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PaulB Offline OP
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Just passing along some recent info:

A study, published in the American.Journal of Epidemiology, finds people who drink 4 of caffeinated coffee a day have half the risk of dying from oral/ pharyngeal cancer as people who drink it either occasionally or not at all. The study began in 1982, Cancer Precvention Study II, by the American Cancer Society. Researchers were able to examine 968,432 men and women, none of whom had cancer at the time of enrollment. There is more to the study, if you care to look into.

I drank as much coffee, so I must have been in the other 50 percent. I hope they will find it will have a positive effect in chemo prevention for recurrences, in the future, if they do research on that too.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
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10/13 TBO/Angiograph
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12/13 25 Protons 50Gy 6 Wks Carbo
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Paul

I saw that study reported in CBS news yesterday.
CBS - coffee reduces oral cancer risk and death I thought it would be in the OCF news feed but then wondered if maybe it did not pass the vetting process. But lo and behold, OCF news had a similar article back in August, only dealing with an Italian study OCF news coffee reduces oral cancer risk Brian is always so ahead of the curve in covering oral cancer news.
Thank you Paul for posting this as this is exactly the type of real adjunctive therapy this forum was created for, instead of touting new age woo woo or alternative cures under the guise of "discussion".
I still start off each day by pouring Jevity 1.5 into a large coffee mug, then topping it off with coffee. It really comes in handy when travelling also. My experience is that undiluted Jevity is too thick to easily push through my syringe.
Unfortunately, I seem to be in the other 50% also, but maybe all my coffee drinking kept the cancer at bay so long since I acquired all my HPV+ infections back from 1969 until 1982 when I met my wife and became forsook all others.
Charm

Last edited by Charm2017; 12-13-2012 09:01 AM. Reason: added OCF * CBS URL

65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
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Can I just ignore the coffee study? I have been on my husband to cut back on the coffee. Even bought him 2 Keurigs so he could make single cups at home and in his office instead of making a whole pot.

Now if I'm honest with him I'll have to tell him I was wrong and let him keep buying all the flavored coffee and drinking it. Oh well, I tend to take his coffee cup when it is just the right temperature. I would rather he drink more of the Chaga tea that we actually cut off the birch trees in our woods here in northern MN and boil it down for a tea that is very high in antioxidants. At least he does drink 3 cups of that a day.


Husband diagnosed Oct '11 Cancer of the vocal cord Nov '11 removed right vocal cord. Neck Dissection, cancer in one node, .2, very small & contained) Jan '12 Radiation and Cisplatin, 6 doses. June '12 & Dec '12 clear Pet scan. April '13 Celebrating 1 year cancer free since treatment ended.
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PaulB Offline OP
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I have a Keurig, and a Nesspresso machine, so I'm well covered, and highly caffeinated lol.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Here is a crabby dentist complaining about the study because of the damage caffeine causes to teeth -

http://www.sciencedaily.com/releases/2012/12/121213142204.htm

I am sure he is correct about that, but it just goes to show you can't make everyone happy.

Not changing my coffee drinking habits cool

Last edited by Maria; 12-14-2012 10:46 AM.

CG to husband - SCC Tonsil T1N2M0 HPV+ Never Smoker
First symptoms 7/2010, DX 12/2010
TX 40 IRMT (1.8 gy) + 10 Cetuximab
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PaulB Offline OP
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I'm not stopping either smile I heard rubbing the teeth with the inside of a banana peel, soft part, is good for teeth discoloration, such as coffee, and just as good as any teeth Whitner product. I haven't eaten Banana's for a while, so I haven't tried it yet. I do swish and swallow with virgin organic coconut oil, which is supposed to be good for the mouth, gums, teeth.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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I figured this topic would come up, as the news story is getting lots of ink around the country. I was interviewed by a couple of large newspapers after it broke and I will briefly state here what I said in those interviews. But first let my just say this was a huge study population-wise and it was huge time-wise. That usually bodes well for the accuracy of conclusions and findings, but not always.

I want to state that I have NOT read word for word the entire study, but I have read many overviews of it by others, both in the news and in the professional community. None of these reviews offered observations on it, but merely stated what they felt the report stated. So I have not picked it apart but intend to do so next week with some science people whose opinions I trust.

I am troubled by a couple things about the study. The first is that the finding is about survival as opposed to incidence. Anytime you speak to survival I guarantee you it is very hard to control for bias. The reason the survival finding (the occurrence rate was not improved/lessened) bothers me is that all the nutrition related research that has been going on in the US over the last few decades, has to do with incidence and chemo prevention through the consumption of micro nutrients. You have likely seen them in the OCF news feed, but the numbers of studies showing that in various models animals and humans less so, that dark colored fruits and vegetables, and other derivatives of them such as chocolate, coffee, wine etc. seem to have some chemo protective properties in relationship to cancer and other diseases, likely from the micro nutrients that are unique to them. There have been dueling results, and not all the studies were ideal in their design, but I believe that the data clearly show that there is a measurable impact. What the positive ones show relates to impact on incidence not survival. But this study comes out of left field and speaks for the first time significantly to survival. This is counterintuitive, and I would have expected the opposite, that like other dark heavily micro nutrient and polyphenol loaded foodstuffs, coffee should be chemo preventative ie. it should impact incidence.

Then there is the issue of caffeinated vs non caffeinated, in which the study found that the caffeinated had impact, the non caffeinated less so. That means one of two things to me. The caffeine is having the impact, which I highly doubt since there are so many other forms of high caffeine consumption that do appear to have positive benefits. Think about long haul truckers that pop caffeine pills in large numbers, members of our military and in particular pilots, that take them in combat theaters to stay alert on long or night time missions, etc. Other than alertness we don't find health benefits associated with caffeine. It could actually mean that the process of decaffeination actually degrades the micro nutrients that seem in other foodstuff to be protective. This was not explored, and the source of the effect was not found or speculated on.

