Saturday, October 25, 2008

Treatment options for early-stage breast cancer  has a thorough article assessing the different treatments available for early stage breast cancer.  It does a nice job of explaining how options differ between hormone-negative and hormone-positive.  Complex stuff, so you might want to print it and take it with you to your doctor's appointment. 

Saturday, October 18, 2008

High-Fiber Bread Associated with Reduced Hormone Negative Risk; Fried Potatoes Associated with Increase

I grew up loving white bread—a piece of lunch meat, some mayo and good old Wonder bread was my idea of the best grade school lunch ever. Yummm. Add some potato chips and it didn’t bother me that I had just tried to recite Joyce Kilmer’s “Trees” and kept starting at the last line and Sister Mary Schoolteacher made me sit down in humiliation. (I kept starting with the final line: “Poems are made by fools like me.” No doubt Sister thought, “Fool indeed.”)

It took me decades to get to truly like whole wheat bread. Fried potatoes remain one of my favorites, although I seldom eat them now. And now I can Google the words to “Trees.” (See below.)

New research shows that I was absolutely on the wrong track for most of my life, but my post-cancer diet is right on the money. Swedish researchers monitored the diets of 544 women for 10.3 years. They discovered that those with a diet that regularly included high-fiber bread had a significantly reduced risk of breast cancer—both hormone negative and hormone positive.

Fried potatoes were significantly associated with an increase in hormone negative breast cancer. Their research was published in August in the journal Carcinogenesis.

So, cut the French fries and chomp on whole wheat bread. Chances are you’ll feel better, fight cancer, and lose weight. Had I done that, maybe I would have recited the poem correctly.

by Joyce Kilmer

I think that I shall never see

A poem lovely as a tree.
A tree whose hungry mouth is prest

Against the earth’s sweet flowing breast;
A tree that looks at God all day,

And lifts her leafy arms to pray;
A tree that may in Summer wear

A nest of robins in her hair;
Upon whose bosom snow has lain,

Who intimately lives with rain.
Poems are made by fools like me,

But only God can make a tree.

Wednesday, October 15, 2008

Caffeine Might Increase Hormone Negative Risk

The more caffeine you drink, the higher your risk of hormone negative breast cancer, according to a study published in the October 12, 2008 Archives of Internal Medicine. The research was part of the Women’s Health Study, with 39,310 participants who filled out a comprehensive questionnaire on their eating habits. This study looked at the links between caffeine intake—coffee, black tea, and colas primarily—and breast cancer.

Researchers assumed that the content of caffeine was 137 mg per cup of coffee, 47 mg per cup of tea, 46 mg per can or bottle of cola, and 7 mg per serving of chocolate candy.

The big caffeine Kahuna here, then, is coffee.

Twenty-four percent of the women never drank coffee; 13 percent drank less than a cup a day; 14.2 percent had two to three cups a day, and 15.4 percent had four cups a day. Yikes!

No matter the quantity, though, caffeine had no significant effect on hormone positive breast cancer. But the risk of hormone negative does go up with each cup of coffee. Likewise, the chance of having a tumor larger than 2 cm went up with increased coffee consumption.

Still, as is the case with many breast cancer studies, the number of cases of hormone negative breast cancers was so small that researchers didn’t have enough data to state conclusively that high caffeine leads to hormone negative breast cancer. These findings, they say, may be “due to chance and warrant further study.”

Until the data are in, though, it might be best to cut the coffee.

And, on a side note, most media notices I have read on this focus on the fact that caffeine does not lead to breast cancer, once again making generalizations about breast cancer while ignoring hormone negative.

Monday, October 13, 2008

Plastic Bottles May Hurt Cancer Treatment

Bisphenol A, (BPA), a chemical found in a number of plastic products, can reduce the effectiveness of chemotherapy treatments on breast cancer, according to a study reported in the October 8, 2008 online edition of the journal Environmental Health Perspectives. Researchers at the University of Cincinnati subjected breast cancer cells to low levels of BPA, similar to levels found in the blood of humans. They found that BPA mimics estrogen, which can protect cancer cells from the effects of chemo, thus reducing chemo’s strength. Estrogen has been previously linked to chemotherapy resistance, but researchers have wondered why post-menopausal women can also be resistant. This study might provide some explanation for that connection. It might also be provide some answers for hormone receptor negative cancer.

