By Katherine Brooking, MS, RD
Inflammation is a normal part of the body’s immune response, but too much of it, and for too long, can
lead to pain and disease. The good news is that there are certain foods that may help fight this immuneresponse when it spins out of control. Here are six that you can easily add to your diet:
1. Sweet Cherries: Beginning in early June and stretching into the early days of August you’ll find one ofnature’s best seasonal fruits — fresh sweet cherries — which also happen to be a powerfulinflammation fighter. In fact, a recent study published in the Journal of Nutrition found that eatingsweet Bing cherries can significantly decrease markers of inflammation in the body (like C-reactiveprotein) and help to prevent chronic inflammatory diseases such as cardiovascular disease, diabetes,arthritis, and certain cancers. And once summer’s over, you can still enjoy the taste and health benefitsof this super fruit. Fresh cherries are easy to freeze (simply rinse, pack and freeze) so you can savorthem all winter long.
2. Legumes: Lentils, chickpeas, peas and beans are protein- and fiber-rich and research conducted atPenn State University reported that adding 1 ½ cups of legumes per day (to a calorie-controlled, lowGlycemic Index diet) helped reduce markers of inflammation and improved insulin resistance. Anotherbonus? They’re inexpensive. Use versatile legumes in dips, salads, main dishes or soups, like this LentilSoup.
3. Mango: Mangos are not just nutrient-packed and bursting with color and flavor, research indicatesthat this tropical fruit may also be a powerful inflammation fighter. One study conducted in 2013 foundthat compounds in mangos called polyphenols might inhibit the inflammatory response in bothcancerous and non-cancerous breast cells. In addition to their potential anti-inflammatory benefits,mangos are a source of over 20 vitamins and minerals, including vitamin A, vitamin C, vitamin B6, folate,and potassium. For a flavorful boost to your next meal, try this Tropical Mango Salsa.
4. Turmeric: This golden-hued spice has long been a staple of Indian cuisine and also has been used intraditional Chinese and Ayurvedic medicine for thousands of years. Modern-day science is revealing thata compound found in turmeric called curcumin may be the source of its medicinal effects as well as apotent anti-inflammatory agent. Due to its potential inflammation-fighting benefits, scientists are nowexploring its use in diseases ranging from rheumatoid arthritis and psoriasis to neurodegenerativeconditions like Alzheimer’s disease. Add tumeric to your next curry or use on chicken or fish beforegrilling.
5. Ginger: Ginger has been used to help nausea and pain for centuries. Now modern research isuncovering its potential to temper inflammation. One study compared the effects of ginger extract toplacebo in patients with osteoarthritis. The ginger helped reduce pain and stiffness in joints by 40percent over the placebo. Ongoing research is also investigating the role of ginger to help reduceneuronal inflammation and related declines in memory and cognition. Enjoy ginger in this light andhealthy Ginger Shrimp and Broccoli dish.
6. Leafy greens: Diets rich in leafy greens are associated with lower rates of certain cancers, heartdisease, and other inflammation-related diseases because leafy greens provide anti-inflammatorybenefits. Kale, spinach, watercress, collard greens and broccoli are also some of the most nutrient-richfoods you can eat. Aim for at least 2-3 cups of greens each day and add them to omelets, smoothies,stirfrys, and salads. For a perfect sweet and savory side, try this Kale and Orange Salad.
Small changes can lead to big results. What healthy step can you take today?Editor’s Note: Please note that comments go into a moderation queue prior to posting (so will not
appear immediately). Comments that are in violation of WebMD terms and conditions will not beapproved.
Breast cancer 'alters bone to help it spread'
Breast cancers can manipulate the structure of bone to make it easier to spread there, a study has found.
Researchers at the University of Sheffield said the tumours were effectively "fertilising" the bone to help themselves grow.
The study, in the journal Nature, said it may be possible to protect bone from a tumour's nefarious influence and consequently stop the cancer's spread.
Cancer charities said this opened up "a whole new avenue for research".
Around 85% of breast cancers that spread around the body end up in bone, at which point the cancer is difficult to treat and more deadly.
The scientists discovered patients with secondary cancers had higher levels of an enzyme called LOX being produced by their tumours and released into the blood.
Bone is constantly being broken down and rebuilt. But in a series of experiments on mice, the research team showed LOX was disrupting the process and leaving lesions and holes in the bone.
Using drugs to block LOX prevented the cancer from spreading.
Dr Alison Gartland, a reader in bone and cancer biology at the university, told the BBC News website: "We think it's a significant breakthrough in trying to prevent metastases (secondary tumours) in breast cancer.
"The cancer cells in the primary tumour are actually fertilising the soil for the future growth of itself, LOX is changing the environment in bone to make it better to grow."
The structure of the bone is changed by breast cancers
The animal tests also showed that a set of osteoporosis drugs called bisphosphonates could prevent the spread of cancer.
Bisphosphonates also interfere with the way bone is recycled in order to strengthen it.
They are already given to some cancer patients, but the Sheffield team believe they could have a much larger role.
The effect was discovered only in oestrogen-negative breast cancers. They account for around a third of cases, but are far more deadly.
Katherine Woods, from Breast Cancer Campaign and Breakthrough Breast Cancer, said: "By unveiling the role that the protein LOX is playing, these results open up a whole new avenue for research and treatments that could stop breast cancer spreading to the bone.
"The research also adds weight to the growing body of evidence supporting the role of bisphosphonates in stopping secondary breast cancer in its tracks.
"The reality of living with secondary breast cancer in the bone is a stark one, which leaves many women with bone pain and fractures that need extensive surgery just when they need to be making the most of the time they have left with friends and family."
The findings may also apply in colon cancer.
Mammograms: Are they needed or not?
(CNN)The subject of breast cancer screening is often in the news as ongoing clinical studies publish updates and experts debate the merits of the findings.
Breast cancer is an emotional issue because it kills thousands of women per year. Many are in the prime of their lives.
There seems to be conflicting messages regarding screening, so I can understand how it can be confusing to the layman. I have been a cancer screening expert for more than two decades, and the headlines are often confusing to me. Perhaps I can bring some clarity to the issue.
Mammography (breast X-ray) was developed in the 1950s. The concept of using it to search for early cancer came about soon thereafter.
Dr. Otis Brawley
Does breast screening save lives?
Simply finding cancer is not proof of a test's benefit. One must find the cancer, provide treatment and demonstrate that patients who would have died do not. Several screening tests for other cancers have been found not just useless but also harmful because the nature of the cancer was that early detection and treatment did not save lives.
The best way to determine whether a breast screening test is beneficial is through a prospective randomized study in which women are enrolled and randomly assigned to be screened or not, then followed over time. The goal is to determine that there are less breast cancer deaths in the heavily screened group.
A number of these clinical trials have and are being conducted in North America and Europe. The earliest began in 1963. The last began in Europe and Canada in the 1980s. Unfortunately, no study is perfect; each has flaws.
These studies are huge and follow women for decades. The smallest enrolled 45,000 women and the largest more than 160,000. The studies are logistical challenges; some have even reported different numbers of women enrolled in different publications.
The studies ask different questions. Most studied women 50 and older. Only two were designed to look at women 40 to 49. Some asked whether mammography is better than no screening. Some studied whether screening with mammography and clinical breast examination is better than clinical breast examination.
When looking at these trials in 2014, there are challenges common to every study:
• First, some women in the "do not screen" group began getting screened as initial reports of some studies showed a benefit to screening. The studies began assessing the long-term outcomes of groups of women who had been intensively screened over the years versus groups lightly screened over the past decades.
• The quality of the mammography equipment has improved such that all the studies available used what is now obsolete imaging equipment.
• Treatment of breast cancer has improved. Early detection may be less important today than two decades ago.
These are the studies we have to make decisions from. It is unethical to start new studies because the consensus is that screening has some benefit; we cannot randomize women to the nonscreening arm of a new trial.
It is up to the screening expert to look at each of these studies and handicap them. The expert has to take into account the strengths and weaknesses of each and try to distill the truth. No one finding and certainly no one update on a single trial should change a recommendation.
It is true some of the trials have failed to show a benefit to mammography when compared with a population getting clinical breast examination. Some of the studies show a benefit with mammography screening decreasing risk of death by 15%. Others say it's 35%.
Mammograms should be used with caution
There are huge inconsistencies even in the studies showing benefit. The predominance of medical opinion is there is some lifesaving benefit to screening women 40 to 75.
Screening messages are complicated, and we in medicine often are not good at explaining them. A number of medical organizations regularly put together groups of experts to review breast cancer screening data objectively and make recommendations about screening. Most review all the trials every five to seven years.
The following organizations suggest that average-risk women begin yearly screening with high-quality mammography and clinical breast examination at 40, with screening continuing until the woman is no longer in good health. The year of recommendation is noted in parentheses:
• American Cancer Society (2003)
• American Medical Association (2002)
• National Comprehensive Cancer Network (2009)
• American College of Obstetricians and Gynecologists (2010)
• American College of Radiology (2012)
• American Society of Breast Surgeons (2011)
The U.S. Preventive Services Task Force (2009) and the American Academy of Family Physicians (2012) recommend women 40 to 49 make an individual decision about screening with their doctors. Those concerned about breast cancer should get screening every one to two years while in their 40s. These two organizations recommend screening every two years from 50 to 74.
Most of these organizations have statements that women should be informed of the limitations of mammography, including:
• Screening is a better test for women in their 50s and 60s versus women in their 40s.
• Screening will have some false alarms. Some women will be told they have a finding that requires further testing. Most of these women will ultimately not have cancer.
• Screening will miss some important cancers we wish it would find.
• Screening will find some cancers that do not need treatment and cause some women to get unnecessary treatment.
• There is a small long-term risk of radiation-induced breast cancer.
