Breast Cancer Radiation Therapy: Comparison of Different Protocols

In one of my 2009 blogs, I discussed two clinical trials whose results suggested that breast cancer radiation therapy given in fewer, though higher, doses might be beneficial.  However, one of those studies included only 75 patients and the other included only 105 patients.  I indicated that while the results of these studies were promising, a larger study would be needed to confirm these results.  The results of such a study have recently been made available.

In this new breast cancer radiation therapy study, investigators recruited women who were taking part in the Standardisation of Breast Radiotherapy Trials (START).  These trials consisted of the following radiation therapy protocols:

• 50 Gy in 25 fractions over 5 weeks (2 Gy per fraction; the global standard)
• 41.6 Gy in 13 fractions over 5 weeks (3.2 Gy per fraction)
• 40 Gy in 15 fractions over 3 weeks  (2.7 Gy per fraction)
• 39 Gy in 13 fractions over 5 weeks (3 Gy per fraction)

The breast cancer patients in these trials were asked to complete quality of life questionnaires over a 5-year follow up period.  Side effects and image concerns were recorded and compared between the different radiation therapy procedures.  Some of the results showed that:

• About 40% of the women reported breast changes due to radiation therapy
• About 33% of the breast cancer patients reported arm and shoulder pain
• Compared to the 50 Gy protocol, the 40 Gy and 39 Gy radiation therapy procedures resulted in fewer adverse side effects.
• Patients receiving the 39 Gy protocol had about a 37% lower chance of seeing undesireable skin changes compared to the 50 Gy protocol, while patients receiving the 40 Gy protocol had about a 24% lower chance of seeing these unwanted changes.

The START trials are apparently the largest trials to test the safety and effectiveness of radiation therapy given in fewer fractions at higher doses (hypofractionation).  According to a press release, these trials have shown that this type of radiation therapy procedure is just as effective as the current global standard protocol. The fact that hypofractionated radiation therapy remains effective and results in fewer side effects is great news.  By reducing these side effects, breast cancer survivors are able to experience a better quality of life than they might have otherwise.  As long as breast cancer remains an unwanted fact of life, improving outcomes and quality of life will continue to be a critical medical goal.

By eating properly and living a healthy lifestyle, you can reduce your risk of getting breast cancer.  To learn more about the kind of changes you can make, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Dietary Carotenoids Might Reduce Breast Cancer Risk in Smokers

The carotenoids, particularly beta-carotene, are plant chemicals (phytochemicals) responsible for some plant colors and have anti-oxidant properties.  Several research studies have suggested that beta-carotene might help reduce breast cancer risk.  A new study reports that dietary consumption of alpha- and beta-carotene appears to be associated with a reduction in breast cancer risk among smokers.

In this new study, breast cancer researchers examined the relationship between carotene consumption and the risk of invasive breast cancer in a population of nearly 37,000 Swedish women.  During the 10 year follow-up, 1,008 of these women were diagnosed with breast cancer.  Analysis of the study data showed that: 

• Among women who had ever smoked, consumpton of alpha-carotene was associated with a 68% reduction in breast cancer risk.
• A 65% breast cancer risk reduction was observed among women who had ever smoked and dietary beta-carotene consumption.
• Among women who did not use dietary supplements, increasing consumption of alpha- and beta-carotene was related to a decrease in breast cancer risk.
• These associations were only observed for hormone receptor-positive breast cancers.
• Despite the above results, no relationship between alpha- and beta-carotene intake and overall breast cancer risk was observed.

This is interesting new research that adds to the data on breast cancer risk reducing foods.  Beta-carotene supplementation is somewhat controversial because a couple of studies have suggested that high dose supplements might increase the risk of lung cancer.  Because of this I don't recommend supplements containing super amounts of beta-carotene; food sources are best.  However, other research, including this new study, suggests that beta-carotene might help reduce the risk of breast cancer.  Carrots are rich in beta-carotene and as such make a great food choice to get adequate amounts of this anti-oxidant.  Carrots are also a good source of falcarinol, a phytochemical that has also been reported to reduce cancer risk.  The presence of these anti-oxidants is what makes carrots one of my top ten cancer fighting foods.

To learn about my other favorite cancer fighting foods, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Gene Might Predict Breast Cancer Sensitivity to Endocrine Therapy

The majority of breast cancers are hormone receptor-positive breast cancers and are treated with a variety of endocrine therapies that regulate estrogen and estrogen receptors.  Some of the most common hormone therapies for breast cancer include tamoxifen, aromatase inhibitors, and fulvestrant.  Unfortunately, many breast cancer patients become resistant to hormone therapies over time, requiring an adjustment to their breast cancer therapy regimen.

