Wednesday, September 24, 2008

NCRCC Site Covers Politics and Breast Cancer

The National Breast Cancer Coalition's Web site is worth a look because of its coverage of breast cancer issues related to the presidential campaign. The non-partisan advocacy group was formed in 1991 to lobby "at the national, state and local levels for public policies that impact breast cancer research, diagnosis and treatment. Our grassroots advocacy effort has hundreds of member organizations and tens of thousands of individual members working toward increased federal funding for breast cancer research and collaborating with the scientific community to implement new models of research, improve access to high-quality health care and breast cancer clinical trials for all women, and expand the influence of breast cancer advocates in all aspects of the breast cancer decisionmaking process."

The organization's blog has some informative posts.  One compares Obama and McCain's health care plans and is worth poking into.  Obama's plan has been criticized as being more expensive, but that's because it covers more Americans, even those with existing conditions, such as cancer. As I have noted before, McCain does not cover those with existing conditions.  The site links to an excellent  Wall Street Journal article explaining the impact of the two candidates'  plans. One difference the newspaper notes:  Obama's plan would increase regulation.  McCain's would decrease it.  Interesting.

I have placed the group's pledge on the left column of my site.   Vote to let the candidates know that quality health care is a priority.   By signing, you also pledge to take the candidates' health care positions into consideration when voting.

While the economy is getting the attention this week, as well it should, health care cannot be ignored.   The financial health of the country, yes, is of prime importance.  The physical health, however, is equally important.

Saturday, September 13, 2008

Risk of Late Recurrence Lower for Hormone Negative

Here’s a good news/better new flash: women with early stage breast cancer remain at low risk of recurrence years after treatment. That’s good. Better is that women with hormone negative cancers face a much smaller risk of later recurrence than those with hormone positive. This, despite the fact that hormone negative is considered to be more lethal than positive.

The study, by researchers at the University of Texas M.D. Anderson Cancer Center, included 2,838 women with stage I, II, or III breast cancer between 1985 and 2001. Five years after beginning therapy—chemotherapy, radiation, tamoxifen or all three—those with hormone negative disease faced a seven percent chance of recurrence, while those with hormone positive had a 13 percent chance.

The really good news: 89 percent of all patients had no recurrences within 10 years; 80 percent had no recurrences after 15 years. Within five years, those with stage I cancer had a 7 percent risk of recurrence; stage II faced an 11 percent risk; and stage III faced a 13 percent risk.

The research was published online in the Journal of the National Cancer Institute on August 11, 2008. Because HER2 was not routinely measured at the time and Herceptin and aromotase inhibitors had not been introduced, they were not included in the data. Until 2000, tamoxifen was the only drug for follow-up breast cancer care, and it was limited to women with hormone positive disease.

Researchers say that, while the numbers are small, the fact that cancer can recur years after therapy points to a need for more follow-up care. An interesting conundrum, considering the fact that women with hormone negative cancer faced a lower rate of late recurrence than women with hormone positive disease. That is, women for whom there never has been a long-term drug treatment option did better than women with the drug.

The study does point to continued need for regular follow-up exams and mammograms. I would also emphasize the importance of focusing on a low-fat, healthy diet with plenty of exercise, which have been proven to lower the risk of recurrence of hormone negative breast cancer.

Thursday, September 11, 2008

Younger Women With Hormone Negative Benefit from Removing Second Breast

Having both breasts removed improves survival rates for young women with early stage hormone-negative breast cancer, according to a study presented at the 2008 Breast Cancer Symposium in Washington DC. And the reduction was significant—a 31 percent drop in mortality rates. Researchers at the University of Texas M.D. Anderson Cancer Center in Houston studied records of more than 80,000 breast cancer patients diagnosed from January 1998 through December 2003.

Women 18-49 with stage I-II breast cancer benefited from contralateral prophylactic mastectomy—or removing both the affected breast and the opposite—or contralateral—one. Older patients, those with stage III disease, or with hormone-receptor-positive breast cancer, saw no significant survival benefits from contralateral prophylactic mastectomy.

