratio of chemicals that are pro-inflammatory and pro-carcinogenic.
The positive message out of all of this? We can do better.
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In this case, prevention most certainly is the best cure.