Whole Breast Irradiation vs. Partial Breast Irradiation

Breast cancer treatment options continue to be become more varied and available for breast cancer patients.  Partial breast irradiation is a promising form of radiotherapy that typically requires shorter treatment periods (days versus weeks); however, the full ramifications of this newer technique on breast cancer outcomes are still under investigation.

One recent breast cancer study suggests that there might still be some concern regarding the use of partial breast irradiation.  This recent study reviewed and analyzed published, randomized clinical trials that compared partial breast irradiation to whole breast irradiation in order to assess potential differences in breast cancer outcomes.  The results of this analysis showed that there were no substantial differences between these two breast cancer radiation therapies when it came to supraclavicular (above the collar bone) breast cancer recurrence, distant metastasis, and overall survival.  However, this analysis suggested that patients undergoing partial breast irradiation were 2 times more likely to experience local breast cancer recurrence and were at about a 3-fold increased risk for axillary (underarm) recurrence.

This study reports that there were both positives and negatives associated with partial breast irradiation.  While breast cancer patients undergoing partial breast irradiation appeared to be at greater risk for local and axillary recurrence, this increased risk for recurrence did not appear to negatively impact breast cancer survival or risk for distant metastasis.  In a press release associated with a cancer meeting in 2009 when this study was first presented, the author indicated that this increased risk of breast cancer recurrence might have been due to the inappropriate study designs where a field of radiation was used that might have lead to missing areas of disease during the radiotherapy.  Therefore, it is possible that the risk for recurrence using partial breast irradiation might be slightly overinflated.  While it appears that partial breast irradiation might be a viable alternative to whole breast irradiation, additional research regarding the risk of breast cancer recurrence will likely be needed before partial breast irradiation becomes widely used.  Nonetheless, this might be one treatment option for some breast cancer patients to discuss with their physician.

While the medical community continues to optimize breast cancer therapy in order to prevent breast cancer from returning, there are steps we can take to reduce our risk of ever getting breast cancer.  To learn more about these simple diet and lifestyle changes, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Chemotherapy-Induced Taste Disorders and Nutrient Intake

Most chemotherapy drugs have side effects that can negatively impact the quality of life of cancer patients.  One of these side effects can be changes in taste sensations.  Previous studies have reported that chemotherapy can induce a loss of taste or a more frequent recognition of a bad taste perception.

A new study (free to download) examined the relationship between chemotherapy, changes in taste sensation, and changes in food/nutrient intake.  For this study, researchers tested the ability of cancer patients (including some breast cancer patients) to taste three different flavors (sweet, bitter, novel) after their second round of chemotherapy and compared their results to individuals without cancer.  The study investigators found that:

• Compared to control subjects, cancer patients required higher flavor doses before they could recognize bitter or sweet flavors.
• Patients who required a sweet dose higher than the group average consumed about 500 fewer total calories, less protein, less carbohydrate, and less zinc.
• Cancer patients who needed a higher than average bitter dose consumed fewer total calories (~600 fewer calories), less protein, less carbohydrates, and less fat compared to patients who recognized the bitter flavor at a lower level.
• Compared to patients with normal taste thresholds, cancer patients requiring high doses of bitter and sweet were less likely to consume their daily energy requirements.
• 100% of cancer patients with a higher than average bitter taste threshold experienced weight loss.

This new cancer research identifies an important area of concern for cancer patients treated with chemotherapy.  Most of the patients reported some form of taste abnormality (bad taste in the mouth, loss of taste, etc.) after chemotherapy.  Additionally, many of the cancer patients required high amounts of flavors before being able to recognize them.  These changes in taste perception resulted in inadequate nutrient intake and weight loss in many of the cancer patients.  This can have a serious, negative impact on quality of life and nutritional status.  Discussing changes in taste perception with a physician or dietitian is an important part of post-treatment care in order to avoid nutritional deficiencies.

Maintaining a healthy diet and incorporating cancer fighting foods into this healthy diet can be important for all of us in order to reduce breast cancer risk.  To learn more about some of my favorite cancer fighting foods, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Do Vitamin D Levels Predict Breast Cancer Outcomes?

Currently, vitamin D is one of the most talked about vitamins around.  It has been getting a lot of press regarding the potential health benefits associated with adequate levels of vitamin D and the risks related to vitamin D deficiencies.  In fact, the Institute of Medicine is scheduled to release potentially new recommendations for vitamin D intake later this summer. 

A number of studies have reported that insufficient vitamin D levels are an important risk factor for breast cancer; however, it remains a bit unclear as to whether vitamin D levels in breast cancer patients has an impact on recurrence.  A new research study presented at the 7th European Breast Cancer Conference examined this potential relationship.  For this study, blood levels of vitamin D were measured in 310 Korean women with breast cancer.  The blood levels of vitamin D were analyzed in relation to clinical outcomes and tissue characteristics.  This study reported that:

• Vitamin D levels were deficient (< 20 ng/ml) in ~24% of the breast cancer patients, insufficient (20 - 29 ng/ml) in ~31% of the patients, and sufficient (30 - 150 ng/ml) in only 24% of the breast cancer patients.
• Women with vitamin D levels that were deficient had an almost 3-fold increased risk of breast cancer recurrence compared to patients with sufficient vitamin D levels.
• Vitamin D deficiency was associated with poorer outcomes in breast cancer patients with hormone receptor - positive tumors (almost a 6-fold greater risk), but no relationship was observed for hormone receptor - negative tumors.

This study confirms earlier studies in that about 75% of breast cancer patients did NOT have sufficient levels of vitamin D.  This is an amazingly high percentage of women to have inadequate levels of vitamin D.  While most earlier studies have looked at and shown that adequate vitamin D intake can reduce the risk of getting breast cancer, this new study tells us that inadequate vitamin D intake can also increase the risk of breast cancer recurrence in breast cancer patients and that this is most likely to happen in patients with hormone receptor - positive breast cancer.  This is important new research that emphasizes the need for adequate vitamin D levels.  If you are interested in learning more about vitamin D, the National Institute of Health's Office of Dietary Supplements has an excellent fact sheet.

