7 Key Cancer Trends For 2018

Issues that will affect the lives of cancer patients in 2018

1. Less chemotherapy

A recent report finds that among patients with the most common form of early-stage breast cancer, chemotherapy prescriptions slid, overall, from around 34.5% to 21.3%, in a recent 2-year interval (2013-2015). That’s a huge drop, from over a third of women with stage 1 or 2 disease getting chemo, to just over a fifth taking chemo. This trend is impressive and credible in context of growing discussion and awareness of overtreatment and (although authors of this particular study found no link) wider use and acceptance, among oncologists, of recurrence predictors like OncotypeDx and MammaPrint.

The shift for breast cancer is clear. Whether this pattern will emerge and extend to other and less-tracked malignancies, I’m not sure. Probably it will happen variably, by tumor type, and more in the future.

2. More prescription of novel anti-cancer agents

Doctors increasingly prescribe targeted drugs for tumors with specific molecular aberrations. Examples (among many) include a growing array of hormone-blocking agents for breast and prostate cancers, inhibitors of changed or amplified proteins such as EGFR or ALK in lung cancer, and PARP drugs that have been approved so far in ovarian cancer and are likely to be approved soon for some forms of breast cancer. Many of these targeted agents are pills.

Meanwhile, immune-oncology drugs mainly antibodies that interfere with the PD-1 and PDL-1 receptor and ligand families are used against a variety of tumors. Other monoclonal antibodies, like Rituxan or Herceptin, have become well-established in standard care, as newer ones, like Darzalex (anti-CD38, for myeloma) and antibody conjugates like Kadcyla or inotuzumab (recently approved, Besponsa), enter the anti-cancer armamentarium.* Consider, also, the recent paper on replacing bleomycin, a lung-damaging old chemotherapy staple for treating Hodgkin’s lymphoma (the “B” in ABVD), with the anti-CD30 antibody conjugate brentuximab vedotin (Adcetris). That report reflects a trend, of increasing antibody use and less chemotherapy that is revolutionizing treatment of lung cancer, melanoma, and other types of malignancy.

3. Concern over cancer drug costs

This problem is not going away. Rather, the issue of cancer’s financial toxicity, to individuals and to society, will grow as more drugs become available and might be prescribed. Some argue that anti-cancer medications should not necessarily be covered by private insurers, or by public insurers (Medicare or Medicaid), unless the cancer treatments demonstrate a certain level of benefit to patients. But how oncologists or patients or economists or insurance managers define “benefit” or “value” is a contentious issue, as is how that benefit needs be demonstrated.

This is a societal issue. The discussion reflects values and notions of personal responsibility for cancer care, and whether all people with malignant illness are deserving of equal opportunity to try the anti-cancer treatments they and their doctors think are most appropriate.

4. Focus on diagnostics, quality and payment for genetic cancer tests

This is a crucial matter for patients with malignancy who wish to try novel cancer drugs and need to know if their tumors harbor molecular features that match those new drugs. CMS is currently weighing if Medicare and Medicaid should pay for next-generation sequencing (NGS) of advanced cancer cases. So far, the FDA has approved only one such pan-genetic cancer test, FoundationOne CDx, which costs around $5800.

In general, the debate concerns the quality of diagnostic tests, and costs. You may have heard that liquid biopsies of a patient’s cancer yield disparate findings, depending on the company. Doctors and patients need reliable and reproducible results. And so accreditation of labs that perform molecular testing becomes increasingly necessary as these tests becomes more relevant to everyday prescription of oncology drugs and clinical decisions.

As things stand, payment for molecular testing of cancer has limited uptake of some very useful tests. I will write more on this topic separately.

5. Tumor-agnostic prescription of cancer medications

This modern way of prescribing cancer drugs-based on molecular changes in malignant cells, and not necessarily in which body part the tumor occurs, like “breast” or “colon” makes sense. In general, I see this as the future of oncology.

Last May, for the first time, the FDA approved use of an immune oncology drug, Keytruda, for all patients with cancer in which the malignant cells have certain features, what’s called microsatellite instability. The next month, doctors at the annual big U.S. cancer meeting reported on an experimental drug, larotrectinib, which in initial studies helped most patients with a wide range of cancer types, including previously hard-to-treat cases, in which the cancer cells harbor TRK gene fusions. That medication is under review by the FDA; more will follow.

Not all oncologists see merit, or feasibility, of this sort of approach to treating cancer. Based on preliminary studies, it appears that responsiveness to some drugs may depend on the cancer’s location. At last spring’s AACR meeting, for instance, Dr. David Hyman and colleagues reported on the SUMMIT basket trials of patients with HER2 and HER3 mutations. Evidently, neratinib demonstrated some (and limited) activity in patients with HER2 abnormalities with advanced breast, salivary, bile duct and a few other tumors, but not with colon cancer. This was a limited trial, involving a relatively small number of patients with varied HER2 and HER3 mutations. Yet it points to the need for caution, and for collecting data including post-marketing data regarding tumor locations, and details of pertinent mutations—when anti-cancer drugs are prescribed based on their molecular features.