New breast cancer research has identified a gene that might predict whether breast cancer patients will respond to hormone therapy with tamoxifen.  Because the gene, FKBPL, is a gene that interacts with the estrogen receptor and regulates its levels, these researchers explored the effects of it on breast cancer cell growth.  The results of their study showed that:

• Breast cancer cells overexpressing the FKBPL gene became dependent on estrogen for growth and became more sensitive to tamoxifen treatment.
• Knocking out the FKBPL gene reversed this response, making the cells more resistant to tamoxifen.
• Expression of the FKBPL gene was related to an increase in metastasis-free survival and overall survival of breast cancer patients.

This interesting new research suggests the possibility of improvements in targeted, personalized breast cancer treatments.  If the expression of this gene can be measured accurately in breast cancer patients, it might help to determine which patients will benefit from tamoxifen therapy and which patients will be resistant to tamoxifen therapy.  Patients determined to be resistant to tamoxifen therapy could be treated with a more appropriate breast cancer therapy at an earlier stage rather than having to go through tamoxifen therapy with poor results.  Overall, if this becomes a realistic treatment screening tool, it could result in improved breast cancer survival rates.

Another strategy to reduce breast cancer mortality is to reduce the chances of breast cancer occurring at all.  To learn what you can do to reduce your personal breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Predicting Subsequent Breast Cancers

Ductal Carcinoma In Situ is the most common form of non-invasive breast cancer accounting for about 1 out of every 5 new breast cancers.  About 15-30% of DCIS breast cancers will develop a tumor within 10 years of initial breast cancer treatment and about half of these will be invasive tumors.  Being able to predict which DCIS breast cancers will develop into invasive tumors would enhance breast cancer treatments.

Fortunately, new breast cancer research suggests that cellular markers in DCIS tissue samples might be able to predict future tumor formation.  This new study suggests that over-expression of cellular markers (called p16 and COX-) involved in stress activation can predict better or worse breast cancer outcomes under certain conditions.  In the absence of cell growth, these markers predict a low chance of tumor recurrence.  Contrastingly, in the presence of cell growth, these markers predict a high chance of breast cancer recurrence.  Additionally, these markers were reported to identify a subtype of DCIS breast cancer that is similar to basal-like invasive breast cancer, a form of breast cancer that is aggresive and has a short relapse time.

This is exciting research that opens new doors to breast cancer treatment.  The ability to predict future breast cancer development from current breast cancer characteristics will hopefully lead to new, more targeted treatments to prevent the formation of these future breast tumors.  This could lead to improved quality of life and better overall breast cancer survival.

In addition to preventing breast cancer recurrence, it is also important to reduce the risk of initial breast cancer formation.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com to learn what you can do to reduce your personal breast cancer risk.

Cisplatin Might Be An Effective Chemotherapy for Some Breast Cancer Patients

Cisplatin is a chemotherapy drug approved by the FDA for use in the treatment of a variety of cancers including cancers of the bladder, ovary, testes, and cervix.  However, cisplatin is not commonly used for breast cancer chemotherapy.

New breast cancer research explored the potential benefit of cisplatin as a chemotherapy agent for triple negative breast cancers.  For this study, 28 women with stage 2 or stage 3 triple negative breast cancer were treated with four cycles of cisplatin.  Response to treatment was assessed and tissue samples were examined for markers that might indicate the potential for a good response to treatment.  The results of this study showed:

• 22% of the patients achieved complete pathological response (that is no residual cancer was detected)
• 50% showed good, though not complete, pathological response
• 64% of the triple negative breast cancer patients with complete or partial clinical response
• 14% of these patients showed breast cancer progression
• Patients that were young and had a low level of BRCA1 expression had a good response to cisplatin

With the move to personalized medicine where treatment options are based on each person's individual disease characteristics, finding additional treatment options is an important part of developing an effective breast cancer therapy.  This new study reports that a common chemotherapy agent used to treat other cancers might also have some therapeutic benefits for some triple negative breast cancer patients.  Triple negative breast cancer are often more aggressive and show poorer outcomes, so discovering new ways to effectively treat this type of breast cancer is good news.

While the scientific and medical communities contine to make strides in the treatment of breast cancer, the fight to reduce the incidence of breast cancer is also a critical part of our fight against breast cancer.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) to learn about easy diet and lifestyle changes you can make to reduce breast cancer risk. 

Acupuncture Reduces Joint Pain in Breast Cancer Patients Treated with Aromatase Inhibitors

Aromatase inhibitors are an effective and popular choice of breast cancer therapy for hormone receptor-positive breast cancer.  However, like most breast cancer treatments, aromatase inhibitors are associated with some unwanted side effects.  One such side effect for aromatase inhibitors is a reported increase in joint discomfort, which can sometimes lead to breast cancer patients skipping treatments.

A new breast cancer research study examined the use of acupuncture for the relief of joint discomfort experienced by breast cancer patients being treated with aromatase inhibitors.  In this study, the researchers assigned breast cancer patients to receive either true acupuncture or sham acupuncture twice weekly for six weeks.  Using multiple questionnaires, the researchers assessed joint discomfort at the beginning of the study and after 3 and 6 weeks.  The researchers discovered that after 6 weeks:

• Overall pain scores were lower for breast cancer patients receiving true acupuncture.
• Scores for pain severity were substantially lower in breast cancer patients receiving true acupuncture compared to patients receiving sham acupuncture.
• Breast cancer patients receiving true acupuncture experienced less pain-related interference.