To learn more about vitamin D and its importance in breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Considering Contralateral Prophylactic Mastectomy?

Contralateral prophylactic mastectomy is a procedure where a breast cancer patient has the opposite, unaffected breast removed in hopes of reducing their risk of developing cancer in that breast.  This procedure is becoming more and more common among breast cancer patients.  Various studies have reported increases in the use of this procedure since the 1990's.  One study reported that only 6.5% of patients chose this option in 1999, but that increased to 16% in 2007.  Another study reported that 30% of breast cancer patients in one hospital opted for contralateral prophylactive mastectomy in 2006-2007.  This increase is happening despite the fact that the benefits in regards to preventing recurrence or increasing survival are uncertain.  An excellent editorial published in October 2009 discusses these trends in more detail.

A new study presented at the 7th European Breast Cancer Conference a couple of days ago examined why patients typically request contralateral prophylactic mastectomy.  In this study, the breast cancer researcher questioned 27 patients in 2008 and 2009 about their choice for contralateral prophylactic mastectomy.  After these interviews, the women were offered a "cooling off" period of 12 months (while receiving their standard breast cancer treatments) to give their choice further consideration.  The breast cancer researcher reported that:

• All of the patients believed that they would not survive beyond 5 years.
• All of the patients also overestimated their risk of breast cancer developing in their opposite, unaffected breast.
• This overestimation was at a rate of 5 - 10 times more than their actual calculated risk.
• After the 12-month "cooling off" period, all of the women felt less anxious about their chances of developing future breast cancer and 23 of the 27 patients chose not to have the contralateral prophylactic mastectomy.

This study lends some insight into the rising use of this breast cancer treatment option.  A diagnosis of breast cancer is a scary and very stressful situation.  This study suggests that the stress involved might lead to an increased perception of being at high risk for developing cancer in the opposite breast.  The women in this study requested this procedure for a variety of reasons including being young, having lobuluar cancer, low risk family history, and previous bad experience in family members or friends.  Some of these reasons are commonly seen.  Women choosing contralateral prophylactic mastectomy have been reported to generally be: young (< 40 years), more educated, have larger tumor size, more likely to have a family history, and have lobular histology.  The results of this new study show the importance of providing breast cancer patients with adequate counseling regarding their actual risk of recurrence and treatment options and be offered an opportunity to fully consider their options and choices.  If you want to read the full study abstract, you can search the meeting abstracts for it using the author's name (Sahu).

Breast cancer awareness and education are vital parts of our fight against breast cancer.  Without adequate breast cancer awareness, it is even more difficult to make necessary decisions.  My book, Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) is a great way to increase your breast cancer awareness of ways to reduce your personal risk of breast cancer.

Combining Chemotherapy with Immunotherapy for Cancer Treatment

Immunotherapy for breast cancer and other cancers, while showing promise, still faces a number of challenges before becoming standard cancer therapy practice.  Some of these challenges include promoting an adequate immune response in the face of chemotherapeutic agents that suppress the immune response and difficulty in penetrating the tumor to recognize tumor-associated markers.  A new research report recently examined the effect of combining chemotherapy with cancer immunotherapy (vaccines or transfer of immune cells). 

In this new study, investigators used several different cancer cell lines, including some breast cancer cell lines, to test the effectiveness of combining chemotherapy with a cancer vaccine.  The vaccine was tested with three forms of chemotherapy: paclitaxel, doxorubicin, and cisplatin.  These cancer investigators reported that:

• Mice implanted with breast cancer tumors and treated with a combination of the cancer vaccine and paclitaxel experienced an anti-tumor effect such that breast cancer tumor growth was slowed.
• Chemotherapy appears to make the cancer cells more sensitive to treatment with the cancer vaccine since pre-treating the cancer cells with the chemotherapeutic agents increased the killing ability of the cancer vaccine compared to giving the vaccine alone.
• This increased sensitization of cancer cells appears to be the result of increases in a specific cell receptor and a protein involved in programmed cell death.

This is fascinating research with potential implications on future breast (and other) cancer therapy.  This study not only showed that combining chemotherapy with immunotherapy can have complementary effects that increases cancer treatment effectiveness, but it also reported that the immunotherapy was specific to cancer cells recognized by the immunotherapy.  This suggests that the immunotherapy could be targeted to specific cancer cells while having minimal effect on non-cancer cells.  Previous research has also reported on the potential benefits of cancer vaccines.  The video below from 2008 discusses the use of an experimental HER2 breast cancer vaccine.



While more research will need to be done before combinations of chemotherapy and immunotheray will become standard of care, there are things we can do right now to reduce breast cancer risk.  To learn more read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Newly Discovered Gene Associated with Breast Cancer Outcomes

The Holliday Junction Recognition Protein (HJURP) gene is a newly discovered gene that appears to interact with chromosomal DNA at the site of the centromere, a part of the chromosome important for proper cell division.  Previous research studies have suggested that the HJURP gene might be involved in cancer development, but little is known about its role in breast cancer.

A new breast cancer research study, which is free to download and read, examined the association between the HJURP gene and breast cancer characteristics.  To do this the investigators used various techniques to measure the level of the gene and its protein in primary breast cancer tissues and in breast cancer cell lines.  The results of this study showed:

• HJURP was elevated in 50% of breast cancer cell lines.
• Invasive ductal carcinomas showed higher levels of the HJURP gene than normal ductal tissues.
• Elevated HJURP levels were associated with estrogen receptor-negative status, progesterone receptor-negative status, advanced histological stage (SBR Grade), younger age, and increased cell growth.
• Breast cancer patients whose tumors had high levels of HJURP had shorter disease-free survival and poorer overall survival.

Another interesting aspect of this study was that higher levels of this gene were also associated with breast cancer cells that were MORE sensitive to radiation therapy.  This suggests that radiation therapy might support better outcomes in patients with higher HJURP, though the overall outcomes appear to still be worse than patients with low levels of this gene. 

