Archive for the 'Breast Cancer' Category

New Recommendations for Ovarian Cancer Prevention

Two womenAccording to new recommendations from the Society of Gynecologic Oncologists, women with a strong family history of ovarian cancer or BRCA mutations should have prophylactic bilateral salpingo-oophorectomy after completing childbearing, to reduce the risk of ovarian cancer .

A bilateral salpingo-oophorectomy is a surgical procedure that removes both sets of fallopian tubes and ovaries. 

Read about Ovarian Cancer

Source: “Individualize Decisions about Prophylactic Oophorectomy“, MedPage Today, September 26, 2010

More Information about Prophylactic Oophorectomy from the Mayo Clinic

Beta Blockers May Help Prevent Cancer

Beta Blockers are prescription medications used for high blood pressureTreatment with a certain type of blood pressure medication has been associated with better outcomes in breast cancer, according to British researchers from the Nottingham University Hospital in England.

Based on their review of 466 medical records of breast cancer patients, those taking blood pressure medication referred to as beta blockers, had a 71% reduction in the risk of breast cancer-specific death.  Also, there was a 57% reduction in the risk of distant metastasis, compared with patients on other antihypertensive agents or no antihypertensive therapy. 

The findings of this study add to previous research suggesting that drugs of this type might have anticancer activity.  In one study of patients with cardiovascular disease, there was a significant reduction in total cancer incidence among patients treated with beta blockers versus those on other antihypertensive medications.  In another study, prostate cancer was found to be significantly reduced in patients treated with alpha-1 blockers.

These findings are very compelling, but more research in this area is needed before any definite conclusions can be made.  

Source: Powe DG, et al “Beta-blocker treatment is associated with a reduction in tumor metastasis and an improvement in specific survival in patients with breast cancer” EBCC 2010; Abstract 445. 

Source: “EBCC: Beta-Blocker Role in Breast Cancer Examined ”, MedPage Today, March 30, 2010 

Does A Drink a Day Really Help with Weight Control?

Women drinking wineLight to moderate drinking may keep women from gaining too much weight, according to the researchers from the Brigham & Women’s Hospital in Boston.

In their recent 13-year study of normal-weight women younger than 50, those who drank light to moderate amounts of alcohol daily, gained less weight and had a lower risk of becoming overweight or obese than either teetotalers or those who drank too much.

These findings and conclusions are highly controversial for a number of reasons. Experts do agree that further research is needed to confirm these conclusions, but certainly the findings should not be used as a license to drink. 

The fact remains that alcohol is well known to increase the risk of cancers of the mouth, pharynx, larynx, esophagus, liver, and breast.  Regular consumption of even a few drinks per week is associated with an increased risk of breast cancer in women. In fact, the American Cancer Society warns that those at high risk of breast cancer may want to consider not drinking any alcohol at all.

Source reference:
Wang L, et al “Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women” Arch Intern Med 2010; 170(5): 453-61.

Source: “Cheers! A Drink a Day May Keep the Pounds Away”, MedPage Today, March 8, 2010

Source: “Common Questions about Diet and Cancer” from the American Cancer Society

Breast Cancer Drop Linked to Decreased Use of HRT

2 womenThe decline in breast cancer rates among women over age 50 is linked to less use of hormone replacement therapy (HRT), according to Harvard Researchers. In their study of more than 350,000 women, the decline was most significant for cases of estrogen receptor-positive cancer and among affluent, white women who were most likely to have used HRT.

Source: American Journal of Public Health, February 2010

Aspirin May Reduce the Spread of Breast Cancer

AspirinAn aspirin at least two days a week significantly reduced the risk of death from breast cancer by 64% to 71% in a recently published study from Harvard and Brigham and Women’s Hospital in Boston. 

This study included 4,164 female registered nurses diagnosed with early stage breast cancer. The use of aspirin in the first year after breast cancer diagnosis was excluded in this study since the drug is discouraged during chemotherapy.

