New Test For Breast Cancer Making Individualized Treatment Decisions A Reality
Widely hailed as the next frontier in medical advances, the promise of individualized medicine is becoming a reality thanks to progress in understanding the molecular basis of diseases such as breast cancer. Scientists can now develop treatments that are tailored to individual genetic profiles, as well as tests to predict how a patient will respond to existing therapies.
Today, some women with early-stage breast cancer and their physicians can make more informed treatment decisions with the Oncotype DX Breast Cancer Assay. This service provides quantitative information about genes from a woman's individual tumor to generate a Recurrence Score between zero and 100, indicating whether she is at high, intermediate or low risk for her cancer returning after treatment.
Oncotype DX is intended for patients with node-negative, estrogen receptor-positive breast cancer who are likely to be treated with hormonal therapy. Approximately half of the 230,000 patients diagnosed with breast cancer in the United States each year fall into this category, and are frequently offered treatment with chemotherapy, a widely used treatment with considerable side effects. Clinical studies show that chemotherapy improved patient survival rates in only 4 out of 100 patients, yet thousands of women continue to elect this costly and toxic treatment with only limited information about whether they might respond to it.
A recent study demonstrated that women with high Recurrence Scores are more likely to benefit from chemotherapy, whereas women with lower scores derive only minimal benefit. Further, only 25% of women fell into the high-risk group, compared to 50% in the low-risk group, indicating that this common treatment is not appropriate for every patient.
Elizabeth Sloan of New York City is one of the many breast cancer patients not likely to respond to chemotherapy. An active mother with two young boys, Elizabeth was considering having another child when she was diagnosed at just 40 years old. She wanted to avoid chemotherapy, with its disruptive, short-term side effects and potentially serious long-term implications, but also wanted to be absolutely certain that it wouldn't help her.
Working with her doctor, Ruth Oratz, M.D., at NYU Medical Center, Elizabeth decided to have the Oncotype DX assay, and was delighted when her Recurrence Score turned out to be low-indicating that she may not benefit significantly from chemotherapy.
"No two women with breast cancer are exactly alike. Oncotype DX provides information that goes beyond standard measures, like age, tumor size and tumor grade, in determining the likelihood of disease recurrence," says Dr. Oratz. "Oncotype DX gave Elizabeth and me added confidence and peace of mind in selecting the most fitting treatment for her."
For Susan Bakken of Denver, Colorado, Oncotype DX provided a different kind of peace of mind. Susan's Recurrence Score indicated that she was at high risk of cancer recurrence, and would likely benefit significantly from chemotherapy-to both her surprise and her doctor's.
"Based on the other tests I had, my doctor said he wouldn't have otherwise recommended chemotherapy. I was shocked to find out my result, but I was so glad I did because I believe this test basically saved my life," explained Susan.
Elizabeth Sloan is also grateful for the information she gained from Oncotype DX. "Not all cancers are the same, so why treat everyone the same way with something so toxic?" she said. "It's so remarkable that finally, doctors can distinguish one person's cancer from another-I'm just so thankful."
Oncotype DX is a simple test that can only be ordered by a physician. It is performed on a small amount of breast tumor tissue removed during a standard lumpectomy, mastectomy or biopsy, meaning no additional procedure is required.
Halve Your Risk Of Breast Cancer
We hear it all the time...lose weight for your health. Few people however, realize the extent to which this is critical to their physical well-being and ultimately their life expectancy.
In January 2003, the Journal of the American Medical Association featured a study finding that obesity appears to lessen life expectancy, especially among young adults. The researchers compared Body-Mass Index (BMI) to longevity and found a correlation between premature death and higher BMIs. For example, a 20-year-old white male, 5'10" weighing 288 pounds with a BMI of greater than 40 was estimated to lose 13 years of his life as a result of obesity.Jamie McManus, M.D., F.A.A.F.P. and author of "Your Personal Guide to Wellness" notes that while this study referenced extreme levels of obesity, there are still millions of overweight people in developed countries with a life expectancy rate that is three to five years less than their healthy-weight counterparts. She also estimates that there are 600,000 obesity related deaths each year in America.
Just how does obesity shorten our lifespan? The answer to this question is complex, yet there is a clear link between obesity and the development of cancer. An extensive study conducted by the American Cancer Institute involving 750,000 people showed that obesity significantly increased the risk of cancer developing in the following organs: breast, colon, ovaries, uterus, pancreas, kidneys and gallbladder.
