Hypnosis Eases Pain of Breast Cancer Surgery

Other benefits: Less anesthesia, faster recovery, less cost, study finds

Instead of pills and needles, hypnosis may ease the pain of surgery -- both during and after the procedure.
According to a new study, women who received hypnosis before breast cancer surgery needed less anesthesia during the procedure, reported less pain afterward, needed less time in the operating room and had reduced costs.
"This helps women at a time when they could use help, and it has no side effects. It really only has side benefits," said Guy Montgomery, lead author of the report and associate professor in the department of oncological sciences at Mount Sinai School of Medicine in New York City.
Montgomery hopes that the study, published online in the Aug. 28 issue of the Journal of the National Cancer Institute, will promote greater use of hypnosis in medical treatments.
Side effects such as pain, nausea and fatigue -- both during and after breast cancer surgery -- are commonplace. Previous research has suggested that hypnosis, a simple and inexpensive procedure, can help ease these problems. One small clinical study indicated that hypnosis was also effective for breast cancer patients about to undergo surgery.
For the new study, 200 women set for breast cancer surgery were randomly assigned to receive either 15 minutes of hypnosis with a psychologist or assigned to a group that simply spoke with a psychologist.
During the hypnosis session, the patients received suggestions for relaxation and pleasant imagery as well as advice on how to reduce pain, nausea and fatigue. They also received instructions on how to use hypnosis on their own.
The researchers found that women in the hypnosis group required less anesthesia and sedatives than patients in the control group, and also reported less pain, nausea, fatigue, discomfort and emotional upset after the surgery.
Those who received hypnosis also spent almost 11 minutes less time in surgery and had their surgical costs reduced by about $773, mainly as a result of the shorter time.
Although people think that hypnosis strips a person of control, it actually does just the opposite, said Dr. David Spiegel, author of an accompanying editorial in the journal and Willson professor and associate chairman of psychiatry and behavioral sciences at Stanford University School of Medicine.
"This is something that empowers patients," Spiegel explained. "If you're fighting, you think you're protecting yourself, but, actually, you're losing control, because you're getting into a struggle with your own body. You can teach people to float instead of fighting. You get the body comfortable and think more clearly. The weird thing is it actually works. If thoughts can make the body worse, it follows that thoughts could actually make the body feel better."
But will hypnosis catch on with health-care providers?
"We have this in-built skepticism of what goes on in the brain and the mind, and the idea is that the only real intervention is a physical one. Yet what supposedly distinguishes us is this huge brain on top of our bodies," Spiegel said. "It seems more scientific and desirable to give drugs than it does to talk to people and have them reorganize the way they're managing their bodies."
There are other obstacles. Many doctors find it more expedient to write a prescription than learn to perform hypnosis. Also, there's no industry pushing the technique as there is with drugs, Spiegel said.
On the positive side, little investment is needed to get a hypnosis program going, Montgomery said. "A psychologist or nurse could get training in a short period of time," he said. "It's not that involved."
Dr. Darlene Miltenburg, assistant professor of surgery at Texas A&M Health Science Center College of Medicine, called the new study "superb."
"Anybody who has an open mind would realize that this treatment works and is scientifically proven. It's not black magic," Miltenburg said. "It's real, and we do use it here. It's very time consuming, that's part of the problem, taking a pill is much easier. But just like many things in life, we want a quick fix rather than something that takes longer."

8 tips to cancer-proof your body:Straight from the lab: Stealth strategies for keeping the Big C at bay

The average mouse doesn't care much about skin cancer. Outside of Disney cartoons, you won't see one slathering on sunscreen before heading out to dodge cats and search for cheese. But Gary Stoner, Ph.D., a professor emeritus of hematology and oncology at the Ohio State University medical center, does care about cancer. That's why he spends his days in a lab, feeding rodents polyphenols from seaweed and learning how to shrink skin cancer–like tumors. He's a mouse's best friend. Maybe yours, too.
Stoner is just one of many researchers working to bring new weapons to the cancer battle. Some study humans to take a fresh look at existing theories. Others, like Stoner, are testing tactics so bold that, so far, their only subjects have tails and whiskers.
But all these approaches (seaweed included) have one very positive thing in common: They're just plain good for you and bad for cancer cells. Here are eight strategies that just may turn the Big C into the Big See-Ya-Later. (Or, better yet, See-Ya-Never.)

Drink pomegranate juice

Some say this luscious, lusty red fruit is Eve's original apple, but what the pomegranate truly banishes is cancer risk. The fruit's deep red juice contains polyphenols, isoflavones, and ellagic acid, elements researchers believe make up a potent anticancer combo. It's been shown to delay the growth of prostate cancer in mice, and it stabilizes PSA levels in men who've been treated for prostate cancer. And now University of Wisconsin at Madison researchers have learned that pomegranate may also inhibit lung-cancer growth. If you currently smoke, have smoked in the past, or hang around in smoky places (Cleveland, for instance), the juice of the fruit could bolster your defenses.
Use it: The mice in the Wisconsin study received the human equivalent of 16 ounces of juice per day, so quaff accordingly.

Eat blueberries

Got pterostilbene? Rutgers University researchers say this compound — found in blueberries — has colon cancer–fighting properties. When rats with colon cancer were fed a diet supplemented with pterostilbene, they had 57 percent fewer precancerous lesions after 8 weeks than rats not given the compound did. Eat blueberries and you'll also benefit from a big dose of vitamin C (14 milligrams per cup). In a study of 42,340 men, New England Research Institute scientists discovered that men with the highest dietary vitamin C intake (as opposed to supplements) were 50 percent less likely to develop premalignant oral lesions than men with the lowest intake were.

Use it: "About two servings daily is the human equivalent of what we fed the rats," says Bandaru Reddy, M.D., Ph.D., a chemical-biology professor at Rutgers. Load up at breakfast: A cup and a half of blueberries over cereal, plus 8 ounces of juice and half a grapefruit (for extra vitamin C), will do the trick. If that's too much to stomach at dawn, spread it out over the course of the day.

Relax a little

Purdue University researchers tracked 1,600 men over 12 years and found that half of those with increasing levels of worry died during the study period. Talk about flunking the exam. Only 20 percent of the optimists died before the 12-year study was completed. More anxiety-producing news: Thirty-four percent of the neurotic men died of some type of cancer. How neurotic are we talking? "Think of the biggest worrier you know — someone who stresses out over everything," says psychologist Daniel Mroczek, Ph.D., who conducted the study. "That man is probably above the 95th percentile in neuroticism. Then think of the most cool, calm, collected man you know. He's probably below the fifth percentile."
Use it: To develop that critical, casual Jeff Spicoli vibe, learn to slow down your fast times: "The more time you spend in the present moment, the more relaxed you'll be, because most mental anguish occurs over stuff that's already happened or that may or may not happen in the future," says Claire Wheeler, M.D., Ph.D., the author of "10 Simple Solutions to Stress." "For the most part, right now is pretty damn good. If you practice being present while shaving, for example, eventually you'll also be more present when eating, making love, and working."

