Breast Cancer Awareness Month: Seeing red over pink!

image of pink lit White House from CBC News

It's that time of year when I see red, even though October is all about the color pink. That's because it's Breast Cancer Awareness Month. Here in the states it's referred to as National Breast Cancer Awareness Month (NBCAM), and even the White House is wearing pink! This whole pink thing is really getting old and frankly, since going through my own breast cancer experience, I find I'm actually angered by it all. Now that I've gotten that off of my, er, dare I say, chest - I'll get straight to the issue. How could a positive thing like raising awareness about cancer rouse me to anger?

Well, before I tackle that question, I want to be clear that this isn't going to be a post bashing America, or medical experts, researchers, charities or any others that have made a positive difference in the diagnosis and treatment of breast cancer or any cancer. My family and I have personally benefited from these things, and I am especially grateful for early detection. My hope is that this post will provide some food for thought.

Experts agree that an increased awareness about a disease may encourage a person to receive medical screening that can lead to early detection (6). Obviously, this is a good thing. But after more than 25 years of raising awareness, is NBCAM actually impacting the early diagnosis of breast cancer? A recent study published in the Journal of Health Economics researched this question and they found the answer is no, not any more (1). So, if NBCAM is no longer effectively raising public awareness about breast cancer or encouraging early detection via screening, than why is it we are seeing more pink than ever? I believe it's because breast cancer has turned into a profit generating industry, and I'm not alone in this thinking.

Profiteering of breast cancer? -
What ever happened to the thinking that:

"An ounce of prevention is worth a pound of cure." Benjamin Franklin 

Benjamin Franklin's quote holds true for those of us health seekers doing our best to prevent disease. But how does this resonate with, for example, a pharmaceutical company, whose bottom line is to make a profit? Let's face it, there's just not much money to be made in preventing breast cancer, or any cancer for that matter. Consider the primary breast cancer treatments to date: slash, burn and poison, otherwise known as surgery, radiation and chemotherapy. In a previous post I discussed an instance where a pharmaceutical company that produced a chemotherapy drug also made a bovine growth hormone being used in dairy cows. This hormone has been linked to an increased risk of breast cancer (5). But, hey, we've got a drug for that.

Whose interests are being served here? This is just one sad example of how some corporations have turned breast cancer into a profitable industry. Breast Cancer Action explains it this way:

 "The cancer industry consists of corporations, organizations, and agencies that diminish or mask the extent of the cancer problem, fail to protect our health, or divert attention away from the importance of finding and working to prevent the disease. This includes drug companies that, in addition to profiting from cancer treatment drugs, sometimes produce toxic chemicals that may be contributing to the high rates of cancer in this country and increasing rates throughout the world. It also includes the polluting industries that continue to release substances that are known or suspected to be dangerous to our health, and the public relations firms and public agencies that protect these polluters. The cancer industry includes organizations like the American Cancer Society that downplay the risk of cancer from pesticides and other environmental factors, and that historically have refused to take a stand on environmental regulation. " (3). 

More to NBCAM than meets the eye?-
So what does National Breast Cancer Awareness Month (NBCAM) have to do with this? Well, let's see. According to Wiki, NBCAM "is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. The campaign also offers information and support to those affected by breast cancer. As well as providing a platform for breast cancer charities to raise awareness of their work and of the disease, BCAM is also a prime opportunity to remind women to be breast aware for earlier detection." This sounds great doesn't it?

Well, if we look a little deeper, we find that NBCAM was formed by Imperial Chemical Industries, the creator of Tamoxifen, a breast cancer treatment drug. In the 90's, Imperial Chemical Industries spun off Zeneca Group. Then Zeneca merged with Astra and became Astra Zeneca, which formed a non profit arm that is known today as AstraZeneca Healthcare Foundation, one of the largest financial contributors to NBCAM.  Astra Zeneca also created and markets Arimidex, another breast cancer treatment drug. CancerCares was also involved in the formation of NBCAM. A look at their donors reveals several pharmaceutical companies as well. So, what message would you want to spread if you were a drug manufacturer financially invested in breast cancer treatment medications? Probably not prevention.

