To Cancer : Complementary and Integrative Therapies of Cancer.

Archive for September, 2011

Doctors cannot always explain why one woman develops ovarian cancer and another does not. However, we do know that women with certain risk factors may be more likely than others to develop ovarian cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for ovarian cancer:

• Family history of cancer: Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer.

  If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.

• Personal history of cancer: Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.

• Age over 55: Most women are over age 55 when diagnosed with ovarian cancer.

• Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.

• Menopausal hormone therapy: Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.

Scientists have also studied whether taking certain fertility drugs, using talcum powder, or being obese are risk factors. It is not clear whether these are risk factors, but if they are, they are not strong risk factors.

Having a risk factor does not mean that a woman will get ovarian cancer. Most women who have risk factors do not get ovarian cancer. On the other hand, women who do get the disease often have no known risk factors, except for growing older. Women who think they may be at risk of ovarian cancer should talk with their doctor.

• Most ovarian growths in women under age 30 are benign, fluid-filled cysts.

• There are several types of ovarian cancer.

• The exact causes of ovarian cancer are unknown.

• Risk factors that increase the chance of developing ovarian cancer include a family history of cancer, being over 55 years of age, and never being pregnant.

• The ovarian cancer symptoms and signs can be vague but may include abdominal swelling, pressure, or pain, frequent urination or urinary urgency, back pain, leg pain, unusual veginal bleeding , and feeling full quickly.

• There are no routine screening tests for ovarian cancer.

• A physical examination , ultrasound, X-rays, the CA 125 blood test, and biopsy of the ovary may be needed to detect and diagnose ovarian cancer and determine staging.

• The treatment, prognosis, and survival rate for ovarian cancer depend on the stage of the disease and the age and health of the woman.

The ovaries

The ovaries are part of a woman’s reproductive system. They are in the pelvis. Each ovary is about the size of an almond.

The ovaries make the female hormones — estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).

When a woman goes through her “change of life” , her ovaries stop releasing eggs and make far lower levels of hormones.

Understanding ovarian cancer

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.

Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.

Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant:

Benign tumors are not cancer:

• Benign tumors are rarely life-threatening.

• Generally, benign tumors can be removed. They usually do not grow back.

• Benign tumors do not invade the tissues around them.

• Cells from benign tumors do not spread to other parts of the body.

Overview

Breast cancer recurrence is the return of cancer after treatment of breast cancer.
According to American Cancer Society, roughly one in five women diagnosed with breast cancer will have breast cancer recurrence.

Location

Breast cancer recurrence can occur near the location of the first breast cancer. This is referred to as local recurrence. Breast cancer recurrence can also occur in the lymph nodes (also known as regional recurrence) or in another organ (also known as distant recurrence).

Time Frame

According to the American Cancer Society, one in nine women diagnosed with breast cancer will develop recurrent breast cancer within five years of initial treatment. This number increases to one in five women at 10 years after the initial treatment.

Alcohol Use

Alcohol use was found to increase risk of breast cancer recurrence (www.nature.com). The increased risk of cancer recurrence was highest in women who drink two or more glasses of wine per day.

Prevention/Solution

Chemoprevention is effective against breast cancer recurrence. Chemopreventive agents such as tamoxifen have been shown to reduce the risk of breast cancer recurrence by half. However, chemopreventive agents might increase the risk of some diseases, including strokes and cataracts.
Genetic testing assays such as OncotypeDX and MammaPrint can be used to identify who would benefit most from chemoprevention of breast cancer recurrence.

Breast cancer is a devastating and potentially life-threatening disease, which caused over 40,500 deaths and accounted for more than 194,000 new diagnoses in the United States in 2009, reports the National Cancer Society. Breast cancer is commonly treated with therapies to remove the tumor and kill any remaining cancer cells. In some cases, breast cancer can re-develop after treatment, either at the site of the initial tumor or at distant sites throughout the body. Breast cancer recurrence can be accompanied by the development of a number of symptoms.

