Helping prevent and treat bowel cancer

Identifying apoptosis (cell suicide) as a plausible scientific mechanism for how a high fibre diet and aspirin may prevent and treat bowel cancer.

Bowel cancer is the second most common cause of cancer-related deaths in the UK with over 16,000 deaths a year. Worldwide, it’s the cause of 600,000 deaths annually. Yet, between 60 per cent and 80 per cent of bowel cancer cases can be prevented through changes in diet.

Preventative and therapeutic measures, combined with improved public awareness of its causes, are essential strategies for reducing the number of deaths associated with bowel cancer.

The University of Bristol's Cancer Research UK - Colorectal Tumour Biology Group were the first to show that butyrate, which is a bacterial fermentation product of dietary fibre, triggered molecular mechanisms in cancer cells and benign tumour cells that led to cell suicide – a process known as apoptosis or programmed cell death.

The group also showed that aspirin triggered apoptosis in human colorectal adenoma (benign tumours, sometimes called polyps) and cancer cells, which helps to explain its role in the prevention of bowel cancer as well as treatment of those with cancer.

These findings helped to pave the way for additional studies and collaborative clinical trials to investigate the role of dietary fibre and aspirin in the prevention and treatment of bowel cancer.

Several international collaborative studies established that a high fibre diet lowers the risk of bowel cancer among the general population and that patients with a genetic predisposition to bowel cancer reduced their risk with a daily dose of aspirin.

Public health initiatives dramatically increase awareness

Twenty years later, the researchers have not only collaborated in international clinical trials which have led to better outcomes for bowel cancer patients, they have fuelled national public health initiatives, such as the ‘five-a-day’ campaign, and international guidelines on dietary advice.

The Bristol-based research led to a fundraising campaign in the late 1990s, run jointly by the University of Bristol and the Cancer Research Campaign. Bristol Beating Bowel Cancer (BBC) displayed posters of men’s and women’s bottoms throughout Bristol to increase awareness of bowel cancer and raised £1.5 million for bowel cancer research.

The NHS Direct and prestigious US agencies, such as the Mayo Clinic, recommend a high-fibre diet. The NHS’s famous ‘five-a-day’ campaign lists the role of a high fibre diet in reducing bowel cancer risk as one of its top five reasons for eating five portions of fruit and veg a day.

The importance of diet and dietary fibre in bowel cancer prevention was a pivotal message in the BBC’s campaign. This messaging and the media surrounding the original research led to a considerable increase in public awareness of the importance of dietary fibre.

The Cancer Research UK – Colorectal Tumour Biology Group continues to explore the mechanisms behind colorectal tumour cell survival and identify novel targets for therapeutic drugs. They are committed to translating their research findings to the clinical setting and are helping to establish further clinical trials locally and nationally.

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