This is important information that might impact future breast cancer therapy.  By testing breast cancer biopsies for the presence of this gene, it might be possible for physicians to develop more targeted therapies that prevent the possible cancer-promoting actions of this gene in order to improve outcomes for these breast cancer patients.  

My book Fight Now: Eat & Live Proactively Against Breast Cancer is a great way to start learning more about what you can do in the fight against breast cancer.  You can find it at www.fightBCnow.com.

Anti-Breast Cancer Activity of a Papaya Leaf Extract

The papaya fruit is a excellent fruit that has many food applications.  Like many plants, both the fruit and other parts (seeds, leaves, etc.) of the papaya tree have been used for various medicinal purposes.  Papain is probably the best known component of papaya and is commonly used topically for the relief of rashes, stings, and burns.  

New cancer research has examined the effects of a papaya leaf extract on several cancer cell lines, including breast cancer cells.  For this study, MCF-7 breast cancer cells were grown in a cell culture system and treated with different amounts of the papaya leaf extract.  In addition to the effects on the breast cancer cells, the investigators examined the effects of the papaya leaf extract on a type of white blood cell to determine how the papaya leaf extract might function.  The investigators reported that:

• The papaya leaf extract prevented the growth of breast cancer cells in culture with higher doses having a greater benefit.
• Prevention of cell growth appears to be mediated, at least in part, by stimulating the programmed cell death of the breast cancer cells.
• The papaya leaf extract suppressed the production on inflammatory chemicals from the white blood cells.
• Production of chemicals with possible anti-cancer properties were increased when white blood cells were treated with the papaya leaf extract.
• None of the doses of the papaya leaf extract appeared to have any damaging effects normal cells.

These are very positive research results that suggest possible anti-cancer benefits of a papaya leaf extract.  While this study was not dedicated to just breast cancer, parts of the study were done using breast cancer cells and the anti-tumor effects were noted in these cells as well as the other types of cancer cells.  Overall, this study suggests that a papaya leaf extract inhibits breast cancer cell growth and alters the immune system in an anti-cancer direction.  Additional research will need to be done to determine the active component(s) of the papaya leaf extract, to discover how it functions in breast cancer cells, and to determine if these benefits translate to people.  Nonetheless, this study showed good initial results and makes a great starting point to further examine the benefits of papaya for breast cancer.  Since it is unknown what the active component was in this study, it is also unknown if the active ingredient is present in the papaya fruit as well.  However, the papaya is an excellent food choice as it is very low in saturated fat, cholesterol, and sodium and is a good source of dietary fiber, vitamin A, vitamin C, and folate.

To find out more 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.

Nicotine Induces Breast Cancer Cell Growth in Culture

It is clear that smoking increases the risk for several cancers.  This increased risk of cancer from smoking has generally been thought to be due to chemicals that are produced when the tobacco is burned and which cause genetic alterations in cells causing them to become cancerous.  However, research in the last couple of years has suggested that nicotine might also be involved in breast cancer development and progression.  To learn more about this initial research, there is both a good news story to read and an interesting video to watch.

New breast cancer research looking at the mechanism by which nicotine might stimulate breast cancer development was recently published online.  This new cell culture study examined the role of a cell protein called Cyclin D3, which is involved in cell growth and has been shown to be elevated in breast tumor tissue.  The results of this study showed that (1) treatment of breast cancer cells with nicotine caused a substantial increase in Cyclin D3 and (2) blocking the site on the breast cancer cells where nicotine binds prevented the rise in Cyclin D3.

After determining that nicotine could stimulate breast cancer cell growth in this culture system, the breast cancer researchers tested the ability of a plant extract to block the breast cancer cell growth.  The results of this test showed that one of the major active compounds (Garcinol) from the fruit of the Kokum tree reduced the ability of nicotine to bind to the breast cancer cells and decreased the production of Cyclin D3.

This is interesting research into the ways that nicotine might stimulate breast cancer development and progression.  Based on this new research and the earlier research, it appears that nicotine might be able attach to sites on breast cancer cells and increase some cellular pathways that promote cell growth.  Perhaps just as importantly, this research suggests that the effects of nicotine might be blocked by a compound from a fruit in the mangosteen family.  Of course, it is important to remember that this study was done in a cell culture system, which can behave quite differently than real life situations.  Studies in animals and human clinical trials will still need to be run to determine if nicotine has the same effect in people and if these effects can be overcome.

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 risk of breast cancer.

Effectiveness of Breast Cancer Screening Methods in High Risk Women

The current breast cancer screening guidelines from the American Cancer Society recommend that women at high risk for breast cancer receive both a yearly mammogram in addition to a yearly magnetic resonance imaging (MRI) scan starting around 25-30 years of age.  Women at elevated risk for breast cancer are generally those with gene mutations that increase breast cancer risk or have an elevated risk (> 20% lifetime risk) due to family history. 

A new study published in the March 20th issue of the Journal of Clinical Oncology examines the effectiveness of different breast cancer screening methods in women at elevated breast cancer risk.  For this study, investigators followed 687 women without breast cancer through nearly 1,700 annual screening rounds.  Screening methods included clinical breast examination, mammography, ultrasound, and MRI.  Of the women enrolled in the study, 27 were diagnosed with breast cancer during the study.  Analysis of the different screening methods to determine their effectiveness of detecting breast cancer showed:

• Ultrasound alone detected breast cancer at a rate of 6 of 1,000.
• Mammography alone detected breast cancer at a rate of 5.4 per 1,000.
• Mammography + ultrasound slightly increased the detection rate to 7.7 per 1,000.
• MRI achieved a breast cancer detection of 14.9 of 1,000.
• Combining MRI with ultrasound did not improve upon MRI alone.
• Combining MRI with mammography slightly increased breast cancer detection to 16 of 1,000.
• MRI scanning showed the highest sensitivity (92%) and highest positive predictive value (48%).