I do want to acknowledge again that cancer treatment drugs are not bad. I'm just saying that it's a fact that pharmaceutical companies spend a lot of money on the research and development of new drugs. Forbes  published an article earlier this year that puts the dollar amount between a high of $12 billion and a low of $55 million (4). Considering the magnitude of expense to produce a drug, pharmaceutical companies must be under an enormous amount of pressure to deliver a drug that will generate revenue and for that they need a disease to treat. As I said earlier, there's no profit in prevention.  

Pink washing -
This brings me to what has come to be known as the "pink washing" of breast cancer. You can read more about this here. The term "pink washer" has been used to describe a company "that purports to care about breast cancer by promoting a pink-ribboned product, but manufactures products that are linked to the disease" (Breast Cancer Action) (2). The point is non-profit organizations accepting donations from companies that stand to gain from their philanthropy seems to represent a conflict of interest to me. It's no wonder that little focus is being placed on breast cancer prevention! It's much more profitable for these powerful industries to keep the emphasis on looking for the so-called "cure", which is really just another word for drug treatment.

Awareness, screening and a cure are NOT prevention -
Let's face it,  awareness, screening and early detection is a means to find disease, not prevent it. A cure is defined as the "restoration of health; recovery from disease" (7). Primary prevention of disease is about avoiding or reducing the risk factors for disease. After over 25 years of seeing pink, I think it's safe to say we are aware of breast cancer. I can't help but wonder where we would be now if that focus had been directed toward the prevention of breast cancer.

Well, we can't go back, but we can take action going forward! Let's think before we let our emotions be swayed by all things pink. Let's do some due diligence when donating to a charity.  Where does our money go?  How much of what is spent on that pink colored item will go toward breast cancer prevention research? What chemicals are in my pink marketed cosmetics or foods that my be adversely affecting my body? What's my elected official's stance on this topic? Let's tell those in government how we feel about these issues. Going forward we can shift the focus from awareness to prevention, because the only way we can be cancer free is by preventing cancer from occurring in the first place! 

GO TO: http://org2.democracyinaction.org/o/6098/p/dia/action/public/?action_KEY=11729

Resources

(1) Health awareness campaigns and diagnosis rates: Evidence from National Breast Cancer Awareness Month

Grant D. Jacobsena, Kathryn H. Jacobsen, Journal of Health Economics http://www.sciencedirect.com/science/article/pii/S016762961000144X

(2) Breast Cancer Action, http://bcaction.org/

(3) Breast Cancer Action, 

(4) Forbes - http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-of-inventing-new-drugs/2/

(5) Breast Cancer Fund - http://www.breastcancerfund.org/clear-science/chemicals-glossary/bovine-growth-hormone.html

(6) Planning Implementing and Evaluating Health Promotion Programs, James McKenzie, et al, 4th ed., Pearson, 2005.

(7) The Free Dictionary http://www.thefreedictionary.com/cure

Aerobic exercise: How hard should I work out?

"How hard should I be working out?" This is one of the most common questions people ask me during fitness training. This is a good question and the answer is different for everyone. This is because an individual's exercise intensity level, or how hard they need to be working, is directly related to things like their fitness level, age and health. Everyone should ask themselves this important question before beginning an exercise program and when reassessing a current workout. Knowing your exercise intensity level is important in determining how best to bring about improvements in your health.

You may have heard the expression "in the zone" with regard to exercise intensity. This can be used to describe target heart rate (THR) training levels which are benchmarks that are measured during aerobic exercise. You may have seen this range visually depicted in a chart on your gym's treadmill control panel. Some use the misleading phrase "fat burning zone", more on this later, where others just say training zone. In any case, the theory of training in a target heart rate zone can seem a little perplexing.

Adding to the confusion, especially for women, is the emerging scientific data about a gender specific formula for maximum heart rate, which directly impacts how a woman knows if she's in "the zone." Additional information is available here, but before we get into that let's take a look at several factors that are helpful in determining whether or not you're working hard enough during your aerobic workout.

