Why are more women having mastectomies?


 

In May, Angelina Jolie announced that she was having a double mastectomy even though she was healthy. Since then, according to one British clinic, the number of women requesting a similar operation has risen fourfold. Are women too readily taking on the risk of breast removal?

When Angelina Jolie announced earlier this year that she had undergone a double mastectomy to avoid the risk of breast cancer, she was not alone. The pop singer Michelle Heaton had a similar operation last year – the details of which she shared with viewers of the Lorraine show. And Sharon Osbourne has done it recently, too. When she found out she had a genetic mutation which increased her risk of cancer, she said: “I decided to just take everything off. I didn’t want to live under that cloud.”

It’s a trend, if that’s the right word, that has been rumbling for a while, but it was Jolie’s disclosure which sent shockwaves through the world of cancer care. After her announcement in May, doctors reported that the number of women requesting mastectomies rose steeply.

“The number of women requesting breast-removal surgery rose fourfold [after Jolie’s statement] and the number requesting genetic tests to detect susceptibility was up 67 per cent,” says Professor Kefah Mokbel, of the London Breast Institute at Princess Grace Hospital. “It concerns me that some women will be over-treated.”

Currently about 18,000 mastectomies are performed on the NHS each year in England. That figure has risen by more than 50 percent in the past 10 years. While there is no official figure to show how many of these are preventative operations given to women without cancer, as was the case with Jolie, it is also thought to show a marked increase. Mokbel believes there are two reasons for this: “Fear and desperation.”

“The word cancer strikes such a level of fear that people want to do everything possible to stop it recurring – even if that means more invasive, unnecessary surgery,” he says. “And people such as Angelina Jolie have made it more acceptable. There used to be a stigma associated with the word mastectomy, but not any more.”

In some ways it’s astonishing that this is where we are with cancer treatment in the 21st century. How has something as crude as chopping off body parts become relatively normalised? Just because the medical profession can now carry out good breast implants, is this what we should be offering in terms of “treatment” – bearing in mind that a reconstructed breast has no sensation and is often without nipples? And have we become so risk-averse that removing our breasts is preferable to living with the possibility that one day we might develop cancer?

Mokbel is right about the fear factor. The majority of women interviewed for this piece speak of nothing but the enormous relief the moment they came round from the anaesthetic. “The fear lifted instantly,” says Helen Brown, who had a double mastectomy last year. “Just knowing I didn’t have to face the dread of annual check-ups was hugely liberating.”

Brown, who has breast cancer running in her family, remembers how mastectomies were done in the past. Her aunt, whose five older sisters all contracted breast cancer, had one 30 years ago. “In those days, it was all hushed tones, the big c-word, no one ever even mentioning your breasts,” she says. “There was no reconstruction. Women were savaged by surgeons who didn’t give a monkeys about their long-term care or looks. Stick a couple of pairs of socks in your bra and you’ll be fine, they said. My aunt went from being quite a big lady to having literally no boobs at all. It was quite mutilating.”

Nurse Helen Brown, 40,found a lump when I was 37: 'It was very weird; I had a dream that I'd found one and woke up and checked myself and there it was' (Anna Huix)

Nurse Helen Brown, 40,found a lump when I was 37: ‘It was very weird; I had a dream that I’d found one and woke up and checked myself and there it was’ (Anna Huix)
Dr Andrew Baildam, professor of breast surgery at Barts in London, was one of the first to carry out preventative mastectomies and reconstructions in the UK. “[Ten years ago] it was almost regarded as unethical,” he says. “These are women who don’t even have cancer. A lot of surgeons wouldn’t do it. But as techniques have become more refined, it has become much more routine.”

Baildam estimates that he carries out about 10 operations a year on women without cancer. The most frequent method is the one Jolie opted for, in which the breast tissue is removed and expanders are placed under the pectoral muscles. These little pockets are gradually filled with saline over a few weeks and once enough space is created, the liquid is drained off and implants are inserted. The other method is to take tissue from the stomach or back and use it in a reconstruction. The advantage of this is that, unlike implants, they don’t have to be replaced every 10 to 15 years – but it does leave nasty scars.

“There are technical challenges associated with the surgery,” says Dr Baildam. “These are women who haven’t had cancer and want to look as close as they can to how they did before.”

Which is why the increasing numbers of celebrities apparently cruising so easily through is problematic. Actress Kathy Bates took to Twitter to announce news of her double mastectomy. “I don’t miss my breasts as much as I miss Harry’s Law,” she tweeted cheerfully of the TV series she’d been starring in. The singer Beverley Craven, meanwhile, breezily told the Evening Standard of her three daughters, who have a 50 per cent risk, that, “Once they’ve had babies and breastfed them, they will undergo double mastectomies” – as if their boobs are disposable parts designed to be shed once used.

“We need to be vigilant,” says Mokbel. “We want to be sure women avoid over-estimating the benefits of having this procedure. Sometimes women develop nasty infections or have problems with the implants and end up with disfigurement of the breast. Also, because a reconstructed breast usually has no sensation, it can seriously affect psychosexual function.”