New Lump Growth

A sign of breast cancer recurrence includes the growth of a new lump around the surgical site. Breast cancer surgeries aim to remove affected breast tissue, but if cancer cells remain after surgery, they can develop into a tumor in any remaining breast tissue. This is called local recurrence, and proves relatively rare, according to Imaginis. Local recurrence can be detected in physical examination as a lump around the surgical site. Lumps may also form within the muscles of the chest or the lymph nodes, called regional recurrence. Imaginis reports that regional recurrence may cause a lump in the armpit, or lump in lymph nodes on the neck or near the collarbone. Physicians need to monitor patients who have undergone breast cancer surgeries to remove breast tumors to detect any breast cancer recurrence to allow for early treatment of the new tumors.

Weight Loss and Loss of Appetite

Some cases of breast cancer recurrence involve the development of new tumors in distant organs throughout the body, called distant recurrence. Distant recurrence may occur if the cancer spread before breast cancer surgery, so cells that had migrated to other organs could not become removed with treatment. It may also occur due to failure of chemotherapy or other drug therapy treatments.

One site of possible breast cancer recurrence includes the liver, an organ that detoxifies the body and releases bile that aids in digestion. BreastCancer.org reports that if distant recurrence occurs in the liver, the patient will experience a loss of appetite and unexplained weight loss. Patients experiencing these symptoms must seek medical attention to check for breast cancer in the liver. If left untreated, the breast cancer recurrence can cause more severe symptoms associated with liver failure, which can become fatal.

Headaches

Another possible symptom of breast cancer recurrence is a headache, which can develop if distant recurrence occurs in the brain. Breast cancer metastasis to the brain increases brain mass and intracranial pressure, which can cause headaches. Headaches as a result of distant breast cancer recurrence will often differ from the patient’s usual history of headaches–they may become more severe, last longer and occur more frequently. Headaches due to breast cancer recurrence in the brain may be accompanied by visual disturbances or muscle weakness, according to BreastCancer.org. Breast cancer patients experiencing unusual headaches or other neurological symptoms should seek immediate medical attention to detect possible breast cancer recurrence in the brain.

Overview

Physical activity is therapeutic for a wide range of health conditions, including breast cancer — and not merely because exercise improves the way people look and feel. Breast cancer patients who follow regular programs of even moderate exercise may dramatically decrease the chances of disease recurrence by boosting the efficiency with which their bodies metabolize insulin.

Insulin and Insulin Resistance

Insulin, a hormone made by the pancreas, controls the level of glucose in the blood. Without it, the cells are unable to convert this sugar into energy. Insulin resistance, also known as metabolic syndrome, refers to a group of factors that affect the body’s ability to use insulin effectively and increase the risk of heart disease, stroke and type 2 diabetes. When cells don’t get enough glucose, the pancreas over-produces insulin and as levels of glucose and insulin rise — so do levels of blood fats, affecting kidney function. Being overweight is a major risk factor for insulin resistance, especially when extra weight is concentrated around the midsection.

Findings of Studies

A Harvard Medical School study published in the May 25, 2005, “Journal of the American Medical Association” found breast cancer survivors who walked for three to five hours a week, or exercised more strenuously for shorter periods of time, had a 50 percent lower risk of disease recurrence, regardless of the size of the cancer at time of diagnosis. A Yale School of Medicine study published in the December 2010 “Journal of Clinical Oncology” followed the progress of 527 breast cancer patients for five years, finding an association between improved insulin sensitivity as a result of exercise and increased life expectancy.

Exercise and Risk Reduction

Obesity is a known risk factor for insulin resistance and research suggests that insulin resistance may be a risk factor for disease recurrence in breast cancer patients. Therefore, by helping to reduce body weight and direct fat distribution away from danger areas, the midsection and hips, exercise helps the cells metabolize insulin more efficiently. Jennifer Ligibel of the Dana-Farber Cancer Institute in Boston, one author of a 2007 study on the effects of a 16-week program of cardiovascular exercise and strength training on breast cancer prognosis, says, “Exercise has benefits all through treatment and afterward. It’s an investment in a woman’s health and hopefully will prove to lower her risk of dying from breast cancer.”