 The dose of aspirin was not specified in the study as methodology was limited by self-reporting for aspirin intake. The researchers speculated that most regular use of aspirin is for heart disease prevention at the 81 mg/day level. 

“These are promising findings, and if they are confirmed in additional clinical trials, physicians may be able to regularly recommend aspirin to their breast cancer patients to reduce risk of cancer spread and mortality,”  wrote Lori Pierce, MD, of the University of Michigan in Ann Arbor, on behalf of the American Society of Clinical Oncology, in a prepared statement.

Previous studies have also found benefits of aspirin in relation to breast cancer. In September of 2009 the American Cancer Society wrote, “some studies have found that women who take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen seem to have a lower risk of breast cancer. These, as well as several other drugs and dietary supplements, are being studied to see if they can lower breast cancer risk, although none are approved for reducing breast cancer risk at this time.”

Daily aspirin therapy is also thought to help lower the risk of heart attack and stroke in certain people, but it isn’t appropriate for everyone. Doctors often recommend daily aspirin therapy in some people who’ve had a heart attack or stroke, or who are at high risk of either.

It’s important to note that breast cancer patients should always consult their oncologist or general physician before taking aspirin, especially during the chemotherapy, as it is often discouraged.

Anyone who wishes to start on aspirin should always consult with their physician as there are several potentially dangerous side-effects of this drug:

  1. The anticoagulant effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for its preventive anticoagulant effects only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding.
  2. Aspirin can irritate the stomach or cause GI bleeding. Aspirin should always be taken with food, preferably after a meal due to its potential for stomach irritation and GI bleeding.
  3. Aspirin is also contraindicated in: people with allergy to aspirin or NSAIDs (Advil, Motrin, Alleve, etc), 3rd trimester pregnancy. Precautions: History of asthma or peptic ulcer, severe hepatic (liver) or renal (kidney) dysfunction, bleeding disorders, diabetes, gout, pregnancy or nursing mothers. Aspirin interacts with many medicines. For more contraindications and a list of drugs that interact with aspirin, click here
  4. Children and teen-agers suffering from flu-like symptoms, chickenpox and other viral illnesses shouldn’t take aspirin or aspirin products (acetylsalicylic acid / salicylates) because of the possibility of a deadly disease called Reye’s syndrome.

Source: “Aspirin Benefit Seen in Established Breast Cancer”, MedPage Today, February 16, 2010

Source: Holmes MD, et al “Aspirin intake and survival after breast cancer” J Clin Oncol 2010; DOI: 10.1200/JCO.2009.22.7918. 

Exercise Linked with Lower Breast Cancer Risk

Aerobic ExerciseA number of studies have found an association between regular exercise and decreased breast cancer risk, and now a new study from Alberta Health Services in Calgary finds further supporting evidence in their trial of 320 postmenopausal women. 

The women in this study did aerobic exercise for at least 45 minutes five days a week over a period of 12 months. During the exercise, they monitored their pulse to achieve 70% to 80% of their heart rate reserve.

Periodically the researchers assessed blood levels of hormones and found that exercise was associated with modestly lowered levels of estradiol which is consistent with a slightly lower risk of breast cancer.

Aerobic exercise involves continuous activity that will increase your heart rate and maintain it at a higher rate for a sustained period of time, such as for 20-60 minutes.

In aerobic exercise, you continually move large muscles in the legs and buttocks. This action causes you to breathe more deeply and your heart to work harder to pump blood, thereby strengthening your heart and lungs.

What are aerobic activities? Walking briskly, bicycling or using a stationary bicycle, swimming, running, jogging, stepping machine or climbing stairs, vigorous dancing, ice skating or roller skating, aerobics (regular or low impact) cross-country skiing, rowing and playing racquetball or tennis. Riding a bike is an excellent aerobic exercise that will also strengthen the quadriceps muscles, (thigh muscles) that stabilize the knee joint. 