I am concerned that we in American medicine have led many to believe breast screening is better than it is. That is not to say it should not be used -- it should be used with caution. Women should be informed of the benefits and limitations of mammography and clinical breast examination, and we need to work hard to find a better test.
Traveling With Your Silicone Breast Form
TIPS TO HELP YOU BREEZE THROUGH THE AIRPORT AND ENJOY YOUR FLIGHT
Many women write in to ask us if they can travel the “friendly skies” while wearing their silicone breast forms. The answer is a resounding “yes,” but there are some things you might want to know ahead of time.
· Airport security technology will not harm a silicone breast form
· It isn’t likely that a silicone breast form will set off the metal detector alarm; however, if something on your person triggers the alarm, you will be subject to a secondary search which might include a pat-down
· You can request that this be done in a private screening area
· You can carry a medical Notification Card, to discreetly inform security of your medical condition if you choose (it is not required). A card is available for download atwww.tsa.gov (note that use of the card does not exempt a traveler from the normal security process)
· According to the U.S. Transportation Security Administration, you should neither be asked, nor agree to lift or remove any article of clothing to reveal your breast prosthesis, and you should not be asked to remove the form itself
· If you choose to carry your prosthesis or mastectomy bra in your accessible property rather than wearing it, it will be allowed through the checkpoint after it is screened. The prosthesis or the mastectomy bra is not subject to the 3-1-1 rules that normally applicable to liquids, gels, and aerosols because it is considered to be medically necessary.
Every country has its own security procedures and policies; it is wise to ask your travel agent or do preliminary research online if you are traveling outside your home country.
Don’t worry, travel happy
One other item that we must address: The change in air pressure. It is not uncommon for lightweight silicone breast forms to develop temporary air bubbles if they are in higher elevations where the air pressure changes. If you are a frequent flyer, you may have seen what appear to be small, black dots inside your breast form, due to the change in elevation. This is not a defect, nor will it harm the form. In fact, the air bubbles typically disappear within about two weeks of traveling or climbing. So don’t worry, travel happy!
When You Should Get a Mammogram: Weighing the Pros and Cons of Starting Early
"I'm 48 years old. I've got -- I've got a couple years 'til 50," she told ABC News' Robin Roberts. "If I would have waited, I probably wouldn't even be sitting here."
Different organizations offer different recommendations when it comes to mammograms, but that can get confusing.
For instance, the U.S. Preventive Services Task Force, which is the national independent panel of experts that makes recommendations on when people should get medical tests, says that women should begin to get mammograms, which are an X-ray of the breast that can detect cancer, every other year starting when they turn 50. But the American Cancer Society, the American Medical Association and the American Congress of Obstetricians and Gynecologists say women should get annual mammograms starting when they're 40.
"There continues to be controversy regarding breast cancer screening: both when to do it, what method to use, and who should be screened," said Dr. Jennifer Ashton, ABC News medical contributor and a practicing OBGYN. "Part of the reason for this confusion is due to the fact that data can and is interpreted by different organizations in slightly different ways."
USPSTF doesn't deny that patients die of breast cancers in their 40s, but it says mammography benefits don't outweigh the harms. The potential harms of mammography include stress, unnecessary additional imaging, unnecessary biopsies and unnecessary treatment for cancers that wouldn't end up killing the patient, said Dr. Donna Plecha, director of breast imaging at U.H. Case Medical Center in Cleveland, Ohio.
"Other people say, 'No that's not a harm to me. You're being thorough,'" Plecha told ABC News. "It really depends on your point of view."
"I think mammography saves lives," she said.
Plecha said of every 1,000 people who undergo a mammogram, on average, 900 will have negative results and 100 will be recalled for additional tests. Of those, 26 will be asked to return in 6 months and 19 will need biopsies. Between five and eight of these patients will be diagnosed with breast cancer, Plecha said.
Ashton said patients should work with their doctors to determine what's best for them.
"Medicine is not 'one-size-fits-all' and this is no different," Ashton said. "Each woman is an individual and her risk needs to be assessed by her health care provider so that the best course of action for her can be determined. There is no such thing as a perfect screening test, but rather today, different approaches for women based on their age, family history and personal risk factors."
Studies Show Little Benefit from Too-Frequent Pap Tests: Women Should Discuss New Guidelines with Their Physicians
January was Cervical Cancer Awareness Month, a chance to raise awareness about how women can protect themselves from HPV (human papillomavirus) and cervical cancer. While annual Pap test screenings in the past 30 years have reduced the cervical cancer rate by 50 percent , it isn't the only way to detect cervical cancer. As it turns out, we only need to have one every three years. A newly released survey  from the National Association of Nurse Practitioners and Healthy Women found women and their doctors resistant to change in cervical cancer screening. To help ease some of this fear, let's look at the reasoning behind the new guidelines.
Almost 12,000 new cases of cervical cancer are diagnosed in the U.S. each year . Cervical cancer is almost always caused by HPV, the most commonly sexually transmitted disease. Unfortunately, the Pap smear doesn't detect HPV . The test for high risk types of HPV is done after collecting cells on the surface of the cervix (usually at the same time as the Pap test). Evidence shows that three years is the optimal interval for detecting cervical cancer.
Cervical cancer is very rare in women in their 20s. In fact, only a small number of women maintain a type that can progress into cervical cancer. Therefore, it is recommended that cervical cancer screenings start at age 21 . Women ages 21 to 29 should have the standard Pap test every three years. If your Pap test results are normal you can go three years before your next screening. And, your chance of getting cervical cancer in the next few years is very low. So continue the Pap test every three years, unless you have an abnormal result, until age 29.
For women ages 30 to 64, the new guidelines call for a combination: the DNA test for the high-risk type of HPV along with the conventional PAP test . This combination test needs to be done every five years, as long as there are no abnormal results. So if your Pap test is normal and your HPV test is negative, you can go five years before your next screening. This is great news because screening doesn't go without some risk, and definitely some discomfort.
Remember if you received the HPV vaccine, you still need to be screened. The vaccines protect against the types that cause cancer and genital warts. But if you were sexually active before receiving the vaccine and were infected, the vaccine cannot protect against that type. Also, the vaccines do not protect against all types of HPV. So screening is important, but now it is more strategic -- and thankfully -- less often. Here are some steps you can take to prevent cervical cancer:
- Don't smoke.
- Use condoms during sex.
- Limit your number of sexual partners.
- Get the appropriate screening according to new guidelines.
For more information on Cervical cancer and the HPV virus, visit Swhr.org.
When You Have Cancer And Can't Sleep
By Anna Medaris Miller for U.S. News
Traci Gordon never had a problem falling asleep or staying asleep. In fact, she has a sleep disorder that causes her to sleep too much. “I could sleep through a whole weekend,” Gordon says.
That all changed when Gordon, a 47-year-old administrative assistant in New York, began chemotherapy for breast cancer about seven years ago. The treatment threw her body into an artificial state of menopause, which caused unrelenting night sweats.
“My memory of it was waking up five, six, seven times a night, absolutely dripping,” Gordon says. Each time, she would change her clothes, stand in front of the air conditioner and wonder how much of her fatigue was caused by the cancer, how much was caused by the treatment and how much was caused by her inability to sleepthrough the night. “It was really having an impact on top of everything else,” she says.
Sleep problems during cancer are ubiquitous, affecting up to 80 percent of people undergoing chemotherapy, says Oxana Pales, an assistant professor in the Department of Psychiatry and Behavioral Sciences at Stanford University Medical Center who develops and tests sleep interventions for cancer patients and survivors. One of her studies found that insomnia is about three times more prevalent among cancer patients being treated with chemotherapy than it is in the general population. When you have cancer, Palesh says, "it's much more common to have sleep problems than not."
But at the same time, sleeping well during cancer treatment is critically important in fighting the disease. Without solid res, the body’s level of cortisol -- known as "the stress hormone" -- goes up and the count of “natural killer cells,” or NK cells, hat help fight cancer go down, says Dr. Laeeq Shamsuddi, medical director of the sleep clinic at ancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Illinois.
Poor sleep might even shorten some cancer patients’ survival, Palesh’s preliminary work suggests. “There is a lot of comorbidity between poor sleep and depression, poor sleep and post-traumatic stress disorder, poor sleep and increase in pain,” says Palesh, who directs the Stanford Cancer Survivorship Research program. “Literally, it doesn’t make one thing better.”
When Good Sleep is Out of Reach
Anyone who’s ever lain wake counting sheep, stressing about a work project or ruminating after a fight with a partne knows how hard it is to get a good night’s rest just when you need it most.
Now add cancer to the mix, and it’s easy to see why quality sleep is fleeting. A cancer diagnosis is scary, stressful and anxiety-provoking; cancer treatment can cause side effects including pain, gastrointestinal problems and nausea; and life with cancer often means sleeping at odd hours or in unfamiliar places like a hospital. “Everything they say to promote healthy sleep habits… you’re not doing that,” says Gordon, who’s currently undergoing chemotherapy again for breast cancer in her othe breast.
For Kym Sinclai, a 31-year-old nurse in Santa Cruz, California, some of the most significant sleep disruptions from cancer were psychological. As a former college athlete with no family history of cancer, Sinclair’s Hodgkin’s lymphoma diagnosis at age 27 came as a shock. “I went from being the single ER nurse living in downtown Sacramento with my own cute little apartment to ‘I’m dependent on other people, I’m not working and I’m now the patient,’” she says.
That abrupt loss of identity sent Sinclair on a tailspin toward anxiety and depression. “All I wanted to do was sleep and get away from it… but the anxiety and depression keep you up,” she says. “That’s your first dance with not being able to sleep but wanting to do nothing but sleep.”
As she began chemotherapy, Sinclair struggled with side effects, including bone aches, vomiting, nausea, gastrointestinal distress and the chills -- all of which put a good night’s sleep further out of reach. “You just can’t ever get comfortable. You just constantly feel like you have the flu,” she says.
