Breast Cancer Awareness…Prevention by Dr. Nancy Palermo Lietz, MD
Unless you’ve had your head in the sand you know that October is Breast Cancer Awareness Month. During the month of October it is impossible to avoid articles that highlight Breast Cancer and the inordinate number of women who suffer every minute with the diagnosis of this feared disease. It is said this “awareness” has only added fear without making any measurable difference in the disease. In Preventative Medicine magazine 80% of women state they are moderately or very afraid of the diagnosis of breast cancer and rate this as one of their greatest fears. Despite these fears, the reality is 90% of women will never get this diagnosis.
Breast Cancer Awareness month was established in 1985 by AstraZeneca, the pharmaceutical company responsible for the development of Tamoxifen and Arimidez, common chemotherapy agents used in the treatment of breast cancer. In the first decade, the emphasis on breast cancer awareness increased breast screening through mammograms from 26% to over 70%. This increase in screening did appear to increase the diagnosis of breast cancer through sheer numbers. Unfortunately for every one breast cancer patient diagnosed there were ten women who had unnecessary biopsies or treatments for false positives. These numbers have led to studies to look at screening and treatment modalities. The Preventative Services Task Force recommended changes to screening in 2009. Their recommendations were confusing to women and caused an outrage among a number of healthcare agencies supportive of current practices. All of the experts still can’t agree on what is best for women and it will be a few years before they do. Until then, women must take an active and personal role in breast health and cancer prevention.
Breast screening is not breast health. There is increasing evidence to suggest that lifestyle and dietary changes play a significant role in the prevention of chronic diseases, including breast cancer.
Fear is not healthy. It increases stress and stress hormones like cortisol which have been shown to significantly inhibit our immune system and our overall health. Instead of fearing a diagnosis of breast cancer, women should take preventative measures to avoid such a diagnosis. There are no guarantees and even the woman who lives a pristine life (if she exists) may still get cancer but current data supports that a few changes in lifestyle may have a big impact on cancer risk.
- MANAGE WEIGHT ( GOAL BMI <25)
There is clear evidence that women with an increase in body fat, especially visceral abdominal fat, have a significant increase in risk of breast cancer. A review of over 70 clinical trials showed a 34% increase in breast cancer development in women with increased BMI. Body fat makes estrogen through the actions of an enzyme called Aromatase. The estrogen produced is unopposed and felt to be the culprit in the development of breast cancer.
- AVOID SUGAR & REFINED CARBOHYDRATES (white sugar; white flour)
A diet that is rich in sugar and refined carbohydrates cause production of high insulin levels. The increase in insulin in turn causes an increase in IGF-1 a growth factor that has been shown to cause growth of breast cells in utero. An increase in IGF-1 is associated with breast cancer. Higher insulin levels also cause cellular inflammation which is also felt to be a precursor for all cancers. Thirdly, the increase in insulin levels also reduce the production of Steroid Binding globulin (SBG) a protein produced to bind unopposed estrogens. A decrease in SBG would allow even more estrogens to circulate in the bloodstream.
- GET ADEQUATE VITAMIN D
Optimal blood levels of Vitamin D are 40-60mg/dl to allow adequate availability for its multitude of functions in the body, including its role in reducing inflammation. Most women are deficient of this vitamin. It is said that if all women had normal levels there would be 50,000 fewer breast cancer diagnoses every year. Women should try to get some sunlight exposure daily and should take at least 2000-3000 units of Vitamin D3 a day. Blood levels should be checked at yearly visits to confirm they are adequate.
- EAT MORE FRUITS AND VEGETABLES
Studies have shown that fruits and vegetables have antioxidants and phytochemicals that reduce free radicals which prevent cell damage and mutation. It is important to include all the colors of the rainbow as each color represents a phytochemical that plays a different role in protection. Women should aim to get a minimum of 8 and preferably 12 servings a day. Plant materials are also high in fiber and lignans that help the body excrete excess estrogens in the stool. Women should also aim to consume organic, non-GMO produce as much as possible.
- GET ADEQUATE OMEGA 3 FATTY ACIDS IN DIET
Studies have shown that diets high in Omega 3 fatty acids are associated with a lower risk of developing breast cancer. Omega 3 fatty acids prevent inflammation and tumor growth throughout the body. Diets that include salmon, sardines and swordfish as well as flaxseed, hemp and chia seed are high in omega fatty acids. Dietary supplements of DHA (200-400 mg/day) or purified fish oil (1000-3000 mg/day) can also be taken.
- EXERCISE REGULARLY
Studies have shown that women who engage in moderate to strenuous exercise one hour four times a week may reduce breast cancer risks by 37%. This is related to reduction of blood sugar and insulin levels and decreases in body fat. Exercise is also a great stress reducer. Stress increases Cortisol which contributes to fat deposition and inflammation.
- REMOVE BPAs FROM HOUSEHOLD
Bisphenol A was developed initially to be used as a synthetic estrogen but was later replaced by DES, a known teratogen. Now it is used in containers and to line cans. This substance mimics the action of estrogen and is linked to cancer, thyroid issues and infertility. Aim to remove all items with this substance and never cook foods in containers containing BPAs.
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- MINIMIZE ALCOHOL INTAKE
Studies looking at alcohol consumption have shown an increase in risk of breast cancer. Some studies show a 60% increase in women who consume one or more drinks per day. Higher alcohol intake affects the functioning of the liver in detoxification and elimination of excess circulating estrogens. Aim to limit alcohol consumption to less than two drinks a week and when alcohol is consumed consider red wine which is high in Resveratrol, a potent anti-oxidant that also reduces the action of Aromatase, the enzyme that produces estrogen in fat cells.
- DON’T PUT ANYTHING ON YOUR SKIN THAT YOU WOULD NOT PUT IN YOUR MOUTH
Re-evaluate all skincare and cosmetics. Many cosmetics have high levels of cadmium and parabens. Cadmium is a ubiquitous, heavy metal pollutant in the environment and in fertilizers. It is in high levels in many cosmetics. Studies have shown an association of his toxic metal and breast cancer. Parabens are found in many cosmetics and also in 99% of breast cancer specimens. There are many options for organic paraben free cosmetics available.
- AVOID ARTIFICIAL SWEETNERS, PROCESSED FOODS, PRESERVATIVES AND TOBACCO USE.
There is no place for these substances in the American diet and lifestyle.