Tuesday, August 31, 2010

Breast cancer prevention strategies

National Cancer Institute
When you hear health messages about cancer or any disease do you find yourself filtering it out? Well, if you do than this next sentence might cause you to stop reading, but please continue because there's a point I'm hoping to make. 1 out of 7-8 women will get breast cancer in their lifetime (American Cancer Society). Are you still reading? That's good, because the purpose of sharing that statistic was to illustrate that even though we frequently hear these kinds of health messages, we don't always feel connected to them. Perhaps you might be thinking as I did when hearing those numbers, wow, that sounds like a lot, but I'm not going to be the one.  Unfortunately, this kind of thinking often translates into inaction. Statistical health data, although sometimes shocking and troubling, may not be meaningful enough to inspire change for some of us.

If you find that you aren't motivated by statistics, you're not alone. Evidence suggests that health messages which highlight health consequences and the numbers of people who get disease aren't as effective as was once thought. What can be more successful in motivating change in health behaviors are messages that focus on causes and solutions for disease (McKenzie).

Obviously there is no clear solution to breast cancer at this point in time. However, there is a great deal of data available that is linking lifestyle factors with increased risk. This suggests that our best prevention strategy is to take steps to reduce our risk factors as much as possible. So, let's take a closer look at the modifiable risk factors -  in other words, the things we can do to lower the probability of  becoming one of the seven or eight women who will get breast cancer.

Prevention Strategies-

  • Avoid weight gain and obesity - According to the National Cancer Institute (NCI), a gain in body mass index (BMI) may substantially increase a women's risk for breast cancer, especially after menopause.The NCI states, " In a recent analysis, women who reported a gain in BMI of five points [equivalent to about 30 pounds] or more between age 20 and postmenopausal age (ages 55-74) had nearly twice the risk of developing postmenopausal breast cancer compared to women who maintained their BMI during the same time period."  (You can read more about BMI in this post and more on this study here).  Interestingly, women who had never used hormone replacement therapy had the strongest association between breast cancer and BMI increases. It's also worth noting that regardless of a woman's starting BMI, if it went up 5 points the risk increased also.  This means that even if a woman's BMI is in the normal range to start with, a 30 pound weight gain during her lifetime doubles the breast cancer risk.
  • Avoid hormone replacement therapy (HRT) - The study results of the Women's Health Initiative trial  showed that women taking hormones after menopause had more breast cancer than the women who took a placebo. Not only was increased cancer a risk, according to the Center for Science in the Public Interest, women taking estrogen plus progestin hormones were "29% more likely to have a heart attack, 41% more likely to have a stroke, twice as likely to have a blood clot and 47% more likely to show a marked drop on tests of memory and other mental abililties." Yikes! If avoiding HRT isn't an option, the Mayo Clinic suggests using the lowest dose possible and to shoot for short term use.
  • Watch your diet, particularly the fats consumed - This will help with the first prevention strategy mentioned: avoid weight gain and obesity. The Mayo Clinic recommends limiting fat intake to "less than 35 percent of your daily calories" and also restricting "foods high in saturated fat." The findings from the Women's Intervention Nutrition (WIN) Study further suggests a diet consisting of  "lower proportions of saturated fats and higher proportions of polyunsaturated fats." If you want more details on dietary fat you can read more here and more specific details about the omega fats (polyunsaturated fats) here
  • Get moving - Along with good nutrition, being more physically active will also help control weight gain. In addition, research from a recent study published in the American Journal of Clinical Nutrition on the relationship between BMI, physical activity and a woman's sex hormones showed that "low physical activity is linked with higher amounts of estrogens which is in turn linked with a higher risk of breast cancer."  So, how much physical activity should you aim for? According to the NCI, "existing evidence shows a decreasing risk of breast cancer as the frequency and duration of physical activity increase. Most studies suggest that 30 to 60 minutes per day of moderate- to high-intensity physical activity is associated with a reduction in breast cancer risk." 
  • Limit alcohol consumption - Even though red wine has received a lot of good press with regard to heart health lately, it doesn't appear to be beneficial for reducing breast cancer, nor does drinking any alcoholic beverage. On the contrary, according to the Million Women Study which tracked over a million women for 7 years, "each daily alcoholic drink raised the risk of postmenopausal breast cancer by 12%." This is considered a modest, but significant increase in risk, especially when combined with additional risk factors. Another reason to limit alcohol is because calories contained in alcoholic beverages can be a factor in raising the daily amount of calories consumed, and therefore contribute to weight gain. 
If thinking about tackling the prevention strategies discussed above has you feeling overwhelmed, consider beginning with the most important step first - maintain or get to a healthy weight. This isn't just a positive step to take for breast cancer prevention, it's good for your overall health. There are many great resources on the internet to help you take action, just make sure they are credible sources. Also, make sure to talk these strategies over with your health care professional.

Making healthy choices is within reach when we have the information we need and the motivation to put the information into practice. Having knowledge of the known risk factors for breast cancer, as well as a corresponding plan of attack can be more empowering than a vague threat of becoming a negative health statistic. I know now that becoming a breast cancer statistic is a very real possibility. So it's important to take action sooner rather than later. 

Sources
http://www.cancer.org/acs/groups/content/@nho/documents/document/f861009final90809pdf.pdf
McKenzie, J. An Introduction to Community Health, 5th ed.
http://www.cdc.gov/healthyweight/assessing/bmi/
NCI - http://benchmarks.cancer.gov/2010/04/gain-in-body-mass-index-increases-postmenopausal-breast-cancer-risk/
Center for Science in the Public Interest, Nutrition Action Newsletter
http://www.mayoclinic.com/health/breast-cancer-prevention/WO00091
http://www.ajcn.org/cgi/content/full/86/3/878S
http://www.ajcn.org/cgi/content/abstract/86/3/817S
http://www.cancer.gov/cancertopics/factsheet/prevention/physicalactivity
http://www.millionwomenstudy.org/introduction/
http://mason.gmu.edu/~montecin/web-eval-sites.htm

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