Factoring In Gender: Women’s Health Research at Yale

I just found this health related video on YouTube … and thought you might enjoy it!

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Scientists and community members speak about a variety of topics including: 1) the dramatic need for scientific information on women’s health and on gender-specific factors determining health and disease; 2) the scientific tradition of excluding women as participants in many clinical trials, and the continuing practice of “pooling” subject data rather than analyzing health outcomes by gender that have each contributed to this “knowledge gap,”; 3) the progress being made in reversing these historical trends, and; 4) new scientific information being uncovered in women’s health and gender-specific medicine.

Tell us what you think about this video in the comments below, or in the Battling For Health Community Forum!
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“Look Now: Facing Breast Cancer”: a photographic tribute to breast cancer survivors

What better way to end Pink October than to pay tribute to breast cancer survivors? Sycaruse University launched exactly such an event onWednesday, Oct 27. “Look Now: Facing Breast Cancer” is a photographic project that will feature a series of portraits of women who have faced, fought, and triumphed over the monster that is breast cancer. It aims “to bring awareness of the emotional and physical aspects of breast cancer.”

In our society, looks are very important. For women with breast cancer,  the loss of breasts and hair, physical attributes which make women attractive, is a big blow. This is what the artist will focus on.

Most projects on breast cancer survivorship focus on celebrities. The portraits that artist Angelika Rinnhofer created  and is planning to create would not be of the rich and famous but ordinary women like you and me. This week’s launch started with portraits of 3 central New Yorkers. The project will last for a year as the artist continues to create more portraits of more survivors of different ages, ethnicity and levels of surgery. The target is to have 20 to 25 double portraits, one with the survivor clothed, the other with the survivor nude in the upper torso.

One of the survivors already photographed is Goenka who stated:

“Breast cancer is a disease that sucks you in, chews you up and spits you out. Some women lose their breasts. Most lose their hair. And many lose their lives. But all those who survive lose their sense of themselves and never really feel whole again. I know this because I am a breast cancer survivor myself.”

Each portrait will tell a different story, yet with a common theme. Despite the uniqueness of each case, the portraits will depict the survivors “as vibrant and empowered” and despite undergoing surgery that might have led to loss of 1 or both breasts, are “still whole.”

Says the artist:

“Every case of breast cancer is a unique story that doesn’t just begin with the diagnosis and end with surgery or chemotherapy.”

What the project aims to do:

• [Resist] our culture’s tendency to abstract, obscure or allegorize illness, “Look Now” bears witness to the breast cancer that exists all around us here in our own region.
• “Women’s breasts have always been objectified by society and the media [making their loss] even more traumatizing.” [The project tries] “to heal and restore a sense of wholeness through the power of the individual portrait.”
• “Ultimately, the purpose of the show is multi-fold: to spread awareness, to serve as an artistic testament to living well after the disease and, above all, to empower the women who participate.”

The project will culminate in an exhibition in Pink October 2011. A documentary film about the project is also being planned.

Breast Cancer Action Group launches Think Before You Pink blog

Pink October is coming to an end but the struggle against breast cancer goes on. The Breast Cancer Action (BCA) Group is one of the strongest group the cause and it recently launched the Think Before You Pink blog.

BCA is the first group to crack down on pinkwashing defined as:

“…sponsoring companies positioning themselves as leaders in the effort to eradicate breast cancer while engaging in practices that may contribute to rising rates of the disease.”

Can you imagine that BCA even took on the joint campaign “Buckets for the Cure” of Kentucky Fried Chicken (KFC) the breast cancer giant Susan Komen for the Cure. After all, KFC is not exactly the healthiest fare we should go for if we want to stop breast cancer.  According to BCA:

“Considering that high-fat fast foods lead to obesity, and obesity is a known risk factor for all cancers, not only breast cancer, this is an especially tasteless campaign.”

BCA was also able to help convince Yoplait to go rBGH-free. rBGH is a growth hormone used in cows to enhance milk production. It is also suspected to cause cancer and other health conditions. Its latest campaign is to try to convince rBGH manufacturer Eli Lilly

The Think Before You Pink blog is specifically designed to inform consumers about companies who use the pink color and breast cancer to attract attention and market their products. I mean, some even contribute part of their sales to breast cancer research. However, BCA thinks it is not right to accept financial support from corporate sponsors whose products and services actually promote rather than fight breast cancer.

Here are some other examples of pink washing companies and campaigns:

• Simple Green, whose cleaning products that carry the pink ribbon logo may actually contain carcinogens.
• Lay’s, Frito’s, Cheeto’s, and chips etc. says “Together we can help beat breast cancer.” Definitely not by eating these products, right?
• Cosmetic giant Estee Lauder is a big player in the breast cancer campaign but its products are not necessarily pink and may contain  potentially carcinogenic ingredients.

With the new blog, BCA aims to reach more people about pinkwashing. Battling Cancer is fully supporting BCA and its efforts in fighting pinkwashing.

So next time you think pink, remember these BCA mantras:

• Action speaks louder than pink.
• Think before you buy pink.

Breast Cancer In Pets

While everyone is sporting pink ribbons this month in honor of breast cancer awareness, many people don’t realize that important member of our families can also suffer from the disease. Our pets. Mammary gland tumors are common in dogs and cats, especially those that aren’t spayed or were spayed late in age.

Owners can reduce the chance of breast cancer in their pets to nearly zero by simply having them spayed before the first heat.

Mammary exams and early detection are key for them just as they are for humans.

The fact sheet below details how mammary cancer effects dogs and cats in different ways, compliments of PurinaCare Insurance Services Inc.

