Download Breast Cancer Prevention

Breast Cancer Prevention
Dr. Jake Psenka, ND
Naturopathic Family Care
13832 N. 32nd Street #126
Phoenix, Arizona 85032
www.4wecare.com
602-493-2273
What Are Risk Factors
Risk factors are lifestyle or personal
traits that increase the risk of
developing cancer.
Decreasing the risk factors decreases
the chance of disease.
Established Risk Factors
Family History: especially in your mother,
sister, or daughter(s).
Age: the older you are the higher your risk.
Never having borne a child.
Having your first child after 30 years old.
Early onset of menarche
A history of benign breast diseases
Other Risk Factors
Hormone replacement after
menopause.
Chemical Exposure
Poor dietary choices
Lack of exercise
Heavy metal exposure
Possible Risk Factors
Decreased melatonin
Pesticide exposure
Brest Cancer Family History
Researchers estimate that only 5-27%
of breast cancer cases are a result of
genetics.
In the majority of those cases the genes
involved are:
BRCA1
BRCA2
BRCA1 and BRCA2
BRCA stands for BReast CAncer.
These are the two most common
genetic mutations associated with
breast cancer.
Women inheriting these mutations have
a 40-85% lifetime risk of developing
breast cancer, as well as an
increased risk of ovarian cancer.
BRCA1 and BRCA2
Researchers at the National Institutes
of Health recently completed a study
that offers a more complete
understanding of these mutations in
the US population.
This study looked at 2300 multi-ethnic
women ages 35-64, some with breast
cancer and some without.
BRCA1 and BRCA2
The study found the following:
BRCA1 mutations were more common in white women with
breast cancer than African-American women.
Women with Jewish ancestry had a substantially higher
incidence of the BRCA1 mutation compared to non-Jewish
women.
African-American women are more likely to carry the BRCA2
mutation.
Not every woman who carries one of the genes will get
cancer.
BRCA1 and BRCA2
The real significance of the study was it’s
ability to identify key predictors of whether
a woman with breast cancer will carry the
BRCA1 or BRCA2 mutations.
This information is important because it
can predict those women who will benefit
from genetic testing, increased breast
cancer screening, and other measures
aimed at early detection, treatment, and
prevention.
BRCA1 and BRCA2
The most predictive factors for the
BRCA1 mutation are:
Jewish ancestry
Family history of ovarian cancer
Family history of breast cancer before
the age of 45
BRCA1 and BRCA2
The only predictive factor for the
BRCA2 mutation is early onset in the
patient (before age 45) in the patient
herself or early onset of breast cancer
in mother, sisters, grandmothers, or
aunts.
Genetic Testing
Genetic testing can be performed by
submitting a small blood sample to a
laboratory for analysis.
Remember, testing positive for the
BRCA1 or BRCA2 genes does not
automatically mean a cancer
diagnosis. Just having the gene
doesn’t mean that it will be
expressed.
Age
Risk increases with age. Age is the
biggest risk factor. In other words, all
women have some risk. Hence the need to
promote awareness and take steps for
prevention.
About 18% of breast cancer diagnoses are
among women in their 40s, while about
77% of women with breast cancer are older
than 50 when they are diagnosed.
Children
Women who have had no children or
who had their first child after age 30
have a slightly higher breast cancer
risk. Having multiple pregnancies and
becoming pregnant at an early age
reduces breast cancer risk. Women
who have breast fed their children
also have a decreased risk.
Early Menarche
Women who started menstruating at
an early age (before age 12) or who
went through menopause at a late
age (after age 55) have a slightly
higher risk of breast cancer.
Benign Breast Diseases
Having a history of non-cancerous
breast disease increases breast
cancer risk.
Examples include:
Lobular carcinoma in situ.
Fibrocystic changes
Inflamed breast tissue
Post Menopausal Hormone
Replacement Therapy
A study in the July 2006 issue of the
Archives of Internal Medicine
concluded:
“Women using estrogen and testosterone
therapies have a significantly increased
risk of invasive breast cancer.”
Post Menopausal Hormone
Replacement Therapy
Another study reported in the cancer edition of
BioMed Central stated:
“The relatively feasible lifestyle changes of
discontinuing EPRT use, reducing alcohol
consumption, increasing physical activity, and
lengthening breastfeeding duration could
lower population breast cancer incidence
substantially.”
EPRT = Estrogen/progestin ReplacementTherapy
Post Menopausal Hormone
Replacement Therapy
The International Journal of Cancer
reported in August of 2006 that:
“Higher serum concentrations of
estrogens were associated with
increased breast cancer risk in
postmenopausal women.”