Presidential Politics and Health Care: Pay Attention

With presidential politics mired in lipstick on varied animals, it’s time to force a break from the silliness and look at how the candidates handle issues of actual importance, such as health care. Eerily enough, in her criticism of John McCain’s health care plans last April, Elizabeth Edwards called his proposals “painting lipstick on a pig.” (Perhaps it is time to put that phrase to rest, and leave the poor pigs to their mud.)

Edwards’ major complaint, cosmetics aside, is that McCain’s plan would not apply to either her or McCain—or me. It does not include any provisions to keep insurance companies from denying coverage for preexisting conditions. Elizabeth, John and I are all fine, with affordable health insurance and the resources to pay for care. Well, the other two have quite a few more resources than I do, but I still can afford the health care I need, which makes me fortunate indeed. Had I been diagnosed with breast cancer and not had insurance, though, I would have been in a truly scary place, at risk physically and financially. That happens to far too many Americans with serious illness and it is just plain wrong.

Paul Krugman, in the New York Times, agrees, and wrote at the time of Edward’s comments, “It's about time someone said that and, more generally, made the case that Mr. McCain's approach to health care is based on voodoo economics -- not the supply-side voodoo that claims that cutting taxes increases revenues (though Mr. McCain says that, too), but the equally foolish claim, refuted by all available evidence, that the magic of the marketplace can produce cheap health care for everyone.”

The McCain Web site says:  John McCain will reform health care making it easier for individuals and families to obtain insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.

Sounds good until you realize that there currently is plenty of competition in the insurance market and we still have 45.8 million uninsured American citizens —in a country with a population of 305 million.  That means 15 percent of Americans are uninsured. And 21 percent of those are under 17. So more of the same seems a weak argument. Competition in the market has only led to continued increases in insurance and health care costs. What’s more, portability applies only to those people whose employers offer them insurance in the first place, which happens less and less in this damaged economy.

Barack Obama proposes simply to cover all Americans. In May, he said, “If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”

The Obama site defines Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.

Obama’s plan is similar to one developed in Massachusetts  and instituted in 2006, which mandates coverage. Obama would subsidize costs for those at lower income levels through tax increases on those making more than $250,000.

Chris Hedges of Truthdig says neither candidate has it right, and that only a single-payer national health insurance system makes sense, citing a Harvard Medical School study that says this would save the country $350 billion a year. 

Still, we need to at least take baby steps, and proposing to shut down one of the country’s largest industries just isn’t going to happen overnight. Change will have to come incrementally, and Obama’s plan is a beginning. Canada went to a single-payer system in the 60s, so there is precedent for it happening. We need somebody with the courage and smarts to force that move. Obama’s 18-month focus on change is clearly the way to go, as evidenced by the fact that McCain is now using the same theme.

Whatever your politics, if you have a chance to visit with the candidates or their staffs, hold them accountable to health care change. More of the same is unthinkable. Make the candidates talk specifics on who they would cover and how. And make them stop talking about lipstick.  

Wednesday, August 20, 2008

PST May Offer Hope for Hormone-Negative

The Windsor Star reports that Canadian and Indian researchers are collaborating on a study to determine the use of the drug pancratistatin (PST) specifically for hormone-negative breast cancers. PST, made from the Hawaiin spider lily, has been shown in studies to kill cancerous cells while sparing healthy ones. If successful, it will be the first drug for hormone-negative cancers.

Tuesday, August 19, 2008

Take One Off the Bucket List: I Made it Up the Mountain




Here I am at the miners’ cabin at approximately 10,700 feet on the East Spanish Peak in Southern Colorado. The long shot is of our cabin from the mountain—we’re tucked in that green little valley. And the final shot is of my son, Josh, as a stick figure on top of the ridge, making his way down from the peak, about 2,000 feet above us.

