The Benefits of Flaxseed

Is flaxseed the new wonder food? Preliminary studies show that flaxseed may help fight everything from heart disease and diabetes to breast cancer.

By Elaine Magee, MPH, RD WebMD Feature

Reviewed by Louise Chang, MD

Some call it one of the most powerful plant foods on the planet. There’s some evidence it can help reduce your risk of heart disease, cancer, stroke, and diabetes. That’s quite a tall order for a tiny seed that’s been around for centuries: flaxseed.

Flaxseed was cultivated in Babylon as early as 3000 BC, according to the Flax Council of Canada. By the 8^th century, King Charlemagne believed so strongly in the health benefits of flaxseed that he passed laws requiring his subjects to consume it. Fast-forward 13 centuries, and some experts would say we have preliminary research to back up what Charlemagne suspected all those years ago.

These days, flaxseed is found in all kinds of foods, from crackers to frozen waffles to oatmeal. In the first 11 months of 2006, 75 new products were launched that listed flax or flaxseed as an ingredient. Not only has consumer demand for flaxseed gone up, agricultural use has also increased -- to feed all those chickens laying eggs that are higher in omega-3 fatty acids.

Although flaxseed contains all sorts of healthy components, it owes its healthy reputation primarily to three ingredients:

• Omega-3 essential fatty acids, "good" fats that have been shown to have heart-healthy effects. Each tablespoon of ground flaxseed contains about 1.8 grams of plant omega-3s.
• Lignans, which have both plant estrogen and antioxidant qualities. Flaxseed contains 75- 800 times more lignans than other plant foods
• Fiber. Flaxseed contains both the soluble and insoluble types.

The Health Benefits of Flax

Although Lilian Thompson, PhD, an internationally known flaxseed researcher from the University of Toronto, says she wouldn’t call any of the health benefits of flax "well established," research indicates that flax’s possible health benefits include reducing the risks of certain cancers as well as cardiovascular disease and lung disease. Here are more details:

Cancer

Recent studies have suggested that flaxseed may have a protective effect against cancer, particularly breast cancer, prostate cancer, and colon cancer. At least two of the components in flaxseed seem to contribute, says Kelley C. Fitzpatrick, M.Sc., director of health and nutrition with the Flax Council of Canada.

In animal studies, the plant omega-3 fatty acid found in flaxseed, called ALA, inhibited tumor incidence and growth.

Further, the lignans in flaxseed may provide some protection against cancers that are sensitive to hormones. Some studies have suggested that exposure to lignans during adolescence helps reduce the risk of breast cancer, Thompson says.

Lignans may help protect against cancer by:

• Blocking enzymes that are involved in hormone metabolism.
• Interfering with the growth and spread of tumor cells.

Some of the other components in flaxseed also have antioxidant properties, which may contribute to protection against cancer and heart disease.

Cardiovascular Disease

Research suggests that plant omega-3s help the cardiovascular system via several different mechanisms, including anti-inflammatory action and normalizing the heartbeat, Fitzpatrick says.

Several studies have suggested that diets rich in flaxseed omega-3s help prevent hardening of the arteries and keep plaque from being deposited in the arteries, partly by keeping white blood cells from sticking to the blood vessels’ inner linings.

"Lignans in flaxseed have been shown to reduce atherosclerotic plaque buildup by up to 75%," Fitzpatrick says.

Because plant omega-3s may also play a role in maintaining the heart’s natural rhythm, they may be useful in treating arrhythmia (irregular heartbeat) and heart failure, although more research is needed on this.

Eating flaxseed daily may help your cholesterol levels, too. Small particles of LDL or "bad" cholesterol in the bloodstream have been linked to an increased risk of heart disease, obesity, diabetes, and metabolic syndrome. A French-Canadian study in menopausal women reported a decrease in these small LDL particles after the women ate 4 tablespoons of ground flaxseed daily for a year. Fitzpatrick says the cholesterol-lowering effects of flaxseed are the result of the synergistic benefits of omega 3 ALA; fiber and lignans.

Diabetes

Preliminary research also suggests that daily intake of the lignans in flax may modestly improve blood sugar (as measured by hemoglobin A1c blood tests in adults with type 2 diabetes).

Inflammation

Two components in flaxseed, ALA and lignans, may reduce the inflammation that accompanies certain illnesses (such as Parkinson's disease and asthma) by helping to block the release of certain pro-inflammatory agents, Fitzpatrick says.

The plant omega-3 ALA has been shown to decrease inflammatory reactions in humans. And studies in animals have found that lignans can decrease levels of several pro-inflammatory agents.

Reducing inflammatory reactions associated with plaque buildup in the arteries may be another way flaxseed helps prevent heart attack and strokes.

Hot Flashes

One preliminary study on menopausal women, published in 2007, reported that 2 tablespoons of ground flaxseed (taken twice each day) cut the women's hot flashes in half. And, the intensity of their hot flashes dropped by 57%. The women noticed a difference after taking the daily flaxseed for just one week, and achieved the maximum benefit within two weeks.

Who Shouldn’t Use Flaxseed?

Until more is known, Thompson says pregnant women and possibly breastfeeding mothers should not supplement their diets with ground flaxseed.

"Our own animal studies showed that flaxseed exposure during these stages may be protective against breast cancer in the offspring, but a study of another investigator showed the opposite effect," Thompson says.

Tips for Using Flaxseed

Many experts believe it's better to consume flaxseed than flax oil (which contains just part of the seed) so you get all the components. But stay tuned as researchers continue to investigate.

Tips for Using Flaxseed continued...

"Ground flaxseed, in general, is a great first choice but there may be specific situations where flax oil or the lignans (taken in amounts naturally found in flaxseed) might be as good," Thompson says.

And how much flaxseed do you need? The optimum dose to obtain health benefits is not yet known. But 1-2 tablespoons of ground flaxseed a day is currently the suggested dose, according to the Flax Council of Canada.

Here are more tips for using, buying, and storing flaxseed:

• Buy it ground or grind it yourself. Flaxseed, when eaten whole, is more likely to pass through the intestinal tract undigested, which means your body doesn't get all the healthful components. If you want to grind flaxseed yourself, those little electric coffee grinders seem to work best.
• Milled = ground = flax meal. Don’t be confused by the different product names for ground flaxseed. Milled or ground flaxseed is the same thing as flax meal.
• Buy either brown or golden flaxseed. Golden flaxseed is easier on the eyes, but brown flaxseed is easier to find in most supermarkets. There is very little difference nutritionally between the two, so the choice is up to you.
• Find it in stores or on the Internet. Many supermarket chains now carry ground flaxseed (or flaxmeal). It’s usually in the flour or "grain" aisle or the whole-grain cereal section, often sold in 1-pound bags. You can also find it in health food stores, or order it through various web sites.
• Check the product label. When buying products containing flaxseed, check the label to make sure ground flaxseed, not whole flaxseed, was added. Flaxseed is a featured ingredient in cereals, pasta, whole grain breads and crackers, energy bars, meatless meal products, and snack foods.
• Add flaxseed to a food you habitually eat. Every time you have a certain food, like oatmeal, smoothies, soup, or yogurt, stir in a couple tablespoons of ground flaxseed. Soon it will be a habit and you won’t have to think about it, you’ll just do it.
• Hide flaxseed in dark, moist dishes. The dishes that hide flaxseed the best usually have a darkly colored sauces or meat mixtures. No one tends to notice flaxseed when it's stirred into enchilada casserole, chicken parmesan, chili, beef stew, meatloaf or meatballs. For a 4-serving casserole, you can usually get away with adding 2-4 tablespoons of ground flaxseed. For a dish serving 6-8, use 4-8 tablespoons.
• Use it in baking. Substitute ground flaxseed for part of the flour in recipes for quick breads, muffins, rolls, bread, bagels, pancakes, and waffles. Try replacing 1/4 to 1/2 cup of the flour with ground flaxseed if the recipe calls for 2 or more cups of flour.
• Keep it in the freezer. The best place to store ground flaxseed is the freezer. Freeze pre-ground flaxseed in the bag you bought it in, or in a plastic sealable bag if you ground it yourself. The freezer will keep the ground flax from oxidizing and losing its nutritional potency.
• Whole flaxseed keeps longer. The outside shell in whole flaxseed appears to keep the fatty acids inside well protected. It’s a good idea to keep your whole flaxseed in a dark, cool place until you grind it. But as long as it is dry and of good quality, whole flaxseed can be stored at room temperature for up to a year.

