LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Breast Cancer

Breast Cancer Risk Factors: Surprising Way to Lower Your Risk

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Quitting smoking, limit alcohol use, exercise, more fruits and veggies. We all know these risk factors for breast cancer.

Or at least I hope you know these factors and more. If you need a little refresher, feel free to check out prior blog posts on breast cancer prevention by clicking here.

Some risk factors are a little less obvious. Exposure to toxic chemicals like BPA in plastic water bottles, cooking in Teflon and phthalates from vinyls all increase your risk of breast cancer.  Stress plays a role.  Vitamin D plays a role.

But the gut?

Or, more specifically, the bacteria in your gut.

To understand the relationship of the bacteria in your gut to breast cancer risk, you have to better understand the way the human body breaks down estrogen. The 3 main estrogens in the body are estriol, estradiol and estrone.

Estrogens in the human body are broken down through several mechanisms. The breakdown occurs through several pathways which can be either safe or damaging and this pathway is called hyrodylation.  Hydroxylation can occur down several pathways that produce different end-products.  The 2 pathway is generally considered the friendly pathway.  On the other hand, the 16-alpha pathway creates an estrogen that damages DNA and increases the risk of hormone related cancers like breast and uterine.

Dietary choices like broccoli and cauliflower will help your body breakdown estrogen into the safer 2 pathway. That’s why you should eat more cruciferous vegetables to lower your risk of breast cancer (never saw a poster proclaiming this during any of the Susan Komen 3-days).

But there’s another really important factor that helps to determine what pathway your body will take when breaking down estrogens, which brings us back to the gut.

The bacteria in your gut play a very large role in how estrogens get broken down. And since most of the estrogens that your body is trying to get rid of are dumped into the bile and then into the gastrointestinal and out the body from there.  This means that the estrogens have a very heavy exposure to the bacteria in the gut.

In this particular study, researchers looked at how much the bacteria in the gut played a role in the breakdown of estrogens. Specifically, they looked at estrone and estradiol levels (called the parent estrogens) and compared them to the hydroxylated estrogens.

Without going into details of the study, the take home message is that the more diversity there was in the bacteria of the gut, the better the ratio between the parent estrogens and the estrogen byproducts.

So what does this mean? Anything that destroys bacterial diversity in the gut is likely to increase your risk of breast cancer.

Highest on the list for destroying the good bacteria in your gut? Antibiotics.  And not just in the past week.  As in EVER.

Even 2 years after a course of antibiotics bacterial diversity still has not recovered. There really hasn’t been any studies looking at how long it takes to recover diversity, but I would guess it takes decades when left alone.

You can probably shorten this time by using probiotics and eating foods that support the growth of bacteria in the gut. This includes foods like beans, whole grains and fruits.  These foods contain soluble fiber that the bacteria feeds on.

Remember this info the next time your primary care or urgent care offers you a prescription for your upper respiratory viral infection.

Increase Breast Cancer Survival: Critical Part Often Missed

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I heard a sad story from a patient today. A 50-something friend had just finished treatment for breast cancer, only to suffer a fatal heart attack.

All too often, oncologists are only thinking of a 5-year survival rate as it relates to cancer. A death that occurs that is not cancer related does not count against the statistics of cancer survival.

The problem is that dead is still dead to the cancer survior. Whether from cancer, heart disease or stroke.

We already know that there are some very close associations between all chronic diseases. Patients with heart disease are more likely to have colon cancer. Diabetic patients are at a much greater risk of pancreatic cancer. This list is pretty long.

This means that every cancer patient needs to be educated about the lifestyle changes necessary to increase survival. Cancer treatment can NOT be limited to what happens at the oncology office. Chemotherapy and radiation are only a part of the equation to ensure that you are going to outlive cancer.

This particular article drives this concept home. In it, researchers looked at 2,317 women, ages 50 to 79 years, who were diagnosed with invasive breast cancer to see what kind of an impact lifestyle had on the overall survival rates over 9.6 years. Here’s what they found:

• Women with better quality diets had a 26% lower risk of dying from any cause.
• They also had a 42% lower risk of death from non–breast cancer causes.
• Breast cancer death was 9% lower, although this was not considered significant.
• More importantly, in women with estrogen receptor positive tumors the risk of dying from any cause was an impressive 45% lower.