Pop selenium

Selenium has long been thought of as a cancer fighter, but you can have too much of a good thing, says David J. Waters, Ph.D., D.V.M., director of the Gerald P. Murphy Cancer Foundation, in West Lafayette, Indiana. A study of almost 1,000 men, published in the Journal of the National Cancer Institute, found that when those with the lowest initial levels of selenium in their bodies received a daily supplement over a 4 1/2- year period, they cut their prostate-cancer risk by an impressive 92 percent. But men who started out with high selenium were rewarded with an 88 percent increase in total cancer risk when they took the supplements. Moral: It pays to get your selenium level right.
Use it: Selenium in the body is measured through toenail clippings. Send yours to the Murphy Foundation, and for less than $100 (price varies by state), they'll ship them to a lab and then inform you of your level 2 weeks later. If yours is out of range, the foundation will explain how to adjust your intake of Brazil nuts, tuna, meats, grains, and selenium supplements. Learn more at http://www.seleniumhealthtest.com/.

Order sushi

As mentioned, Gary Stoner is using seaweed to fight the Big C. When he fed the polyphenols from brown seaweed to mice that had been bombarded with UV rays, their incidence of skin tumors dropped 60 percent. And the polyphenols shrank existing tumors by 43 percent. Better still, the doses that produced these effects were the equivalent of only 1 or 2 tablespoons in a human being. "Seaweed is low in calories and fat, yet it provides heart-helping fiber, bone-building calcium and iron," says nutrition consultant Molly Morgan, R.D., C.D.N., owner of Creative Nutrition Solutions, in Vestal, New York. "Dried, roasted seaweed sheets used in making sushi also provide vitamins A and C."
Use it: "Eat more sushi rolls," says Stoner. "It's not quite the same seaweed, but it has some of the same compounds." As a bonus, sushi itself is a great muscle food. A typical spicy tuna roll has only 290 calories but packs 24 grams of protein. Also, look for a Korean-made, seaweed-fortified drink called EntroPower (entropower.com), which should be hitting U.S. health-food stores soon.

Spend more time outside

Scientists have viewed vitamin D as a potent cancer fighter for decades, but there's never been a gold-standard trial — until now. A Creighton University study published in the American Journal of Clinical Nutrition found that women who supplemented their diets with 1,000 international units of vitamin D every day had a 60 percent to 77 percent lower incidence of cancer over a 4-year period than did women taking a placebo. "I don't think the effect is limited to women," says Joan Lappe, Ph.D., the lead study author. "Vitamin D is necessary for the best functioning of the immune system — it causes early death of cancer cells."

Use it: Nature intended us to make vitamin D from the sun, but depending on where you live, the time of year, and how much of an agoraphobe you are, you may not reach the optimal level of 80 nanomoles per liter of blood that way. A blood test can give you a baseline. From there, Lappe recommends supplementing with 1,100 to 2,000 IU of vitamin D in a stand-alone pill every day. Vitamin D is also in sardines, salmon, shiitake mushrooms, and reindeer meat — which may explain Santa's longevity, despite the odd hours and jelly belly.

Clear your air

Secondhand smoke may be even worse for you than we thought. A recent American Journal of Public Health study reveals that nonsmokers working in smoky places had three times the amount of NNK, a carcinogen, in their urine than nonsmoking workers in smoke-free joints had. And their levels of NNK rose 6 percent for every hour worked. "There is no safe level of exposure to secondhand smoke, and the greater the exposure, the higher the risk," says the study's lead author, Michael Stark, Ph.D., principal investigator for the Multnomah County Health Department in Portland, Oregon.
Use it: Nine states have banned smoking in all workplaces, bars, and restaurants: Arizona, Delaware, Hawaii, Massachusetts, New York, New Jersey, Ohio, Rhode Island, and Washington. So change locations, change professions, or change the laws. As you sip your pomegranate juice, sign up with Americans for Nonsmokers' Rights at no-smoke.org.

Invest a little sweat equity

Study after study has pointed to the cancer-beating power of exercise. Now research from Norway has found that even a tiny dose of exercise has big benefits. A study of 29,110 men published last year in the International Journal of Cancer shows that men who exercised just once a week had a 30 percent lower risk of metastatic prostate cancer than did men who didn't work out at all. Increasing the frequency, duration, and intensity of the exercise correlated with a further, gradual reduction in risk.
Use it: Just one bout of weekend warriorism — a company softball game, pickup basketball, racquetball with your crusty uncle — might qualify you for inclusion in the cancer-free 30 percent.

Flower Power: A Cure for Cancer?

There is a flower in my garden that spreads so rapidly it has become a pest, and it has resisted all efforts to kill it.
Now it turns out that the flower — a common bachelor button — and it's more famous relative, feverfew, may have the power to kill cancer.
That's far from certain at this point, but clinical trials are set to begin soon in England to determine whether a modified derivative from this plant is safe to administer to terminal leukemia patients. If it does no harm to the patients, clinical trials will start in this country, possibly within six months, to determine whether the flower does indeed kill cancerous cells in the blood while leaving healthy cells alone.
A successful outcome would be an astonishing breakthrough in the fight against cancer because this type of treatment approaches the disease from a new direction, but because most new drugs fail during the rigorous trials this could turn into just another false hope. However, laboratory tests on cancer cells at the University of Rochester Medical Center have been encouraging enough to at least lead to a next step — testing the drug for safety.
"We don't want to raise false hopes here," said lead researcher Craig T. Jordan of the University of Rochester. "If something bad happens at the phase one trial, we won't go beyond that."
It has taken years to get this far because the road to cancer cures is littered with failed promises, but there were hints many years ago that there was something special about feverfew. The journey from the garden to the cancer ward involved many researchers, helped by some critical breakthroughs in our understanding of cancer. It's not the same battle today that it was just a decade or so ago.
This story begins a couple of centuries ago when people depended upon herbs for medical treatment. Certain plants were known to help alleviate pain and feverfew, which looks a lot like a daisy, was used to ease headaches and inflammation. An extract from the plant, parthenolide, was eventually isolated and packaged in pills, and it is sold today in health food stores as a treatment for migraine, arthritis and other ailments.
There were hints years ago that the chemical might also be useful in the fight against leukemia, but an early trial ended in failure because it was not absorbed into the blood and thus could not attack cancerous blood cells even if it had the power to do so.
Meanwhile, cancer research had turned up a surprising development. In 1977, John Dick of the University of Toronto made a remarkable discovery. He found that some of the cancerous cells in leukemia were stem cells, those magical cells that morph into different kinds of adult cells, like blood cells. Could it be, a few scientists wondered, that aberrant stem cells actually cause cancer?
If true, to have any hope of ever eradicating cancer scientists would need to figure out how to get to the stem cells and stop the disease at its roots. Scientists around the world began searching for stem cells in all sorts of cancers, and found them nearly everywhere they looked — in breast cancer, and later in the brain and bone. Those findings have led some scientists to conclude that many, and possibly all, tumors begin at the stem cell level.
The news electrified the University of Rochester's Jordan and his then-graduate student Monica L. Guzman. About 10 years ago, Guzman began studying the molecular structure of stem cells.
"We were trying to find differences between the normal stem cells and the leukemia stem cells," Guzman said. She found one key difference. The cancer cells had what the researchers call a "survival factor," a mechanism for staying alive.
"The normal stem cells don't have it," she added.
Bingo. If Jordan and Guzman could figure out how to inhibit the survival factor, the cancerous cells would die and the normal cells would be left alone.
Guzman's earlier work on the molecular structure of stem cells suggested a possible course. The researchers now knew enough about stem cells to try and match the cancerous cells with a chemical that could inhibit the survival factor. When they gave the cancerous cells a dose of parthenolide, they hit pay dirt.
"It was very effective on the leukemia stem cells without harming the normal stem cells," Guzman said.
Very encouraging findings, but there was still the problem of absorption. If the drug just passed through the body without remaining in the blood, it couldn't do its work. So Jordan and Guzman turned to colleague Peter Crooks, an internationally known biochemist at the University of Kentucky. Crooks has discovered scores of drugs and holds more than 100 patents. He combined parthenolide with dimethylamino, producing a water-soluble chemical that the scientists believe will attack leukemia at its roots.
A successful outcome will set it apart from other drugs because it would eliminate the source of the cancerous cells, thus there should be no relapses. But of course what works in a laboratory frequently doesn't work in the real world.
"This is a molecule that has never been introduced in a patient before," said Jordan, painfully aware that even discussing his research could lead to heartbreak for thousands of leukemia patients and their families.
So the first step is to ensure that the treatment does no harm. The patients that are awaiting the phase one trial have already been treated with virtually every cancer drug that's available, and all of them failed. They are hanging on mostly to hope. Phase one will begin by the end of this year, and could be completed in about six months.
"But if you say six months to one of these patients they think it's an eternity," Jordan said.
The initial trial will take place in England under the direction of a British colleague of Jordan's who has already been approved to test the drug for safety. If the drug's successful there, Jordan expects numerous trials to begin almost immediately in the United States.
Because the drug is designed to attack cancerous stem cells, it's possible it will be useful in the treatment of various cancers, including breast and prostate, but at this point that's very uncertain.
But if it works on any of those, it will signal a turning point in the fight against one of the most dreaded diseases on the planet. Unfortunately, that's a very big if.