Flaxseed Recipe

Ready to try flaxseed? Here’s a recipe to get you started from The Flax Cookbook: Recipes and Strategies for Getting The Most from The Most Powerful Plant on the Planet.

Fruity Flaxseed Muffins

These moist and high-flavor flax muffins really do taste better than they sound.

Ingredients:

1/2 cup crushed pineapple with juice, canned

1/2 cup finely chopped apples (with peel)

2 tablespoons canola oil

1 large egg, higher omega-3 if available, beaten lightly

2 egg whites (or 1/4 cup egg substitute)

1 cup fat free sour cream

1/4 cup dark molasses

1/2 cup raisins, currants (or any other dried fruit, chopped)

1 1/4 cup unbleached white flour

1/2 cup whole-wheat flour

1 teaspoon baking powder

1 teaspoon baking soda

1/4 teaspoon salt

3/4 cup ground flaxseed

Directions:

1. Preheat oven to 400 degrees. Line muffin pan with paper or foil liners. Coat inside of liners with a quick squirt of canola cooking spray.
2. In large mixing bowl, beat together the pineapple with juice, apples, canola oil, egg, egg whites or egg substitute, sour cream, and molasses until mixture is light and fluffy. Stir in raisins or dried fruit.
3. In medium bowl, whisk together flours, baking powder, baking soda, salt and flaxseed. Beating on low speed, add flaxseed mixture to sour cream mixture just until combined (batter will be a little lumpy). Spoon batter by 1/4 cupful into prepared muffin pan.
4. Bake in center of preheated oven for about 20 minutes or until muffins are golden brown and springy to the touch.

Yield: 12 muffins

Nutritional Analysis: Per muffin: 194 calories, 5 g protein, 31 g carbohydrate, 5.5 g fat, .8 g saturated fat, 2.1 g monounsaturated fat, 2.6 g polyunsaturated fat, 20 mg cholesterol, 4.5 g fiber, 224 mg sodium, 1.7 g omega-3 fatty acids. Calories from fat: 28%.

Recipe reprinted with permission.

Daily Aspirin Linked to Steep Drop in Cancer Risk

MONDAY, Dec. 6 (HealthDay News) -- Long-term use of a daily low-dose aspirin dramatically cuts the risk of dying from a wide array of cancers, a new investigation reveals. Specifically, a British research team unearthed evidence that a low-dose aspirin (75 milligrams) taken daily for at least five years brings about a 10 percent to 60 percent drop in fatalities depending on the type of cancer.

The finding stems from a fresh analysis of eight studies involving more than 25,500 patients, which had originally been conducted to examine the protective potential of a low-dose aspirin regimen on cardiovascular disease.

The current observations follow prior research conducted by the same study team, which reported in October that a long-term regimen of low-dose aspirin appears to shave the risk of dying from colorectal cancer by a third.

"These findings provide the first proof in man that aspirin reduces deaths due to several common cancers," the study team noted in a news release.

But the study's lead author, Prof. Peter Rothwell from John Radcliffe Hospital and the University of Oxford, stressed that "these results do not mean that all adults should immediately start taking aspirin."

"They do demonstrate major new benefits that have not previously been factored into guideline recommendations," he added, noting that "previous guidelines have rightly cautioned that in healthy middle-aged people, the small risk of bleeding on aspirin partly offsets the benefit from prevention of strokes and heart attacks."

"But the reductions in deaths due to several common cancers will now alter this balance for many people," Rothwell suggested.

Rothwell and his colleagues published their findings Dec. 7 in the online edition of The Lancet.

The research involved in the current review had been conducted for an average period of four to eight years. The patients (some of whom had been given a low-dose aspirin regimen, while others were not) were tracked for up to 20 years after.

The authors determined that while the studies were still underway, overall cancer death risk plummeted by 21 percent among those taking low-dose aspirin. But the long-term benefits on some specific cancers began to show five years after the studies ended.

At five years out, death due to gastrointestinal cancers had sunk by 54 percent among those patients taking low-dose aspirin.

The protective impact of low-dose aspirin on stomach and colorectal cancer death was not seen until 10 years out, and for prostate cancer, the benefits first appeared 15 years down the road.

Twenty years after first beginning a low-dose aspirin program, death risk dropped by 10 percent among prostate cancer patients; 30 percent among lung cancer patients (although only those with adenocarcinomas, the type typically seen in nonsmokers); 40 percent among colorectal cancer patients; and 60 percent among esophageal cancer patients.

The potential impact of aspirin on pancreatic, stomach and brain cancer death rates was more problematic to gauge, the authors noted, due to the relative paucity of deaths from those specific diseases.

They also found that higher doses of aspirin did not appear to boost the protective benefit. And while neither gender nor smoking history appeared to affect the impact of low-dose aspirin, age definitely did: the 20-year risk of death went down more dramatically among older patients.

And while cautioning that more research is necessary to build on this "proof of principle," the authors suggested that people who embark on a long-term, low-dose aspirin regimen in their late 40s and 50s are probably the ones who stand to benefit the most.

Dr. Alan Arslan, an assistant professor in the departments of obstetrics and gynecology and environmental medicine at NYU Langone Medical Center in New York City, described the findings as "very significant."

"[This] is the largest study to show that people who take aspirin for a long period of time have a reduced risk of death from many cancers, especially gastrointestinal cancers," he noted.

"The take-home message for patients is that if someone is taking low-dose or regular aspirin, it may put them at a reduced risk of death from cancer," Arslan added. "However, if someone is not already taking aspirin they should talk with their physician before starting. Aspirin has risks of side effects, including bleeding and stroke."

How broccoli protects against breast cancer

An  article published in the December, 2008 issue of the journal Carcinogenesis <http://carcin.oxfordjournals.org/>  explains how broccoli and  other cruciferous vegetables protect against cancer of the breast.  Increased intake of cruciferous vegetables, which also include  cauliflower, Brussels sprouts and cabbage, has been associated with a  lower risk of breast and other cancers, yet their mechanism of action  against the disease has not been thoroughly explored.

