CANCER

Breastfeeding 'cuts mother's cancer risk'

2008-04-29T23:03:00.000-07:00

Mothers should breastfeed for six months after giving birth to cut their risk of developing breast cancer, researchers have advised.

The advice follows a World Cancer Research Fund survey that shows three out of four women are unaware of the link.

Two thirds are unaware that being breastfed also cuts a child's risk of being overweight – a major risk factor for cancer.
While just 13 per cent of men are aware it could cut a mother's risk of developing breast cancer.

The survey follows a review of almost 100 scientific studies in January by the American Institute for Cancer Research that found "convincing" evidence that breastfeeding lowered the risk of breast cancer.
It is the most common form of cancer in women, with about 45,000 cases diagnosed in Britain each year.

It is a real concern that so many women are unaware of a simple way they could help protect themselves, said Lucie Galice, from the WCRF.
"The evidence on this is convincing and this is why we recommend that – if they are able to – mothers should aim to breastfeed exclusively for the first six months and then continue with complementary feeding after that," she said.

"This means that many new mothers are making choices about whether to breastfeed without knowing it can help reduce cancer risk for them and their child."
Of the 1,998 people surveyed, 19 per cent thought breastfeeding reduced a woman's risk of breast cancer, while 25 per cent thought it reduced a child's risk of being overweight.

According to researchers, mothers who breastfeed their baby for six months after giving birth reduce their risk of developing breast cancer. The problem is that the majority of women do not know of this benefit.
The World Cancer Research Fund (WCRF) conducted a survey which showed that 75% of women do not know that breastfeed thing their baby helps cut their risk of breast cancer.
The numbers were even worse for men, as 87% had no idea that breastfeeding could help the mother cut the risk of developing breast cancer.
The survey also found that nearly 70% of women are unaware that breastfeeding helps their babies by lowering their risk of being overweight.
The survey was carried out following studies which has clearly shown the benefit of breastfeeding for mothers.
Breast cancer is diagnosed quite often and is one of the most common forms of cancer among women.
Education is needed to help teach mothers the benefit of breastfeeding not only for themselves, but for their babies too.

Juice 'can slow prostate cancer'

2008-01-04T09:36:00.000-08:00

Drinking a daily eight ounce (0.24 litre) glass of pomegranate juice can significantly slow the progress of prostate cancer, a study suggests.
Researchers say the effect may be so large that it may help older men outlive the disease.
Pomegranates contain a cocktail of chemicals which minimise cell damage, and potentially kill off cancer cells.
The study, by the University of California in Los Angeles, appears in the journal Clinical Cancer Research.

Previous research had indicated that pomegranate juice could have a beneficial effect on prostate cancer in tests on mice.
But the latest study has shown that humans can potentially benefit too.
The UCLA team focused on 50 men who had undergone surgery or radiation treatment for prostate cancer - but had shown signs that the disease was rapidly returning.
The presence of prostate cancer cells is monitored by measuring levels of a chemical they produce called prostate-specific antigen (PSA).
The researchers measured how long it took for PSA levels to double in individual patients - a short doubling time indicates that the cancer is progressing quickly.
The average doubling time is about 15 months, but in patients who drank pomegranate juice this increased to an average of 54 months.
Some men on the study continue to show suppressed PSA levels after more than three years, even though they are receiving no treatment apart from drinking pomegranate juice.

Combination effect

Lead researcher Dr Allan Pantuck said: "I was surprised when I saw such an improvement in PSA numbers.
"In older men 65 to 70 who have been treated for prostate cancer, we can give them pomegranate juice and it may be possible for them to outlive their risk of dying from their cancer.
"We are hoping we may be able to prevent or delay the need for other therapies usually used in this population such as hormone treatment or chemotherapy, both of which bring with them harmful side effects."
Pomegranate juice is known to have anti-inflammatory effects and high levels of anti-oxidants, which are believed to protect the body from damage by particles called free radicals.
It also contains isoflavones which are believed to play a role in cancer cell death.
Dr Pantuck said: "There are many substances in pomegranate juice that may be prompting this response.
"We don't know if it's one magic bullet or the combination of everything we know is in this juice.
"My guess is that it's probably a combination of elements, rather than a single component."
Chris Hiley, of the Prostate Cancer Charity, said more work was needed to firm up the findings.
She said: "It may well turn out that pomegranate juice has a wider application than just delaying disease progression in men with prostate cancer who have already been treated.
"It might also help as a reassuring low-key intervention for men whose cancer is being monitored rather than treated."
Dr Laura-Jane Armstrong, of the charity Cancer Research UK, said: "If the results of this study can be confirmed, it could have important implications for prostate cancer patients, especially by delaying the use of other more aggressive treatments that can have debilitating side effects."
Funding for the study was received from a company which makes pomegranate juice.

Studies show how fruits and veggies reduce cancer

2008-01-04T09:25:00.000-08:00

Just three servings a month of raw broccoli or cabbage can reduce the risk of bladder cancer by as much as 40 percent, researchers reported this week.
Other studies show that dark-colored berries can reduce the risk of cancer too -- adding more evidence to a growing body of research that shows fruits and vegetables, especially richly colored varieties, can reduce the risk of cancer.
Researchers at the Roswell Park Cancer Institute in Buffalo, New York, surveyed 275 people who had bladder cancer and 825 people without cancer. They asked especially about cruciferous vegetables such as broccoli and cabbage.

These foods are rich in compounds called isothiocyanates, which are known to lower cancer risk. The effects were most striking in nonsmokers, the researchers told a meeting being held this week of the American Association of Cancer Research in Philadelphia.
Compared to smokers who ate fewer than three servings of raw cruciferous vegetables, nonsmokers who ate at least three servings a month were almost 73 percent less likely to be in the bladder cancer group, they found.
Among both smokers and nonsmokers, those who ate this minimal amount of raw veggies had a 40 percent lower risk. But the team did not find the same effect for cooked vegetables.
"Cooking can reduce 60 to 90 percent of ITCs, (isothiocyanates)," Dr. Li Tang, who led the study, said in a statement.

A second team of researchers from Roswell Park tested broccoli sprouts in rats.
They used rats engineered to develop bladder cancer and fed some of them a freeze-dried extract of broccoli sprouts. The more they ate, the less likely they were to develop bladder cancer, said Dr. Yuesheng Zhang, who led the research.
They found the compounds were processed and excreted within 12 hours of feeding. That suggests the idea that compounds are protecting the bladder from the inside, said Zhang.
"The bladder is like a storage bag, and cancers in the bladder occur almost entirely along the inner surface, the epithelium, that faces the urine, presumably because this tissue is assaulted all the time by noxious materials in the urine," Zhang said.
In a third study, a team at The Ohio State University fed black raspberries to patients with Barrett's esophagus, a condition that can lead to esophageal cancer.
Black raspberries, sometimes called blackberries or blackcaps, are also rich in cancer-fighting compounds.
Ohio State's Laura Kresty and colleagues fed 1.1 ounces (32 grams) of freeze-dried black raspberries to women with Barrett's esophagus and 1.6 ounces (45 grams) to men every day for six months.
They measured urine levels of levels of two compounds -- 8-isoprostane and GSTpi -- that indicate whether cancer-causing processes are going on in the body.
Kresty said 58 percent of patients had marked declines of 8-isoprostane levels, suggesting less damage, and 37 percent had higher levels of GSTpi, which can help interfere with cancer causing damage and which is usually low in patients with Barrett's.
(Reporting by Maggie Fox, editing by Julie Steenhuysen and Vicki Allen)

The Importance of a Second Opinion Following a Diagnosis of Cancer

2007-11-04T08:24:00.000-08:00

A diagnosis of cancer is usually a critical event in a person's life because it carries with it the threat of premature death, pain and disability. Today, however, many cancers can be cured or palliated for extended periods of time if initial treatment involves the appropriate therapy. In order to receive appropriate treatment, patients must understand the type of cancer they have and the treatment options that are available. As the curative potential for cancer treatments has increased over the past several decades, so has the complexity of information needed to make appropriate treatment decisions. Since very few cancers require emergency treatment, it is important for patients, relatives and friends to allow themselves ample time to learn exactly what their diagnosis means.
Two of the most important things a patient can do following a diagnosis of cancer are to become educated about treatment options and to seek a second opinion. Historically, patients often relied upon a single physician recommendation or out-of-date print materials to make their treatment decisions. Now, the Internet has become a unique resource because it provides a vehicle for real-time distribution of information directly to cancer patients and their families. Currently, there are several Internet resources designed to educate patients. CancerConsultants.com, oncolink.com and the National Cancer Institute web site (www.cancer.gov) are all designed to educate patients and provide current, comprehensive, disease-specific information from screening to treatment.
Each individual involved needs to gather information on the nature of the cancer and how it can be treated (surgery, radiation or chemotherapy). This information educates patients and enables them to ask their physicians the right questions about their cancer treatment so that they can understand the options presented by the physician. However, the main source of information about treatment options comes from the physician who will be directing treatment. For a variety of reasons, it is frequently advantageous for patients with cancer to seek more than one opinion about how their cancer can be treated. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. Getting a second opinion allows patients to become more informed about their cancer and their treatment options and also provides reassurance.

What is a Second Opinion?
Getting a second opinion involves obtaining a review of the cancer diagnosis and the treatment recommendations of the physician who is treating the cancer. Either the patient or the primary physician can initiate the process of getting a second opinion. Usually, patients can obtain a second opinion by getting a referral to a second physician or to a multidisciplinary team of experts in a cancer center. This doctor or team of doctors will review the pathology (how the cancer looks under the microscope), the extent of cancer, the physical condition of the patient and the proposed treatment. The doctor(s) then communicate their opinion regarding treatment to both the patient and the primary physician. The only problem with referral by the treating physician is that there may be a tendency to refer to physicians with the same treatment philosophies, thereby ensuring a concurrent opinion.
A second opinion should be independent and may be best performed by a physician or team of physicians who do not have a close relationship with the treating physician. More and more cancer patients are being evaluated in larger centers where multidisciplinary teams involving surgeons, oncologists, radiation therapists and sub-specialist oncologists have a role in determining treatment recommendations. In this multidisciplinary setting, second opinions are more likely to be comprehensive.