A new study published in the American medical journal Annals of Internal Medicine in September confirms Mokbel’s concerns. The research, carried out by Shoshana Rosenberg at the Dana-Farber Cancer Institute in Boston, discovered that increasing numbers of women with early-stage breast cancer are opting to remove not just the affected breast but the healthy one too. “It’s particularly concerning in young women. They have the highest rates and we are trying to work out why,” says Rosenberg. “Our study suggests the peace-of-mind factor is huge. Even though maybe they have only a very small chance of developing breast cancer in the healthy breast, for some women, any risk is too much.”

Bridgid Nzekwu opted for a double mastectomy after she was diagnosed with breast cancer at the age of 42 and told she had a 25 per cent chance of developing cancer in the other breast. She insisted on having both breasts removed and went through a nine-hour operation in which excess fat was taken from her abdomen to build new ones. It took two weeks before she could stand up because of the tummy tuck, she now needs a further operation to repair some bulgy scar tissue, and currently she has no nipples – yet still, she says, she would tell any woman to do the same.

“I didn’t feel comfortable living with unnecessary risk, and to me 25 per cent was unacceptable,” she says. “Why would you hang around and wait for the cancer to come when you can just get rid of it? Once it was done I felt exhilarated. Now my risk is around 2 per cent.”

While Nzekwu is very happy with her reconstruction, some of the women in Rosenberg’s study were less so. Asking them how they felt after surgery, nearly a third said their confidence about their appearance was worse than they thought it would be, while 42 per cent said their sense of sexuality was worse than expected.

Broadcaster Bridgid Nzekwu, 43, says: 'One of the advantages of having a double mastectomy is that you get a much better result cosmetically' (Anna Huix)

Broadcaster Bridgid Nzekwu, 43, says: ‘One of the advantages of having a double mastectomy is that you get a much better result cosmetically’ (Anna Huix)
“My fear after the Angelina Jolie experience is that a lot of women will step forward and say me too,” says Dr Baildam. “For women of high risk, it is highly effective; we just need to be sure surgery is offered only in the right context.”

Rosenberg agrees. “We are concerned about women who are not high risk who are deciding to do this,” she says. “We need to address the underlying anxiety so these women don’t do anything they regret.”

Plus, concludes Mokbel, there is a lot that can be done to reduce risk before turning to the knife. Exercise routines and changes to diet can reduce the risk from 25 per cent to below 10 per cent. “I don’t think we as doctors can refuse to do it; we just need to ensure women know it’s a massive decision and don’t take it lightly.”

Helen Brown

40, nurse

“I found a lump when I was 37. It was very weird; I had a dream that I’d found one and woke up and checked myself and there it was, exactly where it was in the dream.

“I’ve got a family history of breast cancer, but even so, I still thought they would tell me it was a cyst or an old milk duct. But they said, ‘It’s come to you. You’re going to need a mastectomy next week.’ It was so fast. I felt like I’d jumped on a conveyor belt that I couldn’t get off.

“My brain shut down. I totally lost control. A lot of cancer patients will say this – that the first day of diagnosis is the worst, the moment you hear your death knell. But then four days later the doctor came back and said it was benign. I couldn’t believe it. I had told everyone I knew; I’d called my sister in Australia and made plans for my three children during the treatment.

“That was a turning point for me. I thought, ‘There is no way I’m going to go back to check-ups to go through that again.’ So I booked myself in for a double mastectomy and reconstruction.

“The fear lifted instantly. I remember waking up from the anaesthetic and thinking all that dread, it’s all gone. I went from 85 per cent risk to 5 per cent. It was liberating. And as it turns out, there were some pre-cancerous cells there, so I feel completely justified. Now I have enviable boobs and I kept my nipples.”

Heather Johnson

44, Pilates instructor

“My aunt was diagnosed with breast cancer at 38 and was dead by 43. It hit me hard. My mum was 58 when she was diagnosed. It came back twice; eventually she had a double mastectomy and we thought that was it. Seven years later they found a lump on her reconstructed breast, which is incredibly rare. The breast was removed but when she went for her six-month check they found it had spread to her liver and bones. She died two years ago.

“It was due to my mum’s encouragement that I got a double mastectomy. As soon as I stopped breastfeeding my last child at the age of 32 I went and had a mammogram. I had some benign cysts but the doctor said to me, ‘It’s a matter of when, not if, these lumps become cancerous.’

” I sat down with my husband and said, ‘I don’t want to live with this fear.’ Deciding on a double mastectomy wasn’t difficult after what I’d witnessed with my mum and aunt.

“After the surgery I found it hard to breathe for a while and I certainly found it difficult to look at myself. I was without nipples for two years. You lose something so feminine about yourself.

“I hate it when people tell me how brave I’ve been. I took the easy way out. The women who fight cancer are the brave ones. I’m still amazed that women are so afraid to give up their breasts if cancer is the sure-fire alternative. I would do it again in a heartbeat.”

Bridgid Nzekwu

43, broadcaster

“As a teenager I had Hodgkin’s lymphoma; the treatment was two lots of chemotherapy and a month of daily radiotherapy. In 2007, it was discovered that people who had been through this treatment have a higher-than-normal risk of developing breast cancer. They called me in for annual breast screenings.

“In 2012, they realised a lump I had in my breast had become cancerous. Because I’d had such massive doses of radiotherapy in my teens, the hospital couldn’t give me any more. The only option was to remove my breast.

