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H. pylori treatment, vitamins prevent gastric cancer in high risk patients
Clinical Question
In patients at high risk of gastric cancer, is treatment for H. pylori, vitamin supplementation, or garlic effective to decrease the likelihood of gastric cancer and related death?
Bottom line
Over a long time --22.3 years --patients at high risk of developing gastric cancer are less likely to do so if they have their H. Pylori infection treated or if they take a supplement containing vitamin C, vitamin E, and selenium for seven years. Both treatments, as well as garlic also decrease the risk of dying due to gastric cancer. Given the lower likelihood of gastric cancer in many populations, I don't think this study should prompt any changes in approach. It adds an added benefit to treating H. pylori and gives a reason to take a vitamin C/E and selenium supplement should patients desire to take a vitamin supplement. 1b-
Reference
Study design: Randomized controlled trial (double-blinded)
Funding:
Setting: Outpatient (any)
Synopsis
Researchers randomly identified 14 villages in a single region in China with a high incidence of gastric cancer and asked 4010 middle-aged adult residents to undergo gastroscopy during which they were also tested for H. pylori. A total of 2258 patients were seropositive for H. pylori and agreed to be enrolled in the study, after which they were randomly assigned, concealed allocation uncertain, to receive combination of two of three treatments: H pylori treatment with amoxicillin and omeprazole for two weeks, garlic supplementation, and vitamin supplementation (with vitamins E and C, and selenium) for an average 7.3 years, Every patient received two treatments and no patients were treated with only placebo. In addition, 1107 patients seronegative for H. pylori were also assigned to receive garlic or vitamin supplementation. Even in this high incidence area, Over the next 22.3 years (not a typo), there were 151 cases of gastric cancer (4.4%) identified via scheduled gastroscopies and 94 deaths from gastric cancer (2.8%) among the group, mostly in patients identified as having H. pylori. The odds of developing gastric cancer was significantly decreased in patients who received H. pylori treatment (odds ratio [OR] .48; 95% CI .32 - .71) and with vitamin supplementation (OR = .64; 95% CI.46 - .91) but not with garlic supplementation. All three interventions decreased the risk of gastric cancer-related mortality. Note the length of this trial -- non-significant results were found when analyzed after almost 15 years. Both the incidence of gastric cancer and the rate of H. pylori infection are high in the studied population and the results may not be as profound in patients at lower risk of either.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Subject: Importance of Vitamin -C/E to prevent GRASTRIC cancer .
Dear respected Sir/Mam-Team-CMA-Canada,
Thank you all to add the above medical education subject /tropic about Vitamin -C/E towards the prevention of GRASTRIC cancer In high risks patients.
When, patients/we face GRASTRIC problems inside of our human body /belly then, we should visit GRASTRIC doctors and should take his/her prescribed medicine and counseling. Doctors/GRASTRIC specialist can give Vitamin C/E to protect GRASTRIC problems of clients /patients.
We should take /eat daily natural fruits /vegetables like Vitamin C related example ;Grapes /Guavas /Orange /lemon etc. and should take Vitamin E related fruits.
Vitamin C /E is a blessing by Doctors /GRASTRIC Specialist to prevent GRASTRIC cancer /GRASTRIC problems of patients those, who are suffering with pains /infection related to GRASTRIC problems of human body of patients/clients.
Wishing good health to you all.
Respectfully.
Dr.Muhammad Arif Rana-Manikganj-Bangladesh -Global Family Doctor (LDM-224)-WONCA at SIG Based.
Health Professional Member ID-52698
-MDS-USA.
International Resident Member (IMG)-CMAID-680777-CMA-Canada.
Family Doctor Association (FDA)-UK-Associate Member-User ID-muhammadarifrana3@gmail.com
International Resident Member ID-44770918(Resident No-424504)- SRPC-Canada.
(SIG).
Date : November 03-2019-Sunday-11:52 AM.
Email:muhammadarifrana3@gmail.com
+8801754241555
+8801866313508
(Best wishes and Respectfully)