Michael Thun, MD, vice-president of epidemiology and surveillance research for the American Cancer Society (ACS) says one reason obesity may raise cancer risk is because fat cells produce a form of estrogen called estradiol that promotes rapid division of cells, increasing chances of a random genetic error while cells are replicating, which can lead to cancer. In addition, fat centered around the abdomen may increase insulin and insulin-like growth factors in the blood, which may increase cancer risk.
"Women who are obese after menopause have a 50% higher relative risk of breast cancer," notes Thun, "and obese men have a 40% higher relative risk of colon cancer.... Gallbladder and endometrial cancer risks are five times higher for obese individuals".There is evidence that cancer rates in developed countries are increasing at 5 to 15 times faster than developing countries. A major contributor to this alarming reality has proven to be diet. In populations where the diet consists mostly of fresh fruit and vegetables and whole grains - in contrast to the typical Western diet of fatty meats, refined flours, oils and sugars - the risk of cancer is much lower.
The interaction of diet and the development of cancer is an active field of research and Dr David Heber, M.D., Ph.D. and author of "What Color is Your Diet", says "It appears that diet has its most significant effects after the cancer has already formed, acting to inhibit or stimulate the growth of that cancer". At the risk of oversimplifying a complex set of interactions, the typical Western diet that leads to obesity may actually act to stimulate the growth of cancer cells.It is never too late to improve your health through healthful eating and adopting a more health-giving lifestyle. Here are simple steps to follow which can make an immediate improvement to your health and vitality.
1. Check your Body Mass Index (BMI) to determine if weight has become health risk. According to the Centers for Disease Control and Prevention, 60% of Americans are overweight, defined as having a BMI (a ratio of height to weight) over 25. Of those, nearly half (27%) qualify as obese, with a body mass index of 30 or more. In 1980, just 15% of Americans were considered obese. You can check your BMI at the website below.
2. Match your diet to your body's requirements. If you eat and drink more calories than your body requires you will put on weight. Learn to control calories and portion sizes, make recipes leaner, and eat infrequently from fast food restaurants. Also learn how to snack with healthful choices.
3. Color your diet with a large variety of colorful, cancer-fighting fruit and vegetables. There are seven different color ranges of both fruit and vegetables and by choosing between 5 to 9 daily serves from a wide range of fruit and vegetables, we are extending our consumption of cancer (and other disease) fighting nutrients.
4. Eat lean protein with every meal. Protein provides a powerful signal to the brain providing a longer sense of fullness. The right source of protein is essential to controlling your hunger with fewer calories and necessary to maintain your lean muscle mass. Choices of protein should be flavored soy shakes with fruit; the white meat of chicken and turkey, seafood such as shrimps, prawns scallops and lobster and ocean fish or vegetarians may prefer soy based meat substitutes.
5. Rev up your metabolism with activity. If you want to enjoy a lifetime of well-being, exercise is a key ingredient. Colleen Doyle, MS, RD, director of nutrition and physical activity for the American Cancer Society (ACS), says adults should do something for 30 minutes each day that takes as much effort as a brisk walk. Children should be active for an hour each day. We are more likely to develop habits around things we enjoy, so seek activities which you enjoy doing. It is also helpful to build physical activity into your daily routine: use the stairs instead of the escalator or lift at work, park your car in the parking bay furthest from the super marketing and don't use the remote control to change TV channels.
6. Get support to ensure you develop a healthful eating plan and reach your goal weight. Whilst a small percentage of people possess the discipline to lose weight, many obese people have developed strong thoughts and habits concerning the food they eat. In order to establish new habits, most people respond well to some form of consistent encouragement and coaching. A study, "Effects of Internet Behavioral Counseling on Weight Loss in Adults at Risk of Type 2 Diabetes" shows that participants who had the support of weight loss coaching lost more weight than those who didn't. The study concluded that the support of a weight loss coach can significantly improve weight loss results.
Being overweight or obese has been identified next to smoking, as the most preventable major risk to developing cancer. Even small weight losses have been shown to have beneficial health effects. So it's never to late to start and you can never be too young or too old to be concerned about your health and do something about achieving a more healthy weight.
(c) 2003 Kim Beardsmore
Early Detection Of Breast Cancer Saves Lives
Significant progress in mammography technology continues to help physicians diagnose breast cancer in its earlier stages. When coupled with new treatment options, early diagnosis through mammography screening can significantly improve a woman's chances of survival. That's good news because in the United States more than 200,000 new cases of invasive breast cancer are diagnosed each year.