6. Patient-reported outcomes

How cancer patients feel matters. This has always been so, but doctors (and policy-makers) didn’t pay so much attention to their subjective descriptions of pain, nausea, tiredness and other symptoms. As more anti-cancer drugs become available, patient-reported outcomes (PROs) will enable doctors to identify subtle differences among what some deem “me-too” drugs and, also, weigh on risks and benefits of treatments that may, or more not, do more good than harm.

Some insist that extending overall survival is the main purpose of anti-cancer treatment. But as patients and doctors increasingly weigh treatments that might improve quality-of-life, without necessarily extending survival, these PROs become more relevant. How exactly these outcomes will be measured, especially as more data will be collected post-marketing of drugs, off of clinical trials in a non-blinded fashion, by patients who know what they’re on and may be vulnerable to something like placebo effect, or an anti-placebo effect and the willingness of doctors and policy-makers to trust their patients’ reports, is a Pandora’s box from which I look forward to reading, hearing, and learning more.

7. Artificial intelligence (AI)

Few doctors, even oncologists who subspecialize, can keep up with developments in the field. Whether its IBM’s Watson, about which I remain optimistic, or another brand of artificial intelligence delivering suggestions, data-driven algorithms will be needed to guide physicians’ recommendations. The emerging field of computational biology, which can take big data and apply it to individual patients’ cases, with recommendations based on real-time knowledge of cancer science and approved treatments, is the way forward.

Oncology needs be AI-driven, at least at the level of suggesting treatments to consider, because there is too much molecular information for most doctors or patients to grasp and with some 15 million new cancer cases expected around the globe in 2018 too much potential, otherwise missed, to improve outcomes for those affected.

What’s missing? I haven’t mentioned CAR-T cells, which in some ways dominated this year’s cancer news. While it’s clear these biological therapies, involving gene-edited white blood cells taken from each patient and re-infused, can effect remissions and cures as most cancer drugs have not, I remain skeptical about the possibility of manufacturing these agents safely and efficiently on a large scale so that tens or thousands of patients might be helped, by contrast to simpler cancer drugs.

Prevention is unfortunately absent from my list. Cancer prevention remains a personal priority: the best way to avoid cancer deaths, toxicity and costs of treatment, is to prevent the disease from happening. However, apart from discouraging smoking and its cessation, which is old news and in some parts of the world not trending, and giving vaccines to prevent HPV and hepatitis B infection, which is generally happening more, and continually reminding affluent humans to eat and drink less, there is too little progress on this front.

With a diminished EPA under the current U.S. administration, and few doctors willing to invest careers in the slow-paced field of environmental oncology, to designate carcinogens by proving cause-and-effect, it’ll be a long time before we see meaningful advances in understanding the toxic causes many cancers, and how to avoid those (carcinogens). There’s too little incentive. Maybe, in next year’s list, for 2019, that will change.

Also Read: Breast cancer study uncovers new genetic variants for increased risk

News Source: Forbes

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5 Methods to Cut Breast Cancer Risk

About one in every eight women will have breast cancer at some point in her life, but there are ways to lower chances.

More than 3.1 million women in the U.S. are living with breast cancer right now. Here are five ways to lower your risk.

First, watch your weight. One study found women who gained 21 to 30 pounds after age 18 were 40 percent more likely to develop breast cancer than those who didn’t gain more than five.

Another tip, spend less time sitting. In a study, women who sat for six hours a day or longer when not working had a ten percent higher risk of breast cancer compared to those who sat less than three hours.

Next, limit alcohol. Women who have two to three drinks a day have about a 20 percent higher risk of breast cancer compared to those who don’t drink. The American Cancer Society recommends no more than one alcoholic drink a day for women.

Lastly, if you do develop breast cancer, early detection is crucial for a good outcome.

The mammogram is basically the gold standard and that’s the one that’s been studied the most and has shown to actually decrease deaths from breast cancer, said Dr. Cynthia Litwer, of Cedars-Sinai Imaging.

The five-year survival rate for breast cancer that’s found early is 99 percent. See your doctor right away if you feel a lump and make sure you have all recommended screening tests.

Some experts also recommend avoiding hormone replacement therapy. This treatment can up your risk of breast cancer. But if you stop taking it, your risk returns to normal within five years.


News Source: abc7chicago

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Top 10 Hale and hearty Tips for Breast Cancer Prevention

It is every woman’s duty to take care of their health. Here are some tips to protect your breasts from cancer.

Exercise Regularly: “Keep moving every day”. Exercise is your best friend when it comes to any health-related problem. The more you sweat, the more calories you burn and this helps you stay healthy.

Go for regular checkups: Visit your doctor every now and then, especially if you have any doubts. This is not a condition where you can think and postpone your doctor visit to the next month or even later. The earlier you get diagnosed, the earlier you will save yourself!

Know your family history: It is important to know your family history, because most cancers are hereditary. If anyone in your family suffers or has suffered from cancer, then you are prone to a high risk.

Encourage breast feeding: If you are a new mom, do not stop breast feeding for any reason. Breast feeding makes you and your baby stay healthy and energized. Besides giving good nutrition to the baby, it also helps to keep your breasts in good physical shape.