How long? Beginners might want to start with as little as three 10-minute walks a day, most days of the week.  People who are younger and more fit might want to aim for as much as 60 minutes a day, most days of the week.

How intense? To achieve the benefits of aerobic exercise, the activity must be continuous, without stopping, and strenuous enough to cause a slight but noticeable increase in breathing and heart rate. Hard enough to break a sweat, but not so hard that you can’t comfortably carry on a conversation. If you monitor your heart rate during exercise, what should it be? Calcuate your target heart rate for your age, using this calculater.

In addition to decreasing breast cancer risk, there are at least 17 other very good reasons to exercise regularly. Here is a list of the many benefits of exercise and some important tips on how to get started

Note: Before getting started on an exercise program, it’s always best to first consult with your doctor. 

Source: “For Older Women, Exercise May Cut Breast Cancer Risk”, MedPage Today, February 16, 2010

Source: Friedenreich CM, et al “Alberta physical activity and breast cancer prevention trial: Sex hormone changes in a year-long exercise intervention among postmenopausal women” J Clin Oncol 2010; DOI: 10.1200/JCO.2009.24.9557. 

Important Breast Cancer Highlights 2004-2008

A measuring tape is a good tool for monitoring weight controlObesity linked to increased risk for six cancers
According to a recent report, excess body fat is on course to overtake tobacco as the leading risk factor for cancer in America. Furthermore, the cancer risk increases with only modest weight gain. In this analysis, excess body fat was found to be associated with an increased incidence of cancers of the colon, kidney, and pancreas, adenocarcinoma of the esophagus and endometrium, and breast cancer in postmenopausal women.There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, chickpeas and other legumes. Lignans occur in flaxseeds, whole grains and some fruits and vegetables. Source: World Cancer Research Fund, American Institute for Cancer Research, October 2007

The American Cancer Society recommends MRI screening for women with lifetime breast cancer risk of 20%
Calculate your Lifetime Risk with this tool. Note: There are different risk models. Each one is imperfect and provides only an approximate estimate of risk. The tool should not be used to calculate breast cancer risk for women who have already had a diagnosis of breast cancer or for women known to have breast cancer-producing mutations in the BRCA1 or BRCA2 genes.
Always discuss these results with your doctor.)

Further recommendations from the American Cancer Society include:

  • Screening should begin at age 30 for most high-risk women
  • Annual MRI screening is recommended for patients with BRCA mutations and for patients whose lifetime risk for breast cancer is at least 20%,
  • MRI screening is not recommended for women with lifetime risk below 15%.
  • Annual MRI screening is recommended for patients who received chest radiation (e.g., for Hodgkin disease) between ages 10 and 30 and for patients with several unusual genetic syndromes;
  • The evidence is insufficient to recommend for or against MRI screening for women with dense breasts; women with personal histories of breast cancer, atypical ductal hyperplasia, ductal carcinoma in situ, atypical lobular hyperplasia or lobular carcinoma in situ; or women with lifetime risk of 15% to 20%.

Source: American Cancer Society, June 2007

Women at high risk of breast cancer should get an annual MRI scan plus mammogram
Women who have an especially high risk of developing breast cancer should get magnetic resonance imaging (MRI) scans along with their yearly mammogram, according to a new American Cancer Society guideline released today. This recommendation applies only to the 1% to 2% of women who have at least a 20% risk of developing breast cancer due to their family history. Performing both a mammogram and MRI together improves the chances of finding breast cancer early, when the cancer is easier to treat. In a related study also being released today, the researchers found that, in 969 women newly diagnosed with cancer in one breast, MRI found 30 additional tumors in the opposite breast that had been missed by mammograms and physical exams.