BPA is found in drinking bottles and the lining of food cans. Some experts recommend avoiding plastic bottles marked with the recycling symbols 3,6 or 7. Others say all plastic, even that promoted as being BPA-free, is suspect and can leach dangerous estrogen-like chemicals.

Sunday, October 5, 2008

Obama and McCain On Coverage of Pre-Existing Conditions

Several organizations and publications have evaluated the health care plans proposed by John McCain and Barack Obama recently.

In its November 2008 issue, Consumer Reports compared the two based on real-life needs. One scenario presented the case of 59-year-old Susan Braig, a self-employed artist and grant writer who was diagnosed with breast cancer in 2004. Her current insurance costs only $2,496 a year, but when she was sick, it did not cover chemo and other out patient treatments, leaving her $40,000 in debt. Consumer Reports looks at how McCain and Obama would cover her and offers this bottom line:

Obama would probably do more to cut costs and improve coverage for those like Braig with limited income or a poor health history.   Among other things, he’d prohibit insurers in the individual and small-business market from selling plans with coverage with loopholes like those in Braig’s plan.

In a comparison chart, the magazine looks at the “Ability to get coverage regardless of a pre-existing condition” and says:

MCCAIN: In McCain’s deregulated market, insurers could choose whether or not to cover pre-existing conditions, so rules would vary from policy to policy. People with health issues could instead apply for coverage under a federal-state GAP plan. The campaign promises GAP insurance will be comprehensive and affordable but has offered few details. Existing high-risk pools tend to be costly.

OBAMA: Obama would explicitly require insurers to cover pre-existing conditions. The campaign says those policies would be affordable, since its plan would make the health system more efficient and cut $2500 yearly from the average family’s bill. It offers no specific calculations to support that number, however, and others say costs would go up since more sick people would be covered.

Mary Carmichael, in Newsweek’s October 6 issue, asked Katherine Swartz, a professor of health policy and economics at Harvard, to compare the two programs. An excerpt:

Can you explain McCain's plan to help out people with previously existing conditions by expanding "high-risk pools"?We've had state-sponsored high-risk pools for several decades, but they cover fewer than 200,000 people. They were set up so insurance companies could essentially cede people who they predicted would have very high health-care costs. At one point McCain said he would subsidize high-risk pools with between $7 billion and $10 billion a year. That would cover maybe 3 million people, which is not much of a dent in the 47 million people without insurance now.

Obama would also require insurers to cover people with pre-existing conditions. Wouldn ' t insurers raise premiums?Yes, premiums may be higher. I think people need to consider the alternative—if patients are closed off from coverage, they still go to the ER, and we all pay for that.

The Kaiser Family Foundation gives a side-by-side comparison of the two candidates’ plans. It doesn’t provide a specific category on pre-existing conditions, so it says nothing about McCain’s plan in that respect, saying only that Obama would “Prohibit insurers from denying coverage based on pre-existing conditions.”

Friday, October 3, 2008

Thriving, Not Surviving

I attended a breast cancer survivor’s luncheon today, met a good group of women, and had a surprisingly lively conversation about chemotherapy, oncologists, wigs, and how it feels to be a survivor. Many of us, though, object to being called survivors. “I’m a thriver,” one woman said. I like that. It’s active rather than passive. I can choose to thrive, but calling me a survivor only means I didn’t die.

“Hi, I’m Pat. I’m not dead.”

My friend Diane says she hopes that, of all the dimensions that define her, the fact that she is alive should not be at the top of the list. It’s great, and she likes it, of course, but she’s also smart, accomplished, thoughtful, witty, loving.

Still, when you get cancer, you’re awfully aware of your mortality and you don’t take being alive for granted.

But you want to. The way you did when you thought other people got cancer, not you.