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Chronic Fatigue Syndrome and subsequent Risk of Cancer

Discussion in 'Latest ME/CFS Research' started by redrachel76, Feb 17, 2014.

  1. redrachel76

    redrachel76 Senior Member

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    Israel
    I have been told that the "subset" here is the ID of CFIDS.

    Does anyone understand something in this?


    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434293/

    Chronic fatigue syndrome and subsequent risk of cancer among elderly U.S. adults
    Cindy M. Chang, Ph.D., M.P.H.,1 Joan. L. Warren, Ph.D.,2 and Eric A. Engels, M.D., M.P.H.1
    1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
    2Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
    Address correspondence and reprint requests to: Cindy M. Chang, PhD, MPH, Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute,
    The publisher's final edited version of this article is available at Cancer
    See other articles in PMC that cite the published article.

    Abstract

    Background
    The cause of chronic fatigue syndrome (CFS) is unknown but is thought to be associated with immune abnormalities or infection. Because cancer can arise from similar conditions, we examined associations between CFS and cancer in a population-based case-control study among the U.S. elderly.

    Methods
    Using linked SEER-Medicare registry data, we evaluated ~1.2 million cancer cases and 100,000 controls (age 66–99 years, 1992–2005). CFS was identified in the period more than one year prior to selection using linked Medicare claims. We used unconditional logistic regression to estimate the odds ratios (ORs) comparing the CFS prevalence in cases and controls, adjusting for age, sex, and selection year. All statistical tests were two-sided.

    Results
    CFS was present in 0.5% of cancer cases overall and 0.5% of controls. CFS was associated with an increased risk non-Hodgkin lymphoma (NHL) (OR=1.29, 95% CI=1.16–1.43, p-value=0.0000017). Among NHL subtypes, CFS was associated with diffuse large B cell lymphoma (OR=1.34, 95% CI=1.12–1.61), marginal zone lymphoma (OR=1.88, 95% CI=1.38–2.57), and B-cell NHL not otherwise specified (OR=1.51, 95% CI=1.03–2.23). CFS associations with NHL overall and NHL subtypes remained elevated after excluding patients with medical conditions related to CFS or NHL, such as, autoimmune conditions. CFS was also associated (although not after multiple comparison adjustment) with cancers of the pancreas (OR=1.25, 95% CI=1.07–1.47), kidney (OR=1.27, 95% CI=1.07–1.49), breast (OR=0.85, 95% CI=0.74–0.98), and oral cavity and pharynx (OR=0.70, 95% CI=0.49–1.00).

    Conclusion
    Chronic immune activation or an infection associated with CFS may play a role in explaining the increased risk of NHL.
  2. Kati

    Kati Patient in training

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    While the prevalence for cancers is similar in elderly CFS patients compared to non-CFS control, there seem to be higher risk for B-ell lymphomas and they seem to think that it may be caused by our chronically activated immune system.

    This is in my opinion good news because they seem to accept that ME and/or CFS is a physical ilness characteried by immune activation. So it's all good.

    Moreover I cannot recognize any of the authors, meaning they are not the ME experts we know. Outsiders writing *good*papers in our field is great news.
    redrachel76 likes this.
  3. Martial

    Martial Senior Member

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    Are they sure this is not the result of the of symptoms and an issue with cancer going on but someone being misdiagnosed with CFS in the beginning until some blood tests, or other means of results shows a positive confirmation of said cancer?

    I do believe there can definitely be issues that arise from complications of M.E. for sure though.. Perhaps in some cases the physiological changes of CFS can trigger cancer in people that are susceptible or under a certain set of circumstances.

    What is also the role of chronic infection then? similar to CFS? or to say that all chronic infections leads to higher cancer risk as they say possible of an underlying facet of M.E? What about auto immune disease?
  4. alex3619

    alex3619 Senior Member

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    There is an older thread on this somewhere on PR. We get lymphoma more often. We often respond to a lymphoma chemo, Rituximab. All the pathogens suspected of triggering ME can live in B cells. B cells gone amok can lead to autoimmune disease. Rituximab responders in RA seem to have occult EBV infections. Its all connected, we just don't know what it all means.

    Abnormal B cells are what clued Lipkin in that this was a real disease, in the late 90s.