Who Should Get a Second Opinion?
Although no one has precisely defined the specific situations that merit a second opinion, there are clearly situations where a second opinion would be helpful and most patients would benefit. Patients who feel that they may not fully understand the consequences of the diagnosis and the treatment options should consider a second opinion. The basic complexity of the diagnosis and treatment options, as well as failure of the physician to communicate with the patient, can interfere with the understanding of the situation. In some instances, a patient may experience denial, which can be overcome if a second physician or team of physicians offers similar advice.
Patients, relatives and friends need to keep in mind that second opinions are a normal part of cancer management and they should not be concerned about hurting the feelings of the primary physician. If a patient decides to obtain an independent second opinion, it is important to communicate with the primary physician not only to obtain needed information for review, but also to keep the treating physician informed. Most physicians welcome the opportunity to have another consultant review and approve their care decisions, or perhaps suggest another treatment that may be better. There are instances when a patient will have a basic disagreement with their physician and will need to change physicians, but this is not the main purpose of a second opinion. Most of the time, patients simply need to make sure they are getting the best advice.

Specific Situations Where A Second Opinion is Useful
Non-Cancer Specialist Treatment Recommendations: In the United States , doctors other than oncologists often diagnose and treat patients with cancer. Cancers are diagnosed and treated by family doctors, internists, pediatricians, gynecologists, urologists, ear-nose-and-throat doctors and other non-cancer specialists. In most instances, appropriate therapy is administered. However, patients not treated by specialists in cancer treatment should consider seeking a second opinion. In some situations, physicians will not refer patients for a second opinion because they may lose control and revenue from treatment, they may be threatened by having their patient believe some other doctor is more knowledgeable or often they are just too busy to bother with consulting other physicians. The patients of these types of physicians are probably the most in need of a second opinion.
Cancer Sub-specialists: Many types of cancers are treated by several different types of cancer specialists. For example, prostate cancer may be appropriately treated by urologists who are surgeons, radiation oncologists and/or medical oncologists who use drug treatment. Each specialist may think that the treatment they advise and are involved with is the best treatment for the patient. This is dramatically shown in recommendations for the primary treatment of localized prostate cancer. For localized prostate cancer, surgeons almost invariably advise surgery (radical prostatectomy) as the primary treatment and radiation oncologists invariably advise radiation therapy (either external beam or brachytherapy). A patient with early prostate cancer may want to consult an oncologist or multidisciplinary team who would not be treating this stage of prostate cancer as well as a surgeon and a radiation oncologist to obtain a thorough understanding of treatment options. Seeking a second opinion from a different type of specialist can be informative but it can also, unavoidably, create confusion about treatment options that will need to be resolved by having all of the available information and making an informed decision.
Apparent Lack of Treatment Options: A second opinion can be useful in some patients who are told that there is no appropriate treatment for their cancer and that there is no hope of survival or palliation. Such patients have nothing to lose by seeking a second opinion. In this situation, patients should seek out physicians and institutions that specialize in treating their type of cancer and perform clinical trials. Often, this is accomplished by finding out who is performing clinical trials of novel treatments for the type of cancer in question. Here again, information available on the Internet can help locate such physicians and institutions.
Clinical Trials: Progress in cancer treatment has come predominantly from participation in clinical trials. There are many types of clinical trials, some of which may benefit a patient with a specific cancer and some of which may not. Doctors who participate in clinical trials, whether from a single center or as part of a multi-center trial, need to put patients on these trials and often have trouble finding patients to participate. Unconsciously, such doctors may suggest a trial that may not represent the best treatment for a patient with cancer. When participation in a clinical trial is recommended by the treating physician, a second opinion should probably be obtained to make sure this is the appropriate treatment. The patient should also be aware of all the clinical trials that are available for his or her cancer before selecting the one the treating physician recommends. Two sources of ongoing information regarding clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.
Rare cancers: If a patient has a rare cancer, it is usually best to seek a second opinion unless the diagnosis is made at a center that specializes in the treatment of this cancer. If a local expert is available, treatment should probably be switched to that doctor. If the expert is far away, which is likely, the treating physician can usually coordinate treatment by phone or e-mail communication. Even if your cancer isn't all that rare, there may be benefit from finding someone with a special interest in the specific type of cancer being treated. For instance, kidney cancer is not really rare, but it's not common either. Usually patients with kidney cancer are treated on multi-center protocols carried out in large institutions. This is because the newer treatment protocols require specialized treatment and clinical trial accrual has to be pooled from several institutions to be meaningful.
Surgery as Primary Treatment: If there is any doubt about the operability or inoperability of a cancer, a second opinion is in order. In this situation, patients are urged to seek second opinions in institutions where large numbers of patients are treated. For instance, esophageal cancer may be considered inoperable in a hospital that performs one such procedure a month, but may be considered operable in an institution that performs several per day. Just as important can be the determination that a cancer deemed operable is in fact inoperable and surgery would be harmful.
Small and Rural Hospitals: Patients who live in a rural area and get treatment at a small hospital probably should get a second opinion from a larger medical center before treatment is initiated. Although smaller hospitals typically deliver excellent treatment, it is prudent to ensure that the recommended treatment is appropriate and can be safely administered. Small and rural hospitals may not see a large volume of cancer patients, and while they are usually fully capable of delivering treatment, it is best to seek a second opinion to help determine what the appropriate treatment is. Sometimes, the recommended treatment will determine whether a patient should receive their treatment at their local hospital or travel to a larger medical center. For example, most small hospitals can effectively deliver chemotherapy; whereas patients requiring a complicated procedure, such as a stem cell transplant, may need to travel to a larger institution that treats a higher volume of patients.
Aggressive Treatment: Most of the cancers that can be cured with chemotherapy (acute leukemias, lymphomas, testicular cancers) require intensive treatment. Intensive treatment may consist of high doses of chemotherapy or radiation therapy and requires rigid adherence to prescribed doses of drugs to ensure that optimal treatment is delivered. Intensive treatment also requires careful monitoring for complications and aggressive supportive care. In many instances, intensive treatment can be administered locally, but such patients are usually best treated in centers that use state of the art protocols (clinical trials) and treat large numbers of patients. All too often, oncologists treat patients with curable cancer with lower doses of chemotherapy in order to decrease side effects. This practice can seriously compromise the chance for cure. Patients should determine how many patients are treated per year and what the results of local treatment are at the treating institution. Treating physicians should present patients with their own results and not results from patients treated in other institutions.
Specialized Treatment: In many instances, specialized treatment is required to achieve optimal cure or control rates. One example of this is stem cell transplantation. Allogeneic or autologous bone marrow or blood stem cell transplants can often offer the best result for patients with blood and lymphoid cancers such as leukemia, lymphoma and multiple myeloma and other cancers such as breast, ovarian and testicular. However, not all medical centers offer this type of therapy. If the treating center does not offer stem cell transplant, a second opinion may be in order. Another example of specialized treatment is treatment for liver cancer. Recent clinical trials have suggested that sophisticated treatment techniques such as intra-arterial chemotherapy, chemo-embolization, radiofrequency ablation, radioactive isotopes and conformal radiation therapy can be of major benefit for the treatment of liver cancers. However, not all centers have the capability of delivering this type of treatment. Patients with liver cancer and other cancers that can be treated by specialized methods require second opinions at specialized institutions.

Cost of Second Opinions
One of the problems with second opinions is that insurers may not cover the expense. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. In some situations, insurers will even insist on a second opinion. This is often the case when the primary physician advises an expensive treatment.
Health Maintenance Organizations (HMOs) have a vested interest in keeping patients within the system. This may cause a conflict of interest between the patient and the HMO, especially if very expensive treatment is only available outside the HMO system. The more money the HMO spends on second opinions and treatments outside the HMO system, the less money there is available to treat patients within the system and the less the HMO makes in profit. However, most reputable HMOs can deliver state of the art treatment for most cancers. It is a good idea, however, for HMO members with cancer to make sure they are informed about clinical trials or other promising new treatments. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. It is also important for HMO members undergoing cancer surgery to inquire about the number of such procedures performed each year by the HMO and the results. The best protection for an HMO member is to seek a second opinion even if she or he has to pay for it.
In summary, patients should become their own advocates and become as knowledgeable about their treatment options as possible. When there is any doubt about the diagnosis or treatment plan, patients should obtain a second opinion. Second opinions will not offend competent physicians. Second opinions will, however, provide reassurance to patients and family members and ultimately allow patients to receive the most appropriate therapy.

Understanding Cancer Treatment Options

2007-11-04T08:22:00.000-08:00

Introduction
Very few cases of cancer require emergency treatment. Most patients benefit from taking the time to learn about their disease and explore all treatment options. Before choosing a treatment strategy it is important to understand the stage and extent of cancer, the different types of cancer treatment and the goal of treatment. Many patients decide to obtain a second opinion in order to help them make treatment decisions.
Staging
After cancer is diagnosed, a physician will perform several tests to determine the stage and extent of disease. Staging is the process of describing the location of the disease at the time of diagnosis. The American Joint Commission on Cancer is the most widely used cancer staging system. The stage is determined by measuring the size of the primary Tumor, the extent of lymph Node involvement, and the absence or presence of Metastases. This is referred to as the TNM staging system.
Staging provides invaluable information about the location and extent of the disease. After determining the stage of the cancer, physicians and patients can begin to explore treatment options. At this point, it is important for patients to gather as much information as possible about the treatment of their cancer.
Understanding the Different Types of Treatment
There are several different types of cancer treatment. One type of treatment may be best for some cancer patients, while another will be more beneficial for other patients. It is up to the individual to determine which course of action is most appropriate.

Conventional Treatment: In the West, methods of cancer treatment traditionally follow the medical, or allopathic, model. The term allopathy derives from two Greek words: allo meaning opposite and pathos meaning suffering. The basis of this medical system is to focus on disease and employ methods that oppose it. In the medical model, treatments are based on evidence, usually gathered in carefully controlled clinical trials that determine whether a new treatment is effective and safe for patients. In the United States, these conventional treatments are approved by the Food and Drug Administration (FDA) before they can be administered to patients. Conventional treatment can be divided into two categories:
Standard Treatment: Standard treatment refers to treatment that has been proven safe and effective in clinical trials and is approved by the FDA for a specific use. Standard treatment is the “accepted” best treatment for a specific type and stage of cancer.
Experimental Treatment: Experimental treatment refers to a potentially encouraging treatment that is under evaluation, but has not yet been approved by the FDA. Experimental treatment is offered through a clinical trial. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Often, clinical trials offer access to the newest and most promising treatment strategies. It is extremely important to decide whether or not to participate in a clinical trial before receiving any treatment from a physician. Once treatment has been initiated, this almost always excludes patients from participating in a clinical trial designed for patients in their circumstance. Even when there is evidence that a new treatment modality may be better than standard treatment, it takes years to change the existing standard treatment.

