Living with Breast Cancer
9/1/2010 (9:22:22pm)Tags: alcohol recurrence riskComments: (0)
Ok, I admit it. I really hate these studies about alcohol increasing the recurrence risk. Those of you who are regular readers of this blog may remember that the first study about this was presented at the San Antonio Breast Meeting in December. At that time, I was in Paris and definitely not interested in learning that red wine at dinner (or lunch) might be a bad idea. My most favorite lunch, perhaps my most favorite, meal in the whole world is in France: cheese omelet, green salad with the simple dressing that I am unable to duplicate (and I am a good cook and have tried), pommes frites, and a glass of red wine. Heaven. So, the obvious challenge here is balancing what is smart and sensible about our health and what makes us happy and our lives wonderful. I am just not willing to never again have that lunch or wonderful wine with dinner. My compromise is to go to the gym every day, or almost every day, and hope that the exercise will neutralize the wine. What you do is up to you.
Print This Close Window
Moderate Drinking May Boost Risk of Breast Cancer's Return
But it could reduce the risk of dying from other causes, study finds
By Alan Mozes
HealthDay Reporter
MONDAY, Aug. 30 (HealthDay News) -- Drinking even moderate amounts of alcohol may raise the risk for breast cancer recurrence in some women, new research indicates. The association seems confined to former breast cancer patients who are postmenopausal or overweight or obese, the researchers noted.
However, drinking moderately (about three to four drinks per week) was not linked to increased risk for all-cause death, and may in fact lower the risk for dying from a non-breast cancer-related health issue, the study suggests.
The observations are reported in the Aug. 30 online edition of the Journal of Clinical Oncology by a team led by Marilyn L. Kwan, a researcher at Kaiser Permanente in Oakland, Calif. The findings are "consistent with what we already know about alcohol's role in increasing the risk for developing primary breast cancer," said Kwan.
"But I want to emphasize that women who consume less than three to four drinks per week didn't see any increased risk in terms of recurrence or breast cancer death," Kwan added. "And, in fact, we did see a suggestion that women who consume small amounts of alcohol get some protection against the risk of death due to cardiovascular disease." But that finding was not statistically significant, she noted.
Between 2000 and 2002, Kwan and her colleagues recruited about 1,900 women in California and Utah, most of whom had been diagnosed about two or three years earlier with early-stage breast cancer.
To explore the potential relationship between drinking and breast cancer risk, the researchers asked the women to complete a dietary survey, indicating their routine consumption of wine, beer and/or liquor. Just over half the women were considered drinkers. Nearly nine in 10 drank wine, more than 40 percent consumed liquor, and almost 36 percent drank beer.
Over nearly seven and a half years of follow-up, 293 women experienced breast cancer recurrence, and 273 died from a variety of health complications.
Kwan's team found that study participants who were postmenopausal or overweight/obese raised their risk for breast cancer recurrence by nearly 1.5 times if they regularly consumed a minimum of three to four drinks of any type of alcohol a week.
Similarly, that group of women faced a 1.5 times greater risk of dying from breast cancer if they followed the same drinking patterns.
On the other hand, the research team unearthed indications that drinking any amount of alcohol may possibly decrease the risk of dying from causes other than breast cancer. However, Kwan stressed that the findings will need to be confirmed by other studies.
Dr. Paula Klein a medical oncologist and breast cancer specialist at the Beth Israel Comprehensive Cancer Center in New York City, who was not involved in the research, described the observations as useful, as long as they are
taken in context.The researchers only looked at moderate drinking, not heavy drinking, and their finding is confined to women who are postmenopausal and those who are overweight or obese, she stressed. "But that's a good thing, because
information like this -- where risks and benefits are confined to different subgroups -- is part of the new push to personalize medicine," she said. "Because one size doesn't fit all in terms of risk factors and treatments."
The study is important because it adds to a woman's awareness of risk factors for the development and recurrence
of breast cancer, she said. "And it's another gentle reminder of the risks associated with being overweight and obese, and how small additional factors can influence outcomes," she added. When patients ask what they can do to lower their risk, this is a modifiable change, alongside weight loss and exercise, she said.
"For those patients who really want to enjoy their wine and are thin, you can assure them that a little bit of wine with dinner is not going to make a dramatic difference in their breast cancer risk. But for those who are overweight/obese, you can ask them to control their alcohol intake."
More information
For more on breast cancer prevention, visit the U.S. National Cancer Institute.
SOURCES: Marilyn L. Kwan, Ph.D., division of research, Kaiser Permanente, Oakland, Calif.; Paula Klein, M.D.,
medical oncologist and breast cancer specialist, Beth Israel Comprehensive Cancer Center, New York City; Aug. 30,
2010, Journal of Clinical Oncology, online
9/1/2010 (7:05:19am)Tags: information internet sourcesComments: (0)
Reading about cancer is a perfect example of the best and the worst of the Web. On the positive side, it is often very helpful to find information about types of cancer, treatments, medical centers, and to connect with others. On the other hand, there is a lot of incorrect and scary information (see recent posts), and it can be hard to distinguish truth from myth--especially when you are vulnerable.