Choose the right food: Food plays a vital role for any problems we might have. Avoid charred meat, unfermented soy products, genetically engineered foods and sugar. Try to consume a good amount of iodine, foods rich in Vitamin A and D and naturally fermented food.

Reduce Stress: Stress is a waste of time – just try to relax! Engage yourselves in stuff that makes you feel busy. Stress is your health’s biggest enemy and the very best friend of all diseases.

Quit smoking: As everyone knows, drinking and smoking support and help cancer survive in our body. Quit smoking and alcohol today and protect yourself from this disease.

Focus on your weight: Studies show that women who have gained too much weight since the age of 18 are more likely to develop breast cancer. When you reach high obese levels then you are at a high risk. It is always considered safe to check on your weight scale and BMI rate.

Get a mammogram done: This is the best way to detect breast cancer. Some may say it has potential risks, but in the end, it gives an accurate result like no other method out there. It is recommended to do this type of screening every year.

Enough Sleep: Getting a good night sleep helps you stay healthy. Continuous 8 hours of sleep make the human mind and body feel fresh and relaxed. Some people don’t give it much credit but they should. Consult your doctor today and discuss this to get the right solution and stay on a safer side.

Also Read: Cancer doctors cite risks of drinking alcohol

Article Source: Ezine

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Cancer doctors cite risks of drinking alcohol

The American Society of Clinical Oncology, which represents many of the nation’s top cancer doctors, is calling attention to the ties between alcohol and cancer. In a statement published Tuesday in the Journal of Clinical Oncology, the group cites evidence that even light drinking can slightly raise a woman’s risk of breast cancer and increase a common type of esophageal cancer.

Heavy drinkers face much higher risks of mouth and throat cancer, cancer of the voice box, liver cancer and, to a lesser extent, colorectal cancers, and the group cautions.

The message is not, don’t drink. It’s, if you want to reduce your cancer risk, drink less. And if you don’t drink, don’t start, said Dr. Noelle LoConte, an associate professor at the University of Wisconsin-Madison and the lead author of the ASCO statement. It’s different than tobacco where we say, Never smoke. Don’t start. This is a little more subtle.

Other medical groups have cited the risks of alcohol as a possible cause of cancer. But this is the first time that ASCO has taken a stand.

Drinking overall, as well as heavy drinking and problem drinking, are on the rise in the U.S. and affect all segments of society, including women, older adults, racial and ethnic minorities and the poor, several surveys have shown.

Yet few adults, when asked, identify alcohol consumption as a risk factor for cancer, even though the vast majority were familiar with other cancer risk factors, like smoking and sun exposure, a recent ASCO survey of 4,016 adults found. Fewer than 1 in 3 adults identified alcohol as a risk factor for cancer. (Most also failed to mention obesity as a risk factor.)

For women, just one alcoholic drink a day can increase breast cancer risk, according to a report released in May from the American Institute for Cancer Research and the World Cancer Research Fund that was cited by ASCO. That report analyzed 119 studies, including data on 12 million women and over a quarter of a million breast cancer cases, and concluded there was strong evidence that alcohol consumption increases the risk of both pre- and postmenopausal cancer, and that drinking a small glass of wine or beer every day about 10 grams of alcohol increases premenopausal breast cancer risk by 5 percent and postmenopausal risk by 9 percent.
The more you drink, the higher the risk, said Dr. Clifford A. Hudis, the chief executive of ASCO. It’s a pretty linear dose-response.

Even those who drink moderately, defined by the Centers for Disease Control as one daily drink for women and two for men, face nearly a doubling of the risk for mouth and throat cancer and more than double the risk of squamous cell carcinoma of the esophagus, compared to nondrinkers. Moderate drinkers also face elevated risks for cancers of the voice box, female breast cancer and colorectal cancers.

The risk for heavy drinkers defined as eight or more drinks a week for women and 15 or more a week for men, including binge drinkers are multiples higher. Heavy drinkers face roughly five times the risk of mouth and throat cancers and squamous cell esophageal cancers than nondrinkers, nearly three times the risk of cancers of the voice box or larynx, double the risk of liver cancer, as well as increased risks for female breast cancer and colorectal cancer.

If you look at these figures, you see alcohol is a contributing factor; certainly it has a causal role, Dr. Hudis said.

The International Agency for Research on Cancer, which is part of the World Health Organization, first classified the consumption of alcoholic beverages as carcinogenic to humans in 1987, tying consumption to cancers of the mouth, throat, voice box, esophagus and liver, said Susan Gapstur, vice president for epidemiology at the American Cancer Society.

Since then, she said, more and more evidence has accumulated tying alcohol to a broader group of cancers, including colorectal cancer and, in women, breast cancer. A more recent IARC report concluded that alcohol is a cause of cancers of the oral cavity, pharynx, larynx, esophagus, colorectum, liver and female breast. (The esophageal cancer is largely specific to squamous cell carcinoma.)

One way alcohol may lead to cancer is because the body metabolizes it into acetaldehyde, which causes changes and mutations in DNA, Gapstur said. The formation of acetaldehyde starts when alcohol comes in contact with bacteria in the mouth, which may explain the link between alcohol and cancers of the throat, voice box and esophagus, she suggested.