From this information, lifestyle clearly has an important impact on the survival of a cancer patient, even if it is not directly from the cancer itself. If we can understand that cancer treatment is incredibly harmful to the patient, then lifestyle becomes critical to protecting the cancer patient from additional damage during this time.

For those of you really interested in 12 standards that make up the “Healthy Eating Index” referred to in this study, you can find a synopsis of the details by clicking here. Overall though, these standards are not that difficult to meet, especially when your life is on the line…

Common Wallet Item Ups Diabetes, Obesity Risk

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We live in a toxic sludge and Resistance is futile. There is no good argument against this statement, but you can at least start with awareness.

Knowing where your toxic environmental exposures are can at least minimize the impact. Many would prefer to live blissfully unaware that he or she is surrounded by chemicals well known to create health hazards. The thyroid gland alone is known as the “yellow canary” of the human body, affected by toxins long before other systems of the body. Didn’t you ever wonder why your thyroid gland just “gave out” in your twenties??

In the case of environmental chemicals creating harm, what you don’t know WILL kill you.

Top of the list of these chemicals is Bisphenol A, or just BPA. Notoriously associated with plastic water bottles and the linings of aluminum cans (yes–just in case the mercury, artifical sweeteners and high fructose corn syrup wasn’t enough to destroy your health…) and most soup cans. There are clear associations between BPA exposure and obesity, diabetes and certain cancers (mainly hormonally driven cancers like breast). It’s not good.

So just avoid plastic water bottles and cans and you’ll be OK, right? Turns out it may not be quite that easy. This particular study goes into a very common exposure that, if you’re aware of it, will allow you to make some changes to lower your exposure.

Thermal cash register receipts. Yup. Those near-ubiquitous curly sheets of paper that we all have because we all use plastic to pay for just about everything in life these days. In the study, 24 students handled register receipts for two hours and, one week later, performed the same set of activities with nitrile gloves. Here’s what they found:

  1. Prior to exposure, 83% had BPA in urine samples; this jumped to 100% after handling receipts.
  2. Urine levels jumped from an average of 1.8 micrograms/L to 5.8 after exposure.
  3. One participants, after drinking 4 cans of beverage, was excluded. The urine level was 49.3.
  4. There was no rise in urine BPA levels with the use of gloves.

These are some scary findings. First, the massive increase after drinking canned beverages should put everyone on alert. Second, there is a very real increase in your body’s exposure to BPA after handling register receipts. So what can we all do to lower our risk other than wear blue nitrile gloves around everywhere we go?

Obviously, reducing our exposure to these receipts is first and foremost. For our office, although we are dealing with maybe 10 receipts per day and not hundreds, the concern is there. Handling the receipts with dry hands rather than when wet or greasy can lower your absorption of the BPA. Do not recycle thermal receipts as the BPA may get incorporated into the recycled paper. Wash your hands after handling receipts and never use an alcohol-based hand cleaner, as this will increase BPA absorption through the skin.

And, for god’s sake, never gnaw on your receipts.

Follow these simple guidelines can help cut your risk of exposure. But, as I mentioned, you need to be aware of how you are being exposed before you can begin to protect yourself.

Mammography Takes a Major Hit—Again

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This is not the first time I’ve addressed the highly emotional topic of mammography, both in general and in women from 40-49 years of age.

I found it disappointing that, despite strong evidence suggesting that screening mammography actually led to greater harm, especially in the 40-49 year age group, the groups that had financial ties to mammography pretty much ignored the data and stated that they were going to continue business as usually. This included the Komen Foundation, the American Cancer Society and numerous radiological associations in the United States.

If these groups essentially admitted that mammography had questionable value, they would be going back on everything they stood for. This groups made it their major purpose to make sure every single woman had access to and received her annual mammogram. To now turn around and say, “Ummm…we MAY have been wrong about that whole getting a mammogram thing…” would devastate these organizations and their resultant credibility.

So they all came up with their reasons why some of the most recent and well designed studies were wrong. Never once was there a discussion that the data may actually have been accurate. And, without screening mammography as “prevention,” what exactly do these groups have to offer? These groups are very weak on prevention, and saying that early detection by mammography is worthless pretty much leaves true prevention via lifestyle as the only answer.