This is good news for breast cancer patients being treated with aromatase inhibitors.  It is important that breast cancer treatments are followed through to completion, but for many individuals the side effects of treatment often cause them to skip treatments or stop them entirely.  Methods to relieve or minimize the treatment side effects are an important part of ensuring that treatments regimens are completed.  Acupuncture appears to be a promising method for reducing joint discomfort and has been previously shown to reduce hot flashes in breast cancer patients as well.

To find out more about what you can do to reduce your breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Curcumin Kills Triple Negative Breast Cancer Cells in Culture

Curcumin is a natural component of the spice turmeric that is responsible for the spice's yellow pigment.  Previous research in cell culture systems and animals has suggested that curcumin might have a variety of anti-cancer properties.  In fact, a recent paper reported that the combination of curcumin and piperine, an active chemical from black pepper, might inhibit the self-renewal of breast cancer stem cells.

A new research study suggests that curcumin might also have cancer fighting benefits for individuals with triple negative breast cancer.  Triple negative breast cancer is a specific type of breast cancer that is defined as lacking in estrogen receptors, progesterone receptors and HER2 receptors.  Triple negative breast cancer is typically considered to be more aggressive and presents as a higher grade of breast cancer.

In this new study, breast cancer researchers treated triple negative breast cancer cells with different amounts of curcumin in a cell culture system.  Curcumin was shown to have a number of cancer fighting properties in this system:

• Curcumin induced DNA damage in triple negative breast cancer cells
• Treatment with curcumin caused a localization of BRCA1 such that it was unable to repair the DNA damage.
• Curcumin induced the death of triple negative breast cancer cells within 72 hours, while having minimal effect on non-cancerous breast cells.
• While both triple negative breast cancer cells and hormone-positive breast cancer cells were susceptible to curcumin treatment, triple negative breast cancer cells were more sensitive.
• Curcumin suppressed the ability of triple negative breast cells to grow independently and to migrate.

This new research shows exciting promise for curcumin as a triple negative breast cancer fighting agent.  Because triple negative breast cancer is not responsive to hormonal therapies, the standard treatment typically involves chemotherapy and radiation.  While research suggests that this type of breast cancer responds well to chemotherapy, it has also been reported that triple negative breast cancer generally has poorer outcomes compared to other types of breast cancer.  Any new developments in treatment options for this type of breast cancer are an important step in the fight against breast cancer.  While curcumin certainly shows promise as a cancer fighting agent, studies in clinical trials will need to be conducted to determine if the positive benefits seen in cell culture systems translate to benefits in breast cancer patients.  You can learn more about triple negative breast cancer at BreastCancer.org or by downloading the free Guide to Understanding Triple-Negative Breast Cancer.

Read more about what steps you can take to proactively reduce breast cancer risk in my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com).

Lifestyle Habits Impact Breast Cancer Recurrence & Survival

Numerous reasearch efforts have been put forth over the years to determine the various diet and lifestyle habits that impact the risk of getting breast cancer.  This research has led to recommendations of healthy lifestyle habits that can help reduce breast cancer risk.  One of the most comprehensive set of recommendations is the Food, Nutrition, Physical Activity, and Prevention of Cancer: A Global Perspective report published by the World Cancer Research Fund and the American Institute for Cancer Research.  However, the information about lifestyle factors that effect breast cancer survival and recurrence is not as clear.

A new breast cancer study examined the scientific literature related to lifestyle changes and breast cancer outcomes.  For this study, the breast cancer researchers analyzed papers that looked at the effects of physical activity, dietary patterns (nutrients, good groups, etc.), and body fat on the health of breast cancer survivors.  Some of the results of this study are listed below:

• Physical activity was protective and reduced the risk dying from breast cancer by about 30%.
• Body fat was associated with about a 30% increase in breast cancer mortality.
• Increased dietary fat intake was associated with an increased rate of breast cancer deaths.
• Dietary fiber consumption by breast cancer survivors was protective, reducing the risk of breast cancer death.
• A prudent dietary pattern (high in fruits, vegetables, legumes, whole grains, fish, and chicken) was associated with a protective effect, while a Western dietary pattern appeared to slightly increase breast cancer mortality risk.
• While only a little information was apparently available for vitamins and minerals and the results were mixed, calcium and vitamin C intake appeared to be protective.

The information in this paper appears to be mixed in many cases, making conclusions and recommendations difficult at this time.  However, this breast cancer report shows that many of the lifestyle habits that help us reduce breast cancer risk might also help breast cancer survivors reduce their risk of getting breast cancer again or dying from breast cancer.  This appears to be particularly true in regards to exercise and body weight.  Maintaining a healthy body weight and getting adequate amounts of regular exercise seem to be two of the most important factors for reducing the risk of breast cancer mortality.  This is a great step in the right direction of increasing our breast cancer awareness in regards to things we can do personally to improve breast cancer outcomes.