Complementary/Alternative Treatment: Complementary and Alternative Medicine (CAM) describes medical therapies practiced outside “mainstream” or conventional Western medicine. CAM contains a variety of healing philosophies and medical practices that are not currently accepted or used by conventional medicine, such as acupuncture, aromatherapy, biofeedback, herbal remedies and more.
Complementary medicine consists of medical therapies that are most often used to supplement conventional medical treatments. Because these treatments are utilized in addition to allopathic therapies, they most often focus on promoting wellness or managing symptoms. Most CAM therapies can be used as a complement to conventional medicine. A benefit of complementary therapies is that the patient can use well-researched conventional treatments against cancer while utilizing complementary medicine to reduce stress, enhance their immune system and/or reduce side effects of conventional cancer treatment. The vast majority of CAM practitioners and cancer patients who utilize CAM therapies use complementary medicine as a means of integrating the best of what both types of medicine have to offer.
In contrast to complementary medicine, alternative medicine is used in place of conventional medicine. Alternative medicine attempts to treat disease specifically, without use of any allopathic therapies. Therapies commonly used as complementary medicine are considered alternative medicine when used in place of conventional treatment. For minor health issues, alternative medicine is generally not dangerous. However, most practitioners of conventional medicine, and many who practice complementary medicine, are uncomfortable with the exclusivity of alternative medicine and its failure to utilize treatments that are known to benefit certain diseases when the illness is serious. In such instances, alternative therapies may delay conventional treatment and result in a more serious illness, complications or death. Many patients who do turn to alternative medicine do so only after conventional medicine has nothing more to offer or because they believe the risks of a mainstream treatment outweigh the risks of the alternative therapy they are investigating. In some instances, a very negative experience with conventional medicine leaves a patient in search of alternative forms of medicine.

Goals of Treatment
In order to explore treatment options, it is important to understand the goal of treatment. The ultimate goal of treatment is cure, which requires eliminating all detectable or measurable disease and any undetectable disease. Micrometastases are undetectable areas of cancer that have spread away from the original site of cancer. Primary treatment is an initial approach to remove detectable disease, but may not remove all micrometastatic disease. In many earliest stage cancers, primary treatment is curative if the cancer is limited to detectable disease.
Since there is a potential for micrometastatic disease even after all of the measurable disease is removed, the primary treatment for many stages of cancer is non-curative. When the potential for micrometastatic disease is significant, additional treatment is often necessary to eradicate any remaining cancer cells. Adjuvant therapy is treatment that is delivered following primary treatment and may include chemotherapy, hormonal therapy and/or biologic therapy. Neoadjuvant therapy refers to treatment that is delivered prior to primary treatment. Sometimes, cancer has grown so large that surgical removal of the entire cancer is difficult. The goal of neoadjuvant treatment is to shrink the cancer, thereby facilitating more complete surgical removal.
Sometimes with advanced cancer, primary and adjuvant treatment may not be beneficial because eliminating measurable disease is not possible. In such cases, patients may elect to receive palliative treatment. The goals of palliative treatment are to alleviate pain and side effects from the disease, prolong life and maintain quality of life.
Treatment Modalities
Cancer treatment may consist of one or more treatment modalities, depending on the type, stage and extent of cancer. Some treatment modalities, such as surgery and radiation, are local treatments used to eradicate visible tumors. Other treatment modalities, such as chemotherapy and biological therapy, are systemic treatments that circulate in the blood to eradicate cancer that has spread away from the original site.
Optimal treatment of cancer often requires more than one therapeutic approach. Often, one or more treatment modalities may be used in order to provide the most complete treatment for the patient. Increasingly, it is common to use several treatment modalities concurrently or in sequence, with the goal of preventing both local and systemic cancer recurrence. This is referred to as multi-modality treatment of the cancer. These modalities may include surgery, radiation therapy, chemotherapy and/or biological therapy. Thus, it is important for patients to be treated at a medical center that can offer multi-modality treatment involving medical oncologists, radiation oncologists and surgeons.

Surgery: Surgery is a local treatment used to remove visible tumors. In addition, surgeons frequently remove the tissue adjacent to the cancer during surgical resection of a tumor. Information gained about the tumor during surgery is useful in predicting the likelihood of tumor recurrence and the need for other treatment modalities.
Radiation Therapy: Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumors. Radiation therapy is not typically useful in eradicating cancer cells that have already spread to other parts of the body. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumor site from a machine outside the body. Internal radiation, or brachytherapy, involves the implantation of a small amount of radioactive material in or near the cancer.
Chemotherapy: Chemotherapy is the general term for any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs. Chemotherapy can be administered through a vein, injected into a body cavity or delivered orally in the form of a pill. Chemotherapy is different from surgical or radiation therapy because it is considered a systemic treatment. The cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original tumor.
Biological Therapy: Biological therapy is referred to by many terms including immunologic therapy, immunotherapy or biotherapy. Biological therapy is a type of treatment that uses the body’s immune system to facilitate the killing of cancer cells. Types of biological therapy include interferon, interleukin, monoclonal antibodies, colony stimulating factors or cytokines and vaccines.
Hormone Therapy: Hormones are naturally occurring substances in the body that stimulate the growth of hormone sensitive tissues, such as the breast or prostate gland. When cancer arises in breast or prostate tissue, its growth and spread may be caused by the body’s own hormones. Therefore, drugs that block hormone production or change the way hormones work, and/or removal of organs that secrete hormones, such as the ovaries or testicles, are ways of fighting cancer. Hormone therapy, similar to chemotherapy, is a systemic treatment in that it may affect cancer cells throughout the body.

Choosing the Appropriate Treatment
Appropriate cancer treatment choices vary depending on many factors. What is appropriate for one patient may not be appropriate for another. Patients who understand the specific characteristics of their disease and understand the many different facets of cancer treatment will be able to make informed treatment decisions.

Understanding the Relationship Between Anemia and Cancer

2007-11-04T08:18:00.000-08:00

Anemia, a common side effect of cancer treatment, is a condition in which there are fewer red blood cells than normal. The function of red blood cells is to transport oxygen to the tissues of the body. Without an adequate number of red blood cells, the body’s need for oxygen cannot be effectively met. Common symptoms of anemia include severe fatigue, shortness of breath, diminished activity level, reduced overall feeling of well-being, and possible mental dysfunction. Anemia may also exacerbate existing medical conditions. For example, the heart has to work harder in an anemic patient, which may aggravate a heart condition. Furthermore, severe anemia may cause a treatment delay or dose reduction, as well as reduce the effectiveness of some chemotherapy agents and radiation, thus jeopardizing the possibility of the best long-term results from treatment. Fortunately, there are treatments available to improve anemia and its symptoms.
Anemia in cancer patients may occur either as a direct result of the cancer or as a side effect of cancer treatment. Chemotherapy, radiation therapy, and blood loss during surgery are all common causes of anemia in cancer patients. Over 60% of patients treated with chemotherapy develop anemia. This is because chemotherapeutic agents kill rapidly dividing cells in the body, including cancer cells, as well as several types of normal cells like red blood cells.
Early detection and prompt treatment of anemia is the best strategy for preventing severe anemia from occurring and ensuring that when anemia does occurs, the duration is limited. Although healthcare providers try to monitor for anemia, patient observations are an important source of information on warning signs and they should notify their doctor or nurse if they are feeling abnormally fatigued.
The treatments available for chemotherapy-induced anemia in cancer patients are Procrit® and Aranesp®. These agents are FDA approved and have been safely used in cancer patients. They contain a synthetic erythropoietin, which stimulates the production and maturation of red blood cells, ultimately increasing red blood cell levels enough to correct anemia. Procrit® is approved to be given 3 times per week, while Aranesp® is approved for administration only once every 2 weeks. Every 2 week administration has the added advantage of reducing the burden of frequent doctor visits for patients and their caregivers.
Although most patients develop anemia as a direct consequence of chemotherapy, diet may also play a role in reducing the severity or duration of anemia in some patients. Iron, folic acid, amino acids, and vitamins B6, B12, and C are all important components to the development and maturation of red blood cells. Green leafy vegetables, eggs, fruit, legumes, grains, and meats should be included in the diet of a person that is diagnosed with cancer, or one that has already developed anemia. Additionally, patients should ask their physicians if supplementation is necessary to manage their anemia.
Although anemia can pose serious consequences, early identification and subsequent intervention with effective treatments such as Procrit® and Aranesp® may help to correct anemia, thereby improving patients’ quality of life and making it possible for them to receive optimal therapy.

Patient Action to Prevent Infection During Treatment for Cancer

2007-11-04T08:07:00.000-08:00

Most patients would prefer to prevent infection rather than having to deal with its results. Your first line of defense should always be prevention. Below are some simple but effective steps to avoid infection:
-Always wash your hands with soap and plenty of water. Many infections are transmitted through hands and things that you touch, such as doorknobs. Washing your hands thoroughly is the most important thing you can do to prevent infection.
-Avoid people with colds or the flu.
-Avoid large crowds to reduce the likelihood of coming into contact with sick people.
-Bathe daily and carefully dry your skin.
-Take steps to prevent cuts or scrapes, as these provide entry points for infection.
-Use an electric razor instead of a blade to avoid cuts.
-Use caution with sharp objects.
-Wear gloves when appropriate.
-If you have a cut or scrape, keep it covered with a clean bandage until it heals.
-Prevent cracks in your skin by using lotion.
-Cook your food thoroughly to kill any potential microorganisms that may be on raw food.