This is a good tip list from ASCO re how to tell the good from the bad:
Evaluating Cancer Information on the Internet
Last Updated: August 23, 2010
The Internet is a useful tool for finding information about cancer and connecting with other patients and caregivers. However, it can be difficult to find credible, reliable information about cancer causes, risk factors, treatment, and recovery. Because Internet content is not regulated, you need to use good judgment when searching online. Consider the following questions when viewing cancer information websites:
Who operates the website? The person or organization that operates the website should be identified throughout. This way, users know the source and purpose of the information, for example, whether it is educating people about a disease or selling a product. Find the "About Us" section to learn more about who operates the site, and use this information to help you judge the material.
Who is responsible for the website's content? Reliable websites tell you who edits and approves the content (such as an editorial board) and how to contact the organization that operates the website. For example, the About Us section on Cancer.Net includes a list of Cancer.Net Editorial Board members—
including more than 150 medical, surgical, radiation, and pediatric oncologists, oncology nurses, social workers, and patient advocates—and the seal of approval from the Health On the Net (HON) Foundation,
an organization that established a code of conduct for health and medical websites. The "Contact Us" link provides users with an address, phone number, and e-mail address to reach the Cancer.Net editorial staff.
Be cautious when reading information posted on discussion groups or bulletin boards because this part of the website may not be regularly reviewed or updated.
Who funds the website? A website's financial backing may affect how information is presented. This is called bias. High-quality websites make it easy to tell the difference between advertisements and medical
information. Avoid websites that try to promote a specific medication or treatment over another.
How does the website maintain your privacy? If the website requires you to give confidential information —such as your name, address, e-mail address, or diagnosis—there should be a separate security or privacy policy statement that tells you how this information will be used. Read Cancer.Net's privacy policy.
Where do they get their information? Reliable cancer information is based on scientific evidence and not personal feelings or experiences. When learning about treatment options, look for links or references to research studies. If information is based on an opinion, it should be clearly labeled. Be cautious about scientific-sounding material that has no data to support it.
How current is the information on the website? Cancer information changes quickly as researchers learn more about the various cancer types and develop new treatments. Thus, information that is several years old
may no longer be accurate. Look for a date at the beginning or end of an article, which will tell you when the article was last posted or reviewed.
Does the website have a linking policy? Links may take you to other websites on the Internet. Be aware that the new website may not have the same standards as the one you left. Some sites have a policy of only linking to websites that meet specific criteria, while other sites may include links to any website. Read
Cancer.Net's linking policy.
What does your doctor say? Discuss information you find on the Internet with your doctor or health care provider. Your doctor can help you evaluate the information and determine whether it applies to you.
Other suggestions
Ask your doctor to suggest reliable websites.
Bookmark the websites you like and check back often for new information.
Trust your judgment if something you read does not seem right or seems too good to be true.
8/31/2010 (9:08:37am)Tags: stress anxietyComments: (0)
This seems a nice companion piece to yesterday's entry about personality not making a difference in cancer incidence or recovery. While I hope that you are now totally convinced that your mood or personality or coping style make no difference at all in your cancer health, we all know that feeling less stressed is more comfortable. This is a nice list from CureToday of simple ways to manage stress:
Stress Reducers
BY LAURIE M. FISHER
Ten science-based stress reducers to help manage post-treatment stress.
Here are 10 science-based stress reducers to help manage post-treatment stress, provided by Barbara L. Andersen, PhD, of Ohio State University’s Department of Psychology and the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute.
1 .
Understand stress and your responses to it.
Recognize cancer stressors and try to identify the physical changes it may produce for you, such as headaches, heart pounding, and abnormal breathing. Emotional tolls may manifest as fatigue, difficulty making decisions, or anxiety.
2 .
Learn how to relax.
Progressive muscle relaxation lowers tension and reduces wear and tear on the body. Relaxation can help control cancer therapy symptoms,such as nausea and fatigue. Practice at least three times per week for 20-minute sessions. Learn to relax through other methods, including meditation, yoga,massage, and/or deep breathing.
3 .
Resolve to problem solve.
Define and target your problem. Generate and implement solutions and evaluate the result.
4 .
Identify a social support network.
Share your reactions to the cancer crisis and adapt coping techniques. Accept the spontaneous offers of help from friends and family. Seek out help through online support and cancer message boards.
5 .
Communicate how stress is affecting you.
Express your thoughts, feelings, and needs for help to your health care providers, support groups, friends, and family.
6 .
Focus on nutrition.
Eat less fat and more fiber. Fuel up with fruits, vegetables,and proteins. If appetite loss is a problem, eat smaller meals and eat more frequently.
7 .
Get plenty of sleep.
Aim for seven to nine hours of sleep to encourage health and well-being. Even with adequate sleep, however, individuals can experience cancer-related fatigue.