Dr. Anne McTiernan, a scientist at the Fred Hutchinson Cancer Research Center who was an author of one of the earlier reports on alcohol and breast cancer, said she was pleased that oncologists were focusing on alcohol.

That puts some weight behind this, she said. It shows they’re serious about it and willing to put their name on the line for changes in policy, and willing to say that even small amounts of alcohol can increase the risks of some cancers to a small degree.


News Source: The Post and Courier

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Risk of breast cancer recurrence lasts for decades

By Lisa Rapaport

Many women who follow initial breast cancer treatment with five years of hormone therapy to keep tumors at bay may still experience new malignancies up to two decades after their diagnosis, a study suggests.

Researchers examined data from 88 clinical trials involving 62,923 women with estrogen receptor (ER)-positive tumors. After treating ER-positive tumors with chemotherapy, radiation or surgery, women typically get five years of follow-up therapy with daily hormone-based pills – either tamoxifen or aromatase inhibitors. The goal of the adjuvant therapy is to destroy any lingering cancer cells not killed by initial treatment.

All of the women were cancer-free when they completed five years of adjuvant hormone-based therapy.

During the next 15 years, however, cancer returned for 41% of the highest-risk women in the study who originally had the largest tumors that had spread the most beyond the breast, the study found.

Even the lowest-risk women who originally had small tumors that hadn’t spread to the lymph nodes or other parts of the body still had 10% odds of cancer coming back during the study, breast cancer research report online November 13 in the New England Journal of Medicine.

We know that adjuvant (hormone-based) therapy for 5 years substantially reduces the risk of recurrence and mortality,” said senior study author Dr. Daniel Hayes of the University of Michigan Comprehensive Cancer Center in Ann Arbor.

We now have good evidence that extending adjuvant (hormone-based) therapy beyond five years continues to suppress and reduce recurrence and mortality,” Hayes said by email.

Doctors have long known that five years of tamoxifen reduces recurrence by approximately half during treatment, and by nearly a third over the next five years. Aromatase inhibitors, which work only in post-menopausal women, are even more effective than tamoxifen at reducing recurrence and death from breast cancer.

Some recent research suggests an additional five years of hormone-based therapy is even more effective, but the side effects make some women reluctant to continue. Life-threatening side effects are rare, but women taking these hormones can have menopause symptoms like hot flashes and vaginal dryness.

The data suggest that women with ER-positive breast cancer should at least consider continuing adjuvant therapy beyond five years, the authors conclude.

Breast cancer cells can travel from the primary tumor to the lymph nodes and can circulate throughout the body undetectable with current screening (methods) and over time, these circulating cancer cells can attach to other organs in the body and this is generally when there is a detectable cancer recurrence,” said Albert Farias, a cancer researcher at the Keck School of Medicine of the University of Southern California in Los Angeles who wasn’t involved in the study.

One way that adjuvant breast cancer treatment works is to kill and/or stop the undetectable cancer cells from growing and dividing, Farias said by email.

Even though the study suggests some women may have more risk of recurrence based on their original tumor characteristics, it can still be hard to predict and women need to remain vigilant, said Dr. Sharon Giordano of the University of Texas MD Anderson Cancer Center in Houston.

Breast cancer can be dormant for many years, so that women can have no apparent disease, but can still recur years later if the tumor becomes active again, Giordano said by email. We do not know why some cancers become active again after years of dormancy.

Women need regular checkups and breast screenings, as well as annual mammograms, said Dr. Alana Biggers, a researcher at the University of Illinois-Chicago who wasn’t involved in the study.

If a woman is high risk for breast cancer, such as a lady with a gene mutation, she may need both mammograms and breast MRIs, Biggers added by email. Additionally, women should maintain a healthy weight, exercise, stop smoking, and limit alcohol consumption to reduce their risk of recurrence.

Also Read: Researchers Discover Link between Bacterial Levels and Breast Cancer

New’s Source: Business Insider

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Researchers Discover Link between Bacterial Levels and Breast Cancer

Differences in the bacterial composition of breast tissue have been revealed by researchers at Cleveland Clinic while studying the tissue of healthy women vs. those with breast cancer. What they’ve discovered is that the breast tissue of healthy women contains higher levels of the bacterial species Methylobacterium. This finding could help in the development of new, more effective breast cancer treatments moving forward.

Microbiomes are bacteria that live within the body that are responsible for influencing various diseases. Although we’ve known for a long time that microbiomes exist in the gut, we’ve never really explored them in the breast until more recently. This research is the first step toward understanding how this bacterium develops in the breast by looking at distinct microbial differences between the cancerous and healthy tissue samples.

To my knowledge this is the first study to examine both breast tissue and distant sites of the body for bacterial differences in breast cancer, said co-senior author of the study, chair of Cleveland Clinic’s Genomic Medicine Institute, and director of the Center for Personalized Genetic Healthcare, Charis Eng, M.D., Ph.D. we hope to find a biomarker that would help us diagnose breast cancer quickly and easily.