“I said I wanted both breasts off now. I was 42 at the time and had a three-year-old; I wanted to eliminate my risk. They said it was completely healthy and there was no reason to remove it. So I transferred to another hospital and had both breasts removed and immediate reconstruction.

“One of the advantages of having a double mastectomy is that you get a much better result cosmetically. They look better if they are done at the same time and they are more likely to match. Also, because I’d been through cancer in my teens, I knew I just couldn’t go through it again.

“Now, although I’m taking Tamoxifen [a hormonal therapy used to treat breast cancer], I’m in early-stage menopause; I’m having hot flushes and I’m trying to stave off the weight gain that goes with it. All of that is preferable to not being alive.”

Breast cancer in numbers

1 in 8 women will be diagnosed with breast cancer in their lifetime

136 women a day were diagnosed with breast cancer in 2010

80% of women live for at least five years with breast cancer (it was 50 per cent in the 1970s)

18,000 mastectomies are performed by the NHS each year (up 50 per cent over the past decade)

Millions of People Have Been Wrongly Diagnosed and Treated for Cancer.


A devastating new report commissioned by the National Cancer Institute reveals that our 40-year long ‘War on Cancer‘ has been waged against a vastly misunderstood ‘enemy,’ that in many cases represented no threat to human health whatsoever.

If you have been following our advocacy work on cancer, particularly in connection with the dark side of breast cancer awareness month, you know that we have been calling for the complete reclassification of some types of ‘breast cancer’ as benign lesions, e.g. ductal carcinoma in situ (DCIS), as well as pointing out repeatedly that x-ray based breast screenings are not only highly carcinogenic but are also causing an epidemic of “over-diagnosis” and “over-treatment” in US women, with an estimated 1.3 million cases in the past 30 years alone.

This week, a National Cancer Institute commissioned panel’s report published in JAMA online confirmed that we all – public and professionals alike – should stop calling low-risk lesions like DCIS and high-grade prostatic intraepithelial neoplasia (HGPIN) ‘cancer.’

There are wide-reaching implications to this recommendation, including:

Millions of women in this country have been diagnosed with DCIS, and millions of men with HGPIN, and subsequently [mis]treated. Are they now to be retroactively reclassified as ‘victims’ of iatrogenesis, with legal recourse to seek compensation?
Anyone engaged in a cancer screening will now need to reconsider and weigh both the risks and benefits of such a ‘preventive’ strategy, considering that the likelihood of being diagnosed with a false positive over 10 years is already over 50% for women undergoing annual breast screening.


The burgeoning pink ribbon-bedecked ‘breast cancer awareness’ industry will be forced to reformulate its message, as it is theoretically culpable for the overdiagnosis and overtreatment of millions of US women by propagating an entirely false concept of ‘cancer.’

High-risk features in radiation-associated breast angiosarcomas.


Radiation-associated breast angiosarcoma (RT-AS) is an uncommon malignancy with an incidence of less than 1% of all soft tissue sarcomas. The overall prognosis is quite dismal with high rates of recurrences and poor overall survival. There is an obvious paucity of data regarding clinical outcomes of patients with breast RT-AS.

methods:

We identified all patients with RT-AS treated at the Memorial Sloan-Kettering Cancer Center between 1982–2011 and collected their correlative clinical information.

results:

We identified 79 women with RT-AS with a median age of 68 (range 36–87). The median interval between radiation and development of RT-AS was 7 years (range 3–19). The median time to local and distant recurrence was 1.29 years (95% CI 0.72–NA) and 2.48 years (95% CI 1.29–NA), respectively. The median disease-specific survival was 2.97 years (95% CI 2.21–NA). Independent predictors of worse disease-specific survival included age greater than or equal to68 years (HR 3.11, 95% CI 1.20–8.08,P=0.020) and deep tumors (HR 3.23, 95% CI 1.02–10.21, P=0.046.)

conclusion:

RT-AS has high local/distant recurrence rates, limited duration on standard chemotherapy and poor disease-specific survival.

Source: BJC

Design and evaluation of a laboratory prototype system for 3D photoacoustic full breast tomography.


Photoacoustic imaging can visualize vascularization-driven optical absorption contrast with great potential for breast cancer detection and diagnosis. State-of-the-art photoacoustic breast imaging systems are promising but are limited either by only a 2D imaging capability or by an insufficient imaging field-of-view (FOV). We present a laboratory prototype system designed for 3D photoacoustic full breast tomography, and comprehensively characterize it and evaluate its performance in imaging phantoms. The heart of the system is an ultrasound detector array specifically developed for breast imaging and optimized for high sensitivity. Each detector element has an acoustic lens to enlarge the acceptance angle of the large surface area detector elements to ensure a wide system FOV. We characterized the ultrasound detector array performance in terms of frequency response, directional sensitivity, minimum detectable pressure and inter-element electrical and mechanical cross-talk. Further we evaluated the system performance of the laboratory prototype imager using well-defined breast mimicking phantoms. The system possesses a 2 mm XY plane resolution and a 6 mm vertical resolution. A vasculature mimicking object was successfully visualized down to a depth of 40 mm in the breast phantom. Further, tumor mimicking spherical objects with 5 and 10 mm diameter at 20 mm and 40 mm depths are recovered, indicating high system sensitivity. The system has a 170 × 170 × 170 mm3 FOV, which is well suited for full breast imaging. Various recommendations are provided for performance improvement and to guide this laboratory prototype to a clinical version in future.

