Breast Cancer: Can THIS Lower Your Risk?

I hope you are having a great day. Here in Seattle, we are looking at sunny and a temperature of 71F (22C). While we have largely focused on wellness (including musings on the benefits of meditation and of sex), today I want to talk a bit about a recent study from researchers from the University of California, San Diego (USA). I am often asked about vitamins and cancer risk reduction, and to be frank, most studies have not shown a benefit to taking vitamins, at least with respect to cancer risk reduction; here, I am a big advocate of getting our cancer-fighting nutrients through diet.

A lower risk of breast cancer is found among older women who have greater levels of vitamin D, according to a study from the University of California, San Diego.

While the study doesn’t prove cause and effect, it’s the latest among many that find those with higher levels of vitamin D have lower risks of various diseases. It was recently published in the journal PLOS ONE, and can be found at j.mp/vitdbcancer.

Women with the highest levels of vitamin D in the blood had 20 percent of breast cancer risk as those with the lowest levels.

Researchers used data from two randomized clinical trials with a total of 3,325 participants, and another study with 1,713 participants. All participants were women 55 and older. Their blood was examined between 2002 and 2017 for the main form of vitamin D in the blood. 25(OH)D. This was correlated with any diagnosis of breast cancer.

Over the course of the studies, 77 new cases of breast cancer were diagnosed. Participants with blood levels above 60 nanograms per milliliter had just 20 percent of the risk, compared to those those with less than 20 ng/ml.

But…

The official recommended level of vitamin D is set at 20 ng/ml by the National Academy of Medicine, an advisory body to the president and Congress on health issues. The issue remains hotly debated, in part because the evidence at this point is mostly associational, not causal.

“Increasing vitamin D blood levels substantially above 20 ng/ml appears to be important for the prevention of breast cancer,” co-author Sharon McDonnell, an epidemiologist and biostatistician for GrassrootsHealth, said in a statement.

Garland said the study was limited to postmenopausal breast cancer, and mainly included white women. So more research is needed on whether high vitamin D levels might protect against premenopausal breast cancer, including other ethnic groups,

To reach the recommended blood level of vitamin D, Garland said daily supplements of 4,000 to 6,000 international units are required. This can also be achieved at low latitudes, such as in Southern California, by wearing minimal clothing in the sun for 10 to 15 minutes per day.

The National Academy of Medicine recommends 400 IU of vitamin D3 daily for infants; 600 IU for those 1 to 70 years, and 800 IU for those over 70.

Other studies have examined the correlation of various diseases with exposure to sunshine, which the body uses to produce vitamin D. The studies found lower incidences of various diseases with lower latitudes, and higher levels at higher levels. When charted, this association produces a curve that’s called the “vitamin D smile.”

Not So Fast…

Now, should you run out and start taking a ton of vitamin D? We have no evidence that doing so will reduce your risk of breast cancer. Everything in moderation. For me, that means a sojourn to Hawaii in February, as we can make 5,000 IU in 10 to 15 minutes of “reasonable” sun: That means 8 to 10 in the morning, after 4 in the afternoon. No sunburns, please! I’m Dr. Michael Hunter, and I thank you for letting me ramble a bit on this sunny and glorious Seattle Tuesday!

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I received an undergraduate degree from Harvard, a medical degree from Yale, and completed a residency in radiation oncology at the University of Pennsylvania. I have been blessed to be named a “top doctor” in Seattle Magazine, US News & World Report, Seattle Metropolitan Magazine, 425 Magazine, and WA magazine. On multiple occasions, readers of the Kirkland Advertiser have voted me the top doctor (in any field) in the region. I help individuals with cancer at Evergreen Hospital, outside Seattle. Any information provided herein is not to serve as a substitute for the good judgment of your valued health care provider. Thank you.

References

Primary source

Vitamin D and Breast Cancer

Breast Cancer: Do Non-Starchy Vegetables Lower Risk?

Limited evidence suggests that non-starchy vegetables may lower the risk for estrogen-receptor (ER) negative breast cancer, a less common but more challenging to treat type of tumor. Limited evidence also links dairy, diets high in calcium and foods containing carotenoids to lowering the risk of some breast cancers. Carrots, apricots, spinach and kale are all foods high in carotenoids, a group of phytonutrients studied for their health benefits.