8 .
Start or resume an exercise -regime.
Increase your activity level. Gentle exercise, such as walking or swimming, can help relieve tense muscles and improves mood. Consult with your physician to affirm your readiness for exercise. Start with a small achievable goal, such as 10 minutes a day, and slowly increase as endurance improves. Exercising with a friend often can help to maintain your own interest and motivation.
9 .
Learn to manage physical and mental health symptoms.
Call your doctor,when necessary, or come to your appointments with questions. Comply with follow-up visits and medical advice. Seek professional psychological help if needed.
1 0 .
Make time and care for yourself.
Treat yourself to something you enjoy.
8/30/2010 (8:51:45am)Tags: personality stress causes of cancerComments: (0)
I love this study. For years, I have promising women that personality or coping or stress do not impact either the development or the possible progression of cancer. Old myths die hard (see yesterday's blog)--especially when there is an industry and culture built around them. So, let's say it together and believe it: personality does not matter vis a vis cancer. Your outlook or mood definitely make a difference in your quality of life in any given day, but don't make one whit of difference to your cancer health.
This is a summary from MedScape about a study by Naoki Nakaya, PhD and his colleagues at the Danish Cancer Society, The study was published in the Journal of Epidemiology:
Given the evidence, we think that it is time to retirethe hypothesis.
From
Medscape Medical News
August 27, 2010 — Personality has no effect on cancer risk or cancer survival, concludes a new study based on the largest and most relevant dataset to date. Other recent studies have also found no link or have been inconclusive.
It is time to finally retire the hypothesis that personality has an effect on cancer, say psychologists reporting and discussing these findings in the August 15 issue of the
American Journal of Epidemiology
.In the study, Naoki Nakaya, PhD, and colleagues from the Institute of Cancer Epidemiology at the Danish Cancer Society in Copenhagen, analyzed data from more than 4500 cancer patients and found no effect of personality on either risk or survival.
"Cancer patients should not think that their personality traits may have affected their cancer or cancer prognosis," the researchers conclude.
"Given the evidence, we think it is time to retire the hypothesis that personality— as it has been studied until now — is causally related to the onset of and survival from cancer," said Adelita Ranchor, PhD, professor of health psychology at the University of Groningen, the Netherlands.
"Studies so far have failed to find any epidemiological evidence," she told
Medscape Medical News. Dr. Ranchor coauthored an editorial that accompanied the study with Robbert Sanderman, PhD, also from the University of Groningen, and James C. Coyne, PhD, professor of psychiatry at the University of Pennsylvania in Philadelphia.
Dr. Nakaya, principal investigator of the study, told
Medscape Medical News that he agrees that it is time to retire this hypothesis, and urges physicians to tell cancer patients about these findings so that they can stop worrying.
"Many patients worry that their own personality has made their cancer develop, or that their personality shortens longevity," Dr. Nakaya said. "But our research shows that this is not the case, so cancer patients need not worry about this," he reported.
Strongly Held Cultural Beliefs
The hypothesis that personality influences cancer can be traced back to the times of the Ancient Greeks, the editorialists note. The idea resurfaced in the 1960s after a few positive studies — which have since been severely criticized — led to the idea that some personality traits lead to an increased risk for cancer, and that once cancer has developed, optimism and a fighting spirit can extend survival.
Some of these ideas have now become "embedded in a matrix of strongly held cultural beliefs," the editorialists note. Many of the theories on personality and cancer were proposed by Hans Eysenck, who was involved in some of the early studies and who developed the personality test that was used to measure extraversion and neuroticism in many of these studies.
The personality test itself is "well validated and widely accepted," the editorialists point out, "but Eysenck's views on the relation of personality to cancer are not." He was "one of the most vigorous proponents of personality as a risk factor for cancer," and even though much of his work in this field has since been discredited, his ideas are still influential because not everyone is aware of the criticisms surrounding his controversial work, which continues to be cited, Dr. Ranchor said.
On the basis of a small study, published in 1962, that found that lung cancer patients were more likely than control subjects to score high on extraversion and low on neuroticism, Eysenck proposed that these personality traits affect an individuals' risk for cancer because they affect stress, which in turn affects the immune and endocrine systems. His explanation for this was that people who scored high for extraversion would seek out stimulation and would therefore experience high levels of stress, and that people who scored low for neuroticism (which measures emotional instability) would tend not to express their feelings and would therefore experience a high level of emotional stress.
Some of these theories were extended to cancer patients, with the idea that the accumulated repression of emotions would cause stress, which again, through an effect on immune and endocrine functions, would have a negative effect on cancer progression. This led to the idea that psychological factors such as optimism and fighting spirit can have a positive effect on cancer. "These views are still widely held, even though evidence from high-quality studies does not support these theories, and no reasonable mechanisms to explain how the effect can be mediated have been identified," Dr. Ranchor explained.