Source: http://www.opticsinfobase.org

Women’s breasts age faster than the rest of their body.


Breasts typically age more quickly than the rest of the female body. So suggests a system that may be the most accurate way yet of identifying a person’s age from a blood or tissue sample.

As we age, the pattern of chemical markings on our DNA changes. Each gene becomes more or less methylated, that is, they have methyl chemical groups added or removed. This generally increases or decreases gene expression. The whole process is known as epigenetics.

The question "how old are you?" just became a lot harder to answer <i>(Image: REX/Cultura)</i>

Steve Horvath at the University of California, Los Angeles, and his colleagues have used these changes to estimate a person’s age. To do so, they first performed a detailed statistical analysis of methylation patterns in 7844 healthy tissue samples from 51 different types of tissue. The tissue covered a range of ages – from fetuses to people 101 years old.

Universal ageing

The analysis allowed the team to weed out methylation patterns that varied between tissues, leaving just those that are common to all tissues. This enabled them to identify a subset of 353 specific regions of the genome that became either more or less methylated with age in almost all types of tissue.

By measuring the total amount of methylation in these regions, the team was able to create an algorithm that identified the age of the tissue.

The team validated the algorithm against thousands more samples of known age. Horvath says the method is twice as accurate as the next best method of ageing tissue, which is based on the length of telomeres – tips of chromosomes that “burn down” with age like candle wicks. He says that his method has a 96 per cent chance of accurately identifying someone’s age to within 3.6 years compared with around 53 per cent for telomeres.

“What’s unique about this study is the idea that there’s a signature of ageing common across tissues in spite of the significant tissue specificity of DNA methylation patterns,” comments Moshe Szyf, who studies methylation at McGill University in Montreal, Canada. “The data point to the possibility that DNA methylation signatures could be used as robust markers of biological ageing.”

Young at heart

Horvath says that, remarkably, their analysis shows that some parts of the body age at different rates. When they used their algorithm on healthy breast tissue from a group of women of average age 46, for example, it churned out a result that was on average two to three years older than the woman’s actual age. Whereas in two groups aged 55 and 60 across both sexes, heart tissue appeared nine years younger than true age.

If it is known where the sample comes from, it is still possible to accurately predict age after some straightforward adjustment, says Horvath. However, in general, the algorithm is most accurate for samples from people under 30 years of age. “The older one gets, the less accurate it becomes,” he says.

Horvath thinks that breast tissue ages more quickly because of its constant exposure to hormones. Heart tissue may remain younger, by contrast, because it is constantly regenerated by stem cells.

Cancerous tissue also appeared to age prematurely, coming out at 36 years older than the person’s actual age on average across 20 cancers from 20 different organs.

Because ageing is a risk factor for all cancers, Horvath suggests that the premature ageing of breast tissue might explain why it is the most common cancer in women. “It could be so prevalent because that part of the female body is older,” he says.

Blood work

Because the method also works on blood it might have the potential to be used forensically, to reveal the age of a murder suspect, suggests Horvath. It might also be used to diagnose cancer, by revealing accelerated ageing in tissue biopsies.

“The data raises questions about whether these DNA methylation changes play a causal role in ageing and, if so, whether epigenetic interventions could reverse these and therefore slow down ageing,” says Szyf. “The chemical robustness of DNA methylation and the ability to accurately measure it make it a very attractive tool to study ageing, which could well be superior to measuring telomere length, which is the current practice.”

Horvath says that further studies comparing telomere and epigenetic ageingcould be useful, and hopes the two can be complementary. He also says that the software for his algorithm is openly available so that other researchers can try validating it on their own tissue samples.

Journal reference: Genome Biology, DOI: 10.1186/gb-2013-14-10r115

‘My diagnosis hit me in the face’: readers on living with breast cancer.


The rosy glow of ‘Pinktober‘ is everywhere this month, so we asked Guardian readers how cancer has changed their lives

‘I had chemotherapy during my last two trimesters of pregnancy’

Heidi, breast cancer patientHeidi, 44, Indiana

I was pregnant when diagnosed with breast cancer, and had chemotherapy during my last two trimesters of pregnancy. I’ve had lumpectomies, a mastectomy, reconstruction, oophorectomy, chemotherapy, radiation, and have taken more medicine than I can remember. My son was born healthy, strong and very handsome, in spite of his dangerous start. He is wonderful. Chronic pain and fatigue are constant reminders of my cancer, but knowing I persevered for someone other than myself is the greatest reward.

On ‘Pinktober’: To me, the positive comes from helping other people going through this journey – women, men, children. When one person in a family is diagnosed, they all play a part in what happens after diagnosis. Friends, colleagues or church members all want to help, but are sometimes unsure what to do. I’ve found great comfort in helping people identify those needs.

Also, not all charities actually care about breast cancer patients. Some, horribly, only see cancer as a business model or a strategic plan to help boost product sales or worse, careers. People need to diligently research where their money is going, and if it actually helps patients.