Yoga can give women with breast cancer a boost

Special yoga classes can significantly improve the quality of life and well being of women with breast cancer patients -- particularly those who are not taking chemotherapy -- a new study shows.
A diverse group of low-income women participated in the study, Dr. Alyson B. Moadel of the Albert Einstein College of Medicine in the Bronx, New York, noted in an interview with Reuters Health. "Our patients really enjoyed the yoga classes, it was very well received by them," she said. "It really fit in with their own cultural interests."
There is mounting evidence that yoga can improve quality of life in both healthy and chronically ill people, Moadel and her team point out in the Journal of Clinical Oncology, while quality of life may be particularly affected for cancer survivors who belong to ethnic minorities and other underserved minority populations.
To investigate whether yoga could help cancer patients and survivors feel better, the researchers randomly assigned 128 women to a 12-week yoga intervention or a wait list "control" group.
Classes were offered three times a week, and participants were urged to attend at least one class a week, and also instructed to do the exercises at home with the help of an audiotape. The Hatha yoga-based exercises had been developed especially for breast cancer patients by one of the study's authors, and were done while participants were either sitting in a chair or lying down.
During the course of the study, patients in the control group showed greater declines in well being than women in the yoga group. When the researchers omitted patients undergoing chemotherapy from their analysis, they found that the women who did yoga showed improvements in quality of life; greater emotional, social and spiritual well being; and less distress.
People often feel fatigued and sick while undergoing chemo, Moadel noted, which is likely why yoga didn't appear to be helpful for study participants on chemotherapy.
Just 69% of the women in the yoga group actually attended classes, and those who did attended an average of seven during the course of the study. Study participants had many demands to cope with, from medical and health issues to taking care of family members, Moadel noted, which may explain why many didn't make the classes.
Nevertheless, the women who did attend the classes enjoyed them, she added, and the more classes they attended, the more benefit they experienced.
Hospitals and cancer centers are increasingly offering yoga programs to cancer survivors, Moadel said, and interested people should contact local facilities or advocacy groups like the American Cancer Society to find out if there are yoga programs in their area. However, she cautioned that breast cancer survivors should talk with their doctor before starting an exercise program, and should only take classes specifically designed for them.
"I would not recommend a regular yoga class at a studio that is not geared or targeted to someone with cancer, particularly if they are undergoing treatment," Moadel said, noting that breast cancer patients frequently have arm and shoulder problems that could be aggravated by some exercises.

Take an active role in fighting breast cancer

Reducing the risk for breast cancer is part healthy living and part vigilance about screening for the disease.
Doctors recommend a colorful, balanced diet of fruits, vegetables and whole grains. But no matter how many blueberries or broccoli bunches a girl eats, there remains some fundamental bad news when it comes to dodging breast cancer.
"The biggest risk factors are being female and getting older, and you can't control those," said Michele Ostrander, executive director of the Houston affiliate of Susan G. Komen for the Cure.
Indeed, 75 percent of women diagnosed with breast cancer's only risk factor is aging, said Dr. Therese Bevers, medical director of the cancer prevention center at University of Texas M.D. Anderson Cancer Center.
But that doesn't mean that women — or men — can't take an active role in fending off the disease, Ostrander said. In general terms, that means stay fit, eat healthy foods, know your risk category, perform monthly self breast exams and get regular mammograms.
"We know when we catch the cancer when it is still in the breast tissue...the survival rate is 98 percent," Ostrander said.
That's the good news.

Risk factors

• Age: "If you look at women diagnosed with breast cancer, the vast majority have no other risk factor," Bevers said.

• Family genes or history: Doctors pay particular attention to close relatives, especially fathers, and mothers, sisters and daughters who had premenopausal cancer.

• Hormones: Periods that started before age 12 or ended after age 55. Women who never had children or had the first child older than 30. Estrogen and progesterone hormone mixes taken for menopause.

• Breast biopsies: It's not so much the biopsies but the condition that required them or a diagnoses such as lobular carcinoma in situ.A run-in with cancer earlier in life is also a risk to consider.

Risk categories and tips

• Average risk: This group has few risk factors, but, well, we are all getting older by the minute. Maintain a body mass index of less than 25. Eat 5 to 9 servings of fruit and vegetables daily. Go easy on the red meat. Exercise at least 45 minutes five days a week since regular exercise can reduce the risk by 10 to 25 percent, Bevers said. Do not drink more than seven alcoholic drinks a week. Minimize use of hormone therapies for the symptoms of menopause.

• Increased risk: This group has more risk factors including a prior history of breast cancer, breast biopsies, or diagnoses such as lobular carcinoma in situ. Reduction tips include drug therapies. There are serious risks and varying opinions about the efficacy, so patients should consult their doctors and carefully make a decision. For some patients, drugs such as tamoxifen or raloxifene, recently FDA approved, can reduce risk, Bevers said.

• High risk: Group includes carriers of an abnormality in the breast cancer genes, and family history, especially of a mother or sisters with premenopausal breast cancer. For women at really high risk levels, running, eating spinach and abstaining from alcohol probably won't tip the scales much. But they can't hurt, doctors said. In addition to drug therapies, doctors and patients also consider prophylactic mastectomy, said Dr. Banu Arun, associate professor of breast medical oncology and co-director of clinical cancer genetics at M.D. Anderson. "It comes down to the patient's preference and choice," she said. "We are there to give them the facts in detail."

Komen's screening guidelines

• Age 20: Monthly self breast exams. Know your body.

• Age 20-39: In addition to self exams, exam by a physician every three years.

• Age 40: Mammography annually

• Note: Those at high risk should have a clinical breast exam every six months, MRI screening and ovarian screening.

