LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Breast Cancer

Mammography Screening; Still Think it Works to Save Lives?

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breast cancer overdiagnosis
Monkey Business / Dollar Photo Club

We live in a society that chooses early cancer detection over prevention and calls it a cure.  I can sum it up no more clearly than that.

I am not advocating that mammography (and PSA testing while we’re at it…) is a bad thing.  Certainly there are cases where the very first hint of anything was detected on a routine mammography.  But this is not normally the case.  For this we need to differentiate “mammography-detected” from “mammography-confirmed” results.  In mammography-confirmed cases, this is where a suspicious lump or mass was detected by breast self exam or at the OB’s office.  The mammography is then ordered just to further evaluate the mass.

However, this usually leads to the mammography getting the “credit” for detecting the mass although this is not really what happened.  The pro-mammography people then chalk up another one for mammography saving lives.

For years, mammography reigned supreme as THE method to “prevent” breast cancer and saves lives.  No one would question something so powerful and amazing for women’s health.  Until someone did.

It was not until research started to emerge suggesting that many small tumors (most often of the DCIS-type) will actually resolve on their own.  Without treatment.

That then raised the question of over detection and over treatment.  That’s when all heck broke loose.  When the dust settled around the studies looking at how often breast cancer was overdiagnosed, leading to massive levels of overtreatment, costs and lifetimes of emotional and treatment-related scars, those who were willing to accept the data realized that we were seeing the downfall of a generation of “prevention.”

However, the industries that were built on breast cancer detection and treatment were a wee bit loath to accept this new data, even going as far as to discount the USPTF’s recommendation for women 40-50 years of age to forgo routine mammography.

Just in case you’re still a solid believer in mammography and how much it benefits society and how this single intervention has completely turned the tide for women dying of breast cancer, let me present this particular study.  In it, researchers looked at varying rates of mammography across the US to see if this had an impact on breast cancer survival rates.

In other words, if mammography is slashing breast cancer mortality rates and saving lives, than the areas of the country that have higher rates of mammography screening should have lower breast cancer mortality rates.  Here’s what they found in this large study of 16 million women (40 years or older):

  • As expected,  the areas of the country that had higher rates of screening had higher rates of breast cancer incidence.
  • However, screening rates had no impact on breast cancer mortality rates.
  • For ever 10% increase in screening rates there were 16% more breast cancer diagnoses but no corresponding drop in breast cancer deaths.
  • More screening led to higher rates of small breast cancers (≤2 cm) but there was no corresponding decrease in large breast cancers (>2 cm) found (in other words–more screening didn’t lead to cancers being detected earlier instead of advancing and being found at a later stage).

To put it more plainly, there is consistent evidence that mammography does NOT save lives, but does lead to the overdiagnosis of small breast “cancers” (keep in mind that DICS is not actually cancer, but really a pre-cancerous lesion).

All of this focus over the decades has been on mammography for “prevention” instead of educating the general public on how powerful lifestyle is for breast cancer prevention.  I got a text from one of my colleagues just today saying that she was portrayed as the “bad guy” in a conversation when she suggested that lifestyle played a role in breast cancer.

In today’s day and age, with literally hundreds (if not thousands) of peer-reviewed medical research studies confirming links between breast cancer and lifestyle, this lack of knowledge on the part of the public is inexcusable.  Period.  And yet every person who is unaware that lifestyle plays a role in breast cancer will proudly stand up and declared that mammography saves lives and is the strongest form of breast cancer “prevention” known.

Should Our Children Be Eating Soy?

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The is no doubt that the earlier a girl experiences menarche, the scarier it is.  This greatly increases the risks of estrogen related cancers like endometrial and breast cancers.

Early menarche also means that the hormonal disturbances that caused the early onset of menses are NOT due to “Mother Nature-planned” physiological changes.  In other words, hormonal disturbances are only the beginning of the problem.  Overall, anything we can do to slow the onset of menarche the better.

In this particular study, researchers found that in girls, the higher her levels of isoflavones were (found principally in soy) the later they reached menarche.  Seems strange, doesn’t it?  The “they” who say soy is evil would have us believe that it is loaded with hormones that interfere with normal development, but in this study (and many others…) we actually see soy intake intake protecting normal development.

As usual, I have to include the typical disclaimer when talking about soy–not the processed, GMO laded textured vegetable protein that makes up the bulk of veggie burgers that you can buy in the grocery store.  Rather, organic or GMO-free soy in all its forms–tofu, edamame, miso, natto, etc…

Shining the Light on Breast Cancer Statistics–Literally

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night shift and breast cancer
Pakhnyushchyy / Dollar Photo Club

Most solid cancers have a long list of well-documented ways to prevent them. Treatment, however, remains shaky. Breast, prostate, colon and pancreatic cancers are all very preventable.