MRI scans are not recommended for women with an average risk of breast cancer. Although the scans are more sensitive than mammograms, they are more likely to result in false-positives, or false alarms in other words. This creates a great deal of prolonged anxiety, and an additional costly and invasive biopsy or procedure to adequately investigate a questionable area in a woman who is not likely to have breast cancer. Another significant drawback of the MRI scan is that its cost is about 10-times that of a mammogram. Thus the American Cancer Society only recommends the additional MRI scan in those with the highest risk. Source: American Cancer Society, March 3, 2007

Breast Reconstruction Referrals Not Always Offered by Surgeons
Women’s Health and Cancer Rights Act of 1998 mandates that insurance companies cover breast reconstruction for patients who undergo breast cancer surgery. Source: MedPage Today, March 2007

Radiation patients greatly benefit from nutrition counseling
Periodic nutrition counseling significantly improved the nutritional status of cancer patients were undergoing radiation therapy. Those patients who received dietary counseling, not only avoided malnutrition, and also experienced a significantly smaller decrease in overall quality of life, and had a faster recovery with regard to physical function, compared to those who did not receive counseling. Source: Journal of the American Dietetic Association, March 2007

Weighing yourself daily is recommended for weight controlObesity appears to increase risk of breast cancer
Another recent study strengthens the current theory that adult weight gain increases the risk of breast cancer. In a recent study of 44,000 post-menopausal women not taking hormone therapy, researchers compared women who gained only 20 pounds or less after the age of 18, with those who gained 60 or more pounds. The women in the higher weight gain group had an elevated risk of every type, stage, and grade of estrogen receptor-positive tumor. The most likely explanation offered by the American Cancer Society researchers is that fat tissue increases the level of estrogen circulating in the body, thereby increasing the risk of estrogen-positive tumors. Source:  MedPageToday, May 23, 2006
  

Reduced levels of fat in the diet may decrease the risk of breast cancer recurrence
In a recent, large-scale clinical study, postmenopausal women who had undergone treatment for early-stage breast cancer and then subsequently reduced the fat in their diet, appeared to reduce their chances for breast cancer recurrence or a second breast cancer.

At the start of the study, women in both control and intervention groups consumed on average 57 grams of fat per day. Both groups decreased their fat intake and maintained this decrease during the five years of the study. The intervention group decreased the fat in their diet by an average of 24 grams per day, while the control group only decreased it by an average of 5 grams per day. By the fifth year of the trial the women in the intervention group not only weighed an average of 6 pounds less than the women in the control group, but had a decreased incidence of recurrent breast cancer. Source: National Cancer Institute, December 2006

Weight gain of 21 pounds or more, after age 18, increases the risk of breast cancer
A recent American Cancer Society Study found that women who gained 21-30 pounds since age 18 were 40% more likely to develop breast cancer than women who had not gained more than 5 pounds, and women who gained 70 pounds doubled their risk. Furthermore, women who gained more than 60 pounds since age 18 were 3 times more likely to have metastatic breast cancer than women who gained less than 20 pounds as an adult. Source:  American Cancer Society

Computer factory workers may have increased cancer risk
Brain, kidney and breast cancer and non-Hodgkin’s lymphoma were more common causes of death for IBM computer employees than the rest of the population from 1969 to 2001, according to a recent analysis of a large mortality database. This data was released by the company involuntarily during litigation. No information was available to link these deaths to any specific chemicals or other toxic exposures.

Computer manufacturing and semiconductor fabrication have been known to expose workers to a variety of potentially carcinogenic chemicals, metals (especially arsenic, nickel and chromium), and electromagnetic fields (especially ultraviolet light, radiofrequency, and, in one process, x-ray radiation). These manufacturing processes have changed over time in the industry, and exposures have changed as well. Environmental Health October 2006

The link between soy protein, heart health and breast cancer risk…
Based on a recent review of 22 studies on the effects of soy protein with isoflavones and its association with heart health, the American Heart Association committee made the following recommendations: Taking soy or isoflavone supplements is unlikely to reduce your risk of heart disease. Eating foods that contain soy protein to replace food high in animal fats may prove beneficial to heart health. Circulation/American Heart Association, April 2006

Phytoestrogens are a weak form of estrogen that occurs naturally in certain foods.
Some studies suggest that high isoflavone levels might increase the risk of cancer, particularly breast cancer. On the other hand, some studies show just the opposite–that under some conditions, soy may help prevent breast cancer. It is this scientific controversy that is causing many researchers to urge caution until further clinical evidence is available.