BREAST CANCER IN PETS FACT SHEET

Many people don’t realize that pets can also suffer from breast cancer. Mammary gland tumors are common in dogs and cats, especially those that aren’t spayed or were spayed late in age.

Mammary exams for pets are important and early detection is key. Once your dog or cat is five years old, perform a mammary exam monthly. Gently feel the tissue under and around each nipple, “rolling” the tissue between your fingers. If you feel even a tiny lump, bring your pet to the veterinarian.

Dogs:

• 25% (1 in 4) of un-spayed female dogs will get mammary cancer
• Most common in older female dogs
• Less than 50 percent of canine mammary tumors are malignant
• Spaying a dog before their first heat will reduce the chance of breast cancer to almost zero.
• Most “at-risk” breeds: poodle, Brittany spaniel, English setter, pointer, fox terrier, cocker spaniel, Boston terrier
• Diagnosis: affected area will be red, swollen, feverish, and painful to the touch
• Early detection/prompt treatment can successfully treat even serious tumors. Look for small, firm pea-sized lumps in the breast tissue.
• Surgical removal is the first treatment method and chemo is sometimes a secondary treatment, depending on the severity of the tumor

Cats:

• Less common in cats than dogs, 1/4000 will have mammary cancer
• Early spaying is the best prevention and also if a cat has had kittens they’re less likely to get it
• Around 90 percent of feline mammary tumors are malignant
• Siamese cats and cats over the age of 10 are the most prone to mammary cancer
• Diagnosis: affected area will be painful to the touch, swollen, infected, and the cat may have a fever
• Surgical removal of the tumor and aggressive chemo is the recommended treatment, however mammary cancer is usually fatal in cats

THE MOST IMPORTANT PREVENTION MEASURE A PET OWNER CAN TAKE:

Spaying before the first heat can reduce the chance of breast cancer to nearly zero. That simple decision can save a pet’s life.

About PurinaCare Insurance Services Inc.

PurinaCare Insurance Services Inc., a wholly-owned subsidiary of Nestlé Purina PetCare Company, is dedicated to providing pet owners with a Lifetime of Care® for their dogs and cats. PurinaCare® pet health insurance is offered to dog and cat owners in all 50 states and the District of Columbia. PurinaCare is committed to promoting responsible pet care, providing humane education, supporting community pet involvement, and fostering the positive bond between people and their pets. PurinaCare pet health insurance is underwritten by Central States Indemnity Co. of Omaha, a subsidiary of Berkshire Hathaway Inc. PurinaCare pet health insurance is also offered as a direct benefit to select employees and associations nationwide and its high-deductible policies have earned the AAHA Seal of Acceptance. For more information about PurinaCare pet health insurance, call 877-8-PURINA or visit www.purinacare.com

Male breast cancer: risks and perceptions of family members

In another tribute to Breast Cancer Awareness Month, we tackle a type of breast cancer that is rare but equally dangerous – male breast cancer.

Men do get breast cancer, too. Male breast cancer may be rare but having a male relative diagnosed with breast cancer may present similaror even higher chances of developing the disease than having a female relative with breast cancer. Yet, perceptions and behavior of family member of cancer patients based on the gender of the diagnosed family member vary a lot. This is a according to a study by researchers at Multidisciplinary Breast Care Program at the James Graham Brown Cancer Center.

Typically, people with male relatives with breast cancer perceive their risk to be higher than those whose familial history of breast cancer is restricted to females. This is in most cases right. Yet, despite this perception, these people are less likely to take action to find out more about their genetic predisposition such as seek genetic counseling or undergo genetic testing.

The study results were based on data from “2,429 individuals with a first-degree relative – a parent, sibling or child – with breast cancer. The data were separated into two groups – those with a first-degree male relative with breast cancer, and those with a first-degree female relative with breast cancer. Data about perceived risk of inheriting genetic disease, genetic counseling and genetic testing were collected and compared between the two groups.”

The actual figures found by the study comparing the 2 groups (male relative vs. female relative) are as follows:

• Perception of risk of developing breast cancer:  more than 60% vs. 46%
• Awareness of genetic testing for breast cancer gene mutations: 38.4% vs. more than 50%
• Discussion about genetic risk with health care provider: none vs. 13%

This discrepancy between risk perception and actual action may be due to many factors, such as:

• Breast cancer in males is rather rare, accounting for only about 1% of all cases of breast cancer.
• People are not well-informed about breast cancer genetic testing.
• Doctors may fail to ask the right questions that would make patients reveal significant information.

The study authors wrote:

“Our findings speak to a real communication issue in health care. Patients need to be made aware of the risk posed by having one or more first-degree relatives who have had breast cancer, and physicians need to be meticulous in taking family histories and discussing risk with the patients they see.”
“Patients need to be educated about their risks and what to look for, and on the flip side, doctors need to be sure they are taking complete family histories and referring patients for genetic evaluation if any red flags are raised.”

Family history of breast cancer? There’s something you can do to reduce your risk!

It is Pink October, a month dedicated to Breast Cancer Awareness. In the next 2 weeks, Battling Cancer will focus on the latest news on breast cancer.

There is no denying the genetic component of breast cancer. But having a family history of the disease need not be a death sentence. Studies have shown that through healthy lifestyle and behavioral strategies, breast cancer can be slowed down, even stopped in its tracks.

Familial predisposition to breast cancer is for real and the risk should be taken seriously. However, women should not live in hopelessness because there are ways and means of reducing the risk.

According to Dr. Robert E. Gramling, associate professor of Family Medicine, and Community and Preventive Medicine at the University of Rochester Medical Center:

“It’s important to note that a family history of breast cancer can arise in part due to shared unhealthy behaviors that have been passed down for generations. Untangling the degree to which genes, environments, and behaviors contribute to the disease is difficult. But our study shows that engaging in a healthy lifestyle can help women, even when familial predisposition is involved.”