What is an aerobic workout? When we perform aerobic exercise, or aerobics as coined by Dr. Kenneth Cooper way back in 1968, we are increasing our need for oxygen by performing an activity that engages the larger muscles of the body.  This sustained activity, in turn, causes the heart and lungs to work harder than when the body is at rest in order to provide more oxygenated blood to fuel the working muscles (1). There are many health benefits to aerobic exercise (3), and the Mayo Clinic lists ten of them here.  One reason we are focusing on in this post is heart health. 

Heart rate or pulse is the rate at which blood is squeezed out of the heart per minute (BPM). We can use our heart rate to measure how hard our heart is working at rest or during aerobic exercise. This can be done by taking a pulse or heart rate and determining our BPM number. Pulse points are places where an artery passes close to the skin and makes it easier to feel blood pulsing through it. There are several pulse point locations on the body, but 2 of the more commonly used sites are found on the wrist (radial pulse), or on the neck (carotid pulse).

Once you've found your pulse, count the number of times you feel the blood pulsing under your fingers for 10 seconds. Then multiply that number by 6 and you will have your heart rate for one minute. For a more precise measure, you can also use a blood pressure monitor that counts your pulse for you. To learn more about manually taking your pulse, just follow the link here to the Cleveland Clinic's website.

Resting heart rate (RHR) is another useful indicator of heart health. This is the number of times our heart beats per minute while we aren't engaging in any activity and is best taken in the morning before we get out of bed (3). I suggest measuring it for 3 mornings and then taking the average. According to the National Institutes of Health, a normal RHR range is:
Newborn infants - 100-160 BPM
Children 1 to 10 yrs. - 70-120 BPM
Children over 10 and adults (including seniors): 60-100 BPM
Well-trained athletes - 40-60 BPM (5)

Maximum heart rate (MHR) - Knowing your MHR will help you in calculating your target or training heart rate (THR).  The gold standard for determining your MHR is to take a doctor supervised treadmill test. However, for many of us this may not be practical, so exercise physiologists have developed several formulas to help estimate MHR.  One of these is called the estimated maximum heart rate formula:

MHR = 220 BPM - age

At the beginning of this decade, research conducted on the estimated MHR formula found that it "underestimated MHR in older adults" (7). These scientists proposed a new MHR formula:

MHR = 208 - 0.7 x age

This year, more recent research has found that this formula overestimates the MHR for age in women, especially those over the age of 35. See footnote (8). As a result of this finding a new gender specific MHR formula is being proposed, however it is not yet being used in a clinical setting because the research is considered preliminary. The gender specific formula is:

MHR = 206 - .88(age)

After we have determined our MHR we can calculate our training heart rate.


Training heart rate (THR) and finding the right intensity for you - THR is the desired heart rate range which will provide us with the most benefit from our aerobic workouts. Calculating a THR zone helps us determine the level of sustained exercise intensity that best challenges our heart and lungs safely. When calculating THR, I prefer to use the Karvonen or Heart Rate Reserve Formula.  This formula is more personalized because it factors in the resting heart rate (RHR) to determine heart rate reserve (HRR). The formula for calculating HRR is:

HRR = MHR - RHR

Now we move to the next step in determining THR. We multiply HRR by the desired training intensity range at which we want to workout. The American College of Sports Medicine recommends healthy adults exercise at a range beginning at 55% and up to no higher than 90% of MHR.

Let's put all this information into practice. A 30 year old healthy female who has a RHR of 70 and is of average fitness level wants to determine her THR zone.  Here is how she would calculate her THR range:
Begin by calculating MHR. Using the new gender specific MHR formula -
MHR = 206 - .88(age)
179.6 = 206 - 26.4
MHR = 180
Next we determine HRR using the formula HRR = MHR - RHR
HRR = 180 - 70
HRR = 110
Now we plug the HRR number into the rest of the Karvonen equation to determine the THR range.  We begin with the lower end of her training range (light to moderate) or 65%.
THR = 110 x .65 + RHR
THR = 71.5 + 70
THR  lower range = 141
Now we find the THR for our sample female of average fitness level at the top end of her training range (moderate to vigorous) or 85%.
THR = 110 x .85 + 70
THR  higher range = 164

So, this individual would monitor and strive to maintain for the duration of her aerobic activity a target heart rate zone between 141-164 BPM.  These numbers would be adjusted as her fitness level changed.