The specific concerns about soy focus on components of soy, such as the soy isoflavones daidzein and genistein, not the whole food or intact soy protein, such as tofu. These chemicals, available over the counter in pills and powders, are often advertised as dietary supplements for use by women to help lessen menopausal symptoms such as hot flashes. (FDA) The bottom line, women who have concerns about breast cancer should not take soy dietary supplements (pills) without first consulting with their health care provider.

Large studies are currently underway and should offer better information regarding soy and breast cancer risk.

The medicine in your spice cabinet Turmeric, the main ingredient in curry powder appears to have potent anti-inflammatory and anticancer activity. Turmeric is a yellow powder made from the roots of a plant in the ginger family and is widely used in Indian and Southeast Asian cooking. For thousands of years, many cultures have used turmeric for medicinal purposes to treat everything from heartburn to arthritis.

A number of clinical studies have focused on curcumin, the most active compound in turmeric, and have found that curcumin can indeed slow inflammation. It also appears to slow the spread of cancer (metastasis), slow down the growth of new tumor blood vessels (angiogenesis), and cause cancer cells to die the way normal cells do (apoptosis). A word of caution, however, at least one study has shown that curcumin may inhibit the action of certain chemotherapy drugs.

Researchers have recently launched a number of new human trials to find out more about curcumin’s anticancer effects. Source: American Cancer Society

Postmenopausal women with more body fat are more likely to develop breast cancer than those with less body fat.
Researchers have found that increased body fat may contribute to breast cancer. Fat cells produce a type of estrogen, the “female hormone,” which can stimulate certain types of breast cancer tumors to grow. Researchers studied more than 7,500 women and found that women who weighed more, who had gained a lot of weight since age 25, had a high BMI, a wide waist, or who had a high percentage of body fat were somewhat more likely to have developed breast cancer. Source: Journal of the American Geriatrics Society, January 2006

Raw cabbage is thought to improve breast cancer riskStudy: A Diet High In raw and short-cooked cabbage may help prevent breast cancer
Cabbage contains anti-carcinogenic glucosinolates and myrosinase enzymes and it may be at the reason why the breast cancer risk of Polish women triples after they immigrate to the United States. The study found the protective effect to be only for raw and short-cooked cabbage, not long-cooked. Source: American Association for Cancer Research

Blood Test Better Predicts Cancer Treatment Outcomes
A new technology that counts cancer cells in the blood helps predict the success of breast cancer treatments more quickly and more reliably than traditional methods. A study published in a recent edition of The New England Journal of Medicine said the new technique allows doctors to determine within weeks, not months, whether a breast cancer patient’s treatment is working. This could help physicians, at the start of treatment, determine more accurately which patients need more aggressive therapy and which patients need less aggressive therapy. This would spare some women from the most potent chemotherapy. Source: New England Journal of Medicine August 19, 2004

Study: Breast MRIs may find nearly twice as many breast cancer tumors as mammograms
Although breast MRIs are not routinely being performed, the procedure is emerging as a recommended screening test for women at high risk for developing breast cancer. It is also being used to further evaluate an abnormality that has already been detected. Unfortunately, MRI may produce a greater number of false alarms than mammography.  Source: The New England Journal of Medicine, July 2004

Tomatoes, citrus fruits, cabbage and broccoli lower your risk of cancerLower your risk of cancer through food by the National Foundation for Cancer Research
Research findings indicate the following foods help protect the body against cancer. Tomatoes, ketchup, tomato sauce, real teas (green, black and oolong), foods rich in Vitamin C (citrus fruits), and cruciferous vegetables (cabbage, broccoli, brussel sprouts and turnips). Source: National Foundation for Cancer Research, www.nfcr.org