Dr. Gramling and colleagues looked at data from the Women’s Health Initiative Observational Study which enrolled more than 85,000 postmenopausal women aged 50 to 79, One group of participants had a family history of later-onset breast cancer (after age 45) and another group did not. The women were followed up for an average of 5.4 years.

Data analysis showed that three health behaviours were strongly associated with reduction in risk for breast cancer and the risk reduction was the same for women with and without a family history. These lifestyle factors were regular physical activity, a healthy weight, and less alcohol consumption.

Indeed, this is good news for women with family history of breast cancer. The study results show that even our grandmothers and mothers may have succumbed to the disease, we have great chances of beating it and so do our daughters and their daughters by reducing the risk through a healthy lifestyle.

Dr. Gramling continues:

“Given the strong awareness of breast cancer and distress about inheritable risk, it is essential that scientists understand the actions women can take to reduce their risk”.

And here is another strategy to reduce breast cancer risk regardless of genetic disposition – breast feeding! I will tell you more about breast feeding and breast cancer in an upcoming post.

Pink (ribbon) is not only for girls

“ I do not want to go to the Pink Ribbon run with you!”, moaned one of my 7-year olds. “That is so silly.” It is not about the run as he is a good runner. He meant that pink is just for girls, uncool and downright plain stupid. After all, he saw from the posters that the runners were all wearing pink last year.

Okay, so he is at the age when gender issues are very important and his “boyness” shouldn’t be threatened. It didn’t help that his Dad had to cancel at the last minute due to work issues. “Ok, then I’ll go with your (twin) brother, you can stay at home, but you have to entertain yourself because Daddy has to work on his computer upstairs.” Daddy didn’t want this, of course, and finally managed to talk his son into going.

For adults, the significance of charity walks for breast cancer is quite easy to grasp. For girls, the pink color is so cute and the chance to meet Miss Switzerland at the run is absolutely fabulous. For boys, it is pure horror.

So I tried to explain. How Mommy’s friend has breast cancer and needs to find a cure. How the Swiss Cancer Foundation (Krebsliga) needs the money so they can do what they’ve done in their school last summer: go visit the local schools and distribute sun caps and talk to the kids about cancer prevention. “But we will be the only boys there!” “I don’t think so,” crossing my fingers behind my back. “Besides, you will know a lot of people there since we will be running with your English school team.”

Then we got to the stadium. They were at first overwhelmed by the crowd of women in pink. Then we saw one of their good friends from kindergarten with his mom. She, too, showed relief when she saw me with my boys. “See, I told you there will be other boys and look who’s here,” she said to him.

From then on, it got better. We saw a couple of teachers from their kindergarten, one of them a man. We met another boy and his little brother from their once-a-week English classes. They played football with a dad and his son while waiting for the run to start. Then it was time for the run. We jogged the 2.5 km all the way and were among the first at the finish. They got their promised ice cream afterwards. And they loved their give-away bags.

“That was so cool, Mom.” Finally! Ok, so they refused to wear the pink T-shirts. That was fine. I’ll have presents for grandma and auntie. But at least they found out that pink is not only for girls and that a Pink Ribbon Run can actually be cool.

I don’t think I will have problems convincing them to run with me next year.

Pink Ribbon Charity Walk 2010, Zürich, October 2, 2010

• 6 to 18 years old: 96
• 19 to 45 years old: 545
• 46 and older: 160 Total participants – 801

Cancer News: Pink October and cancer awareness runs

It’s the beginning of October and it is also the start of the National Breast Cancer Awareness Month in the US. But the rest of the world is going pink this month, too.

The Empire State Building to Shine Pink on October 1^st
This observance kicks off today, October 1 with famous landmarks and buildings shining pink. This is in connection with Estee Lauder’s attempt to set a new Guinness World Records for “most landmarks illuminated for a cause in 24 hours.” The lighting of the Empire State Building will be the culminating event for The Estee Lauder Companies’ Breast Cancer Awareness Campaign’s (BCA Campaign) Global Landmarks Illumination Initiative. Other iconic landmarks that will be lighted pink are:

• Castle Schonbrunn in Austria
• Taj Mahal Palace & Tower Hotel in India
• Kuala Lumpur Tower in Malaysia
• Rockefeller Center in New York City

Susan G. Komen Race for the Cure® Global Events Kick Off in Four Countries

Four races done, 6 more to go. The first 4 Susan G. Komen Race for the Cure of this autumn started last Sept 26 in

• Frankfurt, Germany
• Bologna, Italy
• Athens, Greece
• Antwerp, Belgium

Runs scheduled in October:

October 2

• The 3rd Bosnia and Herzegovina Race for the Cure in Sarajevo in partnership with the American Jewish Joint Distribution Committee’s Women’s Health Empowerment Program

October 10

• The 6th Susan G. Komen Puerto Rico Race for the Cure in San Juan

• The 1st Susan G. Komen Italia Race for the Cure in Naples, Italy

October 23

• The 2nd Egypt Race for the Cure at the Pyramids of Giza in partnership with the Breast Cancer Foundation of Egypt

October 24

• The 1st Brazil Race for the Cure in Rio de Janeiro in partnership with the Franco-Brazilian Oncology Society, Oncoguia, FEMAMA, Brazilian Mastectomy Society and the Brazilian Society of Clinical Oncology

October 28

• The 1st Israel Race for the Cure in Jerusalem in partnership with Hadassah Organization and the City of Jerusalem

Finally, an anti-cancer run for me

This promises to be a good month for advocates of breast cancer awareness, including me. For one thing, I finally found a local breast cancer walk/run event here in Zurich, my city of residence.