The study involved examining the tissue of 78 patients who had been in the hospital for a mastectomy for elective cosmetic breast surgery or for invasive carcinoma. They also took both urine and oral rinse samples to determine the bacterial composition of these distant sites. In addition to the Methylobacterium find the researchers discovered that cancer patient’s urine samples had high levels of gram-positive bacteria which may be a key to understanding and developing better treatments for breast cancer.

If we can target specific pro-cancer bacteria, we may be able to make the environment less hospitable to cancer and enhance existing treatments. Larger studies are needed, but this work is a solid first step in better understanding the role significant role of bacterial imbalances in breast cancer, said co-senior author Stephen Grobymer, M.D.


New’s Source: TrendinTech


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15 Procedures You Can Reduce Your Risk of Breast Cancer

Here are some ways you can arm yourself with the best defense against this terrible disease.

Breast cancer affects us all

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The numbers are staggering. One in 8 (12.4 percent) U.S. women will develop breast cancer during her lifetime, according to the National Cancer Institute. The Susan G. Komen Breast Cancer Foundation estimates that approximately 255,000 people will be diagnosed with breast cancer in the U.S. this year alone, and more than 40,000 lives will be lost to this disease. These are numbers we feel every day, as most people, regardless of who they are or where they live, are impacted by breast cancer in some way, whether it be a family member, friend, or colleague who has or knows someone who has this disease. While there’s much left out of a woman’s control when it comes to getting breast cancer, especially considering most cases appear randomly and do not always run in families, there are several important steps that can reduce this risk substantially. In honor of Breast Cancer Awareness Month, doctors share the steps you can take every day, week, month and year to put your best foot forward towards lowering your risk.

First things first: Know your family history

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It’s standard procedure nowadays for nearly every type of doctor you see to inquire about your family history, as genetics have been proven to be a key contributor to an individual’s cancer risk and it’s especially important when it comes to breast cancer. Some women (and men) have an especially high risk of developing breast cancer related to inherited predisposition, history of radiation treatments to the chest wall during adolescence or early adulthood, or because of ‘overactive’ breast tissue that is sometimes detected on breast biopsies,” explains Lisa Newman MD, MPH, a member of Komen’s Scientific Advisory Board and director of the Breast Oncology Program for the Henry Ford Cancer Institute. Red flags that she says suggest possible inherited predisposition include having multiple relatives with breast or ovarian cancer, male relative(s) with breast cancer and relatives that were diagnosed with breast cancer at young ages. “Patients who are found to have an increased risk of breast cancer should then discuss risk-reducing options (such as medication or surgery) or more aggressive breast cancer screening options (such as mammograms starting at younger ages or a special breast imaging test called an MRI), adds Dr. Newman.

Perform self breast exams monthly

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While the American Cancer Society recently revised its guidelines on self breast exams, noting that there’s not enough research to support their clear benefits, experts agree that they’re still important and there’s absolutely no downside. Knowing what your baseline ‘lumps’ are so you’ll be able to immediately recognize when something feels new or different is key, says Phoebe Harvey, MD, chief of hematology/oncology for Kaiser Permanente Northwest in Portland, Oregon. Women who have naturally lumpy breasts often say they find it hard to know what’s ‘normal. Her best advice is to pay attention to lumps that feel unlike the rest of your breast tissue, for example, that are harder or just seem out of place. These should be checked out by your provider. There can also be visual clues as well, like a change in the size or shape of your breast, or dimpling of the skin, she adds. And if you do find a lump, don’t freak out.

Schedule yearly mammograms

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Women who have an average risk of breast cancer should begin having annual mammograms, basic x-rays of the breast, according to the American Cancer Society. However, there’s been a great deal of controversy in recent years with regard to the age and frequency. Experts recommend discussing your risk factors with your doctor to determine if a mammography before the age of 40 is right for you. Although getting screened for breast cancer does not reduce your risk, it can help identify the proper screening methods you should be using based on your risk factors and can help to identify cancer early when it is easiest to treat, explains Jane Kakkis, MD, medical director of breast surgery at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, California. If you are old enough to have a screening mammogram, Dr. Kakkis recommend also asking your doctor whether or not you have dense breast tissue. If you have dense breast tissue, then your risk of breast cancer is increased and, depending on other risk factors that you might have, your doctor may recommend supplementing your mammogram screening with ultrasound or MRI.

Maintain a normal body weight

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Among the laundry list of reasons why a healthy BMI (body mass index) is beneficial is that it has been known to significantly reduce your risk of cancer, as well as several other diseases including heart disease and diabetes. “One reason for this is that body fat produces estrogen, which increases the risk of developing breast cancer,” explains Dennis Holmes, MD, breast cancer surgeon and researcher and interim director of the Margie Petersen Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California. This is even more important as we get older, as Dr. Newman notes that women who are overweight or obese after menopause have a 30 to 60 percent higher breast cancer risk compared to those who are lean. Aim for a BMI that is between 18.5 to 24.9, as anything above is considered overweight and anything above 30 is considered obese.