And when Sinclair tried to catch up on the sleep she missed by napping during the day? There was the neighbor mowing the lawn or the other neighbor’s dog barking. “All you want to do is sleep, but life goes on,” she says. “It can’t just stop because you want to take a nap.”
Achieving Sweet Dream
Gordon, the administrative assistant in New York, clearly remembers waking up after her first solid night’s sleep following her first battle with breast cancer. It was exactly one month after she finished radiation treatments, and her period returned. “I sat up in bed the following morning, and I was so disoriented,” she recalls. “My body was just kind of in shock -- what just happened? What day is it? And that’s what really drilled home just how much my sleep had been disrupted.”
Gordon’s current treatment is causing some of the same sleep problems she had before, but she’s looking into solutions like acupuncture at her cancer center’s integrative health department. She’s also more persistent when it comes to asking her health care providers how treatment might affect her sleep. When Gordon pressed a nurse for details on chemotherapy side effects, for example, the nurse mentioned that the steroids -- prescribed to quell some of the treatment’s side effects -- could make her more wired. “I was so relieved that she had told me that rather than me tossing and turning,” Gordon says.
It's important that patients talk to their primary care doctor or oncologist about sleep during cancer treatment in part because sleep disorders -- among people with and without cancer -- are treatable, says Cancer Treatment Centers of America’s Shamsuddin. In most cases, he says, the approach to treatment is the same. “There are about 70 known sleep disorders out there, and any one of those can obviously affect cancer patients,” he says. “Treating them helps to improve [patients’] tolerance to chemotherapy, radiation therapy, as well as their physical, psychological and cognitive functioning.”
With sleep apnea -- the most common sleep disorder -- patients at CTCA’s sleep center are counseled on behavioral changes known to help with the condition, such asweight loss and sleeping on their sides rather than their backs. Patients with more severe cases might get a continuous positive airway pressure machine, a device that helps keep airways open.
“[Cancer patients] are going through so much, and they’re going to be fatigued from the chemotherapy regardless,” Shamsuddin says. “But if we can at least avoid them being fatigued from sleep apnea or any other sleep disorder, that’s going to affect their quality of life and their energy level and their overall outlook tremendously.”
For Sinclair, who has been cancer-free for three years and now works in an oncology uni, learning to make time for naps, limit visitors and take care of herself through yoga, massages and other integrative therapies helped during treatment and beyond. Before cancer, she says, “I could work a 16-hour shift and go grab a beer with friends afterward and then go to sleep for 10 hours… I knew how to function on little rest.” Now, she's always in bed by 9 p.m. “It’s been a difficult behavior to change,” she says.
Still, developing healthy sleep behaviors early i necessary, says Palesh, who is testing an intervention that brings mental health professionals to cancer patients' bedsides o ducate them about sleep problems during treatment and the importance of addressing them. Her team also uses behavioral strategie to help patients associate their beds with sleep -- not reading, watching TV, working or being awake.
"We don’t want to see patients who recover and [finish] chemo and radiation and whatever other treatment they receive and still suffer long-term sleep problems," Palesh says. "It’s always easier to treat things when they first appear than when they become chronic.”
Why You Can't Lose Weight -- But Your Best Friend Can -- On The Same Diet
At last a nutrition and weight loss study has revealed what millions of people have already known all too well from personal experience: different folks lose weight at different rates – even when their calorie deficit is the same.
“This study is the first time that it has been shown in a laboratory setting that individual differences in biology make it difficult for some obese people to lose weight,” said Susanne B. Votruba, a nutrition researcher at the National Institute of Diabetes and Digestive and Kidney Diseases and senior author of the study published in the journal Diabetes yesterday.
The findings suggest that weight loss is a bit more complex “calories in, calories out,” and that a calorie for one person is not necessarily equal to a calorie for another person in terms of how their bodies burn the energy. In the small in-patient, all 12 participants lost weight, and yes, they did so because they were burning more calories than they were consuming. However, even when their calorie restrictions were proportionally identical, some lost twice the percentage of their body weight as others during the six weeks of a strict diet.
“It’s nice to see direct calorimetry employed to prove that the friend who can ‘eat anything’ and not gain weight probably is put together differently than most of us,” said Yoni Freedhoff, an assistant professor of family medicine at the University of Ottawa and the founder and medical director of the Bariatric Medical Institute, which provides non-surgical weight management.
Votruba’s team defined two different body types as “thrifty” or “spendthrift” based on how the participants’ bodies burned calories during a 24-hour fast, measured in a whole-room calorimeter. (The room measures breath to calculate precisely how many calories the body is burning.) Some participants’ metabolism slowed down when they fasted, meaning they burned fewer calories – a thrifty person. “Therefore, when restricting calories, the body of a thrift person slows its metabolism more in effort to conserve energy, making weight loss more difficult,” Votruba said.
In other words, the less the person eats, the fewer calories their body burns, relatively speaking. “Spendthrift” folks have the opposite going on: they burn calories faster when they fast. The researchers don’t know whether these differences are there from birth or whether they develop over time. In this particular study of seven men and five women, most of the spendthrift people were men and most of the thrifty ones were women.
The 12 participants, with an average weight of 237 pounds, first spent three in-patient weeks maintaining their weight with a strictly regulated diet (50% carbs, 30% fat, 20% protein). Then they spent the next six weeks consuming only a liquid diet of Ensure that contained 50 percent of of the calories required to maintain their weight (individualized to each person) and not exercising. Contrary to the popular idea that cutting 3,500 calories equates to losing a pound, the researchers found the loss of one pound equated to anywhere from 1,560 to 3,000 calories depending on the person.
“We all have our own internal fuel efficiencies when it comes to our bodies’ abilities to handle calories,” Freedhoff said. “This isn’t in and of itself news, of course. Ten different people with the same degree of caloric excess or restriction will vary in the amount of weight they’ll gain or lose as a consequence.”
But what does the study’s findings actually mean for people with obesity who are trying to lose weight? Not much. There is no easy way for the average person to learn whether they have a “thrifty” or “spendthrift” metabolism – only a few of those metabolic research chambers exist in the world – and it’s not clear that knowing would make a difference in terms of a weight loss strategy.
“In general, as things currently stand, weight loss strategies should be the same for all: make smart food choices, practice portion control and increase movement and exercise,” Votruba said. She pointed out that every volunteer in the study lost a significant amount of weight, suggesting that “regardless of biological differences, weight loss is plausible with sustained effort.”
But while this finding doesn’t offer any new ideas for weight loss strategies, it may offer something far more valuable: validation to those who have felt shamed for not “trying hard enough” when they’ve cut calories significantly and still struggled to lose weight, or much of it. While all the participants in this study did, as Votruba said, lose quite a bit of weight, they also ate half of what their bodies needed to maintain their weight, a pretty severe diet (and all liquid in this case) and one that may not be sustainable for many people. This study only compared metabolic differences in people with obesity, but psychology plays a role in weight management as well, and the discouragement of not seeing results if one has a “thrifty” metabolism may feel less dispiriting if there were a way for the person to find that out.
Until then, Freedhoff offers a more realistic approach to thinking about weight.
“Ultimately, the goal in weight management, for anyone, is to live the healthiest life that they can actually enjoy enough to sustain, and where their weight goes living with that lifestyle, well that’s their ‘best’ weight,” he said, echoing some of the points he drives home in his bookThe Diet Fix. “That some people’s ‘best’ weight will be better than others? Well, that’s just life doing what life does by being unfair.”
WHY ARE CANCER RATES SO LOW IN INDIA?
It is estimated that many tumors start around the age of 20. However, detection of cancer is normally around the age of 50 or later. Thus, it takes cancer decades to incubate. Why does it take so long? Recent studies indicate that in any given type of cancer, hundreds of different genes must be modified to change a normal cell into a cancer cell. Although cancers are characterized by the dysregulation of cell signaling pathways at multiple steps, most current anticancer therapies involve the modulation of a single target. Chemotherapy has gotten incredibly specific, but the ineffectiveness, lack of safety, and high cost of these monotargeted therapies has led to real disappointment, and drug companies are now trying to develop chemo drugs that take a multitargeted approach.
Many plant-based products, however, accomplish multitargeting naturally and are inexpensive and safe compared to drugs. However, because drug companies are not usually able to secure intellectual property rights to plants, the development of plant-based anticancer therapies has not been prioritized. They may work (and work better for all we know), and they may be safer, or even fully risk free.
If we were going to choose one plant-based product to start testing, we might choose curcumin, the pigment in the spice turmeric (the reason curry powder looks yellow). Before we start throwing money at research, we might want to ask some basic questions, like “Do populations that eat a lot of turmeric have lower cancer rates?” The incidence of cancer does appear to be significantly lower in regions where turmeric is heavily consumed. Population-based data indicate that some extremely common cancers in the Western world are much less prevalent in regions where turmeric is widely consumed in the diet.
For example, “overall cancer rates are much lower in India than in western countries.” U.S. men get 23 times more prostate cancer than men in India. Americans get between 8 and 14 times the rate of melanoma, 10 to 11 times more colorectal cancer, 9 times more endometrial cancer, 7 to 17 times more lung cancer, 7 to 8 times more bladder cancer, 5 times more breast cancer, and 9 to 12 times more kidney cancer. This is not mere 5, 10, or 20 percent more, but 5, 10, or 20 times more. Hundreds of percent more breast cancer, thousands of percent more prostate cancer—differences even greater than some of those found in the China Study.