Read Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) to discover lifestyle changes you can make to reduce breast cancer risk.

Breast Cancer Survival Disparity and Insulin-Like Growth Factor

It is generally well known that ethnic disparities exist in breast cancer survival.  Between 2002 - 2006 breast cancer incidence was highest in Caucasion women, but death from breast cancer was highest in African American women.  Research suggests that part of the reason for this disparity in breast cancer survival is a difference in social economic status.  Because of this, African American women are often diagnosed with breast cancer after it has reached more advanced stages, possible resulting in a poorer chance of survival. 

New breast cancer research suggests that there also might be some biological reasons for this disparity in breast cancer survival.  In this study, breast cancer researchers tested their theory that differences in insulin-like growth factor II (IGF-II) might explain some of the ethnic differences in breast cancer survival.  To test this theory, the investigators examined the expression of the IGF-II protein and its regulation of cell death in breast cancer cells and tissues from African American women and Caucasian women.  The results of this study showed that:

• IGF-II levels were higher in African American breast cancer tissue compared to Caucasian breast cancer tissue.
• Blocking the function of IGF-II decreased levels of other proteins that were involved in protecting breast cancer cells from death.

Growth factors, including the insulin-like growth factors, have long been implicated in breast cancer development and progression.  This new research continues to show that.  More importantly, this new breast cancer research shows that IGF-II, a protein involved in breast cancer development, is higher in African American breast cancer cells.  These results indicate that biological differences in breast cancer cells might be partly responsible for the ethnic differences in breast cancer survival.  This new breast cancer research suggests that we might be able to fight the ethnic disparity in breast cancer survival on at least two fronts, by gaining a better understanding of biological differences and by improving access to appropriate health care.

The fight against breast cancer continues to be fought from many sides.  One such side is the fight to reduce the risk of breast cancer occurrence.  To learn what you can do to reduce your personal breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Breast Cancer and Bone Loss

A new report in the British Journal of Cancer assessed fracture risk in breast cancer patients based on current guidelines for treatment with bisphosphonates to protect bone health.  This study compared this assessment with emerging international guidelines. 

Current Guidelines:  These state that bisphosphonates are appropriate for "patients with plain radiographic evidence of bone destruction", which means patients with osteoporosis defined as a bone mineral density score of less than -2.5.

Emerging International Guidelines:  Any patient receiving therapy with aromatase inhibitors with any two of the following risk factors are recommended to receive bisphosphonate treatment:  T-score <–1.5, age >65 years, low BMI (<20), family history of hip fracture, personal history of fragility fracture after age 50, oral corticosteroid use >6 months, and smoking.

The results of this comparison showed:

• Low bone mineral density was more common in postmenopausal women than in premenopausal women.
• Postmenopausal women with estrogen receptor - positive (ER+) breast cancer had a higher rate of poor bone health compared to postmenopausal women with estrogen receptor - negative breast cancer.
• Based on current guidelines, only 9% of the breast cancer patients studied would have been eligible for bisphosphonate treatment.
• Based on the emerging international guidelines, 28% of the breast cancer patients would have been eligible for treatment with bisphosphonates for bone health.
• The authors estimated that current guidelines would prevent only 18% of possible fractures, while the emerging guidelines would prevent about 45% of possible fractures.

While the incidence of poor bone health in ER+ breast cancer patients, particularly postmenopausal patients, is not surprising, the difference between the current guidelines for bisphosphonate treatment and the emerging guidelines are rather astonishing.  The emerging guidelines would substantially increase the number of breast cancer patients eligible for bisphosphonate treatment and might substantially decrease the occurrence of bone fractures.  Should these emerging guidelines become part of the standard of care for breast cancer patients, we might see an improvement in the overall quality of life for breast cancer survivors.

Become proactive and fight against breast cancer now.  To find out many simple steps you can take to reduce your breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Potential Benefits of Digital Mammography

For years mammograms have been taken using the standard screen-film mammography where an X-ray image of the breast is printed on X-ray film.  Over the last few years, developments in a new type of mammography, called full-field digital mammography, has shown that digital mammography might be a substantial improvement over standard mammography in some regards. 

New research in breast cancer screening compared the technical performance of standard screen-film mammograpy with digital mammography.  For this study, mammography screening data from nearly 4,400 subjects was examined.  The results of this study showed that the average compression force was about 5% less for digital mammography and the breast did not have to be compressed quite as much for digital mammography (about 2% less compression).  Additionally, the amount of radiation needed for digital mammography imaging was 22% lower compared to screen-film mammography.  In contrast to these benefits, digital mammography needed more than the four normal views in about 21% of cases, whereas only 12% of standard mammography cases needed more than the four standard views.  Nonetheless, even when these extra views were taken into consideration, total radiation dose was still 17% lower for digital mammography.  In addition to the technical improvements in digital mammography, one earlier breast cancer research study reported that digital mammography detected substantially more breast cancers than standard mammography in women younger than 50 years of age.  You can read the full paper in the New England Journal of Medicine.