Exercise several times a week

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According to Marc Hurlbert, Ph.D, breast cancer specialist and chief mission officer for the Breast Cancer Research Foundation, physical activity may be the most potent lifestyle factor in reducing the risk of breast cancer, especially after menopause. “It not only helps in achieving and maintaining a healthy weight, but exercise also reduces the levels of metabolic hormones including insulin and leptin, and it reduces levels of estrogen, all of which promote tumor growth,” he says. “Exercise may be most beneficial in overweight women who may have high levels of insulin and estrogen.” The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity, or 75 minutes of vigorous intensity, activity each week, preferably spread throughout the week.

Watch your diet

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When it comes to maintaining a healthy weight, diet goes hand-in-hand with exercise. “Changes to your body as you age, and especially after menopause, make it necessary to change lifestyle and eating habits to maintain a healthy weight,” Dr. Kakkis explains. She recommends the Mediterranean diet, which incorporates a lot of fresh vegetables, healthy sources of fats, lean protein sources, and whole grains. “All of these, especially when coupled together, benefit your cardiovascular system and lead to a substantial amount of health benefits.” She does note, however, that even with a healthy diet, portion sizes should be appropriate, with the largest food group in each meal being vegetables. Also, do your best to eliminate preservative-laden foods, especially nitrates, as well as hormone and pesticide additives. “Soy concentrated products should be avoided by high-risk persons or breast cancer survivors, (soy supplements, soy milk, etc.) and natural food sources of soy, such as tofu should be limited to three small servings per day,” she says. “Using proper oils for deep frying is important, as oils that are heated past their optimal temperature develop chemicals known to cause cancer to enter the food.” Peanut oil is an example of oil that can be used for deep frying.

Cut down on the cocktails

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While it’s not exactly clear why, there is a growing body of evidence that suggests as little as one alcoholic beverage a day is enough to increase an individual’s risk of breast cancer. “Among other things, alcohol is thought to raise estrogen levels and can also contribute to weight gain,” explains Dr. Harvey. This can be a tough pill to swallow for those who enjoy a nightly cocktail or glass of wine, but Dr. Harvey urges that the correlation is strong enough. She advises people to strongly consider reducing their intake, especially since alcohol is a known risk factor for a number of other cancer types as well.

Quit smoking, stat

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Recent studies show that smoking, especially heavy smoking, may increase the risk of certain breast cancers,” says Dr. Hurlbert. “The effect may be stronger when a woman starts smoking before her first child.” Second-hand smoke plays a role in increasing a person’s risk too. “In animal studies, chemicals from first or second-hand smoke caused breast tumors and was found in the milk of nursing rodents,” he says. Bottom line: Smoking is terrible for your health and may be a catalyst for increasing your breast cancer risk. Quitting is your only option to reduce this risk.

Take aspirin or ibuprofen regularly

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Seriously! Research has found that women who take two or more tablets of aspirin or ibuprofen each week for at least five years have a 20 percent lower risk of developing breast cancer. “Taking these medications for more than 10 years lowers the risk even further,” notes Dr. Holmes. “Either mediation is capable of reducing chronic inflammation within the body, which can predispose some women to develop cancer.” While the ideal dose and frequency of use of aspirin or ibuprofen have not been determined, Dr. Holmes recommends women to consider taking a low dose of aspirin (81 mg) or ibuprofen (200 mg) twice a week if they’re not already doing so for other reasons.

Have children earlier in life (if possible)

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While the reasons aren’t totally clear, research suggests that women who conceive children earlier in life have a lower risk of breast cancer. The Nurses’ Health Study, for one, shows that women who give birth in their 20s compared to those who give birth in their 30s or later, have a reduced risk of breast cancer. “It is believed that the hormonal and other cellular effects of pregnancy influence the breast tissue positively and is protective against cancerous transformation,” explains Jack Jacoub, MD, medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California. Additionally, women who have multiple children see a decreased risk. One reason for this, notes Dr. Jacoub, is that pregnancy limits the periods of “incessant ovulation” over a woman’s lifetime. “This is when ovaries are functional and producing high levels of sex hormones, namely estrogen.

Breastfeed your baby

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While this isn’t always easy, or feasible, for all women, research shows that women who breastfeed, when compared to those who don’t, have a modestly decreased risk of breast cancer. “The effect is greatest in women who breastfeed for one and a half to two years,” notes Dr. Hurlbert. “Breastfeeding delays the return of menses after childbirth and this lowers the lifetime exposure to estrogen.” He also notes that total exposure to estrogen over a lifetime can increase the risk of breast cancer after menopause. “That’s one reason why having children is also protective, as a woman’s estrogen levels drop during pregnancy.

Limit oral contraceptive use

Following on the discussion about exposure to estrogen, oral contraceptives increase this exposure,” says Dr. Hurlbert. In other words, women who use oral contraceptive have a slightly higher risk of breast cancer compared to those that don’t. “The risk decreases over time after stopping contraceptive use and women who have not taken contraceptives for more than ten years are no longer at increased risk from contraceptive use.” He recommends that women discuss their use of hormone-based contraception with their doctors to determine what is best for their particular health concerns and situation

Quit menopausal hormone use

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The practice of using menopausal hormone therapy (MHT) to relieve symptoms of menopause, such as hot flashes and sleep disturbances, has been used for more than a century, but recently it’s been linked to an increase in breast cancer risk. “The combination of estrogen plus progestin for several years increases the likelihood of developing breast cancer and can make mammograms more difficult to interpret,” explains Dr. Newman. “You can reverse some of this risk by discontinuing these hormones.” She recommends talking with your doctor about safe alternatives to control menopausal symptoms.