Lastly, when the study was originated decades ago, the authors made some attempt to limit bias by accounting for some confounders, such as tobacco, but the elimination of that type of bias was really incomplete, and this I think is the real weak point in the study.

We all know here that during the actual study period, that HPV16 arose as a very strong player in both incidence of oral and oropharyngeal cancers and survival of them. HPV16 positive cancers in peer reviewed papers have as high as a 35% survival advantage depending on staging at diagnosis etc. That alone throws a wrench in this whole study. Since they did not (they didn't know at the beginning of the study what we know today about HPV) eliminate HPV as a potential cause of survival, nor did they determine if the virus was more common in coffee drinkers than non coffee drinkers. Peer reviewed retrospective published studies (your donations at work as partial funders of this) showed the growing influence of HPV16 specifically, all the way back to 1972. So this is a huge confounding factor in the study that is unresolved.

Finally, anytime that you discuss survival and not incidence, besides the obvious core driver, (stage at time of diagnosis), there are many hard to define confounders. For instance just this week we put a news story up that clearly shows that patient outcomes at smaller regional hospitals are not as good as at the major CCC's, and institution is a factor in the survival numbers. Socio -economic issues also play a huge role in survival, and it is clear that in the US we have very pronounced disparities; between affluent and poor populations, those with and without insurance, those in rural areas vs. those in major cosmopolitan areas etc. This is all a huge issue when we speak to survival and not incidence, because we know in the real world, data clearly shows negative impact to those on the bottom end of the socio economic scale. This is tied to everything from education and awareness, access to healthcare itself let alone screening that might allow for earlier discovery and staging, ability to afford care even if it is available, or insurance to pay for it. Those are the broad areas, but there are smaller confounding issues in this group as well, such as diet and exercise in different populations.

So I am always pleased when a study shows that something impacts survival in oral cancer, but I think my initial gut reaction is that this study has significant unresolved bias in it, and while I like coffee, particularly in the AM, no one could really put up with me if I drank 4 cups a day.

I would like to see what micro nutrients coffee has in common with dark fruits like blackberries, blueberries etc. (all in our news feed) as perhaps there is a simple compound/s that we could take as supplements that would have the same impact.

I don't now if this makes sense to others, but I will post again when some much smarter people than I have a chance to discuss this study next week.




Last edited by Brian Hill; 12-14-2012 08:47 PM.

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PaulB Offline OP
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Thank you Brian. You bring up excellent points that are lacking in the study, and makes sense.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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The trouble with observational cohorts is that it is very difficult to adjust effectively for things that cloud the results (confounders).

If these confounders and biases are not correctly identified and adequately adjusted for, then it doesn't matter how big the cohort is, it just means the magnitude of erroneous results are just on a bigger scale.

The Nurses Health study as a classic example of how to kill people using observational trials. This was a very famous cohort of nearly 50,000 women, which set out to determine factors that influenced women't healt. It was well put together with meticulous follow up over 10 years. One of the findings was that the use of HRT post menopause was protective against cardiovascular events. As a result, hundreds of thousands of women around the world were prescribed HRT to protect their hearts.

It was dead wrong!!!

When the randomised controlled trial was completed, it was discovered that HRT INCREASES the likelihood of cardiac events. (NB for all you women who are on HRT and reading this, my comments are heavily simplified so don't panic and take yourself off HRT - there are good reasons to be on it depending on your circumstances).

In this latest study with coffee, it appears they have also failed to adjust for some significant confounders. As Brian has already mentioned, there are some significant disparities in survival for non-white, lower socio-economic status, insurance status, which cancer centre one attends (US only) as well as the well known ones such as tobacco use, alcohol use and gender. This study appears not to have adjusted for all of these biases. HPV infection does not present in all people equally, so this is likely to be a significant bias as well.

There is also a very different profile for men and women coffee drinkers. High use is most frequent in women who are younger than their non-drinking counterparts whilst the reverse is true for the men. I find that fascinating ...

Having said all that, coffee makes Alex happy and in the absence of data to suggest harm, I am happy to take this information with a pinch of salt and add it to the list of things that MIGHT improve Alex's well being. If Alex were NOT a coffee drinker, I certainly would not push him to start based on these data.


Karen
Love of Life to Alex T4N2M0 SCC Tonsil, BOT, R lymph nodes
Dx March 2010 51yrs. Unresectable. HPV+ve
Tx Chemo x 3+1 cycles(cisplatin,docetaxel,5FU)- complete May 31
Chemoradiation (IMRTx35 + weekly cisplatin)
Finish Aug 27
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Which, in layman's terms, boils down to the fact that you don't really know what exactly it is you are looking at with some of these studies, although they do have big numbers.

When you are looking at statistics like these, you're seeing a correlation (more caffeinated coffee associated with better survival) but the study has not proved that it's the caffeinated coffee causing the improvement.

As Karen says, we're not seeing harm demonstrated, so lucky Alex gets to keep his coffee. On the other had, my husband HATES coffee (except in the gravy I make for Swedish meatballs) so I am not about to suggest he take up coffee drinking.

Maria

Last edited by Maria; 12-16-2012 08:53 AM.

CG to husband - SCC Tonsil T1N2M0 HPV+ Never Smoker
First symptoms 7/2010, DX 12/2010
TX 40 IRMT (1.8 gy) + 10 Cetuximab
PET Scans 6/2011 + 3/2012 clear, 5 year physical exam clear; chest CT's clear of cancer. On thyroid pills. Life is good.
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