Radiation Helpful in Women With Ductal Carcinoma in Situ

This looks to contradict other information we have on the website. We'll keep watching here. For a bay area second opinion on DCIS, go to If you have DCIS , talk to Dr. Michael Lagios:

NEW YORK (Reuters Health) Sept 26 - Radiation therapy has meaningful benefits for older women with ductal carcinoma in situ (DCIS), even those at low risk, according to findings in the September 20th Journal of the National Cancer Institute.

Dr. Benjamin D. Smith of the Yale School of Medicine in New Haven, Connecticut and colleagues identified 3,409 women aged at least 66 years with DCIS treated with lumpectomy. The team sought to determine whether additional treatment with radiation was associated with a clinically significant benefit.

Data analysis showed that women who received radiation therapy experienced a 68% lower relative risk for each component of the combined outcome -- recurrence of ipsilateral in situ or invasive breast cancer and/or a subsequent mastectomy.

For women at high risk of a subsequent breast event, the 5-year risk was 13.6% without radiation versus 3.8% with radiation. For low-risk women, the 5-year risk was 8.2% without radiation versus 1.0% with radiation.

The relative benefit of radiation therapy persisted regardless of the presence or absence of accepted risk factors such as being younger at diagnosis, large tumor size, high tumor grade, and aggressive tumor histology.

The researchers point out that "the absolute benefit associated with radiation therapy in DCIS was "considerable and compared favorably with that of other accepted clinical interventions."

Dr. Smith noted in comments to Reuters Health, that "these results suggest that radiation therapy effectively prevents recurrence and mastectomy for older women with DCIS and should be considered a reasonable component of therapy."

J Natl Cancer Inst 2006;98:1302-1310.

Reuters Health Information 2006. © 2006 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Short delay of chemo safe after breast surgery

NEW YORK (Reuters Health) - Research has shown that women who undergo chemotherapy after surgery for early-stage breast cancer have an improved chance of survival. Now, investigators have evidence that therapy can be safely delayed for up to 12 weeks - but waiting longer may adversely affect the outcome.

"Our findings can reassure women with early-stage breast cancer that it is okay to take some time before they start chemotherapy -- to gather information and be actively involved in treatment decision-making," lead author Dr. Caroline Lohrisch, from the British Columbia Cancer Agency in Vancouver, Canada, said in a statement.

The study, which is reported in the Journal of Clinical Oncology, involved an analysis of data for 2,594 women who underwent chemotherapy for early breast cancer at between 1989 and 1998. The women were divided into four groups based on the time between surgery and the start of chemotherapy: within 4 weeks, 4 to 8 weeks, 8 to 12 weeks, or 12 to 24 weeks.

No significant differences in survival were seen among the three groups that began chemotherapy within 12 weeks of surgery. By contrast, starting chemotherapy at greater than 12 weeks was associated with inferior survival.

Eighty-four to 89 percent of women who started chemotherapy within 12 weeks of surgery were alive 5 years later compared with 78 percent of women who began chemotherapy after 12 weeks.

Similarly, the percentage of women who were alive and had no evidence of cancer relapse after 5 years was also higher in the groups that started chemotherapy within 12 weeks.

"Based on currently available data, including the findings in this study, patients should be encouraged to start chemotherapy before more than 3 months have elapsed from surgery, to maximize the anticipated benefit," the researchers conclude. "The issue of timing between surgery and chemotherapy warrants further study, particularly in specific subgroups."

SOURCE: Journal of Clinical Oncology, October 20, 2006.

US study looks at second opinions in breast cancer

WASHINGTON (Reuters) - Breast cancer patients were urged to change their treatment plans more than half the time when they received a second opinion from a team of specialists, U.S. researchers reported on Wednesday.

Overall, 52 percent of patients whose original diagnosis and treatment recommendations were taken to a multidisciplinary team were advised to make one or more changes in their treatment, the researchers at the University of Michigan Comprehensive Cancer Center found.

The changes were a result of breast imaging specialists reading a mammogram differently or breast pathologists interpreting biopsy results differently, the researchers reported in this week's issue of the journal Cancer.

The team, called a multidisciplinary tumor board, included surgeons, radiation oncologists, medical oncologists, radiologists and pathologists.

"A multidisciplinary tumor board that involves the collaborative effort of multiple medical specialties allows expert opinion and recommendations based on the most recent research findings," said Dr. Michael Sabel, a surgeon who worked on the study.

"Meanwhile, the patients come to only one setting, with no need to visit multiple specialists individually."

His team looked at the records of 149 breast cancer patients referred to the Cancer Center's multidisciplinary breast tumor board for a second opinion.