We have owned this property for 16 years and I have been looking up at “our” mountain—it is our focal point here—and imagining myself up there. My husband, son, daughter, brother, and nephews have made it up to the “bowl,” an expanse of rock about 75 percent of the way up the peak. I have heard the stories of the beautiful views, the miners’ cabin, the challenge of the climb, and have envied those who have made it. Three years ago, before I was diagnosed with breast cancer, I began a fitness regimen, with one goal being to make it up to the bowl. I have not had a desire to go the entire way up to the peak, as traversing that rock seemed seriously out of my league. Instead of climbing the East Peak at that time, though, I climbed my own mountain of chemotherapy and radiation. So, finally making the hike last week felt like a double victory—over the mountain and over the cancer.

So, there, I did that.

Saturday, June 28, 2008

Magnificent Hummingbirds


These fellows are actually called Magnificent Hummingbirds (Eugenes fulgens), as far as I can tell from my bird book. They’re mesmerizing to watch—they zip straight up about thirty feet into the air then dive back down at featherneck speed and stop on a dime. Sometimes they will fly directly into your face and levitate a few inches in front of your nose, then abrupt fly off sideways. They make a little teek sound and they do not seem to play well with others. Usually there is a dominant bird who bosses the others around and pushes them out of the feeder so he can eat. They love sugar---we feed them a cup of the crystal octane to about three cups of water. That gives them the buzz to act like bomber pilots.

This has nothing to do with breast cancer, except to provide perspective and a little beauty. I took the picture on the deck of our Colorado cabin at dusk as a storm was brewing in the background. I could try for some metaphors here:

We should embrace life like these winged creatures and fly freely, focusing just on the present
. Bleach. Let’s all chirp “namaste.”

If a hummingbird, which weighs about an ounce and measures four inches long, can fly from Colorado to Mexico for the winter, doesn’t this dwarf the challenges we face? Maybe, maybe not. Personally, I would love to be able to fly. Wouldn’t you? I bet I would be really skinny if I could exercise by flying. Of course, if could fly, others probably could as well and then the skies would be a mess of people in business suits and briefcases buzzing above. Occasionally a woman with sensible heels would lose a shoe and it would pop you on your head. Next metaphor….

Hummingbirds maintain a healthy body mass index through strenuous exercise. OK, this isn’t a metaphor. And, besides, they might have a nice BMI, but look at their tummies.

As storm clouds build, look to one another for sustenance. Or look to a whole lot of sugar.

Nature’s beauty is its own reward. A truism, not a metaphor. But true indeed.

Wednesday, June 18, 2008

Hormone-Negative Breast Cancer Can Return As Hormone-Positive

Doctors have long assumed that, if a woman’s breast cancer recurred, it would return with the same receptor status. New research presented at the American Society of Clinical Oncology’s 44th Annual Meeting, shows that a fairly high proportion of recurrences—28 percent—had changes in receptor status: estrogen, progesterone, or HER2.

Interestingly, doctors said that most women do not get additional biopsies for relapsed or metastatic breast cancer. This new information, though, suggests that all new cancers should be biopsied, as changes in receptor status can mean significantly different treatment. For example, if you had been estrogen and progesterone negative, doctors would not treat you with hormone therapy such as tamoxifen. If cancer returns as positive for either estrogen or progesterone, such therapy could be beneficial. Likewise, if you were originally estrogen and progesterone positive and your cancer returned as negative, hormone therapy would not help.

The research was done on tissue samples of women in British Columnia who had relapses between 1986 and 1992.

Forty-five of the original 160 samples showed some type of change. Of these, 11 were local recurrences—at the site of the original tumor—and 34 were regional or distant relapses—in other parts of the body. Of the 34 regional or distant relapses:

11 changed from ER/PR positive to ER/PR negative
14 changed from ER/PR negative to ER/PR positive
3 changed from HER2 negative to HER2 positive
6 changed from HER2 positive to HER2 negative.