Researchers  at the University of California Santa Barbara laboratories of Professors  Leslie Wilson and Mary Ann Jordan studied the effects of sulforaphane, one  of a group of cruciferous vegetable compounds known as isothiocyanates, on  cultured human breast cancer cells. They found that sulforaphane inhibits  tumor cell proliferation in a manner similar to that of taxol and  vincristine, which are powerful anticancer drugs. The drugs help prevent  cell division during a process known as mitosis, in which duplicated DNA  in the cells’ chromosomes is distributed to two daughter cells. The  chromosomes are separated with the assistance of tube-like structures  known as microtubules, whose function is interfered with by taxane and  vinca alkaloid drugs. Sulforaphane similarly interferes with microtubule  function during mitosis, but its action is weaker than the pharmaceutical  agents, lessening the potential for toxicity.

"Breast  cancer, the second leading cause of cancer deaths in women, can be  protected against by eating cruciferous vegetables such as cabbage and  near relatives of cabbage such as broccoli and cauliflower," first author  and UC Santa Barbara graduate student Olga Azarenko commented. "These  vegetables contain compounds called isothiocyanates which we believe to be  responsible for the cancer-preventive and anticarcinogenic activities in  these vegetables. Broccoli and broccoli sprouts have the highest amount of  the isothiocyanates.”

"Our  paper focuses on the anticancer activity of one of these compounds, called  sulforaphane, or SFN," Dr Azarenko stated. "It has already been shown to  reduce the incidence and rate of chemically induced mammary tumors in  animals. It inhibits the growth of cultured human breast cancer cells,  leading to cell death."

"Sulforaphane  may be an effective cancer preventive agent because it inhibits the  proliferation and kills precancerous cells," concurred Dr Wilson, who is a  professor of biochemistry and pharmacology at UC Santa Barbara. The  compound also has potential as an additive therapy to antimitotic drugs to  enhance their effects without increasing toxicity.

Breast cancer genes raise prostate risks in men

Thursday, 29 January 2009 00:00 WASHINGTON - The so-called breast cancer genes BRCA1 and BRCA2 can raise the risk that a man who develops prostate cancer will get an aggressive form of the disease, U.S. researchers reported on Thursday. Certain mutations in the genes indicated a man was at risk of more aggressive cancer and should be treated right away, the team at the Albert Einstein College of Medicine of Yeshiva University said. Their study of 2,000 Jewish men shows the gene mutation, more common among Jews of European descent, might help show which men have a slow-growing tumor that may not need immediate treatment.

From MSNBC.com

The so-called breast cancer genes BRCA1 and BRCA2 can raise the risk that a man who develops prostate cancer will get an aggressive form of the disease, U.S. researchers reported on Thursday.

Certain mutations in the genes indicated a man was at risk of more aggressive cancer and should be treated right away, the team at the Albert Einstein College of Medicine of Yeshiva University said.

Their study of 2,000 Jewish men shows the gene mutation, more common among Jews of European descent, might help show which men have a slow-growing tumor that may not need immediate treatment. “One of the biggest problems with early-stage prostate cancer is being able to distinguish between tumors with the potential to become aggressive and those that may persist for many years without enlarging or spreading,” said Dr. Robert Burk, who led the study.

He said Ashkenazi Jewish men diagnosed with early-stage prostate cancer might want to consider getting tested for the mutations in BRCA2 and BRCA1.

“Our large study shows conclusively that prostate cancer patients with either the BRCA2 gene mutation or the BRCA1-185delAG mutation are more susceptible to aggressive cancers than people without that mutation,” Burk added in a statement.

For their study, Burk and colleagues tested 979 men with prostate cancer and 1,251 men without it for BRCA1 and BRCA2, both rare genetic mutations known in women to raise the risk of breast and ovarian cancers considerably. Men with any one of three mutations in the two genes were not any more likely to be in the prostate cancer group. But, if they did have one, their cancer was much more likely to be of an aggressive type, Burk’s team reported in Clinical Cancer Research.

Prostate cancer is the second-leading cancer killer of men, killing 221,000 every year globally, with 679,000 new cases diagnosed.

It is easily cured in early stages with surgery or radiation and some men have such slow-growing tumors that they are advised not to have any treatment at all. But distinguishing between the two is tricky and doctors welcome any new tools they can use to guide them.

NCCN Updates Breast Cancer and Breast Cancer Risk Reduction Guidelines

NCCN announces new updates to the NCCN Guidelines for Breast Cancer and Breast Cancer Risk Reduction Guidelines. Noteworthy additions include new recommendations on when to use MRIs in breast cancer evaluations, statements discouraging the use of PET/CT scanning for evaluative purposes, and new cosmetic recommendations for women undergoing reconstructive surgery.For complete story, click here.

Daily aspirin reduces estrogen receptor positive breast cancer risk

  A  report published online on April 30, 2008 in the journal Breast Cancer Research   concluded that the use of  aspirin on a daily basis reduced the risk of estrogen receptor-positive  breast cancer, which makes up 75 percent of breast cancer cases. These  cancers have receptors on their surface for female hormone estrogen, which  fuels the tumors’ growth.

Gretchen  L. Gierach and her colleagues at the National Cancer Institute evaluated  data from 127,383 women aged 51 to 72 who were enrolled in the National  Institutes of Health-AARP Diet and Health Study, which examined the  relationship between diet, health-related behaviors and cancer.  Questionnaires completed upon enrollment between1995 and 1996 provided  information on diet history, demographic characteristics and other data. A  second questionnaire completed between 1996 and 1997 collected information  concerning medication use, including aspirin and nonaspirin nonsteroidal  anti-inflammatory drugs (NSAIDs). Breast cancer cases were identified  through cancer registry information through the end of 2003.

Over  the period examined, 4,501 women developed breast cancer. Of the invasive  breast cancer cases for which estrogen receptor status was available,  1,439 were estrogen receptor positive and 280 estrogen receptor negative.  Although NSAID use was not linked to a reduction in overall breast cancer  risk, women who reported daily aspirin use had a 16 percent lower risk of  estrogen receptor positive breast cancer than women who did not use the  drug. There was also a significant reduction in risk in breast cancer in  situ (localized cancer) among daily aspirin users.

The  study is one of the largest to date to evaluate the association between  the type of NSAID used and breast cancer risk by tumor characteristics.  The authors remark that the association of a reduction in estrogen  receptor-positive breast cancer with aspirin is consistent with aspirin’s  ability to permanently inactivate cyclooxygenase-2 (COX-2), which  suppresses estrogen synthesis by decreasing aromatase activity, among  other pathways of risk reduction. COX-2 is expressed both in situ and  invasive breast cancer, and its upregulation may be an early event in  carcinogenesis.

“Our  results provide support for further evaluating relationships in  prospective studies with well-defined measures of NSAID use by NSAID type,  by breast cancer stage, and by estrogen receptor status,” the authors  conclude.

Impact of Off Label Chemotherapy in Breast Cancer

M. D. Anderson Study First to Evaluate Prevalence, Impact of Off Label Chemotherapy in Breast CancerDrugs not always approved for reimbursement, despite shown to be efficacious

[ABSTRACT #1016]

ORLANDO – At some point during their care, more than one-third of metastatic breast cancer patients receive chemotherapy off label, the legal use of FDA-approved drugs in a different indication than for which they were approved, according to researchers at The University of Texas M. D. Anderson Cancer Center.

The study, to be presented in a poster discussion at the American Society of Clinical Oncology’s upcoming annual meeting, is the first to evaluate the prevalence and impact of off label therapies in breast cancer. According to Sharon Giordano, M.D., associate professor in M. D. Anderson’s Department of Breast Medical Oncology, the only other study looking at off label chemotherapies and their prevalence was conducted almost 20 years ago by the US General Accounting Office, and evaluated their use in cancer overall.

