Advancements in management protocols and chemotherapeutics have improved outcomes for patients diagnosed with cancer. Cancer, however, continues to claim many lives annually in the United States and around the world. There is a large body of evidence that is strong and consistent that through modification of diet and lifestyle habits, cancer can be a preventable disease. This article discusses these changes and highlights the evidence for and against implementing them.
Costs to Medicare. 1 Colorectal Cancer Takes a Large Toll on the Medicare Population Colorectal Cancer takes a significant toll on the Medicare population, both in terms of lives affected and staggering treatment costs. Of the 153,760 people diagnosed with colorectal cancer in 2007, nearly two-thirds of those cancer patients are of Medicare age. In addition, with the introduction of biologics, oncolytics and other targeted therapies, Medicare is now facing a staggering increase in costs in order to treat advanced colorectal cancer with state-of-the-art therapy. Doctors and patients are excited about these life extending therapies, but drugs such as Avastin and Camptosar cost vastly more than the drugs they replaced. Today, some estimates for one-year treatment cost for a patient with metastatic (late stage) colorectal cancer are as high as $310,000, an annual cost typically found only for medicines used to treat rare diseases. Given the large burden of this disease on the Medicare program and the increasing size of this population, these costs are a growing concern to policy makers.
CBT sessions over 30 weeks. The outcomes were anthropometric measures, eating behaviors, anxiety, depression, and quality of life measurements. Researchers measured eating behaviors with the DEBQ. They quantified anxiety and depression using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively, which are 21-item self-reported measures scored on a scale of zero to 63, with higher scores indicating worse anxiety or depression. Researchers measured quality of life by the World Health Organization Quality of Life Brief assessment, a 26-item self-administered questionnaire, scaled on a score of zero to 100, with higher scores indicating better quality of life. Researchers analyzed pre-and postintervention data using the Wilcoxon test for paired samples and compared results between the groups using the Kruskal-Wallis test. The average weight loss in the IT+CBT group was 3.1 kg (95% CI, -3.9 to -2.2) and 1.4 kg in the PE group (95% CI, -2.1 to -0.81). Although both the IT+CBT group and PE group had significant weight loss, there was no difference in weight loss between the two groups. The EH group did not have a significant weight reduction. IT+CBT also improved eating behaviors (total change on DEBQ5 -8.4; 95% CI, -8.5 to -8.3) and depressive symptoms (total change on BDI5 -10; 95% CI, -13 to -7) but not quality of life and anxiety symptoms. Limitations included small sample size, a 56% participant dropout rate without an intention-to-treat analysis, reporting bias, bundling CBT with all other interventions, and the lack of any identifiable clinical impacts of improvements in weight, eating behaviors, and depressive symptoms.
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