Exercise Recommendations for Breast Cancer Patients

Yale School of Medicine endorses exercise for all breast cancer patients but advises women to consult their doctors before starting, especially if they are still undergoing active treatment. Women with no underlying health problems can usually follow any exercise program of their choice after treatment is finished. Start gradually by exercising five to 10 minutes a day and work up to 30 minutes. Walking, cycling, swimming and strength training are all beneficial, as are fitness clubs, many of which now have special programs for cancer survivors. Staying motivated is essential and according to Yale, some studies have found women who walk in their own neighborhoods stick with their exercise routines longest because no travel is required.

Overview

Exercese is a critical part of recovery and ongoing health maintenance for breast cancer survivors. It improves your physical fitness and general well-being, and helps fight fatigue. An exercise regime also helps you get back into the rhythm of daily living after surgery and treatment, providing structure and healthy goals. Essential Exercises depend on your physical capabilities, and your exercise choices expand as you gain strength and endurance.

Weight Benefits

Exercising to obtain and maintain a healthy weight is beneficial for breast cancer survivors. A study published in the August 2010 issue of the journal Breast Cancer Research and Treatment identified that obesity, post-diagnosis weight gain or excessive weight loss can lead to early mortality for survivors. The study also noted that additional research is needed to develop effective weight control strategies for breast cancer patients, because some treatment options cause weight gain.

Survival Benefits

Research demonstrates that exercise might increase survival rates for breast cancer survivors. A study published in the May 2005 Journal of the American Medical Association found that women who walked at a moderate pace for three to five hours each week might reduce their risk of death from breast cancer. The study demonstrated that the more exercise performed, the greater the chances of survival for longer periods of time for women included in this study.

Osteoporosis Protection

Weight-bearing exercise plays an important role in helping breast cancer survivors combat osteoporosis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases says that survivors have an increased risk of developing osteoporosis, a condition that increases the possibility of bone fractures and breaks. This occurs due to chemotherapy, when a woman’s ovaries stop or slow the production of estrogen, a hormone that protects the bones. Engaging in weight-bearing exercises such as walking, jogging or dancing forces bone tissue to become stronger and counters the effects of low estrogen levels.

Post Surgery

Breast cancer patients may undergo several surgeries. Exercise is essential to relieve the soreness and pain from surgery and regain your shoulder’s full range of movement. The American Cancer Society advises waiting until the third day post-surgery to begin exercising, and recommends performing gentle, upper-body stretching exercises through the first week after surgery. With your doctor’s advice, add light aerobic exercise such as walking and perform light weight lifting to reduce swelling and retain muscle tone.

Ongoing

The website American Fitness Professionals and Associates recommends exercises for women at various stages of recovery and survivors. For example, it advises that women who have TRAM flap reconstruction avoid sit-ups and high-intensity exercise during treatment. Tailor your exercise program to your physical state, beginning with light aerobic exercise for short periods, and slowly adding weight-training and intense cardiovascular exercises as your strength increases.

Warning

Talk with your doctor before beginning or significantly changing your exercise program, particularly as you recover from surgery or undergo chemotherapy or radiation. Your doctor may tell you to wait to begin upper body exercises until your sutures, drains and port-a-caths are removed. Additionally, your immune system may be compromised by chemotherapy and radiation, and your doctor might advise you to stay out of public gyms until your immune system recovers.

Overview

Breast cancer affects as many as one out of eight American women in their lifetime, according to Breastcancer.org. In 2010, approximately 2.5 million women in the United States were breast cancer survivors. Fish oil supplements contain omega-3 fatty acids, which may have several health benefits for breast cancer survivors, although more studies are needed. Omega-3 fatty acids reduce inflammation and have antioxidant properties. Always ask your doctor before adding dietary supplements to your health regimen.

Reducing the Risk of Recurrence

A report published by researchers from the University of California, San Diego in the February 2011 issue of “The Journal of Nutrition” studied the effects of omega-3 fatty acids found in fish oil on breast cancer recurrence in survivors treated for early breast cancer. The study, which lasted on average for 7.3 years of follow up, used self-reported dietary recall to assess omega-3 fatty acid intake. women with the highest intake of omega-3 fatty acids DHA and EPA reduced their risk of recurrence by 25 percent. Researchers concluded that increased dietary intake of omega-3 fatty acids could reduce breast cancer recurrence in some cases.