This study confirms the importance of using MRI as a breast cancer screening tool for women at high risk of breast cancer.  Additionally, this study reports that screening with both MRI and mammography is only slightly better than MRI alone.  Because of this observation, the study investigators suggest that breast cancer screening guidelines might need to be revisited for women at high risk for breast cancer if future studies confirm that breast cancer screening by MRI alone might be sufficient. An editorial that accompanies the research article discusses this recommendation in detail and is worth reading.  This editorial suggests that mammograms remain a part of annual screening in women with high risk of breast cancer for several reasons.  Some of these reasons include (1) the fact that other studies have reported that MRI + mammography was substantially better than MRI alone and (2) MRI expertise is variable among medical centers.  For now it appears that MRI + mammography might be the wiser breast cancer screening choice; however, as MRI techniques continue to improve it is possible that women at high risk for breast cancer might be able to reduce their screening routine to only one type of annual screening.

Routine screening is a vital part of our fight against breast cancer and something everyone can make part of their arsenal.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) to learn about other lifestyle choices you can make to reduce your breast cancer risk.

Breast Cancer Epithelial-Mesenchyme Transition Gene Identified

The 'epithelial-mesenchyme transition' (EMT) is a developmental program that has been shown to be involved in cancer progression and metastasis.  This transition involves the change of epithelial cells to a fibroblast type cell (found in connective tissue) that is capable of migrating.  The development of the ability to migrate is an essential step in tumor invasiveness and metastasis.  This transition is an area of intense research since preventing this transition from occurring could reduce breast cancer metastasis.

In a recent study, investigators examined the genetic signature of this cell transition in breast cancer cell lines.  By looking at epithelial breast cancer cells and connective tissue breast cancer cells, the investigators were able to identify an epithelial-mesenchyme transition signature that included 200 genes.  The investigators further examined the potential role of the highest ranked gene in this signature (called LYN) and discovered the following:

• The presence of the LYN gene was associated with substantially shorter survival.
• The LYN gene was also associated with basal-like, triple-negative breast cancer, a more aggressive form of breast cancer.
• Suppressing the function of LYN in breast cancer cell lines prevented cell invasion and migration.

This new research has the potential to open the doors to future breast cancer therapy options.  The results of this new study identify at least one gene that seems to be important in breast cancer invasion and migration.  Blocking the function of this gene has the potential to reduce or prevent breast cancer from spreading to other parts of the body.  This could lead to improved breast cancer outcomes for many patients with aggressive forms of breast cancer.

While the medical and scientific communities continue to make amazing advancements in breast cancer therapy, we can participate in the fight against breast cancer by adopting healthier lifestyles designed to reduce breast cancer risk.  To find out more about what you can do, read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com).

Breast Cancer Treatment with Cryotherapy

New breast cancer research presented yesterday at the 35th Annual Meeting of the Society of Interventional Radiology demonstrates the advancements made in cryotherapy as a breast cancer treatment.  Cryotherapy for cancer uses freezing temperatures to destroy the cancerous tissue.  It has been used in a number of different cancers for several years; however, in many cases this procedure has been used during surgery because it is easier to visualize the tumor and its margins or used only in patients who refused surgery.  This new research reports that breast cancer tumors can be successfully destroyed by freezing without surgery.

In this new breast cancer study, researchers treated 13 breast cancer patients with cryotherapy.  For this treatment, multiple small cryoprobes (needles that can deliver the freezing temperatures) were inserted through the skin under local anesthesia into the breast cancer tumor using ultrasound or computed tomography (CT) + ultrasound to guide the placement of the needles and visualize the freezing procedure.  Using this procedure to destroy breast cancer tumors showed the following:

• Ultrasound was capable of visualizing the procedure for small tumors, while larger tumors required visualization with CT + ultrasound.
• Biopsies taken at the edge of the cryotherapy site immediately after the procedure and at follow-up showed no evidence of cancerous tissue.
• After an average of 18 months of follow-up (up to ~5 years in some cases), no local breast cancer recurrences have been found.
• The study volunteers reported only minimal discomfort with the procedure and satisfaction with the cosmetic results.

This is exciting research that is currently showing very positive results.  Earlier research in this area suggested that only small tumors could be treated with cryotherapy; however, this research typically used only a single cryoprobe.  This new study suggests that using multiple cryoprobes successfully treats larger breast cancer tumors and can freeze a large enough area to destroy breast cancer cells at the very edges of the tumor.   This video provides a good description of the procedure, though one done with a single needle rather than the latest multiple cryoprobe procedure used in this new breast cancer research.

While this is an exciting advancement in the treatment of breast cancer, another important goal is to keep breast cancer from occurring at all.  There are many things we can all do to reduce our breast cancer risk.  To learn more, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Combined Therapy for Hormone Receptor-Positive Metastatic Breast Cancer

Growth factors, like epidermal growth factor, have been shown to play important roles in tumor development and cancer progression.  For this reason, drugs that inhibit growth factors are frequently used for a variety of targeted cancer therapies.  Drugs that inhibit the function of epidermal growth factor receptors are frequently used for a variety of cancer types.  By blocking the receptor, these drugs might prevent or reduce the ability of growth factors to stimulate cancer development.

Recent breast cancer research published in the March 15th issue of Clinical Cancer Research suggests that combining an epidermal growth factor inhibitor, Gefitinib, with an aromatase inhibitor, anastrozole, might improve breast cancer outcomes.  For this study, postmenopausal women with hormone receptor-positive metastatic breast cancer were treated with either (1) anastrozole + placebo or (2) anastrozole + gefitinib.  The results indicated that:

• The combination of an aromatase inhibitor with an epidermal growth factor inhibitor lengthened progression-free survival (about 15 months for the combination versus about 8 months for patients treated with only the aromatase inhibitor).
• Clinical benefit rate was 49% in patients receiving the combination therapy compared to only 34% in patients receiving the aromatase inhibitor alone.

