UK-US Brexit Trade Deal – Increased Bowel Cancer Risk

Fears of illness caused by nitrites commonly used in US, but currently banned in Britain and EU.

Processed meat increases the risk of bowel cancer.
 
Processed meat increases the risk of bowel cancer. Photograph: Alamy
 

British stores could be flooded with “dangerous” bacon and ham from the US, marketed under misleading labels, as the result of a transatlantic trade deal, says the author of a new book based on a decade of investigation into the food industry.

The meat has been cured with nitrites extracted from vegetables, a practice not permitted by the European Commission because of evidence that it increases the risk of bowel cancer. But it is allowed in the US, where the product is often labelled as “all natural”. The powerful US meat industry is likely to insist that the export of nitrite-cured meat is a condition of a post-Brexit UK-US trade deal, which the UK government is under intense pressure to deliver.

“The American processed-meat industry acts just like big tobacco,” Guillaume Coudray, author of Who Poisoned Your Bacon Sandwich?, told the Observer. “It obscures the truth about nitro-meats and clouds the facts for its own commercial benefit – and they have been at it for decades. They have done this despite clear and overwhelming evidence that nitro-meats cause bowel cancer.”

Coudray’s claims echo the row over chlorinated chicken. The practice of washing poultry meat with chlorine is common in the US but banned in the UK. The government has said it will not allow the import of chlorinated chicken and hormone-treated beef under a transatlantic trade deal, but has refused to sign those pledges into law.

The US processed meat industry uses nitrites derived from celery juice to cure pig meat, keep it pink and preserve it so it can stay on supermarket shelves longer. Nitrites are harmless in themselves, but when they are cooked and ingested, they produce nitrosamines which are carcinogenic.

In 2015 the World Health Organization linked 34,000 worldwide cases of colorectal cancer a year to diets high in processed meats. Its report – based on epidemiological data from hundreds of thousands of people – advised that eating 50g of processed meat a day, the equivalent of a couple of bacon rashers, raised the risk of bowel cancer by 18% over a lifetime.

Coudray, whose book is published this week, said: “The American meat industry uses celery juice nitrites to cure bacon and ham. The Americans overtly mislead their consumers by claiming their products are ‘nitrite-free’ or ‘all natural’, whereas such claims have been banned in Europe.

“A free trade deal between the UK and the US poses a real risk of flooding the British market with dangerous bacon. As a result of inaccurate and misleading American packaging, consumers will have no way of knowing which products are genuinely safer.”

Despite its ban on vegetable-derived nitrites, the EU continues to allow conventional nitrites. But, said Coudray, progressive meat producers in the UK, France, Italy, Germany and Denmark had “taken great strides” in recent years to remove all nitrites from their products. For example, Italian producers have made Prosciutto di Parma for three decades without the use of nitrites. Naked Bacon, the UK’s biggest bacon brand, is also nitrite-free.

“France is considering banning nitrites altogether in a landmark bill before the French parliament,” said Coudray. “It is time the UK government did the same – and guaranteed these substandard American products will be banned entry into Britain.”

Bee Wilson, a food historian and writer who contributed a foreword to Coudray’s book, told the Observer: “The really interesting thing to watch is whether the French ban on nitrite-cured meat will come into force. If it does, this will be a huge shift in food policy which could encourage other governments in Europe to follow suit. But at the moment there is no sign of the rest of the EU following France.

“The traditions of curing bacon with these chemicals became established at a time when no one knew that they caused any harm. But now that we do know that they cause harm, the question is what to do next. [This] needs tougher regulation at a governmental level so that the whole industry is forced to change in unison.”

Coudray’s book also reveals aggressive lobbying by the US meat industry to overturn a UK ban on nitrite-cured meat during the second world war amid shortages of bacon and ham. Confidential diplomatic cables obtained by Coudray show the head of the US Bureau of Animal Industry accusing the British of “unfair discrimination”. The British board of trade warned that the US was “very disturbed about this matter”, “will not let it rest”, and “might be expected to take reprisals”.

US nitrite-cured bacon was allowed into Britain in 1944, prompting a 20-year campaign by the UK’s processed meat industry to be allowed to use nitrites. It was eventually successful.

Is FIT fit for purpose? Yes.

Re. Restoring Cancer Services (posted 18/1/2021). This may be of interest – from the British Journal Of Cancer 19th Jan 2021 – Don


Diagnostic Performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England.

Background: The faecal immunochemical test (FIT) was introduced to triage patients with low-risk symptoms of possible colorectal cancer in English primary care in 2017, underpinned by little primary care evidence.

Methods: All healthcare providers in the South West of England (population 4 million) participated in this evaluation. 3890 patients aged ≥50 years presenting in primary care with low-risk symptoms of colorectal cancer had a FIT from 01/06/2018 to 31/12/2018. A threshold of 10 μg Hb/g faeces defined a positive test.