Potentiating Medication Effects

Researchers at Fox Chase Cancer Center presented a paper at the April 2011 annual meeting of the American Association for Cancer Research on the benefits of fish oil as a possible adjunct to medical treatment for breast cancer. The animal study conducted using rats found that the combination of fish oil and tamoxifen, a drug commonly used to treat breast cancer, reduce tumor growth and and increased tumor responsiveness to tamoxifen more than tamoxifen alone or corn oil and tamoxifen. The news was not all good, however; in addition to boosting immune defenses against tumor cells, omega-3 fatty acids also increased expression of genes that trigger inflammation and allergic reactions, which could decrease cell’s cancer-fighting abilities. Do not take fish oil with tamoxifen without your doctor’s approval, since human studies have not yet shown a benefit.

Reducing Muscle Loss

Breast cancer survivors often lose muscle mass, which can increase the chances of weight gain that leads to obesity and possible cardiovascular disease or diabetes. A University of Queensland study presented at the 2011 Universitas 21 Graduate Research Conference on Food in Malaysia found that fish oil reduced chronic inflammation, which may contribute to muscle breakdown in breast cancer survivors. Clinical trials are still needed to prove the benefit and the effective dosages.

Considerations

As of 2011, only a few studies have shown potential benefit in adding fish oil to your post-breast cancer dietary regimen. Some studies done on animals may not prove to have the same benefits in humans in clinical trials. Talk with your doctor about the pros and cons of any dietary supplements, including omega-3 fatty acids, if you’re recovering from breast cancer.

Overview

According to BreastCancer.org, one in eight women will develop breast cancer in her lifetime. Breast cancer can affect women of all ages, and even men. Those who have recovered from breast cancer or are currently in remission may be taking medications or undergoing continual screenings to watch for recurrence. Another way for breast cancer survivors to reduce their risk of recurrence is to change their diet and eating habits.

Fruits and Vegetables

The more fruits and vegetables, the better, when it comes to fighting breast cancer recurrence. Fruits and vegetables contain phytochemicals, which keep the immune system strong and can even fight off cancer cells, according to Johns Hopkins Medicine. Eating at least five servings of fruits and vegetables every day will help people with breast cancer recover and will help breast cancer survivors stay healthy.

Proteins

Protein is an important macronutrient that helps to prevent muscle wasting and helps you feel full. Meat is the most common protein-rich food that people think of, but breast cancer survivors may want to change the types of proteins that they consume most frequently. The Physician’s Committee for Responsible Medicine, or PCRM, explains that in countries where very little animal protein is consumed, such as in Japan, the breast cancer rates are very low. Fat from animal products like beef and pork may increase a woman’s breast cancer risk and recurrence rate, so PCRM recommends reducing red meat intake and eating more tofu and beans instead. Fish, shellfish and white meat like chicken are also better options for breast cancer survivors.

Supplements

Those recovering or who have recovered from breast cancer should ask their doctors about the possibility of taking supplements. Some supplements may be beneficial for cancer survivors. Science Daily explains that taking fish oil can increase the effectiveness of the medication tamoxifen, which is often give to breast cancer patients and survivors.

Healthy Weight

Maintaining a healthy weight through eating the right foods in the right portions is essential for breast cancer recovery. Johns Hopkins Medicine says that obese women have higher amounts of estrogen than women who are of a healthy weight. Since breast cancer is often hormone-related, keeping fit can boost recovery efforts. A Registered Dietitian or doctor can help to determine your ideal weight for height and can also suggest how many calories you should be eating each day to lose weight or maintain your weight. Moderate-intensity exercise for a half hour or more on most days of the week is also important.

Cancer is a disease process in which cells grow beyond normal limits and at a faster rate. Cancer cells grow and invade surrounding tissues, lymph nodes and organs, depending on location. Through this process, cancer uses the body’s metabolism and nutrients. This disease compromises the immune system, causes weight loss and fatigue in most cases. Adhering to a balanced diet is very important if you have cancer. A nutritionist should be consulted if diagnosed with cancer.