While the number of patients (174) in this study was small, this preliminary trial shows promising results for the treatment of breast cancer with a combination of endocrine therapy (aromatase inhibition) and growth factor receptor inhibition therapy.  According to the study investigators, there were no unexpected adverse effects and the combination therapy was well tolerated.  Future studies will need to be done to confirm the results of this pilot study and hopefully to expand it to other breast cancer stages.  For now, these results represent an advancement in breast cancer therapy that might pave the way for improved breast cancer outcomes.

In addition to research designed to improve breast cancer therapy and outcomes, research into breast cancer prevention continues to progress.  To learn more about what you can do to reduce breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Curcumin-Derived Compound Suppresses Breast Cancer Cell Growth

The research on the potential breast cancer fighting benefits of curcumin (the main active component of the spice turmeric) continues to show good results.  As I indicated in two previous blogs, curcumin has been shown to block breast cancer stem cell renewal and to kill triple negative breast cancer cells in cell culture systems.  Breast cancer researchers have recently developed specific compounds derived from curcumin as a possible future breast cancer therapeutic.

In this new study, breast cancer researchers examined the effect of two curcumin-derived compounds called FLLL31 and FLLL32 on a cell signaling chemical (called STAT3) shown to be important for breast cancer cell survival and drug resistance.  The results of this cell culture study showed several positive effects of these curcumin-derived compounds, including:

• Inhibition of STAT3's ability to bind to cell DNA, this preventing multiple cancer processes,
• Initiation of programmed cell death of breast cancer cells,
• Reduction in the ability of breast cancer cells to form colonies and grow, and
• Working together with the chemotherapy drug doxorubicin to kill breast cancer cells.

The last 4 or 5 months have shown us the potential benefits of curcumin as a cancer fighting spice.  These new studies have reported that curcumin or curcumin-derived compounds can kill breast cancer cells and/or inhibit their function.  However, it is important to remember that these studies have been done in cell culture systems and additional research will need to be conducted to determine whether oral consumption of curcumin has similar benefits for individuals with breast cancer.  While several clinical trials with curcumin are being conducted, few of these are specific to breast cancer.  While a lot of work still needs to be done, particularly human clinical trials where curcumin is given in the diet, turmeric with it's main active component curcumin, is a flavorful spice that can easily be used in many excellent recipes.

Read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com to learn about other cancer-fighting foods you can easily add to your diet in order to reduce breast cancer risk.

Endocrine Therapy & Memory of Postmenopausal Breast Cancer Patients

The development of endocrine therapies for hormone receptor - positive breast cancer, such as anti-estrogens and aromatase inhibitors, over the years has been a great advancement in breast cancer treatment resulting in improvements in breast cancer survival.  However, like most drugs, these therapies often come with a long list of possible side effects.  Some studies have shown that the anti-estrogen tamoxifen might reduce normal memory functions in breast cancer patients. 

A new study compared the memory functions of postmenopausal breast cancer patients being treated with tamoxifen or exemestane (a common aromatase inhibitor) with the memory functions of healthy women.  For this study, memory function in each group of postmenopausal women was tested before the start of treatment and again after 1 year of treatment.  The breast cancer researchers reported that:

• Compared to healthy postmenopausal women, breast cancer patients treated with the aromatase inhibitor did not experience any worsening in their memory functions.
• Breast cancer patients treated with tamoxifen did worse than healthy women after 1 year of treatment on verbal memory tests (recall of word lists or stories) and tests of executive functioning (ability to plan, memory flexibility, abstract thinking).
• Compared to breast cancer patients treated with exemestane, breast cancer patients treated with tamoxifen processed information slower.
• No differences in other tests (visual memory, working memory, reaction speed, and others) were found between the three groups of women.

In most of the tests of memory function performed in this study, neither tamoxifen nor exemestane treatment made memory worse compared to healthy, untreated postmenopausal women.  However, results from a couple of the memory tests used in this study showed that tamoxifen had mild adverse effects on memory functioning.  Information like this enhances our awareness of the various breast cancer treatments and is important to keep in mind when discussing treatment options with a physician. Weighing the risks and benefits of different breast cancer treatments is an important step.  If one is deciding between two or more drugs that have similar benefits, being able to choose an option with fewer negative side effects might make a major difference in one's quality of life during recovery.

To learn about other choices you can make to reduce breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com).

Breast Cancer Risk Factors in Chinese Women

Rates of breast cancer incidence in China are substantially lower than rates seen in Western countries like the United States.  However, modernization in regards to diet and lifestyle appears to have resulted in an increase in breast cancer incidence in Eastern countries like China.  These changes appear to be leading to an increase in the proportion of overweight adults, adoption of a more Western diet, and a decrease in physical activity.  A new population-based study was conducted to examine some of the breast cancer risk factors in Chinese women.

In this new study, which is free to download from the Asian Pacific Journal of Cancer Prevention (vol 10, pg 877), breast cancer researchers examined 669 breast cancer patients and 682 healthy controls and asked them to complete a detailed lifestyle questionnaire.  Breast cancer risk was determined by their responses and physical examinations.  Some of the results are discussed below.

Body Size - overweight women (body mass index > 25) were 1.48 times more likely to develop breast cancer.

Occupational Work - women that reported having a moderate level of physical activity associated with their jobs were had about a 40% reduction in breast cancer risk.  Interestingly, heavy physical labor at work showed a similar breast cancer risk compared to women with no physical activity at work.

Recreational Physical Activity - Exercising more than once per week was associated with about a 30 - 40% reduction in breast cancer risk.  However, the benefits of physical activity appeared to be greatest for women who exercised between 30 - 60 minutes each time they exercised.  Women exercising for more than 60 minutes per time actually showed a slight increase in breast cancer risk.  Similar results were seen when physical activity was examined on a weekly basis.  Exercising between 60 - 180 minutes substantially reduced breast cancer risk, while exercising more than 180 minutes in this population of women had no benefit compared to women exercising less than 60 minutes per week.

Sleep Duration - This study reported that sleep duration had a significant impact on breast cancer risk.  Compared to women sleeping less than 5 hours per night, women who slept between 5 - 8 hours per night were at a 50 - 70% reduced breast cancer risk.

