Ask most women what would put them at high risk for breast cancer and the likely answer would be genetics, a close relative having suffered from the disease. According to a recent U.K. survey, most women are not aware that more likely causes are old age, obesity, late in life childbirth or never having children, not breastfeeding, and alcohol consumption.
According to the U.K. information, 80 percent of women do not know that alcohol can increase the risk of breast cancer. It isn’t clear why the intake of alcohol would increase the possibility of breast cancer, but a 2007 study of laboratory mice showed clearly that mice injected with estrogen-receptive positive adenocarcinoma cells and fed alcohol in their water supply had a much higher growth rate of the cancer cells than mice injected with the same cells and given only water. The amount of alcohol given to the mice over the four week period was listed as equivalent to "moderate" drinking in a human.
Public Health Minister Dawn Primarolo said, “It’s shocking, even for me, to see the potential risks of drinking over recommended guidelines in black and white. One large glass of 12 percent wine takes a woman to her recommended daily limit in just one drink for regular drinking. Knowing the potential health consequences enables women to make choices that can reduce their risk of developing breast cancer.”
The U.K. study entailed 45,000 annual cases of breast cancer in a country where only 5 percent are attributed to family history and more than 80 percent of cancers occur in women over the age of 50. The lifetime risk of developing cancer is one in nine and drinking more than the recommended daily limit of alcohol could significantly increase that risk. Don Shenkar, chief executive of Alcohol Concern, said that wine is the drink of choice for most women who drink and supermarkets are responding to this by selling heavily discounted wine. Alcohol is generally 65 percent more affordable than in 1980 and since affordability of a product leads to increase in consumption supermarkets need to stop selling alcohol at such low prices.
In this country, over the past 20 years, women have increased consumption of alcohol even knowing the elevated risk of breast cancer and other health concerns. Estimates are that one out of every three American women drink, and 10 percent drink more than two drinks daily.
The adage of “a glass of wine a day is good for your heart” may hold true for men, but is not as clearly indicated for women. Men and women metabolize alcohol differently and indications are that there is a higher risk of liver cirrhosis in women who drink compared with men. Women who drink in moderation, one to three drinks per week, have been shown to have a lower rate of deaths from heart disease. Heavier drinking has been associated with a significant increase in risk for death from breast cancer and from cirrhosis. The type of drink does not affect the outcome, only the rate of alcohol consumption.
The age of the woman drinker does seem to have an effect. Heavier drinking earlier in life does not indicate an increase in breast cancer, only if the woman is postmenopausal. Women who are postmenopausal and who are taking hormone replacement therapy seem to be at particular risk. One possible reason for the age related differences may be that alcohol interferes with folate metabolism. Women who drink should take a folate supplement which may help reduce the risk of breast cancer. Most multi vitamins contained the recommended daily amount.
To drink or not to drink, a personal decision each woman must make. The decision should be based on research and fact, not just the decision that “It won’t happen to me.”
Wednesday, November 5, 2008
Link Between Sedentary Behavior and Uterine Cancer
Women, put down the remote or romance novel and get to exercising! It seems that not only could a little exercise help to reduce weight and other weight-attributing side effects, it may even help to ward off endometrine cancer, also known as uterine cancer, in obese or overweight women. Uterine cancer is the fourth most common cancer in women behind breast cancer, lung cancer and colon cancer.
More than 35,000 women are diagnosed annually in the U.S. with endometrine cancer, the #1 form of gynecologic cancer. The most common subtype is endometrioid adenocarcinoma that usually occurs a few decades after menopause and has been linked to excessive estrogen levels. The most common sign of endometrine cancer is vaginal bleeding between menstrual cycles or after menopause, and the most common treatment is the total removal of the uterus through a surgical procedure known as a hysterectomy.
