Friday, April 25, 2008

The Bypass Effect On Diabetes, Cancer, Surgery Can Send Diabetes Into Remission, And May Reduce Risk Of Certain Cancers - CBS News

The Bypass Effect On Diabetes, Cancer, Surgery Can Send Diabetes Into Remission, And May Reduce Risk Of Certain Cancers - CBS News

Dr. Neil Hutcher from Richmond, Va. has performed more than 3,000 bypass surgeries. Asked how many people gain the weight back, Dr. Hutcher tells Stahl, "You know I think when you’re dealing with an incurable disease that kills many people, if you have an 85 to 90 percent success rate, that’s pretty darn good."

[...]

It used to be that roughly one in 100 people died from this operation. Hutcher says it's now about one in 1,000, which makes it less deadly than most major surgeries.

"It's less than gall bladder surgery. It's about one-tenth of cardiac surgery," he explains.

[...]

A big reason the operation works is because it seems to suppress appetite. "If you listen to your patients, they come back and they say, 'Doctor, you put the fire out,'" Hutcher says.

"When you see a sign for fast food or…she's already shaking her head at me," Stahl asked a patient.

"Don't want it," the female patient replied. "I used to crave sweets all the time. I couldn't go past the gift shop at work without getting a candy bar. Now I go past it and I never give it a thought."

Paul Delios of Saugus, Mass. has lost 90 pounds. He owns a doughnut shop with his siblings, but he's able to resist the cravings. "Before I'd have cravings for everything. Now I really don't," he told Stahl.

For most patients the cravings really do disappear. One theory is that's because the operation suppresses the levels of a stomach hormone called "grelin" that activates the sensation of hunger.

Yet most people who have this operation do not get skinny. Dr. David Cummings, an expert on appetite at the University of Washington, says as a rule these patients end up just one third lighter.

"Most people with severe obesity who undergo gastric bypass do not become fully normal, in terms of body weight. They go from severely obese to mildly obese, or from obese to overweight. But nevertheless it’s an enormous change," Dr. Cummings explains.

And not just in terms of weight loss. Dr. Hutcher says the operation itself can take type 2 diabetes - which has ballooned in this country - and throw it into complete remission.

The group of patients Stahl met say they all had diabetes before the operation; post-surgery, none have diabetes.

That means they no longer need sugar-control medication, like insulin injections.

One patient, Vicki, told Stahl she went from having eight or nine insulin shots a day to none, and that she's diabetes free - "cured" as she put it.

"Would you use the term 'cure diabetes?'" Stahl asks Dr. Hutcher.

"I think my patients are cured," he says.

"Cured?" Stahl asks.

"Well, they go home on no medication," he says. "And I've followed them now for 10 and 15 years, and see no evidence of recurrence. So, it's pretty darn close."

Studies confirm that about 80 percent of diabetics go into complete remission following the operation. Obesity is considered one of the major causes of type 2 diabetes, but here's something odd: when you have the gastric bypass operation, your diabetes goes away long before you lose the weight.

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