‘Two experiences with breast cancer: my wife’s and my own’

Oliver, breast cancer patientOliver, 47, Houston, Texas

I have two experiences with breast cancer: as caregiver for my wife as she went through treatment six years ago, and my own diagnosis and treatment starting in September 2012. We had near-identical treatments: six months of chemo, mastectomy and then radiation, followed by years of Tamoxifen. Of course the odds of this are small. Sharing this experience has brought us closer in an unexpected way, and we understand each other’s fear of recurrence completely.

On ‘Pinktober’: The stark reality of what breast cancer means to many people gets lost [in awareness campaigns.] The focus is on early stage disease in women, with relatively easy treatment and good outcomes. People are invited to celebrate cancer. For many it is a threat to their well being, even their life. Male breast cancer, metastatic breast cancer, triple negative breast cancer, inflammatory breast cancer and breast cancer in young women all get lost.

‘I tested positive for the BRCA gene mutation’

Lori, breast cancer patientLori, 46, New York, New York

I was diagnosed with breast cancer on 28 March 2011. The tumor was in my left breast and was an invasive ductal carcinoma that was 3.5cm long, Estrogen, Progesterone and HER positive, stage IIB. The only reason I even knew something was wrong was that I had pain in my left breast. I went to the doctor who referred me to a radiologist. I was given a mammogram, an ultrasound and a very, very painful biopsy. After a very long weekend, I was told by phone that I had cancer.

I was presented with three options: a lumpectomy, a single mastectomy, or double mastectomy. The deciding factor would be a test for the BRCA gene mutation, but this would delay any action by at least two weeks. After careful consideration that day, I opted for a double mastectomy. I joked that I had wanted a breast reduction anyway and that it should be a matching pair, but honestly, I had a strong suspicion about how the test would turn out since Ashkenazi (eastern European) Jews, of which I am one, have the highest risk of being a carrier. As it turned out, I was right.

A few nights before the double mastectomy, I decided that the only way to decimate a bully (cancer) is to laugh at it. So I invited my friends to my “Bye Bye Boobies” Party. We spared no insult to the boobies that were making my life hell. A Triple-D red velvet cake, lots of dairy products and a song, set to “Bye Bye Baby” to wish them boobies a long goodbye.

On ‘Pinktober’: It misses the actuality of what breast cancer really is. Pink ribbons infantilize the disease and make it appear to be cute – “Pretty in Pink“. There is nothing about breast cancer that is pretty or pink. More information needs to get out to the public about the genetic factors and environmental factors that cause breast cancer and how we need to address these in a way to put people out of harm’s way.

‘I began to think about this as a journey of silver linings’

Ljuba, breast cancer patientLjuba, 31, Cupertino, California

My breast cancer diagnosis hit me straight in my face. I had given birth to beautiful twin girls nine months prior. Saying that my husband and I had our hands full would be putting it mildly. I got “the call” while being told about a potentially necessary skull surgery for one of my twin daughters. “Do you have some time to talk?” my doctor asked. I knew it before she talked me through the rest. My husband knew just by looking at my face. Talk about curveballs.

Me? Now? I was 31, too young for any routine screening. With two babies and a very aggressively growing tumor. One week it measured at 1cm, three weeks later it was estimated at 4cm. The next couple of weeks revolved around waiting for more tests and appointments, while feeling and seeing the mass in my breast grow. This was my rock bottom. It could only get better from there.

But this is where the unexpected part came in.

My daughter didn’t need the surgery after all and I was referred to one of the best cancer centers in the US. The first word that I heard from my oncologist was “curable”. I was surrounded with a team of doctors, surgeons, nurses, dieticians and genetics specialists. I received my first chemotherapy and suddenly began to think about this as a journey of silver linings. An aggressively growing tumor also meant in my case that it was “hungry” and thus eagerly absorbing the chemo. It was half its size after two treatments. The fast metabolism of a young and otherwise healthy body initially caused the cancer to grow quickly, but on the flip side mastered the task of coping with the side effects of the nuclear cocktails injected into my veins.

I lost my hair and started wearing a wig. Getting ready in the morning became a piece of cake. No endless manoeuvring of styling tools and products – perfect salon hair in seconds. My nails stopped growing and manicures would last for weeks. I had a double mastectomy a month ago and am in the process of plastic reconstruction. I can choose my bra cup size and these babies will never sag – what’s not to like? Sure, there were plenty of “one step forward, two steps back” moments in my journey and I am not at the finish line quite yet, but focusing on maintaining a sense of normalcy in my life (I worked part-time, taking days off for treatment, and most of my colleagues still don’t know of my diagnosis) helped me to get through this. But at the core of everything were the silver linings. They will continue to carry me to the last page of this chapter of my life.

On ‘Pinktober’: While I support awareness initiatives, especially for serious illnesses, breast cancer awareness month here in the US has a slightly foul aftertaste of what we call a Hallmark holiday. Pink ribbons on everything from yogurt to toilet paper. A potentially lethal and devastating disease reduced to a sparkly bumper sticker. And while I am thrilled that a percentage of these funds goes towards research, I can’t get rid of this foul aftertaste.