The researchers in this study, highlighted in my video Back to Our Roots: Curry and Cancer, conclude: “Because Indians account for one-sixth of the world’s population, and have some of the highest spice consumption in the world, epidemiological studies in this country have great potential for improving our understanding of the relationship between diet and cancer. The lower rates of cancer may, of course, not be due to higher spice intake. Several dietary factors may contribute to the low overall rate of cancer in India. Among them are a “relatively low intake of meat and a mostly plant-based diet, in addition to the high intake of spices.” Forty percent of Indians are vegetarians, and even the ones that do eat meat don’t eat a lot. And it’s not only what they don’t eat, but what they do. India is one of the largest producers and consumers of fresh fruits and vegetables, and Indians eat a lot of pulses (legumes), such as beans, chickpeas, and lentils. They also eat a wide variety of spices in addition to turmeric that constitute, by weight, the most antioxidant-packed class of foods in the world.
Population studies can’t prove a correlation between dietary turmeric and decreased cancer risk, but they can certainly inspire a bunch of research. So far, curcumin has been tested against a variety of human cancers, including colorectal cancer, pancreatic cancer, breast, prostate, multiple myeloma, lung cancer, and head and neck cancer, for both prevention and treatment. For more information on turmeric and curcumin, check out Carcinogen Blocking Effects of Turmeric Curcumin and Turmeric Curcumin Reprogramming Cancer Cell Death.
I’m working on another dozen or so videos on this amazing spice. This is what I have so far:
- Who Shouldn’t Consume Curcumin or Turmeric?
- Boosting the Bioavailability of Curcumin
- Turmeric Curcumin and Osteoarthritis
- Turmeric Curcumin and Rheumatoid Arthritis
- Spicing Up DNA Protection
- Which Spices Fight Inflammation?
Amla, dried Indian gooseberry powder, is another promising dietary addition:
I add amla to my Pink Juice with Green Foam recipe. Not all natural products from India are safe, though. See, for example, my videoSome Ayurvedic Medicine Worse than Lead Paint Exposure.
-Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.
MALE BREAST CANCER DEATHS HIGHER IN BLACKS
MAY 4, 2015
A new study was just published in the Journal of Clinical Oncology, which states that black men have a 76 percent higher chance of dying from breast cancer than white men. The study found that when insurance and income differences were accounted for, the number of deaths between the two groups of men under age 65 became more similar.
Out of all of the cancers that men get, breast cancer accounted for less than 1 percent of all of them, and only accounted for about 2 percent of breast cancer in the United States. In terms of incidence of cancer, black men were more likely to get breast cancer and also more likely to become diagnosed younger than white men, according to the researcher. In terms of the disparities between black women and white women in terms of treatment, that has been studied numerous times, but the difference in black and white men has not. This could be do to it being less popular in the male population, which makes it harder to get accurate study results and confirm any conclusions or hypothesis.
The study was conducted by Helmneh Sineshaw, MD, and her team found 9,231 men from age 18 and up that had been diagnosed with early-stage breast cancer between 2004 and 2011. Sineshaw and the other researchers found this data by searching the National Cancer Database, which is a hospital-based cancer registry, which is also sponsored jointly by the American Cancer Society and the American College of Surgeons. This database collections various information on the demographics, including age and gender, and also details the first courses of treatment for the cancer.
The treatments of breast cancer were very similar between the blacks and the whites from all ages, and the only group that had a significant increase in death was younger black men when compared to the white counterparts. Once insurance and income were accounted for in the study, the authors said that the gap was significantly lowered. The author of the study believed that poverty played a role in younger black men having a higher death rate than the younger white men. There also could be a lot of biological factors that contributed to the difference as well, and hormone receptor status as well as adhering to treatment could also become factors.
The findings could also suggest that because male breast cancer is so rare and does account for so little of the breast cancer population, that treatments and other factors could be influencing how care is administered in different hospitals. The authors of the study also say that the Affordable Care Act implementation might alter these disparities, but time will tell on that, and research will need to be done to see how that affects lower income populations with cancer.
Breast Cancer Drug Has a Surprising New Application, Study Finds
An early study shows that gel-based tamoxifen may be as effective as the oral drug, and have fewer side effects
July 15, 2014
Tamoxifen is a mainstay of breast cancer treatments: it blocks the effects of the female hormone estrogen on the breast, inhibiting estrogen’s tendency to encourage breast tissue to grow uncontrollably. Now, Dr. Seema Khan, professor of surgery at Northwestern University Feinberg School of Medicine, reports inClinical Cancer Research that putting the drug in a gel, and applying it directly to the breast tissue, where it needs to work, may have merit.
Doctors generally prescribe tamoxifen for women diagnosed with early breast cancer, including very early-stage ductal carcinoma in situ (DCIS), to prevent recurrent growths. But the drug has also been linked to an increased risk of stroke, blood clots and cancers in other tissues, including the uterus. That’s why more women, including those who have not yet had cancer but are at high risk for the disease could benefit from the drug but are reluctant to take it.
Dr. Khan’s study was small—only 26 women—but it provides proof that the principle of applying tamoxifen directly on the breast may be worth investigating. All of the women were diagnosed with DCIS, which generally does not spread. But 30% of DCIS can recur even after surgery and proper treatment, so most women are prescribed tamoxifen. In the current study, about half of the women in the study were randomly assigned to take the oral form of the drug, while the other half were given doses of a tamoxifen gel to apply directly to the breast tissue for six to 10 weeks before their surgery. Khan analyzed the breast tissue after surgery to study markers for tumor growth, and conducted blood tests for levels of tamoxifen metabolites as well.
At the end of the study, the women in both groups showed similar decreases in tumor-related proteins, but blood levels of tamoxifen were five times lower among the women using the gel than those taking the oral pill. That, says Dr. Khan, suggests that the major side effects of the drug, which occur in the blood and other reproductive organs, may be largely avoided if women use the gel.
“Our study showed that applying the drug through the breast skin leads to high concentrations in the breast and low concentrations in the rest of the body,” she says. “The biological effect on the breast is consistent with the benefit of oral tamoxifen, so for that reason, we hope that this kind of approach would make preventive medication more acceptable to women with non-invasive breast cancer and how may be at high risk of developing breast cancer.”
Dr. Khan says that the breast may be uniquely designed for such transdermal therapy, since it is essentially an appendage of the skin, with its own internal lymphatic circulation. That may keep things applied to the breast skin within the breast tissue, and could explain the higher concentrations of tamoxifen metabolites she and her team found after the gel applications.
Still, she says that the small number of participants in the study means more research is needed to confirm the results. Right now, the gel version is not available. The company that provided the experimental doses for the study stopped making that formulation, so Dr. Khan is studying a related, similar metabolite called endoxifen that may have similar cancer-fighting effects on breast tissue.
If the strategy proves effective, it’s possible that cancer treatments, or at least breast cancer treatments, may become useful in preventing cancer as well, as more women at high risk who have yet to be diagnosed with the disease take advantage of them. Applying a gel with relatively few side effects may help more women to eliminate small tumors before they have a chance to grow. And if other types of drugs can be used on the skin as well, that could significantly broaden the therapies available to women looking for ways to prevent the disease.
“For high-risk women who need better prevention strategies, delivering the drug to the breast is a very desirable solution,” says Dr. Khan.
Breast Cancer Breakthrough? 3D Mammograms Offer Sharper Results
BY LINDA CARROLL
First published June 24th 2014
New technologies could help resolve some of the controversy around breast-cancer screening — potentially improving the accuracy of scans that detect the cancer.
At the heart of confusion over when women should be screened is the question of whether mammography could be doing more harm than good because of the many false positives that send women for biopsies of lesions that often turn out to be harmless.
But researchers now say a new screening method, which employs 3-D mammography, resulted in 15 percent fewer call-backs for additional imaging while at the same time spotting more tiny, aggressive and potentially fatal tumors, according to a study published Tuesday in the Journal of the American Medical Association.
And in potentially better news for women, other research published Tuesday suggests that doctors might one day be able to differentiate between benign and malignant lesions — and maybe even between aggressive and slowly developing growths — without the need for a biopsy. That research was published in the journal Clinical Cancer Research.
The JAMA study scrutinized data from 13 medical centers that had switched to 3-D imaging, or tomosynthesis. Mammograms are fairly ordinary X-rays. Tomosynthesis is similar to a CT scan.
The researchers compared results from the years when the centers were using mammography alone to those from more recent years when doctors were using mammograms along with tomosynthesis.
Along with a 15 percent reduction in recall rates with tomosynthesis, the researchers also found a 41 percent increase in the detection of potentially lethal cancers.
"You can think of regular mammography as showing a closed book. With 3-D you are able to page through the book one page at a time without other information superimposed."
The 3-D view also allows researchers to spot tiny lesions they might have missed otherwise — lesions like one tomosynthesis found in Edna Podell.
The 46-year-old from Plano, Texas, went into her breast exam expecting to get a clean bill of health. She felt good and hadn’t felt anything was amiss on self exams.
But the 3-D study found a tiny spot that turned out to be an invasive cancer.
“It was tiny, tiny, tiny,” Podell said. “So tiny that my surgeon as well as the radiation oncologist couldn’t get over the fact that it had been caught. They didn’t want to panic me, but they were very clear that it needed to be taken care of right away.”
A 3D mammogram caught a small, potentially lethal cancer in Edna Podell, 46. Because she caught it early, she was spared the most aggressive treatments.
Because it was spotted so early, Podell’s treatment consisted of removal and then a week of targeted radiation therapy.
“Had it been bigger or had I waited even three months, I probably would have ended up with traditional radiation that takes longer and comes with more side-effects,” Podell said.
The reason for the improvements is in the ability to see the breast in 1-millimeter slices, said the study’s lead author, Dr. Sarah Friedewald, co-medical director of the Caldwell Breast Center and section chief of breast imaging at the Advocate Lutheran General Hospital in Park Ridge, Illinois.
“It allows us to peel away the layers and see underlying lesions that might be obscured by other tissue. You can think of regular mammography as showing a closed book. With 3-D you are able to page through the book one page at a time without other information superimposed.”
Bright spots on a mammogram that look like potential tumors could turn out to be overlapping tissues or a blood vessel folding over on itself, Friedewald said. “On 3-D you can just see that it’s turned over on itself,” she said.