How much aerobic exercise is enough?   According to the American College of Sports Medicine healthy adults under the age of  65 should shoot for at least 30 minutes of aerobic activity, 5 days a week.  The Center for Disease Control (CDC) suggests healthy adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic activity per week. This activity should be sustained for bouts of at least 10 minutes. For even greater health benefits the CDC urges us to shoot for 300 minutes of moderate intensity or 150 minutes of vigorous intensity aerobic activity per week, or an equivalent mix of both, again in bouts of at least 10 minutes.

What's light, moderate or vigorous intensity activity?  According to the CDC, "moderate intensity means "you're working hard enough to raise your heart rate and break a sweat." Examples would be:

• walking fast
• doing water aerobics
• riding a bike on level ground or with few hills
• playing doubles tennis
• pushing a lawn mower (CDC)

Vigorous intensity aerobic activity means "you're breathing hard and fast, and your heart rate has gone up quite a bit" (CDC). Examples include:

• jogging or running
• swimming laps
• riding a bike fast or on hills
• playing singles tennis
• playing basketball

So, having plowed through the formulas and worked through the calculations, we now know how to determine our THR zones.  As important and useful as this information is, it should be noted that it is all an estimation.  One research study found that when monitoring aerobic exercise in a group setting, perceived rate of exertion, or how the person exercising is feeling, was as good an indicator of training intensity as THR calculations.  Plus, the exercisers didn't have to stop to take their pulse. Whatever method you choose to monitor your exercise intensity,it is always best to work within your comfort level and not to exceed 90% of your MHR because of increased risk for injury.

The short video below from the American College of Sports Medicine's Exercise is Medicine Library talks more about using Rate of Perceived Exertion as a way to monitor THR. The take away from all of this is to just get moving because exercise really is good medicine.

Don't forget: It is important to check with your physician before beginning any exercise program. Next post will take a look at the misleading concept of the fat burning training zone, and will be much shorter I promise!

Sources
(1) http://en.wikipedia.org/wiki/Aerobics
http://www.google.com/dictionary?aq=f&langpair=en|en&q=aerobic&hl=en
(3) http://www.mayoclinic.com/health/aerobic-exercise/EP00002/NSECTIONGROUP=2
(4) http://www.americanheart.org/presenter.jhtml?identifier=4701
(5) http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm
(6) Physical activity & health: an interactive approach, Thomas, D.Q., Kotecki, J.E.
(7) Tanaka et al., Age predicted maximal heart rate revisited http://content.onlinejacc.org/cgi/content/full/37/1/153
(8) St. James women take heart study http://circ.ahajournals.org/cgi/content/full/108/13/1554 
American College of Sports Medicine
Centers for Disease Control

Women, heart disease and new max heart rate formula

When it comes to women's healthcare, females are typically treated like smaller versions of males.  We women know we aren't "mini-me's" of men, but a patriarchal society hasn't been as quick to recognize this fact. Thankfully, the emerging science of gender based biology is proving what women already knew to be true. We are different. Here's a sampling of the gender differences research is revealing at the system, organ, tissue and even cellular levels:

1. "3 out of 4 people who suffer from an autoimmune disease (such as rheumatoid arthritis, lupus and multiple sclerosis) are women" (1);
2. women are 2 times more likely than men to be diagnosed with thyroid diseases (1);
3. 2-3 times more likely than men to suffer depression (1);
4. 2 times more likely than men to contract gallstones (1);
5. more likely than men to suffer a second heart attack within the year after their first heart attack (1);
6. women who smoke are up to 70% more likely to develop lung cancer than men who smoke (1);
7. 80% of  people affected by osteoporosis are women (1);
8. women are more like to suffer migraines than men (1)
9. a woman's liver metabolizes alcohol and drugs less efficiently than a man's liver (1);
10. a woman's heart is one third the size of a man's heart and beats faster (1);
11. woman wake up faster from anesthesia after surgery (1);
12. a woman's brain is neurologically different from a man's brain (1);
13. a woman's heart responds to high blood pressure by developing thicker walls which puts them at greater risk for heart failure than men (4).