Although the idea that a fighting spirit prolongs survival offers a sense of hope, it can also cause turmoil in the lives of cancer patients and their families, which is very sad when patients have only a limited time left, Dr. Ranchor said. Patients might be accepting of the disease, but the family thinks that they should fight because they want the patient to recover. And of course, patients themselves can become seriously disappointed if they think it is possible to fight the disease when it "turns out that it is not," she added.
If the doctor sees that the patient and/or family are struggling with such issues, providing relevant information might help, she said.
Latest Study Largest So Far
This study by Dr. Nakaya and colleagues — which is "undoubtedly the largest relevant dataset ever assembled" — found no association between personality traits and all-cancer incidence or mortality, the editorialists write.
We can now be reasonably confident.
Null results should be given a weight that takes into account not only the study's superior sample size but also its methodological strengths, they explain. "We can now be reasonably confident that the overall effect size for a personality–cancer causal association is much too small to have clinical and public health implications, if it exists at all," the editorialists write.
The hypothesis that personality can influence cancer should "quietly pass into oblivion," they suggest. However, they acknowledge that it is not likely to disappear because of "strongly held cultural beliefs and ideology."
Conducted in Scandinavia
The study was conducted while Dr. Nakaya was at the Danish Cancer Institute — he has since returned to Japan, and is now at the Kamakura Women's University. The team was headed by Christoffer Johansen, MD, PhD, DMSc, head of the department of psychosocial cancer research at the Institute of Cancer Epidemiology at the Danish Cancer Society.
They analyzed data collected in twin studies conducted in Sweden and Finland, in which all participants completed personality questionnaires, and linked it to data collected in the national cancer registries of both countries.
For the analysis of the association with risk for cancer, data from both Sweden and Finland were used. It involved 59,548 individuals who had completed questionnaires and 4631 cases of cancer, with a maximum of 30 years follow-up.
For the analysis of the association with cancer survival, only data from Finland were used. It involved 2733 cancer cases and 1548 subsequent deaths, with a maximum of 29 years of follow-up.
Neither analysis found any association between extraversion or neuroticism and the risk for cancer at any site or the risk for death from cancer at any site.
"Our findings are in line with those of recent prospective studies, which provide no support for the hypothesis that personality traits are direct risk factors for cancer at all sites," the researchers conclude.
They note, however, that their own study found a significant positive but very weak association between extraversion and neuroticism and the risk for lung cancer; this has also been seen in previous studies. They explain this by suggesting that this effect is mediated through smoking — people with a certain personality are more likely to smoke,increasing their risk for lung cancer.
The team also found a significant negative association between neuroticism and the risk for liver cancer, but they suggest that this might be a chance finding. There was no mediation by alcohol consumption, and the numbers were small, they add.
The editorialists discuss both of these findings, and agree that smoking might explain the increased risk for lung cancer, but "no plausible biological pathway can be mustered" to explain the reduced risk for liver cancer. "We might concede that both are due to chance, rather than embrace one finding but not the other," they add.
Am J Epidemiol
. 2010;172:377-385, 386-388. Abstract,
Abstract
Medscape Medical News © 2010 WebMD, LLC
Send press releases and comments to
news@medscape.net
.
"The notion that personality is related to cancer onset and its course might cause turmoil for the patients and their families because there might be some pressure on the patient to fight the cancer," Dr. Ranchor added. If doctors see that the patient and family are struggling with this issue, then providing relevant information can bring some peace of mind, she explained.
8/29/2010 (9:13:38am)Tags: email hoaxes rumorsComments: (0)
For a long time, I have occasionally seen an email purporting to be from Johns Hopkins with a scary and incorrect rumor about cancer. The most common one is the plastic bottles cause cancer, but there are others. And there are others that don't pretend to come from Hopkins, but have statements that seem designed to raise your anxiety.
Here, at last, is a clear statement from Johns Hopkins about all those emails. I am betting it does not get the wide circulation that the rumors do. But, next time you receive or hear about one of these false statements, you can respond with this.
Cancer Update Email -- It's a Hoax!
Updated April 2009
STATEMENT: EMAIL HOAX REGARDING CANCER
Information falsely attributed to Johns Hopkins called, "CANCER UPDATE FROM JOHN HOPKINS" describes properties of cancer cells and suggests ways of preventing cancer. Johns Hopkins did not publish the information, which often is an email attachment, nor do we endorse its contents. The email also contains an incorrect spelling of our institution as "John" Hopkins; whereas, the correct spelling is "Johns" Hopkins. For more information about cancer, please read the information on our web site or visit the National Cancer Institute's web site at www.cancer.gov. Please help combat the spread of this hoax by letting others know of this statement.
Another hoax email that has been circulating since 2004 regarding plastic containers, bottles, wrap claiming that heat releases dioxins which cause cancer also was not published by Johns Hopkins. More information from the Johns Hopkins Bloomberg School of Public Health.
Mythbusters: Please help curb the spread of this hoax by sending a link to this page to individuals that forward you this email.