But the lifestyle choices known to prevent these deadly cancers are not always easy.  Luckily, many of them are easy to implement and live by.  More troubling, however, are the risk factors that you may not be aware of or that you can’t change.

Exposures in the womb are something that you can’t go back and change.  It is established that chemicals like diethylstilbestrol (DES) that was given to pregnant women in the 1960s increased the risk of breast cancer in the moms as well as the female children later in life.  Other estrogen-like environmental chemicals like BPA and phthalates have been linked to breast cancer and it is highly likely that exposure in the womb would increase breast cancer rates later in life as well.

Things that happened to you as a teenager can have a lifelong effect on breast cancer rates.  You age when you started menstruation, how much sun exposure you got and how much soy you ate as a teen are all influential factors.

But what about your own personal circadian rhythms?

“My what?”

I’m not talking about a blues band from Atlanta.  I’m talking about your body’s daily rhythm as it pertains to day and night.  We are NOT nocturnal creatures.  We’ll leave that to the bats.  We should be sleeping at night.

Despite this, sleeping disturbances are quite common in society.  Insomnia, sleep apnea, restless legs, late nights and problems falling asleep plague society.  Much of this is because we are so stressed that we can’t relax enough at night to settle into a restful night’s sleep.

Then there are the midnight-shift workers and airline personnel that are frequently changing time zones.  This group of people have problems with their circadian rhythms because of their work schedules.

There are documented health problems that midnight shift workers experience.  Weight gain and obesity are on the top of the list.  Higher rates of breast cancer have also been demonstrated.

Which brings us to this particular article.  In it, researchers take a much deeper look at the relationship between sleep disturbances, light exposure at night and breast cancer risk.  In this study, female mice at an increased risk of breast cancer (along the lines of a BRCA mutation) were evaluated to see what kind of effect swapping dark and light exposure had on tumor growth over a lifetime.  At the end of each week, the mice were exposed to a full 24-hour period of either light or dark.

The results were a little shocking:

  • Switching up light and dark led to a decrease in the body’s ability to stop tumor growth, leading to an increased numbers of tumors that developed faster.
  • In addition, there was an increase in body weight.
  • These mice also slept much more, increasing sleep times by 50% (which led to a reduction in overall physical activity)

Based on this study, it is clear that messing up the normal day-night rhythms that we are all designed for creates problems.  There are a number of ways in which this might occur, such as:

  1. Suppression of the brain-protective melatonin by light exposure at night
  2. Stress from sleep disruption
  3. Alterations in lifestyle due to sleep disturbances (smoking, unhealthy diet, altered timing of food)
  4. Decreased vitamin D levels due to lack of sunlight exposure

Whatever the reason, the links continue to be proven.  If you are one of these people that gets exposed to light at night, here are some tips:

If you have a job that requires the midnight shift or lots of travel to different timezones, there may not be a lot you can do in this regard.  However, there is still a long list of lifestyle choices that go a long way to combat your sleep / wake cycle disturbances.  These choices become that much more important.

 

Alcohol Intake and Cancer–Add this to Negate the Risk

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alcohol and cancer risk
yahyaikiz / Dollar Photo Club

The link between breast cancer and alcohol intake has bounced back and forth between no risk and increased risk.

The past few years has seen this association settling in on the recommendation that alcohol intake does increase your risk for breast cancer. The mechanism relates to the fact that alcohol raises the level of sex-steroid hormones in the bloodstream. Since sex steroids like estrogen are clearly linked to breast cancer, it might make sense that alcohol would then increase breast cancer risk.

For most of you, this is not a good recommendation and one that has not been followed by most of the population. This also remains in conflict with the fact that the risk of many other chronic conditions are lowered by moderate alcohol intake like diabetes and heart disease.

But what if you other healthy lifestyle choices could counteract this increased risk seen with alcohol intake?

That’s just what researchers looked at in this particular study. Since dietary fiber has been shown to lower the impact of elevated sex-steroid hormone levels (via decreased blood concentration and increased sex hormone–binding globulin concentration), it would seem reasonable to assume that dietary fiber would be a good candidate for offsetting the risks of alcohol intake on hormone-dependent cancers like breast cancer.

The study included 3771 women and 2771 men who completed an initial intake and were followed for an average of 12.1 years. In this time, 297 incident hormone-dependent cancer cases, including 158 breast and 123 prostate cancers, were diagnosed. Here’s what they found:

  • Higher alcohol intake was directly associated with a 36% higher risk of hormone-dependent cancers (the risk specifically for breast cancer was 70% higher with no elevated risk for prostate cancer).
  • But when higher alcohol intake was combined with low fiber intake, this risk skyrocketed 76% for hormone-dependent cancer (the risk specifically for breast cancer was 253% higher and prostate cancer risk was no elevated by 37%).
  • These elevated risks were NOT seen in those with the highest dietary fiber intake.