SNM offers PET scan tips for patients during National Nuclear Medicine Week

The first week in October is Nuclear Medicine Week. This year, this awareness week comes just two weeks after the National Academy of Sciences (NAS) released the findings of its yearlong study into the future of nuclear medicine.
The study recommended that federal funding for basic nuclear medicine/molecular imaging research be enhanced. The report recognized the importance of nuclear medicine in the care of patients with many illnesses, including cancer, heart disease, and Alzheimer's and Parkinson's diseases. It helps diagnose disease, plan the best treatment and monitor the effectiveness of therapies. ('Advancing Nuclear Medicine Through Innovation,' NAS Summary)
SNM (the Society of Nuclear Medicine) applauds NAS for bringing light to the crisis in patient care that will develop if the United States lets this line of medical research fall dormant.
"Research funded by DOE over the last 50 years has led to many life-saving techniques that are now used daily, improving patients' outcomes. Positron emission tomography (PET) scans are one of the most important of these techniques. PET scans are used in the diagnosis and staging of cancer," said SNM President Alexander J. McEwan. "With proper funding, basic nuclear medicine research will continue to improve patient care through new therapeutic isotopes to cure disease, earlier diagnosis of Alzheimer's disease and cancer, detection of the effectiveness of cancer therapies, development of the next generation of imaging technologies and more," added McEwan, who speaks for more than 16,000 members of the world's largest society for molecular imaging and nuclear medicine professionals.
Currently, more than 20 million men, women and children need noninvasive nuclear medicine/molecular imaging procedures each year. These safe, cost-effective procedures include PET scans to diagnose and monitor treatment of cancer, cardiac stress tests to analyze heart function, bone scans for orthopedic injuries and lung scans for blood clots.
In light of National Nuclear Medicine Week, SNM offers patients the following tips to better understand what to expect if their doctor recommends a PET scan procedure.

-What is a PET scan? A PET scan is a biological imaging exam that provides information about how a patient's cells are 'behaving' or functioning.

-Why is the doctor recommending a PET scan? A single PET exam can provide information that once would have required many medical studies, and it can do so without the surgery that those studies might have required. PET scans are most often used to detect cancer and monitor response to treatment. PET scans are also used to evaluate heart disease, neurological conditions and other physiological problems.

-What should a patient expect? Most PET scans are done as outpatient exams. Patients receive a small dose of a radioactive pharmaceutical and remain on a bed while the radiotracers are detected or 'traced' by a special type of camera that works with computers to provide precise pictures of the area of body being imaged. The entire process can take as little as one hour. Because PET is noninvasive and does not involve the risks of surgery, PET scans can be performed repeatedly, if necessary, with minimal risk. The very small amount of tracer administered remains in the body for only a short period of time; there are no known long-term adverse effects from such low doses. After the scan, a nuclear medicine physician reviews the images, prepares a written report and discusses the results with the patient's doctor.

-What are the benefits? PET scans provide valuable information for cancer diagnosis (breast, cervical, colorectal, esophageal, head and neck, lung, lymphoma, melanoma, pancreatic, thyroid and others); evaluation of cancer therapy; and diagnosis of heart disease (and the potential effectiveness of treatment), Alzheimer's disease, Parkinson's disease, dementia, epilepsy and other neurological diseases. This type of imaging can show changes much earlier than other imaging tests like CT or MRI.

-Does insurance cover PET scans? Many PET scans are covered by insurance; pre-authorization is usually needed or advised. However, recent changes in legislation have limited access to PET scans for Medicare patients by decreasing reimbursements at outpatient facilities.
-What if my doctor wants me to have a PET/CT exam? Nuclear medicine researchers are investigating new radiotracers and new applications of PET that may reveal disease processes that have never before been imaged. PET is now being combined with other imaging techniques-such as computed tomography (CT)-to create 'fusion' images that provide functional information with anatomical context. PET-alone and in combination with other techniques-will continue to provide a unique closer look into the body and yield valuable information in the development of treatments and preventive health measures.

-Where can I learn more about PET, PET/CT and molecular imaging/nuclear medicine? SNM encourages patients to be their own advocates and talk to their doctors about whether a PET scan is right for them. To learn more about molecular imaging and nuclear medicine, visit SNM's Web site (www.snm.org) for information and resources on specific imaging procedures.

Finding ways to protect yourself from cancer

In college, we do not always think about the way our lifestyles can affect our futures. Certain choices made today may have a direct effect on our health and can specifically increase cancer risk. The following are examples of ways to decrease your risk for some types of cancer.Skin cancer from UV rays is the most common of all cancer types. People who are at a greater risk include those with fair skin, moles, those who burn easily, those who have a family history of skin cancer, take oral contraceptives/antidepressants and spend a lot of time outdoors. To protect from skin cancer, find shade and wear hats and sunglasses when outdoors. When using sunscreen, apply SPF of at least 15 every two hours. Also, check yourself monthly for skin changes and report them to your doctor. Tobacco use accounts for about one-third of all cancer deaths in the United States and causes 90 percent of all lung cancer. Smokers are not the only ones being harmed by their habit. Second-hand smoke kills, too. Cancers caused by tobacco use include cancers of the oral cavity, esophagus and even the bladder. The first thing to do is to quit smoking. Call the Pennsylvania Quit line at 1-800-Quit Now. Call the Student Health Center for an appointment to discuss free medication to help with quitting. Pick up a Quit-Kit at the Wellness Center. If one chooses to smoke, avoid smoking around others.Diets high in fruits and vegetables may help reduce the risk for cancer and heart disease. To get the five recommended servings of fruits and vegetables, try these tips for a day.For breakfast, top cereal with fruit, such as a banana, and drink four ounces of 100 percent fruit juice. At lunchtime, add a small side salad with low-fat dressing to any meal for an extra serving of vegetables. Even if a person only has five minutes, dinner veggies are easy and delicious. Heat canned or frozen peas or cauliflower in the microwave for a quick side dish. For a snack idea, freeze half a cup of fresh fruit.

Also, a handful of fresh baby carrots or a cup of applesauce will add another serving to your diet.Drinking alcohol in college can increase the risk for certain cancers later in life such as breast cancer, esophageal cancer, prostate cancer and stomach cancer. To protect yourself, try to limit alcohol consumption to one drink per day.Genital HPV or Human papillomavirus has been linked to cervical cancer, according to tellsomeone.com. To help protect your future keep these things in mind. Have regular pap tests, limit your sexual partners, and use a condom every time. Stay in a long-term exclusive relationship. Lastly, consider the Gardasil injection, which is available at the health center.For more information on ways to decrease your risk for cancer, please visit www. Cancer.org.

Breast health and cancer prevention tips for women and men

In addition to the bright reds, oranges and yellows seen as the leaves turn this fall, pink will be everywhere during October, which is National Breast Cancer Awareness Month.
According to the American Cancer Society, breast cancer accounts for nearly one in three cancers diagnosed in American women. About 178,480 women will be found to have invasive breast cancer in 2007, according to the ACS. More than 40,000 will die. Breast cancer is the second leading cause of cancer deaths in women, exceeded only by lung cancer.
However, it doesn't just strike women.
The ACS estimates that more than 1,700 cases of breast cancer in men will be diagnosed in 2007. The disease will kill about 460 men.
It is not only women who pass on to female relatives the genes for developing breast cancer, said Robert Goulet Jr., M.D., medical director of the Breast Care and Research Center at the Indiana University Melvin and Bren Simon Cancer Center and professor of surgery at Indiana University School of Medicine. "It is important to recognize that risk can be inherited from the mother's or father's side of the family," he said.