‘I never had a breakdown cry or questioned why’

Amy, breast cancer patientAmy, 39, Huntsville, Alabama

I found out in April, at age 38, that I had breast cancer. I never had a breakdown cry or questioned why. Surprise! Not even once! It’s not because I’m unaware of how serious cancer is, nor is it because I’m in some denial of what I have or what I could lose. It’s not because I’m especially strong or fearless.

I believe it helps that I look at the entire process through the eyes of acceptance and think about what I’m gaining. I accept that I have cancer and the possible outcomes. I accept that it does not define me. I will gain knowledge and experience from having cancer, as well as gain the ability to display my beliefs and principles, and set a good example for my children and family. I believe the most important life lessons don’t come from easy paths; it’s the struggles that show us what we’re made of.

Cancer throws you into a new world, one that can be consumed by your own existence, pain, and treatment. Finding a way to step outside of yourself and look beyond your own cancer is beneficial. There is good in making time and focusing on others, because someone else always has it worse.

When I look around during any chemotherapy treatment, I see that it could be worse: someone younger, someone older, someone suffering more, someone suffering alone … the list goes on. I have spent every one of my chemo sessions talking to the nurses, doctors and volunteers that come my way. I try to remember something personal about them for when I see them again. I have joked and teased with my chemo buddies and tried to make them laugh and feel better, because often I see how lucky I am when I’m there. I see people of all ages afraid, unsure and worried. I feel fortunate by getting to know someone and find a way to get a smile or laugh out of them, and most of the time I do. That is a gift for me!

Cancer does not define me, how I handle cancer defines me. I am going to keep my crazy positive outlook and feel fortunate that I have the ability to fight cancer.

‘I had to learn to shut out the opinions of other people’

Lana, 52, Denver, Colorado

I had stage two triple negative breast cancer, no metastases. Several friends and family members were mortified that I was going to have chemotherapy. They insisted I should try alternative therapies or homeopathic remedies rather than “put poison in my body”. I know those comments came from a place of fear and love for me, but I soon learned to shut out the opinions of other people and march on with the course of treatment my oncologist told me was the only option to kill “the monster.”

No one really knows what it’s like to have cancer, unless they’ve had cancer. That’s the bottom line. We all do what we have to do, individually, to face it, fight it and move on.

On ‘Pinktober’: There seems to be an ever-growing perception (through marketing messages) that we have control over our bodies and can avoid getting cancer. In turn, that translates to many of us as “if you got breast cancer, you must have done something to get it” – ate too much sugar; had a lousy diet; didn’t exercise, etc. There are many of us out here who did everything right (diet, exercise) and got cancer anyway.

I call it The Cancer Crap Shoot. We don’t carry the identified genes and don’t have a family history. So, I think the emphasis needs to be on empowerment: early detection, learning your risk factors and demanding screening (particularly for women 40 and younger if you are at high risk), and even bypassing traditional diagnostics (going straight to MRI or whole-breast ultrasound if you have dense breast tissue).

Yes, diet and exercise are important, however, other physiological factors have been determined to impact risk and women should be educated about them as well (inflammation; keeping your immune system healthy; learning healthy ways of coping with stress).

‘Damage was done to my brain’

Anne Marie, breast cancer patientAnne Marie, New York, New York 

It has been very difficult for me to accept the limitations caused by whatever damage was done to my brain. I was always super organized and could multitask without any issues. Now, I’m lucky if I pay my bills on time.

Realizing I can’t accomplish half of what I could in the past is disappointing, but the fact that I was forced to change directions from office management to writing has been fulfilling in ways I could not have dreamed possible. I try to focus on the fact that I am doing something I love.

On ‘Pinktober’: Breast cancer research has seen many successes over the past decades. Yet, when it is broken down and really examined, we haven’t made the great strides that are hyped, especially during October as we are strangled by pink ribbons.

Treatment is still barbaric. The fact that early detection doesn’t guarantee the disease won’t spread outside the breast is rarely spoken about. The fact that the death rate is substantially unchanged in over 40 years is another problem. Breast cancer is not the great success story it’s hyped to be, it’s just the one that’s been marketed the best.

UCLA scientist uncovers biological clock able to measure age of most human tissues.


Study finds women’s breast tissue ages faster than the rest of the body.