Before we moved to Switzerland, I used to join regularly the Susan Komen Race for the Cure in Frankfurt. The last time was in 2005 and I still have my T-shirt from the event.

Well, this year I finally found out that there is a similar event here in Zurich called the Pink Ribbon Charity Walk. So I am doing it for the first time since moving to this country in 2006. And I am also doing it for the first time with my 2 boys! The 2.5 km Walk will take place this Saturday, October 2 at the new Stadion Letzigrund of Zurich. Proceeds of the Walk goes to local cancer foundation Krebsliga.

Friday cancer news: updates from the breast cancer front

Updates from the Stop Milking Cancer Campaign

The Stop Milking Cancer Campaign ends today, 24 September. Thanks to you, our readers and anti-cancer advocates,  Breast Cancer Action (BCA) attained and even surpassed their targets for this campaign.

If you recall the post a couple of weeks back, Stop Milking Cancer Campaign was launched on September 1 to call on rBGH maker Eli Lilly to stop manufacturing this cancer-causing hormone and break the “cancer profit cycle.”

Here is what BCA has to report about the campaign:

• We’re joined by 10 campaign partners, including Corporate Accountability International, Our Bodies Ourselves, Healthy Child Healthy World, and AllergyKids Foundation.
• We’ve reached our goal of gathering 6,220 signatures on the petition we’ll be sending to Eli Lilly’s leadership – that’s one for every day rBGH has been on the market.
• BCA plans to plaster our message to Eli Lilly in a very public way – on a billboard in Indianapolis, where Eli Lilly’s headquarters are located.
• We’ve had a robust presence on blogs, Facebook, and Twitter!

However, just because the target of 6,220 signatures (representing the number of days rBGH has been on the market) has been achieved, that doesn’t mean that we should stop here. The battle is far from over. BCA continues to collect signatures to be forwarded to Eli Lilly. Do your share! Sign up at www.thinkbeforeyoupink.org.

Breast Cancer Research Symposium

This weekend, you can join the Breast Cancer Research Symposium with the theme “From Research to Action: Tools for Change.” The event is for free and is open to everybody at the Oakland Marriott, Oakland, CA, on September 24-25. Topics covered:

•the basic biology of breast cancer

•new diagnostic tools and personalized therapies

•exploring ways to improve delivery of services new tools for researching disparities and their impact on breast cancer risk

•the influence of breast cancer research on statewide and national chemicals policy

•the role of advocacy and community research  in moving the breast cancer field forward

•ways for you to make your mark in the fight against breast cancer

About Breast Cancer Action

BCA is the watchdog that originally coined the term  pinkwashers, companies that claim to care about breast cancer but make or sell products and services  that are linked to the disease. The site www.thinkbeforeyoupink.org  informs consumers about pinkwashers and pinkwashing campaigns. BCA claims it does not receive any donation or any other form of financial support from companies who may be involved in pinkwashing.

BCA is turning 20 this year, “celebrating 20 years of activism on October 7th 2010.” Check out their site for tickets to the big celebration on October 7, 2010 at The City Club, San Francisco, CA.

Can fish oil stop breast cancer in its tracks?

Fish oil has been touted to prevent cardiovascular disease. Now this heart-friendly supplement has another health benefit: lowering the risk for breast cancer. Fish oil supplements contain large amounts of omega-3 fatty acids, EPA and DHA, substances that are beneficial to heart health and apparently also have some anticancer benefits.

This was revealed in a study conducted by researchers at the Fred Hutchinson Cancer Research Center in Seattle. The study participants consisted of 35,016 postmenopausal women with no family history of breast cancer. The women completed a questionnaire on vitamin use. After 6 years, a total of 880 study participants were diagnosed with breast cancer. The risk of breast cancer was reduced by 32% among those who regularly took fish oil supplements. The protective effects of fish oil seem to be true only for invasive ductal breast cancer, which is the most common form of the disease.

What about other supplements?

Other forms of “specialty supplements” that are used to treat menopausal complaints do not seem to have an effect on cancer risk.

This is the first ever study to report the anti-cancer benefits of fish oil and although the results are promising, and even exciting, experts warn that more studies are needed before they can truly recommend fish oil as preventive measure against breast cancer. Previous studies on fish oil intake obtained inconsistent and inconclusive results.

According to study author Dr. Emily White,

“It may be that the amount of omega-3 fatty acids in fish oil supplements is higher than most people would typically get from their diet. Without confirming studies specifically addressing this, we should not draw any conclusions about a causal relationship.”

According to Dr. Edward Giovannucci, professor of nutrition and epidemiology at the Harvard School of Public Health

“It is very rare that a single study should be used to make a broad recommendation. Over a period of time, as the studies confirm each other, we can start to make recommendations.”

I do not think I would start taking fish oil supplements now but I think this news is comforting for those who are already taking the supplements for heart problems that they might be fighting two monster diseases with just one pill. Or is it too good to be true?

In the meantime, more research studies are being planned and we hope that we will have the answers soon.

Send a message to Eli Lilly: Stop Milking Cancer!

The compound

It goes by many different names: recombinant bovine somatotropin (rBST), recombinant bovine growth hormone (rBGH), artificial growth hormone, Posilac. But its main purpose is to induce cows to produce more milk. And it does. Unfortunately it harms the cow and the insulin-like growth factor IGF-1 in it finds its way into the milk – and our table.

It is a compound that is banned in most developed countries but not in the US. It is even considered unacceptable by the Codex Alimentarius, the international standard list of approved food additives.