Mammography screening is the single most effective method of early detection. That's why an annual mammogram is recommended for women over 40. A clinical breast examination by a health care professional should also be done on a regular basis. Additionally, women can take charge of their own breast health by understanding their personal risks of the disease, performing a breast self-exam every month and reporting any breast change promptly to their health care provider.
Unfortunately, studies have indicated that a significant number of women over 40 years of age fail to get a mammogram, and of those who do, many never follow up with a second mammogram. Women cite a number of reasons for their nonparticipation, including lack of finances and lack of time. It is important that women know that there are resources available to help address these issues. For example, throughout the year, low-cost or free mammography screening is available to many women who are over 40 and underinsured or uninsured. Additionally, many mammography centers offer extended hours and some even provide child care for moms having mammograms.
In an effort to encourage women to have an annual mammography screening, National Breast Cancer Awareness Month (NBCAM) sponsors recommend making every day National Mammography Day. Whether it means scheduling an appointment on a 40th birthday, or if it means reminding a friend to make an appointment, every step counts.
Adherence With Oral Meds An Issue In Breast Cancer Drugs Don T Work In Patients Who Don T Take Them
In the battle against breast cancer, patients are increasingly prescribed oral medications, such as hormonal therapy, to limit the risk of disease recurrence. Research has indicated that patients should stay on these drugs for five years to gain maximum benefits.
But recently, the healthcare community has started to ask a question once limited to managing common colds, not cancer: Do breast cancer patients take their medications as prescribed?
According to the American Cancer Society, more than 200,000 new cases of breast cancer are diagnosed every year in the U.S. Of those, approximately 100,000 have cancer types that are likely to respond to hormonal therapy. Taking the therapy as prescribed for the full five years can reduce their risk of recurrence.
Easier Said than Done
Based on findings from a recent symposium on medication adherence among breast cancer patients, candidates for hormonal therapy-some 500,000 women in the U.S.-may not be reaping the full benefits of their drug regimens. According to some research studies, non-compliance rates have reached as high as 40 percent.
The Symposium, called the Compliance Strategic Initiative (CSI), addressed issues that lead to medication non-compliance among breast cancer patients, and it identified possible solutions to these issues. Representatives from leading patient advocacy organizations and professional healthcare associations, as well as oncology experts and survivors from across the nation, gathered to share their perspectives. The CSI was led by a Steering Committee which included representatives from the American Cancer Society, CancerCare, the National Surgical Adjuvant Breast and Bowel Project (NSABP), and Y-ME National Breast Cancer Organization.
"Through research, we know that five years of adjuvant hormonal therapy in women with estrogen receptor-positive breast cancer prolongs survival and reduces recurrence," said D. Lawrence Wickerham, MD, associate chairman of the National Surgical Adjuvant Breast and Bowel Project. "And yet, studies also show that not all patients stay on hormonal therapy as prescribed. It is important that healthcare providers understand why women make that decision, so we can address the issue with the information, resources and support needed to help them through this part of their treatment."
Based on results of the meeting, participants gained a better understanding of the factors that contributed to non-compliance. Among those factors: patients often do not feel empowered to talk with their doctors about tough issues, such as side effects; doctors and other healthcare professionals aren't equipped with resources to assist patients in coping with or eliminating side effects; and after their acute phase of treatment, women may often feel they are left to manage therapy on their own. Physicians are under increasing pressures of time and performance and may not always have the skill set to listen well to their patients, or, simply not realize their patients may not be taking their medication. These factors combine to create communication gaps through which compliance issues can fall.
In conclusion, breast oncology advocates and experts who attended the symposium agreed that patient support mechanisms can and must be improved. Healthcare providers and patients each play pivotal roles. Through education and communication, they can begin to take the steps that will help some breast cancer patients reduce their risk of recurrence.
Two in five breast cancer patients don't take their medication properly.
Is There A Preferred Way To Detect Breast Cancer Both Digital And X Ray Film Mammograms Can Help Save Lives
In 2006, more than 250,000 U.S. women will be diagnosed with breast cancer. This deadly disease will claim the lives of more than 40,000 friends, neighbors, mothers and daughters. These are staggering statistics.
However, breast cancer death rates are going down. This decline is largely attributed to the benefits of annual mammograms that enable physicians to detect cancer at its earliest stages, and improved treatment programs that help patients better manage their cancer.
Both digital and film-based mammography can identify breast disease in women who may have no obvious signs of breast cancer. Historically, mammograms have been conducted using medical X-ray film. Now, new digital imaging technologies are emerging that offer a complementary method for early detection of breast cancer.