Effect of HRT
Increased breast cancer risk associated with
testosterone may be because enzymes in
breast tissue convert testosterone to
estradiol, an estrogen-like hormone that
could contribute to the development of
breast cancer. Higher levels of
testosterone alone have also been linked
to increased breast-cancer risk in
postmenopausal women.
Checking Your Estrogen Levels
There are a variety of ways to have
your hormonal status evaluated. The
most accurate measures are done via
blood, urine, or saliva samples. Not
all women will have similar circulating
levels of estrogens, even if they are
the same age, race, etc. This
concept is called “Biochemical
Individuality.”
Checking Your Estrogen Levels
Researchers at Rockefeller University have found
that the body metabolizes estrogens into several
different metabolites that can impact cancer
development. One metabolite, 2-hydroxyestrone
(2-OHE1), tends to inhibit cancer growth. Another,
16-a-hydroxyestrone (16-a-OHE1), actually
encourages tumor development. A woman’s
"biochemical individuality" determines which of
these metabolites predominates. Studies have
shown that measuring the ratio of these two
metabolites provides an important indication of risk
for future development of estrogen-sensitive
cancers. The studies also show that this risk is
modifiable!
Identifying Hormone Status
If you are over 40, and especially if you
have a family history of breast cancer,
it’s a good idea to have your
estrogen levels checked. Most
laboratories offer blood testing for
estrogen, progesterone, and
testosterone. Although some are
better than others.
Chemical Exposure and Breast
Cancer Risk
Animal cancer bioassays conducted by the
National Toxicology Program indicate more
than 40 chemicals can induce mammary
tumors, and most of these are still in
production.
How much exposure is too much?
Nobody Knows.
What are all the chemicals that can have a
negative effect?
Nobody Knows.
Chemicals that Cause Cancer
Xenoestrogens- These are synthetic
agents that mimic the action of
estrogens. Chronic exposure to
xenoestrogens may be partially
responsible for the world-wide
increase in breast cancer.
Xenoestrogens are found in
pesticides, fuels, plastics, detergents,
and prescription drugs.
Xenoestrogens
Bisphenol-A (BPA): one of the most pervasive
chemicals in modern life. Used to make
polycarbonate plastic.
Diethylstilbestrol (DES): Drug prescribed to
prevent miscarriges. Banned in 1971after causing
breast cancer in daughters.
Polyvinyl Chloride (PVC): Used in plastic products
such as food packaging, medical products,
appliances, cars, toys, credit cards, and rainwear.
Dieldrin: Pesticide, banned in 1987.
House Hold Products: Cleaners, solvents, and
pesticides.
Solvents
Solvents are a class of chemicals that are used to dissolve
other substances.
Elevated rates of breast cancer have been found in women with
exposure to:
Electronics Manufacturing
Fabricated Metals
Lumber
Furniture
Textiles
Clothing Industry
Aromatic Amines
Are a class of chemicals found in the
plastic and chemical industries, in air
and water pollution, diesel exhaust,
tobacco smoke, and in grilled meats
and fish.
One type, o-toluidine, is known to cause
mammary tumors in animal studies.
Know the Facts
State of the Evidence Report
http://www.bcaction.org/PDF/StateofEvidence.pdf
Diet and Breast Cancer
It’s been estimated that diet contributes
to up to 80% of cancers of the colon,
prostate, and breast. Diet also
negatively affects the risk factors of
other cancers such as pancreatic,
lung, stomach, and esophagus.
Saturated Fat Intake
Elevated saturated fat intake is associated with
higher breast cancer risk.
Diet during puberty influences sex hormone levels, possibly breast
cancer risk.
Journal of the National Cancer Institute. January 2003.
The study found that girls who had a modest reduction in fat intake had significant lower rates of sex
hormones including estradiol, estrone, and testosterone.
The European Prospective Investigation into Cancer and Nutrition
(EPIC)
Public Health and Nutrition. February 2006
This study found that a daily intake of 35 grams of saturated fat doubles the risk of breast cancer
compared to women with a daily intake of 10 grams or less. This study had over 500,000
participants.
Not all fats are bad
International Journal of Cancer
March 2002
Data based on fatty acids levels in breast adipose
tissue suggest a protective effect of n-3 fatty acids
on breast cancer risk and support the hypothesis
that the balance between n-3 and n-6 fatty acids
plays a role in breast cancer.
The best ratio is 3:1 omega-6 to omega-3 fatty acids.
The typical western diet is about 15:1.
Sources of Omega 3 and 6 Fatty Acids
Omega-3:
Flax Seed, Walnuts, Chinook Salmon,
Scallops, Cauliflower, Cabbage,
Sesame seeds.
Omega-6:
Safflower oil, sunflower oil, hemp oil,
wheat germ oil, evening primrose oil.