After rigorous clinical trials for safety and efficacy, drugs are approved by the FDA for use in a specific population and limited indication – metastatic breast cancer patients, in the front line setting, for example. However, once a drug is approved, physicians can prescribe it as they find appropriate.

While the use of chemotherapies off their FDA label is known to be common practice in the management of breast and other cancers, before now, there’s been little research to quantify the use of off label chemotherapy agents and their impact, said Giordano.

“Off labels run a dramatic spectrum – sometimes there’s strong evidence that the use of a particular drug in a specific setting is efficacious, but perhaps the drug company has not gone through the regulatory process of getting an indication. In contrast, some uses of off label drugs that are completely inappropriate and may put patients at risk,” explained Giordano, the study’s senior author.

The issue also is controversial because off label therapies are often not approved by Medicare and/or insurance companies, even when shown to be effective in clinical trials, said Giordano.

Giordano and her researchers used the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, the premier population-based cancer registry representing 26 percent of the country’s population, to identify 2,082 women older than 65 diagnosed with metastatic breast cancer between 1991 and 2002. To evaluate the appropriateness of off label drugs prescribed, the researchers referenced a specific drug compendium, DRUGDEX.

The researchers found that 34.9 percent of the women were treated with off label chemotherapy at some point during their care. Of the 36 chemotherapy agents identified to treat these patients, 8 (22 percent) were FDA-approved for use in breast cancer. However, while 71 percent of the drugs used off label lacked supporting evidence for their use in breast cancer, these drugs were used in a relatively small number of patients – 6.7 percent of the women received off label drugs considered medically inappropriate for use in treatment of breast cancer.

The most common off label chemotherapies noted were vinorelbine (approved for lung cancer), and gemcitabine (approved for pancreatic cancer), with 16 percent and 8.4 percent of the patients receiving these agents, respectively. Both of these agents have shown efficacy in the treatment of metastatic breast cancer, said Giordano. Gemcitabine has been subsequently approved for breast cancer when given in combination with paclitaxel.

As the study focused on women older than 65 - and physicians tend to be more conservative in treating their older patients – Giordano feels that her findings may underestimate the use of off labels across the breast cancer treatment pendulum.

Although commonly used in breast cancer, off label drugs are a greater necessity, and present a bigger dilemma for rare cancers, said Giordano. While perhaps a drug is shown to be efficacious in smaller Phase II clinical trials, conducting large Phase III trials in rare tumors is much more difficult, and thereby of less cost-benefit to drug companies. As a follow-up to this study, Giordano plans to look at off label use across a variety of tumor types and stages of cancer. She also intends to review their use in younger breast cancer patients.

“I think our study represents a very difficult and relevant policy issue that will soon need to be addressed. For all cancers, it’s important to try and strike a balance between having insurance coverage and access to appropriate, potentially life-saving off label drugs and protecting patients from being treated with therapies that haven’t been shown to be efficacious,” said Giordano.

In addition to Giordano, other authors on the all M. D. Anderson study include: Gabriel Hortobagyi, M.D., professor and chair of the Department of Breast Medical Oncology: Shenying Fang, also of the Department of Breast Medical Oncology; Wendy Dean-Colomb, M.D., fellow and the study’s first author; Laura Michaud, Ph.D., PharmD; and Wendy Smith, PharmD, both of the Department of Pharmacy Clinical Programs.

Sharon Giordano, M.D.

FOR IMMEDIATE RELEASE Date: May 14, 2009

Contact: Laura Sussman 713-745-2457 lsussman@mdanderson.org

Diet and Breast Cancer

"Prudent" diet linked to lower breast cancer risk 10-01-09

NEW YORK (Reuters Health) – A diet rich in fruits, vegetables and whole grains, and low in sweets and processed meats, may help lower the risk of breast cancer in some African-American women.

In a study of more than 50,000 African-American women, researchers found that thinner and younger women who ate a generally "prudent" diet were less likely to develop breast cancer than their counterparts who maintained a more Western-style diet.

There was no evidence that healthier eating lowered the risk among overweight women, or those past menopause. However, the prudent diet was linked to a generally lower risk of estrogen receptor-negative breast cancer -- an aggressive type of tumor that accounts for about one-third of breast cancers.

The prudent diet is one rich in whole grains, fruits, vegetables and fish, and lower in red and processed meats, sweets and starchy carbohydrates, like white bread. The opposite pattern is true of the so-called Western-style diet.

The new findings, published in the American Journal of Clinical Nutrition, add to the understanding of how these diet patterns may affect breast cancer risk in different groups of women.

Past studies have suggested that the prudent diet may help lower breast cancer risk in at least some women. But there has been a lack of studies focused on black women, according to the researchers on the new work, led by Tanya Agurs-Collins of the U.S. National Cancer Institute.

Their findings are based on a long-term study launched in 1995 that is following the health and lifestyle habits of 50,778 black women from across the U.S. Between 1995 and 2007, 1,094 of those women were diagnosed with breast cancer.

The researchers found no strong evidence that the prudent diet lowered breast cancer risk for the study group as a whole.

However, when they focused on normal-weight women, they found that as scores on the prudent-diet scale rose, the risk of developing breast cancer declined. The 20 percent of women with the most prudent diets were about one-third less likely to develop the disease than their counterparts with the least prudent eating habits.

Similarly, the healthier diet was linked to a lower cancer risk among premenopausal women. Those with the most prudent diets were 30 percent less likely to be diagnosed with breast cancer.

Other studies, according to the researchers, have found that a healthy diet may lower breast cancer risk in normal-weight women, but not those who are overweight.

The reasons are unknown, but taken together, the researchers write, these studies suggest that the protective effect of a prudent diet may be "largely among thinner women."

The issue of age appears more complicated, however. Agurs-Collins and her colleagues point out that some studies have linked the prudent diet to a lower breast cancer risk in postmenopausal women.

As for why the diet might be protective against estrogen receptor-negative tumors, in particular, the reasons are not clear. But the findings may be particularly important for younger African-American women, as they are more likely than their white counterparts to develop this type of tumor, the researchers point out.

Whatever the effects on breast cancer, though, the prudent diet is one that is recommended for better overall health -- including a lower risk of heart disease, the number-one killer of U.S. women.

SOURCE: American Journal of Clinical Nutrition, September 2009.

Knowledge Improves Outcomes: Using QUOSA

Topic:	Knowledge Improves Outcomes: Using QUOSA
Recording date:	Tuesday, November 24, 2009 9:11 pm
	Eastern Standard Time (New York, GMT-05:00)
Panelist Information:	Stephen Strum, Örn Adalsteinsson (ISCA), Nancy Peress (P2P) & Eszter Hars (QUOSA)
Duration:	1 hour 6 minutes
Description:	We will teach you how to use the application "QUOSA". You will use this to gather medical abstracts and papers from scientific journals and be able to assist your local physician(s) to improve your medical outcome.

Chip measures breast estrogen with just a poke

By AP Medical Writer Lauran Neergaard – Wed Oct 7, 3:36 pm ET WASHINGTON – Estrogen fuels breast cancer yet doctors can't measure how much of the hormone is in a woman's breast without cutting into it. A Canadian invention might change that: A lab-on-a-chip that can do the work quickly with just the poke of a small needle.

Several years of study are needed before the experimental device could hit doctors' offices, but the research published Wednesday opens the tantalizing possibility of easy, routine monitoring of various hormones. Doctors could use it to see if breast cancer therapy is working, tell who's at high risk, or for other problems, such as infertility — maybe even prostate cancer.