They found the original doctors often did not consider new surgery techniques, such as delivering chemotherapy before surgery to help save more of the breast, or sentinel lymph node biopsy, a new technique that helps find whether cancer has spread beyond the breast.

And radiologists reinterpreted imaging results in 45 percent of patients, in some cases identifying previously undiagnosed second cancers.

More than a quarter of patients were advised to have another biopsy.

Specialized breast pathologists made new interpretations of how aggressive a tumor, or what type of tumor it was, in 29 percent of patients, the researchers found.

More than 200,000 U.S. women will be diagnosed with breast cancer this year, according to the American Cancer Society, and 40,000 will die of it. Globally, 500,000 women die every year from breast cancer.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

The Sins of Our Grandmothers

From: New Scientist, Nov. 13, 2006

YOU ARE WHAT YOUR GRANDMOTHER ATE

By Roxanne Khamsi

A mother's diet can change the behaviour of a specific gene for at
least two subsequent generations, a new study demonstrates for the
first time.

Feeding mice an enriched diet during pregnancy silenced a gene for
light fur in their pups. And even though these pups ate a standard,
un-enriched diet, the gene remained less active in their subsequent
offspring.

The findings could help explain the curious results from recent
studies of human populations -- including one showing that the
grandchildren of well-fed Swedes had a greater risk of diabetes.

The new mouse experiment lends support to the idea that we inherit not
only our genes from our parents, but also a set of instructions that
tell the genes when to become active. These instructions appear to be
passed on through "epigenetic" changes to DNA -- genes can be
activated or silenced according to the chemical groups that are added
onto them. Gene silencer

David Martin at the Children's Hospital Oakland Research Institute in
California, US, and colleagues used a special strain of genetically
identical mice with an overactive version of a gene that influences
fur colour. Mice with the AVY version of this gene generally have
golden fur.

Half of the mice were given a diet enriched with nutrients such as
vitamin B12 and zinc. These nutrients are known to increase the
availability of the "methyl" chemical groups that are responsible for
silencing genes. The rest of the mice received a standard diet.

The pups of mice on the standard diet generally had golden fur. But a
high proportion of those born to mice on the enriched diet had dark
brown fur.

Martin believes that the nutrient-rich maternal diet caused silencing
of the pups' AVY genes while they developed in the womb. Passed down

Intriguingly, even though all of the pups in this generation received
a standard diet, those that had exposure to a high-nutrient diet while
in the womb, later gave birth to dark-coated offspring. Their control
counterparts, by comparison, produced offspring with golden fur.

This shows that environmental factors -- such as an enriched diet --
can affect the activity of the AVY gene for at least two generations,
the researchers say.

"The results make it clear that a nutritional status can affect not
only that individual, but that individual's children as well," says
study member Kenneth Beckman. Skin colour

Beckman notes that the AVY gene is linked to weight and diabetes risk.
He adds that there is some evidence that a related gene in humans
might affect skin colour -- but it is unknown if it also affects
weight.

Even though humans may have a similar gene, they should not make
dietary changes based on the results of the mouse experiment,
researchers stress. "It would be irresponsible to make any
prescriptions about human behaviour based on these findings," says
Martin.

An earlier Swedish study which used historical data of harvests in
Sweden, found that a youngster had a quadrupled risk of diabetes if
their grandfather had good access to food during his own boyhood.

Journal reference: Proceedings of the National Academy of Science
(DOI: 10.1073/pnas.0607090103)

Drop in Breast Cancer Rates (colon cancer too!)

Everyone is talking about this one. Where does that leave us with birth control ladies?

U.S. breast cancer rates declined 7.2 percent in 2003
Experts believe drop is due to reduced use of hormone replacement therapy
Drop means about 14,000 fewer cases were actually diagnosed

SAN ANTONIO, Texas (AP) -- In a startling turnaround, breast cancer rates in the United States dropped dramatically in 2003, and experts said they believe it is because many women stopped taking hormone pills. The 7.2 percent decline came a year after a big federal study linked menopause hormones to a higher risk of breast cancer, heart disease and other problems. Within months, millions of women stopped taking estrogen and progestin pills.

A new analysis of federal cancer statistics, presented Thursday at a breast cancer conference in Texas, revealed the drop in tumors. About 200,000 cases of breast cancer had been expected in 2003; the drop means that about 14,000 fewer cases were actually diagnosed. Because breast cancer takes years to form, experts think that withdrawing hormones mostly caused small tumors that had been growing to stop or shrink, making them no longer detectable on mammograms. Whether this is true or will result in fewer cases over the long run will take more time to tell. The next set of cancer statistics, for 2004, is due out in April.