The American Cancer Society’s Prospective Cancer Prevention Study II Nutrition Cohort found that overweight and obese women, who exercised even lightly or moderately instead of being sedentary, in their spare time, reduced their risks of developing uterine cancer. The study began in 1992 with a questionnaire being mailed to those baseline cohort member’s between 50 and 74 years old, who were chosen for the study and resided in one of the 21 states, with a population based state cancer registries. Detailed information in regards to diet, updated lifestyle factors, and prospective cancer and mortality incidence checks were gathered.
From 1992 to 2001, Dr. Alpha Patel and colleagues with the American Cancer Society gathered research from the participants through completed biannual questionnaires. The questionnaires asked questions in regards to time spent participating in recreational or non-recreational physical activities and questions about their time sitting, not including sitting time at work. They followed nearly 60,000 post menopausal women, according to the American Journal of Epidemiology’s April 15th issue. 314 cases of uterine cancer were reported. The study resulted in the conclusion that women who sat more than three hours a day, not accounting for time sitting at work, increasing their odds of developing uterine cancer by 55 percent.
Get to walking or take part in some form of physical activity, not only to reduce weight and the possible side effects extra weight may cause, but also to ward off cancer. The authors involved in the Prospective Cancer Prevention Study II Nutrition Cohort, released in the most recent issue of the International Journal of Cancer, say that the association between sedimentary behavior and uterine or endometrine cancer may be better defined with discoveries of other studies and that "sedentary behavior has been associated with obesity and with metabolic abnormalities, resulting in increased circulating estrogen, insulin, and other hormones that may promote cell proliferation."
More than 35,000 women are diagnosed annually in the U.S. with endometrine cancer, the #1 form of gynecologic cancer. The most common subtype is endometrioid adenocarcinoma that usually occurs a few decades after menopause and has been linked to excessive estrogen levels. The most common sign of endometrine cancer is vaginal bleeding between menstrual cycles or after menopause, and the most common treatment is the total removal of the uterus through a surgical procedure known as a hysterectomy.
The American Cancer Society’s Prospective Cancer Prevention Study II Nutrition Cohort found that overweight and obese women, who exercised even lightly or moderately instead of being sedentary, in their spare time, reduced their risks of developing uterine cancer. The study began in 1992 with a questionnaire being mailed to those baseline cohort member’s between 50 and 74 years old, who were chosen for the study and resided in one of the 21 states, with a population based state cancer registries. Detailed information in regards to diet, updated lifestyle factors, and prospective cancer and mortality incidence checks were gathered.
From 1992 to 2001, Dr. Alpha Patel and colleagues with the American Cancer Society gathered research from the participants through completed biannual questionnaires. The questionnaires asked questions in regards to time spent participating in recreational or non-recreational physical activities and questions about their time sitting, not including sitting time at work. They followed nearly 60,000 post menopausal women, according to the American Journal of Epidemiology’s April 15th issue. 314 cases of uterine cancer were reported. The study resulted in the conclusion that women who sat more than three hours a day, not accounting for time sitting at work, increasing their odds of developing uterine cancer by 55 percent.
Get to walking or take part in some form of physical activity, not only to reduce weight and the possible side effects extra weight may cause, but also to ward off cancer. The authors involved in the Prospective Cancer Prevention Study II Nutrition Cohort, released in the most recent issue of the International Journal of Cancer, say that the association between sedimentary behavior and uterine or endometrine cancer may be better defined with discoveries of other studies and that "sedentary behavior has been associated with obesity and with metabolic abnormalities, resulting in increased circulating estrogen, insulin, and other hormones that may promote cell proliferation."
Breast Cancer Patients Welcome Hot Flashes & Night Sweats
Women have long dreaded the days and nights when hot flashes and night sweats—consequences of age and gender— disrupt their lives and cause much emotional and physical discomfort. But there are other women, those receiving treatment for breast cancer, who might learn to appreciate, in a necessary way, that those side effects are also signs of a successful treatment program.
Anastrazole and tamoxifen were the two treatments recently given to women in a trial to assess the drugs’ side effects as compared to the recurrence, or lack thereof, of breast cancer in the patients. The results of the trial found that the women who reported vasomotor or joint symptoms as a result of the drugs, the former symptom being the one that produces hot flashes and other similar responses, had a greater decrease in the recurrence of breast cancer than those without any symptoms.