If Cancer Runs in Your Family: Understanding Hereditary Risk and Genetic Testing

2007-11-04T07:50:00.000-08:00

A genetic risk for cancer means that certain cellular mutations that increase an individual’s risk for developing cancer are passed down through generations, giving each new family member who inherits a cancer susceptibility gene a potentially increased risk for developing certain cancers. These hereditary mutations are responsible for about 5–10 percent of cancer incidence.
Although hope remains that research in the field of gene therapy may someday find a way to repair these gene alterations, for now we are at least able to identify gene mutations through genetic testing—an important step in understanding your genetic susceptibility for cancer and the first step in managing your risk. However, even though you may gain important information from a genetic test, the decision to be tested should be made carefully. Here are some things to consider as you decide whether genetic testing is an appropriate choice for you:
Genetic Counseling
Because the implications of genetic testing and its findings for you personally and within your family are potentially very complicated, you may wish to seek the guidance of a genetic counselor. Testing and its results are complex—for example, if a genetic mutation is revealed, it is not certain that an individual will develop the associated cancer nor is the absence of a mutation a guarantee that an individual will not develop cancer. Furthermore, genetic testing does carry certain risks and limitations, which should be considered before you undergo such a procedure. A genetic counselor can help you understand these issues as well as the following:
Whether genetic testing is the right choice for you
Your results and their particular significance for you
How to share your results with other family members, as these findings may indicate that they are also at risk for the same hereditary mutation
Is Genetic Testing Right for You?
Potential candidates for genetic testing have one or more of the following characteristics:
Diagnosed with early-onset cancer*
Experienced more than one cancer diagnosis
Have a strong family history of cancer or a family history of rare cancers**Consult with your physician to determine if you’ve been diagnosed with early-onset cancer or whether you have a strong family history of cancer and to learn which types of cancer are consider rare cancers.
What You Can Learn from Testing
If you do undergo genetic testing, you may learn the following:
Your high-risk status will either be confirmed or you’ll be able to rule out the presence of a genetic alteration found in other family members.
If you do test positive, you can increase your screening practices, which may detect cancer at an early and most treatable stage.
Some cancers may be prevented entirely with preventive surgeries.
Limitations and Risks of Genetic Testing
In some circumstances genetic tests don’t offer any benefit. For example, if you may be at genetic risk for a type of cancer for which there is no reliable screening method or effective treatment, knowledge of this alteration would be of little or no use. Additionally, because these tests are only predictive and not definitive, there are no absolute answers about the likelihood that you will develop cancer. As well, though these tests are technologically sophisticated, they are still not 100 percent accurate, allowing the possibility that they will fail to identify a cancer-causing mutation or that a gene may be incorrectly identified as mutated. Risks to further look into include the potential for employment or insurance discrimination based on high-risk status for developing cancer and the potential anxiety for the entire family that the knowledge of an inherited mutation may cause.
For more information about genetic testing, go to http://patient.cancerconsultants.com/Testing.aspx?TierId=1085&DocumentId=736.

Six Tips for Choosing a Doctor and Getting High-quality Care

2007-11-04T07:42:00.000-08:00

If you’re like most people who have been diagnosed with cancer, you want the best care possible from the best doctor possible. But how do you know which doctor is right for you? The answer is not simple. Different people have different needs and different priorities that play into their choice of a doctor. The following six tips can help guide your search:

1.Understand Your Diagnosis
A great first step is to find out as much specific information as you can about the details of your diagnosis. Knowing exactly what type of cancer you have can help you find the best doctor to treat your specific case.
Understanding the extent to which your cancer has spread is also important. If you have localized cancer, your first encounter should probably be with a cancer surgeon. If you have widespread cancer, you may more appropriately be referred to a medical oncologist.
Once you understand your diagnosis, a next step is to learn about standard treatment options for your type and stage of cancer. If your doctor offers you a treatment plan that is inconsistent with what you’ve learned from your research, you may not be able to assess on your own whether it’s a better or worse approach, but it will allow you to initiate informed discussions with your doctor or to seek a second opinion.

2.Get Input from People You Trust
As you begin your own research into your diagnosis and treatment, you may also want to ask people you trust for a physician referral. For example, your primary care doctor or a local oncologist may be able to refer you to an expert in your type of cancer.
The first doctor you see for your cancer care may also be able to help you plan your subsequent care. If you have lung cancer, for example, you first see a surgeon. The surgeon can then refer patients to the physicians who will provide the post-surgery cancer care.

3.Get the Care That Your Diagnosis Requires
Keep in mind that though many doctors will be able to provide high-quality cancer care, those who focus on your specific type of cancer may have important additional expertise.
Finding a physician who focuses on your particular type of cancer may require some travel and visiting a large cancer center. Once your treatment strategy is developed, however, you may be able to receive the bulk of your care closer to home.
In particular, patients facing stem cell transplants and rare cancers these or similar may benefit from highly specialized care because most oncologists do not handle these situations on a regular basis.
All patients may want to consider choosing a doctor who is board certified in the specialty in which he or she practices.

4.Consider a Second Opinion
Another step that many cancer patients take when selecting a doctor is to get a second opinion. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options. Getting a second opinion allows patients to become more informed about their cancer and their treatment options and also provides reassurance.
For tips on when to seek a second opinion, go to When to Seek a Second Opinion.

5.Be Comfortable with Your Choice
In addition to finding a doctor with expertise in your type of cancer and pursuing a second opinion if you choose, keep in mind the value of finding a doctor with whom you feel comfortable. Some patients, for example, believe strongly in the role that complementary and alternative medicine plays in treatment. When choosing a doctor, these patients will need to consider how much it matters to them that their doctor either does or does not endorse those beliefs.

6.Remember: There’s No One Right Answer
There is no simple or one-size-fits-all formula for finding a doctor. Each patient—and each doctor—is unique. Finding a doctor who specializes in your type of cancer is a good starting point, but you may also wish to consider such factors as travel time and how comfortable you are with the doctor. You may be happiest taking the recommendation of a trusted individual, or you may want to research options on your own. Ultimately, you need to do what’s right for you.

Nutrition Tip: Green Tea

2007-11-04T07:34:00.000-08:00

Research has been pointing to evidence of green tea’s powerful disease-prevention benefits for years. Now recent laboratory and human studies are starting to show that green tea may even have the ability to kill specific cancer cells.1,2
The component plentiful in green tea shown to be responsible for chemopreventive and chemotherapeutic actions in laboratory studies is the polyphenol called epigallocatechin gallate (EGCG). This compound has been found to prevent cancer cells by changing the way normal cells react to potential carcinogens entering the body. EGCG also appears to create chemical changes that kill active cancer cells in multiple myeloma, breast, cervical, and colon cancer tumors.3,4,5,6
In addition, recent observations from the Mayo Clinic suggest that green tea may fight chronic lymphocytic leukemia (CLL), and a clinical trial is now underway to test the effect of green tea in CLL patients.7 Clinical studies at the University of Parma in Italy have also produced statistically significant evidence of EGCG’s ability to treat precancerous changes in the prostate.8 As well, recent human studies at the David Geffen School of Medicine at UCLA have shown the effectiveness of green tea extracts in treating skin toxicity associated with radiotherapy for solid head, neck, and pelvic tumors. 9
While we wait for further confirmation from clinical trials that green tea both prevents and fights cancer, we can enjoy it knowing that it has no known side effects other than high doses delivering too much caffeine. By following the proper consumption and brewing instructions below, you can get maximum benefit while minimizing caffeine content.

How Much?
Drink three to six cups each day. Drink the tea throughout the day, as studies have found that continuous administration of the EGCG is more effective than a single dose.

Preparation Tip
The most important tip for steeping green tea is to use water that is just below the boiling point. Steep for under three minutes. This will draw out the maximum benefit from the tea and the least amount of caffeine.

Brewing Green Tea
Use one teaspoon of loose tea leaves for a small pot of tea. Use two teaspoons for a large pot of tea. Boil water, then pour into a porcelain teapot or mug and let cool for one minute. Add tea leaves and let brew for 1 to 3 minutes, depending on the desired strength. Serve or add to juice immediately.

