“You can’t expect from mammography what it cannot do. Screening is not prevention. We’re not going to screen our way to a cure.”
“It’s just not true to say that ‘if you get a mammogram, all will be well.’
A recent study indicates that most stage II and III breast cancers actually turn up clinically, between normal planned screens.
We are not saying that screening is bad. It’s what you do with the information that makes it good or bad. We need to refocus and figure out how to tailor screening.
I think people like the simple message that screening is good and are uncomfortable with complexity. I understand that. However, cancer is a complicated disease.
We need to expand our messages to say, among other things, that many screen-detected cancers are slow growing and may not need treatment.”
-Dr. Laura Esserman, Director of the Breast Cancer Center at the University of California, San Francisco, quoted in the NYT 10/24/11 “Mammogram’s Role as Savior is Tested.” –
“Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed.”
-Dr. H. Gilbert Welch, MD, Dartmouth Institute of Health Policy & Clinical Practice-
Dr. Susan Love, the prominent breast cancer surgeon & women’s advocate who is a Clinical Professor of Surgery at UCLA, “says the scientific understanding of cancer has changed in the years since mammography screening was adopted.”
As a result Love would like to see less emphasis on screening and more focus on cancer prevention and treatment for the most aggressive cancers, particularly those that affect younger women. Roughly 15 to 20% of breast cancers are deadly. NYT 10/24/11 “Mammogram’s Role as Savior is Tested.”
Honestly, I didn’t plan on writing about breast cancer prevention today. No way. I was all set to summarize the BBC’s fascinating documentary, “Eat, Fast, and Live Longer” I watched it on Saturday & loved it! So, I’m absolutely clueless how today’s post morphed into a breast cancer prevention mash-up.
Let’s blame it on October–It’s Breast Cancer Awareness Month
Hope it’s worthwhile, because it took way too long to put together.
No worries, gentleman, I’m not forgetting about you. I’ve got some fascinating & eye-opening excerpts to share from the latest edition of Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer–all about the role of diet on prostate cancer. Hint: It has to do with evolution, meat & dairy. Stay tuned.
Why So Little Information on Breast Cancer Prevention?
How About Something More Than Mammograms?
Up until 4 years ago, I figured that getting my annual mammogram was my best strategy for preventing breast cancer.
I dutifully went for my annual mammogram–and yes, I don’t plan on stopping until sometime in my 70’s. But, we have to remember that an annual screening mammogram is just a diagnostic tool. Sure, it may prevent us from dying of breast cancer, but, it doesn’t do a single thing to prevent or slow the development of breast cancer in the first place.
Here are some sobering facts to consider.
- Mammography does a great job of finding microscopic precancerous lesions like Ductal Carcinoma In Situ(DCIS) that often don’t progress to invasive cancer–but once they’re found on a mammogram they’re treated. Read more about DCIS here.
- The really fast-growing aggressive cancers are often missed because they aren’t visible at the time of an annual mammogram–so screening is often of no help for these “bad cancers.” “Roughly 15-20% of breast cancers are deadly,” according to Dr. Susan Love in the Oct. 24, 2011 New York Times.
- Many cancers are slow-growing (known as indolent) and can be found and successfully treated when they’re discovered either in that every-other-year mammogram or with a breast exam.
- But here’s the kicker! Mammograms are diagnostic tools–they don’t do a single thing to help women prevent cancer. There is plenty of research pointing to real strategies that can help us prevent breast cancer–yet, how often do we hear about them? Not very often.
What’s a Woman to Do? Consider These Four Breast Cancer Prevention Strategies
1. Do Diet & Exercise Matter in Preventing Breast Cancer? Yes, according to two registered dietitians, Sally Scroggs, MS,RD,LD, and Clare McKinley, RD,LD, at the University of Texas M.D. Anderson Cancer Center, one of the leading cancer hospitals in the world. They say that breast cancer risk could be decreased by up to 38% through lifestyle factors, including maintaining a healthy weight, exercising regularly, and eating a healthy diet. Read Scoggs’ & McKinley’s detailed recommendations later in this post, along with a few “editorial additions” from me.