Everyone grows older, but scientists don’t really understand why. Now a UCLA study has uncovered a biological clock embedded in our genomes that may shed light on why our bodies age and how we can slow the process.
Published in the Oct. 21 edition of the journal Genome Biology, the findings could offer valuable insights to benefit cancer and stem cell research.
Biological clock
While earlier biological clocks have been linked tosalivahormones and telomeres, the new research is the first to result in the development of an age-predictive tool that uses a previously unknown time-keeping mechanism in the body to accurately gauge the age of diverse human organs, tissues and cell types. Unexpectedly, this new tool demonstrated that some parts of the anatomy, like a woman’s breast tissue, age faster than the rest of the body.
“To fight aging, we first need an objective way of measuring it. Pinpointing a set of biomarkers that keeps time throughout the body has been a four-year challenge,” said Steve Horvath, a professor of human genetics at the David Geffen School of Medicine at UCLA and a professor ofbiostatistics at the UCLA Fielding School of Public Health. “My goal in inventing this age-predictive tool is to help scientists improve their understanding of what speeds up and slows down the human aging process.”
To create his age predictor, Horvath focused on a naturally occurring process called methylation, a chemical modification of one of the four building blocks that make up our DNA. He sifted through 121 sets of data collected previously by researchers who had studied methylation in both healthy and cancerous human tissue.
Gleaning information from nearly 8,000 samples of 51 types of tissue and cells taken from throughout the body, Horvath charted how age affects DNA methylation levels from pre-birth through 101 years. For the age predictor, he zeroed in on 353 markers linked to methylation that change with age and are present throughout the body.
Horvath tested the predictive tool’s effectiveness by comparing a tissue’s biological age to its chronological age. When the tool repeatedly proved accurate in matching biological to  chronological age, he was thrilled — and a little stunned.
“It’s surprising that one could develop a predictive tool that reliably keeps time across the human anatomy,” he said. “My approach really compared apples and oranges, or in this case, very different parts of the body — including brain, heart, lungs, liver, kidney and cartilage.”
While most samples’ biological ages matched their chronological ages, some diverged significantly. For example, Horvath discovered that a woman’s breast tissue ages faster than the rest of her body.
“Healthy breast tissue is about two to three years older than the rest of a woman’s body,” he said. “If a woman has breast cancer, the healthy tissue next to the tumor is an average of 12 years older than the rest of her body.”
The results may explain why breast cancer is the most common cancer in women. Given that the clock ranked tumor tissue an average of 36 years older than healthy tissue, it could also explain why age is a major risk factor for many cancers in both genders.
Horvath next looked at induced pluripotent stem cells, adult cells that have been reprogrammed to an embryonic stem cell–like state, enabling them to form any type of cell in the body and continue dividing indefinitely.
“My research shows that all stem cells are newborns,” he said. “More importantly, the process of transforming a person’s cells into pluripotent stem cells resets the cells’ clock to zero.”
In principle, the discovery proves that scientists can rewind the body’s biological clock and restore it to zero.
“The big question is whether the underlying biological clock controls a process that leads to aging,” Horvath said. “If so, the clock will become an important biomarker for studying new therapeutic approaches to keeping us young.”
Finally, Horvath discovered that the clock’s rate speeds up or slows down depending on a person’s age.
“The clock’s ticking rate isn’t constant,” he explained. “It ticks much faster when we’re born and growing from children into teenagers, then slows to a constant rate when we reach 20.”
In an unexpected finding, the cells of children with progeria, a genetic disorder that causes premature aging, appeared normal and reflected their true chronological age.
Horvath noted that it will take additional research to dissect the precise molecular or biochemical mechanism in the body that makes his age predictor possible.
UCLA has filed a provisional patent on Horvath’s age-predictive tool. His next studies will examine whether stopping the body’s clock halts the aging process and whether a similar clock exists in mice.

Sea cucumber extract kills 95 percent of breast cancer cells and shrinks lung tumors .


A new study has shown that sea cucumber extract kills up to 95 percent of breast cancer cells, 90 percent of melanoma cells, 95 percent of liver cancer cells and 88 percent of lung cancer cells in vitro. The extract also stimulates the immune system against cancer and impedes key processes required for metastasis. While the science behind this is very new to Western medicine, the sea cucumber has been used in Chinese medicine for centuries.

cancer

Sea cucumber extracts potently kill multiple cancer cell lines

In previous studies, extracts of sea cucumber have demonstrated potent cytotoxicity against pancreatic, lung, prostate, colon, breast, skin and liver cancer cells as well as leukemia and gioblastoma. Researchers have identified a key compound responsible for sea cucumber’s anti-cancer properties: a triterpenoid known as frondoside A.

A new study has now confirmed the anti-cancer effects of frondoside A at a whole new level. In the lab, it has killed up to 95 percent of ER+ breast cancer cells, 90 percent of melanoma cells, 95 percent of liver cancer cells and 85-88 percent of three different lines of lung cancer. But the benefits of this compound don’t just stop at directly inducing programmed cell death (apoptosis). It also inhibits angiogenesis (the ability of tumors to grow new blood vessels to get their food) and stops cancer metastasizing by impeding cell migration and invasion. Even more intriguing is the ability of frondoside A to activate our immune system’s natural killer cells to attack cancer cells. This has been shown for breast cancer in particular but may also apply to all cancers, because it involves the immune system and not cancer cells directly. This may partially explain why frondoside A was so effective at shrinking lung tumors in mice that it rivaled chemo drugs in performance.

Lung tumor shrinkage that rivals chemo drugs – without the side effects

Frondoside A is potently cytotoxic to three different types of lung cancer in vitro, including NCI-H460Luc2, LNM35 (non-small cell lung cancer) and A459 (epithelial adenocarcinoma). And when given to mice with xenografted human non-small cell lung cancer, it shrank the tumors by 40 percent in 10 days. This compares very well with the shrinkage of 47 percent obtained with a standard chemo drug. But the similarities between the two compounds stop there. The chemo drug used in this study is known to damage DNA and carry potent negative side effects, such as kidney damage and immunosuppression, and it may actually induce leukemia in the patient. Frondoside A, however, actually stimulates the immune system, potently kills leukemia cells and produced no visible side effects in the mice, according to the researchers – all at a fraction of the price of chemo. But the most impressive part of this study was that this was achieved at a very small dose of frondoside A – equivalent to less than a single milligram for an adult human weighing 75 kilograms. It is also noteworthy that frondoside A given together with the chemo drug shrank the tumor by a remarkable 68 percent.