What You Should Know About the Side Effects of Surgery for Cervical Cancer

2007-11-04T07:28:00.000-08:00

A hysterectomy is a common surgical treatment of early stage cancer and precancerous disease of the cervix in women. With any treatment of cancer it is important to first understand your responsibility and your medical team’s role as well as explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of surgery can be significant, talk to your doctor prior to treatment so that you understand the specific type of surgery you will undergo and the expected side effects. The type of hysterectomy used to remove the cervical cancer depends on the extent of the cancer. A radical hysterectomy removes the entire uterus, including the cervix with the cancer and an area of normal tissue through a low abdominal incision. This area of normal tissue also includes a portion of the upper vagina, and may result in vaginal shortening after the operation. A modified radical hysterectomy is similar to a radical hysterectomy but less invasive. A less extensive operation, called a simple hysterectomy, is used when the cancer is not invasive (precancerous, stage 0) or in the earliest stage of invasion (stage IA). A simple hysterectomy removes a smaller rim of normal tissue, and spares most of the length of the vagina. With both types of surgery, the ovaries and Fallopian tubes can be removed as well, and this is known as a bilateral salpingo-oophorectomy. The decision to perform a bilateral salpingo-oophorectomy depends on your age and whether the ovaries are still functioning.
A radical hysterectomy is most effective if the exploration during surgery shows that the cancer has not spread beyond the cervix. However, some patients will have cancer that has spread outside the cervix into the lymph nodes in the pelvis. Before performing a hysterectomy, the doctor will sometimes perform a pelvic lymph node dissection. Pelvic lymph node dissection involves the removal of lymph nodes to determine the presence or absence of cancerous cells. If the lymph nodes contain cancer, usually the surgeon will not proceed with a radical hysterectomy. Instead, another form of treatment, usually radiation therapy and chemotherapy, is generally recommended.
Despite undergoing surgical removal of cervical cancer, some patients may experience recurrence of their cancer. Cancer recurrence occurs more commonly with bulky stage IB or stage II cervical cancer. It is important to realize that some patients with cervical cancer already have small amounts of cancer that have spread outside the cervix and were not removed by surgery. These cancer cells cannot be detected with any of the currently available tests. Undetectable areas of cancer outside the cervix are referred to as micrometastases. The presence of these micrometastases causes recurrence following the initial treatment. External beam radiation therapy with or without implant radiation and chemotherapy are often recommended to cleanse the body of micrometastases in order to improve the cure rate achieved with surgical removal of the cancer.
Surgery on top of living with a diagnosis of cancer can be both an emotionally and physically draining experience. Understanding associated surgical risks, short-term side effects and long-term side effects, as well as asking your doctor pertinent questions before surgery, will give you the tools to mange and cope after your surgery.
Any form of hysterectomy is major surgery with associated surgical risks. Hemorrhage, blood clots, surgical wound complications or allergic reaction to anesthesia are surgical risks that should be discussed with your doctor. In-hospital death occurs after radical hysterectomy in less than 1% of cases.
Normal and expected temporary effects of surgery for the treatment of cervical cancer may include pain, nausea, fatigue and anxiety. Urinary tract infection after the surgery is also common. Additional temporary side effects may include difficulty urinating or having a bowel movement. Since the bladder may be pushed and pulled due to all of the dissection around it, a temporary catheter (tube in the bladder to drain the urine) is usually required to give the bladder time to heal. With a simple hysterectomy, disturbance to the bladder is minimal making urinary complications rare. However, approximately one-third of women undergoing a radical hysterectomy may experience temporary bladder difficulties which may last a few weeks after surgery. Although most women return to normal bladder functioning, a very small percentage may require more permanent self-catheterization. Depending on the type of hysterectomy, your age and general health, recovery from short-term side effects may take 6 to 8 weeks.
In addition to rare bladder dysfunction, injury to the rectum and lower leg lymphedema are also potential long-term side effects of a hysterectomy. In a few cases, injury to the rectum or tubes that drain the kidneys (ureters) or bladder can occur. This may be in the form of a "fistula" or abnormal connection to the vagina. This is a chronic problem that may require surgery to repair the opening. Lower leg lymphedema (swelling) as a result of lymph node dissection may also occur in some cases. Elastic stockings or support hose as well as preventing infection and injury to the leg, can help minimize lymphedema.
Long-term sexual complications due to the removal of the uppermost part of the vagina are reportedly minor. In a few cases, patients indicate some loss of sensation and lubrication, as well as intercourse difficulty due to vaginal shortening. The emotional impact of the surgery may also affect libido in some patients.
The physical loss of reproductive organs has significant long-term physical and emotional side effects and should be discussed with your doctor before surgery. Some patients may want to investigate having their eggs harvested for possible surrogacy before surgery. Once the uterus is removed, women no longer menstruate and can no longer have children. Furthermore, if the ovaries are removed in a woman of child-bearing age, menopause will be induced. Some of the side effects of early menopause include hot flashes, irritability, vaginal dryness, sweats and nervousness. Hormone replacement therapy may be used to help control some of the side effects associated with menopause. The impact of losing reproductive organs is far reaching, affecting future plans as well as emotional well-being.
Surgery is a common form of therapy in the treatment of early stage cervical cancer. The risks of surgery, while remote, should be discussed with your doctor prior to surgery. The potential short-term side effects may cause varying degrees of discomfort that can usually be managed by you and your doctor. Potential long-term effects such as bladder and bowel problems, early induced menopause, as well as the physical loss of reproductive organs, are reportedly the most difficult for patients to deal with emotionally and physically. Using a surgeon and medical team highly experienced in performing hysterectomies may decrease your surgical risks and provide optimal management of side effects. Support groups, family support or professional support may help patients emotionally cope with side effects. Before undergoing any treatment you should understand your responsibility, your medical team’s role, explore treatment options, ask questions and get a second opinion(s).

Who Should be Screened for Cervical Cancer?

2007-11-04T07:24:00.000-08:00

Cervical cancer accounts for 6% of all cancers in women. Approximately 15,000 new cases of cervical cancer are diagnosed each year in the United States and roughly 5,000 women die annually from this disease. Screening for abnormal, precancerous or cancerous cells in the cervix is critical for prevention, early detection and diagnosis of cervical cancer.
The National Cancer Institute recommends that women over the age of 18 or those sexually active before the age of 18 should be screened for cervical cancer annually. Women at an increased risk of developing cervical cancer should be particularly diligent in their annual screening. Risk factors include early age at first intercourse (16 or younger), history of multiple sexual partners, smoking and poor nutrition. In addition, a history of sexually transmitted diseases, such as chlamydia, human immunodeficiency virus (HIV), and especially human papillomavirus (HPV) appear to increase the risk of developing cervical cancer. Thirteen different HPVs (wart-causing viruses) have been linked to almost every case of cervical cancer. However, the converse is not true, as the presence of HPV does not guarantee that cervical cancer will develop.
Annual cervical cancer screening involves a pelvic exam and Pap smear. Patients who have an abnormal Pap smear may undergo a relatively new screening test called a Hybrid Capture II to determine the nature of the abnormal cells.
A pelvic examination screens for any palpable abnormal growths or irregularities. During a pelvic exam, a health-care provider inserts a gloved and lubricated finger into the vagina to feel the vagina, cervix, uterus, ovaries, fallopian tubes, bladder and rectum. The pelvic examination is usually performed in conjunction with the Pap smear.
Routine screening with a Pap smear is used to detect cancerous cells as well as abnormal cells that may or may not be precancerous in the cervix. During a Pap smear, a sample of cells from the cervix is taken with a small wooden spatula or brush and examined under a microscope. The results of a Pap smear are classified into five categories: negative or within normal limits (normal); atypical squamous cells of undetermined significance (ASCUS); low-grade squamous intraepithelial lesions (abnormal); high-grade squamous intraepithelial lesions (abnormal); or carcinoma (cancer).
If the Pap smear results are normal, no further evaluation is necessary. Women who have normal results will simply need to continue undergoing an annual examination and Pap smear.
Abnormal results from a Pap smear do not necessarily indicate cancer. Other conditions such as inflammation and sexually transmitted diseases can cause abnormal changes in cells. Some women will exhibit mild dysplasia (abnormal cells), in which case they may need to schedule frequent Pap smears to monitor for any changes. Women with severe dysplasia may need to undergo a biopsy for closer examination of abnormal tissue. A relatively new test called the Hybrid Capture II is used to determine the presence of 13 HPV viruses specifically linked to cervical cancer. The presence of one of these key HPV viruses may further define the nature of abnormal cells identified by a Pap smear. The presence of abnormal cells and one of the 13 high risk HPV virus may indicate that the abnormal cells are precancerous in nature. Conversely, if a high-risk HPV is not present, then abnormal cells are less likely to be precancerous.
Pap smear screening techniques have facilitated the early detection of cervical cancer and have reduced the incidence of cervical cancer by 75% over the past 50 years. To determine if you are at high risk and require additional follow-up other than yearly screening, please consult your doctor.

Understanding Cervical Cancer

2007-11-04T06:47:00.000-08:00

What Is Cervical Cancer?
The cervix forms the opening to the uterus from the vagina. It is covered with two main types of cells: squamous cells, which cover the part of the cervix that extends into the vagina, and columnar cells, which line the cervical opening. Most cervical cancers develop close to where these two cell types come together, in an area called the transformation zone. Once cervical cancer develops, it can spread throughout the cervix to neighboring organs or to distant sites in the body.
Cancerous and precancerous changes in cervical cells are often first detected by a Pap test, wherein a sample of cells is removed from the cervix using a small wooden or plastic spatula and a brush. The cells are then examined under a microscope in a laboratory. If Pap test results are abnormal, a physician may perform a colposcopy, using a microscope called a colposcope to better see the cervix. The physician applies a mild vinegar solution to the cervix, which makes abnormal cells appear more white than pink. If abnormal areas are identified, the physician may remove samples of tissue so that the cells can be further evaluated—a procedure called a biopsy.
The results of the biopsy allow the physician to diagnose cancer or precancerous conditions. Precancerous changes to the cervix are called cervical intraepithelial neoplasia (CIN). The severity of CIN is graded on a scale of 1 to 3, with 3 being the most severe. CIN2 and CIN3 are considered “high-grade” CIN and may progress to cancer if not treated.

What Is HPV?
There are more than 100 different types of human papillomavirus (HPV), and different types of HPV cause different conditions. Some types of HPV are linked with common skin warts, others cause genital warts, and still others are linked with cancers of the cervix, vulva, vagina, penis, and anus as well as some cases of head and neck cancer. HPV types 6 and 11 account for a majority of cases of genital warts, and HPV types 16 and 18 cause roughly 70 percent of all cases of cervical cancer. The remaining cases of cervical cancer are linked with other high-risk types of HPV.
The types of HPV that cause genital warts or cervical cancer are transmitted sexually. Sexual transmission of HPV is extremely common and generally occurs soon after an individual becomes sexually active. Most infections resolve on their own, but others persist. Persistent infection with a high-risk type of HPV can lead to precancerous changes to the cervix and, if these changes are not treated, to cervical cancer.

How is HPV linked to Cervical Cancer?
The sexually transmitted types of HPV most commonly linked with cervical cancer are HPV 16 and HPV 18 (transmitted sexually), but several other high-risk types contribute to cancer as well.
Though a link between cervical cancer and a sexually transmitted infection was long suspected, studying HPV was historically a challenge because it could not be grown in cell or tissue cultures like some other organisms. It would take the molecular techniques that were introduced in the 1970s to adequately study and understand the virus. Once these techniques were applied, it became apparent that most cervical cancers contained evidence of HPV.
Infection with a high-risk type of HPV does not necessarily lead to cancer. Many infections disappear on their own, and others may persist without causing cancer. Infection does, however, increase the risk of cancer, and virtually all cases of cervical cancer can be linked to infection with a high-risk type of HPV.

Is There a Test for HPV?
The recognition that specific types of HPV are the cause of cervical cancer led to the development of tests to identify women infected with high-risk types of HPV. Information about HPV status may guide decisions about follow-up care.
HPV testing may also have a role in initial cervical cancer screening, but conclusive evidence about this is still lacking. In the meantime some organizations have supported the combination of HPV testing and Pap testing for screening women over the age of 30. Women who test negative for both tests may need not be rescreened for up to three years. The combination of HPV testing and Pap testing is not recommended for screening younger women because most will have HPV infections that will clear without causing precancerous cervical lesions.