In addition, a woman is at greater risk of developing breast cancer if she has one of the following:
A personal history of breast, ovarian or colon cancer
A close relative who was diagnosed with breast cancer before menopause or in both breasts
Never had children or delivered her first child after age 30

Dr. Goulet added that a patient's medical history also is important in determining if she will develop breast cancer. Patients who have a history of receiving radiation therapy for other conditions are at greater risk, as are those who have undergone numerous breast biopsies.
Obese women,especially those who are post-menopausal, women who consume excessive amounts of alcohol (greater than two ounces per day) and those who smoke are at increased risk.
As with so many other diseases, exercise can help ward off breast cancer. "Women who exercise as little as 30 minutes three times a week can decrease their risk of breast cancer," Dr. Goulet said.
He also added that exposure to underarm deodorants, hair dyes and caffeine does not increase a person's chances of developing breast cancer.
Unfortunately, most women - and men - often don't have any symptoms to make them suspect anything is wrong. "Most women who present with clinically detectable breast abnormalities have had their cancers for a decade or more," Dr. Goulet said.
What should women look for?
An obvious mass and changes in the skin or nipple such as itching, reddening, thickening, ulceration, or retraction are causes for concern, according to Dr. Goulet.

Other symptoms include:
Spontaneous nipple discharge
Bloody nipple discharge
Changes in the size or shape of the breast
Although uncommon, breast pain may be an indication

Once detected, breast cancer is usually treated by both local therapy and systemic therapy.
In local therapy, the goal is to eliminate the cancer in the breast and the related lymph nodes and minimize the risk of recurrence. Treatment options include surgery and radiation therapy.
Systemic therapy involves eliminating tumor cells that might have escaped into the circulation and minimizing the risk of developing distant sites of tumor growth. Treatment options include chemotherapy, hormonal therapy, and a newer and ever-expanding class of agents known as biological therapy.
"The biological agents are utilizing scientific breakthroughs in the secrets of tumor cells to destroy cancer in ways that are focused specifically to the patients' tumor," Dr. Goulet said.
He added, "These options are the same for male breast cancer patients. Stage for stage, they have the same outcome as women."
Overall, breast cancer knows no boundaries. "Breast cancer follows no rules with respect to age, race, or gender and if a patient is unsure of risk or concerned with a new finding, she -- or he -- should seek attention," Dr. Goulet said.

Beauty tips for cancer patients

Looking good can be an effective hedge against feeling absolutely rotten. So when cancer treatments take a toll on your skin and hair, that's truly adding insult to injury. But there's help from makeup artist Ramy Gafni, a survivor of non-Hodgkins lymphoma.
Mr. Gafni, who has a cosmetics line at www.ramy.com, teaches classes at New York's CancerCare and has written Ramy Gafni's Beauty Therapy: The Ultimate Guide to Looking and Feeling Great While Living With Cancer (M. Evans and Co. Inc., $25).
Here are some of his tips for looking good throughout your cancer treatment.
Skin care
Your favorite products probably won't be kind enough right now. "It's best to just assume you're sensitive, and treat yourself with kid gloves," Mr. Gafni says. "Use very basic products – no anti-aging or fruit acids, anything exfoliating. In fact, I highly recommend baby products – Johnson's Baby Wash or Baby Lotion."
If you lose your hair, give your scalp tender care. "Treat the top of the head as an extension of your face. It's skin, just like the rest of you, but it's like baby skin that's never been exposed to anything."

For radiation burns, try 100 percent pure aloe vera gel. "You can get it at health-food stores. Keep it refrigerated. It's very refreshing."

Skin tone
"I went through chemo myself. You look white, you look green, you look yellow. It was like multicolor skin. Every day was an adventure."
Men and women look better with a touch of powder or gel bronzer. "It livens up your complexion, and that's true for people of any ethnicity." Choose a medium shade. "Apply it where the sun would naturally hit you on your hairline, cheeks, chin." If the color seems bright, tone it down with translucent powder. "I prefer pressed to loose because with loose powder you get too much powder on your skin."
For dark circles around the eyes, apply a moisturizing concealer around the orb of the eye, from lash line to brow bone.
Even if you don't usually wear cosmetics or you gravitate to quiet colors, go for bold. "Adding a slightly bright blush or lip color can make a huge difference. Your face suddenly comes to life. If you're intimidated by color, try a sheer formula or a gloss."

Eyebrows and eyelashes
False eyelashes aren't a great idea. "When you're going through treatment, your immune system is compromised, and you're more susceptible to infection from the glue." Plus, he points out, you could be pulling out real, regrown eyelashes when you remove the fakes.
Use a neutral color to line the upper lash line. "Pen or pencil adheres to bare skin better than a powder. Don't make a straight line, smudge it. It doesn't have to be perfect. That actually looks like real hair."
While your lashes are vulnerable, avoid waterproof mascara. "It's cumbersome to remove, and you'll be pulling out the good lashes while you're tugging to remove it."
If your eyebrows get sparse, fill in the gaps with a color that's lighter than the remaining hairs.
If you lose your eyebrows altogether, make drawn-on brows look more natural by choosing a color that's as close as possible to your natural brows and then pat on some translucent powder. "That takes the sheen off the color, makes it look not so strong."
As your brows grow back, resist the temptation to clean up stragglers. "Wait until there's a line to work with. Bite the bullet and let it grow in. Don't keep pulling out strays. They might be part of your eyebrows once they come in."

Hair
People usually approach the wig issue one of two ways, Mr. Gafni says. One group gets playful and becomes the blonde, brunette, redhead or baldie Mother Nature never intended. Others are traumatized by the hair loss and want a wig that matches as close to their own hair as possible. "I advise those people to go shopping for a wig while you still have your hair. You don't know wigs, but the wig person knows hair. If it's too late to go while you have hair, bring a swatch and a picture of yourself with hair."

Weight gain over adult life increases women's risk of breast cancer

PUTTING on weight throughout adulthood can increase a woman's risk of breast cancer in middle age, according to new research.
Obesity was already known to be associated with post-menopausal breast cancer.

But new findings published in the Archives of Internal Medicine, link the risk of developing the disease after the menopause with weight gain from the age of 18.
The pattern was seen in women who did not take hormone replacement therapy, which is known to increase the risk.
Scientists in the US studied data from 99,039 post-menopausal women beginning in 1996.
A total of 2,111 of the women developed breast cancer in 2000.
Women who were not overweight or obese at 18, but were by the ages of 35 and 50, had a 1.4 times increased risk of developing breast cancer.
Losing weight appeared to protect against the disease. Women who lost weight had the same risk as those whose weight remained stable.
The scientists wrote: "These findings may reinforce public health recommendations for the maintenance of a healthy weight throughout adulthood as a means of breast cancer prevention."
• A new kind of sun protection ointment made from broccoli juice can marshal the body's defences against harmful ultraviolet rays, research in the US suggests.
In early tests on six human volunteers exposed to pulses of UV radiation, the extract reduced sunburn symptoms by up to 78 per cent. Conventional sunscreens used in the same experiments were ineffective.