"It's thought-provoking to think, 'What could I do with a tool like this?'" said Dr. Kelly Marcom, breast oncology chief at Duke University Medical Center, who wasn't involved with the new invention. "It opens up an avenue of investigation that without tools like this, you couldn't explore."

The University of Toronto researchers used a powerful new technology to measure tiny droplets of estrogen from samples at least 1,000 times smaller than today's testing requires. Called digital microfluidics, it uses electricity to separate and purify droplets of the hormone from a mix of other cells — all on the surface of a chip no bigger than a credit card.

"Droplets essentially can be made to dance across the surface," said University of Toronto engineer Aaron Wheeler, who co-invented the device and calls the project "the most fun I've had in science."

The research was published in a new journal, Science Translational Medicine.

Here's the problem: Scientists have long known that estrogen plays a role in many breast cancers. While hormone tests traditionally are done with blood, estrogen is particularly concentrated in breast tissue and breast cancer patients have much higher levels than other women. But measuring breast estrogen requires a fairly substantial biopsy, a painful and invasive procedure with its own risks. Then come hours of intense laboratory work to extract and purify the estrogen from the mishmash of other cells. So that breast-testing is hardly ever done.

If doctors had a way to easily monitor breast estrogen levels, they could track which cancer survivors are responding to widely used estrogen-blocking therapies — tamoxifen or drugs known as aromatase inhibitors — that aim to avoid a recurrence. They might even shed light on who's at high risk for developing cancer.

"The breast makes its own estrogen," explained Toronto gynecology specialist Dr. Noha Mousa. "We have solid evidence that measuring estrogen inside the breast is important. No. 1 is to see if these medications are working."

The Toronto team put the multi-step lab processing onto the surface of the new chip. Electrical currents move droplets around the chip, allowing solvents and other chemicals to dissolve a dried tissue sample and remove other biological substances until just droplets of estrogen are left. The team took small breast tissue samples — the amount pulled from a needle instead of an open biopsy — plus blood samples from two breast cancer patients, and reported that the chip allowed accurate estrogen measurement.

Next up: Mousa will use the technique to measure estrogen levels in a soon-to-start study of more than 200 Canadian women at high risk of getting breast cancer, who are testing whether taking those estrogen-blocking aromatase inhibitors for a year lowers their risk.

But the technology is applicable to more than breast cancer. Mousa points to infertile women who have large amounts of blood drawn several times a month to see if treatment is sparking ovulation, saying she's also testing whether the chip might substitute pinpricks of blood.

Soy Beneficial for Breast Cancer Survivors: Study

http://health.usnews.com/articles/health/healthday/2009/12/08/soy-beneficial-for-breast-cancer-survivors-study.htmlSurprising finding shows it reduces risk of death, recurrence

Posted December 8, 2009

By Serena Gordon HealthDay Reporter

TUESDAY, Dec. 8 (HealthDay News) -- Regular, moderate consumption of soy foods can help lower the risk of death and cancer recurrence in women who've had breast cancer, new research shows. What's more, the association between soy and a reduced risk of death held true even for women with estrogen receptor-positive cancers and women taking tamoxifen, according to the study published in the Dec. 9 issue of the Journal of the American Medical Association.

"We found that women with a history of breast cancer who consumed moderate amounts of soy food were doing better in terms of prognosis. They had reduced mortality and reduced recurrence," said study author Dr. Xiao Ou Shu, a professor of medicine and a cancer epidemiologist at Vanderbilt University Medical Center in Nashville, Tenn.

There has been some concern that soy might increase the risk of breast cancer or worsen the prognosis for women already diagnosed with the disease because soy is what's known as a phytoestrogen. That means that it can act like a weak form of estrogen in the body. However, it appears those concerns may have been unfounded because Shu and her colleagues found that soy actually reduces the availability of naturally occurring estrogen by binding to its receptors.

"In our study, we found that soy food has a very similar effect to tamoxifen," said Shu. Tamoxifen is a drug that blocks the action of estrogen in the body, which can be helpful for treating cancers that are fueled by estrogen.

Shu's study included just over 5,000 Chinese women who had been previously diagnosed with breast cancer between 2002 and 2006. The women were aged 20 to 75, with the majority of women between 40 and 60 at the time of diagnosis.

The researchers collected information on cancer diagnosis and treatment, lifestyle factors (including diet) and disease progression at six months after diagnosis, and then again at 18, 36 and 60 months after diagnosis.

Women who had the highest intake of soy had a 29 percent reduced risk of death and a 32 percent decrease in the risk of cancer recurrence compared to those who ate less than 5.3 grams of soy per day.

"There was a linear response, and we found the higher the intake, the lower the mortality, up to 11 grams of soy protein," Shu said, adding that after 11 grams daily the benefit leveled off, but didn't decline.

Eleven grams of soy translates to about one-fourth of a cup of tofu each day, she said. Both Shu, and Dr. Gina Villani, chief of hematology/oncology at The Brooklyn Hospital Center in New York City, said it's important to note that Chinese women tend to get their soy from natural sources, such as tofu, edamame or unsweetened soy milk, instead of the processed types of soy foods that many Americans eat, such as sweetened, flavored soy milk or soy-based protein bars.

"The take-home lesson is that whole foods are what we need to eat more of," said Villani.

"Try to stay away from the processed stuff. Don't bulk up on soy milk or soy candy bars." Shu also pointed out that Chinese women may be replacing unhealthier food choices, such as red meat, with soy. In an accompanying editorial in the same issue of the journal, experts from the U.S. National Cancer Institute noted that the average daily soy intake for people living in China makes up 10 percent or more of their daily protein intake.

Both Shu and Villani advise against loading up on soy supplements, as these haven't been proven to be beneficial, and Villani said it's unclear if such high levels of soy could cause harm.

And, Villani added, "supplements don't replace food. We haven't even begun to understand the interactions between nutrients in food and the body. Soy as a bean may react different than soy from a candy bar in the body."

"Soy food intake has been shown to reduce the risk of breast cancer, and it may have cardiovascular benefit, so overall, whether or not you have cancer, soy could be very beneficial to you and could become an important component of a healthy diet," Shu said.

"But try to get it in natural sources, not from processed food."

More information For more on soy, visit the U.S. National Library of Medicine.

Copyright © 2009 U.S.News & World Report LP All rights reserved.

A healthy diet may trim breast cancer risk

2010-03-25By Lynne Peeples

NEW YORK (Reuters Health) - A woman may not be able to change her family history of breast cancer, but she can typically control what she eats and drinks. And consuming more vegetables and whole grains -- and less alcohol -- just might trim her chances of getting the disease, according to an analysis of published studies.

"As the incidence of breast cancer continues to rise, with many of the risk factors for the disease non-modifiable, potentially modifiable risk factors such as diet are of interest," Dr. Sarah Brennan of Queen's University Belfast in Northern Ireland, who led the analysis, noted in an email to Reuters Health.

It's estimated that more than 120 out of every 100,000 American women are diagnosed with breast cancer each year, yielding a lifetime risk of about 1 in 8. The idea that diet might influence these numbers is not new; yet solid evidence for such a link has remained elusive.

"Even though we have hypothesized a relationship between diet and the risk of breast cancer, showing it has been very hard to do," Dr. Michelle Holmes, an epidemiologist at Harvard Medical School in Boston who was not involved in the study, told Reuters Health. Individual studies are often too small to uncover modest relationships; combining them, however, offers a better chance of detecting a diet's true effects.

