Breast cancer prevention strategies

When you hear health messages about cancer or any disease do you find yourself filtering it out?  If you do, this next sentence might cause you to stop reading, but please continue because there's a point I'm hoping to make. At the time of writing this, statistics say that one out of eight 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.

There may be no sure way to prevent breast cancer yet. However, this doesn't mean we're powerless. 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 out of eight women who will get breast cancer.


A few Prevention Strategies

• Excercise- Enough said.
• Avoid weight gain and obesity - Exercise and healthy nutrition are the keys. 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  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 here.
• Eat plenty of fruits and vegetables - Preferably organic.  Organically grown produce lowers exposure to pesticides which can effect hormone levels, particularly estrogen dominance.
• Have your vitamin D levels checked -  A low level of Vitamin D is linked to increased risk for breast cancer. 
• Reduce chronic inflammation - I've blogged about this very important element of cancer prevention here, but simply put, if our immune system is preoccupied and overwhelmed responding to environmental and food stressors, it's possible that it can miss the angiogenesis of a sneaky cancer cell. 

Here's some additional information about eating "nutritarian" from Dr. Fuhrman's informative website which explains how to support our wellness with healthy nutrition. The foods we eat can either support or oppose our bodies. Experts now agree that there are even so-called power foods that do an especially good job of restoring our bodies. 

  

So, rather than tuning out messages about disease, consider the strategies that you can incorporate into your lifestyle that will help prevent illness from starting in the first place - because "an ounce of prevention is worth a pound of cure."

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/
Breast Cancer.org http://www.breastcancer.org/symptoms/understand_bc/statistics
Breast Cancer.org http://www.breastcancer.org/risk/factors/low_vit_d

More lifestyle changes to reduce chronic inflammation

What's the big deal about inflammation? Well, researchers have been finding that it's a big deal when inflammation becomes chronic.  We're all familiar with the acute inflammation that occurs with a broken bone, scrape or infection. This is a short term, healing response to injury. The immune system responds with a cascade of events.  Once the threat or injury to the body has been addressed, the acute inflammatory response turns off.

Chronic inflammation arises when the immune system doesn't shut off.  It continues its healing response and the inflammatory cascade of events can occur for weeks, months or even years. You might think that having the immune system working all the time is a good thing. However, it's a case of too much of a good thing, because over time this abnormal response can damage body tissues. Research has identified that chronic inflammation can be the springboard for many diseases, like Alzheimer's, asthma, emphysema, bronchitis, chronic pain, various cancers, Type 2 diabetes, heart disease, inflammatory bowel disease, stroke and diseases where the immune system attacks the body's own tissues.

Clearly with chronic inflammation linked to so many diseases it's important to prevent it.  There are several lifestyle changes that make a big difference in limiting chronic inflammation: 

1. Nutrition - According to the Linus Pauling Institute at University of Oregon, "Overall, studies suggest that diets rich in saturated fats, trans fats (hydrogenated or partially hydrogenated oils), and high glycemic index foods stimulate inflammation." The take away here is - avoid animal products, refined sugar, refined vegetable oils, and refined carbohydrates. 
   
   
   
   
   
   • Eat at least 5 and shoot for 7 servings of anti-oxidant rich, low glycemic index (GI) fruits and vegetables a day. You can find the University of Sydney's GI listing of foods here and the National Cancer Institute's list of anti-oxidant rich foods here. The table below shows a few of the anti-oxidant powerhouse foods. Note the serving sizes.

   

   Estimates of antioxidant capacities of selected foods. Micromole TE per household measure and grams. (Credit: USDA)

   • Eat wild salmon, walnuts, ground flaxseed, purified fish oil and leafy greens rich in the good Omega 3 fat. Exclude all commercially produced fats like those found in margarine, crackers, chips, cookies and deep fried foods like french fries.  Read food labels and be on the look out for partially hydrogenated oils.
     
   • Eat fresh herbs and spices that reduce inflammation like ginger, turmeric, green tea and nettles. The American Cancer Society lists oregano as the herb containing the highest levels of anti-oxidants. "It has 42 more times antioxidant activity than apples, 30 times more than potatoes, and 12 times more than oranges." Evidently good things do come in small packages because "gram for gram, oregano and other fresh herbs ranked even higher than fruits and vegetables that are known to be high in antioxidants." Check out the  Phytochemicals website here, for their list of the herbs and spices highest in anti-oxidants.
   • Eat whole grains and skip the refined, white flour. Whole grains have a lower glycemic index than refined grains and more fiber. The Whole Grains Council has details on types of whole grains and daily serving requirements here.
   • Speaking of whole grains, it's best to eat whole foods in general. They contain fiber and vital nutrients that are lost when foods are processed.
   • Another great resource for information on an anti-inflammatory eating plan can be found at Dr. Weil's website.  
     