The Study: Diet, Nutrition, Physical Activity and Breast Cancer evaluated the research worldwide on how diet, weight and exercise affect breast cancer risk in the first such review since 2010. The report analyzed 119 studies, including data on 12 million women and 260,000 cases of breast cancer.

Results: The report points to links between diet and breast cancer risk. There was some evidence — although limited — that non-starchy vegetables lowers risk for estrogen-receptor (ER) negative breast cancers, a less common but more challenging to treat type of tumor.

Limited evidence also links dairy, diets high in calcium and foods containing carotenoids to lowering risk of some breast cancers. Carrots, apricots, spinach and kale are all foods high in carotenoids, a group of phytonutrients studied for their health benefits.

These links are intriguing but more research is needed, says McTiernan. “The findings indicate that women may get some benefit from including more non-starchy vegetables with high variety, including foods that contain carotenoids,” she said. “That can also help avoid the common 1 to 2 pounds women are gaining every year, which is key for lowering cancer risk.”

Steps Women Can Take: Aside from these lifestyle risk factors, other established causes of breast cancer include being older, early menstrual period and having a family history of breast cancer.

While there are many factors that women cannot control, says Alice Bender, MS, RDN, AICR’s Head of Nutrition Programs, the good news from this report is that all women can take steps to lower their breast cancer risk.

“Wherever you are with physical activity, try to nudge it up a bit, either a little longer or a little harder. Make simple food shifts to boost protection — substitute veggies like carrots, bell peppers or green salad for chips and crackers and if you drink alcohol, stick to a single drink or less,” said Bender.

There are no guarantees when it comes to cancer, but it’s empowering to know you can do something to lower your risk.

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The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

And, one more thing: NEW free apps for Android and iOS (Apple): In apps, search My Breast Cancer by Michael Hunter.

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Reference: S. J. Lowry, K. Kapphahn, R. Chlebowski, C. I. Li. Alcohol Use and Breast Cancer Survival among Participants in the Women’s Health Initiative. Cancer Epidemiology Biomarkers & Prevention, 2016; 25 (8): 1268 DOI: 10.1158/1055-9965.EPI-16-0151

How Much Cardio Do You Really Need?

Aerobic exercise, or “cardio,” might be the closest thing to a miracle drug that we have. I would humbly add that less intense exercise, such as a brisk walk 30 minutes for 5 days per week can have tremendous value, too.

A growing body of research suggests that when we commit to regular workouts that raise our heart rate and get us moving and sweating for a sustained period of time, magical things happen to our body and brain. We think more clearly, feel better overall, and protect ourselves against some of the cognitive decline that occurs with age.

“Aerobic exercise … has a unique capacity to exhilarate and relax, to provide stimulation and calm, to counter depression and dissipate stress,” the authors of an article in the Harvard Medical School blog “Mind and Mood” wrote.

But how long should you be cycling, swimming, walking, or running to reap these benefits?

Overall, research suggests that the magic happens somewhere in the window of about 30-45 minutes at minimum.

A recent research paper looked at the exercise habits of hundreds of breast cancer survivors who were experiencing symptoms like “chemo brain,” which involves memory loss and trouble focusing. The researchers found that as little as 30 minutes of an aerobic exercise like walking was linked with significantly better performance on cognitive quizzes.

Another study published in May provided some additional support for that research — it found that in adults aged 60-88, walking for 30 minutes four days a week for 12 weeks appeared to strengthen connectivity in a region of the brain where weakened connections have been linked to memory loss.

Similarly, a pilot study in people with severe depression found that just 30 minutes of treadmill walking for 10 consecutive days appeared to be “sufficient to produce a clinically relevant reduction in depression.

Other research suggests it might be better to do cardio for longer. A study in the British Medical Journal found that in adults over 50, the best results for the brain appeared to come from a routine that combined aerobic exercise with resistance training (that is, muscle-building exercises like planks and push-ups) and lasted at least 45 minutes.