Increased Calories and Nutrients

Good nutrition is imperative for cancer patients. Cancer causes nutritional deficiencies because it is exhausting the vitamin and mineral supply. The USDA food pyramid is a simple nutritional guideline to start following every day. Because cancer starves the body of calories and nutrients, it is advised by the National Institutes of Health to increase caloric intake. Cancer patients need to follow the food pyramid and increase serving sizes to receive more calories and nutrients.

Low-Fat Diet

A low-fat diet may help cancer patients who have developed a strong opposition to fatty foods. Also, in cases of breast cancer, a low-fat diet may decrease the risk of recurrence. A low-fat diet requires you to reduce saturated and trans fats in your diet. This includes butter, margarine and shortening. In addition, all fat needs to be trimmed from meat and you must choose lean meat with less than 10 percent fat. If you need to use oil, choose monounsaturated fats such as olive oil or canola oil. When purchasing dairy, pick skim milk and low-fat yogurt and cheeses over the full-fat varieties.

Protein-Rich Foods

Muscle-wasting can occur with cancer. This is because cancer has increased metabolic needs. Cancer will burn the energy from fat and muscle, resulting in a thinner appearance and muscle atrophy. For these reasons, protein intake is needed every day because it rebuilds muscle and tissue. Protein can be achieved from a variety of foods such as yogurt, lean meats and cottage cheese. A good way to increase calories and protein, is to include a protein shake in your diet every day. Protein shakes can be purchased from specialty vitamin stores.

One source for sound nutrition advice on cancer prevention and diet is the American Dietetic Association (ADA). As a reference for meal planning, the ADA recommends the Food Guide Pyramid and the Dietary Guidelines for Americans. Both of these support the “total diet approach” to eating. This means long-term eating habits are more important than what you eat at a single meal. In their words, “there are no good or bad foods, only good or bad diets or eating styles.”

The food guide pyramid is a guideline to help you eat a healthy diet. The food guide pyramid can help you eat a variety of foods while encouraging the right amount of calories and fat. The United States Department of Agriculture (USDA) and the US Department of Health and Human Services have prepared the following food pyramid to guide you in selecting foods.
The Food Pyramid is divided into 6 colored bands representing the 5 food groups plus oils:

• Orange represents grains: Make half the grains consumed each day whole grains. Whole-grain foods include oatmeal, whole-wheat flour, whole cornmeal, brown rice, and whole-wheat bread. Check the food label on processed foods – the words “whole” or “whole grain” should be listed before the specific grain in the product.
• Green represents vegetables: Vary your vegetables. Choose a variety of vegetables, including dark green- and orange-colored kinds, legumes (peas and beans), starchy vegetables, and other vegetables.
• Red represents fruits: Focus on fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.
• Yellow represents oils: Know the limits on fats, sugars, and salt (sodium). Make most of your fat sources from fish, nuts, and vegetable oils. Limit solid fats like butter, stick margarine, shortening, and lard, as well as foods that contain these.
• Blue represents milk: Get your calcium-rich foods. Milk and milk products contain calcium and vitamin D, both important ingredients in building and maintaining bone tissue. Use low-fat or fat-free milk after the age of two years. However, during the first year of life, infants should be fed breast milk or iron-fortified formula. Whole cow’s milk may be introduced after an infant’s first birthday, but lower-fat or skim milk should not be used until the child is at least two years old.
• Purple represents meat and beans: Go lean on protein. Choose low fat or lean meats and poultry. Vary your protein routine – choose more fish, nuts, seeds, peas, and beans.

Activity is also represented on the pyramid by the steps and the person climbing them, as a reminder of the importance of daily physical activity.

To find more information about the Dietary Guidelines for Americans 2005 (the most recent guidelines) and to determine the appropriate dietary recommendations for your age, sex, and physical activity level, visit the Online Resources page for the links to the Food Pyramid and 2005 Dietary Guidelines sites. Please note that the Food Pyramid is designed for persons over the age of two who do not have chronic health conditions.