Clearly, the contrasts between the sexes go way beyond the basic XX and XY chromosomes and our reproductive capabilities. Unfortunately for women's health, prior to the 1990's men were the model on which medical research was conducted. An example of this is the practice of pharmaceutical companies testing their new drugs only on men. The exclusion of women and minorities from medical research continued until Congress mandated that they be included. As a result of this change in practice, researchers in gender based biology are starting to reexamine drugs that were tested only on men. They are checking for their potential effectiveness because women metabolize drugs differently than men. 

Women and heart disease-

Heart disease is another area where gender based biology has identified differences between men and women. In 1991 the National Institutes of Health (NIH) implemented a landmark observational study concluded in 2006 called the Women's Health Initiative (WIN). WIN provided a great deal of data on women's health. Noteworthy is the finding that women aged 65 and older were more likely to die from heart disease than men. Also, under age 50 a woman's heart attack is twice as likely to be fatal as a man's (5). Experts suggest there are several reasons for this, one of them being that the symptoms of heart attack that men experience aren't necessarily the same for a woman (3). They can be more subtle than the severe chest pain that is the hallmark symptom for men. As a matter of fact, 71% of women reported feeling flu like symptoms in the weeks prior to having a heart attack (5). You can find more information on the topic of heart attack symptoms on The Mayo Clinic website here. A simple, noninvasive way to test for heart disease is the exercise stress test and recent research has provided more insight into the uniqueness of a woman's heart and the use of this diagnostic test.

Women Take Heart Study-

The Women Take Heart Study, conducted by researchers at Northwestern University, focused on determining the normal response of a woman's heart to exercise stress testing. An exercise stress test or treadmill test is used to check a variety of heart functions including: "heart rate, breathing, blood pressure ECG, and how tired you become when exercising" (7). A stress test can also help diagnose or predict safe levels of exercise, coronary artery disease, possible causes of chest pain,  and risk for heart attack (7). During a stress test doctors monitor a patient to determine if they are unable to reach at least 85% of their maximum heart rate. Failure to reach this benchmark means a greater risk of death from heart disease. How a woman's heart rate (HR), or the number of times a heart beats per minute (BPM), responded to the stress of an exercise stress test wasn't understood very well until the Women Take Heart Study. This is because up until this point most of the research in this area had been conducted on men.

Maximum heart rate formula based on male data-

Scientists have known that maximal heart rate (MHR) decreases with aging (9). As a result, the formula that doctors typically use to calculate a normal response to exercise stress includes a person's age. However, the formula doesn't take into account gender differences. The simplest form of the maximal heart rate calculation based on data gathered from research using men is: Average maximal HR (MHR) = 220 - age in years (9).

New maximum heart rate formula for women-

Now to the Women Take Heart study's exciting findings! This year Northwestern University researchers published results of their study that found "the traditional male-based calculation [of  MHR = 220 - age] overestimates the maximum heart rate for age in women" (8) especially in women over age 35 (10). The new gender specific formula for MHR is:

MHR = 206 -  88 percent of your age

Aerobic physical activity and heart rate-

Women whose stress tests were measured using the old formula tended to show a poorer prognosis, so this gender specific formula reflects a more accurate prediction of a woman's risk for heart disease.  The new formula is also important because heart rate is the standard method for monitoring aerobic exercise intensity. Using this new formula for MHR while calculating an aerobic training heart rate will more accurately reflect how hard a woman is exercising during aerobic physical activity. For example, a 50 year old woman's MHR using the old formula would be: 220 - 50 = 170. If she were shooting to work at a moderate to vigorous intensity range her training heart rate (THR) using the old MHR formula and the simple THR formula would be: 111 (170 x 65%) at the range's lower end and 145 (170 x 85%) at the range's higher end (see the Heart Rate Training Zones Chart below).

From American Council on Exercise

Using the new Women Take Heart MHR formula a 50 year old woman's MHR would be: 206 - .88(50) = 162. So, now the lower end of her THR range would be: 105 (162 x 65%) and at the higher end of her THR: 138 (162 x 85%).

