Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.

Fear of cancer returning is one of the top health concerns. And managing this fear is an important part of cancer treatment.

But how likely is it to get cancer for a second time?

Why can cancer return?

While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.

This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called metastasis.

Actor Hugh Jackman has gone public about his multiple diagnoses of basal cell carcinoma (a type of skin cancer) over the past decade.

The exact reason why cancer returns differs depending on the cancer type and the treatment received. Research is ongoing to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.

What are the chances of cancer returning?

The risk of cancer returning differs between cancers, and between sub-types of the same cancer.

New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by 31-68%. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.

For most types of cancer, the highest risk of cancer returning is within the first three years after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.

Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.

What about second, unrelated cancers?

Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) shortly after being treated for breast cancer.

Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.

Australian research from Queensland and Tasmania shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.

Who’s at risk of another, unrelated cancer?

With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.

Reasons for such cancers include different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.

The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is relatively small when compared with the (sometimes lifesaving) benefits of these treatment and procedures.

While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.

Similarly, in a large US study only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).

The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.

People diagnosed with cancer as a child, adolescent or young adult also have a greater risk of a second, unrelated cancer.

What can I do to lower my risk?

Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.

Maintenance therapy may be used to reduce the risk of some types of cancer returning. However, despite ongoing research, there are no specific treatments against cancer recurrence or developing a second, unrelated cancer.

But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of cancer returning and getting a second cancer.

Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and Terry Boyle, Senior Lecturer in Cancer Epidemiology, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

If you spend any time looking at diet and lifestyle content on social media, you may well have encountered a variety of weight loss “hacks”.

One of the more recent trends is a home-made drink called ricezempic, made by soaking uncooked rice and then straining it to drink the leftover starchy water. Sounds delicious, right?

Its proponents claim it leads to weight loss by making you feel fuller for longer and suppressing your appetite, working in a similar way to the sought-after drug Ozempic – hence the name.

So does this drink actually mimic the weight loss effects of Ozempic? Spoiler alert – probably not. But let’s look at what the evidence tells us.

How do you make ricezempic?

While the recipe can vary slightly depending on who you ask, the most common steps to make ricezempic are:

1. soak half a cup of white rice (unrinsed) in one cup of warm or hot water up to overnight
2. drain the rice mixture into a fresh glass using a strainer
3. discard the rice (but keep the starchy water)
4. add the juice of half a lime or lemon to the starchy water and drink.

TikTokers advise that best results will happen if you drink this concoction once a day, first thing in the morning, before eating.

The idea is that the longer you consume ricezempic for, the more weight you’ll lose. Some claim introducing the drink into your diet can lead to a weight loss of up to 27 kilograms in two months.

Resistant starch

Those touting ricezempic argue it leads to weight loss because of the resistant starch rice contains. Resistant starch is a type of dietary fibre (also classified as a prebiotic). There’s no strong evidence it makes you feel fuller for longer, but it does have proven health benefits.

Studies have shown consuming resistant starch may help regulate blood sugar, aid weight loss and improve gut health.

Research has also shown eating resistant starch reduces the risk of obesity, diabetes, heart disease and other chronic diseases.

Resistant starch is found in many foods. These include beans, lentils, wholegrains (oats, barley, and rice – particularly brown rice), bananas (especially when they’re under-ripe or green), potatoes, and nuts and seeds (particularly chia seeds, flaxseeds and almonds).

Half a cup of uncooked white rice (as per the ricezempic recipe) contains around 0.6 grams of resistant starch. For optimal health benefits, a daily intake of 15–20 grams of resistant starch is recommended. Although there is no concrete evidence on the amount of resistant starch that leaches from rice into water, it’s likely to be significantly less than 0.6 grams as the whole rice grain is not being consumed.

Ricezempic vs Ozempic

Ozempic was originally developed to help people with diabetes manage their blood sugar levels but is now commonly used for weight loss.

Ozempic, along with similar medications such as Wegovy and Trulicity, is a glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs mimic the GLP-1 hormone the body naturally produces. By doing so, they slow down the digestive process, which helps people feel fuller for longer, and curbs their appetite.

While the resistant starch in rice could induce some similar benefits to Ozempic (such as feeling full and therefore reducing energy intake), no scientific studies have trialled ricezempic using the recipes promoted on social media.

Ozempic has a long half-life, remaining active in the body for about seven days. In contrast, consuming one cup of rice provides a feeling of fullness for only a few hours. And simply soaking rice in water and drinking the starchy water will not provide the same level of satiety as eating the rice itself.

Other ways to get resistant starch in your diet

There are several ways to consume more resistant starch while also gaining additional nutrients and vitamins compared to what you get from ricezempic.

1. Cooked and cooled rice

Letting cooked rice cool over time increases its resistant starch content. Reheating the rice does not significantly reduce the amount of resistant starch that forms during cooling. Brown rice is preferable to white rice due to its higher fibre content and additional micronutrients such as phosphorus and magnesium.

2. More legumes

These are high in resistant starch and have been shown to promote weight management when eaten regularly. Why not try a recipe that has pinto beans, chickpeas, black beans or peas for dinner tonight?

3. Cooked and cooled potatoes

Cooking potatoes and allowing them to cool for at least a few hours increases their resistant starch content. Fully cooled potatoes are a rich source of resistant starch and also provide essential nutrients like potassium and vitamin C. Making a potato salad as a side dish is a great way to get these benefits.

In a nutshell

Although many people on social media have reported benefits, there’s no scientific evidence drinking rice water or “ricezempic” is effective for weight loss. You probably won’t see any significant changes in your weight by drinking ricezempic and making no other adjustments to your diet or lifestyle.

While the drink may provide a small amount of resistant starch residue from the rice, and some hydration from the water, consuming foods that contain resistant starch in their full form would offer significantly more nutritional benefits.

More broadly, be wary of the weight loss hacks you see on social media. Achieving lasting weight loss boils down to gradually adopting healthy eating habits and regular exercise, ensuring these changes become lifelong habits.

Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.