Overall, it was clear that dietary choices were able to impact the risk of hormone-dependent cancers from increase alcohol intake. This finding could go a long way towards explaining some of the discrepancies seen in prior research studies looking at the links between alcohol intake and hormone-related cancers.

 

Childhood Obesity and Breast Cancer Links

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overweightl woman meditation on beach
Kokhanchikov / Dollar Photo Club

I have said that a girl developing breasts at 8 and starting her menstrual cycle by age 9 is a very scary recipe for breast cancer.

And yet this is exactly what we are seeing.  The number of Elementary school girls who can be classified as overweight or obesity has risen continually in the past decade or so.  While these numbers seem to be leveling off, it will remain a concern for many years to come.

I have written continually about how situations that occur in childhood will affect that child decades later as an adult.  Obesity cuts across so many of future health conditions in so many ways, with conditions such as heart disease, diabetes and cancer having roots in childhood health conditions.

In this particular study, researchers looked at how the bodies of obese adolescent girls break down estrogen.  In general, estrogens can get broken down into one of 3 pathways—the 16 and 4 pathways, which are known to damage DNA and cause cancer, and the 2 pathway, which is generally considered protective and lowers the risk of cancer.

In this small study, researchers looked at 12 lean and 23 obese pre-pubertal girls (Tanner Stage I breast and pubic hair) and compared body weight to estrogen breakdown products.  Here’s what they found:

  • Estradiol concentrations were 6.9 times higher in obese versus lean girls (3.45 pg/ml vs 0.5).
  • Concentrations of 16α-OH-E1 were 14.34 times higher in the obese girls (7.17 vs 0.5).
  • The protective 2-MeO-E2 levels were lower in the obese group.

In other words, even at a very young age, these girls were priming their risk for breast cancer.  Obviously, maintaining an ideal body weight is a top priority.  It is also very important for society to understand that being overweight as a child is not a temporary thing or something to brush aside as aesthetic but not health-damaging.

In the meantime, cruciferous vegetables (broccoli, cauliflower, cabbage, radishes, Brussel sprouts…) are known to help our bodies break down estrogens in a protective, non-cancerous way.

Another very important factor that is hardly ever addressed is our exposure to environmental estrogens.  Plastics, Styrofoam, phthlates and flame retardants can all have estrogen-like activity in the human body. Identifying and eliminating (or at least reducing) these chemicals in yours and you children’s lives needs to be a consistent habit.

Lastly, constipation can actually increase the estrogen levels in the body.  The body eliminates estrogens through a process called conjugation that occurs in the liver.  The conjugated estrogen is then put into bile and is supposed to be eliminated in the feces.  But, if you’re constipated, that estrogen never makes it out—rather it is broken down by bacteria in the gut and thrown back into the bloodstream, free to wreak havoc on estrogen sensitive tissues like the breast and endometrial lining.

Of course, living an anti-cancer lifestyle in general will also help protect the estrogen levels from obesity from damaging the breast tissue, but this is all just going to be a band-aid until the weight is better managed.

The Mammography Debate Continues; Are You a Victim?

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breast cancer overdiagnosis
Monkey Business / Dollar Photo Club

Society and medicine are very slow to adapt and change.  This may be fine in some situations, but when it comes to mammography and breast cancer, the consequences are extreme.

The story needs to start with what exactly constitutes “breast cancer.”  The two most common types are lobular and ductal carcinomas.    Both of these have invasive and is-situ versions.  There is no doubt that the invasive forms of both are scary situations.  With the in-situ types, the abnormal cells have not penetrated beyond the surface of the cells.

You’ll notice I did NOT call this cancer.

In-situ is a precancerous state.  It is NOT cancer, although it does indicate that your current state of health is in jeopardy and that the risk of developing invasive cancer in the future is high.  Overall, though, only a small percentage of women with DCIS will progress to invasive ductal carcinoma.  Some 15% of women have DCIS found at autopsy; meaning that these women died WITH DCIS not FROM DCIS.

But what happens when you get diagnosed with DCIS?  All the scary things that you think about—the worry, the discussions with family, the surgery, the chemo, the radiation and the lifelong damage that you carry from this pattern of treatment.

Let’s put this in perspective.

  • You have an abnormal PAP screen. Your doctor immediately gets you in for a surgical removal of your uterus and ovaries, followed by chemo and radiation.
  • Your dermatologist removes a small lesion on your skin by burning it off, just to be safe. But, just to be REAL safe, you undergo PET scans and biopsies to make sure nothing has spread followed by chemo and radiation.
  • You come out of your colonoscopy and your GI doc said they took out a small polyp. He then immediately schedules you for a colon resection with follow up chemo and radiation.