HPV test detects cancer with 95% accuracy

No one wants cervical cancer screening to be like flipping a coin.
A recent study revealed the human papillomavirus (HPV) test is more effective at detecting cervical cancer than traditional Pap smears.
The preliminary research of the Canadian Cervical Cancer Screening Trial (CCCaST) was led by Dr. Eduardo Franco, director of the Division of Cancer Epidemiology at McGill University’s Faculty of Medicine.
Dr. Franco’s study discovered the HPV test detects signs of cancer with an accuracy rate of 94.6 per cent without generating false results. The Pap test has an accuracy rate of 55.4 per cent, which Franco compared to “flipping a coin.”
The CCCaST’s results, published in The New England Journal of Medicine, offer an alternative to the Pap smear, which has been the standard test for cervical cancer for almost 50 years.
Both the Pap smear and HPV test require the collection of a cervical sample; the difference lies in the analysis of the sample, explained Dr. Peter Ainsworth, head of molecular diagnostics at the London Health Science Centre.
Pap tests analyze cells under a microscope searching for abnormalities, while the HPV test is automated and detects the DNA of high-risk HPV strains known to cause cervical cancer.
“The Pap smear is looking at dismorphisms [where] the cells take different shapes and don’t look normal,” Ainsworth said.
“This DNA test is actually looking for the viral genome of these two specific subtypes of [HPV] that cause [cervical] cancer. They have a specific DNA sequence.”
The study concluded although the sensitivity of the HPV test was almost 40 per cent higher than the Pap test, the latter is less likely to generate false positives.
In a press release, Dr. Franco noted while a false positive may be psychologically distressing for a patient, it is more desirable than a false negative — which could allow cancer to develop undetected.
Ainsworth said, the HPV test will likely be an add-on to traditional screening.
“You must be very cautious about adopting a test without being fully sure that it is doing the job the original test is doing,” Ainsworth said.
Dr. P.K. Lala, professor emeritus of anatomy and cell biology at Western, said the HPV test is powerful.
“But on the other hand, it’ll take time for the test to be readily available.”

Breast cancer myths debunked

WITH so many rumors and controversy surrounding the causes of breast cancer these days, it is hard to determine what to believe. One thing is certain, being able to separate fact from fiction could play a major role in saving your life.
Here are some common myths surrounding breast cancer that have been circulating through emails, some sounding unbelievably realistic and around which many have sealed their fates. Dr Venslow Greaves, radiation oncologist at the Radiation Oncology Centre weighs in on what's true and what's fabricated. 1. The email: A girl whose mother recently got diagnosed with breast cancer said her doctor told her that women should not drink bottled water that has been left in a car. She said the doctor said the heat and the plastic of the bottle have certain chemicals that can lead to breast cancer. The heat causes toxins from the plastic to leak into the water and they have found these toxins in breast tissue. The truth: No, not true. No study has shown that plastic bottles or drinking from a plastic bottle causes cancer of the breast.
2. The email: Antiperspirants are a leading cause of breast cancer. Antiperspirants prevent you from sweating out dangerous toxins and these become trapped in the body causing breast cancer.The truth: Not so. This is a theory that has not been subjected to randomised testing. It is a theory that has run its time.
3. The rumour: Wearing a bra to bed, or wearing bras with wires can cause breast cancer. The claim is that underwire bras can constrict the body's lymph node system, causing breast cancer.The truth: Not true. This is another theory put forward because people don't know the exact cause of breast cancer. It cannot really be proven. This has not been statistically proven.
4. The rumour: If someone in your family had breast cancer you will automatically have it too.The truth: Not necessarily. You will be more predisposed to developing the disease than people without the hereditary trait, especially if a close family member had it, say a mother, father, sister or brother. Certain genes are said to be linked to breast cancer. But it doesn't mean you MUST get it.
5. The rumour: If there is no history of breast cancer in the family you are not at risk of getting the disease.The truth: That is not true. Most breast cancers arrive in women without family members having the disease.
6. The myth: Breast cancer only occurs after menopause.The truth: Not true. As long as you reach menstrual age then you can develop breast cancer. I have seen a patient who was 16. Studies have shown that women who start the menstrual cycle at an early age and menopause at a late age are at a higher risk.
7. The myth: Mammograms prevent breast cancerThe truth: Mammograms do not prevent breast cancer, but diagnose it very early.
8. The rumour: Eating high-fat foods and dairy products boosts your risk of breast cancer.The truth: Yes. Studies have shown that your diet is very important. This was shown in respect to both breast and prostate cancer.
9. The story: If you have small breasts, you're much less likely to get breast cancerThe truth: Myth
10. The story: Getting a hard blow eg a kick or punch in the breast can cause breast cancer.The truth: Myth

Broccoli Extract Could Help Head Off Skin Cancer

New research suggests that broccoli, the vegetable that the former president famously demonized as inedible, can prevent the damage from ultraviolet light that often leads to skin cancer. And as Bush would surely appreciate, he would not even have to eat it.

In tests on people and hairless mice, a green smear of broccoli-sprout extract blocked the potentially cancer-causing damage usually inflicted by sunlight and showed potential advantages over sunscreens.
The product is still in the early stages of development. Among other issues to be worked out is how best to remove the extract's green pigments, which do not contribute to its protective effects and would give users a temporary Martian complexion.
But scientists said the research represents a significant advance because the extract works not by screening out the sun's rays -- which has the downside of blocking sun-induced Vitamin D production -- but by turning on the body's natural cancer-fighting machinery. Once stimulated, those mechanisms work for days, long after the extract is washed away.
"Ultraviolet radiation is probably the most universal and abundant carcinogen in the world," said Paul Talalay of the Johns Hopkins School of Medicine in Baltimore, who led the research, published yesterday in the online edition of the Proceedings of the National Academy of Sciences. And although the new study stops short of proving that broccoli extracts can prevent human skin cancer, he said, it demonstrates "direct protection" against that carcinogen, which contributes to the 1 million U.S. skin cancer cases seen annually.
"It's very important work," said Michael Sporn, a professor of pharmacology at Dartmouth Medical School, who for nearly two decades headed the National Cancer Institute's program on cancer prevention by means of natural products.
"The use of dietary substances, like the antioxidant vitamins C and E, has been pretty much a colossal failure for protection against almost any kind of human disease," Sporn said, "because when you eat them they don't go where you want them to . . . and as soon as your body uses them up, they're gone."
By contrast, he said, boosting production of the body's own cancer-fighting mechanisms "is a new and promising approach."
Broccoli's rise from farm to pharma began in 1992 when Talalay and colleagues reported that broccoli -- and especially three-day-old broccoli sprouts, they found later -- is rich in sulforaphane, a compound that activates certain enzymes in the body.
Those "Phase 2" enzymes, such as glutathione S-transferase, can neutralize the DNA-damaging molecules that are created in the skin by the mix of oxygen and sunlight. They can also temper the inflammatory reactions that can turn precancerous cells into life-threatening tumors.
Talalay's discovery got his family and Johns Hopkins into the broccoli-sprout business. His son is chief executive of Brassica Protection Products LLC, which licensed the technology from Johns Hopkins and produces "BroccoSprouts" brand broccoli sprouts, a popular health food. But more recently Talalay has focused on sulforaphane as a topical protective against skin cancer.
His team exposed areas of volunteers' skin to intense ultraviolet light one to three days after the broccoli-sprout extract was applied to some areas. The extract was all but rubbed and washed away by the time the light exposure occurred, but by then the sulforaphane had turned on key genes in the skin cells, which beefed up production of Phase 2 enzymes.
Compared with untreated areas, spots treated with the extract had, on average, 37 percent less redness and inflammation -- key measures of future skin cancer risk. Other tests have shown that mice treated with the extract get significantly fewer and smaller skin tumors after exposure to ultraviolet light.
Allan Conney, director of the laboratory for cancer research at Rutgers University's School of Pharmacy, warned that the work only hints at an ability to prevent cancers in people and that in the study, the extract's ability to reduce ultraviolet-induced damage varied considerably from person to person, from a low of about 8 percent protection to a high of 78 percent. Still, he said, the broccoli approach "could have truly broad significance."
Albena Dinkova-Kostova, co-leader of the new study with Talalay and now at the University of Dundee in Scotland, said several hurdles stand between the experiments and a broccoli-based anti-cancer skin cream.
Among them are the need to find the most effective concentration of sulforaphane, increase the active ingredient's shelf life, and improve skin absorption of sulforaphane. That last task was accomplished in the tests by mixing it with acetone, an ingredient in nail polish remover that, while safe in small quantities, is not something people would want to slather on their skin.
Then there is the extract's green tint, which would be absent if the team were to synthesize the sulforaphane instead of getting it from sprouts. But that would raise safety and regulatory concerns.
"The advantage of starting with sprouts is that we all eat broccoli so we're not concerned with toxicity issues," Dinkova-Kostova said, adding that she anticipated no problems getting the green out.