Its manufacturers claim there is not enough evidence to show that rBGH is harmful to humans. And if the cow injected with rBGH gets mastitis, who cares?

There have been recent studies, however, that point to a link between IGF-1 and tumor formation. In one 2009 review, the authors wrote:

“Insulin and Insulin-like Growth Factors (IGFs) systems play a key role in cellular metabolism, differentiation, proliferation, transformation and apoptosis, during normal and malignant growth. Moreover, these molecules seem essential in promoting tumor vascularization.”

The company

Posilac was the brainchild of the agricultural giant Montsanto. It now belongs to the pharma company Eli Lilly. The company is known for its best-selling and sometimes controversial products Prozac (anti-depressant), Thimerosal (vaccine preservative) and Methadone (narcotic drugs treatment. The company is also the manufacturer of the anti-cancer chemotherapy drug Gemzar and the breast cancer preventive drug Evista. In this context, Eli Lilly has the “perfect cancer profit cycle” by manufacturing Posilac which may cause breast cancer and by selling drugs that should prevent or treat breast cancer. In other words, the company is milking cancer to the very last drop. It is a win-win situation for Eli Lilly and the consumers are the ultimate losers.

You can help BCA in trying to stop Eli Lilly from Milking Cancer by sending an email message to Eli Lilly at the www.thinkbeforeyoupink.org

But what is even concerning is the increasing use of rBGH in developing countries in the guise of augmenting food production. Posilac is going global – and so is cancer.

The campaign

The campaign is called Stop Milking Cancer and its aim is to put pressure on Eli Lilly to stop the manufacture of rBGH. Behind the campaign in none other than the Breast Cancer Action Group (BCA), the watchdog group that coined the term “pinkwashers” – companies that claim to care about breast cancer but make or sell products that are linked to the disease. They launched the www.thinkbeforeyoupink.org site to identify pinkwashers.

Here is what the campaign has to say:

Eli Lilly is Milking Cancer!

Eli Lilly is now the sole manufacturer of rBGH — the artificial growth hormone given to dairy cows that increases people’s risk of cancer. Eli Lilly also manufactures breast cancer treatment medications and a pill that “reduces the risk” of breast cancer. Eli Lilly is milking cancer. Tell them to stop making rBGH.

You can help BCA in trying to stop Eli Lilly from Milking Cancer by sending an email message to Eli Lilly at the www.thinkbeforeyoupink.org site.

Breast cancer survivor: psychological intervention improves outcomes

Surviving breast cancer is a big victory. But it comes with a lot of psychological stress, reduced quality of life, and the constant threat of relapse. Health experts believe that postcancer care and follow-up for breast cancer survivors should include psychological intervention that would address the previously mentioned issues.

Researchers at the Ohio State University in Columbus and at the Ohio State University Comprehensive Cancer Center compared women had breast cancer, and randomly received either a psychological intervention or standard assessment during posttreatment and were followed up for about 11 years.

Psychological intervention included the following clinical objectives for patients:

understand the nature of cancer stress; learn tangible ways to reduce stress and improve quality of life; maintain adherence and follow-up to cancer care; enhance communication with medical care providers; increase well-being during treatment, facilitate recovery and improve overall health.

The study results showed that women who underwent psychological therapy have a 45% reduction in recurrent rates. A follow-up study also showed that these women had a 59% reduction in the risk of dying of breast cancer.

According to lead researcher Barbara L. Andersen

“Survival advantages occurred above and beyond the improvements from state-of-the-science oncology treatments received at an NCI-designated comprehensive cancer center. An empirically supported psychological intervention for cancer patients can yield robust gains of enduring quality, and ones that may include important health benefits.”

The study results suggest that postcancer follow-up treatments should not only address the physical effects of cancer but the psychological impact of the disease that has some long-term consequences. The psychological stress of cancer leads to disruptions in quality of life, health behaviors and immunity, and all these contribute to poorer health outcomes of cancer patients. Providing psychological intervention can help reduce the risk for recurrence and mortality due to breast cancer.

According to Dr. Sarah Gehlert of The Brown School, Washington University, St. Louis:

“We currently have few empirically supported psychosocial interventions for use with women who have been diagnosed with breast cancer. An intervention that increased survival would be incredibly valuable. It represents a new tool for improving the lives of women with breast cancer.”

Researchers are hopeful that these results can help not only breast cancer survivors but survivors of other cancers.

Pregnancy after breast cancer

One of the main concerns of cancer survivors is loss of fertility and the ability to bear children. However, although a large number of breast cancer survivors still retain their reproductive potential, doctors are worried that pregnancy for these women can lead to hormonal changes that cause recurrence of the cancer.

A recent study however reports that these concerns are unfounded and that pregnancy for breast cancer survivors is quite safe and does not seem to increase the risk for recurrence.

Belgian researchers lead by Dr. Hatem Azim of the Institute Jules Bordet conducted a meta-analysis of results from 14 previous trials that involved 1,400 pregnant women with a history of breast cancer. Their outcomes were then compared to outcomes of more than 18,000 breast cancer survivors who were not pregnant. Surprisingly, pregnancy seemed to actually lower the risk of recurrence of the cancer – by 42%.

According to Maria Leadbeater, a cancer expert at Breast Cancer Care:

“For many years, pregnancy was considered a risk for women who had breast cancer…  But this study seems to show the risk is not an issue once you’ve been treated.”

Experts used to believe that pregnancy is too risky for breast cancer survivors due to the complex relationship between the female hormones and the development of cancer.

“Estrogen is known to trigger breast cancer and women typically have more estrogen when they’re pregnant. But very high doses of the hormone can also kill cancer cells… Other hormones that are elevated in pregnancy, like the one for breast-feeding, have been proven to protect against breast cancer.”