Wednesday, June 11, 2008

Chemobrain

I had an article in the January/February issue of Mamm on chemobrain. I enjoyed writing it and learned a great deal--mainly, that chemo does not cause chemobrain, so it is more aptly called cancer brain.  Researchers are learning fascinating stuff about genes, our brains, and cancer.  

 

Sunday, June 8, 2008

Traditional Chemo Better Than New Drug for Hormone Negative

Patients taking a new cancer drug for operable hormone-negative breast cancer faced a far higher risk of death or recurrence than those on standard chemotherapy drugs, according to research presented at the 2008 annual meeting of the American Society of Clinical Oncology. Xeloda (capecitabine) was found to be far less effective than the traditional regimen of AC (doxorubicin/cyclophosphamide) or CMF (cyclophosphamide/methotrexate/fluorouracil) in a test of women aged 65 and older. Xeloda is an oral drug, so it has a bit more appeal than AC and CMF, which are administered intraveneously.

Thirty-four percent of the patients in the study were hormone receptor-negative. Those on Xeloda faced a five to six times greater risk of recurrence and death than those on standard chemo.  Among all participants, the risk was two times higher, so the effects of the drug were especially reduced among women with hormone-negative breast cancer. This is consistent with previous research that has shown a greater benefit from chemo for hormone-negative patients than for hormone-positive.

Patients were studied for two years. Enrollment in the study was stopped after the first 633 patients because the results showed reduced benefit from Xeloda.

Friday, May 30, 2008

Understanding Your Pathology Report: A Short Primer

Your pathology report will include information your doctor will use to determine your treatment and to gauge your prognosis. If you had a biopsy before surgery, you will probably have two different reports—one from the biopsy and one from surgery. Make sure you get a copy of all your reports as they will help you understand your doctor’s recommendations. Lalit vora, MD, director of breast MRI at the City of Hope, even suggests women talk to the radiologist who did the original screening. “The radiologist should be part of your team,” he says. This can be easier said than done, however, as many radiologists prefer to work through the doctor, to reduce the risk of misunderstanding.

Your pathology test has seven sections: specimen, clinical history, clinical diagnosis, gross description, microscopic description, special tests or markers, and summary or final diagnosis.

SPECIMEN: Where the test was taken, such as left or right breast or lymph nodes. A biopsy report will not have data on lymph nodes.

CLINICAL HISTORY: A cryptic statement about your history related to this and any previous cancers. On a biopsy report, this will explain why the test was done, with a notation such a “density” or “palpable lump.” On a surgical report, it will refer to why the surgery was done, often with a simple reference to “left breast cancer.” It may also explain your surgery—“mastectomy” or “partial mastectomy,” for example.

CLINICAL DIAGNOSIS: Your specific type of cancer, such as infiltrating ductal carcinoma (a cancer that has broken through the wall of the milk duct) or ductal carcinoma in situ (the cancer remains contained in the duct).

GROSS DESCRIPTION: The size of the tumor and, for a surgical report, the size and status of the surgical margins and lymph node involvement. This includes:

•Tumor size: Tumors are measured by centimeters (cm). One cm is .394 of an inch. The smaller the better, with under 2 cm usually considered “early stage beast cancer.” 

• Lymph node involvement: The number of lymph nodes tested, and those that tested positive for cancer. A positive lymph node is one to which cancer has spread. A negative node means cancer has not spread.

• Surgical margins: This measures the amount of tissue the surgeon removed around the tumor. Ideally, this should be between 1cm and 10 cm. Clear margins mean that the cancer has not spread to the surrounding tissue.

Microscopic Description: How the cells looked under the microscope. This is most likely where you receptor status is indicated.

• Receptor status: Pathologists measure this using a system that stains the tumor after a biopsy. Different labs present results differently. Some will quantify the result; others will simply note that the cancer is positive or negative. Quantification is ideal, because the more hormones present in the cell, the less aggressive the cancer and the more likely it is to react to hormone treatment.