While 3-D imaging can lower the rates of callbacks and detect more invasive cancers, it does little to reduce the rate of biopsies.
But that may change if researchers manage to refine a technique, based on combining multiple screening technologies, that seems to be able to distinguish between cancerous and benign tumors.
The new imaging technique, called multiparametric 18FDG PET-MRI, showed a 96 percent accuracy in distinguishing malignant breast tumors from benign ones, according to a report published in Clinical Cancer Research. The European researchers estimated that it could cut the biopsy rate by 50 percent.
By adding other types of imaging, such as PET, doctors can see tumors on the cellular level, said Dr. Katja Pinker, lead author of the new study and an associate professor of radiology at the Medical University of Vienna.
ADVOCATE LUTHERAN GENERAL HOSPITAL
On the left is a traditional 2D mammogram. On the right is 3D tomosynthesis.
Cancerous lesions tend to pack cells in more densely than benign growths, Pinker explained. They also tend to use up glucose more quickly. PET scans spot this action, while the MRI gets a more accurate picture of the structure than an x-ray can.
“With normal imaging you just see structure,” Pinker said. “This goes beyond that to the functional level where you can see how much sugar the tumor is consuming and how fast it’s proliferating. In a benign growth, cells are more loosely grouped together. In a fast-growing tumor, it’s like the subway at rush hour with people squeezed into each [car].”
Pinker suspects that the technique will also be able to distinguish between slow growing and aggressive tumors.
The new studies are a big leap ahead, said Dr. Margarita Zuley, an associate professor of radiology at the University of Pittsburgh and medical director of breast imaging at the Magee Women’s Hospital of the University of Pittsburgh Medical center.
“The significance of the tomosynthesis study is that it fundamentally changes the discussion about mammography,” Zuley said. “The controversy started roaring over the last two years. But now the risk-benefit ratio has shifted. I think this is a real game-changer in the discussion.”
The second study is highlighting an area that specialists are “really, really interested in for the future,” Zuley said. “It’s not here yet. But it’s a window into where we’re going with this.”
Can breast cancer risk be predicted by skin moles?
Wednesday 11 June 2014
PLOS Medicine has simultaneously published two new studies finding that moles - or cutaneous nevi - may be a predictor of breast cancer. The two teams - from the US and France - find that women with a greater number of moles are more at risk of developing breast cancer.
Moles are benign skin tumors that occur more frequently in light- than dark-skinned people. Individuals can be born with moles or they may acquire them throughout life. Twin studies have shown that there is a 40-80% genetic influence over the extent to which people develop moles, and childhood sun exposure is also thought to be a contributing factor.
Some studies have shown that women with a greater number of moles are more at risk from hormone-influenced conditions such as endometriosis, leiomyoma and thyroid diseases.
The number of moles that a person might acquire - as well asmelanoma risk - has also been associated with the CDKN2A gene. Inactivation of this gene - which is implicated in cell cycle regulation - is associated with breast cancer.
French researchers find association between number of moles and risk of breast cancer
Therefore, the team of French researchers - from the Institut National de la Santé et de la Recherche Médicale (INSERM) - decided to investigate whether number of moles is associated with breast cancer risk.
To do this, they analyzed data from the E3N Teachers' Study Cohort in France, which followed 89,902 women for 18 years. The women were asked to report whether they had no, a few, many or very many moles.
Women reporting having "very many" moles were found to have a 13% higher risk of breast cancer than women reporting having no moles. However, when the results were adjusted for known breast cancer risk factors, the association was no longer statistically significant. These confounding risk factors - such as benign breast disease or family history of breast cancer - are themselves associated with mole number.
In their study, the authors write that "a causal relationship between number of nevi and breast disease risk seems unlikely." However, the researchers speculate that the same genetic factors could contribute to development of both breast cancer and moles. Alternatively, the researchers suggest that levels of sex hormones may influence both development of moles and breast cancer.
American researchers investigate hormonal influence on mole-breast cancer association
The hormonal influence on moles and breast cancer was further explored by the American team. The authors - from Indiana University and Harvard University - observed that moles usually become bigger or darker during pregnancy, which suggests a possible link between moles and hormones.
Although both studies find an association between breast cancer and number of moles, neither study is able to clearly identify the mechanism that drives this association.
This team analyzed data from the US Nurses' Health Study - a cohort of 74,523 female nurses, followed for 24 years. Participants were asked to report the number of moles greater than 3 mm on their left arm.
The researchers found that women reporting 15 or more moles were 35% more likely to be diagnosed with breast cancer than those reporting no moles. From this, they calculated that women with 15 or more moles had an absolute risk of 11.4% of developing breast cancer, compared with an absolute risk of 8.48% in women with no moles.
Within a subgroup, the team also tested a possible association between elevated hormone levels and moles and breast cancer. They write:
"We further found that postmenopausal women with more cutaneous nevi had higher levels of plasma total and free testosterone and estradiol, and that the number of cutaneous nevi was associated with increased risk of breast cancer only among [estrogen receptor]-positive tumors, suggesting that a hormonal effect underlies this association."
Although both studies find an association between breast cancer and number of moles, neither study is able to clearly identify the mechanism that drives this association. The studies do raise the possibility of number of moles being used to predict breast cancer risk, but they are unable to give an indication of how reliable this test would be.
Also, as the studies mainly observed white participants, it may not be possible to generalize the findings of the studies to non-white women.
Written by David McNamee
The Type of Weight Gain That Can Raise Your Risk of Breast Cancer
PACKING ON THE POUNDS AS YOU GET OLDER DOES MORE THAN FORCE YOU OUT OF YOUR SKINNY JEANS.
PUBLISHED: MAY 7, 2014
You've probably heard that your weight can impact your risk of breast cancer, but there's a more specific link that you should be aware of: putting weight on during middle age. Women who gain as little as two pounds a year during middle age (between 40-50 years old) have an increased risk of getting breast cancer before age 50, according to a new study in the International Journal of Cancer.
The researchers recruited more than 205,000 women from nine countries and weighed them twice—once at the beginning of the study, then again about four years later. For another seven and a half years, they tracked the rate of breast cancer among the women—and an interesting relationship emerged: The ladies in the "high weight gain" category (defined as gaining about two to 11 pounds per year) had a nine percent higher breast cancer risk.
This association was strongest when the researchers just looked at breast cancers diagnosed before or at age 50. And interestingly, losing weight was not associated with breast cancer risk in this study. (Although it should be noted that previous research shows that a high weight can increase your breast-cancer chances.)
So why might middle-age weight gain increase your risk of breast cancer? The researchers speculate that it's because of the pattern of weight gain among women in their mid- to late-forties and fifties: Fat tends to congregate around their belly. Past research has also suggested a link between waist size—an indicator of visceral fat, the most dangerous kind—and a risk of being diagnosed with breast cancer before menopause.
Learn more about how your weight—and what you do to keep it in check—influences the health of your girls.
Parkinson's Drug Could Help Prevent Breast Cancer In High-Risk Women
By Rachael Rettner, Senior Writer
Published: 04/23/2014 09:19 AM EDT on LiveScience
Women with mutations in the BRCA1 gene are at high risk for breast and ovarian cancer, and there are currently no drugs proven to reduce their cancer risk.
Now, early research suggests that existing drugs, already approved to treat other conditions, may help prevent breast cancer in these women, although more research is needed to prove this.
One drug, called benserazide, is currently used for Parkinson's disease, and in studies it reduced the formation of breast tumors in mice that had been implanted with cancer cells containing the BRCA1 gene mutation. All of the mice that did not receive the drug developed breast tumors, but 40 percent of mice given the drug were tumor-free, said study researcher Elizabeth Alli, of Stanford University School of Medicine. [7 Diseases You Can Learn About From a Genetic Test]
Some studies show that women with mutations in the BRCA1 gene have a 50 to 70 percent chance of getting breast cancer by age 70, compared with a 12 percent lifetime risk for the average American woman. Last year, actress Angelina Jolie announced she had undergone a double mastectomy to prevent breast cancer because she has a BRCA1 gene mutation.
Two drugs, tamoxifen and raloxifene, are already approved to prevent breast cancer, but there's little information about how well they work for women with BRCA1 gene mutations. Both drugs work by blocking the action of estrogen on breast cells; the hormone can fuel the growth of certain types of breast cancer.
"The data out there for the efficacy of these drugs [among carries of BRCA1 mutations] is controversial, and inconsistent," Alli said. "So really it'd be ideal to identify new drugs that are more effective for this population."
The BRCA1 gene is involved in repairing damaged DNA — a critical function, because damage to DNA can lead to cancer. Mutations in the BRCA1 gene increase the risk of cancer because they impair this repair process.
Benserazide, and possibly other drugs, may work to prevent breast cancer from BRCA1 mutations by restoring cells' ability to perform one type of DNA repair, the researchers said. Alli noted that tamoxifen also increases the risk of endometrial cancer (cancer of the uterus lining), and for some women, this risk may outweigh the drug's benefits.
The next step in the research is to see whether benserazide, or other drugs that work similarly, prevents breast cancer in mice that have been genetically engineered to have BRCA1 gene mutations. The drug will also need to be tested in a clinical trial before researchers know whether it works in people. It's not clear how soon a trial could start after the work in mice, but it could be relatively quick because the drug is already being used in people, Alli said. However, even after a trial begins, it can take many years to enroll enough people to complete a study, she said. The study was presented this month at the American Association for Cancer Research meeting in San Diego.
Pfizer breast cancer drug shows promise
April 07, 2014
An experimental drug has shown encouraging results in treating advanced breast cancer in an early clinical trial, pharmaceutical giant Pfizer reported Sunday.
Pfizer, the world's second largest drugmaker, said the drug prevented breast cancer from worsening for 20.2 months in a trial involving 165 patients. Current medications do so for 10.2 months. The drug, known as palbociclib, is among a new class of cancer drugs that target specific proteins to block tumors.
