Simple tips to combat breast cancer

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.

Smart nutrition tips to help prevent breast cancer

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.

Take an active role in fighting breast cancer

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

Risk factors

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

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

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

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

Risk categories and tips

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

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

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

Komen's screening guidelines

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

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

• Age 40: Mammography annually

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

Breast health and cancer prevention tips for women and men

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

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

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

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

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

Tips for coping with breast cancer

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

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

Alterna-exercise

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