What are HPV Vaccines and How Might They Prevent Cervical Cancer?
HPV vaccines fall into two broad categories: preventive and therapeutic. Preventive vaccines are designed to prevent infection with the virus, whereas therapeutic vaccines would treat the infection, precancerous lesion, or cancer in individuals who are already infected. Although prevention of infection is the ultimate goal, treatment of existing infections and cervical changes would benefit the many women who are currently infected.
The two vaccines that are farthest along in development are preventive vaccines. Gardasil™, developed by Merck, targets HPV types 6 and 11 (which are linked with genital warts) as well as the cancer-associated types 16 and 18. Cervarix™, developed by GlaxoSmithKline, targets HPV types 16 and 18 only. Clinical trials of these vaccines suggest that they are likely safe and highly effective. The duration of effectiveness is still uncertain, but it appears to be at least four to five years. Because HPV types 16 and 18 are thought to account for roughly 70 percent of all cases of cervical cancer, widespread use of these vaccines would have the potential to eliminate most (but not all) cases of cervical cancer and precancerous changes to the cervix.
Because infection with HPV is extremely common and generally occurs soon after an individual becomes sexually active, the vaccines are likely to have the greatest effect when administered before the teen years. In addition to being less likely than older children to be sexually active, younger children versus older adolescent and young adult women appear to develop a stronger immune response after HPV vaccination. This may increase vaccine effectiveness.
It is thought that for these vaccines to have the greatest impact it will ultimately be important to vaccinate both girls and boys. Vaccinating a larger number of individuals will reduce transmission of these viruses in the community and will make it less likely that an unvaccinated individual will become infected. Furthermore, in addition to reducing the risk of cervical cancer, the vaccines are likely to reduce the risk of other HPV-related cancers, such as cancer of the penis, anus, and oropharynx (part of the throat). Protection against genital warts would also benefit both boys and girls.
In June 2006, Gardasil was approved by the U.S. Food and Drug Administration (FDA) for use in girls and women between the ages of nine and 26 years. Approval for use in males may be considered after more data become available. GlaxoSmithKline plans to apply to the FDA for approval of Cervarix by the end of the year.

Cervical cancer survivors prone to other cancers

2007-11-04T06:43:00.000-08:00

Women who survive cervical cancer are at increased risk for developing other cancers decades later, according to a report in the Journal of the National Cancer Institute. The increased cancer risk is primarily seen in women who were treated with radiation therapy and involves organs that lie near the cervix.
"Previous studies have indicated that the risk of second cancers is increased among cervical cancer survivors, but overall and (body) site-specific risks among very long-term survivors were unclear," Dr. Anil K. Chaturvedi, from the National Cancer Institute in Bethesda, Maryland, and colleagues note.
The findings are based on an analysis of data for 104,760 cervical cancer survivors drawn from several Scandinavian countries and the U.S. The researchers calculated the rate of second cancers over more than 40 years of follow-up.
On the overall analysis, the survivor group was 30 percent more likely to develop a cancer than were women in the general population. Further analysis showed that the rates of human papillomavirus (HPV)- and smoking-related cancers were elevated in survivors who had radiotherapy and those who did not.
Survivors treated with radiotherapy had an elevated risk for cancers in close proximity to the cervix, including cancers of the colon, rectum, anus, bladder, ovaries and genitals. By contrast, no increased risk for these cancers was seen in survivors who did not receive radiotherapy.
The 40-year cumulative rate of a second cancer was higher for survivors diagnosed with cervical cancer before rather than after they were 50 years old: 22.2 vs. 16.4 percent, respectively.
"The most important finding is that even 40 years after a diagnosis of cervical cancer, survivors remain at increased risk of second cancers. These results are consistent with previous studies that showed increased second cancer risks beyond 30 years of follow-up, but that did not have sufficient data on time periods beyond 30 years," Chaturvedi told Reuters Health.
"The increased second cancer risk among cervical cancer survivors underscores the need for screening or regular medical surveillance," he emphasized.

Breast-feeding isn't such a drag on breasts

2007-11-04T06:19:00.000-08:00

Study says nursing isn't the culprit, but smoking has droopy side effect

Breast-feeding won’t make a new mom’s breasts sag, but having more babies might, a new study indicates.
"A lot of times, if a woman comes in for a breast lift or a breast augmentation, she'll say 'I want to fix what breast-feeding did to my breasts,'" said University of Kentucky plastic surgeon Brian Rinker. So he decided to study any possible connection.
Rinker and his colleagues interviewed 132 women who came in for breast lifts or augmentation between 1998 and 2006. On average, the women were 39 years old, and 93 percent had experienced at least one pregnancy. Among the mothers, 58 percent had breast-fed at least one of their children. The average duration of breast-feeding was nine months.

The researchers evaluated the womens' medical history, body mass index (BMI), pre-pregnancy bra cup size and smoking status.
The results of the study, presented this week at a conference of the American Society of Plastic Surgeons, showed no difference in the degree of breast ptosis (or sagging) between women who breast-fed and those who didn't.
The main factors that did affect sagging were age, smoking status and the number of pregnancies a woman has had.
Rinker noted that the smoking connection made sense because "smoking breaks down a protein in the skin called elastin, which gives youthful skin its elastic appearance and supports the breast."
Pregnancy also "has a very strong contribution to breast ptosis (sagging)," Rinker said in an email interview. "In fact, our study showed that those negative effects increase with each pregnancy."

Rinker says this finding should alleviate the fears of new mothers over what nursing their child might do to their breasts in the long run and will encourage them to breast-feed because of the health benefits to their infant.
"Women may be reluctant to breast-feed because of this unfounded myth that doing so means the end of youthful breasts," Rinker said. "Now, expectant mothers can relax knowing breast-feeding does not sacrifice the appearance of their breasts."

Doctors urge cancer patient mental screening

2007-11-04T06:13:00.000-08:00

Doctors treating cancer patients should try harder to help them deal with the emotional toll the disease exacts, an expert panel said on Tuesday.
The panel convened by the Institute of Medicine recommended that cancer care providers systematically screen patients for emotional distress and other mental problems and connect them with people who can help.
The medical establishment has worked hard to develop new and better ways to treat tumors while devoting less effort to patients' emotional needs, the panel said.

"We have spent gazillions of dollars for getting Cadillac treatments for the biomedical piece of it. But we haven't spent money on the gas to make it go," said Nancy Adler, a professor of medical psychology at the University of California, San Francisco who headed the panel.
Many cancer patients undergo harsh chemotherapy and radiation treatments and sometimes disfiguring surgical operations. They suffer prolonged nausea, fatigue, pain and hair loss and are unable to work or maintain social or family obligations.
Link patients to servicesAnd some often have little time left to live.
"Unmet psychosocial needs are common among cancer patients and their families. There are services available that could help them. But right now, they're not being linked up to these services," Adler said in a telephone interview.
Psychosocial health services are an integral part of cancer care, the panel said. Many such services already exist, often at no cost to patients, but care providers often fail to identify patients' needs and do not help them find and use these resources, the committee said.
Screening patients to find those who might need more support for emotional issues may be as simple in some cases as a short questionnaire that a patient would fill out while sitting in the doctor's office waiting room, Adler said.
The panel said it is important that cancer care providers not only screen patients for emotional issues but periodically re-evaluate them to see if their needs have changed.
Such needs might include more information about medical therapies they are undergoing and their possible side effects, treatment for depression and assistance with normal daily activities they can no longer do on their own, the panel said.
The Institute of Medicine advises U.S. policymakers on medical issues.

Some face long-term cervical cancer risk

2007-11-04T06:05:00.000-08:00

Women with pre-cancerous lesions may need follow-up tests for 25 years
Women treated for pre-cancerous lesions are at increased risk of developing cervical or vaginal cancer for at least another 25 years, according to a study suggesting that follow-up tests fall dangerously short.
Using data from Sweden’s national cancer registry, the researchers said on Friday women who have had severe lesions in the cervix are more than twice as likely to develop one of the two cancers than women in the general population.
The findings underscore the need for follow-up tests to continue for at least 25 years after treatment, far longer than the current five or 10 years standard in most European countries, said Bjorn Strander, a gynecologist at Sahlgren’s University Hospital in Sweden, who led the study.

“This is a warning to the healthcare system to keep track of these women,” he said in a telephone interview. “It has not been known these women remain at risk for such a very long time.”
Most cases of cervical cancer are caused by the sexually transmitted human papilloma virus and is the second most common type of cancer in women. Vaginal cancer is far more rare, with about 13,000 women diagnosed each year.

Risk remains steady
Women in many countries have an annual Pap smear to check for early signs of these lesions, which are easily removed if caught before they develop into cancer.
Nonetheless cervical cancer kills 300,000 each year, mostly in developing countries. Merck and Co’s Gardasil and GlaxoSmithKline’s Cervarix vaccines protect people against certain strains of HPV, but not all.

In their study, the researchers mined the National Swedish Cancer Register for information recorded from 1958 to 2002 on more than 132,000 women diagnosed with pre-cancerous lesions.
They found that 881 women had developed cervical cancer and 111 women had vaginal cancer more than one year following their diagnosis — even after they had their lesions removed.
And the risk remained high for a long time, they said.
“We haven’t investigated why but there are indications it could be because a lack of surveillance,” Strander said. "The risk is quite steady. It does not decrease.”
A woman’s risk also rose if she was older at diagnosis, also possibly due to the healthcare system letting down its guard during follow-up care, Strander said.
The Swedish study, published in the British Medical Journal, did not look at whether a Pap smear or DNA test represented the best way to screen these women but said it merits further study, Strander added.
Two Italian researchers writing in a related editorial agreed the findings should spark further study and said they clearly show current testing guidelines are not sufficient.
“One clear indication is that women treated for (severe pre-cancerous lesions) should continue surveillance beyond the age limit of regular screening,” they wrote.

3 drinks a day raises breast cancer risk

2007-11-03T23:07:00.000-07:00

All types of alcohol — wine, beer or liquor — add equally to the risk of developing breast cancer in women, American researchers said Thursday.
"This is a hugely underestimated risk factor," said Dr. Patrick Maisonneuve, head of epidemiology at the European Institute of Oncology in Italy, who was not connected to the study.
"Women drinking wine because they think it is healthier than beer are wrong," he said. "It's about the amount of alcohol consumed, not the type."

Previous studies have shown a link between alcohol consumption and breast cancer, but there have been conflicting messages about whether different kinds of alcohol were more dangerous than others.
The researchers, led by Dr. Arthur Klatsky of the Kaiser Permanente Medical Care Program in Oakland, Calif., revealed their findings at a meeting of the European Cancer Organization in Barcelona.
Researchers analyzed the drinking habits of 70,033 women of various races and asked them questions during health exams between 1978 and 1985. By 2004, 2,829 of these women had been diagnosed with breast cancer.