Standing or Walking Around - Women in this study who reported spending more than 1 hour per day either standing or walking around were at a decreased risk of breast cancer.  Standing or walking around for 3 hours per day was associated with the greatest breast cancer risk reduction (about 70%).

While some of these results are what we would expect in terms of lifestyle habits and breast cancer risk (increased exercise and a healthy body weight reduce breast cancer risk), there is some additional, interesting information provided in this study.  For example, simply standing or walking around reduced breast cancer risk in this population of Chinese women.  This is an easy lifestyle habit one can adopt.  When talking on the phone, don't sit down; instead get up and walk around.  Don't necessarily try to save trips when doing household chores; making several trips might be healthier.  Getting enough sleep appears to be another possible way to easily reduce one's breast cancer risk.  Other studies have reported similar results.  While the duration of recommended sleep seems to vary from study to study, getting between 6 - 7 hours per night seems to substantially reduce breast cancer risk.  Research continues to show that by adopting some simple lifestyle habits, we can improve our overall health and reduce breast cancer risk.

To learn more about other diet and lifestyle changes you can make to reduce your personal breast cancer risk, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

21-Gene Recurrence Score Predicts Distant Breast Cancer Recurrence

In a previous blog, I discussed the effectiveness of a 21-gene test for predicting breast cancer recurrence in breast cancer patients with node-negative, estrogen receptor - positive breast cancer and the impact the results of this test have on physicians and patients regarding breast cancer treatment options.  As I indicated in my earlier blog, high recurrence scores using this 21-gene test predicted recurrence and many physicians gained more confidence in their treatment recommendations after assessing the recurrence scores. 

New breast cancer research expands upon these earlier studies by exploring the utility of this 21-gene test in different breast cancer populations.  For this new study, investigators examined the predictive ability of this multigene test in node-negative and node-positive postmenopausal breast cancer patients being treated with the anti-estrogen tamoxifen or the aromatase inhibitor anastrozole.  The 21-gene test was used to determine recurrence scores in over 1,200 breast tumors.  The results of this analytical study showed:

• In node-negative (no lymph node involvement) breast cancer patients:
• A low recurrence score (< 18) had a breast cancer recurrence rate = 4%
• An intermediate recurrence score (18 - 30) had a recurrence rate = 12%
• A high recurrence score (> 31) had a recurrence rate = 25%
• In node-positive (lymph nodes involved) breast cancer patients:
• Breast cancer recurrence = 17% in patients with low recurrence score
• Breast cancer patients with an intermediate recurrence score had 28% rate of breast cancer recurrence
• A high recurrence score had a breast cancer recurrence rate of 49%
• The ability of this 21-gene test to predict breast cancer recurrence was similar in patients treated with the aromatase inhibitor or tamoxifen.

Like the initial studies I discussed, this new study shows the value of this new multigene test for predicting the risk of breast cancer recurrence.  In both sets of breast cancer patients (node negative and node positive), a higher recurrence score was related to a higher recurrence of breast cancer and treatment differences in this study did not alter the predictive value of the multigene test.   This is important research that might positively impact breast cancer outcomes and survival.  If physicians can use this or similar tests to determine individuals at a greater risk of breast cancer recurrence, treatment options and future monitoring can be adjusted to minimize their risk or catch any recurrence at an earlier stage.

In addition to reading this blog to enhance your breast cancer awareness, there are steps you can take to reduce your personal risk of breast cancer.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Effectiveness of DNA Repair Mechanisms Predicts Chemotherapy Sensitivity

Chemotherapy is an important tool in our fight against breast cancer.  However, breast cancer patients often have different individual responses to any one specific form of chemotherapy.  For this reason, the breast cancer research community continues to look for ways to determine how each individual breast cancer patient might respond to specific types of chemotherapy.  If physicians can determine whether a patient will respond to a particular treatment before the treatment is given, they can then assure that each patient receives the type of treatment to which they will best respond and which will provide the best possible outcome.

Anthracycline-based chemotherapies are one of the most common forms of chemotherapy and these typically work by damaging the DNA in breast cancer cells, causing their death.  A new study (free to download) published a few days ago examined whether individual differences in the ability of breast cancer tumors to repair DNA damage caused by chemotherapy has an effect on chemotherapy effectiveness.  For this study, breast cancer researchers collected core needle biopsy samples from 60 breast cancer cases before chemotherapy treatment and 18-24 hours after chemotherapy treatment in order to assess the possible relationships between the production of DNA damage repair proteins and the tumor's response to chemotherapy. 

The results of this study showed that chemotherapy increased the level of proteins responsible for DNA repair in many cases.  A higher level of these proteins individually either before or after chemotherapy was associated with lower response to chemotherapy, such that tumor size was not reduced as much as in individuals with low levels of these repair proteins.  Overall, the results of the study indicated that breast cancer tumors with high functioning DNA repair mechanism were more resistant to chemotherapy, which resulted in poorer reductions in tumor size.

This new study reports that the ability of individual breast cancer tumors to repair DNA damage caused by chemotherapy has a substantial impact on the effectiveness of the chemotherapy.  This in important new research that might one day have a real impact on breast cancer treatment and outcomes.  By evaluating each tumor's ability to repair DNA damage, it might be possible to determine the effectiveness of a specific chemotherapy drug before use and permit individual treatment options that provide the best possible outcomes.

Although the medical and research communities continue to make amazing discoveries that will hopefully lead to better treatment options and survival rates, it is important to remember that we also can take steps to fight against breast cancer.  To learn more, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Weight Gain and Hot Flashes in Breast Cancer Survivors

The majority of breast cancers are hormone receptor positive, meaning that receptors for estrogen and/or progesterone are present on the breast cancer tumor cells.  These cancers are routinely treated with some form of endocrine therapy, typically anti-estrogens like tamoxifen or aromatase inhibitors like anastrozole.  Since aromatase inhibitors block the production of estrogen thereby lowering the body's estrogen levels, one of the common side effects in breast cancer survivors is hot flashes.  However, the risk factors for hot flashes in breast cancer survivors are poorly understood.