And don’t miss checking out Dr. Michael Greger’s excellent Breast Cancer & Diet Recommendations, here.
2. Consider Vitamin D for breast cancer protection. According to one recent UCSD study that reviewed 11 observational studies, a serum 25(OH)D level of 47 ng/mL was associated with a 50% lower risk of breast cancer. For many of us, it may take a lot more than 1000 IUs of vitamin D/day to get up to a 47 ng/mL level, especially if you live up North! There’s only one sure-fire way to know what your level is–get tested. I’ve finally got my level up to 43 ng/mL & I plan to keep it there. Click here and here to read more.
What about the vitamin D cancer connection? It seems so far-fetched, right? (read more here)
Dr. Bruce Hollis of the Medical University of South Carolina has collaborated with Dr. Walter Willett and the Harvard School of Public Health for over 15 years, studying epidemiologic data on the effects of vitamin D on cancer. These studies have routinely shown that an adequate vitamin D status protects against 13 or 14 different cancers, including breast, prostate, and colon cancer.
Still, Hollis is skeptical that vitamin D could treat cancer once you get it–its benefit is in preventing it in the first place–and having adequate levels will lower your risk.
Researchers in Nutrition Reviews project that a vitamin D blood level over 52 ng/mL would reduce breast cancer by 50%, and levels over 34 ng/mL would prevent 50% of the colon cancers. (Note: a more recent study put the number at 47 ng/mL)
Here’s how it works: Vitamin D helps control cell growth and that’s why we think that it will reduce the risk of many deadly cancers like prostate, breast, and colon by as much as 50 percent. In its role as a hormone, vitamin D travels all over our body delivering messages to activate genes and control cell growth.
3. Avoid unnecessary diagnostic radiation whenever possible. Here’s what breast cancer surgeon & spokesperson, Dr. Susan Love has to say about it: “Don’t get that X-ray unless it’s absolutely necessary. Stay away from unnecessary radiation–so if somebody orders an X-ray, you’ve got to say, ‘How is this going to change my care?’ And if it’s not, don’t do it.”
4. Limit Your Intake of Animal Protein. Consuming more animal protein and especially dairy products raises blood levels of insulin-like growth factor-1 (IGF-1), and elevated IGF-1 levels have been associated with increased breast cancer risk in many studies. According to Valter Longo, PhD of USC Davis School of Gerontology, lowering one’s blood level of IGF-1 protects against cancer & wild cell growth. The two ways to lower IGF-1 levels are by limiting or eliminating animal protein–and by eating fewer calories. We need adequate levels of IGF-1 and other growth factors when we are young & still growing, but high levels later in life appear to lead to accelerated ageing. As levels of the IGF-1 hormone drop, a number of repair genes appear to get switched on, according to ongoing research by Professor Longo. Here’s why: When our bodies aren’t getting overfed with the extra calories & animal protein found in a typical Western diet, they switch from “growth mode” to “repair mode”. In case anyone’s wondering–Dr. Longo is “pretty much a vegan” based upon his research. Interesting, huh? Click here to read more.
If you do not see this video on your screen, click here.
The MD Anderson Cancer Center’s Recommendations for a Diet to Reduce the Risk of Breast Cancer
Does Diet Really Matter in Breast Cancer?
Written by Dr. Melina Jampolis (additions by the Healthy Librarian–noted in ORANGE)
Since October is Breast Cancer Awareness month, this is the perfect time to answer this question.
And the answer is a resounding yes. To get you the best possible information, Dr. Melina Jampolis turned to registered dietitians Sally Scroggs, MS,RD,LD, and Clare McKinley, RD,LD, at the University of Texas M.D. Anderson Cancer Center, one of the leading cancer hospitals in the world. They explained that breast cancer risk could be decreased by up to 38% through lifestyle factors including maintaining a healthy weight, exercising regularly, and eating a healthy diet. In fact, less than 10% of breast cancer appears to have a genetic basis.