Tips for coping with breast cancer

Life for a breast cancer patient can be a lonely one within. Besides having to deal with new treatments and possible side effects, a patient can feel the need to appear strong for family, friends and even herself.While support from loved ones is irreplaceable, women may also find it comforting to tackle the experience with the help of professionals available for free throughout the city.Nonprofit and government support programs can harness a breast cancer patient's wellness with everything from free counseling to support groups to activities such as yoga, cooking and even self-hypnosis. Others may turn to hotlines or online support with questions about treatment, doctor referrals or financial aid.
Coping techniques

Research shows that psychological help can aid physical condition as well as mental health. By easing stress or depression, treatment may encourage better relationships, engagement in additional treatments, exercise, nutrition and sleep. At support groups, patients can also learn from others' coping techniques when dealing with children, spouses or side effects.

Alterna-exercise

We all know the benefits of exercise. For breast cancer patients, it can boost feel-good endorphins and help patients change focus from plaguing thoughts. Gentle aerobics workouts, like classes offered at the free cancer support center Gilda's Club, are beneficial for post-reconstructive surgery patients.A new craze taking mats by storm is laughter yoga, which can actually boost natural killer cells, which attack some types of cancer and tumor cells. In this practice, yoga poses and breathing are interspersed with forced "ha," "hee" and "ho" sounds.Laughter yoga involves the skeletal system, heart and lungs."It's hard to make yourself laugh, but then something goes off and you can just feel it," said Nicole Ohebshalom, holistic counselor and laughter yoga instructor.

MRI: Better Than Mammography for Diagnosing Breast Cancer?

In the fight against breast cancer, there's a new method of early detection that may be more accurate that the mammogram.
Mammography is currently the most common method used to detect breast cancer, but it is only effective in women older than age 40 and often is not an option for women with very dense breasts.
Throughout the month of October — National Breast Cancer Awareness month — the idea that magnetic resonance imaging (MRI) may some day replace the mammogram has been much talked about.
The method has been hailed by experts as more effective in detecting early breast cancer than mammography. The only problem? It's an expensive method — the test can run about $1,000 compared to $100 for a mammography — and some insurance companies won't cover the procedure.
Some recent studies, conducted by the National Cancer Institute (NCI), found that MRI was not only more effective than mammography, but also better than ultrasound or other clinical breast exams in finding breast cancer in woman who had the screening.
A study conducted by the NCI between 1998 and 2002 found that MRIs were accurate in detecting breast cancer in 83 percent of the 54 women who participated in the study. The MRI returned a false positive in 17 percent of its diagnoses.

Still, more research is needed to support the fact that it is the better option in detecting breast cancer. Dr. Mitchell Schnall, professor of radiology at the University of Pennsylvania and the principal investigator for the NCI-funded group of researchers at the American College of Radiology Imaging Network (ACRIN) studying the benefits of MRI, believes mammograms should not be replaced by MRI.
“Mammography is the traditional way of finding breast cancer,” said Schnall. “In mammogram imaging, you can feel it.
“An MRI finds breast cancer by highlighting areas that have high blood flow which can signal possible cancer," continued Schnall. "It’s something that adds more contrast to images of blood flow."
Mammography is also better at detecting breast cancer calcifications, tiny calcium deposits within the breast tissue that appear as white spots on a mammogram, said Schnall. These calcifications are common, and most women have at least one, but tighter clusters of calcifications in irregular shapes may indicate breast cancer. Schnall said MRI may or may not pick up on calcifications.
Schnall added that women should consider having an MRI if they feel they are at risk of acquiring breast cancer. However, the extra cost of an MRI can be an impediment for some so they should only get one if they have had breast cancer in their family or feel they are in the high risk category.
“I don’t recommend doing all women, but I recommend women who are at (high) risk," he said. "Studies show that an MRI can pick up more cancer. Right now, it’s too costly to do study on the benefits on the general population, but it has proven good at detecting cancer.”
There can also be some hit or miss with mammography as well, according to one radiologist. “It is well known that mammography is not 100 percent sensitive in detecting all breast lesions,” said Dr. Michal Schneider-Kolsky, PhD, a senior lecturer at the School of Biomedical Sciences at Monash University in Victoria, British Columbia. “Miss rates vary on average by 10 to 20 percent depending on each clinic. Many clinics perform double reporting in order to reduce the miss rate. Ultrasound is the second line of investigation if there is a suspicion. Again, ultrasound can miss some lesions and patients may then be referred to MRI. At this stage, only a small number of patients will have an MRI since most clinics do not have the specific set up to perform breast MRI and because of the costs involved.”
Schnall and his colleagues will continue to focus on MRI and other screenings and their efficiency in detecting breast and other cancers — breast cancer being their largest area of research. So far, the group has 20 different trials, which are in various stages, and are tracking various aspects of imaging in detecting different cancer.
In addition to detecting cancer, they are also looking to MRI as an indicator in the effectiveness of cancer treatments. “We’re looking at MRI as a response marker in chemotherapy, so we can tell if chemotherapy is working early on, or if it is not working,” added Schnall.
Schneider-Kolsky and his colleagues are currently conducting a preliminary study of the usefulness of a targeted ultrasound after MRI in detecting breast lesions. He added that MRI can be the better option, but agrees that more research needs to be done to evaluate its effectiveness for screening the general population. Costs also need to be adjusted, so more women will not feel deterred by having an MRI if needed.
“MRI has, over the last 10 years or so, found a role in breast lesion evaluation," said Schneider-Kolsky, "specifically for preoperative planning for conserving surgery in infiltrating and in situ cancers, assessment of other lesions in the breast (same breast or other side), evaluation of lesion recurrence after lumpectomy or chemotherapy, screening in women at high risk for breast cancer, and also in the evaluation of suspicion of breast cancer when other imaging modalities (mammography/x-ray and ultrasound) were negative or equivocal.”

