Thursday, October 16, 2014

The Prevention of Breast Cancer

Breast cancer continues to be a prevalent, and deadly cancer. It is the most common cancer in women and next to lung cancer, the second most common cause of death from cancer in women. 
A recent column in the Times Colonist lamented that with all the focus on screening and the use of mammography, what gets lost in the story is the need to pursue aggressive prevention strategies such as a health diet and adequate exercise. With the recent U.S. and Canadian governments issuing major guidelines on the use of a technology, and another recent U.S. Food and Drug Administration change in approval for a pharmaceutical, one has to wonder why isn't more attention being paid to prevention? 
There are strong evidence based recommendations on how to prevent breast cancer. One is to eat a healthy diet. This means maintaining a healthy weight and for most of us eating more vegetables. A major goal is to increase the fiber-to-sugar ratio in the diet. 
Exercise has been shown consistently to positively affect the healthy life span. This is also true when it comes to breast cancer. Not only is exercise a preventive strategy, it likely is also of benefit to increase the percentage of otherwise health, cancer survivors. 
The situation with alcohol usage is not as clear. It appears to increase the rate of breast cancer but when taken in moderation, also decrease the risk of an adverse cardiovascular event. Smoking, because of its strong association with other severe diseases, namely lung cancer and heart disease, is not recommended. Greater emphasis toward smoking cessation, or ideally never starting, would thereby make an enormous impact upon women's health. 
Alberta Physical Activity and Breast Cancer Prevention Trial: Inflammatory Marker Changes in a Year-long Exercise Intervention among Postmenopausal Women. Friedenreich C, Neilson HK, Woolcott CG, Wang Q, Stanczyk FZ, McTiernan A, Jones CA, Irwin ML, Yasui Y, Courneya KS. Cancer Prev Res (Phila). 2011 Oct 7. [Epub ahead of print]
Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial. Saarto T, Sievänen H, Kellokumpu-Lehtinen P, Nikander R, Vehmanen L, Huovinen R, Kautiainen H, Järvenpää S, Penttinen HM, Utriainen M, Jääskeläinen AS, Elme A, Ruohola J, Palva T, Vertio H, Rautalahti M, Fogelholm M, Luoto R, Blomqvist C. Osteoporos Int. 2011 Sep 3. [Epub ahead of print]
Vegetables, but not pickled vegetables, are negatively associated with the risk of breast cancer. Yu H, Hwang JY, Ro J, Kim J, Chang N. Nutr Cancer. 2010;62(4):443-53. Erratum in: Nutr Cancer. 2010 Jul;62(5):700.
Published by Tom Heston MD 11/30/2011
Tom Heston MD is a Johns Hopkins trained physician who practices clinical medicine in the Pacific Northwest.