Some labs use a 3-point system, with a score a “0” meaning none of the cells in the biopsy sample contained receptors, and a “3” meaning most cells contained receptors. A “2” is usually considered weakly positive. Other labs may simply indicate a percentage, with 0 percent meaning no hormones were present and 100 percent meaning all cells in the sample had receptors. In this case, anything under 50 percent is usually weakly positive.

SPECIAL TESTS OF MARKERS: Two common means of assessing how rapidly the tumor is likely to grow are the Bloom-Richardson Scale and the Nottingham Histologic Score. Both readings will likely be high with HR- cancer.

• A Bloom-Richardson high grade means a fast-growing tumor; Low grade means slow-growing. The pathologist might also use the term “poorly-differentiated,” which is another way of saying aggressive.

• The Nottingham Histologic Score rates the tumor numerically based on its “mitotic” count, or how rapidly it appears to be dividing and growing. A Grade I tumor has between 1-5 points and is slow-growing. A Grade II has between 6 and 7 points and is growing at a medium pace. A Grade III is over 8 points and is rapidly growing.

SUMMARY OR FINAL DIAGNOSIS: An overview of the important aspects of your tumor.

WHAT THIS ALL MEANS: The best prognosis comes with smaller tumors that have not spread, with a low Bloom-Richardson rating or Nottingham Histologic Score. Even small HR- tumors, though, are considered aggressive.


Read more about testing and treatment for TNBC in my book, Surviving Triple-Negative Breast Cancer.

Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Tuesday, May 27, 2008

Footsteps on The Appalachian Trail


I should have added “Hike the Appalachian Trail” to my bucket list. I don’t expect to do much of the trail, certainly not the whole thing, but I would like to at least spend a day or two on it.

I got a start this month in Falls Village Connecticut. OK, we only walked it for an hour—we had a plane to catch—but I at least set foot on the same ground that others have passed since the trail was completed in 1937. The first part of our trek was not all that scenic—we walked along Connecticut Highway 7, over the Housatonic River, down Warren Turnpike, past the Housatonic Valley Regional High School and then, finally, into the woods.

Maybe next spring we’ll go to Georgia, where the trail begins. Then, some other time, we may go to Maine, where it ends. Then we can say we went on the trail from beginning to end.

Saturday, May 24, 2008

My Life In Cemeteries: Memorial Day Musings


As a kid, I spent part of every Sunday at Roselawn Cemetery in Pueblo, Colorado. We would “visit” my Prijatel and Okicich grandparents, put fresh flowers on their graves, and then wander to see my parents’ various relatives and friends. It was an oddly rewarding experience. I enjoyed hearing my Mom and Dad reminisce about their pasts and I loved the serenity of the place. Water sprinklers often chattered in the background, keeping the lawn lush and the lilac trees and snowball bushes healthy and fragrant.

My Mom taught me to walk around the graves, making sure I did not walk on top of anybody, being especially careful to avoid humps in the lawn. Occasionally, we would go to the pauper’s cemetery, where there was no lawn, the gravestones were ancient and poorly maintained, and tumbleweeds were the flowers of choice. My mother had an aunt buried there in the early 1900s, and I felt like I was walking into the Wild West when we wandered through those graves, walking gingerly to make sure we didn’t step on any humps that could be rattlesnakes.

We listened to the Slovene Hour as we drove to Roselawn, and sometimes Dad left the radio running so we could hear a favorite waltz or polka. Pueblo, Colorado, my hometown, had a healthy Slovenian population, brought there to work at the steel mill, the Colorado Fuel and Iron Corporation. My name, Prijatel, means friend in Slovene. The names on the gravestones were Slovene, Croatian, Serbian. My Dad used a racial epithet for the Serbs—a word I do not remember and am fine forgetting—inheriting a hostility toward an entire country from his parents who were Slovene immigrants. The Balkans have a long history of conflict—far longer than the recent wars between Serbia, Croatia and Bosnia in the early 1990s. That conflict lived on in the cemetery, at least in my Dad’s mind.