Researchers still aren’t sure why this type of exercise appears to provide a boost to the brain, but some studies suggest it has to do with increased blood flow, which provides our minds with fresh energy and oxygen. One recent study in older women who displayed potential symptoms of dementia also found that aerobic exercise was linked with an increase in the size of the hippocampus, a brain area involved in learning and memory. Another reason might have to do with cardio’s ability to help reduce levels of the body’s natural stress hormones, such as adrenaline and cortisol, according to a recent study in the Journal of Physical Therapy Science.

Joe Northey, the lead author of the British study and an exercise scientist at the University of Canberra, said his research suggests that anyone in good health over age 50 should do 45 minutes to an hour of aerobic exercise “on as many days of the week as feasible.”

Explore this blog more here: Wellness

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I received an undergraduate degree from Harvard, a medical degree from Yale, and completed a residency in radiation oncology at the University of Pennsylvania. I have been blessed to be named a “top doctor” in Seattle Magazine, US News & World Report, Seattle Metropolitan Magazine, 425 Magazine, and WA magazine. Readers of the Kirkland Advertiser have voted me the top doctor (in any field) in the region. I help individuals with cancer at Evergreen Hospital, outside Seattle.

Any information provided herein is not to serve as a substitute for the good judgment of your valued health care provider.

http://www.businessinsider.com/how-long-to-do-cardio-exercise-2017-8

Nighttime Light Exposure: Does It Increase Your Risk of Breast Cancer?

Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from the Harvard T.H. Chan School of Public Health. The link was stronger among women who worked night shifts.

 

Background: Previous studies have suggested that exposure to light at night may lead to decreased levels of the hormone melatonin, which in turn can disrupt circadian rhythms – out internal “clocks” that regulate sleepiness and alertness. As a result, your risk of breast cancer may increase.

The Study: In the most comprehensive study to date (investigating possible links between  outdoor light at night and breast cancer, researchers examined data from nearly 110,000 women enrolled in the Nurses’ Health Study II from 1989-2013. The researchers linked data from satellite images of earth taken at nighttime to residential addresses for each study participant, and also considered the influence of night shift work. The study also factored in detailed information on a variety of health and socioeconomic factors among participants.

Results: Women exposed to the highest levels of outdoor light at night — those in the top fifth — had an estimated 1.14-times increased risk of breast cancer during the study period, as compared with women in the bottom fifth of exposure. As levels of outdoor light at night increased, so did breast cancer rates. The association between outdoor light at night and breast cancer was found only among women who were premenopausal and those who were current or past smokers. In addition, the link was stronger among women who worked night shifts, suggesting that exposure to light at night and night shift work contribute jointly to breast cancer risk, possibly through mechanisms involving circadian disruption.

 

My Take: While provocative and consistent with historic studies, there are many potential variables for which the investigators did not control. Still, while we need confirmatory studies, this may be a caution regarding night exposure. For my patients, this typically means limiting blue light exposure in the hour before bedtime. Watch out for those computer screens, cell phones, and televisions! I’m Dr. Michael Hunter.

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The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

And, one more thing: NEW free apps for Android and iOS (Apple): In apps, search My Breast Cancer by Michael Hunter.

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Reference: Peter James, Kimberly A. Bertrand, Jaime E. Hart, Eva Schernhammer, Rulla M. Tamimi, Francine Laden. Outdoor Light at Night and Breast Cancer Incidence in the Nurses’ Health Study II. Environmental Health Perspectives, 2017 DOI: 10.1289/EHP935

 

Alternative Medicine for Cancer Ups Death Risk

Researchers from the Yale Cancer Center (USA) found that reject conventional medicine (for a potentially curable cancer) in favor of alternative treatments have a 2.5-fold higher risk for death.

 

Complementary versus alternative: If a non-mainstream practice is used together with conventional medicine, it is considered “Complementary.” If a non-mainstream practice is used inlace of conventional medicine, it is considered “alternative.” Today, we are addressing the latter. In my practice, we often bring conventional and complementary approaches in a coordinated way, an approach known as integrative medicine.