Of course these 3 scenarios sound like massive overkill a ridiculous approach to treatment.  But they are NO different then what we do with ductal carcinoma in situ.  When women are told that this is cancer (which it is NOT, it is precancerous) the entire psychological impact of the “C” word comes into play.

Every statistic related to DCIS will tell you that it accounts for about 20% of breast cancer cases and that the incidence of DCIS has been increasing over the past few decades.  This increase mirrors the increase in the public health recommendations to increase mammogram screenings.

Here’s the rub.  Despite this increase in DCIS and the increased number of women undergoing breast cancer treatment, the overall mortality rate from breast cancer has not changed.  Should raise some questions, don’t you think?

Should we be aggressively treating DCIS that, in most cases, will never create a problem?

Some women would prefer the aggressive treatment just on the off-chance that the aggressive treatment will save them in the future.  Think Angelina Jolie.

Just in case you are in this camp of taking the aggressive treatment, this particular article really helps put everything in perspective.  In it, researchers looked at the substantial harms associated with overdiagnosis associated with mammography and the medical and societal costs from this overdiagnosis.

The researchers looked at the cost data from a major healthcare insurance carrier covering some 700,000 women 40 to 59 years old, who had undergone routine mammograms from 2011 to 2013.  Here’s what they found:

  • 11% of the routine screening mammograms resulted in false positives.
  • The translates to 3.2 million receiving false positive mammograms each year, at a cost of $2.8 billion annually (yes—with a “B”).
  • Of the true cancers detected, with an accepted overdiagnosis rate of 22% (based on previous studies), 20,116 women would be overdiagnosed with invasive breast cancer, at a cost of $1 billion each year.
  • For DCIS, the rate of overdiagnosis is a shocking 86%. With these numbers for DCIS the estimated the cost of DCIS overdiagnosis nationwide to be $243 million.
  • Put together, they estimated costs of $1.2 billion in overdiagnoses for both invasive breast cancer and DCIS and another $2.8 billion for the workup and treatment costs associated with false positives.

These are serious numbers.  This may help you understand why so many groups were against the recommendations to stop routine screening women under age 50.  There’s a LOT of money to be lost.  These groups continue to shout from the mountaintops that routine screening should be done and the mounting evidence demonstrating significant harm from routine mammography is all hogwash.

No one seems to be taking you, the female patient, into consideration.

The best discussion between you and your doctor would be one that discusses the very real and very likely chance that you will be diagnosed with a condition that will never harm you.  This should take into account your family history, lifestyle factors and age.  This discussion should then naturally steer towards what lifestyle choices you should choose to dramatically lower your personal risk of breast cancer.

If this is NOT the discussion you are having with your primary care physician, then maybe it’s time to find a new one.

 

Slash Breast Cancer Risk with this Supplement

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CAN THIS SUPPLEMENT SLASH BREAST CANCER RISK??

Hate to beat a dead horse, but I’m going to anyway.  Most types of cancer are repeatedly shown to be lowered through lifestyle factors.  Exercise, Vit D levels, stress, diet, chemical exposure.  The list is endless and puts almost all the power for prevention back in the hands of the patient at risk.

This particular study was a little different, and actually looked at supplement use instead of dietary intake.  The authors found that fish oil supplements may potentially lower the risk by up to 32%.  While they stress that this is not a recommendation to prevent breast cancer (yet), it again points to the power of lifestyle in the ability to prevent breast cancer.

Do NOT EVER rely on early detection (i.e. mammography, self exams, GYN app’ts) to prevent breast cancer.  These are designed to detect problems already present and should NOT be mistaken for “prevention.”

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Vitaman D and Breast Cancer

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WHAT’S THE CHEAPEST WAY TO LOWER YOUR RISK OF BREAST CANCER BY 25%??

It should come as no surprise that the answer is maintaining adequate Vit D levels.  I’ve said it time and time again that the current culture of slapping on SPF 80 to walk to the car has produced more harm than any other public health recommendation (with maybe the exception of 3 servings of dairy…).  Vit D is a hormone, NOT a  vitamin.  The levels of deficiency are of epidemic levels and yet we still hedge on changing the recommended daily allowances.  Look at your ancestors.  There was no sunscreen.  No SPF cosmetics.  No hiding out in our houses.  No glass (some concern that UVA penetrating glass breaks down Vit D forming in the skin).  No particulate matter in the air (blocks UVB penetration).  No showering at night (washes off Vit D being produced).  Our bodies were designed for high levels of sun exposure and higher levels of Vit D.

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