A few years before Dad died, I recorded a walk around the cemetery with him. I wanted a record of his memories about the people. He talked about his parents, both of whom died before I was born, and about the men he worked with at the steel mill. Dad made nails, which was a great metaphor for him—he was a strong as nails and about as sharp, in both a good and bad way. He was smart and he was acidic. As we walked over the manicured lawns in early spring, with lilacs blooming and graves festooned with irises, Dad talked in his mix of censure and compliment. “Oh, look, here’s old Frank. The old [another racial epithet, this time for Italians], I always liked him. He worked hard but he didn’t take any guff from anybody.” Farther along: “Yeah, here’s Jorge. The [another racial epithet, this time for Hispanics]. Smart, really smart. He made the rail spikes and, boy, he could fix that machine in no time flat.”

Fortunately, I did not inherit Dad’s racial perspective , but I did get the love of cemeteries. When my husband and I visited Vienna, our first stop was Zentralfriedhof, the Central Cemetery, where Beethoven, Brahms, Schubert, and Johann Strauss the elder and the younger are buried. In tiny Wrangall, Alaska, we saw one of our most intriguing cemeteries, in which graves were smothered with the special symbols of the person who had died—one was done in a nautical theme, covered with a boat wheel, nets, and a photo of the deceased in his craft.

We visited the beauty in the picture above, the Old Dutch Church and cemetery in Claverack, New York, earlier this month and it made me wonder why I love to visit cemeteries. Part of it is historical interest, to continue a link with the past, to see when people died, how long they lived, and to wonder about their lives. Partly it is because of the art involved. Gravestones can be magnificent granite monuments; outlandishly ornate mélanges of angels, crosses, and hands raised in prayer; sweetly simple rocks with loving text, or roughly rustic homemade jobs with jagged, barely visible scrapes chiseled in wood.

Everywhere, though, they are a reminder that, even though these people are gone, they left behind people who loved them and who continue to remember them. I visit the Pueblo cemetery once a year or so—my parents are now there—and I like to chat with them a bit and to spend some time with the grandparents I never knew but whom I will not forget.

Americans make their cemetery pilgramages on Memorial Day, but in Slovenia, the big celebration is on November 1—All Saints Day. For at least a block before the cemetery entrance, kiosks are set up to sell everything from the obvious to the absurd. Lots of flowers, of course, are a natural. But cotton candy? And ice cream? Our visit there was like going to a carnival. The graves were covered in flowers—fresh bouquets, plants, a mix of both—and the cemetery was packed with people, as though it were some sort of fair.

It is ironic, then, that when we tried to find my great-grandparents’ graves in Slovenia, we were told that the cemetery had moved and they were not moved with it. In Slovenia, many graves are leased, not purchased outright, so when people die or leave the country and stop paying rent, the graves they left behind revert to the church or the city.

That’s what happened to my Slovene grandparents—they moved to America and the graves of their parents simply disappeared in an abandoned churchyard. Still, my parents continued the Slovene tradition of respecting and remembering the dead and passed it on to their kids and grandkids. And so we honor other grandparents, in other graves, in other cemeteries around the world.

Friday, May 23, 2008

My Second Anniversary

I have passed the two-year mark since diagnosis.   The chances of cancer recurring decrease significantly over time, which makes every milestone important.   Hormone-negative breast cancer is most likely to recur within the first three years, so being cancer-free and healthy so far is great news, and I plan to continue in this vein.   Time to celebrate! The big party, though, will be in five years. Perhaps on Machu Picchu.

Sunday, May 18, 2008

Exercise benefits younger women

Physically active premenopausal women significantly reduce their risk of breast cancer, according to research in the May 13 edition of the Journal of the National Cancer Institute. Many studies have shown an exercise benefit to postmenopausal women, but this new research shows that younger women also reduce their cancer risk. The research is part of the long-range Nurses Health Study and included 64,777 premenopausal women. Some details:

• The greatest risk reduction came from exercise between 12 and 22, with those 23 to 34 showing a slightly reduced benefit. Women over 35, in this study, gained no risk reduction, which contradicts other studies that show a benefit to lifelong exercise.