However, the issue of pregnancy needs to be seriously discussed with doctors because this might not be advisable for all patients.  Some factors to be taken into consideration are:

• type of breast cancer
• response to treatment.
• time after treatment

Doctors’ opinions as to the time between treatment and trying to have a baby vary.

• Hormone therapy for breast cancer typically lasts for about 5 years, during which pregnancy is not advisable.
• Others believe a waiting time of 2 years as this is the period when relapse rate is highest.

The study results give hope to women who would like to have children despite cancer. The researchers hope that doctors should more open-minded and encouraging.

According to Dr. Azim:

“I hope this changes what doctors tell their patients. There’s no reason to tell women who survive breast cancer not to get pregnant.”

In the pipeline: preventive vaccine against breast cancer

Could this be the vaccine we have been waiting for? Researchers at Cleveland Clinic announced last week that we may be closer to having a vaccine to fight breast cancer that previously thought. The researchers have developed a vaccine that was tested and shown to be effective in mice. The next step is to test the vaccine in clinical trials, e.g. in humans.

According to Vincent Tuohy, Ph.D., the study’s principal investigator and an immunologist in Cleveland Clinic’s Lerner Research Institute Department of Immunology:

“We believe that this vaccine will someday be used to prevent breast cancer in adult women in the same way that vaccines prevent polio and measles in children. If it works in humans the way it works in mice, this will be monumental. We could eliminate breast cancer.”

There are two main types of vaccines: preventive vaccines and therapeutic vaccines. Preventive vaccines are those that we are most familiar with – the childhood inoculations such as MMR and DPT, as well as adult vaccines against yellow fellow and hepatitis. These vaccines start up the immune system to produce that antibodies for certain antigens, thus protecting the recipient from certain diseases. Therapeutic vaccines (also called treatment vaccines), on the other hand, are the new kid in the block. They work not a preventive measure but as treatment of an already existing condition.  The vaccine is designed to boost the immune system to better fight or control an ongoing infection or disease. Currently, there are many therapeutic vaccines against cancer being developed and tested.

There are currently two preventive vaccines targeting some types of cancer. According to the US-based National Cancer Institute:

“The U.S. Food and Drug Administration (FDA) has approved two types of cancer preventive vaccines: A vaccine against the hepatitis B virus, which can cause liver cancer in chronically infected people, and a vaccine against human papillomavirus types 16 and 18, which are responsible for about 70 percent of all cases of cervical cancer.”

The Cleveland Clinic prototype is the first of its kind preventive vaccine for breast cancer. The vaccine is made from the antigen and has been shown to prevent the development of breast cancer tumors in mice as well as slow down the growth of existing tumors. The mice tested were genetically engineered to be prone to breast cancer, thus representing a high-risk population. All these mice did not develop breast cancer. The α-lactalbumin antigen targets breast cancer cell without damaging healthy breast tissue. The vaccine will be tested in women as early as next year, targeting women over 40 years old, the age where breast cancer risk starts to increase and the likelihood of pregnancy is low.

Cancer in the headlines, June 4: breast cancer news

Peaches, plums induce deliciously promising death of breast cancer cells
What do peaches and plums have in common aside from being yummy? They are great as cancer cell fighters! Researchers at Texas AgriLife Research report that extracts from these two fruits make even the most aggressive breast cancer cells “keel over”. The anti-cancer powers of these two fruits are attributed to phenolic acids. More about these, next week.

Bone drug suppresses wandering tumor cells in breast cancer patients
Zoledronic acid (marketed as Zometa) is a drug prescribed to strengthen bones. But researchers at the Washington University School of Medicine in St. Louis report that this drug can also be beneficial for patients with metastatic breast cancer. “When the drug was given along with chemotherapy for three months before breast cancer surgery, it reduced the number of women who had tumor cells in their bone marrow at the time of surgery.”

Olive-oil enriched diet helps breast cancer survivors lose more weight
Olive oil is well-known for being a heart-friendly oil. Miriam Hospital researchers report additional benefits of this oil – inducing weight loss in breast cancer survivors. Brest cancer patients are prescribed low-fat diet to control weight because weight increase in these patients elevates the chances of cancer recurrence. The researchers report that a diet rich in olive oil is more likely to help weight loss than the standard calorie-poor diet.

Breast cancer genes not worsened by lifestyle
So you have the genetic predisposition for it. Does lifestyle make a difference? Researchers at the Cancer Epidemiology Unit at the University of Oxford say that lifestyle factors do not increase the risk for genetically-determined breast cancer. That doesn’t mean to say that you shouldn’t care about your lifestyle. Say lead author Ruth Travis:
“There’s a danger of feeling you’re at the fate of your genes. But whatever you’re born with, there are things you can do to modify your risk.”
Unhealthy lifestyle may not elevate your risks but a healthy one might help lower them. Think about it.

UT Southwestern unveils next generation CT scanner that views whole organs in a heartbeat
After all the recent safety issues of CT scans, this new generation scanner launched recently at UT Southwestern Medical Center is very much welcome because it is fast. The new scanner allows “doctors to image an entire organ in less than a second or track blood flow through the brain or to a tumor – all with less radiation exposure to patients.” Radiation from CT scans are believed to increase cancer risk, including breast cancer in women.

Mother and son fight breast cancer together

What are the chances that cancer strikes twice in a family? Rather high, I would say, since genetics is a risk factor in many types of cancer. However, the case of breast cancer striking a mother and son duo is rather uncommon as in the case of Lynda and Cedric Skillom.