Preventative surgery

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Although all women are at risk of developing breast cancer, some women are at particularly high risk because of personal health factors and family history. These “high risk” women, many of which are carriers of the BRCA 1 or BRCA 2 genetic mutations, should consider taking preventative action, which often involves surgery, to dramatically reduce their risk of breast cancer. “If you have a strong family history of breast cancer, genetic testing is highly recommended so you can better understand your options,” says Nikita Shah, MD, breast cancer specialist at the Breast Care Center at Orlando Health UF Health Cancer Center. If someone in your family has been diagnosed with breast cancer, especially before age 40, ask your doctor about getting tested for the BRCA gene. In some cases, your doctor may recommend you go ahead with a preventative surgery, such as removal of the breasts, ovaries, and Fallopian tubes, to reduce your risk of getting cancer.

Understand how your community and identity can affect your risk

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Research suggests that those with certain ethnic and socioeconomic backgrounds may be at a predisposition to be diagnosed with breast cancer, for example, Ashkenazi Jewish families have a significantly higher risk of carrying mutations or abnormalities, Dr. Newman notes. “We also know that breast cancer mortality and death rates are significantly higher among African American compared to white American women.” She explains that this disparity is related to socioeconomic disadvantages and healthcare access barriers that are more prevalent in the African American community, but it has also been shown that a biologically more aggressive pattern of breast cancer (triple negative breast cancer) is twice as common among African American compared to White American women. Breast health awareness and early detection or screening programs, as well as research, are essential to address and eliminate these disparities, so use what is available to you and use it wisely.


Article Source: Reader’s Digest

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Support more funding for research of metastatic breast cancer

This month marks the two-year anniversary of my first breast cancer diagnosis and just one year since the cancer spread beyond my breasts and to my bones. With four children — ages 3, 5, 7 and 11 — I can’t begin to describe how it felt to be told that my cancer is incurable.

Metastatic breast cancer is stage IV breast cancer that has spread to other parts of the body. Someone with this cancer dies every 13 minutes in the U.S.

As Breast Cancer Awareness Month comes to an end, I ask that you not forget about the 155,000 men and women in America living with metastatic breast cancer and fighting for their lives each day. While 20 percent to 30 percent of people initially diagnosed with early stage breast cancer will develop metastatic breast cancer, the funding to support research specific to this cancer is greatly disproportionate to the number affected. Only 7 percent of the $15 billion of funding for breast cancer research is specifically allocated to finding a cure for metastatic breast cancer.

For me, there is no time to debate funding and policy issues within our country’s health care system. My life with cancer depends on access to regular treatments, and it depends on advances in research for new treatments and someday, a cure. I’d like more time with my kids, my family and my friends — which means we cannot just recognize this disease in October.

Please sign the It’s About Time campaign’s petition, which reminds our state leaders to protect our access to treatment through affordable insurance coverage and out-of-pocket costs. If it gives even just one person with metastatic breast cancer more time to be with the ones that they love, it’s worth it.


Article Source: ST.Louis Post-Dispatch (Stltoday)

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Breast cancer study uncovers new genetic variants for increased risk

Researchers hope new discoveries will help explain why some women are predisposed to breast cancer, as well as why certain forms are harder to treat.

Common inherited genetic variants that together increase the risk of breast cancer by about a fifth have been identified by scientists.
A huge team of researchers working together around the world uncovered 65 new variants. On their own, they contribute around 4% of the two-fold heightened risk of women with a strong family history of breast cancer developing the disease.
Adding these variants to the list of 180 already known is thought to account for an estimated 18% of the relative familial risk.

In addition, a further 10 genetic variants specifically linked to stubborn breast cancers that do not respond to hormone treatment were found. They could be responsible for as much as 16% of the increased risk of this cancer sub-type in women from affected families.

The OncoArray Consortium project involved 550 researchers from around 300 different institutions on six continents. The scientists analysed genetic data from 275,000 women, including 146,000 who had been diagnosed with breast cancer.

Professor Doug Easton, one of the lead investigators from Cambridge University, said: These findings add significantly to our understanding of the inherited basis of breast cancer.

As well as identifying new genetic variants, we have also confirmed many that we had previously suspected.

There are some clear patterns in the genetic variants that should help us understand why some women are predisposed to breast cancer, and which genes and mechanisms are involved.

Genetic studies of this sort look for loci – regions of DNA that increase the risk of disease. The loci may contain rogue genes, or DNA sequences that do not contain instructions for making proteins but regulate gene activity.

Pinpointing specific genes is difficult, but the OncoArray scientists were able to make predictions about many target genes a first step towards designing new treatments.

However most of the new variants found were in gene-regulating regions. When the researchers took a closer look at these, they found distinct patterns specific to breast cancer.