You can see the dilemma.

For all the reasons they gave that mammography still has value, this particular study makes this position even more tenuous. Here are the details of this study:

  • The study was done on 89 835 women, aged 40-59 in Canada were randomly assigned to either annual mammography or no mammography.
  • Women aged 40-49 in the mammography arm also had annual breast exams, but those in the control group only had a single exam followed by whatever normal care they would receive.
  • All women aged 50-59 in both groups received annual physical breast examinations.

This group of women were then followed for the extended period of 25 years to see how many actually died as a result of breast cancer. Here’s what they found:

    During the initial 5 years of the study, 666 invasive breast cancers were diagnosed in the mammography group and 524 in the controls.

  • In this same 5 years, 180 women in the mammography group and 171 women in the control group died of breast cancer.
  • The risk of dying of breast cancer was almost identical.
  • After the full 25 years, 3250 women in the mammography group and 3133 in the control group were diagnosed with breast cancer.
  • Overall, in 25 years, 500 in the mammography group and 505 controls died of breast cancer.

From this study, which was able to successfully address the limitations found in other studies not showing a benefit, there was no difference in those who received a mammography versus those who did not.

Ok. So it’s all equal. Let everyone make their money and keep everything running as it is. Everyone’s happy.

Everyone, that is, except for the 106 women who were over-diagnosed with breast cancers that were never going to cause any problems but were treated anyway. The proverbial “won’t you don’t know won’t hurt you.” Worse, this study only looked at invasive breast cancers (the scarier type) and NOT ductal carcinoma in situ (DCIS). DCIS accounts for 25% of the cancers detected by mammography. Had this study included the numbers of overdiagnosis associated with DCIS found on mammography, this 106 number would go up greatly. Just looking at the invasive breast cancer, there was an overdiagnosis for every 424 women screened. And, as mentioned, if DCIS was included, this number is likely to be much higher.

The conclusion of the authors says it all: “Our data show that annual mammography does not result in a reduction in breast cancer specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community. The data suggest that the value of mammography screening should be reassessed.”

For a procedure that serves as the cornerstone for mainstream medicines’ “prevention” of cancer, this is a big hit. Sadly, I don’t think we will see any real changes occur in our lifetimes. There is just WAY too much money to be lost.

Multivitamins: Waste of Money or Saving Lives in Breast Cancer?

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multivitamin and breast cancer
Mutltivitamins cut breast cancer death risk

The saga continues.  Studies showing no effect from vitamins get promoted, while the powerful ones get shoved aside.

First of all, nothing will ever replace a good quality diet and lifestyle.  This is NOT the goal of a multivitamin.  Consider instead that a multivitamin is an insurance policy to make sure you have enough of what you need when you need it.  This does mean that, most of the time, your diet will be supplying what you need and the vitamins and minerals in the multivitamin will not be used.  But those times when you need the extra backup it’s there.

The recent data on the use of  multivitamins for preventing a second heart attack and protecting against cognitive decline did not show any benefit.  In reality, though, the use of multivitamins to protect in these two situations is a losing battle.  Expecting something as subtle as multivitamin use for not even 3 years to protect against a second heart attack (which assumes that the patient had already-compromised health) is treating a multivitamin like a pharmaceutical drug.

Before I belabor the point, let’s get to this particular article.  In it, researchers looked at the data from the Women’s Health Initiative, a massive study looking at 7.728 women aged 50-79 who had been diagnosed with invasive breast cancer at some point while the study was ongoing.  Here’s the details:

  1. 37.8% of women were multivitamin users at the beginning of the study period.
  2. For the entire group, 518 women died from breast cancer.
  3. For those  in the group who were taking multivitamins, the risk of dying from breast cancer was 30% lower.
  4. This protection was on top of other factors like stage of breast cancer, estrogen-receptor and progestin-receptor status of the tumor, education, smoking status, body mass index (BMI), alcohol use, physical activity, self-reported health, and diabetes.