After carefully reviewing the relevant research to date, Brennan and her colleagues pooled the results of 18 studies that enrolled a total of more than 400,000 people. Each study aimed to associate breast cancer risks with at least one common dietary pattern: the "unhealthy" Western diet (high in red meats and refined grains), a more prudent "healthy" diet (high in fruits, vegetables and whole grains), or varying levels of alcohol drinking.

Since foods and beverages are never consumed in isolation, this more holistic view of intake better reflects a person's diet than looking at particular nutrients, Brennan and her colleagues explain in the American Journal of Clinical Nutrition.

The team found an 11 percent lower risk of breast cancer among women in the highest versus lowest categories of the prudent diet, while those consuming larger amounts of wine, beer and spirits had a 21 percent increased risk -- a relationship that has been highlighted in many previous studies. Surprisingly, no overall risk difference was seen between high and low categories of the Western diet.

Just how a healthy diet might lower breast cancer risk is not well understood. Alcohol's link, on the other hand, is generally known: Estrogen levels are higher in postmenopausal women who drink alcohol, noted Holmes. And a higher lifetime exposure to estrogen has been tentatively linked to the disease.

Brennan stressed that these findings need to be interpreted cautiously, noting that there are inherent statistical problems in combining the results of multiple studies, in addition to the limitations of each included study, such as recall bias. She pointed to the need for more carefully designed studies in the future to further examine the diet-breast cancer link.

In the meantime, Holmes said: "Consuming a prudent, healthy diet that includes lots of fruits, vegetables and whole grains is a wise idea, because there is lots of scientific evidence that it prevents heart disease and diabetes. This study shows that an additional benefit might be a small decrease in breast cancer risk."

SOURCE: American Journal of Clinical Nutrition, March 10, 2010

Coffee May Reduce Risk of Deadly Prostate Cancer (Update1)

By Simeon Bennett Dec. 8 (Bloomberg) -- Drinking coffee may lower the risk of developing the deadliest form of prostate cancer, according to a Harvard Medical School study.

In research involving 50,000 men over 20 years, scientists led by Kathryn Wilson at Harvard’s Channing Laboratory found that the 5 percent of men who drank 6 or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn’t consume any. The risk was about 20 percent lower for the men who drank 1 to 3 cups a day, and 25 percent lower for those consuming 4 or 5 cups.

The study is the first to associate coffee with prostate cancer, contradicting previous research that’s found no link. The difference may be because Wilson and colleagues looked for the first time at the link between coffee and different stages of the disease, instead of grouping them all together. More research is needed to confirm the findings, she said.

“People shouldn’t start changing their coffee consumption based on one study,” Wilson said in a phone interview on Dec. 5. “It could be chance, and we really need to see whether it pans out in other studies.”

Prostate cancer struck almost 200,000 men in the U.S. this year and killed more than 27,000, making it the second-deadliest malignancy among American men after lung cancer, according to the American Cancer Society. About 54 percent of U.S. adults drink coffee, according to the New York-based National Coffee Association.

Multiple Components

The researchers aren’t sure which of the many components of coffee is responsible for the effect, though it probably isn’t caffeine because the same association was seen for decaffeinated coffee, Wilson said. The link wasn’t seen in patients with an earlier stage of prostate cancer, she said.

Coffee lowers the risk of Type 2 diabetes by increasing the body’s ability to use insulin to convert blood sugar to energy, previous research has shown.

Higher insulin levels have also been associated with an increased risk of prostate cancer, suggesting the hormone may be the link between coffee and the disease, Wilson said.

The data were presented at an American Association for Cancer Research conference in Houston.

To contact the reporter on this story: Simeon Bennett in Singapore at sbennett9@bloomberg.net

Last Updated: December 8, 2009 01:21 EST

Surgery offers Long-Term Survival for Early-Stage Prostate Cancer Patients

ROCHESTER, Minn. — In the largest, most modern, single-institution study of its kind, Mayo Clinic urologists mined a long-term data registry for survival rates of patients who underwent radical prostatectomy for localized prostate cancer. The findings are being presented at the North Central Section of the American Urological Association's 84th Annual Meeting in Chicago. A radical prostatectomy is an operation to remove the prostate gland and some of the tissue around it. In this study, Mayo Clinic researchers discovered very high survival rates for the 10,332 men who had the procedure between 1987 and 2004. This time period was chosen because it reflects the modern era of prostate cancer detection with the introduction of the prostate-specific antigen (PSA) test.

The researchers looked at overall survival, cancer-specific survival, progression-free survival and local recurrence at five to 20 years. Only 3 percent of patients died of prostate cancer. Five percent showed evidence of cancer spread to other organs and 6 percent had a local recurrence of cancer. Study participants had a median survival time of 19 years, and 8,000 are living to date. The mean and median follow-up period was 11 years.

"These are excellent survival rates," says R. Jeffrey Karnes, M.D., a Mayo Clinic urologist and senior author on the study. "They show that radical prostatectomy is a benchmark for treatment of men with prostate cancer that has not spread."

Radical prostatectomy was the primary treatment for the men. Studies done before the introduction of the PSA test showed less favorable survival results. Prior to the PSA test, prostate cancer was detected by symptoms or by a digital rectal exam (DRE), both of which were less likely to detect cancer before it had spread beyond the prostate.

"The findings are a testament to the individuals who have helped manage the database over the years, the many Mayo surgeons who performed the procedures with a similar approach and, ultimately, the patients," says Dr. Karnes.

Collaborators include Eric Bergstralh, Xin Wang, Ph.D., and Rui Qin, Ph.D., of Mayo Clinic. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education, visit www.mayo.edu.MayoClinic.com (www.mayoclinic.com) is available as a resource for your health stories.

How Synthetic Progestin in HRT and the Pill Can Lead to Breast Cancer

ScienceDaily (Oct. 1, 2010) — Breast cancer is one of the most common cancers, affecting up to one in eight women during their lives in Europe, the UK and USA. Large population studies such as the Women's Health Initiative and the Million Women Study have shown that synthetic sex hormones called progestins used in hormone replacement therapy, HRT, and in contraceptives can increase the risk of breast cancers. Now medical researchers at the Institute of Molecular Biotechnology of the Austrian Academy of Sciences in Vienna have identified a key mechanism which allows these synthetic sex hormones to directly affect mammary cells.

The research builds on previous work by Prof Josef Penninger, the IMBA director, who found the first genetic evidence that a protein called RANKL is the master regulator of healthy bones. In a complex system that regulates bone mass, RANKL activates the cells that break down bone material when it needs to be replaced. When the system goes wrong and we make too much of the protein it triggers bone loss, leading to osteoporosis in millions of patients around the world every year. Finding exactly the same molecule in breast tissues led the scientists to the new link between sex hormones and breast cancer.

In a scientific article published in the journal Nature, the research team show that a synthetic female sex hormone used in HRT and contraceptive pills can trigger RANKL in breast cells of mice. As a consequence, these mammary cells start to divide and multiply and fail to die when they should. Moreover, stem cells in the breast become able to renew themselves, ultimately resulting in breast cancer.

In a different set of mouse treatment tests, reported in a second Nature article, researchers at Amgen have found that pharmacologic blocking of the RANKL system significantly delays mammary tumor formation leading to significantly fewer breast cancers in mice. In another mouse model, RANKL inhibition not only decreased breast tumor formation but also reduced lung metastasis.