The results of the Arimidex, Tamoxifen, Alone, or in Combination (ATAC) trial were published in the most recent edition of The Lancet Oncology. Researchers Jack Cuzick PhD, Ivana Sestak PhD, David Cella PhD, and Lesley Fallowfield PhD supplied the report on behalf of the trial group, whose funding was provided by Cancer Research UK and AstraZeneca. Though more studies will need to be pursued, the outcome of the trial is an overall positive one that gives hope to breast cancer patients.
A total of 3,964 women participated in the ATAC trial, all of whom had hormone-receptor-positive tumors in the postmenopausal stages of their lives. The purpose of the study was to compare those who reported vasomotor or joint symptoms to those who did not to examine the relationship between the symptoms and the frequency of breast cancer recurrence. The 37.5 percent of women, which equaled 1,486 of the subjects, reported those symptoms at the time of the three-month follow-up appointments. What was discovered was that approximately one-third of the total number of patients with the post-treatment symptoms saw a decrease in the cancer recurrence over the following nine years.
In more exact terms, of the 37.5 percent of women who noted hot flashes and night sweats at the three-month follow-up visit saw 18 percent who had no breast cancer recurrence after nine years, as compared to a 23 percent figure from those reporting a lack of those symptoms. And of the 31.4 percent of women who reported joint symptoms, only 14 percent saw a cancer recurrence, while 23 percent was the number for those not reporting joint symptoms.
The cause of the vasomotor and joint symptoms is the depletion of estrogen due to the drugs given to the women. While the estrogen levels were not the focus of the study, the correlation between them and the symptoms and subsequent cancer recurrence reduction will need to be studied more comprehensively in further studies.
Cuzick, one of the researchers and an epidemiologist at Cancer Research UK, noted, “The treatment is designed to starve potential cancers of estrogen and these symptoms mean that there are lower levels of estrogen in the body. But it is too early to say whether having these symptoms is essential for the treatment to be effective. At the moment all we can say is that the symptoms indicate the likely success of the treatment.”
The basis of the study could help reassure women who suffer from the taxing symptoms that they may see less of a chance of cancer return as a result. Considering that approximately 1.3 million new cases of breast cancer were diagnosed in 2007 alone, according to the American Cancer Society, any positive results of breast cancer research give hope to those suffering from it and dealing with the treatments available for it.
While doctors continue to seek remedies for patients who suffer from joint problems, hot flashes, and/or night sweats as a result of the breast cancer treatments, the symptoms can--for now--be viewed as a sign that the medications are working. The effects of anastrazole and tamoxifen seem to be positively linked to a lessened recurrence of the cancer, and that can only be viewed as a positive sign in cancer research and treatment.
Anastrazole and tamoxifen were the two treatments recently given to women in a trial to assess the drugs’ side effects as compared to the recurrence, or lack thereof, of breast cancer in the patients. The results of the trial found that the women who reported vasomotor or joint symptoms as a result of the drugs, the former symptom being the one that produces hot flashes and other similar responses, had a greater decrease in the recurrence of breast cancer than those without any symptoms.
The results of the Arimidex, Tamoxifen, Alone, or in Combination (ATAC) trial were published in the most recent edition of The Lancet Oncology. Researchers Jack Cuzick PhD, Ivana Sestak PhD, David Cella PhD, and Lesley Fallowfield PhD supplied the report on behalf of the trial group, whose funding was provided by Cancer Research UK and AstraZeneca. Though more studies will need to be pursued, the outcome of the trial is an overall positive one that gives hope to breast cancer patients.