US co-author Professor Peter Kraft, from the Harvard TH Chan School of Public Health, said the findings revealed a wealth of new information about the genetic mechanisms underlying the disease.

This should provide guidance for a lot of future research, he added.

Approximately 70% of all breast cancers are fuelled by the hormone oestrogen and respond to hormone therapies such as tamoxifen.

Others, known as oestrogen-receptor negative, are not affected by the hormone and are more difficult to treat. Ten new genetic variants linked to these cancers were identified.

The new studies, published in the journals Nature and Nature Genetics, underscored the fact that the two cancer types are biologically distinct and develop differently.

Mutant versions of the two genes BRCA1 and BRCA2 have by far the biggest impact on breast cancer risk. Inheriting either of these genes raises the lifetime risk of developing the disease by as much as 90% for BRCA1 and 85% for BRCA2. It also increases the risk of ovarian cancer to a lesser degree.

Other genetic variants linked to breast cancer are much less potent on their own, but their effects add up. Those identified in the new studies are relatively common some carried by one woman in 100 and others by more than half of all women. The combined effect of these variants is likely to be considerable said the researchers.

They estimate that 1% of women have a risk of breast cancer more than three times greater than that of women in the general population. Combining the genetic factors with hormonal and lifestyle influences was likely to increase the risk further, they said.

Professor Jacques Simard, from Laval University in Quebec city, Canada, another member of the international team, said: Using data from genomic studies, combined with information on other known risk factors, will allow better breast cancer risk assessment, therefore helping to identify a small but meaningful proportion of women at high risk of breast cancer.

These women may benefit from more intensive screening, starting at a younger age, or using more sensitive screening techniques, allowing early detection and prevention of the disease.


Article Source: The Guardian

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Five Breast Cancer Myths You Should be Aware Of

October is Breast Cancer Awareness Month, which is an annual occasion to increase awareness of the disease. If you perform a quick search on the disease, you will find tremendous information on contributing factors to the risk of breast cancer, including some types of food, drinks, cleaning materials and even devices. This information leads to confusion on what to believe as fact and what to ignore as a myth.

Marking this important awareness-raising month, we present to you this information on five of the most circulated myths about the disease.

Myth No 1: Drinking milk (or dairy) causes breast cancer

some early studies raised concerns about the correlation between drinking milk from cows treated with hormones and the risk of cancer. The truth is that over many decades, studies failed to find a clear link and have shown that dairy consumption does not increase the risk of cancer, according to the American Cancer Society.

Moreover, the International Journal of Epidemiology published in 2002 the results of 20 studies on the relationship between dairy and increased risk of cancer. All the studies showed that there is no significant association between intakes of total dairy fluids or solids and breast cancer.

Myth No 2: Antiperspirants and deodorants cause breast cancer

The truth is that there is no conclusive evidence on links between the use of underarm antiperspirants or deodorants and the subsequent development of breast cancer, according to the National Cancer Institute (NCI).

Some people have concerns that deodorants and antiperspirants block the body from sweating toxin which might build up in the lymph glands under the armpit causing breast cancer. But the human body has several other ways of disposing of toxins that do not involve the lymph glands. Furthermore, the “Breast Cancer Care” initiative explained there is also no evidence ingredients used in deodorants and antiperspirants like aluminum or parabens cause breast cancer.

Myth No 3: Finding a lump in your breast means you have breast cancer

The truth is that only a small percentage of breast lumps are cancer. However, it is very important to see a physician for a clinical breast exam if you notice a persistent lump in the breast or any changes in breast tissue. A physician is the only one who can determine whether this lump or change is of concern or not. Furthermore, it is essential to keep the habit of performing routine breast self-exams and getting an annual clinical breast exam, including scheduling routine mammograms.

Myth No 4: Men do not get breast cancer, it is a women’s only disease

While the percentage of breast cancer occurrence is small among men, they are also affected by the disease. In fact, breast cancer leads to higher mortality among men compared to women as a result of the lack of awareness that they can also be affected by the disease, which leads to delay in seeking treatment.

Men should also check themselves periodically by doing a breast self-exam in the shower to discover any hard lump underneath the nipple and areola so that they can report these changes to their physicians.

Myth No 5: A mammogram can cause breast cancer to spread 

The truth is that any breast compression while getting a mammogram cannot cause cancer to spread. Also, the benefits of mammograms outweigh the potential harm from radiation exposure as they require very small doses of radiation, according to the National Cancer Institute.

The standard recommendation is an annual mammographic screening for women and men, in addition to any other recommendation by the physician.

Myth No 6: Breast cancer is contagious

Breast cancer cannot transfer to someone else’s body. The disease results of uncontrolled cell growth of mutated cells that begin to spread into other tissues within the breast. Everyone can reduce their risk of being affected by the disease by practicing a healthy lifestyle and being aware of the risk factors and following an early detection routine.

There are some things that can help us avoid breast cancer like keeping a healthy weight, paying attention to your alcohol consumption, stop smoking and keeping active. While there are some factors that we cannot control like aging and exposure to high levels of radiation can increase the risk of breast cancer.

Read More: About Breast Cancer

Article Source: Egypt Today

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