"Ten years ago we formulated the hypothesis that RANKL might be involved in breast cancer and it took us a long time to develop systems to prove this idea," says Prof Josef Penninger. " I have to admit it completely surprised me just how massive the effects of the system were. Millions of women take progesterone derivatives in contraceptives and for hormonal replacement therapy. Since our results show that the RANKL system is an important molecular link between a synthetic sex hormone and breast tumors, one day women may be able to reduce their risk by taking blocking medicines in advance to prevent breast cancer."

A monoclonal antibody, denosumab, that blocks RANKL has been recently approved in the US and the EU for the treatment of osteoporosis, and is currently under review for the treatment of bone metastases in patients with advanced cancer. "Further studies will be needed to prove the principle of our findings," says Dr Daniel Schramek, who carried out the studies with Prof Josef Penninger at the Institute of Molecular Biotechnology in Vienna. "But we hope that medical trials using denosumab can be started in the near future to test whether the mouse studies can be directly translated to human breast cancer." Scientists have uncovered how hormone replacement therapy can increase the risk of breast cancer, according to new research published on Nature’s website today (Wednesday 29 September, 2010). They found that the link is a protein molecule RANKL, which is essential to regulate bone mass and which is also involved in milk production. The Austrian researchers have shown that a synthetic progesterone, frequently used in HRT and hormonal contraception, can switch on the activity of RANKL within breast cells, causing them to divide and multiply and preventing them from dying when they should. Moreover, stem cells in the breast become able to renew themselves, ultimately resulting in breast cancer. (Credit: Copyright IMBA)

This work was an international collaboration between lead researchers at IMBA and scientists at the Medical University of Vienna; the Garvan Institute of Medical Research, Sydney, Australia; the Ontario Cancer Institute, University of Toronto, Toronto, Canada; Harvard School of Public Health, Harvard Medical School and the Ragon Institute of MGH/MIT and Harvard, Boston, USA; the Institute for Genetics, Centre for Molecular Medicine (CMMC), and Cologne Excellence Cluster (CECAD), University of Cologne, Germany; University College London, UK; and the University of Erlangen-Nuremberg, Germany.

High Dietary Fat, Cholesterol Linked to Increased Risk of Breast Cancer and Prostate Cancer

ScienceDaily (Jan. 7, 2011) — Elevated fat and cholesterol levels found in a typical American-style diet play an important role in the growth and spread of breast cancer, say researchers at the Kimmel Cancer Center at Jefferson. The study, published in the January issue of The American Journal of Pathology, examines the role of fat and cholesterol in breast cancer development using a mouse model. The results show that mice fed a Western diet and predisposed to develop mammary tumors, can develop larger tumors that are faster growing and metastasize more easily, compared to animals eating a control diet.

The research team led by cancer biologist Philippe G. Frank, Ph.D., Assistant Professor in the Department of Stem Cell Biology and Regenerative Medicine at Thomas Jefferson University, was interested in learning about the link between diet and breast cancer. The incidence rate of this cancer is five times higher in Western countries than in other developed countries. Moreover, studies have shown an increase in breast cancer incidence in immigrant populations that relocate from a region with low incidence. "These facts suggest strong environmental influence on breast cancer development," says Dr. Frank.

Dietary fat and cholesterol have been shown to be important risk factors in the development and progression of a number of tumor types, but diet-based studies in humans have reached contradictory conclusions. This has led Dr. Frank to turn to animal models of human cancer to examine links between cholesterol, diet, and cancer.

The research team turned to the PyMT mouse model to determine the role of dietary fat and cholesterol in tumor development. This mouse model is believed to closely parallel the pathogenesis of human breast cancer. PyMT mice were placed on a diet that contained 21.2 percent fat and 0.2 percent cholesterol, reflective of a typical Western diet. A control group of PyMT mice was fed a normal chow that had only 4.5 percent fat and negligible amounts of cholesterol.

The researchers found that tumors began to develop quickly in mice fed the fat/cholesterol-enriched chow. In this group, the number of tumors was almost doubled, and they were 50 percent larger than those observed in mice that ate a normal diet. "The consumption of a Western diet resulted in accelerated tumor onset and increased tumor incidences, multiplicity, and burden, suggesting an important role for dietary cholesterol in tumor formation," Dr. Frank says. There was also a trend towards an increased number of lung metastasis in mice fed the fatty diet, he adds.

To confirm the aggressive nature of the cancer in animals fed a cholesterol-rich diet, the researchers examined the levels of several biomarkers of tumor progression and found a signature of a more advanced cancer stage, compared to tumors that developed in the control group.

The researchers also showed that plasma cholesterol levels in experimental mice that developed tumors were significantly reduced compared to a group of "wild-type" mice -- animals with no predisposition to develop tumors -- that was also fed a cholesterol-rich diet. "This suggests that tumor formation was responsible for the reduction in blood cholesterol levels observed in our animals," indicates Dr. Frank.

Dr. Frank explains the use of cholesterol in breast tumors this way: "In a neighborhood, if you want to build more houses, you need more bricks. In tumors, cholesterol provides the bricks that are the foundation for further growth, and this cholesterol comes from the blood. A drop in blood cholesterol may signify that some tumors are growing as cholesterol provides support for breast cancer growth."

"These data provide new evidence for an increase in cholesterol utilization by breast tumors and thus provides many new avenues for prevention, screening, and treatment," indicates Dr. Frank. These findings suggest that use of cholesterol-lowering drugs, such as statins, may both protect against breast cancer as well as treat patients carrying tumors. Since researchers also found that blood cholesterol levels dropped significantly as tumors began to develop, the study indicates measuring blood cholesterol levels may also be an effective method of screening cancer development.

This research team also discovered the same association between cholesterol and growth of prostate cancer in mice in a study published in the December issue of The American Journal of Pathology. The results of these two new studies indicate, according to Dr. Frank that, "Cholesterol does indeed seem to be an important factor in the regulation of tumor formation in several cancer types."

Potential Tooth Loss Link To Breast Cancer

13 Feb 2011 A new study suggests that women may be over 11 times more likely to suffer from breast cancer if they have missing teeth and gum disease.

The study (1), carried out by the Karolinska Institute in Sweden on over three thousand patients, showed that out of the 41 people who developed breast cancer those who had gum disease and loss of teeth were 11 times more likely to develop cancer.

As this appears to be the first study presenting such findings, Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, believes more needs to be done in order to confirm the results.

Dr Carter said: "If future studies can also testify to the link between missing teeth and breast cancer, more has to be done to raise public awareness on the issue. The British Dental Health Foundation has a history of campaigning for better oral health, and the findings presented in the study indicate another clear link between your general and oral health."

Gum disease is caused by the bacteria in dental plaque. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.

In the past several findings have been released to support the notion infections in the mouth can affect other areas of your general health. In people who have gum disease, it is thought that bacteria from the mouth can get into the blood stream and affect the heart, causing a higher risk of heart disease. The same principles affect those with diabetes, as people with the condition are more likely to pick up infections. People with gum disease are also thought to be at a higher risk of strokes, chest infections, and pregnant women are seven times more likely to have a premature baby with a low birth weight.

As gum disease develops painlessly, there aren't many ways in which you can detect problems evolving. Look out for inflamed gums causing them to be red, swollen and bleed easily, an unpleasant taste in your mouth, bad breath, loose teeth and regular mouth infections. With only a few of these symptoms visible, Dr Carter recommends a safe course of action if you start showing any signs of gum disease.