Studies: Breast cancer survivors reap the rewards of fitness

A study published in the Journal of the American Medical Association said moderate exercise could cut the risk of dying from breast cancer in half. This study showed that for women with breast cancer, moderate exercise - three to five hours of walking a week at a 3.2 to 4.7 km/h pace - could cut the risk of dying from the disease by 50%.
Two other studies are touting the benefits of physical activity for breast cancer survivors with the suggestion that exercise can improve the functioning of the immune system, improve energy levels, and make survivors feel better about their bodies.
In the first study, presented at a meeting of the US Department of Defense's Breast Cancer Research Program, researchers compared blood markers for immune system health in 28 breast cancer survivors who had been assigned to an exercise program to those of 21 survivors in a non-exercise group. The women were between the ages of 29 and 71 and had undergone chemotherapy, which can affect healthy cells in addition to the cancerous ones.
"We know that chemotherapy-induced decreases in T cells (which fight infection) can persist for many years, and data from the literature suggest that, in the period immediately following chemotherapy, the surviving T cells may be weakened as well," said lead author Dr. Andrea Mastro. "That's why we're pleased to find evidence that appropriate exercise can help a breast cancer survivor's immune system bounce back after therapy."
The exercise program, which lasted for six months, consisted of a warm-up routine, resistance training using flex bands, and an aerobic segment. For aerobic activity, participants could choose between walking, riding an exercise bike, and using a treadmill.
In addition to the boost in T cells, exercisers saw a decrease in blood concentrations of IFN-a, an inflammatory substance indicating trauma. The non-exercisers, meanwhile, saw an increase. As well, the exercisers showed improvements in such fitness markers as endurance, upper body strength, and maximal oxygen intake. They also scored higher on questionnaires measuring quality of life, social well-being and other psychological factors.
In the second study, 86 women who had completed treatment for early-stage breast cancer were assigned to either 12 weeks of exercise counseling delivered via telephone or to a control group, where they received a phone call but no counseling. After 12 weeks, the counseling group reported significantly more physical activity.
While there were no significant differences among the groups in body fat or body mass index, women in the "exercise counseling" group reported higher energy levels and a greater reduction in fatigue. They also seemed to have more improvements in mood and body esteem.

Breast cancer is Welsh women’s biggest fear

BREAST cancer is the “biggest fear for women in Wales”, according to a survey published today.
The Ipso Mori survey, carried out for Breast Cancer Campaign, found that more than two in five women in Wales (43%) of all ages
are most afraid of getting breast cancer, followed by Alzheimer’s disease/dementia (31%).
More than eight in 10 women interviewed for the survey in Wales said they recognised progress into research and treatment had been made over the past 10 years.
The campaign currently funds six breast cancer research projects in Wales, worth almost £400,000.
Most of those polled (88%) also knew that survival rates have improved compared with those for breast cancer 10 years ago.
More than half those questioned correctly identified earlier diagnosis, better surgical techniques (45%), improved methods of diagnosis (31%) and breast cancer screening (23%) as contributing to better survival rates.
In addition, continued advances in surgery, radiotherapy and chemotherapy, as well as hormone and targeted treatments, have led to breast cancer mortality rates falling by 20% since 1989, a campaign spokeswoman said.
Pamela Goldberg, chief executive of Breast Cancer Campaign said, “Despite acknowledging that the outlook for breast cancer patients is far brighter than ever before, the fear of breast cancer is still significant among women in Wales.
“Longer survival also means patients are just as concerned about quality as well as quantity of life and the psychosocial aspects of breast cancer are becoming ever more important.
“Indeed, the 21st century woman with breast cancer is justified in feeling more positive about the future with the introduction of drugs such as herceptin and the aromatase inhibitors which are bringing real benefits for people with breast cancer.
“Genetic testing for those with a family history of breast cancer is also giving high risk women a choice about their future.
“More than 80% of people diagnosed with breast cancer today will survive for more than five years. This is the result of years of breast cancer research.
“However, there is still a long way to go.”
Breast Cancer is the most common cancer in the UK and accounts for nearly one in three of all cancers in women. Wales has the second highest cancer rates in the UK.

Natural Medicine: Pap tests key to cervical cancer prevention

Is it time for your annual exam? Annual pelvic exams are an important step toward reducing the chance of developing cervical cancer. Over the past 30 years, regular women's exams have significantly decreased the incidence of cervical cancer in many population groups studied in the United States.
Pap tests are one of the best cancer screening tests available, and one of the key reasons that annual exams are recommended by physicians. A Pap test uses a bristled tool to loosen the first layer of cells off the cervix in a procedure not often felt by the patient. A pathologist then examines these cells to determine the health of the cervix, and monitor any unusual cellular changes. Today, it is estimated that approximately 99 percent of changes caused to the cervix are due to the human papilloma virus (HPV). While these changes may take several years to progress to cancer, treatment is most effective and least invasive if the cellular changes are identified early.
Regular gynecological exams are required to detect any changes in cervical cells before they progress to cervical cancer. Many times, a Pap test will indicate an adequate number of normal cells. However, in the case of an abnormal Pap test, here are some terms your doctor may use to describe your results: ASC-US (atypical cells of undetermined significance); LSIL (low grade squamous intraepithelial lesions); and HSIL (high grade SIL).These terms indicate various stages of abnormal cell changes and guide your physician toward the best course of treatment.
Recommendations on the frequency of Pap testing have changed in recent years to accommodate current clinical observations and research on cervical health. After the age of 30 and three consecutive negative Pap results in a five-year period, a woman can reduce Pap testing to once every three years. This also assumes no new sexual partners in this period of time. Even with this reduction in Pap testing frequency, an annual pelvic exam is still recommended for other reproductive and pelvic health considerations. Speak with your physician to clarify your Pap testing schedule.
-- Dr. Kris Somol, naturopathic physician at Bastyr Center for Natural Health and an adjunct faculty member at Bastyr University
Non-profit, accredited Bastyr University (bastyr.edu) offers multiple degrees in the natural health sciences, and clinical training at Bastyr Center for Natural Health (bastyrcenter.org), the region's largest natural medicine clinic.

Arizona company testing cream to prevent skin cancer

TUCSON - A company spun off from research conducted at the University of Arizona is testing a drug that's intended to prevent the formation of spots or patches on skin that can be a precursor of nonmelanoma cancers.The cream, Myristyl Nicotinate, has entered human clinical trials here. The product is a derivative of niacin developed by UA Cancer Center professors Mike and Elaine Jacobson.The Jacobsons, who are married, have spun off their UA-based research into Tucson-based Niadyne Inc., which has developed and marketed a number of niacin-based skin care products and is moving to introduce clinical products such as the anti-cancer drug. Niacin is a water-soluble B vitamin.
Mike Jacobson said that Tucson, with its abundant sunshine, high number of skin cancer cases and the resources of the Arizona Cancer Center, is the perfect place for Niadyne's research."It's a major issue for Arizona," he said. "This is by far the most common type of cancer."About 80 Arizonans die from nonmelanoma skin cancers per year, compared to 150 to 200 deaths per year from melanoma, said Dr. Lee Cranmer of the Arizona Cancer Center.Jacobson said Arizona ranks second worldwide, after Australia, for per-capita skin cancer incidence.The phase one human clinical trial of Myristyl Nicotinate that's now under way is to prove the safety and tolerability of the drug, Elaine Jacobson said.Twenty-five Tucson participants are applying the drug to one arm and a placebo to their other arm daily for 30 days, she said.After the safety and tolerability trials are completed and approved by the U.S. Food and Drug Administration, phase two trials will seek about 130 participants with active actinic keratosis lesions - the spots or patches that can develop into nonmelanoma cancers - to test the cream to see if it prevents the recurrence of the lesions on subjects after they have existing ones removed before the test, she said.The approval process will take time and money - an estimated $30 million to $50 million - before the drug is available for public use. "We hope that by 2010 this could be helping people," she said.