Mammography is a critical part of breast cancer screening, early detection, and diagnosis.  Therefore, improvements in mammography procedures are an important part of our fight against breast cancer.  For many women, the fear of excess radiation exposure over time prevents them from getting regular mammograms.   Using digital mammography appears to reduce radiation exposure, which will hopefully alleviate some of the concerns about cumulative radiation exposure.  The video below discusses digital mammography in more detail.



In addition to getting regular mammograms in your fight against breast cancer, there are simple dietary and lifestyle changes you can make to reduce your personal breast cancr risk.  To learn more, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

New Biomarker of Breast Cancer Resistance to Chemotherapy

The development of new and improved breast cancer therapies often relies upon the discovery of new targets to attack in the fight against breast cancer.  New breast cancer research published in the January issue of the British Journal of Cancer reports on the discovery of one such potential new target.

In their study, breast cancer researchers used gene expression patterns of breast cancer cells known to be resistant to chemotherapy to detect potential new biomarkers related to this chemotherapy resistance.  After examining the genetic profiles of four different breast cancer cell lines, overexpression of one particular gene, called PSMB7, was common enough for the study investigators to examine in more detail.  To test the role of this PSMB7 gene in breast cancer chemotherapy resistance, the gene was silenced (made non-functional) in chemotherapy resistant breast cancer cells and cell survival was measured.  The results of this study showed:

• Nearly 80% of resistant breast cancer cells survived chemotherapy treatment
• Only about 32% of breast cancer cells survived after disabling the PSMB7 gene.
• Patients with high levels of PSMB7 gene expression had a shorter survival time compared to patients with low PSMB7 gene expression.

This is intriguing new breast cancer research that will require additional follow-up studies.  One of the most interesting aspects of this study is the fact that not only does this gene appear to be involved in breast cancer chemotherapy resistance, but that levels of the natural expression of this gene appear to be related to breast cancer survival.  The results of this study show that making this gene non-functional reduces the chemotherapy resistance of the breast cancer cells tested.  Additional research will likely be needed to determine in clinical trials whether making this gene non-functional will also improve breast cancer survival.  Not all of the breast cancer cells were killed by making this gene non-functional, meaning that different doses or co-treatment with other agents might be necessary to completely kill the breast cancer cells.  Nonetheless, this research suggests that targeting this gene in future breast cancer treatments looks potentially promising.

While progress continues to be made in designing new breast cancer treatments, don't forget that there are proactive steps that you can take to reduce your risk of breast cancer.  To learn about some of my favorite foods to fight breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Controversies in Breast Cancer 2009

Enhancing our breast cancer awareness is one of the most important things we can do in our fight against breast cancer.  This awareness can encompass many aspects of breast cancer depending upon each of our personal relationships with breast cancer.  For those of us without breast cancer, it is important to learn and understand what we can do personally to reduce our breast cancer risk.  For individuals with breast cancer, it is in their particular interest to understand their breast cancer treatment options and lifestyle changes they might have to make during recovery.

One of my favorite scientific resources for keeping up with the advancements in breast cancer research is the journal Breast Cancer Research.  This journal publishes high quality research papers that are free to the public to read.  For the last few years, they have published a journal supplement called "Controversies in Breast Cancer" that explores the current status or thinking on multiple topics related to breast cancer.  Browsing through these concise articles is an excellent way to enhance one's breast cancer awareness.  Controversies in Breast Cancer 2009 covers a wide range of topics including:

• An overview of alcohol consumption and breast cancer risk
• The importance of mammogram density on breast cancer risk
• An article on the current thinking about antiperspirants and breast cancer risk
• The potential importance of tailored, targeted breast cancer therapy (personalized medicine)
• Genetic markers of breast cancer
• Indicators of long-term breast cancer outcome (markers of cell growth and changes in breast connective tissue)
• Possible future changes in endocrine therapy guidelines (aromatase inhibitors and bisphosphonates)

This is only a sampling of the topics in this year's issue.  While I might blog about a few of these papers in more detail, I know that I probably won't blog about all of them and I wanted to make sure that you all had the opportunity to read these papers and enhance your own breast cancer awareness.  In addition to Controversies in Breast Cancer 2009, you can also read Controversies in Breast Cancer 2008 and Controversies in Breast Cancer 2007 if you are interested.

Another way to enhance your breast cancer awareness is to read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com, which discusses many very simple dietary and lifestyle changes you can make to reduce your personal breast cancer risk.

