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MS research update - Overall cancer risk is lower in people with MS - 27 June 2012

MS is generally thought to be an autoimmune condition. This means that the immune system, which should protect us from infection, turns on the body's own tissues and, in the case of MS, attacks myelin which forms the insulating covering of nerves.

As the immune system is behaving unusually in people with MS, there has been some research on whether people with MS are more likely to get other conditions or, perhaps, could be more protected.

This study in Canada looked at whether people with MS were more or less likely to get cancer. 6,820 people with MS were followed for up to 27 years and compared with the general population.

The researchers found that people with MS were, overall, less likely to get cancer than people matched for age and sex from the general population. The risk was the same for men and women with MS and for people with either relapsing remitting or primary progressive MS.

The risk of colorectal cancer (bowel cancer) was particularly low. However, in people with relapsing-onset MS, the risk for non-melanoma skin cancer was significantly greater. The risks for brain cancer and bladder cancer were slightly higher.

An unexpected finding was that the tumour size at diagnosis of breast, prostate, colorectal and lung cancer was larger in people with MS compared with the general population. This may be because people with MS experience a wide range of symptoms including fatigue so the early symptoms of cancer may not be noticed.

The researchers suggest that it is still important for people with MS to follow cancer screening guidelines to ensure that any cancer is caught early, even though the overall risk of cancer is lower.

Kingwell E, Bajdik C, Phillips N, et al.
Cancer risk in multiple sclerosis: findings from British Columbia, Canada.
Brain. 2012 Jun 21. [Epub ahead of print]

Anxiety, depression and fatigue in MS

A study in Tasmania looked at how many people with MS experienced anxiety, fatigue or depression.

198 people with MS were examined every six months for two and a half years. At the beginning of the study almost half (45%) experienced anxiety, about one in five (19%) experienced depression and just over half (54%) had fatigue. The number of people experiencing these symptoms did not vary according to the time of year.

With time, the number of people experiencing anxiety decreased but this was mostly in women rather than men. Younger people were more likely to be anxious than older people.

Depression and fatigue, but not anxiety, were more common in those with more severe disability. Overall, levels of depression rose over the period of the study but this was accounted for by an increase in disability. Fatigue was more common in men than women.

About one in nine (12%) people with MS experienced all three symptoms at the same time which was much higher than in the general population. However, perhaps surprisingly, a quarter (27%) had none of these symptoms at the same time which was much lower than in the general population. Depression alone was unusual as there was usually either anxiety or fatigue as well.

The researchers commented that it was important that health professionals recognised anxiety, fatigue and depression in people with MS so that treatment could be offered. Clinicians should also be aware that all three symptoms can occur at the same time.

In addition, people with MS should feel able to discuss feelings of anxiety, depression or fatigue with their health team rather than holding these feelings inside.

Wood B, van der Mei I, Ponsonby AL, et al.
Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis.
Mult Scler. 2012 Jun 22. [Epub ahead of print]

Research by topic areas...

Symptoms and symptom management

Yokoyama T, Chancellor MB, Oguma K, et al.
Botulinum toxin type A for the treatment of lower urinary tract disorders.
Int J Urol. 2012 Mar;19(3):202-15.

MS relapses

Morrow SA, Jurgensen S, Forrestal F, et al.
Effects of acute relapses on neuropsychological status in multiple sclerosis patients.
J Neurol. 2011 Sep;258(9):1603-8.

Drugs in development

Miller AE, O'Connor P, Wolinsky JS, et al.
Pre-specified subgroup analyses of a placebo-controlled phase III trial (TEMSO) of oral teriflunomide in relapsing multiple sclerosis.
Mult Scler. 2012 Jun 21. [Epub ahead of print]


Muto M, Mori M, Sato Y, et al.
Seasonality of multiple sclerosis and neuromyelitis optica exacerbations in Japan.
Mult Scler. 2012 Jun 21. [Epub ahead of print]

Patten SB, Williams JV, Lavorato DH, et al.
Disability in a community population with MS with and without mental disorders.
Int J Psychiatry Med. 2012;43(1):51-65.

Vitamin D

Steffensen LH, Jørgensen L, Straume B, et al.
Can vitamin D supplementation prevent bone loss in persons with MS? A placebo-controlled trial.
J Neurol. 2011 Sep;258(9):1624-31.


Gourraud PA, Harbo HF, Hauser SL, et al.
The genetics of multiple sclerosis: an up-to-date review.
Immunol Rev. 2012 Jul;248(1):87-103.

Psychological aspects

Pardini M, Capello E, Krueger F, et al.
Reward responsiveness and fatigue in multiple sclerosis.
Mult Scler. 2012 Jun 21. [Epub ahead of print]

Fazekas C, Khalil M, Enzinger C, et al.
No impact of adult attachment and temperament on clinical variability in patients with clinically isolated syndrome and early multiple sclerosis.
Clin Neurol Neurosurg. 2012 Jun 19. [Epub ahead of print]

Gündüz T, Emir O, Kürtüncü M, et al.
Cognitive impairment in neuro-Behcet's disease and multiple sclerosis: a comparative study.
Int J Neurosci. 2012 Jun 22. [Epub ahead of print]


Reis A, Mateus C, Macário MC, et al.
Independent patterns of damage to retinocortical pathways in multiple sclerosis without a previous episode of optic neuritis.
J Neurol. 2011 Sep;258(9):1695-704.


Galimberti D, Scarpini E.
Progress in multiple sclerosis research in the last year.
J Neurol. 2012 Jun 22. [Epub ahead of print]

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