The arrival of more digital imaging options sometimes can cause some patients to "wait it out" until their health care provider installs digital imaging systems. But the advice from physicians appears to be overwhelming: Do not wait for the latest digital technology. One of the most critical aspects for a full recovery is early detection, and it is far better to have any kind of mammogram than to delay or skip a mammogram entirely. The decision on which imaging technology to use should be a secondary issue that patients can discuss with their physicians.
"Digital technologies show great promise in helping to detect breast cancer in certain patients," said Dr. John M. Lewin, Diversified Radiology of Colorado, a leader in providing technologically advanced radiology imaging. "In fact, the Food and Drug Administration (FDA) is considering relaxing guidelines that may make it easier for manufacturers of digital mammography systems to bring new products to market faster."
Should the FDA adopt revised guidelines, it is possible that health care providers and patients could have access to a broader range of new digital mammography products earlier-and perhaps at a lower cost-as more competition among manufacturers may drive down prices of these systems.
One of the innovators of digital medical imaging systems is Eastman Kodak Company, which currently markets a digital mammography system for use in Europe, Latin America, Asia and other parts of the world. Kodak has applied to the FDA for approval to market this system in the U.S. and the company is conducting clinical trials of this system in the U.S. and Canada. "We applaud the FDA for examining ways to streamline the approval process for digital mammography products that may lead to increased adoption and improved access to these innovative systems," said Michael Marsh, vice president, Kodak's Health Group.
Given the benefits and improvements in both digital and film mammogram technology, there is more reason now than ever before to encourage mothers, grandmothers, sisters and friends to get an annual mammogram.
The American Cancer Society continues to recommend the importance of mammograms as a highly effective tool in the detection of breast cancer. What is critical is not the technology used to produce a mammogram, but ensuring that women age 40 and older have regular mammograms as part of maintaining a healthy lifestyle.
Breast Cancer Its Causes
Breast cancer is a malignant tumor developed from cells of the breast, and it is one of the most common cancers affecting females, at time has not been established what is the exact cause of this one, but last researches clearly pointing that there are several risks factors;
These are the most probably breast cancer risk factors;
-Last researches have established that in the age group above 50 years there is a high incidence; on the other hand, in the age group below 25 years the incidence is very low. It is very important to say that this disease is very aggressive in patient 25-50 years old.
-Menstrual cycle is other factor that should be considered; common in the ladies who have a longer menstrual life, i.e. the onset of menarche is earlier and cessation of menstruation is late.
-The women that smoke and drink alcohol increase the risk of developing breast cancer.
-Breast cancer is developed more frequently in spinsters and married woman that have not given birth to children, or if given birth then have not breast fed their offspring.
-The women that have had a breast cancer on one side have greater risk to develop cancer on the opposite side, and if there are antecedents of breast cancer in their families (mother, sisters and daughters), there are greatest risks too.
-Breast cancer is linked with obesity and higher intake of saturated fatty acids
-Breast cancer is linked too, with the continuous or sequential uses of combined oestrogen plus progestin hormone therapy (CHT)
-Women that have been using oral anti contraceptives for more than ten years are more vulnerable to the development of this disease.
On the other hand, women doing 4-5 hours of exercises per week reduce their risk of developing breast cancer.
In short, these facts derive from the statistical analysis; they should not be taken as causative or predisposing factors.
What You Need To Know If Your Mother Had Breast Cancer
If your mother had breast cancer, you have an increased chance of developing it yourself. Knowing your family history, understanding your personal risk, getting appropriate screening tests and making lifestyle choices are important steps toward good breast health, according to the Susan G. Komen Breast Cancer Foundation.
"If breast cancer runs in your family, understanding your risk and how to approach your breast health is important to both your physical and emotional well-being," says Cheryl Perkins, M.D., senior clinical advisor for the Komen Foundation.
Family History and
If your mother, sister or daughter has breast cancer, your risk of developing the disease is two to three times greater than a woman without this family history. However, being at increased risk for breast cancer does not guarantee you will develop the disease. Talk to your provider to discuss your personal risk and his/her recommendations for regular screening. Regular screening usually includes mammography, clinical breast exams and breast self-exam. Additional screening may be recommended depending on your personal risk.
Gene Mutations and
Only 5 to 10 percent of all breast cancer is due to heredity. Genetic testing can determine if you inherited the mutated BRCA1 or BRCA2 genes, which are key in the development of some breast cancers. However, having a mutated gene does not guarantee that you will get breast cancer. If you have concerns about your family history and personal risk, talk with your doctor about whether genetic testing is right for you.