Most charts will reflect training heart rate zones calculated with the old "men only" formula so keep this in mind when you're at the gym monitoring your exercise intensity. Also, exercise equipment and heart rate monitors have usually calculated THR using the old formula. However, some companies are already updating their equipment, but ask to be sure. There's also talk of an I phone app that can do the calculations for us.

It's important to note that some medications, like beta blockers taken for blood pressure control for example, can give false pulse readings. In this case, it is more accurate to measure your level of aerobic exercise intensity using Rate of Perceived Exertion or the Talk Test. You can read more about the rate of perceived exertion here, and the talk test here. Next week's post will go into a little more detail about the aerobic training zones, discuss the myth of the fat burning zone and also look at how doctors are using heart rate response to exercise as a predictor of disease and even death.

There were some limitations to the Women Take Heart study. Nevertheless, the researchers at Northwestern state that their findings "should be incorporated into clinical practice" (12). This research also underscores the importance of conducting more studies that take into consideration the fact that women are biologically unique and not just mini-men. Thanks to gender based biology research, health care might begin to treat the sexes differently.  

Sources

(1) Gender Biology: Men and Women Really Are Different. Films Media Group, 1998. Films On Demand. Web. 20 November 2010. <http://digital.films.com/PortalPlaylists.aspx?aid=10103&xtid=11115>.

(2) http://www.nature.com/nm/journal/v2/n11/abs/nm1196-1248.html 

(3) http://www.mayoclinic.com/health/heart-disease/HB00040 

(4) http://www.washingtonlifescience.com/readlist/ceo_bianco.htm

(5) http://www.womensheart.org/content/HeartDisease/heart_disease_facts.asp, http://www.womensheart.org/content/HeartAttack/heart_attack_symptoms_risks.asp

(6) http://www.nhlbi.nih.gov/whi/  

(7) http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Non-Invasive-Tests-and-Procedures_UCM_303930_Article.jsp
(8) http://www.medpagetoday.com/PrimaryCare/ExerciseFitness/20954

(9) American College of Sports Medicine, Resource Manual for Guidelines for Exercise Testing and Prescription, 2nd ed.

(10) http://seattletimes.nwsource.com/html/health/2012244688_heart05.html 

(11) http://www.cdc.gov/physicalactivity/everyone/measuring/index.html
(12) http://www.medpagetoday.com/PrimaryCare/ExerciseFitness/20954

Breast cancer risk indicators

Wouldn't it be great if doctors had a way to determine our individual risk factors for breast cancer? Then armed with this knowledge we could take specific steps or treatments to prevent the disease? Now you might be thinking, well, there's the mammogram, which has become the gold standard for breast cancer screening. There's also the breast MRI and ultrasound, and let's not forget the clinical or self breast exam. As important and useful as these tools are, they are not about the prevention of breast cancer. The focus of these tests is on detection not prevention, and these are two totally different things.

The National Cancer Institute (NCI) defines cancer prevention as an "action taken to lower the chance of getting cancer". When it comes to disease, prevention really is the best cure. Yet, compared to screening information, not much discussion about prevention is offered to women. 

There are three approaches to disease prevention one can take: reducing risk factors, increasing protective factors or doing both.  Risk factors are defined as anything that increases the chances of getting a disease. Protective factors are anything that helps to reduce the chances of getting a disease. Some risk factors for disease can be avoided and others cannot. For example, tobacco smoking, poor nutrition or lack of exercise can be changed, but a genetic tendency toward cancer cannot. Reducing risk factors and increasing protective factors can help lower the risk of getting cancer, but this doesn't guarantee you won't ever get it either. 