The future of sea cucumber as a natural medicine for cancer

Sea cucumber extract is a highly promising natural medicine for cancer. There are currently two clinical trials using it (with other natural extracts) against myeloma and multiple myeloma, but more trials against breast and lung cancer are clearly called for, as a start. In the meantime, dried and powdered sea cucumber is available in North America in over-the-counter health supplements aimed at inflammatory conditions (such as arthritis), because sea cucumber also happens to be a rich source of chondroitin.

Sources for this article include:

http://www.ncbi.nlm.nih.gov

http://www.ncbi.nlm.nih.gov

http://www.ncbi.nlm.nih.gov

http://www.ncbi.nlm.nih.gov

http://www.ncbi.nlm.nih.gov

http://www.clinicaltrials.gov

http://science.naturalnews.com

Learn more: http://www.naturalnews.com/042506_sea_cucumber_breast_cancer_cells_lung_tumors.html#ixzz2htDJU4Sl

Fatigue related to radiotherapy for breast and/or gynaecological cancer: a systematic review.


Abstract

AIMS AND OBJECTIVES:

To assess the profile, evaluation criteria and fatigue treatment.

BACKGROUND:

Fatigue, characterised by tiredness, weakness or lack of energy, involves physical, cognitive and emotional aspects. Its aetiology is not well defined and the prevalence ranges from 30-70% in women with breast cancer, reaching up to 80% when they are undergoing radiotherapy. This is one of the most frequent side effects of radiotherapy, and it may interfere with self-esteem, social activities and quality of life.

DESIGN:

Literature systematic review.

METHODS:

A search for studies published from 2000-2010 was carried out in Pubmed, Scielo and Bireme databases, using the descriptors fatigue and radiotherapy and their correlates in Portuguese.

RESULTS:

We selected 12 articles of 1085 found. The number of studies involving breast cancer was higher than those related to gynaecological cancer. Functional Assessment of Cancer Therapy-Fatigue was the most used scale specifically for the evaluation of fatigue. Pretreatment fatigue level may be an important risk factor to aggravate it during radiotherapy and decrease the quality of life. Five studies proposed interventions, all of them involving nonpharmacological therapies: cognitive-behavioural therapy associated with hypnosis, moderate-intensity physical exercises, stretching programmes, yoga and polarity therapy. The studies showed good results in relation to fatigue, physical and psychological aspects, and quality of life.

CONCLUSION:

Early detection of fatigue, using appropriate scales, is relevant to propose suitable treatments and achieve better clinical conditions, adherence and continuity of radiotherapy treatment, aiming to ensure more effective responses.

RELEVANCE TO CLINICAL PRACTICE:

Fatigue is a frequent symptom in patients undergoing radiotherapy. It may become a factor that limits or prevents the continuity of radiotherapy and therefore should be diagnosed in the initial appointments, so that it can be properly treated.

Source: Pubmed.

German Adjuvant Intergroup Node-Positive Study: A Phase III Trial to Compare Oral Ibandronate Versus Observation in Patients With High-Risk Early Breast Cancer.


Abstract

PURPOSE:

Bisphosphonates prevent skeletal-related events in patients with metastatic breast cancer. Their effect in early breast cancer is controversial. Ibandronate is an orally and intravenously available amino-bisphosphonate with a favorable toxicity profile. It therefore qualifies as potential agent for adjuvant use.

PATIENTS AND METHODS:

The GAIN (German Adjuvant Intergroup Node-Positive) study was an open-label, randomized, controlled phase III trial with a 2 × 2 factorial design. Patients with node-positive early breast cancer were randomly assigned 1:1 to two different dose-dense chemotherapy regimens and 2:1 to ibandronate 50 mg per day orally for 2 years or observation. In all, 2,640 patients and 728 events were estimated to be required to demonstrate an increase in disease-free survival (DFS) by ibandronate from 75% to 79.5% by using a two-sided α = .05 and 1-β of 80%. We report here the efficacy analysis for ibandronate, which was released by the independent data monitoring committee because the futility boundary was not crossed after 50% of the required DFS events were observed.

RESULTS:

Between June 2004 and August 2008, 2,015 patients were randomly assigned to ibandronate and 1,008 to observation. Patients randomly assigned to ibandronate showed no superior DFS or overall survival (OS) compared with patients randomly assigned to observation (DFS: hazard ratio, 0.945; 95% CI, 0.768 to 1.161; P = .589; OS: HR, 1.040; 95% CI, 0.763 to 1.419; P = .803). DFS was numerically longer if ibandronate was used in patients younger than 40 years or older than 60 years compared with patients age 40 to 59 years (test for interaction P = .093).

CONCLUSION:

Adjuvant treatment with oral ibandronate did not improve outcome of patients with high-risk early breast cancer who received dose-dense chemotherapy.

Source: Pubmed