The outcome wasn't as positive as some initial results reported earlier in the tests, said University of Michigan business professor Erik Gordon, who studies the biomedical industry but isn't affiliated with the trial.
But, he added, "there's been a lot of hope surrounding this class of cancer drugs, and this keeps that hope alive."
Wall Street analysts have been closely watching the tests given the potential market for palbociclib. Breast cancer is the most common cancer to strike women.
"It's good news, but some investors are disappointed, because they expected more," Gordon said. In earlier results, the drug had kept the cancer from worsening for 18 additional months, rather than 10.
The results were presented by the lead researcher, Dr. Richard S. Finn, associate professor of medicine at UCLA, during the annual meeting of the American Association of Cancer Research in San Diego.
The drug will likely need to undergo broader testing with more patients before the Food and Drug Administration will approve it. The FDA sometimes accelerates approval for drugs that show promise.
Other companies, including Eli Lilly and Novartis, have similar medications that are also in clinical trials.
Pfizer's fledgling cancer drug business has been a recent bright spot for the company, which has many older drugs that will soon lose patent protection.
The good fight: A drug that can add years to lives of ovarian cancer patients
MARCH 16, 2014
THERE'S a drug that can add years to the lives of those with ovarian cancer – so how can it be fair that treatment is a “postcode lottery”? Rachel Carlyle meets the brave women who believe it should be every patient’s right
Annie Mulholland and Ann Bevan share more than a name. They have both fought hard for the right to be given a drug that can extend the lives of women with ovarian cancer, yet is routinely denied to many patients in the UK.
Charity campaigners estimate that 2,500 women could benefit from Avastin every year, yet only a third receive it because of a cruel postcode lottery. Annie was told she couldn’t have it, yet other patients at her hospital who lived in a different area were eligible. Ann was also denied the drug and had to spend thousands out of her own pocket to get it privately.
Another ovarian cancer patient, Sharon Graham from Scotland, was repeatedly told “no” – despite the fact that she had two teenage sons and was only 44. Tragically, after successfully campaigning on behalf of other women, she died from the disease last month.
With 7,000 new cases each year, ovarian cancer is one of the deadliest forms of the disease. The five-year survival rate, although rising, is a mere 46 per cent, compared to 85 per cent for breast cancer.
Avastin isn’t a cure but it canextend lives for up to two years (the average is 9.4 months) and although it costs £20,000 to £30,000 per year for each patient, it is the only new treatment in this neglected field for the past 20 years. “Compared to Avastin, the drugs we have are like rusty old tools in the toolbox,” says Frances Reid of the charity Target Ovarian Cancer.
Ann Bevan, from Winchester, knows how true this is. She was diagnosed 10 years ago, aged 56, after doctors confused her symptoms first with haemorrhoids, then kidney disease. “By the time I was diagnosed my stomach was so swollen I looked as if I was having twins,” she says.
Despite treatment, the cancer returned and Ann was sent home to die in 2011. Then her son read about Avastin, which at the time was only available privately. Ann, a businesswoman, decided to raid her savings and spent £75,000 over the following year. “After just one infusion my oncologist couldn’t believe it – my cancer marker had gone down by two thirds. I cried with joy,” she recalls.
“I struggled on, paying for it myself, until finally I was invited to take part in a clinical trial which meant I could get free access.” Ann was on the drug for two-and-a-half years and is now the longest- living ovarian cancer patient on Avastin in the world. She is now having more chemotherapy (ovarian cancer has a habit of returning) but she is responding well and is hopeful she can return to Avastin soon. “My feeling is that I’ve had 10 good years and I still have a lot to live for. I feel awful for those women who can’t do what I’ve done. I’m lucky that I could afford to pay for it.”
Annie Mulholland, from Cardiff, also had to think outside the box when she was denied the drug. Women in Wales, Scotland and Northern Ireland have the most trouble accessing Avastin – each must prove she’s an “exceptional case”. But because the drug helps most women, it is almost impossible to prove you’re an exception. Frances Reid says: “It’s a back-to-front argument.”
Annie, 61, a university access officer, was diagnosed in 2010 and was never offered Avastin, even though her oncologist was giving the drug to other patients living just 35 miles away. Then last June, after thecancer returned, she pushed for Avastin and got a place on a clinical trial at London’s Royal Marsden hospital. This would have paid for the drug but Annie’s health board refused to support the application.
In desperation, she rang the hospital, who said that if she lived in England, she would be eligible.
“I was distraught,” says Annie. “I went to see the Minister for Health in Wales and said, ‘Do you realise,if I lived in England I would live longer?’ He had no answer to that.”
Annie then took matters into her own hands, renting a room in London so she would qualify. She bought a folding bicycle so it would be cheaper to get to and from the hospital and finally started taking the drug last October. “It’s perfectly legal,” says Annie. “I have changed the address on my driving licence and my credit
card is registered there. But I couldn’t believe it when I arrived at the Marsden – it was a different world. I could have had any drug I needed.
“It makes me so angry,” she adds. “I run a support group for women with ovarian cancer in Wales and
I have to face them all the time. One friend is having the same chemo as me, which attacks the white blood cells and leaves you vulnerable to infection. There’s a £250 injection you can have to boost the cells which I get, no questions asked, yet was told to pay £995. She feels she’s not worth anything – that, if she dies, they will just shrug their shoulders.”
So far, Annie has had five out of six cycles of Avastin and her tumours have halved in size, though she knows it’s not a magic wand. “My five-year survival chance is only five to 15 per cent but I could get remission of 10 months, or it could be a couple of years. I’m aiming for years.
“We all have to die sometime,” adds Annie. “My children – two daughters and three stepdaughters – all accept that. But in the meantime I want to fight as hard as I can so other patients don’t have to go to the lengths I have.”
Experimental breast cancer drug to be trialled in lung cancer patients
March 11, 2014
“We’re increasingly seeing that drugs originally designed for one type of cancer are proving to be effective for many other types." - Kate Law, director of clinical research at Cancer Research UK
The drug, called olaparib – a type of treatment called a PARP inhibitor – will be given after chemotherapy to patients with non-small cell lung cancer (NSCLC) to see if it delays the growth of their tumour.
The phase II trial will recruit over 100 people with advanced non-small cell lung cancer at 25 hospitals around the UK. It is funded by Cancer Research UK and AstraZeneca through a National Cancer Research Network initiative and is being co-ordinated by Cancer Research UK’s Wales Cancer Trials Unit at Cardiff University and Velindre NHS Trust in Cardiff.
On the trial, patients will first have chemotherapy and those who respond will then be given either olaparib or a placebo. They will be closely monitored to see how long the drug prevents their tumour from growing.
Around half of NSCLCs have faults in one of the ways they repair DNA damage. Research has shown that adding a PARP inhibitor makes it even harder for the cancer to repair this damage – ultimately killing the lung cancer cells by targeting their key weakness. Olaparib is also being tested in phase III trials for ovarian and stomach cancers.
Professor Dean Fennell, the chief investigator based at the University of Leicester, said: “We urgently need better treatments for patients with lung cancer – just 30 per cent of them survive for a year after being diagnosed. We hope that using this drug that was originally developed for breast cancer will slow the progression of lung cancer, improving the quality of life for our patients.”
Around 42,000 people are diagnosed with lung cancer every year in the UK and it is the most common cause of cancer death.
Kate Law, director of clinical research at Cancer Research UK, said: “We’re increasingly seeing that drugs originally designed for one type of cancer are proving to be effective for many other types. It’s through research that we’ve seen how this PARP inhibitor could be effective in other cancers that have faults in their DNA repair mechanisms. We’re now taking this knowledge from the lab to see if and how it can help cancer patients.”
Immune System Produces Lasting Remissions For Melanoma Patients
By Deena Beasley
Mar 3 (Reuters) - A drug that uses the body's own immune system to kill cancer cells has produced lasting remissions - some as long as two years - in patients with melanoma that had spread to other parts of the body, according to data published on Monday.
Follow-up from an early-stage, 107-patient trial of the drug, Bristol-Myers Squibb's nivolumab, found that a year after treatment, 62 percent of patients were alive. After two years, 43 percent were alive.
Patients with advanced melanoma, the deadliest form of skin cancer, have a median life expectancy of around a year, said Dr. F. Stephen Hodi, director of the Melanoma Treatment Center at Boston's Dana-Farber Cancer Institute and one of the study's senior authors.
"The durability of clinical benefit, now with long-term follow-up is fairly remarkable," he said. "As well as the notion that somebody who stops the drug still gets a benefit."
Patients in the Phase 1 trial, whose cancer had worsened despite prior treatment with standard drugs, were given intravenous infusions of nivolumab every other week for up to 96 weeks.
Side effects of the drug included fatigue, rash, and diarrhea.
The trial results were published in the latest edition of the Journal of Clinical Oncology.
An editorial accompanying the study noted that the nivolumab data suggest the drug may be even more effective in patients with earlier-stage cancer.
Nivolumab is part of a new class of experimental immunotherapies designed to work by disabling a protein known as PD-1, or Programmed Death receptor, which acts as a brake on the immune system's ability to attack cancer cells.
Bristol Myers is conducting several Phase 3 trials of nivolumab in different types of cancer, including melanoma, lung and kidney cancer.
Some of the trials involve combination therapy with Yervoy, also known as ipilimumab, a Bristol immunotherapy cancer drug designed to disrupt a different cell receptor.
Bristol declined to comment on when it expects to report data from later-stage, randomized nivolumab trials.
About That Study That Says Mammograms Don't Save Lives... What You Need to Know
FEBRUARY 18, 2014
The idea behind getting a yearly mammogram starting at age 40 (or 50, depending on whose guidelines you’re following) is pretty straightforward: If you can detect breast cancer earlier, you can improve your odds of survival. But a new study published in The British Medical Journal is questioning that logic: According to its findings, mammograms may not cut mortality risk. It adds even more intensity to a question that’s been hotly debated by the medical community in recent years: Are mammograms worthwhile?