    I suspect the odds ratios are too weak - it would be diluted by large numbers of misdiagnoses of CFS in patients with other things wrong with them. On the other hand, at least some controls will have CFS and be undiagnosed.
  5. Martial

    Martial Senior Member

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    I think this is also in the case of Lupus as well, correct?
  6. alex3619

    alex3619 Senior Member

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    Yes. Lupus (SLE) has a higher risk, and its not associated with the use of immune suppressants, nor with severity of the Lupus symptoms. Just having Lupus appears to be enough. However they need much larger studies than I am aware of, though I have not investigated this much.

    See for example: http://www.webmd.com/lupus/news/20101108/lupus-linked-increased-risk-cancer
  7. Martial

    Martial Senior Member

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    Interesting... Also there always seems to be major underlying factors that are involved in most chronic disease states, as well as heightened chances of other issues like certain forms of cancer which were mentioned..

    Interesting to know we are in a time period where we may just find out what some of these major underlying issues are and the subsequent treatment... The whole aspect of raising immune illness issues, cancer, and other strange changes all seem to point to some kind of dramatic shift in the environment or lifestyle that was not present in earlier times of history.

    A really interesting time period to life through for sure, so much going on all at once and huge shifts in technological, scientific advancement, etc..

    * I really wanted to emphasis interesting lol
  8. alex3619

    alex3619 Senior Member

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    ;) Beware of interesting times.
  9. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    natural killer cells not only kill viruses but also---- cancer cells??
    NK17 likes this.
  10. alex3619

    alex3619 Senior Member

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    Yes, @heapsreal. Low NK function might increase risk of cancer. What it does not explain is why its primarily a risk for lymphoma. That is due to something else. A leading candidate is pathogens, including EBV. However poor NK function might increase EBV pathogenicity. Its a tangled web.
    NK17, Kati, Valentijn and 3 others like this.
  11. NK17

    NK17 Senior Member

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    I think that there is still so much that we don't know about EBV and its workings and what I like to call its Immune System Hijacking Capacity ...

    Makes me wonder if there is something to learn from computers' hacking, but then nature and viruses are so much more smart, sophisticated and older than our little brains ;)

    We are slowly getting there though, important research and published papers are coming out from all over the world (Australia, Germany, Sweden) on the role of EBV and faulty immune responses.

    The next step is translating this discoveries into actual treatments.

    I had a bad case of IM at age 14 and looking back I can tell you that that was the blow that opened a crack in my immune system, I'm absolutely certain of this.

    I also have a family history of what in GB is still called Glandular Fever and subsequent NHL, on my maternal side of the family.

    Do you see where I'm getting?
    heapsreal likes this.
  12. SilverbladeTE

    SilverbladeTE Senior Member

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    ok my brain simply cannot cope with anything above simple arithmetic any more :(
    what is the percentage increased risk of getting non-hodgkins lymphoma in M.E. patients over norms, from this? :)
  13. Daffodil

    Daffodil Senior Member

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    the good news never ends for us, does it
  14. Esther12

    Esther12 Senior Member

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    Probably loads of confounding factors there: low levels of exercise, less alcohol + recreational drugs, less sunshine, more speculative medical treatments... all those things could be related to cancer rates. Who knows what's really related to what?
  15. Tristen

    Tristen Senior Member

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    Since my NK cell count and function had long been very dysfunctional, the thought of developing cancer was always there in the back of my mind. Not like a negative, self defeating type thing....just an awareness of a very real possibility.

    After a year on Vistide (2009) my NK cells, along with the rest of my immune system did a re-boot bringing most values into normal, or close to it. My doc (Peterson) routinely tests precursors for lymphoma's, so I felt somewhat comfortable in that respect, but I did develop a different type head/neck cancer, which I'm pretty sure is more common with me/cfs as well. I wasn't all that alarmed with the news after years of knowing what I knew. With treatment I cleared the cancer, and I remain clear now 2 years post treatment.

    I never really got all freaked out about the cancer because I consider it a walk in the park compared to me/cfs. But I was concerned the chemo would cause a relapse of my progress made from the Vistide treatment. It didn't. I've returned to baseline. Yeeehaaa!
    Last edited: Mar 5, 2014

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