Breast Cancer Treatment with Focused Microwave Thermotherapy

Focused Microwave Thermotherapy is a relatively new form of breast cancer treatment that shows promise for reducing tumor size and the need for mastectomy.  Focused microwave thermotherapy uses microwave generators placed on either side of the breast to heat the tumor to a specific temperate and kill breast cancer cells.  A more detailed, scientific description of the method can be read in the breast cancer researchers' 2007 paper.

A newly published paper reviews the results from recent studies using focused microwave thermotherapy for breast cancer treatment.  The studies examined the use of this breast cancer therapy either by itself or in combination with anthracycline-based chemotherapy.  Some of the results are outlined below:

• In one study, 8 of 10 patients receiving a single low dose of focused microwave thermotherapy exhibited a reduction in tumor volume and/or an increase in breast cancer cell death.
• In another study, 0 of 34 patients treated with focused microwave thermotherapy prior to breast conserving surgery had positive tumor margins, compared to about 10% of patients receiving surgery alone.
• In breast cancer patients with large tumors (1 - 1.5 inches in size), average reduction in tumor volume was about 88% in patients treated with a combination of focused microwave thermotherapy + chemotherapy compared to a reduction of 60% in breast cancer patients treated with chemotherapy alone.

In a related press release, it was also reported that the percentage of patients needing a mastectomy was reduced from 75% to only 7%.  This is excellent news on the breast cancer treatment front.  Overall, early studies of this new treatment have been very positive and report a reduction in tumor size and reduction in positive tumor margins.  These early results suggest that focused microwave thermotherapy has the potential to improve the results of breast cancer chemotherapy, which could lead to improved breast cancer survival.  To date, these early studies have used small numbers of patients, so larger studies will be needed to confirm these early positive results.

As the medical community continues to make great strides in breast cancer treatment, we have the ability to reduce our risk of getting breast cancer.  To find out more about lifestyle changes you can make to reduce your breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Exercise & Green Tea Help Fight Depression in Breast Cancer Survivors

The stress of dealing with breast cancer leads to a wide range of emotions experienced by breast cancer survivors and their friends and families.  According to the American Cancer Society, for some breast cancer survivors (about 25%) this emotional turmoil can lead to depression, which can make coping and treatment follow-through that much more difficult.

A recent breast cancer study examined the relationship between multiple lifestyle factors and depression among breast cancer survivors.  For this study, information was collected from nearly 1,400 breast cancer survivors in Shanghai, China regarding their exercise habits, supplement use, quality of life, and symptoms of depression.  The result of this study showed that:

• 26% of women reported symptoms of depression
• 13% were diagnosed with clinical depression
• Breast cancer survivors with a higher exercise level were about 30% less likely to develop mild depression and 40% less likely to develop clinical depression.
• Women who increased their exercise level showed a reduced risk for depression
• Consumption of green tea on a regular basis (more than 100 grams dried leaves per month) was associated with a lower risk of depression in breast cancer survivors.

Overall, the results of this new study suggest that regular green tea consumption and regular exercise, lifestyle modifications that can be easily made, can help fight symptoms of depression in breast cancer survivors.  While depression is not uncommon in breast cancer survivors, it seems to be a topic that is less talked about compared to other aspects of cancer survivorship.  However, depression can cause some breast cancer survivors to have a difficult time following their treatment plans, which over time can lead to worse outcomes.  It is not unusual for breast cancer patients to have one or more symptoms of depression for a short period of time; however, it these persist for several weeks, it is important to discuss these emotions with your physician.  For more information, visit the American Cancer Society website, which has an excellent resource section on coping with emotional changes.

In addition to increasing our awareness of issues that face breast cancer survivors, it is also important to increase our awareness of things we can do to help reduce breast cancer risk.  Read my book, Fight Now: Eat & Live Proactively Against Breast Cancer, at www.fightBCnow.com to learn about lifestyle changes you can make to reduce your personal breast cancer risk.

Photodynamic Therapy & Breast Cancer Metastasis in the Spine

As breast cancer develops, breast cancer cells can break off from the main tumor, enter the circulatory system and spread throughout the body.  One common site of this breast cancer metastasis is the spine, which can result in structural damage of the spine.  Current therapy for breast cancer that has spread to the spine is generally a combination of chemotherapy, bisphosphonates, and some form of local therapy (radiation, surgery, etc.) at the site of metastatic tumor.

A new breast cancer study in mice explored the effect of combining bisphosphonate treatment with photodynamic therapy for breast cancer that had spread to the spine.  In this study, breast cancer researchers injected human breast cancer cells into mice.  After 7 days, the mice either received treatment with bisphosphonates or no treatment.  On day 14 of the study, all the mice received a single treatment with photodynamic therapy.  The results of this study showed that photodynamic therapy reduced spinal bone loss and resulted in tumor death.  The co-treatment with photodynamic therapy + bisphosphonates improved bone structure and strength even more.

