I am grateful to the World Cancer Research Fund / Wereld Kanker Onderzoeks Fonds for supporting our research in which we are combining lifestyle behaviours and immune-related tumour characteristics in the context of colon cancer recurrence. This integrative approach is unique and offers a powerful opportunity for investigating the dynamics of lifestyle, immune-functioning and colon cancer. Ultimately, this research could contribute to the development of personalised guidelines based on the tumour characteristics for individuals diagnosed with cancer of the large bowel. By contributing to personalised guidelines we hope to lower the burden and recurrence of large bowel cancer for public health, health care and most importantly, for persons diagnosed with cancer.
Dr Evertine Wesselink
Background
In every group of ten people, one of them will be diagnosed with cancer of the large bowel during their lifetime. In approximately 30% of these survivors of large bowel cancer, the cancer returns which is of major impact on the person’s life. Whether the cancer will return depends on the stage of disease at diagnosis, type of treatment received, but also on specific properties of the tumour, also called tumour characteristics.
For each person, these tumour characteristics are different, therefore, responses to treatment and changes in lifestyle could be different between persons. A healthy lifestyle is essential for an optimal immune response, which is essential in the fight against cancer in our bodies. However, tumours develop smart mechanisms to fool the immune-system.
These mechanisms can be studied in more detail when investigating the tumour tissue itself, especially tumour characteristics related to immune functioning, for now called immune-related tumour characteristics. One of the main mechanisms by which an unhealthy lifestyle influences our immune-response against the tumour is by inducing chronic inflammation. Chronic inflammation results in exhaustion of our immune-system and thereby a decreased ability to fight cancer. A healthy lifestyle including healthy eating e.g. higher intake of fruits and vegetables and lower intake of processed and fast foods, smoking cessation, maintaining a healthy weight and being physical active could lower inflammation.
In a previous study in persons diagnosed with a tumour in the large bowel, a diet associated with more inflammation was linked to the risk of tumours with only a few immune cells, but not with the risk of a tumour with a lot of immune cells. This implies that diet could influence cancer risk and recurrence by influencing our immune response against the tumour.
Aims and Objectives
The overall aim of the proposed study is to elucidate the role of lifestyle-associated inflammation in relation to recurrence in patients with colon cancer by focussing on immune-related tumour characteristics. The main objectives are:
- To investigate associations between the inflammatory potential of lifestyle factors and immune- related tumour characteristics,
- To investigate associations between immune-related tumour characteristics and cancer recurrence, and
- To explore whether the association between the inflammatory potential of lifestyle and recurrence could be (partly) explained by immune-related tumour characteristics.
How it will be done
We will use data of two studies among individuals with large bowel cancer. From these studies, data from 180 persons who had a cancer recurrence and 720 who did not have a recurrence were selected. These individuals already completed questionnaires on dietary intake and lifestyle.
After surgery to remove the primary tumour, blocks of the tumour were routinely stored in pathology archives. We obtained these tumour blocks from the pathology archives to assess the immune-related tumour characteristics.
We will investigate whether the associations between diet and lifestyle and risk of cancer recurrence can be explained by immune-related characteristics of the tumour.
Potential Impact
This integrative approach, combining lifestyle behaviours and immune-related tumour characteristics in the context of cancer recurrence is unique and offers a powerful opportunity for investigating the dynamics of lifestyle, immune-functioning and colon cancer.
Ultimately, this research could contribute to the development of personalized guidelines based on the tumour characteristics for individuals diagnosed with cancer of the large bowel.
By contributing to personalised guidelines, we hope to lower the burden of recurrence of large bowel cancer for public health, health care and most importantly, for persons diagnosed with cancer.