One thing I found a little disturbing was in the comments section on Medscape (one of the more popular medical sites geared towards doctors), mainly from oncologists.  Comments such as “I think Is not true,” “There is no confirmation yet. it is still controversial ! Also, according to other studies, taking multivitamins daily, might decrease life span,” “The effect seen is so small or seems not worth following with an RCT to discover if the hypothesis generated is true. Patients should be told there is no reliable evidence supple ration is beneficial” and “I am concerned that you are airing this type of material. You need to screen your sources better and not rely on magical claims.”

There weren’t a lot of comments, but these were some of the ones labeled as oncologists.  It just struck me as sad how, when faced with good evidence to show a benefit from something that is natural, doctors can cry foul and say there is no evidence but turn around and use the SAME process to make treatment decisions on patients.  Until this attitude is no longer pervasive, medicine will remain were it is.

 

Diet More Powerful for This Type of Breast Cancer Type

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I have certainly written about the powerful effects of lifestyle choices on the risk of breast cancer, but rarely do studies look at the type of breast cancer.

First, a primer on the types of breast cancer as it relates to receptor type.  Cellular receptors sit on either the outside of the cell membrane or on the actual DNA of a cell.  When a trigger (like a hormone), lands on one of these receptors, they cause changes in the way a cell behaves.  Many of these receptors are set up to receive the messages from hormones like estrogen and progesterone.

When estrogen lands on its receptor, one of the effects is to fire a signal down into the nucleus of the cell causing it to divide over and over again.  If this is a tumor cell, that’s going to be a very bad thing.  In a estrogen receptor positive breast cancer (ER-positive), that cancer cell produces a lot more estrogen receptors on its surface, leading to a perfect scenario for the progression of the cancer.  Treatment of breast cancers that are ER-positive involves the use of drugs like Tomoxifen to block this receptor site.

The role of progresterone receptors (PR) in breast cancer is not as clear and it may have more to do with how the PR intacts and affects the ER.  There are no direct treatments for PR+ breast cancer; instead, they fall under the same treatments as ER+ breast cancers noted above.

HER2 is another receptor that is found in higher number in about 20-30% of breast cancer tumors.  This receptor also stimulates rapid cell division which would also promote tumor growth.   Herceptin is the blockbuster drug that was designed to treat HER2+ breast cancers.

When you hear that a tumor is ER+/PR+, HER2+, triple positive or triple negative, these are the hormones that are referred to.  In general, the hormone receptor negative and triple negative breast cancers are harder to treat.  Because of this, prevention of these types of cancers is even more important.

Which brings us to this particular article.  In it, researchers identified 5 main diet patterns:

  1. Plant-based diet, high in fruit and vegetables
  2. High-protein, high-fat diet, high in meats, eggs, fried foods, and high-fat condiments
  3. High-carbohydrate diet, high in convenience foods, pasta, and bread products
  4. An ethnic diet, high in legumes, soy-based foods, rice, and dark-green leafy vegetables
  5. A salad and wine diet, high in lettuce, fish, wine, low-fat salad dressing, and coffee and tea

They used these patterns to evaluate the risk between the risk of breast cancer and these diet patterns.  Here’s what they found:

  • The plant-based pattern led to a 15% lower risk of breast cancer risk.
  • However, for hormone receptor negative tumors, the protection was much greater at 34% lower risk.
  • The salad and wine pattern, however, led to a 29% higher risk of ER+/PR+ tumors.

Your first reaction may be to question how a good diet, like salad and wine, could increase the risk of breast cancer.  But let’s look at what many consider a “salad.”  Iceberg lettuce, maybe a tomato and low fat dressing.  What did they replace the fat with in these “healthy” dressings?  High fructose corn syrup.

You basically have a diet with some good stuff, but the salads are low-value loaded with high fructose corn syrup.  Not really part of a healthy diet when you break it down like that.

Either way, it is clear that the plant based diet pattern made a strong impact on one of the more difficult breast cancers to treat.

BRCA1, BRCA2 and Breast Cancer Risk; Are You Doomed?

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The answer to the above question is, of course, a strong yes.  After all, if Angelina Jolie decided to have her breasts removed and the medical community performed the procedure, it must be that severe.