This is fascinating research with future implications for the treatment of breast cancer that spreads to the spine.  Photodynamic therapy is a unique form of therapy that has been successfully used for esophogeal cancer and skin cancer.  Photodynamic therapy entails the injection of a drug that sensitizes cells to light.  This drug, a photosensitizing agent, is absorbed by all cells of the body, but remains in cancer cells longer.  When most of this drug has left the other cells of the body, but is still present in the cancer cells, the tumor is exposed to a specific wavelength of light.  This light causes the drug to produce a form of oxygen that kills the cancer cells with minimal damage to healthy cells.  One of the current limitations of photodynamic therapy is that the light has limited penetration through the skin, so this cancer therapy is generally limited to cancers on or just under the skin.  This new research suggests that photodynamic therapy might one day be a feasible treatment option for breast cancer that has metastasized to the spine.  However, human clinical trials will need to be conducted to confirm this therapy's effectiveness and safety.  You can learn more about photodynamic therapy at the American Cancer Society and the National Cancer Institute. 

The fight against breast cancer has many aspects with advancements in breast cancer therapy being an important one.  Breast cancer prevention is another aspect of the fight against breast cancer.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) to find out more about what you can do to reduce your breast cancer risk.

Green Tea Polyphenol Sensitizes Breast Cancer Cells to Chemotherapy Agent

While chemotherapy is an effective and important part of breast cancer treatment, breast cancer cells often become resistant to the chemotherapy drugs.  Because of this, the discovery of agents that can re-sensitize breast cancer cells to chemotherapy is an active area of research.

Newly published breast cancer research examined the ability of epigallocatechin gallate (EGCG), a bioactive phytochemical found in green tea, to sensitize breast cancer cells to the chemotherapy drug paclitaxel in cell culture and in a mouse model of breast cancer. 

In the cell culture test, the study investigators treated three different breast cancer cell types with either EGCG alone, paclitaxel alone, or a combination of EGCG + paclitaxel.  Compared with paclitaxel alone, treatment of breast cancer cells with the combination of EGCG + paclitaxel resulted in a dramatic decrease in cell viability and increase in programmed cell death.

For their mouse study, the researchers injected breast cancer cells under the skin of mice and allowed tumors to develop.  After the tumors were large enough to feel, the mice were treated with either EGCG alone, paclitaxel alone, or a combination of EGCG + paclitaxel. At the amounts used, neither paclitaxel nor EGCG had much effect on preventing tumor growth.  However, co-treatment with EGCG + paclitaxel substantially reduced tumor growth.  This reduction in tumor growth appeared to be related to programmed cell death since the index used to measure cell death was greater with co-treatment (12%) compared to either treatment alone (1.8% for EGCG alone and 4.2% for paclitaxel alone).

These study results indicate that the main bioactive phytochemical in green tea, EGCG, is capable of sensitizing breast cancer cells to a standard chemotherapy drug.  These results suggest that EGCG has the potential to improve the effectiveness of standard breast cancer chemotherapy, which is great news.  The dose of EGCG used in this study was 30 mg/kg of body weight.  For a 150-lb person, this would translate into about 2 grams of EGCG per day.  While this would probably be difficult to obtain from drinking green tea, it could be more easily obtained in capsule form.  However, smaller doses were not tested in this study and future studies might show that lower amounts might also be effective.  Overall, this is more good news for green tea.  In addition to the benefits shown in this study, other studies have shown that drinking green tea can reduce breast cancer risk, something I discussed in an earlier blog.

To learn about other foods that can help reduce your breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Mango Extracts Kill Breast Cancer Cells In Culture

Fruits and vegetables are an important part of a healthy diet.  One of the reasons they are has to do with the various bioactive phytochemicals found in them.  There is a very large number and variety of these phytochemicals and research continues to suggest that many of them can provide us with important health benefits.

New research from Texas AgriLife Research suggests that phytochemicals in mangoes can kill breast cancer cells in a cell culture test system.  While few details were reported in the press release, it appears that the researchers tested extracts from five different mango varieties.  The extracts were rich in gallotannins, a phytochemical also found in wine, grape seeds, and tea.  The researchers found that treating breast cancer cells with the mango extracts interrupted the cell growth cycle resulting in death of the breast cancer cells.  While the mango extracts were able to kill the breast cancer cells, they did not harm normal cells.

This is interesting research that builds on the potential health benefits of bioactive phytochemicals.  Since this study was done in a cell culture system using extracts of the mango fruit, there is still a lot of research to be done before determining the potential breast cancer fighting benefits of eating mangoes.  However, the mango is an excellent fruit to consider adding to one's diet due to it nutritional benefits.  A single mango fruit is a good source of dietary fiber (~15% of the daily value [DV]), vitamin B6 (~14% DV), and vitamin E (~12% DV) and an excellent source of vitamins A (~32% DV) and C (~96% DV).  In addition to being a good source of vitamins, many of the phytochemicals in the mango have antioxidant properties to help fight free radical oxidative damage.