A new breast cancer study was conducted to determine if body size and/or weight change after breast cancer diagnosis was related to hot flashes in breast cancer survivors receiving aromatase inhibitor therapy.  For this study, 300 breast cancer survivors receiving aromatase inhibitors were enrolled and changes in body weight and incidence of hot flashes were assessed.  Results of this analysis showed:

• 59% of study volunteers experienced hot flashes and 32% reported moderate to severe hot flashes.
• Current body size was not related to hot flash occurrence or severity.
• Breast cancer survivors who gained 10 lbs or more were twice as likely to experience hot flashes and about 2.5 times more likely to have severe hot flashes.

As we have discussed before, being overweight or obese is an important risk factor for breast cancer and can lead to poorer outcomes.  While this new study does not look at breast cancer outcomes, it does indicate that gaining weight, even as little as 10 lbs, increases the amount and severity of hot flashes in breast cancer survivors being treated with aromatase inhibitors.  Aromatase inhibitors are an effective breast cancer therapy for some breast cancers, but like most drugs, they carry their own side effects.  While hot flashes might not be considered a 'serious' side effect by some individuals, hot flashes can be debilitating and have a very negative impact on a breast cancer survivor's quality of life.  Discovering the factors that increase the risk of these side effects is an important research endeavor.  This new research shines light on yet another reason to maintain a healthy body weight throughout life.

You can read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com to learn about diet and lifestyle changes you can make to reduced your breast cancer risk.

Breast Cancer Survivors: Beliefs Versus Behaviors

In addition to discussing new medical discoveries in breast cancer, one of the main goals of this blog is to provide information on steps we can all take to reduce the risk of breast cancer and breast cancer recurrence.  There are many diet and lifestyle changes that each of us can make to reduce our own personal risk of breast cancer and I make a point of discussing new research results in these areas as often as possible in order to increase our awareness of things we can do in our fight against breast cancer.

An interesting paper that is free to download and read was published yesterday that examined the relationship between breast cancer survivors' beliefs about diet and exercise and their actual behaviors.  This study was conducted by analyzing responses to a questionnaire sent to breast cancer survivors by the Susan G. Komen For the Cure foundation.  The breast cancer survivors were asked to respond with their level of agreement (strongly agree, agree, disagree, etc.) to a variety of statements and answer questions about their diet and exercise habits.  Some of the results are outlined below:

• 67% of breast cancer survivors agreed that regular physical activity will reduce the risk of breast cancer recurrence.
• 65% of breast cancer survivors agreed that maintaining a healthy body weight throughout life will reduce the risk of breast cancer recurrence.
• Only 50% of breast cancer survivors agree that eating 5 servings of fruits and vegetables will reduce the risk of breast cancer recurrence.

In regards to how well the beliefs of these breast cancer survivors translated into actual behaviors, the results were a little disappointing:

• Only 48% of survivors who strongly agreed with the benefits of fruits and vegetables for reducing breast cancer recurrence actually eat 5 servings per day.
• Of breast cancer survivors who strongly agreed that regular exercise reduces the risk breast cancer recurrence, only 51% actually exercised at the recommended level (30 minutes or more per day for 5 or more days per week).
• Of survivors who strongly agreed that maintaining a healthy body weight throughout life will reduce the risk of breast cancer recurrence, only 47% exercised at the recommended level and only 44% consumed 5 servings of fruits and vegetables.

Based on these results, there remains a lot of work to do in order to enhance the awareness of breast cancer survivors about the importance of diet and lifestyle in their fight against breast cancer.  These results suggest that nearly one-third of breast cancer survivors do not believe that regular exercise and maintaining a healthy body weight can reduce the risk of breast cancer recurrence.  Additionally, these study results show that about half or less of breast cancer survivors actually follow diet and exercise recommendations even though they believe these recommendations will reduce their risk of breast cancer recurrence.  Based on the results of this study, it appears that there are at least two challenges that need to be met.  A better job needs to be done to spread the news about the importance of diet and lifestyle changes for reducing breast cancer risk and it is necessary to find ways to motivate individuals to actually adopt these changes.

Read my book Fight Now: Eat & Live Proactively Against Breast Cancer to learn more about some of the simple diet and lifestyle changes you can make to reduce your breast cancer risk (www.fightBCnow.com).

Risk of Breast Cancer Recurrence Might Be Increased By A Delay in Radiotherapy

The use of radiation therapy after breast conservation surgery has continued to rise over the last decade or two and has done so to the point where waiting times for radiation therapy have increased substantially.  Currently, a 6-week wait between breast surgery and radiation therapy is generally considered acceptable; however, the impact of this waiting period on breast cancer outcomes (recurrence and mortality) is uncertain.  Some studies have suggested that the risk of breast cancer recurrence increases with a longer waiting period, while other studies have not observed this relationship.

A new breast cancer study was recently published with the hopes of clarifying this relationship.  For this study, breast cancer researchers examined information from over 18,000 women over 65 years of age who had been diagnosed with Stage 0 - 2 breast cancer between 1991-2002 who received breast cancer conservation surgery and radiation therapy.  Analysis of this information provided the following results:

• On average, the time between breast surgery and radiation therapy was 34 days.
• About 30% of the breast cancer patients started radiation therapy after 6 weeks.
• Waiting more than 6 weeks between breast cancer surgery and radiation therapy resulted in about a 19% increase in local breast cancer recurrence.
• The risk of breast cancer recurrence increased with longer waiting periods.