Whereas breast cancer is commonly thought to be a woman’s disease, men do get the cancer even though breast cancer in men is relatively rare. Whereas the lifetime risk of developing breast cancer is 12% in women, the figure in men is about 1 in 1000. The American Cancer Society estimated that about 1,910 new cases of invasive breast cancer were diagnosed in men in 2009 and that about 440 men would die of the disease.

A large fraction of breast cancer is due to mutations in the BRCA1 or BRCA2. These two genes are tumor suppressors and mutations lead to uncontrolled cell growth and cancer. Although the BRCA gene mutations are closely linked to breast cancer, these mutations also increases the risk for other cancers such as cervical, colon, pancreatic, uterine, bile duct, gallbladder, pancreatic, and stomach cancers, and melanoma. The latest development in genetic testing has enabled testing for these mutations

Lynda Skillom was diagnosed with breast cancer and underwent treatment at the Loyola University Health System. She tested positive for BRCA2 mutation. Her 29-year old son Cedric also underwent genetic testing and tested positive for the same mutation. In men, inheriting the BRCA2 mutation means higher risk than inheriting BRCA1 mutation. About 10% of breast cancer in men is due to the BRCA2 mutation.

A precancerous lump found in Cedric’s breast warranted the performance of a double mastectomy, which according to oncologist and hematologist Dr. Patricia Robinson at Loyola: “A double mastectomy is often the best option for long-term prognosis for these patients.”

The American Cancer Society estimated that about 1,910 new cases of invasive breast cancer were diagnosed in men in 2009 and that about 440 men would die of the disease. Breast cancer screening is routine among women but not in men. In many cases, breast cancer in men is detected at a later stage than in women, thus with poorer prognosis. Thus, the breast cancer diagnosis and genetic testing of Lynn Skillom led to early screening and detection of breast cancer in her son that might have saved his life.

Lynda and her son Cedric celebrated Mother’s Day cancer-free.

The young drinker and her risk for breast cancer

Young and free – that’s how adolescents feel. But remember that you are not free to do anything you want as if there is no tomorrow. What you do today, can affect your health in the future.

Take the case of alcohol consumption. Teenage binge drinking is becoming a widespread problem in developed countries. A previous post indicated the health risks of adolescent drinking. Here is another study that reports an additional and very serious risk: the risk for breast cancer.

Researchers at Washington University School of Medicine in St. Louis and Harvard University report that teenage girls who drink alcohol increases their risk for benign breast disease and eventually more aggressive cancerous form of the disease.

According study author to Dr. Graham Colditz at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital:

“Our study clearly showed that the risk of benign breast disease increased with the amount of alcohol consumed in this age group. The study is an indication that alcohol should be limited in adolescence and early adult years and further focuses our attention on these years as key to preventing breast cancer later in life.”

The researchers looked at 6,899 American girls aged 9 to 15 years old as part of the Growing Up Today Study. The results of the study indicate that alcohol consumption increased the likelihood of developing benign lumps in the developing breasts. The higher the alcohol consumption, the greater is the risk. Those who drank 6 to 7 days a week have a 5.5 times likelihood of developing breast lumps and lesions. You may ask: who cares about a few benign breast lumps? However, many aggressive breast cancer start as benign, thus making these seemingly innocuous lumps important markers for cancer risk.

The validity of the results is high because it studied adolescents and followed them up to adulthood. Other studies on association between alcohol and breast cancer were on adult women who had to report on drinking habits in their younger years.

“There’s growing evidence that physical activity can lower breast cancer risk. We also know that diet and weight are important factors. Now it is clear that drinking habits throughout life affect breast cancer risk, as well.”

There has been evidence showing that alcohol consumption increases cancer risk. The current study suggests that the earlier a woman starts drinking alcohol, the higher is risk increase.

Acupuncture improves sex drive, quality of life in breast cancer patients

Cancer treatment comes with a lot of side effects, mild and severe, short-term and long-term. In recent years, complementary medicine has become an integral part of the management of the side effects of cancer treatment. The most popular complementary therapies are yoga, transcendental meditation, and acupuncture

In this recent study by researchers at the Henry Ford Hospital, acupuncture has beneficial effects that can reduce two other common side effects of breast cancer treatment – hot flashes and decreased sex drive.

 Acupuncture vs. drug therapy

The study compared venlafaxine (Effexor), a drug commonly used to manage hormone therapy side effects vs. acupuncture in 50 patients undergoing hormone therapy for breast cancer. Although effective, venlafaxine has its own die effects such as dry mouth, decreased appetite, nausea and constipation. The study showed that acupuncture is more effective in improving overall as well as mental health in this group of patients.

 Hot flashes

Night sweats and hot flashes are commonly experienced by breast cancer patients who undergo hormone therapy for breast cancer treatment. Although there are pharmacological agents (e.g. venlafaxine) that help ease these symptoms, acupuncture seems to have a longer-lasting effect compared to drugs.

According to lead author Dr. Eleanor Walker, division director of breast services in the Department of

Radiation Oncology at Henry Ford Hospital:

“Acupuncture offers patients a safe, effective and durable treatment option for hot flashes, something that affects the majority of breast cancer survivors. Compared to drug therapy, acupuncture actually has benefits, as opposed to more side effects.”

 Sex drive

Reduced sex drive is another side effect of cancer treatment. The study observed improved sex drive among patients who underwent acupuncture. Increasing a woman’s sex drive improves her sense of well-being.

 Quality of life

Night sweats and decreased sex drive are vasomotor symptoms caused by long-term hormone therapy. These symptoms lead to decreased quality of life, depression and even discontinuation of cancer treatment. However, patients who underwent acupuncture seemed to be able to cope better with the vasomotor symptoms. These reported a sense of well- being, more energy, and clarity of thought.