To learn about other foods that you can add to your diet to aid you in your fight against breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Effectiveness & Impact of a Multigene Breast Cancer Test

Two new studies published in the Journal of Clinical Oncology examined the effectiveness of a 21-gene test for predicting locoregional breast cancer recurrence and the impact the results of this test have on physicians and patients regarding breast cancer treatment options.

In the first study, breast cancer researchers investigated the association between the multigene test's recurrence score and the 10-year risk for locoregional return of breast cancer in patients with node-negative (lymph nodes not involved), estrogen receptor - positive breast cancer.  The results showed a close relationship between the recurrence score and risk for breast cancer recurrence in breast cancer patients treated with tamoxifen:

• Patients with a low recurrence score had a 4.3% estimated risk of breast cancer recurrence.
• Patients with an intermediate recurrence score had a 7.2% estimated risk of breast cancer recurrence.
• Patients with a high recurrence score had a 16% estimated risk of breast cancer recurrence.

Similar relationships between the recurrence score and risk of breast cancer recurrence were observed in placebo-treated patients and in breast cancer patients treated with tamoxifen + chemotherapy.

In the second study, breast cancer researchers examined the impact of the 21-gene recurrence score on physician and patient treatment selection and satisfaction.  For this study, physicians were asked to recommend an appropriate breast cancer therapy and their confidence in it both before and after conducting the 21-gene test.  The results were rather dramatic:

• Physicians changed their treatment recommendation for 31.5% of the breast cancer patients after seeing the recurrence scores from the 21-gene test.
• 27% of patients altered their treatment decision after seeing their recurrence scores.
• In nearly 23% of the cases, physicians changed treatment recommendation from hormone therapy + chemotherapy to just hormone therapy, since chemotherapy is generally not recommended for breast cancer patients with low scores.
• Physician's confidence in their treatment recommendation improved in 76% of cases, while patient anxiety regarding treatment decisions was improved after seeing their recurrence scores.

This is important research that can very possibly impact breast cancer therapy, at least in estrogen receptor - positive breast cancer patients, which make up the majority of breast cancer patients.  These results indicate that this 21-gene test does a good job of determining the risk of breast cancer returning and can guide breast cancer therapy choices based on the score.  Women with a low recurrence score in this test, might well be able to avoid chemotherapy.  These results continue to show a move toward personalized medicine where treatment decisions are based on an individual's personal risk factors.  To learn more about this 21-gene test, visit their website.

While personlization of medicine continues to make great strides, we can all make personal decisions to help lower our risk of getting breast cancer.  My book, Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com), discusses many of the diet and lifestyle changes you can make to help fight breast cancer. 

Hormone Therapy & Trends in Breast Cancer Incidence

Recent breast cancer research studies have reported that breast cancer rates have been declining, which is great news.  However, the reasons for this decline in breast cancer is uncertain, generally being attributed to improvements in breast cancer screening or reductions in the use of menopausal hormone replacement therapy that occurred after the publication of the Women's Health Initiative study.  A new breast cancer research study published just a few days ago and free to download looked more closely at the relationship between breast cancer incidence and hormone therapy use.

In their study, researchers used data from the California Teachers Study to investigate changes in hormone therapy use and breast cancer incidence among nearly 75,000 women 50 years of age or older.  Hormone therapy use was classified as 'never', 'past', or 'current' according to questionnaires completed in 1995-1996 and in 2000-2001.  The research investigators reported:

• 75% of women reporting estrogen-progestin therapy use and 58% of women reporting estrogen-only therapy use in 2000-2001 had stopped hormone therapy use by 2005-2006.
• Irrespective of hormone therapy use, rates of invasive breast cancer dropped by 26% between 2000-2002 and 2003-2005 with a 25% drop in ER-positive breast cancer and a 14% drop in ER-negative breast cancer.
• Rates of invasive breast cancer were relatively stable for women who were 'never' or 'past' users of hormone therapy; however, women classified as 'current' estrogen-progestin hormone therapy users at the beginning of the study showed a 46% decline in breast cancer from 2000-2002 to 2003-2005.
• Breast cancer rates dropped by nearly 40% in women who stopped hormone therapy use by 2000-2001.
• The decline in breast cancer in this population of women was most likely due to a decline in hormone therapy use because most of the women were hormone therapy users at some time in the past and the majority of the hormone therapy users had stopped by 2005.

While breast cancer screening is vitally important for discovering breast tissue changes and catching breast cancer early, this study suggests that the greatest reason for the recent decline in breast cancer incidence is the decline in the use of hormone therapy, particularly estrogen-progestin therapy.  Previous studies have reported similar results, but this current study appears to have a greater level of information on individual use of hormone therapy, making the argument against hormone therapy use more compelling.  The U.S. FDA recommends that menopausal hormone therapy be used at the lowest doses for the shortest duration to reach treatment goals.  You can learn more about the risks and benefits of menopausal hormone therapy in the National Institute of Health's fact sheet.

In addition to following appropriate guidelines for hormone therapy use, there are many other easy changes you can make to reduce your breast cancer risk.  To learn more, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.