Study: Exercise improves survival chances in breast cancer patients
In a study of 2,987 breast cancer patients, Harvard researchers found physically active women to have a greater chance of survival from the disease than those with sedentary lifestyles. This large study of U.S. nurses found that patients who walk or do other types of moderate exercise for three to five hours per week are about 50% less likely to die from the disease as sedentary women. Source:  Journal of American Medical Association, 2005

Combining an MRI scan and a mammogram is the most effective way to detect breast cancer in women with a high risk of the disease
In a study of 650 women at high risk of breast cancer, researchers found that MRI was nearly twice as effective as mammograms in finding signs of the disease. Mammograms picked up 40 percent of tumors in the women but MRI detected 77 percent. When the two methods were combined, 94 percent of tumors were identified.  Source: The Lancet, May 2005

Over 100,000 Cancers in the U.S. Each Year are Linked to Obesity

Weighing yourself is a good way to keep an eye on any upward trendsAccording to data recently released by the American Institute for Cancer Research (AICR), more than 100,000 cancers in the US each year are linked to excess body fat. It is well known that being overweight puts people at an increased risk of some types of cancer, but this research highlights the extent of the problem.

Excess body fat appears to be linked to 49% of endometrial cancers, 35% of esophageal cancers,  28% of pancreatic cancers, 24% of kidney cancers, 21% of gallbladder cancers, 17% of breast cancers, and 9% of colorectal cancers. 

According to one of the researchers, “The evidence is clear: If people sustain a normal body weight and remain physically active throughout life, it will have a major impact on cancer incidence.”

Learn more about the benefits of exercise and How to Start an Exercise Program

Source:  American Cancer Society, November 2009

Huge Government Changes in Breast Cancer Screening

A woman and her familyHuge changes in breast cancer screening have recently been announced by a government appointed task force, the U.S. Preventive Services Task Force (USPSTF). But the American Cancer society is highly critical of the new guidelines.

The USPSTF now says average-risk women between the ages of 40 and 50 don’t need a mammogram, and those between the ages of 50 and 74 should only have a mammogram every two years instead of every year. Routine screening is not recommended for women older than 74, whereas previously it was recommended every one to two years.

According the to USPSTF, the changes have been made because the benefits of earlier testing are minimal compared to the risk of false alarms and unneeded biopsies.

But this appears to be nothing more than a cost-cutting measure by the federal government. According to the Chief Medical Officer of the American Cancer Society, this recommendation is based on the conclusion  “that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not”.  This ”is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them.”  

Source: AP, November 2009

 

 

Regular Exercise Linked with Lower Breast Cancer Risk

Tennis is a good source of regular exerciseWomen over age 30 who exercised for more than an hour each week had a lower risk of developing breast cancer than women who were less active, according to a recent study presented at the American College of Sports Medicine’s annual meeting in Seattle.

Several other previous studies have also found this same association between lack of exercise and the incidence of breast cancer.  What’s more, being physically active appears to boost the odds that breast cancer patients will survive the disease, according to a 2005 study from Harvard. 

Regular exercise also results in a tremendous number of other health benefits that will dramatically enhance any person’s quality of life.  Regular physical activity has been found to improve depression, promote a sense of well being, increase self-image and self esteem, improve quality of sleep, diminish facial wrinkles, help ward off viruses and other illness, strengthen muscles, increase energy, improve endurance, promote weight loss and burn fat, lower cholesterol and triglyeride levels, strengthen the heart, improve hypertension, lower blood sugars, decrease pain from arthritis, and improve balance and help prevent falls. 

Source: “WOMEN AGE 30+ MODIFY BREAST CANCER RISK WITH EXERCISE”, American College of Sports Medicine
Source: “Exercise and Stretching” from Bay Area Medical Information