Other Dietary Risk Factors
Alcohol:
2-5 drinks per day increase risk 1.5 times over that of women who
don’t drink.
Excessive Red Meat Intake:
Increased inflammation, source of carcinogenic substances ie.
heterocyclic amines.
Excess Sugar/Calories:
Sugar intake is a strong risk factor that contributes to higher breast
cancer rates, particularly in older women. Sugar containing foods
cause and increase in insulin and insulin-like growth factor- which
can promote cancer growth. Annals of Oncology, February, 2006.
Exercise
The positive effects of exercise cannot be
overstated. Regular physical activity can
impact the body in a variety of ways, and
there are several hypothesized biological
mechanisms for the physical activity-cancer association. These mechanisms
include changes in hormone levels,
reduced percentage of body fat,
enhancement of the immune system,
and alteration in free radical damage by
scavenger systems.
Quick Review- What Do We Know?
1.
2.
3.
4.
We know that women who have elevated hormone levels
can have a 2-3-fold increased risk of cancer. Exercise
can decrease hormone levels.
We know that elevated saturated fat intake, and an
increased body fat content can double breast cancer risk.
Exercise can decrease body fat.
We know that a decreased immune system is a risk factor
for cancer, we also know that it is a big problem for people
undergoing cancer therapy. Exercise stimulates the
immune system.
We know that chronic exposure to free radicals can
increase cancer risk. Exercise can help to neutralize
free radicals.
Journal of the National Cancer
Institute, Sept. 1994
“Our results suggest that
implementation of regular physical
exercise programs as a critical
component of a healthy lifestyle
should be a high priority for
adolescent and adult women.”
How Much Exercise?
The available data indicate that 30-60
minutes per day of moderate-tovigorous physical activity is needed to
be protective against breast cancers.
Heavy Metal Exposure
The documented effects of heavy metals:
Depletion of immune system activity.
Disruption of the haematopoiteic system.
Accumulation in breast cancer tissue.
Increased breast cancer risk.
Increased cardiovascular risk.
What are heavy metals?
Metallic chemicals like cadmium, arsenic, copper,
mercury and zinc that can be harmful pollutants
when they enter soil and water. These chemicals
are put into animal feed to help make animals
grow faster. Heavy metals are present in human
and animal waste and can enter the environment if
waste is released without being treated. Animal
waste is never treated to remove heavy metals.
Once in the environment, heavy metals are almost
impossible to get rid of because they do not
decompose.
Sources of Heavy Metal Exposure
Water
Food (animals and plants)
Make-up and Cosmetics
Air pollution
Smoking
Assessing Heavy Metal Loads
The best way to determine your heavy
metal exposure is through a timed
urinary collection. To correctly
assess exposure over long periods of
time it is necessary to use a
provoking agent such as EDTA,
DMPS, or DMSA. These chemicals
are called “chelators,” and they
“claw” onto heavy metals and
promote their excretion.
Removing Heavy Metals
Chelation: Using chelators either IV, orally,
or as suppositories.
Sweating: Saunas can be used- the skin is
the largest eliminative organ in the body
Detoxification: Targeted supplementation,
diet, exercise, IR heart.
Melatonin
Melatonin is a natural hormone that is
found in nearly all living creatures.
Melatonin is the hormone that
regulates our sleep cycle.
Additionally, melatonin levels can
stimulate the immune system, and act
as an antioxidant.
The Melatonin Hypothesis
Melatonin synthesis can be modulated by
sleep cycle and exposure to artificial
lighting. The hypothesis is that with
decreased melatonin in our bodies we may
be increasing our cancer risk through
increased stress, decreasing the
effectiveness of the immune system, and
increased anti-oxidant burden. Increased
melatonin levels have even been shown to
decrease breast cancer growth.
Pesticide Exposure
Pesticide exposure is recognized as an
important environmental risk factor
associated with cancer development.
Maternal exposure to pesticides can
have harmful effect on the fetus.
It is important to take steps to decrease
exposure and bodily burden.
Minimizing Pesticides
The best way to avoid pesticides is to
eat organic foods. It’s important to
wash your produce thoroughly- the
best way is to fill up your sink with
water and then add 1 cup hydrogen
peroxide. Add your produce and
allow to soak for 15 minutes. Rinse
and eat. This will help to eliminate
waxes, pesticides, and any microorganisms may be on your foods.
Removing Pesticides/Residues
A good detoxification program that
targets fat tissues, as well as
stimulation of the detoxification
processes liver can help to move
these chemicals out of the body.
Stopping Breast Cancer
Remember that roughly 85% of breast cancer
cases are due to environmental and dietary
causes. Making some simple lifestyle
changes can have a profound impact on
the prevalence of breast cancer.