• Running 3.25 hours a week or walking 13 hours a week brings a 23 percent risk reduction.

NOTE: Hormone-negative breast cancer is most common among premenopausal women.

Exercise—the best medicine for hormone-negative

Physical activity, including moderate walks and cycling, reduces the risk of breast cancer, with the greatest benefit among women who are hormone-negative, according to a literature review of 62 studies on the effect of exercise on breast cancer risk. Other women whose gains are especially significant: non-whites, those with a family history of breast cancer, and those who have given birth to two or more children benefit the most from exercise.

The review, published in the May 13 edition of the British Journal of Sports Medicine, found that:

• In 76 percent of the studies, physically active women had a lower breast cancer risk; risk reduction was significant in 30 of the 62 studies.

• Among the studies that showed an effect, breast cancer risk was reduced by an average of 25 percent.

• Moderate activity such as walking or leisure cycling brought better odd—a 26 percent reduction—than high intensity exercise—a 22 percent reduction.

• Lifetime activity showed the greatest benefit—greater than that from activity around the time of diagnosis.

• Active postmenopausal women benefit the most. Activity over age 50 showed a greater risk reduction that activity in adolescence and early childhood.

• Thin is best, but only when associated with exercise. Women with a BMI of less than 22 had 19 percent greater risk reduction than women with a BMI above 25. (See the link on the left to compute your BMI.)

• A high BMI cuts the effect. Women with a BMI over 30, even if they are active, had no risk reduction from exercise.

Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!


Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

Sunday, May 11, 2008

Carbohydrates increase hormone-negative breast cancer risk

A diet heavy in simple carbohydrates—sugar, white bread, cakes and cookies—can put a woman at risk of hormone-receptor-negative breast cancer, according to research in the American Journal of Nutrition’s May 2008 issue. French researchers studied the diets of 62,739 postmenopausal women from 1993 to 2002; 1812 of these women eventually were diagnosed with breast cancer. The researchers note that, because simple carbs are rapidly absorbed by the body, they elevate insulin levels, which can be the link to hormone-receptor-negative breast cancer. According the Centers for Disease Control, complex carbohydrates—whole grains, seeds, vegetables and most fruits—are more slowly digested and less likely to increase insulin levels.

Friday, May 9, 2008

Need a Last-Minute Mother's Day Gift? Support Cancer Information

Breastcancer.org's gift shop offers organic bouquets, Lenox vases and other goodies, with 10 percent going to the group's activities.  Or just give a donation in Mom's name.  Breastcancer.com offers comprehensive, accurate, and up-to-date  information on breast cancer.  It is an excellent site.

Finding the right genes

I am fascinated by the Human Genome Project, a wide-ranging, long-term study of DNA—and its implications on finding, treating, and avoiding diseases. Doctors say our cancer is as unique as our DNA, so I would really love to try to delve into the “why” and the “how” of my illness. I have a grandmother who died of stomach cancer—although I have long wondered if that was a euphemism for some "woman's problem" like uterine cancer. My mother died of liver cancer that started in her pancreas. My dad had a form of leukemia—often called pre-leukemia, although he died of pneumonia.

In the future, doctors speculate they will be able to customize cancer treatments based on genetic information. And drugs can be developed for specific genes. So, theoretically, our genes could be used to treat illnesses, rather than just cause them.

Still, even though I have a genetic predisposition toward cancer, other lifestyle factors such as diet and exercise are essential. Did the weight I gained in my 50s make me more susceptible?

As I said, this is a compelling medical mystery. It might be my next big project.

Wednesday, April 30, 2008

Report on Healthy Ways to Prevent Cancer

Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, a comprehensive report on a five-year study of the relationship between diet and exercise and cancer risk, is must reading.

A product of the American Institute for Cancer Research and the World Cancer Research Foundation in the United Kingdom, it's an excellent overview of research, with recommendations for preventing cancer through lifestyle improvements.