A total of 3,964 women participated in the ATAC trial, all of whom had hormone-receptor-positive tumors in the postmenopausal stages of their lives. The purpose of the study was to compare those who reported vasomotor or joint symptoms to those who did not to examine the relationship between the symptoms and the frequency of breast cancer recurrence. The 37.5 percent of women, which equaled 1,486 of the subjects, reported those symptoms at the time of the three-month follow-up appointments. What was discovered was that approximately one-third of the total number of patients with the post-treatment symptoms saw a decrease in the cancer recurrence over the following nine years.
In more exact terms, of the 37.5 percent of women who noted hot flashes and night sweats at the three-month follow-up visit saw 18 percent who had no breast cancer recurrence after nine years, as compared to a 23 percent figure from those reporting a lack of those symptoms. And of the 31.4 percent of women who reported joint symptoms, only 14 percent saw a cancer recurrence, while 23 percent was the number for those not reporting joint symptoms.
The cause of the vasomotor and joint symptoms is the depletion of estrogen due to the drugs given to the women. While the estrogen levels were not the focus of the study, the correlation between them and the symptoms and subsequent cancer recurrence reduction will need to be studied more comprehensively in further studies.
Cuzick, one of the researchers and an epidemiologist at Cancer Research UK, noted, “The treatment is designed to starve potential cancers of estrogen and these symptoms mean that there are lower levels of estrogen in the body. But it is too early to say whether having these symptoms is essential for the treatment to be effective. At the moment all we can say is that the symptoms indicate the likely success of the treatment.”
The basis of the study could help reassure women who suffer from the taxing symptoms that they may see less of a chance of cancer return as a result. Considering that approximately 1.3 million new cases of breast cancer were diagnosed in 2007 alone, according to the American Cancer Society, any positive results of breast cancer research give hope to those suffering from it and dealing with the treatments available for it.
While doctors continue to seek remedies for patients who suffer from joint problems, hot flashes, and/or night sweats as a result of the breast cancer treatments, the symptoms can--for now--be viewed as a sign that the medications are working. The effects of anastrazole and tamoxifen seem to be positively linked to a lessened recurrence of the cancer, and that can only be viewed as a positive sign in cancer research and treatment.
Osteoporosis Drug May Cause Heart Problems
Osteoporosis is a disease in which bones become fragile and more likely to break. Any bone can be affected, but fractures of the hip and spine are of special concern as they can have serious consequences. A hip fracture usually requires hospitalization and major surgery. It can impair a person’s ability to walk unassisted and may cause prolonged or permanent disability. Spinal or vertebral fracture can cause severe back pain, loss of height and deformity. One class of drugs used to treat osteoporosis is the bisphosphonates, which increases mass to deteriorating bones and reduces the risk of future fractures caused by aging, estrogen deficiency and corticosteroid use. This class of medications includes alendronate (Fosamax), zoledronic acid (Reclast), ibandronate (Boniva), risedronate (Actonel), and others. Although effective, these medications can cause side effects, such as heartburn, abdominal pain, irritation of the esophagus, constipation, and diarrhea. But of more concern are rare side effects which include serious problems with bone healing, particularly after dental surgery, unusual bone fractures, severe or incapacitating bone, joint and muscle pain and most recently—atrial fibrillation (AF), or irregular heartbeat.
For the study, presented at the annual meeting of the American College of Chest Physicians in Philadelphia, researchers analyzed three studies involving more than 16,000 women aged 69 to 75, some of whom took bisphosphonates and some a placebo. Of those who took the drugs, some 2.5 to 3 percent experienced AF, and 1 to 2 percent were hospitalized or died from the irregular heartbeats. Overall, the women taking bisphosphonates were twice as likely to suffer a serious, irregular heartbeat as compared to those taking placebos. “In addition to possible gastrointestinal side effects, bisphosphonates can have possible cardiac side effects. For serious cases of AF, there was a significant increase in risk—about 68 percent,” said review lead author Dr. Jennifer Miranda, an internal medicine resident at Jackson Memorial Hospital in Miami.