    
2. Physical Activity - Excess body weight and chronic inflammation are linked.  Studies have shown that "various forms of exercise decrease both acute and chronic inflammation" (Linus Pauling Inst.). This is because increasing physical activity usually has the effect of reducing body weight.  The more healthy the body weight, the less chronic inflammation results.
3. Persistent Stress - Researchers are linking the ways physical and psychological stressors such as poor sleep, PTSD, and depression, trigger the inflammatory response and increase the risk of disease. Try to limit stress and get some sleep.
   
4. Tobacco Use - Tobacco products contain toxins that cause inflammation to the mouth, throat and respiratory tract, among other things. Don't smoke and if you do, quit.
   
5. Environmental Toxins - Take a look at your cleaning products. Learn what's in your water. Become familiar with which foods contain the most chemical residues here and which fish have the most mercury content here. Limiting your exposure to chemicals, airborne irritants and heavy metals, like mercury, is important in reducing chronic inflammation.

For more detailed information about the steps outlined above there are two books that I've found helpful: The Anti-Inflammation Diet and Recipe Book by Jessica K. Black, N.D. and The Whole Life Nutrition Cookbook by Alissa Segersten and Tom Malterre, MS, CN. 

Making lifestyle changes isn't easy. Attempting to tackle all of these suggestions at once may feel overwhelming. Try implementing one change at a time.  Since chronic inflammation is something we can't see or feel, it may not seem like that big of a deal.  However, as more research continues to reveal the increasing numbers of diseases being linked to chronic inflammation, it seems prudent to take steps to reduce this silent condition.

Sources:
http://lpi.oregonstate.edu/ss07/inflammation.html
http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Common_Cooking_Herbs_Packed_with_Antioxidants.asp
http://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_ai_diet_patient.pdf 
http://www.drweil.com/drw/u/ART02995/Dr-Weil-Anti-Inflammatory-Food-Pyramid.html
http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/ORAC/ORAC_R2.pdf 
http://www.ewg.org/ourfood
http://www.gotmercury.org/article.php?list=type&type=75

http://www.phytochemicals.info/research/antioxidants-herbs.php

First step to reduce chronic inflammation

Eat your vegetables. I can't count how many times I heard my Mom say this and how often I repeated it to my children.  There really is wisdom in this statement, especially when it comes to reducing chronic inflammation, among other things.  It turns out vegetables, as well as other plant foods, contain something really good for us called phytochemicals.

Phytochemicals are chemical compounds that occur naturally in plants. Plant foods also contain essential nutrients. Phytochemicals and essential nutrients work synergistically, like a team, in the body.  Scientists aren't exactly sure yet how each specific phytochemical and nutrient in plant foods benefits the body. However, research clearly shows that phytochemicals have a positive impact on the process of chronic inflammation and the progression of cancer. As a matter of fact, some experts believe as much as 30-35% of all cancers are linked to poor nutrition! If you would like more information, check out "Cancer is a Preventable Disease that Requires Major Lifestyle Changes" written by a group of researchers from the M.D. Anderson Cancer Center.

It's also good to become familiar with what's called the glycemic index (GI) and the glycemic load (GL) of foods. The GI is a measurement of how fast a food causes your blood sugar to rise after you've eaten it. This is important because high GI foods cause insulin levels to rise rapidly and when this occurs repeatedly it can lead to a variety of health problems. The University of Australia has a great website, The Glycemic Index. It lists the GI and GL of thousands of foods.

I've also learned that specific vegetables are particularly important in reducing breast cancer.  These are cruciferous vegetables like broccoli, brussells sprouts, cabbage, cauliflower and kale.  These are nutritionally valuable because they contain something called indole-3-carbonyl (I-3-C), which helps in regulating certain enzymes that deal with estrogen metabolism.  This is especially beneficial for cancer that is an estrogen receptor positive type of breast cancer. 

So, the first step in reducing chronic inflammation is to eat more plant foods, and I'm not talking french fries here. That leads me to the next step: watching what oils you're eating, but that's for next post.  For now, I'm wondering...does beginning to take steps to reduce inflammation seem as overwhelming and daunting to you as it first did to me? I have learned that it's all doable, if I take it in steps. When I get discouraged it also helps to remind myself of the proverb, "Eat to live and not live to eat." This message makes sense to me, and although they're not my Mom's words of wisdom, they're just as motivating.