Taking Preventive Steps-Making Healthy Lifestyle Choices
Many factors can increase a woman's chance of getting breast cancer. While some risks, such as being a woman and getting older, are out of your control, others can be managed. For example, risk factors such as consuming alcohol, lack of exercise and being overweight are all factors that you can modify.
Helping Your Mother Through Breast Cancer
If your mother is diagnosed with breast cancer, she needs your support. From diagnosis through treatment and beyond, your mother's co-survivor network of family and friends will be a vital part of her support system.
A 10 Year Drive To Put The Brakes On Breast Cancer
Breast cancer is a highly treatable disease that now has a survival rate of 85 percent. Yet more than 212,000 women are still diagnosed with the condition each year.
Since early diagnosis is an important key to successful treatment, doctors say it's important that all women over the age of 18 do a Breast Self-Exam (BSE) every month, two or three days after their menstrual cycle. In addition, women between 20 and 39 should have a clinical breast exam at least every three years and women 40 and older should have a mammogram every year.
For the past 10 years, BMW of North America has worked with The Susan G. Komen Breast Cancer Foundation-the largest fund-raiser for breast cancer research in America-to help spread the message of early detection and to help ensure that breast cancer research continues. The groups' Ultimate Drive program has raised millions to help fund the efforts.
The initiative, fully underwritten by BMW, consists of two fleets of specifically badged BMWs making a cross-country trek, stopping in communities along the way to hold daylong events. People will be invited to test-drive the cars-at no cost to the participants-to raise money for breast cancer research, education and screening treatment programs.
The car company donates $1 directly to the Komen Foundation for each mile driven, along with whatever other proceeds are received from the program. Upon completion of every drive, each participant adds his or her own name to the Signature Vehicle-this year, a BMW 3-Series.
This year's goal is to raise over $1 million, bringing the program's 10-year total up to over $10 million. To help celebrate the initiative's 10th anniversary, the 240-stop cross-country trek has been expanded to include Alaska.
People can test-drive the cars to help fight breast cancer. They can also:
(*) Regularly conduct BSEs, have clinical exams and mammograms
(*) Stop smoking and stressing
(*) Get more exercise
(*) Cut or reduce their alcohol consumption
(*) Watch their diet. Try to eat plenty of olive oil, fruits, vegetables, grains, fresh fish and poultry.
Breast Cancer Estrogen Dominance The Imbalance Of Hormones
Estrogen Dominance is a term coined by the late John R. Lee, M.D., author of a number of books on the topic of women's hormones. The theory of Estrogen Dominance describes a condition where a woman can have deficient, normal or excessive estrogen but has little or no progesterone to balance its effects in the body. Even a woman with low estrogen levels can have estrogen dominance symptoms if she doesn't have any progesterone. Basically estrogen dominance reflects hormones that have gone out of balance. Out of balance hormones can affect women from 14 to 94.
How do we become estrogen dominant? Our food chain is laced with toxic pesticides, herbicides and growth hormones - a sea of endocrine-disrupting chemicals that mimic estrogen in the body. If we are overweight, our body's store of excess fat can be converted into estrogen. Insulin resistance also leads to estrogen dominance. Then there is estrogen found in ERT, HRT and Birth Control Pills.
Estrogen dominance also occurs in men. As men age, estrogen gradually rises, while saliva levels of progesterone and testosterone gradually fall. We often find men of fifty having higher saliva estrogen levels than women of fifty! A sign of estrogen dominance in men is the tendency for some to develop breasts.
An imbalance of hormones in our bodies results in hormone-related health problems such as PMS, endometriosis, uterine fibroids, infertility, post-partum depression, weight gain, increased blood clotting, thyroid dysfunction, even breast and uterine cancer in women and in men breast cancer, prostate problems and prostate cancer.
Estrogen Dominance can be detected by taking a saliva test. This simple test can accurately reveal hormone levels. Men can also take this simple at-home test to determine if their hormones are out of balance.
A saliva test evaluation will either move a man or woman to take action to bring balance to their own hormones or cause them to sit back and reflect on their good hormone health. Those over 50 can take an annual saliva test to keep track of their hormone levels.
Men and women who experience hormone imbalance feel unwell - bringing balance to their hormones is often a key to their wellness. There are safe natural alternatives available to drug therapies. Women and men must become more informed about their own hormone health.
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