The Truth about the "Cancer Update" Email
It has become such a problem, that the National Cancer Institute, American Cancer Society, and individual cancer centers like the Johns Hopkins Kimmel Cancer Center have posted warnings on their Web sites. Emails offering easy remedies for avoiding and curing cancer are the latest Web-influenced trend. To gain credibility, the anonymous authors
falsely attribute their work to respected research institutions like Johns Hopkins. This is the case with the so-called “Cancer Update from Johns Hopkins.”
The gist of this viral email is that cancer therapies of surgery, chemotherapy, and radiation therapy do not work against the disease and people should instead choose a variety of dietary strategies.
Traditional therapies, such as surgery, chemotherapy, and radiation therapy, work. The evidence is the millions of cancer survivors in the United States today who are alive because of these therapies. We recognize that treatments don’t work in every patient, or sometimes work for awhile and then stop working, and there are some cancers that are more difficult
to cure than others. These problems are the focus of ongoing cancer research.
We’ll go through each statement in the email hoax and provide real responses from Johns Hopkins Kimmel Cancer Center experts.
Email hoax contentions #1 and 2: Everyone Has Cancer Cells
Cancer is a genetic disease resulting from a variety of mutations and alterations either inherited from our parents or, more commonly, acquired over time due to environmental exposures and behaviors, such as smoking and poor diet.
These alterations turn off important cell growth regulators allowing cells to continually divide unchecked, explains Luis Diaz, a clinician-scientist in Ludwig Center for Cancer Genetics. This type of cell is called a malignant or cancer cell. Among the trillions of cells in the human body, inevitably everyone has some abnormal or atypical cells that possess
some of the characteristics of cancer cells, most resolve themselves and never result in cancer, says Diaz.
There is no single or standard test for cancer. There are ways to screen for certain cancers with tests such as colonoscopy for colon cancer, mammography for breast cancer, PSA for prostate cancer, and the Pap smear for cervical cancer, and these tests can detect cancers in a very early and curable stage. For many cancers, there currently are no
screening tests, and they are diagnosed when they begin to cause symptoms.
Diaz and other Kimmel Cancer Center researchers are working on new tests that detect abnormal DNA shed by cancer cells into blood and body fluids and have the ability to find cancers before they cause any symptoms. Approaches like this could lead to a broad-based screening test for cancer.
Tests like these also are being used to detect cancer recurrences and malignant cells left behind following surgery, and can find cancers that are not detectable under the microscope or in x-rays.
Other researchers are studying cancer stem cells. They are stealth cells that make up just a tiny fraction of a tumor. While small in number, investigators believe they may be the cells that drive certain cancers and lead to cancer recurrence. Therapies that target these cells are now being tested in clinical trials. A team of our breast cancer researchers has developed a method that could make it possible to detect breast cancer from the DNA contained in a single drop of blood.
But, while evasive cancer cells are a challenge and the focus of ongoing research, it does not mean, as the email contends, that all patients, even those treated successfully for cancer, have cancers-in-waiting—undetectable but still there. People are treated and completely cured of cancer everyday.
Email hoax contention #3: A Strong Immune System Destroys Cancer
When it comes to cancer and the immune system, it is not a matter of strong or weak as the fictional report contends, but rather an issue of recognition. The immune system simply does not recognize cancer. In its complexity, the cancer cell has learned to disguise itself to the immune system as a normal cell. Infected cells send out danger signals setting the
immune system in action. Cancer cells do not, explains Elizabeth Jaffee, co-director of cancer immunology and leading expert on cancer and the immune system. By deciphering the methods cancer cells use to make them invisible to the immune system, Jaffee and team have developed cancer vaccines that have successfully triggered immune reactions
against prostate cancer, pancreatic cancer, leukemia, and multiple myeloma.
Email hoax contention #4 and #5: Cancer is caused by Nutritional Deficiencies and Supplements Will Correct Them
Dietary habits and lifestyle choices, such as smoking, contribute to the development of many human cancers, says Kimmel Cancer Center director William Nelson. Our experts recommend a balanced diet (see response #11) as a way of reducing cancer risk. In terms of supplements, Nelson points out that while they may help mediate vitamin deficiencies,
taking doses above what the body needs provides no added benefit.
Email hoax contentions #6, 7, 8, 9, and 10: Chemotherapy and Radiation Therapy Harms Normal Cells. Surgery Causes Cancer to Spread
Chemotherapy and radiation therapy kills cancer cells with remarkable selectivity, says Nelson. There are some temporary and reversible side effects common to cancer therapies, including hair loss and low blood counts. Limiting and managing these side effects is an integral part of treatment.
Surgery is the first line of treatment for many types of cancer. It does not cause cancer to spread. Cancers spread to other tissues and organs as a tumor progresses and cancer cells break away from the original tumor and travel through the bloodstream to other body sites.