Results: Six hundred and eighteen (15.9%) patients tested positive; 458 (74.1%) had an urgent referral to specialist lower gastrointestinal (GI) services within three months. Forty-three were diagnosed with colorectal cancer within 12 months. 3272 tested negative; 324 (9.9%) had an urgent referral within three months. Eight were diagnosed with colorectal cancer within 12 months. Positive predictive value was 7.0% (95% CI 5.1–9.3%). Negative predictive value was 99.8% (CI 99.5–99.9%). Sensitivity was 84.3% (CI 71.4–93.0%), specificity 85.0% (CI 83.8–86.1%). The area under the ROC curve was 0.92 (CI 0.86–0.96). A threshold of 37 μg Hb/g faeces would identify patients with an individual 3% risk of cancer.

Conclusions: FIT performs exceptionally well to triage patients with low-risk symptoms of colorectal cancer in primary care; a higher threshold may be appropriate in the wake of the COVID-19 crisis

Click here for the full article

Ed – Thanks to Don for sending this in.

Self-Management and the “app”

Electronic devices for home use which measure physical health parameters such as blood pressure, heart rate, blood oxygen levels and activity etc. proliferate. Results from them may be shared, usually as a part of a treatment programme, with a doctor, nurse or pharmacist. However, what is not being regularly monitored is the patient’s general health and well-being. IT companies have been encouraged to develop software to allow  patients to record and display this at home, using a mobile programme or app – one such is Vinehealth.

It would be good if C-Side members, could evaluate this, since there is no doubt that programmes such as this will become commonplace in the not too distant future.

You can learn more about Vinehealth here (or click on the picture). You can download the app from the App Store (Apple) and Google Play, It is free to download and use and is unlikely to present any risk to confidential information. Remember it is a mobile app, designed for use on a phone (IOS or Android) or an iPad; not at present on a laptop or similar.

New Recovery Plan for Cancer Services

The NHS has set out how it plans to return essential cancer services to pre-COVID-19 levels in a new plan. The Cancer Recovery Plan outlines actions to:-

  • restore demand for endoscopy services to at least pre-pandemic levels
  • reduce the number of people waiting longer than they should for diagnostics and/or treatment, set by the NHS, at least to pre-pandemic levels on both screening and symptomatic pathways
  • ensure sufficient capacity to manage future increased demand, including for follow-up care

To read more about the specific target areas, as described in an article in Beating Bowel Cancer UK, please click here or click on the above picture.

A New Take on Colonoscopy?

Could this be the way ahead?

This development, at first sight, looks like an April Fool spoof, but it isn’t. The article describes a proceedure where a small camera (with its own light source) is introduced into the digestive sysem orally. During its transit it captures images of the bowel wall in order to reveal abnormalities. Imagery is radio transmitted to a receiver carried by the patient.
Many proceedureds and treatments are now being considered as a way to reduce visits by patients to hospitals, beset as they now are by Covid cases. This is being roled out in Scotland; one wonders why not in the rest of the UK? 

Click on the photo to see the complete article published by the BBC in November.

 

 

New treatment for advanced bowel cancer

NICE recommends new combination treatment for advanced bowel cancer

Bowel Cancer UK
Friday 20 November 2020

Today the National Institute for Heath and Care Excellence (NICE) announce their final recommendation for a new treatment combination for people diagnosed with a rare form of bowel cancer. NICE draft guidance initially refused to recommend the treatment due to its cost effectiveness.

The drugs – BRAFTOVI® (encorafenib) in combination with Erbitux® (cetuximab) – will be available within three months on the NHS for adults with a particular form of colorectal cancer, known as BRAFV600E mutant metastatic colorectal cancer (mCRC), living in England and Wales.

Researchers found the combination of the two drugs significantly improved the amount of time patients lived after receiving the treatment, with a median overall survival rate (the amount of time patients lived after receiving the treatment) increasing from 5.9 months to 9.3 months compared to other treatments. It also reduced the risk of death by 39%, compared to the control arm of the trial.

In June 2020, the combination took a major step forward when it was approved by the European Commission. However NICE published draft guidance in September not recommending the combination of drugs because of its cost effectiveness, but after reviewing feedback from the clinical community, charities like us, and patients who have been affected by the decision, they are now recommending the drug to be used on the NHS.

Genevieve Edwards, Chief Executive of Bowel Cancer UK, said: “Approximately one in ten people diagnosed with advanced bowel cancer have a BRAFV600E mutation, and their treatment options are currently extremely limited. We worked closely with clinicians to submit evidence to the NICE consultation on the benefits of the combined therapy, and are really pleased that today’s announcement offers new hope to patients.”

How To Zoom

How to sign up to Zoom and respond to an invitation to join a meeting.

This page may change and evolve as a result of feedback and questions from members, there are two parts to this:-

How to Register a Zoom Account for the first time (sorry about the introduction!)

How to Respond to a Zoom Invitation that you might receive by email

These are both Youtube videos, just click on the link and give them a try!