Dr Carter said: "The best way to prevent and treat gum disease is to ensure you remove all the plaque from between your teeth by brushing for two minutes twice a day with fluoride toothpaste. You also need to clean in between your teeth at least once a day with interdental brushes or dental floss as this is the area where gum disease starts. Regular visits to the dentist can also help to identify early signs of gum disease."

(1) Söder, B, Yakob, M, Meurman, J, Andersson, L, Klinge, B, Söder, P, 8 October 2010, 'Periodontal disease may associate with breast cancer', Karolinska Institute, Sweden. The main purpose of the study was to evaluate the association between periodontal (gum) disease and the prevalence of breast cancer in 3273 randomly selected subjects aged 30-40. Breast cancer incidence was registered from 1985 to 2001 according to the WHO International Classi?cation of Diseases criteria. At baseline, 1676 individuals also underwent a clinical oral examination (Group A) whereas 1597 subjects were not clinically examined but were registered (Group B). The associations between breast cancer, periodontal disease, and missing molars were determined using multiple logistic regression models with several background variables and known risk factors for cancer.

Source: British Dental Health Foundation 13 Feb 2011

A new study suggests that women may be over 11 times more likely to suffer from breast cancer if they have missing teeth and gum disease.

The study (1), carried out by the Karolinska Institute in Sweden on over three thousand patients, showed that out of the 41 people who developed breast cancer those who had gum disease and loss of teeth were 11 times more likely to develop cancer.

As this appears to be the first study presenting such findings, Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, believes more needs to be done in order to confirm the results.

Dr Carter said: "If future studies can also testify to the link between missing teeth and breast cancer, more has to be done to raise public awareness on the issue. The British Dental Health Foundation has a history of campaigning for better oral health, and the findings presented in the study indicate another clear link between your general and oral health."

Gum disease is caused by the bacteria in dental plaque. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.

In the past several findings have been released to support the notion infections in the mouth can affect other areas of your general health. In people who have gum disease, it is thought that bacteria from the mouth can get into the blood stream and affect the heart, causing a higher risk of heart disease. The same principles affect those with diabetes, as people with the condition are more likely to pick up infections. People with gum disease are also thought to be at a higher risk of strokes, chest infections, and pregnant women are seven times more likely to have a premature baby with a low birth weight.

As gum disease develops painlessly, there aren't many ways in which you can detect problems evolving. Look out for inflamed gums causing them to be red, swollen and bleed easily, an unpleasant taste in your mouth, bad breath, loose teeth and regular mouth infections. With only a few of these symptoms visible, Dr Carter recommends a safe course of action if you start showing any signs of gum disease.

Dr Carter said: "The best way to prevent and treat gum disease is to ensure you remove all the plaque from between your teeth by brushing for two minutes twice a day with fluoride toothpaste. You also need to clean in between your teeth at least once a day with interdental brushes or dental floss as this is the area where gum disease starts. Regular visits to the dentist can also help to identify early signs of gum disease."

(1) Söder, B, Yakob, M, Meurman, J, Andersson, L, Klinge, B, Söder, P, 8 October 2010, 'Periodontal disease may associate with breast cancer', Karolinska Institute, Sweden. The main purpose of the study was to evaluate the association between periodontal (gum) disease and the prevalence of breast cancer in 3273 randomly selected subjects aged 30-40. Breast cancer incidence was registered from 1985 to 2001 according to the WHO International Classi?cation of Diseases criteria. At baseline, 1676 individuals also underwent a clinical oral examination (Group A) whereas 1597 subjects were not clinically examined but were registered (Group B). The associations between breast cancer, periodontal disease, and missing molars were determined using multiple logistic regression models with several background variables and known risk factors for cancer.

Source: British Dental Health Foundation

DCIS Patients Who Get Invasive Breast Cancer Have Higher Mortality, Study Finds

ScienceDaily (June 20, 2011) — Women with ductal carcinoma in situ -- DCIS -- who later develop invasive breast cancer in the same breast are at higher risk of dying from breast cancer than those who do not develop invasive disease, according to a study published online March 11 in the Journal of the National Cancer Institute. Retrospective studies of women with DCIS have compared breast conserving surgery (lumpectomy) to mastectomy and found that survival rates are similar. However, women who have lumpectomy alone, without further treatment, are at higher risk of developing invasive breast cancer in the same breast. Whether women who develop invasive breast tumors after DCIS are also at higher risk of dying of breast cancer has not been clear.

To explore this question as well as the long-term effects of treatments aimed at avoiding invasive recurrence after lumpectomy, Irene Wapnir, M.D., of Stanford University School of Medicine, and James Dignam, PhD of University of Chicago looked at the long-term outcomes of patients with localized DCIS who took part in two large randomized trials, both carried out by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The B-17 trial compared lumpectomy alone to lumpectomy plus radiation therapy in women with DCIS. The B-24 trial compared lumpectomy plus radiation in combination with either tamoxifen or placebo.

Wapnir and colleagues analyzed data on outcomes in both trials after 15 years, including overall and breast cancer-specific survival and survival after development of invasive breast cancer in the same, or ipsilateral, breast.

They found that the development of invasive ipsilateral breast cancer was associated with death rates that were statistically significantly higher than those in women who did not develop an invasive ipsilateral breast cancer. Recurrence of DCIS was not associated with higher mortality. Radiation treatment after lumpectomy reduced the risk of ipsilateral invasive breast cancer compared to lumpectomy alone, and treatment with radiation and tamoxifen reduced the risk compared to radiation only. The reductions in risk were statistically significant.

Among all patients in the trials, the 15-year cumulative incidence of death from breast cancer was 4.7% or less for all treatment groups. Some of these events could be attributed to new invasive contralateral breast cancers.

The authors conclude that, regardless of treatment, women with DCIS have an excellent overall prognosis "despite persistent risks of breast cancer in the same or contralateral breast." They note that three other NSABP trials now in progress will provide more information on other treatment options following lumpectomy.

Journal Reference:

Irene L. Wapnir, James J. Dignam, Bernard Fisher, Eleftherios P. Mamounas, Stewart J. Anderson, Thomas B. Julian, Stephanie R. Land, Richard G. Margolese, Sandra M. Swain, Joseph P. Costantino, Norman Wolmark. Long-Term Outcomes of Invasive Ipsilateral Breast Tumor Recurrences After Lumpectomy in NSABP B-17 and B-24 Randomized Clinical Trials for DCIS. Journal of the National Cancer Institute, 2011; DOI: 10.1093/jnci/djr027

R.S., North Carolina

February 11, 2009 Hello ISCA

I cannot begin to express my gratitude to you and the team of health care professionals for my mother’s treatment. Brings a whole new meaning to "The Dream Team"! It was an absolutely phenomenal, overwhelming experience. Sounds like an oxymoron considering we went for (Mom’s) breast cancer treatment! Elese, my mom, and I, decided we had more "air time' with the most knowledgeable and compassionate doctors than we have had in our combined lives. Again, I thank you from the bottom of my heart. It was incredible to meet you and the rest of the team. Elese and I had to try to quell our "spinning brains" as we were trying to figure out how to seek funding, fight politicians, recruit doctors etc ,etc.etc. so we can help the brilliant pioneers we met this past week (who are) fighting passionately to swing the pendulum for personalized healthcare in America and around the world.

My sincerest regards,

R.S. North Carolina