Email hoax contentions #11, 12, 13, and 14: Cancers Feed on Certain Foods
The premise is that cancer cells feed on certain foods, and if a person refrains from eating these foods, the cancer will die. According to our experts, a poor diet and obesity associated with a poor diet is a risk factor for the development of cancer. However, there is no evidence that certain foods alter the environment of an existing cancer, at the cellular level, and cause it to either die or grow.
While there is such a thing as tumors that produce mucus, the mucus made by a tumor does not result from drinking milk. And, eating less meat, while a good choice for cancer prevention, does not free up enzymes to attack cancer cells, explains cancer prevention and control expert Elizabeth Platz. Moderation is key, says Platz. As part of a balanced diet, sugar, salt, milk, coffee, tea, meat, and chocolate—the foodsthe “Update” calls into question—are all safe choices, she says. The real concern with many of these, particularly sugar,
is that it adds calories to a diet and can lead to obesity, and obesity is a major risk factor for cancer. A balanced nutritious diet, healthy weight, physical activity, and avoiding alcoholic drinks may prevent as many as 1/3 of all cancers.
Platz recommends eating at least five servings of fruits and vegetables per day and limiting red and processed meats, like hot dogs.
Several Johns Hopkins experts participated in the World Cancer Research Fund - American Institute for Cancer Research report Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, published in November 2007, which is considered by cancer prevention experts to be an authoritative source of information on diet,
physical activity and cancer. Their recommendations for cancer prevention and for good health in general are:
1. Be as lean as possible without becoming underweight.
2. Be physically active for at least 30 minutes every day.
3. Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat).
4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
7. Limit consumption of salty foods and foods processed with salt (sodium).
8. Don't use supplements to protect against cancer.
Our experts recommend that people meet their nutritional needs through their food choices. While vitamin supplements can be helpful in people with nutritional deficiencies, evidence suggests that supplementation above what the body can
use provides no added health benefit.
Email hoax contention #15: Cancer is a Disease of Mind, Body, and Spirit
Cancer is a disease caused by genetic alterations. Many times, these alterations occur through our own behaviors— cigarette smoking, a poor and unbalanced diet, virus exposures, and sunburns, says cancer prevention and control expert John Groopman.
How stress, faith, and other factors influence this is largely unknown. We would like people to be happy, loving, and stress free, simply because it is a nice way to live and can contribute to an overall feeling of well being, says Platz.
There is no evidence, however, that a person prevents or causes cancer based on his or her state of mind. Still, we understand that a cancer diagnosis can make patients and families feel stressed and anxious, and these are not pleasant feelings. So, we offer extensive patient and family services, including a cancer counseling center, pain and
palliative care program, chaplain services and a meditation chapel, an image recovery center, and the Art of Healing art and music program.
Email hoax contention #16: Oxygen Kills Cancer Cells
Platz recommends regular exercise as a part of any healthy lifestyle, but says there is no evidence that breathing deeply or receiving oxygen therapy prevents cancer.
On its Web site, the American Cancer Society includes the following statement about oxygen therapy, “Available scientific evidence does not support claims that putting oxygen-releasing chemicals into a person's body is effective in treating cancer. It may even be dangerous. There have been reports of patient deaths from this method.” Read more
Please pass this information on to family and friends.
Questions?
Contact:
Johns Hopkins Kimmel Cancer Center
Office of Public Affairs
410-955-1287
8/28/2010 (7:59:32am)Tags: therapist counselor therapyComments: (0)
As all therapists and anyone who has ever seen a therapist know, at least half of the work depends on the human connection. That is to say, chemistry matters. This is the primary reason that it is sometimes suggested that you meet with more than one therapist before making a decision. You will know who feels right.
When I talk with women about looking for the right person, I also remind them to ask about the therapist's experience with other breast cancer patients/survivors. You don't want to spend your time and dollars educating someone about treatment and side effects and normal reactions. Frankly, you also don't want to deal with someone who has her own issues about cancer and may be tempering her own anxiety. Geography, schedule, and insurance matter, too. (and the first two are sometimes reasons why I am helping someone identify a therapist in the community rather than working with her myself).
Sage Bolt, MSW, PhD responded beautifully and fully to this question for LBBC:
Question: Can you please review what a counselor can do for a person, and where I should
go to find one?
Dr. Bolte: A mental health professional can be helpful to an individual, couple or family in a
variety of ways. This professional can help assess and identify coping skills to help you better
manage thoughts, feelings or areas of your life that are creating or reacting to stress and
decreasing your quality of life. For example, if you are experiencing increased anxiety around your
diagnosis, or if fear of recurrence is interfering with your quality of life, a counselor could help you
identify triggers that may be increasing these fears. The counselor can then work with you to
better manage these fears and improve your overall quality of life.
There are different kinds of mental health professionals. The most common are: licensed clinical
social workers, psychiatrists, licensed clinical psychologists, licensed professional counselors and
certified sex therapists (who help address sexual health issues after cancer). It is essential that
you verify the professional is licensed by your state licensing board to practice individual therapy.