What are the risk factors for breast cancer? According to the NCI, studies have shown the following risk factors:

• Age
• Personal history of breast cancer
• Family history of breast cancer
• Certain breast changes
• Genetic alterations
• Menstrual history
• Race/ethnicity
• Radiation therapy to the chest
• Breast density
• DES (diethylstilbestrol) exposure
• Reproductive history
• Hormone use
• Obesity after menopause
• Physical inactivity
• Alcoholic beverage intake

The good news is that "most women who have these risk factors do not get breast cancer" (NCI). If you're interested in learning more about each of the risk factors listed above you can view more detailed information here. The National Cancer Institute also has an excellent resource called the Breast Cancer Risk Assessment Tool which you can access here. This tool helps estimate a woman's individual risk of developing invasive breast cancer. The NCI points out that no risk assessment tool is 100% accurate and that the tool does have limitations, but it is useful for providing insight into the factors that increase each individual woman's risk for breast cancer. Armed with this knowledge, it can then provide a jumping off point for discussion of an action plan for breast cancer prevention with a health care provider.

If you're considering a breast cancer prevention action plan, experts suggest beginning with specific lifestyle changes to increase the protective factors against developing breast cancer. There are several nutrition and exercise steps you can take, such as limiting alcohol, staying physically active, maintaining a healthy weight, watching the type of fat consumed in your diet (see previous post on understanding the omegas) and eating a diet that is rich in fruits and vegetables. Also, other lifestyle changes like limiting chemical exposure and avoiding antibiotics and hormones found in food can be protective as well (Mayo Clinic and Linus Pauling Institute).

Many of the posts in this blog are focused on providing more information about each of these protective factors against cancer. I believe that when it comes to our health, knowledge is power. It's easy for medical misinformation to result. For example, a news story might have misinterpreted the findings from a research study, or the story that is reported may be a small portion of the bigger picture. In addition to confusing information, medical terminology, data and statistics can often seem overwhelming and frightening.

Rather than living in the shadow of fear that can be created by misinformation and technicality, we can attempt to become empowered by educating ourselves. We can learn more about our own health, beginning with knowing our own realistic level of breast cancer risk. Armed with this knowledge, we can then talk to our medical professional about ways to reduce the risk factors and increase the protective factors that are within our control.  That old saying really is true - an ounce of prevention is worth a pound of cure.



Sources
National Cancer Institute -
Breast Cancer Risk Assessment: http://www.cancer.gov/bcrisktool/
Mammogram: http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms
MRI and ultrasound: http://www.cancer.gov/cancertopics/factsheet/Detection/breast-cancer
Risk factors: http://understandingrisk.cancer.gov/a_breast/01.cfm
Science Daily - http://www.sciencedaily.com/releases/2010/04/100421102338.htm
http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-detection

Because you're worth it!

If you've ever flown you probably have listened to the flight attendant's safety drill. They talk about how in the event of cabin depressurization a parent needs to put their oxygen mask on first and then put their child's mask on. Obviously, if we put our child's mask on first we run the risk of passing out from lack of oxygen ourselves. Isn't this a good metaphor for motherhood?

Good metaphor or not, it typically isn't easy for a mom to put herself first. I hear it all the time. Who has time to exercise? I'm too busy with ______________ (fill in your list here). I don't mean to single out women, but generally speaking we do tend to put ourselves at the very end of our list of priorities. Yes, women tend to be more nurturing and giving, but usually not to themselves. So, in honor of Mother's Day let's consider ourselves for just a moment.

Constantly putting yourself last is an unhealthy habit that can be difficult to break, especially if you might end up feeling a little selfish and guilty about taking time out for you. As a result, we may end up feeling stressed out, anxious, irritable and maybe even a little depressed. The result? Sort of like an empty cup, with not much left to give. Ultimately, this isn't healthy for us, or for the ones we care for.

What if we change our perspective and view making time for ourselves as important as taking care of others? This mindset is a win/win! We fill up our cup and when it is full we have more to give. This allows us to be more patient and loving caregivers. If you're not convinced yet I took these points straight from a paper on the mental health benefits of physical activity published by Dr. Daniel Landers, a leading authority on exercise and mental health.

Physical activity:

• Reduces anxiety and depression.

• Increases positive self-esteem.

• Increases restful sleep.

• Improves ability to respond to stress.

These are just a few of the health benefits associated with increased physical activity. Don't put yourself last on your list. It's okay to put your oxygen mask on first.

Happy Mother's Day.