 About acupuncture

Acupuncture is a well-known form of traditional Oriental medicine based on the principle of stimulation of certain key body points. Acupuncture has been previously dismissed as “quack” by medical experts. However, its the health benefits is now slowly been recognized by. In a consensus statement in 1997, the National Institute of Health (NIH) stated

 “Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.”

The mammogram debate: the two sides

Mammogram guidelines questioned

Mammogram, the gold standard for breast cancer, is currently questioned just like what happened to prostate-specific antigen (PSA) s for prostate cancer. This was brought about by inconclusive research evidence that screening starting at 40 and beyond increases survival rates.

Last week, a heated debate started when the US Preventive Services Task Force (USPSTF) issued new federal guidelines on mammography which recommends that the starting age for mammograms to be raised to 50.

The previous US guidelines, with full backing from the American Cancer Society recommend that women should have the mammograms every 2 years starting at age 40. The recommendations applied to women with no family history of breast cancer and are therefore not considered to be high-risk. Those who have high risk profiles still need to continue regular screening tests.

The pros

The reasons for these new recommendations are quite similar in some ways to the reasons why many medical professionals (including the American Cancer Society) do not support routine prostate cancer screening with the PSA tests. Some of these reasons are:

• Too many false positives that result in unnecessary but invasive biopsy
• Overdiagnosis and overtreatment of a disease that is not necessarily fatal and may go away by itself.
• Too many false alarms that lead into mental pressure, unnecessary fears and worries. Why worry 10 years earlier?
• Mammograms present health risks, such as exposure to radiation
• Upgrade to international standards.
• Unnecessary healthcare costs

Indeed some of these points sound familiar in connection with the PSA test in 2008 and it was the same task force USPSTF that recommended the PSA 2008 guidelines. However, those guidelines were widely accepted, even embraced by the health community.

Regarding international standards, guidelines vary from country to country. Many developed countries, including the UK, Canada, set the age limit at age 50. I had my first mammogram 4 years ago in Germany. During my last gynecological check up here in Switzerland, I asked my doctor whether it’s time for the next one. But you are not yet 50, she told me.

Health care cost is another sore issue. Countries with universal health care system tend to cut down on screening methods that do not show conclusive benefits in order to allocate limited resources for what is necessary without compromising health care quality. Americans may dismiss this as “rationing” but it does have the upside of giving access to affordable health care to everybody.

The fact remains that there is no significant differences in breast cancer mortality between countries who start screening at 40 and those who start 10 years later.

The contras

Many health experts however, do not agree with the new guidelines

• For one thing, women without family history of breast cancer can have the disease before the age 40. For these women, forewarned is forearmed. They’d rather take unnecessary anxiety than miss the chance of an early diagnosis and therefore early treatment.
• Although the recommendations are not binding, there is danger that insurance companies might not cover mammogram expenses before the age of 50.

Some high profile health experts explicitly expressed their disagreement with the new guidelines.

American Cancer Society (ACS)

According to Dr. Otis W. Brawley Chief Medical Officer of ACS

“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider. When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions.”

Health and Human Services Secretary Kathleen Sebelius

Secretary Kathleen Sebelius in an interview advises women to “keep doing what they have been doing” with regards to breast cancer screening.

“The task force has presented some new evidence for consideration but our policies remain unchanged.Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action. ..My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions and make the decision that is right for you.”

Former head of the National Institute for Health Dr. Bernadine Healy

Ex-NIH director Dr. Bernadine Healy’s take is to ignore the new guidelines, which he believes, could save money but not lives.

Other resources:

Mammogram advice accurate but not ‘right’

Five Reasons to Welcome the New Mammogram Guidelines‎

To remove or not to remove a healthy breast

To remove or not to remove a healthy breast. That is a very difficult decision many women have to face when diagnosed with breast cancer.

Why remove a healthy breast?

The procedure is called prophylactic mastectomy, which is the removal of a noncancerous breast. This is considered to be an aggressive preventive measure in order to reduce the risk of developing cancer, and can also involve removal of the ovaries (oophorectomy).

What are the reasons for removal?

Women diagnosed with cancer in one breast can opt for removal of the non-cancerous breast as well.

Women with a strong family history of breast cancer.

Women who tested positive for mutations in the breast cancer genes BRCA1 and BRCA2.

How prevalent is prophylactic mastectomy?

Historically, the number of women opting for prophylactic mastectomy is low. However, a recent report by researchers from the New York State indicates that the number is increasing. The report looked at female New York residents from 1995 to 2005. 6,275 women underwent prophylactic mastectomy. 81% of these women have been diagnosed with cancer in one breast but not the other. The rest had no personal history of breast cancer. During the study period of more than a decade, the rate of prophylactic mastectomy doubled. The increase is mostly due to women who had cancer and opted for removal of healthy one.

According to study leader Dr. Stephen Edge of the Roswell Park Cancer Institute

“These data from New York are the only data on a large population of women that examine the use of bilateral prophylactic mastectomy. These data demonstrate that prophylactic mastectomy is an uncommon procedure that is performed most commonly on women with a personal history of breast cancer. Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing.’ In addition …women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.”

Is prophylactic mastectomy necessary?

Current state of evidence does not support the belief that removal of a non-cancerous breast would lower the risk or prevent the development of cancer, even among those in high-risk groups.

According to Dr. Marissa Weiss at Breastcancer.org:

“Simply having a proven gene abnormality does not necessarily mean that a woman will develop breast cancer, or that her cancer will be any worse than cancer that does not stem from an inherited genetic flaw.”

The take home message is that women should think twice and weigh the risks and benefits of having a noncancerous breast removed.

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