Living With & Beyond Bowel Cancer – Some Useful Links

Here’s part of a message form Rosie Sadler from the Brighter Outlook Team – Albion in the Community. It followed on from a meeting where attendess were able to share their expert knowledge and tips and advice on living well with and beyond bowel cancer, and/or a stoma, and the effects of treatments.

Here’s some links and contact information for points of contact on what was discussed.


C-Side Support Group

Support group for anyone affected by colorectal cancer. For more information on the C-side support group visit their website http://c-sidebrighton.org/

If you would like to join their next meet up, either on zoom or when it restarts (at the Horizon Centre), contact either:
Denise Savage sdsavage16@gmail.com
Or Steve Tedman (Chair of C-Side) Steve.tedman@sky.com


Contact details for Stoma Nurses or Colorectal Nurses if you have any problems or questions, they’re always happy to help J

STOMA CARE DEPARTMENT  bsu-tr.stomacaredepartment@nhs.net

LowerGIMacmillanRSCH bsuh.lower.gi.macmillanrsch@nhs.net


Recipe books

“Every Mouthful Counts” Recipe book by Mhairi Donald (Macmillan Dietician at Sussex Cancer Centre) – https://sussex-cancer-centre.org.uk/index.php/cookbooks/  

“Wizz it up” written for cancer patients who are having difficulty eating and swallowing – http://sussex-cancer-centre.org.uk/index.php/439-2/   

Macmillan recipes for people affected by cancer – https://be.macmillan.org.uk/Downloads/CancerInformation/LivingWithAndAfterCancer/MAC17345RecipesLowresPDF20181220.pdf

Or you can buy it here: https://www.amazon.co.uk/Recipes-affected-MacMillans-Information-Development/dp/B00XJTWWV4

or https://be.macmillan.org.uk/be/p-22480-recipes-for-people-affected-by-cancer.aspx

There are also eating well tips and other useful information on the following websites:

Bowel Cancer UK: https://www.bowelcanceruk.org.uk/about-bowel-cancer/our-publications/eating-well/
  
Colostomy UK: https://www.colostomyuk.org/information/diet/


Cookery classes at Horizon Centre

Eat Well Feel Better cookery workshops are great, run by experts, and you get to eat the food you cook after! – https://www.macmillan.org.uk/cancer-information-and-support/get-help/centres/macmillan-horizon-centre  


 Bowel Cancer Recovery Toolkit

A fantastic book by Sarah Russell (clinical exercise specialist) – https://www.amazon.co.uk/Bowel-Cancer-Recovery-Toolkit-lifestyle/dp/178161136X

Sarah Russell also did a live Q+A session with 5K Your Way and definitely worth a listen/watch here – https://www.youtube.com/watch?v=wnUv_cJ0wu0&feature=emb_title


Tai Chi was discussed and recommend as a great way to improve balance

Tai Chi Fit over 50 – Balance exercises David-Dorian Ross – https://www.amazon.co.uk/Tai-Chi-Fit-David-Dorian-Bestseller/dp/B01N6L9TIQ   

Here is a video too: https://www.youtube.com/watch?v=fVxlXrRroRI

The Brighton Buddhist Centre also sometimes run Tai Chi classes


In Conversation with Macmillan

When is the event?
Wednesday 25 November, 6-7pm

Background to the Event
During the pandemic, Macmillan has discovered from our social media shout-outs in September (Instagram, Twitter and Facebook), that 94% of people want to hear from a case study, 94% want to hear about how to manage side effects, 95% want to hear about emotional support and 91% about rights at work.

It is hoped that this event will connect people with cancer together and highlight some of the support that is available during the pandemic. It will provide an opportunity for people to hear from Macmillan professionals and other people living with cancer on themes around: treatment and care since the pandemic; signposting to Macmillan support; loneliness and isolation; rights at work; and some of the queries that may come up in the live chat.

What’s the Event Format?

6-6.30 pm Mandy, a person living with cancer, in conversation with Terri (Macmillan communications manager).  Broad discussion on themes.
6.30 – 7pm Presentations from a panel of colleagues across Macmillan, a Clinical Nurse Specialist and the Macmillan Cancer Information Support team. Broad themes will be: treatment and care since the pandemic, and the implications of the pandemic on loneliness and isolation, signposting to Macmillan support, works assessments and rights at work.

During the event, people will be able to submit questions via a live stream.

After the event, the video will still be available to view on Facebook and YouTube and there will be a shareable link to the recording.

Please find the link below to the Facebook page.

https://www.facebook.com/macmillancancer/photos/-mark-it-in-your-diary-and-set-your-alarm-our-in-conversation-with-macmillan-eve/10158591812647199/

Mark Witcomb
Macmillan Engagement Lead – Surrey and Sussex
Telephone: 07458 056996
Macmillan Cancer Support 
3 Fawcett Street, York, YO10 4AH

For information, support or just someone to talk to,
call 0808 808 00 00 or visit macmillan.org.uk
Tailored resources for people with cancer concerned about the coronavirus are available at macmillan.org.uk/coronavirus
Further resources to support Macmillan professionals are available on Learnzone