Why do doctors think the 2003 drop is largely due to hormones? Cases declined most among women 50 and older, with tumors whose growth is fueled by estrogen -- the age group and type of cancer most affected by hormone use. The drop also was seen in every single cancer registry that reports information to the federal government. Researchers looked for a similar drop in other cancers, which could indicate something other than hormones was at work, "and we didn't see anything," said Kathy Cronin, a National Cancer Institute statistician who worked on the analysis.

When the 2003 numbers were first released a few months ago, they were grouped with 2001 and 2002 and portrayed as a leveling off of breast cancer after decades of steady rise. The big single-year drop was not pointed out because experts did not want to make too much of it without knowing whether the trend would continue. However, Dr. Peter Ravdin, a breast cancer specialist at the University of Texas M.D. Anderson Cancer Center who led the new analysis, said the single-year drop is important regardless, because it was so huge and came after years of steady increases. "We don't know about whether or not it's going to be a trend but we know for this year it was a significant effect," he said.

Doctors estimate that half of women who were taking hormones stopped after July 2002, when the federal Women's Health Initiative study was halted because more women taking estrogen/progestin pills developed breast cancer or heart problems. That led to new warning labels on the drugs and doctor groups urging women to use the lowest dose for the shortest time possible. "The hypothesis is entirely plausible, that the discontinuation of hormone replacement therapy could be having an effect," said Dr. Michael Thun of the American Cancer Society. Copyright 2006 The Associated Press . All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Fat in the Diet and Cancer Recurrence

A lot of the studies on fat don't account for the rancid oils, hydrogenation or trans fats. This one is not clear.

REDUCED LEVELS OF FAT IN THE DIET MAY DECREASE THE RISK OF BREAST CANCER RECURRENCE ACCORDING TO NEW CLINICAL TRIAL

Postmenopausal women who reduce their consumption of dietary fat and have been treated for early-stage breast cancer may reduce their chances for breast cancer recurrence or a second breast cancer, according to results from the Women's Intervention Nutrition Study (WINS). WINS was the first large-scale randomized trial to show that a change in diet can improve breast cancer outcomes in women who are receiving conventional treatment for early-stage breast cancer. Results of this study, which was sponsored by the National Cancer Institute (NCI), part of the National Institutes of Health, appear in the December 20, 2006, issue of the "Journal of the National Cancer Institute"* along with an editorial on the findings by NCI scientists**. This report is based on an interim analysis of the trial data.

Red Meat Increases Breast Cancer Risk

Interesting in light of the carnitine issue. Red meat is the best source. Maybe it has something to do with how we treat the cows. Would you like some hormones and antibiotics with that?

This is from the Cancer Project Newsletter

New data from Harvard’s Nurses’ Health Study II show that women who consumed one and a half or more servings of red meat per day had nearly double the risk of developing hormone-receptor-positive breast cancer compared with women consuming three or fewer servings of red meat per week. Hormone-receptor-positive breast cancer is the most common type of breast cancer and has been on the rise in recent years. This study involved more than 90,000 premenopausal women age 26 to 46 who completed food surveys during a 12-year period. Animal fat and red meat intake were found to increase premenopausal breast cancer risk in a previous analysis of the Nurses’ Health Study II. Possible reasons for this association include carcinogens produced as meat is cooked, hormones given to cattle for growth promotion, red meat’s high content of heme iron, which has been shown to increase estrogen-dependent tumor growth, and red meat’s high fat content.

Cho E, Chen WY, Hunter DJ, Stampfer MJ, Colditz GA, Hankinson SE, Willett WC. Red meat intake and risk of breast cancer among premenopausal women. Arch Intern Med. 2006;166:2253-2259.

Carnitine and Cancer fatigue

There is a new study out about Carnitine. If you have fatigue during cancer treatment, you might be deficient in carnitine. Still we always recommend working with a professional to help sort out the deficiencies in your body rather than throwing nutrients based on a new study.

Here is a link to the webpage from NIH

Carnitine: What is it?
Carnitine, derived from an amino acid, is found in nearly all cells of the body. Its name is derived from the Latin carnus or flesh, as the compound was isolated from meat. Carnitine is the generic term for a number of compounds that include L-carnitine, acetyl-L-carnitine, and propionyl-L-carnitine [1-2].

Cancer
Fatigue resulting from chemotherapy, radiation treatment, and poor nutritional status is common in cancer patients [23]. They may also be deficient in carnitine [23]. In one study, treatment with carnitine supplements (4 grams/day for one week) ameliorated fatigue in most chemotherapy-treated subjects and restored normal blood levels of carnitine [24]. In another trial, terminal cancer patients supplemented with carnitine (doses ranged from 250 milligrams to 3 grams/day) experienced less fatigue and improved mood and quality of sleep [23]. In both studies, most subjects were carnitine deficient before taking the supplements.