1. Limit Alcohol Consumption. From the Nurses’ Health Study: alcohol converts androgens to estrogens; 1 to 1.5 drinks per day is associated with a 19% nonsignificant increase in risk for breast cancer; 2.5 to 4 drinks per day is associated with a 41% increase in risk for breast cancer; and some studies show synergistic effect with hormone therapy. Update 11/01/11: A new study published in JAMA shows that women who routinely have even small amounts of alcohol, as few as three drinks a week, have an elevated risk of breast cancer. The recommendation now is to limit alcohol intake to 1-3 drinks a week. Click here to read more. (H.L. addition)
2. A Whole Food Plant-Based Diet is Best. It’s Synergistic. According to the American Institute for Cancer Research, “no single food or food component can protect you against cancer by itself. But scientists believe that the combination of foods in a predominantly plant-based diet may. There is evidence that the minerals, vitamins and phytochemicals in plant foods could interact in ways that boost their individual anti-cancer effects. This concept of interaction, where 1 + 1 = 3, is called synergy.” A recent article in the American Journal of Epidemiology looked at the incidence of breast cancer in the long-running Nurses’ Health Study & found the risk of developing the “harder to treat” estrogen-negative breast cancer was reduced by 20% in woman who ate the highest amounts of vegetable protein, like beans, soy, & nuts–and the highest numer of fruits & vegetables. (H.L. addition)
3. Eat a High-Fiber Diet–every 10 grams of fiber/day will decrease one’s risk of breast cancer by a significant 7% Click here (H.L. addition) Also, consider including a daily dose of lignans from flaxseeds in your diet, too. “Women eating more flaxseeds with a documented higher serum enterolactone were found to have a 42% reduced risk of death from postmenopausal breast cancer and a dramatic (40 percent) reduction in all causes of death.” Click here and here to read more.
4. The Best Cancer-Fighting Vegetables & Fruit: Some of their top picks for cancer prevention include beans, berries, cruciferous vegetables (broccoli, cauliflower, cabbage, brussels sprouts), dark leafy green vegetables (spinach, kale, chard, romaine, mustard greens), flaxseed, garlic, grapes/grape juice, green tea, soy, tomatoes and whole grains. A recent study in mice suggests that walnuts may also play a role in breast cancer prevention, but these findings need to be confirmed in humans.
5. Curcumin–a possible cancer-fighting spice. There is also a growing body of research suggesting that curcumin, one of the active components of curry, may play a role in both the treatment and prevention of various types of cancer including breast cancer.
6. Weight Matters. Lose It! Being overweight is strongly associated with the risk of postmenopausal breast cancer. Adult weight gain of 22-44 pounds is associated with a 50% greater risk and a weight gain above 45 pounds is associated with an 87% increased risk. (For the benefits of exercise, combined with a high-fiber-low-fat diet on the prevention of breast cancer read this and for the benefits of exercise on preventing breast cancer, read this. H.L.)
7. Banish the Belly Fat. Excess belly fat seems to be particularly harmful, most likely because of its effects on inflammation and its association with elevated insulin levels, so if you tend to be more “apple shaped” and carry extra weight in your belly, it is especially important to lose weight, exercise regularly, and limit refined grains, sugar sweetened beverages, and added sugar in your diet. (Read more about belly fat here H.L. addition)
8. Whole Soy Foods are OK–Limit Processed Soy or Soy Protein Supplements. When it comes to breast cancer survivors, a healthy lifestyle is just as important, if not more so. Many women are concerned about soy consumption, which I’ve written about before. Sally and Clare agree that up to three servings per day is safe, but they emphasize that soy should come from whole foods like soy milk, edamame and tofu, and that supplements like smoothies, bars and soy fortified cereals should be limited. (Rethinking Soy for Breast Cancer Survivors. H.L. addition) Read more about soy, here, too.
9. Supplement? Should I or Shouldn’t I? Finally, during treatment, diet is very important to maintain health and optimize energy levels, but before taking any supplements, it is best to consult with a registered dietitian, preferably one that has experience with cancer treatment, because some supplements may actually interfere with chemotherapy or radiation.
(reprinted from CNN: “Does Diet Really Matter in Breast Cancer?” )
Slowing the Growth of Cancer – Dr. Michael Greger, NutritionFacts.org
Researchers Discovered a Dietary Intervention that May Slow the Progression of Cancer
Here’s the video link, if it’s not visible on your screen.