You can identify an oncology-certified social worker by going to the Association of Oncology
Social Work directory. You can find other mental health professionals through your insurance
provider list, word of mouth or a list of professionals recommended by your oncology team. It is
important to remember that you can interview a variety of therapists to find the right fit. Whether
this is a short- or long-term relationship, it is important that you feel comfortable with the
professional’s model of practice.
Questions to ask your mental health professional include:
1. Do you take insurance?
2. Do you bill the insurance company or provide me with reimbursement papers?
3. What is your hourly fee?
4. What is your practice model?
5. Are you comfortable working with individuals who have or have had cancer or other illnesses?
6. Are you familiar with how cancer and its treatments may impact my quality of life?
7. Do you work with individuals, families and couples of all ages?
8/27/2010 (8:45:14am)Tags: gene mutations BRCA1 BRCA2Comments: (0)
Genetic testing has been especially on my mind over the past few weeks. Because my mother had post-menopausal breast cancer and because my first breast cancer was diagnosed when I was in my early 40s, I had the genetic testing a number of years ago. The results were negative. When my second breast cancer was diagnosed in 2005, I thought again about this and lamented how little we know about the causes of cancer.
Earlier this summer, my older daughter had an appointment with a high risk breast clinic in the city where she lives. She needed copies of some of my records and whatever information I had about my mother and other family members. This stimulated me to speak again with my doctor who said that the genetic mutation test had been improved since my first test, and there was another rare (about 8% of the total positives) variant that could now be identified. She speculated that the chances of my having that variant were less than 1%, but it still seemed worth doing as my daughters are, of course, vigilant and concerned about their own health. All this is to say that I had the blood test again and, again, blessedly, the results were negative. This is excellent news for my daughters, but still leaves me with all the unanswered questions about "why".
Enough background. This is a good short article from Living Beyond Breast Cancer (www.lbbc.org) about common misconceptions re genetic mutations and testing.
Five Common Misconceptions About
Genetics and Breast Cancer
By Debbie Lerman, for LBBC
1. MISCONCEPTION: Most breast cancers are inherited.
Actually, only about 5 percent to 10 percent of all breast cancers are thought to be caused by an inherited genetic mutation. This means that 90 percent to 95 percent of breast cancers are caused by other risk factors during a person’s lifetime.
2. MISCONCEPTION: You can only inherit breast cancer gene mutations from your mother’s side of the family.
You have an equal chance of inheriting a mutated BRCA1 or BRCA2 gene from your father’s side of the family. A genetic counselor can explain how the genes are passed from generation to generation.
3. MISCONCEPTION: Getting a positive result on a genetic test will give you a clear prevention or treatment plan.
There are many options for preventive steps if you test positive for an inherited breast cancer gene mutation. Decisions about prevention are very personal and cannot be determined just based on your test results. Consider talking with your doctors and genetic counselors, getting second and even third opinions if you feel they might help and discussing options with your family before deciding. Support groups for women at high risk for developing breast cancer and online resources can also help.
4. MISCONCEPTION: Getting a negative result on a genetic test will give you a clear prevention or treatment plan.
As with a positive test result, negative results do not provide a final answer on whether you should take certain preventive steps. For example, if you test negative for BRCA mutations, but you have a strong family history of breast or related cancers, you might still consider prophylactic (preventive) surgery or other treatments to reduce your risk. Consider all your options and discuss them with your genetic counselor, your healthcare team, family and other women who have had similar experiences.
5. MISCONCEPTION: Testing positive for BRCA1 or BRCA2 is basically the same thing.
Actually, researchers have found some important differences between the two breast cancer genes. One of the main differences is that BRCA2 is associated with other malignancies such as melanoma, pancreatic cancer and stomach cancer in addition to breast and ovarian cancer; BRCA1 is not.
BRCA Mutation Risk Factors
By Debbie Lerman, for LBBC
Genetic testing is not recommended for most people with breast cancer. Instead, genetic testing is useful if you and your family have a health history that points to a cancer-related genetic mutation being passed from one generation to another. Your genetic counselor may ask questions to find out whether your family fulfills one or more of the following criteria:
• A premenopausal breast cancer diagnosis in the family
• A diagnosis before age 50 with a triple-negative breast cancer, meaning the cancer is estrogen receptor-negative (ER-), progesterone receptor-negative (PR-) and HER2 negative
• Multiple family members affected by breast cancer on the same side of the family
• Ovarian cancer in the family
• Pancreatic cancer in the family at a young age, in combination with family history of breast cancer
• The family is of Ashkenazi (Eastern European) Jewish descent. About 2.5 percent of Ashkenazi Jews have the genetic mutations with the strongest known link to breast cancer, which is ten to 20 times higher than the general population
• A member of the family has had both breast and ovarian cancer or multiple breast cancers
• Male breast cancer in the family
• Medullary breast cancer in the family, where the border between the cancer tissue and the normal tissues is relatively well-defined (associated with the breast cancer gene BRCA1)
8/26/2010 (7:15:31am)Tags: research studies CAM alternative medicines complementary therapiesComments: (0)
I have written numerous time about CAM (complementary and alternative medicines) and the value that some treatments seem to bring to many women. The caveat is always that those treatments or medications have not been rigorously tested per our usual research standards, and there are many questions/concerns about their efficacy. Perhaps, more worrisome, there are questions about possible negative interactions between some herbs or "natural" medicines and chemotherapy drugs. This is a fine editorial from the Journal of Clinical Oncology by Mark Levine, MD. Here is a quote and then a link to read more. If you use or are considering the use of any CAM medications, I strongly urge you to read the whole thing.