Sources
http://www.drmercola.info/2009/09/8-ways-to-avoid-chronic-inflammation.html
http://www.psychiatrictimes.com/display/article/10165/100433
http://www.cfp.ca/cgi/content/abstract/53/11/1905
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
http://www.glycemicindex.com/
 http://lpi.oregonstate.edu/infocenter/phytochemicals/i3c/

Chronic inflammation and breast cancer

When it came time for me to consider treatments for early stage breast cancer, I learned that each treatment option had the potential to reduce the risk of the cancer recurring.  Even with the best of odds, I began to realize that there was no sure thing. Kind of like placing a bet, only instead of chips I was playing with my health! Scary stuff. If only, I wished, there was some way that doctors could better predict the chances of cancer returning. Well, my wishful thinking may be one step closer to becoming a reality!

Last month, an article published in the National Institutes of Health News discussed results of the National Cancer Institute's HEAL (Health, Eating, Activity, & Lifestyle) study. In this well conducted study, researchers were able to identify biological markers that may indicate poor breast cancer outcomes. The research report states that:

 "breast cancer patients with elevated levels of C-reactive protein (CRP) and serum amyloid A (SAA) were approximately two to three times more likely to die sooner or have their cancer return than those patients who had lower levels of these proteins, regardless of the patient’s age, tumor stage, race, body mass index, or history of previous cardiovascular issues."

Wow! These protein markers have the potential to identify breast cancer risk of recurrence in women who have had treatment and show no visible signs of cancer. This could contribute to a better understanding of why cancer returns in some women and not in others. Also, these biological markers could be indicative of why an initial breast cancer develops in 1 out of 8 women.  With this insight  women could have the ability to address risk factors with lifestyle changes. We all know that when it comes to disease, prevention is the first and best treatment of all!

So why are CRP and SAA important? They are both markers for inflammation.You might remember from a previous post that there are two kinds of inflammation: acute and chronic.  Acute inflammation is the beneficial response that occurs immediately after an injury to the body. Chronic inflammation is the same response in the body, but it occurs on a long term basis and can cause tissue damage.

 (Image from:DeNardo and Coussens Breast Cancer Research 2007 9:212   doi:10.1186/bcr1746)
 
Experts now believe that tumors are triggered by cancer stem cell growth in response to chronic inflammation. So in my mind the really big question is, how do I avoid chronic inflammation? Well, I'll get to that in my next post. My take away now is knowing I may be able to do things that potentially help prevent a recurrence of breast cancer. Obviously there's no sure bet, but it looks like the odds may be improving!

Sources:
http://www.nih.gov/news/health/may2009/nci-26.htm
http://appliedresearch.cancer.gov/cgi-bin-pubsearch/pubsearch/index.pl?initiative=HEAL
http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1417
http://breast-cancer-research.com/content/9/4/212/figure/F4?highres=y
http://www.cancer.org/docroot/cri/content/cri_2_2_1x_how_many_people_get_breast_cancer_5.asp

Refined grains and chronic inflammation

My doctor suggested that I consider making changes in some of the foods I eat. Her thinking is: eliminate foods that can cause the body stress and it will then be better able to prevent disease or cope with any disease present. This makes sense to me. One of the ways the body copes when it is stressed is through the immune system response of inflammation. The inflammatory response to injury or germs, for example, is a good thing.  It's the chronic inflammatory response that's not so good.

Some of the foods we frequently eat can cause chronic inflammation, others can reduce inflammation. One group of foods to avoid are those made with refined flour. I'm replacing these with whole grains, which experts believe help reduce chronic inflammation.

Image from www.grainsessential.ca

What are whole grains? Well, this may be obvious but it's important so I'll point it out anyway- they're whole. This means whole grains contain all parts of the grain; the starchy endosperm, the bran, and the germ. In comparison, refined grains and flour are composed of only the starchy endosperm of the grain. They are missing a significant portion of important nutrients. Let's look at a slice of white bread.  The Mayo Clinic states that "a slice of commercially prepared white bread has 66 calories, 1.9 grams protein and 0.6 grams fiber. A slice of whole-wheat bread has 69 calories and provides 3.6 grams protein and 1.9 grams fiber." But that's not the only difference.


Let's now look at the link between eating refined grains and chronic inflammation. Foods have an effect on blood sugar. This is measured by the glycemic index (GI). A food that has a low glycemic index will raise blood sugar much more slowly than a food with a high GI.  According to Dr. Weil, chemical reactions occur in the body between the sugars and protein that produce pro-inflammatory compounds called AGEs (advanced glycation end products). These AGE's can be moderated by keeping blood sugar levels low and stable. So inflammation can be controlled by by eating low GI foods.

Recent research suggests that the glycemic load of foods may be just as important to consider as the index, but that's for another post.  Make sure to check out The University of Sydney, School of Molecular and Microbial Biosciences, Human Nutrition Unit link to their glycemic index tool.  You just enter a food and it tells you the GI and load.http://www.glycemicindex.com/ 

The bottom line - eat more whole grains. 

Sources:
http://www.drweil.com/drw/u/id/QAA359518
http://www.glycemicindex.com/