Klatsky and his colleagues looked at which types of alcohol the women drank, as well as their total alcohol intake. They compared that to women who had less than one drink a day.
Researchers found no difference in the risk of developing breast cancer among women who drank wine, beer, or liquor. Compared with light drinkers — those who had less than one drink a day — women who had one or two drinks a day increased their risk of developing breast cancer by 10 percent. Women who had more than three drinks a day raised their risk by 30 percent.
"A 30 percent increased risk is not trivial," Klatsky said. "It provides more evidence for why heavy drinkers should quit or cut down."
Other factors countSome experts said that people might be confused by suggestions that drinking red wine is healthy, since some studies have suggested that it protects against heart disease.
"None of these mechanisms have anything to do with breast cancer," Klatsky said. Though it is not entirely clear how alcohol contributes to breast cancer, some experts think it raises hormone levels in the blood to levels that could potentially cause cancer.
Still, doctors said that other factors, such as genetics, obesity, and age, were more important in raising the breast cancer risk than was alcohol consumption.
More public education may be needed. "Alcohol has had a lot of good publicity. People may not realize the risk they're taking when they have a few drinks," said Tim Key, of the Cancer Research UK Epidemiology Unit at Oxford. Key was not involved in the study.
According to data published in the British Journal of Cancer in 2002, 4 percent of all breast cancers — about 44,000 cases a year — in the United Kingdom are due to alcohol consumption.
Only a small proportion of women are thought to be heavy drinkers. But experts now say there is enough evidence to blame alcohol for breast cancer — and to start educating the public.
"Any alcohol consumption will raise your breast cancer risk," Key said. "Women don't have to abstain from alcohol entirely, but they need to be aware of the risks they're taking when they have a few too many drinks."

Simple tips to combat breast cancer

2007-11-03T23:04:00.000-07:00

Q. In honor of National Breast Cancer Awareness Month, what are some simple tips you can offer to empower women in the fight against breast cancer?
A. It wasn't long ago that people felt helpless when it came to defending themselves against cancer. Now, we know that awareness, medical advancements and personal action can help us win this fight against cancer.
Breast cancer statistics have proven that women can take measures to protect themselves. In the 1980s, there was a rapid increase in breast cancer cases (probably at least in part due to better screening via mammography). Though the increase in cases continued into 2000, it has slowed.
While it is the most common cancer among American women (excluding skin cancers) and the second leading cause of cancer death, there is some very encouraging news. Death rates from breast cancer have continued to decline since 1990, and the largest decreases are in women under age 50. Most likely, these decreases are a direct result of increased awareness, early detection, and improved treatment.

WINNING AGAINST BREAST CANCER
There are two key tools women have when it comes to winning against breast cancer: prevention and early detection. Here are some ways to put these tools to work:
Prevention:
1) Watch Your Weight: Those extra pounds translate into added risk. Added fat cells produce additional estrogen, which can stimulate growth in our breast cells and increase our risk of developing cancer.
2) Exercise Regularly: Research has given us plenty of motivation to embrace daily exercise. Studies have indicated that exercise can lower estrogen levels over time, as well as strengthen our immune system and lower stress.
3) Reduce Estrogen Exposure: Any extra exposure to estrogen can stimulate breast cell growth, thereby increasing our risk of breast cancer. In addition to extra weight, other sources and triggers of estrogen include: hormone replacement therapy (HRT) or dehydroepiandrosterone (DHEA), significant alcohol consumption, and red meat or other animal fats (including dairy fat).
4) Eat Cancer-Fighting Foods: There is some truth to the old saying, "You are what you eat." Our eating habits directly affect our bodies' functions, from maintaining energy levels to fighting cancer cells. A cancer-fighting diet will include plenty of fruits and vegetables, while limiting fats. Some people are going with organic diets, in hopes of eliminating extra hormones, pesticides and genetically modified organisms from their diets; however, the research is still needed to learn if organic foods carry additional health benefits over other foods.
5) Quit Smoking: If you needed another reason to quit, here it is. Smoking is a key culprit behind many diseases, and breast cancer is one of them. If you have breast cancer, smoking can even interfere with your treatment. Talk with your physician to learn about the many resources available to you to help you stop smoking.
6) Know Your Risk: Most women with breast cancer have no apparent risk factors and having one or more risk factors doesn't necessarily mean you'll get breast cancer; however, women should discuss their risk factors with their physician. This information may affect their recommendations for mammograms. There is a wide range of uncontrollable and controllable risk factors. Some of these include: age, genetics, family history, previous incidence of breast cancer or abnormal biopsy, weight, alcohol use, and tobacco use.
Another key factor is race. Overall, Caucasian women have the highest incidence rate for breast cancer among U.S. racial/ethnic groups, but African American women have the highest death rate from breast cancer. Research has shown that African American tend to seek treatment when their cancer is at a more advanced, less treatable stage, which tells us there continues to be a need for increased awareness and accessibility to health care resources.

EARLY DETECTION
1) Regular Exams: Around age 20, women should self-examine their breasts monthly, about three to five days after their period ends. This allows women to become familiar with their breasts' normal structure and identify any changes or abnormal characteristics. Also, your physician should exam your breasts once every three years starting at age 20, and every year after age 40. If you're not sure if you're doing a self-exam properly, talk to your physician.
2) Report Any Changes: In addition to lumps or masses within the breast tissue, women should look for changes in skin color (reddening or bruised appearance) or texture (ridges or dimpling), nipple changes, nipple discharge, swelling and changes in shape or symmetry. Also, talk to your doctor if you experience any tenderness or burning in your breasts.
3) Get Your Mammogram: Mammograms are an extremely powerful ally in detecting breast cancer in its early stages. At age 35, women should consider getting a baseline mammogram, which provides a reference point for future mammograms. At age 40, women should begin getting a yearly mammogram.

Smoking not linked to aggressive breast cancer

2007-11-03T23:01:00.000-07:00

Women who develop breast cancer are no more likely to have aggressive or advanced tumors if they are cigarette smokers than if they do not smoke, researchers said on Sunday.
Whether cigarette smoking raises a woman’s chances of ever developing breast cancer has remained a controversial question, with some research indicating a risk and other studies not.
Researchers at Fox Chase Cancer Center in Philadelphia investigated whether female smokers who got breast cancer were more likely to have a more serious form.

They analyzed data on 6,162 women with breast cancer evaluated at the facility from 1970 to 2006, and found that whether a woman smoked did not affect whether her tumor was more advanced or particularly aggressive at the time of diagnosis.
Nine percent of the breast cancer patients were smokers when they were first seen.
“For patients who developed breast cancer, there did not appear to be a difference in the cancers that they presented with based on whether or not they had ever smoked,” Dr. Matthew Abramowitz of Fox Chase Cancer Center, one of the researchers, said in a telephone interview.
“In addition, there did not appear to be a difference in the type of treatment they were offered, whether or not they were smokers,” added Abramowitz, whose findings were presented at a meeting of the American Society for Therapeutic Radiology and Oncology in Los Angeles.
Abramowitz said the study did not evaluate whether smokers were more likely than nonsmokers to have complications in treatment for breast cancer or die from the disease.

“I was expecting that maybe there would be more advanced stage (tumors) in patients who were smoking,” Abramowitz said.
Abramowitz said the findings do that mean that smoking is any less hazardous than multitudes of studies have shown.
The National Cancer Institute said cigarette smoking causes 87 percent of lung cancer deaths and is responsible for most cancers of the larynx, mouth, esophagus and bladder. It said tobacco use, particularly cigarette smoking, is the most preventable cause of death in the United States.

Quality of life is key to cancer survival

2007-11-03T22:57:00.000-07:00

Having someone who cares may be more important than medical factors

Having someone to drive you to cancer treatments or make sure you are eating may be even more important than tumor size or other medical factors in predicting cancer survival, U.S. researchers said on Tuesday.
They found patients with a below-average quality of life before getting treatment for lung cancer — those in poor health or with inadequate support networks — had nearly a 70 percent higher death rate than those with a better one.
"It's intuitive that someone who is in better physical shape and has a support system will do better than someone who comes in already debilitated and doesn't really have anyone to help them go through treatment," said Dr. Nicos Nicolaou of Fox Chase Cancer Center in Philadelphia in a telephone interview.

"We have now shown this," said Nicolaou, whose study was presented on Tuesday at the American Society of Therapeutic Radiology and Oncology meeting in Los Angeles.
Doctors routinely consider factors such as tumor size, stage of the disease and other measures to predict how long a patient with cancer will survive.
But factors that make up a patient's quality of life — overall health, mobility, emotional stability, social support and financial resources — may make the most difference, Nicolaou and colleagues found.
"If you have someone to help you with your meals, transportation, give you your medications and take care of your daily needs, both physical and emotional, you will be able to get through the treatment better," he said.
Researchers at Fox Chase and Henry Ford Hospital in Detroit studied 239 patients with lung cancer enrolled in a treatment trial involving both radiation and chemotherapy.
The study was designed to evaluate the role of quality of life as a prediction for survival. Questions included things like: "Do you have trouble taking a long walk?" or, "In the past week, did you feel irritable? Did you feel depressed?"

The researchers also analyzed classic predictors of survival such as gender, race, age, marital status, state of disease and tumor location.
Some 91 percent of patients completed a standardized quality of life survey before treatment. All patients were followed for at least 17 months.
What they found is quality of life emerged as the most significant predictor of overall patient survival.
"We conducted two different statistical analyses including all the usual prognostic factors and either way, quality of life remained the strongest predictor of overall survival," Dr. Benjamin Movsas of Henry Ford Hospital said in a statement.
"What's more, if a patient's quality of life increased over time, we saw a corresponding increase in survival," he said.
People who were single, divorced or widowed had significantly lower quality of life scores, and fared far worse in the study.
For these patients, doctors may need to take a more active role in ensuring that support services are in place before a patient undergoes cancer treatment, Nicolaou said.
"It is incumbent on the treatment team to make sure the patient's needs are met and the patient gets the support he needs to get through the treatment," he said. "It has to be an integral part of decision-making."