Every medical test comes with both potential risks and benefits to consider—and some experts are becoming increasingly vocal about their belief that the guidelines for who should get mammograms and how often should be revisited. While this study has certainly added fuel to the fire, it shouldn’t cause you to steer clear of mammograms—here’s why.
The New Findings
For the British Medical Journal study, Canadian researchers looked at data from the Canadian National Breast Screening Study, which recruited 89,835 women who were 40-59 at the beginning of the study, gave each of them a clinical breast exam, then assigned each participant to one of two groups: a group that would receive annual mammograms and clinical breast exams for the next four years, or a group that would receive only annual clinical breast exams for the next four years (or, in the case of the women 40-49, would just remain under the care of their regular doctors). Researchers then continued to follow up with the participants until 25 years after their original recruitment.
During the initial screening period, a total of 1,190 breast cancers were diagnosed (666 in the mammography group, and 524 in the control group). The tumors detected by mammograms did tend to be slightly smaller and were a little less likely to be node positive (meaning they had cancerous cells in them). But the mortality rate didn’t differ much between the two groups: During the 25-year follow-up period, 180 women in the mammogram group died, compared to 171 women in the control group.
If you look at the entire study period, 3,250 women in the mammogram group and 3,133 in the control group were diagnosed with breast cancer. The number who died were, again, virtually identical: 500 women in the mammogram group, compared to 505 in the control group.
What’s more, the study authors are asserting that about one in five of the breast cancer diagnoses made as a result of mammograms were over-diagnoses. In other words, had these tumors not been detected, researchers say they never would have caused health issues or required treatment.
“Early detection could be of greater benefit in communities where most cancers that present clinically are larger and a higher proportion are node positive,” write the researchers (who could not be reached for comment for this article). “However, in technically advanced countries, our results support the views of some commentators that the rationale for screening by mammography should be urgently reassessed by policy makers.”
But Was it Truly a Random Trial?
While the study authors say the women were randomly placed in either the mammogram group or the control group, some members of the medical community claim that, after examining the women at the onset of the study, nurses may have put women with larger cancers into the mammogram group so they would receive better care and improve their odds of survival, says Marisa Weiss, M.D. president and founder of Breastcancer.org.
“When you look at the methods section and it says 68 percent of the cancers in the mammography arm were palpable [meaning they were big enough to be detected without a mammogram], that doesn’t make sense,” says Weiss, who notes that the number should be much smaller if the women were truly placed randomly into either the experimental or control group. “They were more likely to go in the mammography arm because [the nurses] wanted them to have more comprehensive care, but it also made the mammography arm look worse because it had more cancers in it.”
The researchers state in the study text that the nurses played no role in assigning participants to one group or the other—that the randomization was blinded:
“The examiners had no role in the randomisation that followed; this was performed by the study coordinators in each centre. Randomisation was individual and stratified by centre and five year age group. Irrespective of the findings on physical examination, women aged 40-49 were independently and blindly assigned randomly to receive mammography or no mammography.”
The American College of Radiology has openly disputed this claim and has gone as far as to state that the randomization couldn’t have been blinded:
“To be valid, randomized, controlled trials (RCT) must employ a system to ensure that the assignment of women to the screening group or the unscreened control group is random. Nothing can/should be known about participants until they have been assigned to one of these groups. The Canadian National Breast Screening Study violated these fundamental rules. Every woman first had a clinical breast examination by a trained nurse so that they knew which women had breast lumps, many of which were cancers, and which women had large lymph nodes in their armpits, many of which indicated advanced cancer. Before assigning the women to be in the group offered screening or the control women, investigators knew who had large incurable cancers. This was a major violation of RCT protocol. It most likely resulted in the statistically significant excess of women with advanced breast cancers assigned to the screening arm compared to those assigned to the control arm. This guaranteed more deaths among the screened women than the control women.”
Even if this new research were based on a truly randomized trial, there are still some issues with it, says Weiss. For one thing, it looks only at survival—and not at other factors like quality of life. “The fact is that there are other things that are important to women besides, ‘Are you alive or dead?’” she says. “Most women would like to be diagnosed at an earlier stage when they can avoid chemotherapy.” While this study didn’t look at whether women were able to avoid chemotherapy or improve their quality of life in any other way by getting mammograms, it’s worth noting that women in the mammography group tended to have their cancers detected when they were smaller (even with the potential contamination, which would have inflated the average tumor size in the mammogram group).
Technology has also advanced quite a bit since the data was collected for this study. “When you’re talking about mammograms for women who are 40-49 who have dense breasts, we know that digital mammography is better than film screen, which is what they used in the test,” says Weiss. “If you’re thinking about predicting accidents on the street and you used data on car-safety standards from 25 years ago, would you ever do that? Would you ever choose to cast future guidelines based on old-fashioned technology?”
As for the issue of over-diagnoses—and the fact that study authors say one in five of the tumors detected by mammography fall into this category—Weiss says there’s no one medical definition as to what that means exactly. “That’s an assumption that requires a judgment that’s not necessarily true,” she says. “Each study has to make its own claim about what researchers think is worth finding and what isn’t.” In other words, one in five of the masses detected my mammograms fit the definition these study authors came up with—but not all medical professionals agree on which tumors are “worth” detecting and which ones would be harmless if they were never identified.
The Future of Mammogram Guidelines
In an ideal world, only women in certain subgroups who are at a particularly high risk of getting breast cancer would receive mammograms, says Weiss. We’re moving toward that—but at this point, Weiss says that we simply don’t have enough information about who’s most at risk to advise the general female population against getting regular mammograms.
“Most people who get breast cancer don’t have a family history, don’t have a gene abnormality,” says Weiss. “There’s nothing about them that makes it obvious that they need a mammogram. … We want to get to a place where we’re recommending mammograms earlier on to the women who really need it and not recommending it to the women who don’t, but the default of ‘just talk to your doctor and decide if you need one’ I believe is irresponsible because we don’t know enough to identify who has a high risk at this point.”
And as the authors of this new research point out in their study, its findings contradict those of many other studies that have investigated the impact of getting regular mammograms. The fact is that there is conflicting evidence on the effectiveness of mammograms right now. We don’t know for sure that mammograms are beneficial for every woman.
That said, the risk associated with getting a mammogram—namely, a small amount of exposure to radiation (about the same amount you’d get by getting an X-ray at your dentist’s office)—is minimal. So at this point, Weiss encourages all women over the age of 40 to keep their yearly mammogram appointment. “It’s irresponsible to say mammography doesn’t lead to improved survival based on this study,” says Weiss. “What we’re talking about is the most common cancer to affect women and something that is treatable with early detection. … It makes sense to do what you can that’s reasonable to try to find it as early as possible so that you can live as long as possible and so that you can also avoid some of the more aggressive forms of treatment, like chemotherapy.”
ALTERNATIVE BREAST CANCER TREATMENT CITED IN WOMAN'S DEATH
Jan. 8, 2014
A Colorado woman died after injecting the supplement cesium chloride into her breast as an alternative treatment for breast cancer, according to a new case study published in The Journal of Alternative and Complementary Medicine.
The 61-year-old woman, whose name was not released for privacy reasons, had been taking cesium tablets and a handful of other vitamin supplements for more than a year, according to Dr. Daniel Sessions, the medical toxicologist who treated the woman at the Rocky Mountain Poison and Drug Center in Denver.
Cesium chloride is the salt form of the element cesium. It's often used in radioactive materials and sometimes used in rodent studies to produce the abnormal cardiac rhythms that scientists study to learn about heart function. It's sold as a dietary supplement in pill form and readily available at health food stores.
Cesium has been offered up as an alternative cure for cancer as far back as the 1920s, according to American Cancer Society research. Proponents of "high pH therapy" claim the pH inside of tumor cells is usually very low, or acidic, compared to normal cells, and that cesium chloride supplements raise the pH level of tumor cells to a normal level, which slows the cancer's growth.
But there is no scientific evidence that cesium is effective for fighting breast cancer and no clinical trials have looked into its effectiveness, according to the American Cancer Society. And long-term cesium use in animal studies caused serious blood and neuromuscular side effects and even death.
Sessions said the woman was following the advice of a nutritionist and that both she and her husband also worked for a supplement company. He said that the woman's doctor found a lump in her breast about a year before she died but she refused a biopsy even though she was told it was most likely cancer.
The night before she was rushed to the emergency room in 2011, her husband helped her crush up some cesium tablets, mix them with liquid and inject it into the mass, Sessions said.
"This was the first time she had taken an injection but not long after, she started to feel sick," Sessions told ABC News. "After a few hours, she went into cardiac arrest in front of her family and was rushed to the hospital."
By the time Sessions and the rest of the medical team examined her, the woman was in a vegetative state. She never regained consciousness and died 10 days later.
Sessions said several factors were the cause of the woman's death. For one, she had abnormally high levels of cesium in her blood. She also had advanced breast cancer that had spread into her lymph nodes. And her heart malfunction is a well-documented symptom of cesium injections, he added.
"These are known, common side effects of taking cesium," he said of the woman's abnormal heart rhythm, seizures and loss of consciousness.
Sessions stressed how dangerous it is to take unproven, unregulated supplements to treat a serious health condition like breast cancer. The woman's death should be a cautionary tale for anyone else considering the same sort of treatment, he said.
If you plan on using an alternative cancer therapy, run it by your physician or call the poison control center and get more information about what you're taking," he said. "You have to know what supplements you're putting in your body."
Breast cancer survivors benefit from yoga
Tuesday 28 January 2014
A new US study finds that yoga can benefit breast cancer survivors by reducing fatigue and inflammation. While yoga has many components, the researchers believe breathing and meditation probably had the biggest impact.