This is important information that might hopefully lead to shorter times between breast cancer surgery and radiation therapy.  Previous research has reported that decreasing local breast cancer recurrence can lead to improvements in overall survival.  Therefore, even though the risk of local recurrence with a longer waiting time to radiation therapy was modest in this study, reducing this risk might still improve breast cancer outcomes.  The factors responsible for increased waiting times appeared to be many and complex.  One cause of this delay appears to simply be an increase in demand with the percent of women in the Northeast who started radiation therapy after 6 weeks nearly doubling over a ten year period.  Other factors like increased instances of other health conditions, being Hispanic, having affected nodes, and having a history of low income were also reported to be associated with a delay in starting radiation therapy.  Finding ways to reduce this delay is an important goal for health professionals in order to improve breast cancer outcomes.

To learn about some simple things you can do as part of your normal, daily routine that might help reduce your personal risk of breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com).

Smoking Increases Breast Cancer Risk Based on Genetic Trait

Smoking is thought by many people to be a risk factor for breast cancer.  However, the specific mechanisms by which smoking might increase breast cancer risk remains an area of intense investigation.  One potential mediator of tobacco use on breast cancer risk is an enzyme called N-acetyltransferase 2 (NAT2).  This enzyme is a metabolic enzyme known to convert some chemicals and drugs into cancer causing agents in some individuals.   The rates of these conversions are classified as slow or fast acetylators.  Recently published breast cancer research has explored this relationship between smoking, NAT2, and breast cancer risk.

In this new study, investigators conducted a population-based study that included nearly 350 women diagnosed with breast cancer and 775 control women without breast cancer.  Study volunteers answered questionnaires about smoking habits and other breast cancer risk factors and an analysis was done to determine their NAT2 status.  The results of this study showed that:

• Never-active smokers exposed to second-hand smoke over a long period of time had about an 86% increased risk for breast cancer.
• This increased breast cancer risk to second-hand smoke was greater in slow acetylators, but not increased for fast acetylators.
• Active smokers showed about a 34% increase in breast cancer risk.
• Among active smokers, breast cancer risk was further increased among study volunteers classified as NAT2 fast acetylators (~93% risk for breast cancer), but not among NAT2 slow acetylators.
• Women who were both fast acetylators and had been active smokers for the longest period of time were at more than a 200% risk for breast cancer.

These are interesting and important results that help to more clearly understand the potential impact of smoking, both active and passive, on breast cancer risk.  Overall, these results suggest that not only does both active and passing smoking increase breast cancer risk, but that individual differences in the NAT2 metabolic enzyme modifies each person's breast cancer risk.  The link between breast cancer risk and tobacco use is controversial.  Some studies suggest an increased breast cancer risk with smoking, while other studies report no link between smoking and breast cancer risk.  While this new study does not completely clear up this controversy, it does provide evidence that the possible link between smoking and breast cancer risk might be dependent upon individual genetic factors.  Considering the other known adverse health effects of smoking and the possible link to breast cancer, reducing tobacco smoke exposure might be one lifestyle change that can help us all lead a healthier lifestyle.

To learn more about other diet and lifestyle changes that you can make to reduce your risk of breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com. 

Genetic Screening Might Predict Response to Chemotherapy

The concept of personalized medicine continues to grow in the health profession.  This can range from personalized nutrition to personalized cancer treatments.  However, personalized medicine requires knowledge of an individual's specific characteristics, particularly in relation to a specific health condition.

New research published yesterday in The Lancet: Oncology reports that a new genetic screening test might predict which breast cancer patients will benefit the most from chemotherapy with paclitaxel.  In this study, researchers used a technique called RNA interference where genes are silenced one at a time in order to determine the response of breast cancer cells to chemotherapy with that particular gene not working correctly.  By using this molecular technique, the breast cancer researchers were able to identify 6 genes that, when not working properly, prevented paclitaxel-based chemotherapy from being effective.  Therefore, when these 6 genes did not work correctly, treatment with paclitaxel was not as effective for treating breast cancer. 

This new research is another step forward in the personalization of breast cancer treatment.  While chemotherapy is an important part of breast cancer therapy, many individuals do not respond to specific chemotherapy drugs.  However, it is currently difficult to determine which breast cancer patients will not respond before treatment is begun.  This can lead to some breast cancer patients receiving ineffective treatments, potentially leading to poorer outcomes.  Designing genetic tests that can determine if a breast cancer patient will respond to a particular chemotherapy drug is an important step in improving breast cancer treatments and breast cancer outcomes.

In addition to advances in breast cancer therapy, health professionals continue to discover lifestyle factors that increase breast cancer risk.  By avoiding or minimizing these factors in our lives, we can reduce our breast cancer risk.  To learn more about the type of things you can do to reduce your personal risk of breast cancer, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com.

Metabolic Syndrome and Breast Cancer

The metabolic syndrome is characterized by a constellation of metabolic risk factors including, but not limited to insulin resistance, abdominal obesity, elevated blood pressure, a poor cholesterol profile, and increased inflammatory markers.  Many of the factors that characterize the metabolic syndrome have also been associated with breast cancer risk; however, the impact of the metabolic syndrome on breast cancer appears to be poorly understood.

Newly published breast cancer research has examined the potential impact of the metabolic syndrome on breast cancer in postmenopausal women.  For this new study, the investigators recruited 105 postmenopausal women with newly diagnosed breast cancer and took a detailed clinical history that included a metabolic screening and body composition analysis.  51% of postmenopausal women with a more advanced breast cancer (Stage 2-4) were diagnosed with the metabolic syndrome compared to only 12% of women with early stage breast cancer.  Patients whose breast cancer had spread to include their lymph nodes were also more likely to have the metabolic syndrome.

This study adds to the growing amount of evidence pointing to the dangers of obesity, especially abdominal obesity, in regards to breast cancer risk.  The results of this research showed that the metabolic syndrome and obesity were common in postmenopausal breast cancer patients and appeared to be linked to more advanced breast cancer.  Leading a healthy lifestyle through proper nutrition and physical activity is a critical part of maintaining a healthy body weight and long-term health.  Additionally, many foods have been reported to help reduce breast cancer risk, so including such foods as part of a healthy, balanced diet is a good way to support a healthy lifestyle.

You can read my book Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com) to learn more about the importance of diet and nutrition in the fight against breast cancer.