The Study: Researchers examined records (2004-2013) in National Cancer Database (USA) to find 280 patients with early-stage cancer (breast, prostate, lung, or colorectal) whose treatment was coded as “other-unproven: cancer treatment administered by non-medical personnel.” They then matched the alternative medicine group to 560 patients with the same types of cancer who received conventional treatments.

The Findings: Alternative medicine use was associated with a nearly 6-fold increased risk of death among patients with breast cancer. For those with colorectal cancer, the risk increased by a factor of 4.5, and among patients with lung cancer, the risk of death doubled. The risk among prostate cancers did not differ between the conventional and alternative treatment groups. The last is not a surprise, given the long natural history of prostate cancer and the short median follow-up of this study.

I’m Dr. Michael Hunter.

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The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

And, one more thing: NEW free apps for Android and iOS (Apple): In apps, search My Breast Cancer by Michael Hunter.


Reference: This new study was published online in the Journal of the National Cancer Institute.

Gum Disease and Cancer Risk

dental exam oral cavity white male head and neck oropharynx

New data supports the need to further investigate an association between periodontal disease and cancer risk.

Background: Previous studies have found periodontal disease is a risk factor for breast, oral, and esophageal cancers. Case-control studies have shown a link between tooth loss and the risk for esophagus and stomach cancers.

The Study: Investigators examined periodontal disease information in 65,869 women ages 54 to 86 at 40 centers in the USA. Mean age 68 years. Most were non-Hispanic whites with some college education. Participants answered this question: “Has a dentist or dental hygienist ever told you that you had periodontal or gum disease?”

The Results: This large prospective cohort study shows that postmenopausal women with a history of periodontal disease, including those who have never smoked, are at significantly increased overall risk for cancer as well as site-specific cancers, including lung, breast, esophageal, gall bladder, and melanoma skin cancers.Although periodontal disease and cancer share important risk factors (such as increased risk with increasing age and increased in smokers), this study showed that after adjustment for age, the risk of periodontal disease history and cancer persists regardless of smoking history.

My Take: This study adds to a growing body of evidence from smaller studies that link periodontal disease to total cancer risk. Oral hygiene is important not only in preventing tooth loss, but may have important implications for prevention of systemic diseases, including cancer. I’m Dr. Michael Hunter.

Cancer Epidemiol Biomark Prev. Published online 01 Aug 2017.

Available Today: Your Breast Cancer app on Android (in Search, type Michael Hunter Your Breast Cancer … and voila!)

Poor adolescent diet associated with premenopausal breast cancer

“During adolescence and early adulthood, when the mammary gland is rapidly developing and is therefore particularly susceptible to lifestyle factors, it is important to consume a diet rich in vegetables, fruit, whole grains, nuts, seeds, and legumes and to avoid soda consumption and a high intake of sugar, refined carbohydrates, and red and processed meats.”

– lead author Karin B. Michels, ScD, PhD, professor and chair of the Department of Epidemiology at the UCLA Fielding School of Public Health, Los Angeles

Key points: Women who consumed a diet associated with chronic inflammation  as adolescents or young adults appear to have a higher risk of developing premenopausal breast cancer, as compared with those who had a diet not linked to inflammation.

Background: Researchers used data from 45,204 women in the Nurses’ Health Study II who had completed a food frequency questionnaire in 1998, when they were ages 33 to 52, about their diet during high School. The investigators then assed adult diet by first using a food frequency questionnaire in 1991, when participants were ages 27 to 44, and then every 4 years thereafter. They gave each woman’s diet an inflammatory score using a previously method that links diet with inflammatory markers in the blood.

During 22 years of follow-up, 870 of the women who completed the high school food frequency questionnaire were diagnosed with premenopausal breast cancer and 490 were diagnosed with postmenopausal breast cancer. When women were divided into five groups based on the inflammatory score of their adolescent diet, those in the highest score group had a 35 percent higher risk for premenopausal breast cancer relative to those in the lowest score group. When the same analysis was done based on early adulthood diet, those in the highest inflammatory score group had a 41 percent higher risk for premenopausal breast cancer relative to those in the lowest score group.

I’m Michael Hunter, the Breast Cancer Doctor.