In addition, if you follow the American Cancer Society and the Komen Foundation, you get the idea that all you need to do is get your mammograms on time and everything will be ok.  That way, when you do find breast cancer, you’ve caught it early and your chance of survival is better.  Having just had another close experience with the Komen foundation, the vast majority of walkers in the 3-day still don’t REALLY understand that breast cancer is preventable.  It naturally follows that, if it’s not preventable, we have to develop a miraculous cure.  This miraculous cure will only be found with untold hundreds of millions of dollars being pumped into research and development.

That’s not to say that these organizations do not put money into prevention research and education, but it’s a much smaller portion with a minor emphasis.  Contrast this with the American Institute for Cancer Research, and across the top of the website you get a clear idea that prevention reigns supreme.

As mentioned, many think that breast cancer is inevitable, especially if they have a strong family history or, worse yet, the “breast cancer genes” BRCA1 and BRCA2.  Those women with BRCA mutations (side note: I hate the world “mutations” because it makes it sound like some time of villain in a superhero movie who can’t control the 5 appendages due to a genetic mutation…) have about a 5 times greater risk of developing breast cancer, so the risks are real.

But are they modifiable?

According to this particular study, very much so.  In the Korean Hereditary Breast Cancer Study, enrolling around 2,000 women with hereditary breast cancer, researchers looked at how much soy and animal product intake affected the risk of developing breast cancer in the BRCA gene mutation carriers.  Here’s what they found:

  1. Soy intake whopping 61% lower risk in carriers.
  2. Those with the highest meat consumption led to a 97% higher risk in carriers.
  3. Highest meat consumption led to a 41% higher risk in non-carriers.
  4. These associations were stronger in BRCA2 mutation carriers.
  5. In women who developed breast cancer, the highest intake of soy (but not meat intake) was associated with a 43% lower BRCA-related breast cancer.

Overall, it is clear that the intake of soy and the avoidance of animal products (so basically a plant-based diet) came very close to eliminating the so called “excess” risk associated with the BRCA “mutation.”

As always when I talk about soy, I’m talking about non-processed (i.e. no veggie burgers or veggie hotdogs) and GMO-free soy.  And this study, much like most others, do not take into account the fact that those women who had a longer lifetime exposure to soy were more likely to have the right type of bacteria in their gut to convert protective compounds in soy to the really protective compounds in soy (equol-producers).  If they were able to take this into account, it is likely that the protective effect would’ve been even stronger.

Prenatal, Childhood Diets – Most Important Role in Breast Cancer Risk?? – (10-09-00)

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Prenatal, Childhood Diets – Most Important Role in Breast Cancer Risk??

More and more evidence is suggesting that many of today’s adult diseases actually begin decades earlier as children. This article suggests that the timing of exposure to estrogen is very important for breast cancer development, and exposure as an adolescent protects against breast cancer. This strongly supports the use of soy products in this age group to increase phytoestrogen exposure. It is so incredibly important to start focusing on the health of our younger generation. Children are becoming increasingly obese with nutrient deficient diets, and this portends very, very poorly for our society’s life expectancy.

At the 10th Annual research Conference of the American Institute for Cancer research (AICR), a leading cancer scientist outlined the increasing evidence that fetal and childhood diets may have a greater impact on lifetime breast cancer risk than diets during adulthood. Dr. Leena Hilakivi-Clarke, of the Lombardi Cancer Center at Georgetown University, described her own work and summarized ongoing research efforts around the world. “At certain stages of a woman’s life, particularly in the womb and after menopause, diets that induce high estrogen levels do indeed seem to increase her risk of getting breast cancer. During reproductive years, however, high estrogen levels show no effect at all,” said Dr. Hilakivi-Clarke. She added that incoming laboratory and human studies now suggest that at still another time — childhood — high estrogen levels seem to play a powerful protective role against breast cancer. She reviewed the results of human trials that have linked certain traits associated with high estrogen levels during childhood (ie, high body mass, high-fat diets) to lowered breast cancer risk. Evidence that healthy diets high fruits, vegetables, whole grains and beans offer overall cancer protection is “convincing and compelling,” according the AICR report Food, nutrition and the Prevention of Cancer: A Global Perspective. In fact, AICR estimates that following such a diet, maintaining a healthy weight and getting regular exercise could bring about an astonishing 30 to 40 percent drop in worldwide cancer rates.