For many years, surgery, radiation therapy, chemotherapy, and endocrine therapy have been the mainstays of cancer treatment. These were the modalities available when I ?rst started clinical practice in 1981. In the early 1990s, I began to notice that some patients were choosing alternatives to the mainstream or conventional treatments. These so-called alternative therapies included a range of interventions, such as dietary and behavioral interventions, vitamin supplements and herbs, and traditional systems such as Chinese and homeopathic medicines.
- Most of these were not supported by sound scientific methods. Alternative therapies appealed to certain patients who were exasperated with the conventional treatments they had received, terrified of the adverse effects, or desperate for miracles because they had been told their cancers were incurable. It was not long before the term complementary medicine appeared. This referred to therapies or practices used alongside conventional medicine, whereas alternative medicine was used in place of conventional medicine.
- The goal of this discussion is not to debate the merits of conventional medicine versus CAM. Rather, the objectives are to consider whether these two paths of medicine should be held to the same standards of evidence in terms of clinical and policy decision making and to determine whether a model that historically has been based on weak evidence can be reconciled with the new paradigm of the requirement for high-quality evidence.
Complementary and alternative medicines are often bundled together under the acronym CAM, the goals of which are to increase the efficacy of conventional cancer treatment programs, reduce symptoms, and improve quality of life for patients with cancer. CAM is grouped into four domains to account for the wide diversity in therapies: mind-body medicine, biologically based practices, manipulative and body-based practices, and energy therapies.
- Cutting across all four domains is the category of whole medical systems. These represent comprehensive systems of theory and practice developed before — or parallel to — biomedicine. These systems usually have his- tories of effectiveness ascertained through many years of observation within specific cultural contexts (eg, traditional Chinese medicine).
http://tinyurl.com/2ad7xas
8/25/2010 (7:15:22am)Tags: aspirin recurrenceComments: (0)
I have written about this several times before, but it is so important that it deserves more time. This is very preliminary research, dealing with animal models. However, it seems important when considered in combination with the earlier reports from the Nurses Study that reported a lowered risk of recurrence in women who had breast cancer and then regularly took aspirin( http://tinyurl.com/yaruq43).
This is from Cancer Science. I am including a short summary and then a link if you wish to read more:
Maspin, a 42 kDa protein produced in normal breast cells, has been shown to inhibit the invasion and metastasis of breast cancer in an animal model. Ingestion of acetylsalicylic acid (aspirin) by breast cancer patients has been reported to restore the systemic synthesis of maspin through the stimulation of systemic nitric oxide production. Studies were carried out to determine the effect of aspirin on the incidence of breast cancer metastasis, which is reported to occur in 50% of patients who have previously received chemotherapy, radiation, and/or surgery. Thirty-five female patients (aged 41–65 years) with breast cancer who had previously received these therapies took one 75 mg/70 kg body weight enteric-coated aspirin tablet every 24 h, after an adequate meal, for 3 years. Their plasma nitric oxide and maspin levels were measured. The occurrence of metastasis was ascertained monthly by a qualified oncologist, and confirmed, if necessary, by biopsy. Daily ingestion of aspirin by participants resulted in an increase in maspin levels from 0.95 ± 0.04 to 4.63 ± 0.05 nM after 24 h. These levels were maintained for 3 years. These studies suggest that daily ingestion of aspirin might significantly reduce the incidence of breast cancer metastasis in patients who have previously received anticancer therapies. (Cancer Sci 2010)
http://tinyurl.com/289hr9u
8/24/2010 (10:31:51am)Tags: genetic risk gene testing BRCA1 BRCA2Comments: (0)
Breast Cancer Genetics: Understanding Risk Assessment and Testing
Register now for our next free teleconference, Breast Cancer Genetics: Understanding Risk Assessment and Testing, from 12:00 p.m. to 1:15 p.m. Eastern Daylight Time (EDT) on Thursday, September 16. Learn more.
Our speakers, both from the Abramson Cancer Center at the University of Pennsylvania, will discuss the basics of breast cancer genetics. Susan M. Domchek, MD, director of the Cancer Risk Evaluation Program, and Jill Stopfer, MS, CGC, Senior Genetic Counselor, will help you understand:
- The role genes can play in breast cancer, whether you or a family member has been diagnosed or you are at high risk
- How genetic testing works and possible benefits and limitations
- Making decisions based on your results
- How to share information with family members