At the end of 12 weeks of yoga classes, a group of women who had completed breast cancer treatment, including surgery and radiotherapy, showed an average reduction in fatigue of 57% and up to 20% reduction in inflammation, compared with a similar group that had not received yoga instruction.
The researchers also found the more yoga the women practiced, the better the results.
They report the findings of the randomized controlled trial in the Journal of Clinical Oncology.
Study leader Janice Kiecolt-Glaser, a professor of psychiatry and psychology at The Ohio State University in Columbus, says the study shows how several months of modest yoga practice can benefit breast cancer survivors substantially. She also thinks the results could apply to other people who have problems with fatigue and inflammation.
Largest known trial of yoga in cancer survivors using biological measures
Many studies have shown that yoga can benefit cancer patients. For instance, in 2010, another group from the US reported how 4 weeks of yoga reduced fatigue and improved sleep quality in cancer survivors who also reported taking less sleep medication and improved quality of life.
However, the researchers behind this new study believe it is the largest known randomized controlled trial of the effect of yoga on cancer survivors that includes biological measures. They decided to concentrate on breast cancer survivors because the treatment they undergo is very rigorous and taxing, as Prof. Kiecolt-Glaser explains:
"One of the problems they face is a real reduction in cardiorespiratory fitness. The treatment is so debilitating and they are so tired, and the less you do physically, the less you're able to do. It's a downward spiral."
For the study, the researchers recruited 200 women who had undergone treatment for breast cancer and randomly assigned them to either the intervention group or a control group.
The participants were aged from 27 to 76 and had completed their surgery or radiotherapy between 2 months and 3 years before taking part in the trial: none had done yoga before they took part in the study.
Trial designed so results apply to other cancer survivors
They deliberately recruited a mix of participants with a wide age range, with cancer at various stages (from 0 to 3A), and who underwent a range of treatments, so they could generalize the results to a broad population of cancer survivors.
The researchers believe breathing and meditation were the components of yoga that probably had the biggest impact on breast cancer survivors.
The intervention group received 12 weeks of twice-weekly 90-minute group classes in Hatha yoga, and was also encouraged to practice at home. The participants also kept a log of their total weekly practice.
The control group participants were wait-listed to have the same yoga classes after the study was completed and were asked not to do yoga in the meantime.
Two types of results were recorded at three points in the study period, once at the beginning, then at the end of the 12 weeks of yoga classes, and then again 3 months after that.
At all three points, both groups completed questionnaires that enabled the researchers to assess fatigue, energy levels, symptoms of depression, quality of sleep, diet and exercise.
They also gave blood samples from which the researchers could measure levels of three inflammation-related proteins: interleukin-6 (IL-6), interleukin-1 beta (IL-1B) and tumor necrosis factor-alpha (TNF-a). The participants were first injected with a compound that provoked an immune response before giving the blood samples.
Reduced fatigue, increased vitality and reduced inflammation markers
The results showed that immediately after the yoga classes ceased, the yoga group reported on average a 41% reduction in symptoms of fatigue, and a 12% higher score on vitality, compared with the non-yoga controls.
Also at this point, the yoga group showed on average lower levels of the inflammation-related proteins than the controls: 10% lower level of TNF-a, 11% lower IL-6, and 15% lower IL-1B.
Further analysis showed the yoga group experienced significantly improved sleep, compared with the control group.
This also showed the more yoga the women practiced, the bigger the improvements in fatigue, vitality, depressive symptoms, accompanied by increased reductions in two of the inflammation-related proteins.
Prof. Kiecolt-Glaser says:
"We were really surprised by the data because some more recent studies on exercise have suggested that exercise interventions may not necessarily lower inflammation unless people are substantially overweight or have metabolic problems. In this group, the women didn't lose weight, but we saw really marked reductions in inflammation. So this was a particularly striking finding biologically."
A number of health problems are linked to chronic inflammation, including type 2 diabetes, coronary heart disease, and Alzheimer's disease. Studies have also tied it to age-related frailty and functional decline.
Later, at the 6-month measuring point, 3 months after the yoga classes finished, the benefits appear to have continued to improve: fatigue was 57% lower, and inflammation was between 13% and 20% lower in the yoga group, compared with the non-yoga group.
There are many aspects to yoga, including meditation, breathing, stretching and strengthening. But the researchers think for this study, the parts that produced the most benefits were the breathing and meditation practice, as Prof. Kiecolt-Glaser explains:
"We think improved sleep could be part of the mechanism of what we were seeing. When women were sleeping better, inflammation could have been lowered by that. Reducing fatigue enables women to engage in other activities over time. So yoga may have offered a variety of benefits in addition to the yoga exercises themselves."
Funds from the National Cancer Institute helped finance the study.
Written by Catharine Paddock PhD
MORE YOUNGER WOMEN GETTING BREAST CANCER
May 21, 2013
By Dr. Mercola
Revealing new data from the charity Cancer Research UK reports that a record number of women under the age of 50 are being diagnosed with breast cancer.
For the first time, more than 10,000 women under 50 were diagnosed with the disease in the UK, which translates to one out of every five women diagnosed with breast cancer.
The news comes on the heels of a JAMA study published earlier this year, which similarly found that the number of young women (aged 25-39) in the US being diagnosed with advanced breast cancer is also increasing.
Typically, cancer is much more likely to develop as you get older. The non-profit BreastCancer.org even states:
“ … the aging process is the biggest risk factor for breast cancer. That's because the longer we live, there are more opportunities for genetic damage (mutations) in the body. And as we age, our bodies are less capable of repairing genetic damage.”
So why is it that so many younger women are now being struck by this potentially deadly disease?
What Is Causing Breast Cancer in Young Women?
No one knows for sure, but it’s fairly safe to say that there are likely multiple contributors, many of them environmentally based. More...
THE TRAGIC INEQUALITY OF BREAST CANCER
Jun 16, 2013 - by Rache M. Simmons
BREAST CANCER AFFLICTS WOMEN OF ALL BACKGROUNDS, BUT MINORITY PATIENTS STILL RECEIVE WORSE CARE THAN THEIR WHITE COUNTERPARTS. DR. RACHE M. SIMMONS ON CONFRONTING THE TREATMENT GAP.
It’s reasonable to ask why the Breast Cancer Patient Education Act, a bill currently before Congress, is aimed specifically at helping “members of racial and ethnic minority groups.” After all, breast cancer afflicts women of all races, ages, and nationalities. And white women are actually the most likely to develop the disease.
The answer is quite disturbing. In far too many cases, minority breast cancer patients receive worse care than their white counterparts. As the authors of the Breast Cancer Patient Education Act are right to recognize, addressing this disparity means ensuring that all women are well-informed about the disease and the options for treating it.
Two facts in particular highlight the challenges faced by minority breast cancer patients. First, even though black women are 10 percent less likely to develop breast cancer than whites, black Americans are the most likely to die from the disease. At the same time, a disproportionate number of black, Hispanic, and Asian patients fail to receive breast reconstructive surgery following their mastectomies.
At their core, the problems that confront minority breast cancer patients have to do with education. The alarmingly high rate of breast-cancer deaths in the black American community, for instance, is largely a failure of early detection. Too often with black patients, tumors aren’t discovered until they have reached an advanced stage. Educating black women about the importance of regular mammograms could, by itself, increase breast-cancer survival rates dramatically. More...
BRCA-NEGATIVE RESULTS MAY NOT REDUCE CANCER RISK
Wednesday 27 November 2013
Some women, especially those from BRCA2 families, may test negative to the mutated gene but still develop breast cancer.
Breast cancer will likely affect one in eight women at some point during their lifetime, and the risks increase with age. However, the risk is not the same for all women in any given age group.
Genetic changes, including BRCA1 and BRCA2, are known to carry a higher risk, but now scientists say that even family members who test negative for the genetic differences are still at an increased risk of developing the disease.
The discovery of mutations on the BRCA genes has prompted many women to take drastic preventative measures, including Angelina Jolieand Sharon Osbourne, who sought double mastectomies when it was confirmed they had the breast cancer gene.
Now, a new study, published in Cancer Epidemiology, Biomarkers & Prevention, challenges the belief that a woman from a BRCA family who tests negative for her family-specific BRCA mutation has the same chances of contracting the disease as someone in the general population. More...
FOOD TO FIGHT CANCER
Laura A. Stokowski, RN, MS
November 20, 2013
After receiving a diagnosis of cancer, a patient's thoughts often turn to treatment options and prognosis. Many patients face surgery, radiation therapy, chemotherapy, or a combination of those strategies. Most of their questions and concerns are about how they will get through it all.
Nutrition is not likely to be on their list of immediate concerns, but it should be. Not only will patients reap the benefits of being healthier and better able to withstand treatments and side effects, but mental outlook and quality of life can be improved by taking control of one's nutritional health. Patients might have little control over their disease, but what they eat remains under their own purview, and deciding to eat well and taking the steps to do so is empowering. More...
TELLING THE TRUTH ABOUT RECONSTRUCTION AFTER BREAST CANCER
Where We Go Now - Debbie Woodbury's Blog
"She got her looks from her father. He's a plastic surgeon." Groucho Marx
It's not easy to walk into a plastic surgeon's office for reconstruction after breast cancer. On my first visit, I sat in the waiting room and fumed. All around me were glossy pamphlets and posters promising "enhancement" and "transformative" procedures that would "rejuvenate, polish, and refine."
My transformation felt like staring into a fun house mirror. With the stereotactic and surgical biopsies, my body was becoming more and more freakish and unfamiliar. Being deconstructed bit by bit, I feared reconstruction meant more damage, not less. I wasn't one of those smiling happy pamphlet people thrilled at the prospect of bigger breasts, smaller noses, or fuller lips. I wanted nothing of lifts, tucks, fills, augmentations and reductions. And don't get me started on "mommy makeovers."