AF affects as many as 2.2 million Americans. During AF, the heart’s upper chambers quiver instead of beat, preventing the heart from pumping blood effectively and increasing the risk of blood clots, according to the American Heart Association. If a piece of blood clot leaves the heart and becomes lodged in an artery in the brain, the result is a stroke. An estimated 15 percent of strokes occur in people with AF. “In those patients with a greater risk factor for AF, health care professionals should cautiously choose osteoporosis treatment and consider the potential risks versus the benefits carefully,” Miranda said in a news release.
These new findings add to previous warnings about the medicines. A study and editorial published in the May 3, 2007 issue of the New England Journal of Medicine (NEJM) found that, while the drugs reduced the risk of fractures, it increased the incidence of AF in women getting a once-yearly infusion of bisphosphonates. In October 2007, the U.S. Food and Drug Administration said it would continue to investigate the connection, but did not recommend a change in prescribing patterns.
A spokesman for Merck, the maker of Fosomax, said the company “looks forward to reviewing” the study findings and referred to a statement on Merck’s Web site released after the NEJM data was published suggesting that “an association between AF and treatment with Fosomax was very unlikely.” And in a statement, manufacturer Novartis said, “We are confident about the safety profile of Reclast.” It said that only the NEJM study had shown an increased rate of AF among patients taking the drug, and “90 percent of those events occurred more than one month after the infusion, suggesting that AF was not related to the infusion.”
But researchers at the conference urged continued studies. “Bisphosphonates are widely used to treat millions of women and men who suffer from osteoporosis or low bone density,” said James A. L. Mathers, Jr., president of the American College of Chest Physicians. “A potential link between bisphosphonates and AF warrants additional research in this area.”
For the study, presented at the annual meeting of the American College of Chest Physicians in Philadelphia, researchers analyzed three studies involving more than 16,000 women aged 69 to 75, some of whom took bisphosphonates and some a placebo. Of those who took the drugs, some 2.5 to 3 percent experienced AF, and 1 to 2 percent were hospitalized or died from the irregular heartbeats. Overall, the women taking bisphosphonates were twice as likely to suffer a serious, irregular heartbeat as compared to those taking placebos. “In addition to possible gastrointestinal side effects, bisphosphonates can have possible cardiac side effects. For serious cases of AF, there was a significant increase in risk—about 68 percent,” said review lead author Dr. Jennifer Miranda, an internal medicine resident at Jackson Memorial Hospital in Miami.
AF affects as many as 2.2 million Americans. During AF, the heart’s upper chambers quiver instead of beat, preventing the heart from pumping blood effectively and increasing the risk of blood clots, according to the American Heart Association. If a piece of blood clot leaves the heart and becomes lodged in an artery in the brain, the result is a stroke. An estimated 15 percent of strokes occur in people with AF. “In those patients with a greater risk factor for AF, health care professionals should cautiously choose osteoporosis treatment and consider the potential risks versus the benefits carefully,” Miranda said in a news release.
These new findings add to previous warnings about the medicines. A study and editorial published in the May 3, 2007 issue of the New England Journal of Medicine (NEJM) found that, while the drugs reduced the risk of fractures, it increased the incidence of AF in women getting a once-yearly infusion of bisphosphonates. In October 2007, the U.S. Food and Drug Administration said it would continue to investigate the connection, but did not recommend a change in prescribing patterns.
A spokesman for Merck, the maker of Fosomax, said the company “looks forward to reviewing” the study findings and referred to a statement on Merck’s Web site released after the NEJM data was published suggesting that “an association between AF and treatment with Fosomax was very unlikely.” And in a statement, manufacturer Novartis said, “We are confident about the safety profile of Reclast.” It said that only the NEJM study had shown an increased rate of AF among patients taking the drug, and “90 percent of those events occurred more than one month after the infusion, suggesting that AF was not related to the infusion.”
But researchers at the conference urged continued studies. “Bisphosphonates are widely used to treat millions of women and men who suffer from osteoporosis or low bone density,” said James A. L. Mathers, Jr., president of the American College of Chest Physicians. “A potential link between bisphosphonates and AF warrants additional research in this area.”
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