Vitamin D may not lower cancer deaths

2007-11-03T22:51:00.000-07:00

A large new study found no sign that vitamin D lowers the overall risk of dying from cancer, injecting a note of caution to the latest vitamin craze.
The exception: People with more vitamin D in their blood did have a significantly lower risk of death from colorectal cancer, supporting earlier findings.
Getting enough of the so-called sunshine vitamin — the skin makes it from ultraviolet rays — is vital for strong bones.

But vitamin D has made headlines in recent years because of research saying it may be a powerful cancer fighter, sparking a push for people to get more than currently recommended amounts, either through diet or sun exposure.
The first-of-a-kind government study released Tuesday shows the issue is far from settled.
National Cancer Institute researchers analyzed vitamin D levels measured in almost 17,000 people as part of a national study that tracked their health. About a decade after enrolling, 536 of those people had died of cancer.
Whether people had low or high vitamin D levels played no role in their risk of dying from cancer in general, they reported Tuesday in the Journal of the National Cancer Institute.
Then the researchers examined different types of cancer. There were just 66 deaths from colorectal cancer. Still, people with high levels of vitamin D appeared 72 percent less likely to die of colorectal cancer than people with the lowest vitamin D levels.
"While vitamin D may well have multiple benefits beyond bone, health professionals and the public should not, in a rush to judgment, assume that vitamin D is a magic bullet and consume high amounts," Johanna Dwyer, a dietary supplement specialist at the National Institutes of Health, cautioned in an accompanying editorial.
Indeed, there are numerous risk factors for colorectal cancer, including obesity and low physical activity, and it's unclear if low vitamin D levels play an independent role or are just a marker for those other risks, she said.

Scientists have been interested in vitamin D's effects for decades, since noticing that cancer rates between similar groups of people were lower in sunny southern latitudes than in northern ones. A handful of studies since then have found people given vitamin D supplements have less risk of developing certain cancers, but much of the evidence is circumstantial.
Experts are cautious because other vitamins and nutrient supplements once widely thought to prevent cancer didn't pan out when put to rigorous testing.
The NCI's study is the first to compare blood levels of vitamin D to cancer mortality, and "it's the best research we have on this topic," said Dr. Len Lichtenfeld of the American Cancer Society.
But a big weakness: It measured vitamin D at just one point in participants' lives, when levels can vary widely with dietary changes and especially the seasons.
Overall, most research "seems to be pointing in the direction that there is a role of vitamin D," Lichtenfeld said. Tuesday's study "puts a note of caution in there that says with all the explosion of information and advocacy on behalf of vitamin D, we need to be cautious. ... We really need some further studies that are well done to answer the question."

Smart nutrition tips to help prevent breast cancer

2007-11-03T22:44:00.000-07:00

About 178,480 women in the United States will be found to have invasive breast cancer in 2007; it’s the most common type of cancer among women in the United States, other than skin cancer. While some of the risk factors for breast cancer are not within our control, such as gender, age or family history, there are some factors that are within our control, such as diet and exercise. In regard to lifestyle, here’s what research suggests:

Maintain a healthy weight

Studies show that maintaining a healthy weight (especially for postmenopausal women) is an important aspect of decreasing one's risk of developing breast cancer. In fact, one study showed that obese women (BMI >30) had a 31 percent greater risk of developing breast cancer compared to women of healthy body weight (BMI <>

Exercise regularly

One study showed that women who engaged in strenuous recreational activity for more than six hours a week had a 23 percent reduction in risk of breast cancer. Other studies indicate that anywhere from five to seven hours per week decreases risk. Even active housework has been shown to reduce your risk!
Watch the amount and type of fat you eatResearch suggests that greater total fat consumption (about 40 percent or more of daily calories) poses a greater risk for breast cancer than lower total fat consumption (about 20 percent of daily calories). With that in mind, try to limit total fat intake to less than 30 percent of daily calories in order to help in the prevention of breast cancer.Exercise regularlyOne study showed that women who engaged in strenuous recreational activity for more than six hours a week had a 23 percent reduction in risk of breast cancer. Other studies indicate that anywhere from five to seven hours per week decreases risk. Even active housework has been shown to reduce your risk!

Watch the amount and type of fat you eat

Research suggests that greater total fat consumption (about 40 percent or more of daily calories) poses a greater risk for breast cancer than lower total fat consumption (about 20 percent of daily calories). With that in mind, try to limit total fat intake to less than 30 percent of daily calories in order to help in the prevention of breast cancer.

Saturated fats found in marbled meat and high-fat dairy products are more likely to increase risk of breast cancer than unsaturated fats found in nuts, seeds and avocados, as well as olive and canola oils. Try to limit saturated fat intake to less than 7 percent of total daily calories (if you’re following a 2,000-calorie diet, that’s no more than 15 grams).

Incorporate 5 vegetables/fruits a day

Produce provides numerous phytonutrients and antioxidants — substances which help prevent cellular damage throughout the body. One well-designed study found that regular consumption of five or more servings of veggies a day was associated with lower risk of breast cancer; however, according to a recent study published in JAMA, consuming more than five servings doesn’t seem to have any preventative effect. So when it comes to breast cancer prevention, I say aim for at least five daily servings of colorful produce.
Tip: Cruciferous vegetables such as broccoli, cabbage and brussels sprouts are particularly strong fighters (studies show they inhibit growth of breast cancer cells).

Limit alcohol

Studies show that above moderate (one or more drinks per day) consumption of alcohol is associated with increased risk of breast cancer. Alcohol may raise estrogen levels and decrease the body’s ability to use folic acid, a B vitamin that’s been linked to cancer prevention. To help minimize risk, stick with the Dietary Guidelines for Americans, which recommends no more than one alcoholic drink per day for women (one serving = 12 fluid ounces beer, 5 fluid ounces wine, or 1.5 fluid ounces of 80-proof distilled spirits).

Limit meats cooked at high temperatures

Cooking meats at high temperatures produces chemicals called heterocyclic amines (HCAs), which have been linked to an increased risk of certain cancers. Studies have shown that the risk is higher among people who eat meat (specifically beef) four or more times per week, and who cook their meats more thoroughly. The most HCAs are found in meats that have been fried, broiled or grilled — all cooking methods that typically use high temperatures. Roasting and baking produce fewer HCAs, and poaching, stewing or boiling meat produce the least.
I recommend limiting your intake of red meat altogether (aim for no more than three times each week), and cut back on your consumption of all meats cooked at high heat. When you do grill steak, pork and poultry, just be sure to trim excess fat, flip often and cut off charred or burnt parts of food before eating them (you may also want to cook meat slightly in the microwave or oven first, to lessen high-temperature cooking time). Also, marinate your meat before cooking — it helps to lessen HCA formation — and consider cutting meat into smaller chunks (they’ll cook faster, spend less time on the grill and you’ll reduce the likelihood of carcinogens forming).

Vitamin D

Vitamin D deficiency has been linked to several cancers, including breast. I recommend eating plenty of vitamin D–rich foods (salmon and sardines), and choosing vitamin D–fortified milk, yogurt and cheese. Because few foods provide vitamin D, you should consider a daily multivitamin that provides 100 percent DV of vitamin D3. If you think you’re a candidate for even more, speak with your physician.

Phytoestrogens

Phytoestrogens are a group of plant-derived compounds that are structurally and functionally similar to the hormone estrogen, which is found naturally in our bodies. There are several different groups of phytoestrogens; the most widely studied are the isoflavones, present in high concentrations in soy products such as soybeans, tofu, tempeh and soy milk.

When it comes to breast cancer, there has been some evidence that soy can play a protective role; however, its effects may depend on when in life it’s consumed. For example, Japanese women eat soy throughout life, whereas most American women may have only started eating soy as adults. It’s been proposed that isoflavones act as anti-estrogens in premenopausal women who have high circulating hormone levels. But after menopause, when estrogen levels are low, they may act like estrogens and any estrogen boost, even if weak, may at least theoretically be harmful in such women. The optimal amount of dietary soy is unknown — and different forms of soy may have different effects. For example, highly processed soy foods (meat analogues and energy bars) may have less biological activity than whole soybeans or soy milk.
What’s the bottom line? A moderate amount of soy consumption can be part of a healthy diet (1-2 servings daily), particularly in premenopausal women. A serving = ½ cup tofu, tempeh, edamame (out of the pod), ¼ cup soy nuts or 1 cup soy yogurt or soymilk. **However, if you have or have had breast cancer, or you’re at high risk, it’s important you speak with your personal physician and follow their expert advice when it comes to soy consumption. This remains a controversial topic and you may be instructed to completely avoid.

Important: Always avoid soy supplements — they may contain higher levels of isoflavones than present in soy foods without the other potentially healthy components. Long-term effects are not yet known.

Spice it up with curcumin!

Recent studies show that curcumin, the yellow spice found in turmeric and curry powder, may have anti-tumor compounds that can protect against breast cancer. Try these quick and easy tips to add curcumin to your diet:
If you like eating out, enjoy Indian cuisine for a change.
Add a teaspoon of curry powder to air-popped popcorn as a snack.
Mix ½ teaspoon curcumin or curry powder to hummus (dip with veggies, bonus!).
Butternut squash soup with a dash of curry adds a nice kick.
Add a little turmeric and ginger to oven-roasted veggies for great flavor.

Hypnosis Eases Pain of Breast Cancer Surgery

2007-10-25T21:10:00.000-07:00

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

2007-10-25T20:35:00.000-07:00

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?

2007-10-25T20:31:00.001-07:00

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

2007-10-25T20:21:00.000-07:00

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

2007-10-22T23:57:00.000-07:00

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

2007-10-22T23:39:00.000-07:00

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

2007-10-22T23:34:00.000-07:00

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

2007-10-22T23:27:00.000-07:00

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

2007-10-22T23:15:00.000-07:00

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

2007-10-22T23:10:00.001-07:00

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

2007-10-22T23:05:00.000-07:00

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

2007-10-22T23:01:00.000-07:00

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

2007-10-22T22:55:00.000-07:00

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

2007-10-22T22:47:00.000-07:00

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?

2007-10-22T22:39:00.000-07:00

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

2007-10-22T22:35:00.000-07:00

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

2007-10-22T21:52:00.000-07:00

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

2007-10-22T21:46:00.000-07:00

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

2007-10-22T21:42:00.000-07:00

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.