Breast Cancer Prevention

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Breast Cancer Prevention

• Dr. Jake Psenka, ND
• Naturopathic Family Care
• 13832 N. 32nd Street 126
• Phoenix, Arizona 85032
• www.4wecare.com
• 602-493-2273

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What Are Risk Factors

• Risk factors are lifestyle or personal traits
  that increase the risk of developing cancer.
• Decreasing the risk factors decreases the chance
  of disease.

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Established Risk Factors

• Family History especially in your mother,
  sister, or daughter(s).
• Age the older you are the higher your risk.
• Never having borne a child.
• Having your first child after 30 years old.
• Early onset of menarche
• A history of benign breast diseases

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Other Risk Factors

• Hormone replacement after menopause.
• Chemical Exposure
• Poor dietary choices
• Lack of exercise
• Heavy metal exposure

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Possible Risk Factors

• Decreased melatonin
• Pesticide exposure

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Brest Cancer Family History

• Researchers estimate that only 5-27 of breast
  cancer cases are a result of genetics.
• In the majority of those cases the genes involved
  are
• BRCA1
• BRCA2

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BRCA1 and BRCA2

• BRCA stands for BReast CAncer. These are the two
  most common genetic mutations associated with
  breast cancer.
• Women inheriting these mutations have a 40-85
  lifetime risk of developing breast cancer, as
  well as an increased risk of ovarian cancer.

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BRCA1 and BRCA2

• Researchers at the National Institutes of Health
  recently completed a study that offers a more
  complete understanding of these mutations in the
  US population.
• This study looked at 2300 multi-ethnic women ages
  35-64, some with breast cancer and some without.

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BRCA1 and BRCA2

• The study found the following
• BRCA1 mutations were more common in white women
  with breast cancer than African-American women.
• Women with Jewish ancestry had a substantially
  higher incidence of the BRCA1 mutation compared
  to non-Jewish women.
• African-American women are more likely to carry
  the BRCA2 mutation.
• Not every woman who carries one of the genes will
  get cancer.

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BRCA1 and BRCA2

• The real significance of the study was its
  ability to identify key predictors of whether a
  woman with breast cancer will carry the BRCA1 or
  BRCA2 mutations.
• This information is important because it can
  predict those women who will benefit from genetic
  testing, increased breast cancer screening, and
  other measures aimed at early detection,
  treatment, and prevention.

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BRCA1 and BRCA2

• The most predictive factors for the BRCA1
  mutation are
• Jewish ancestry
• Family history of ovarian cancer
• Family history of breast cancer before the age of
  45

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BRCA1 and BRCA2

• The only predictive factor for the BRCA2 mutation
  is early onset in the patient (before age 45) in
  the patient herself or early onset of breast
  cancer in mother, sisters, grandmothers, or
  aunts.

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Genetic Testing

• Genetic testing can be performed by submitting a
  small blood sample to a laboratory for analysis.
• Remember, testing positive for the BRCA1 or BRCA2
  genes does not automatically mean a cancer
  diagnosis. Just having the gene doesnt mean
  that it will be expressed.

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Age

• Risk increases with age.  Age is the biggest risk
  factor. In other words, all women have some risk.
  Hence the need to promote awareness and take
  steps for prevention. 
• About 18 of breast cancer diagnoses are among
  women in their 40s, while about 77 of women with
  breast cancer are older than 50 when they are
  diagnosed.

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Children

• Women who have had no children or who had their
  first child after age 30 have a slightly higher
  breast cancer risk. Having multiple pregnancies
  and becoming pregnant at an early age reduces
  breast cancer risk. Women who have breast fed
  their children also have a decreased risk.

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Early Menarche

• Women who started menstruating at an early age
  (before age 12) or who went through menopause at
  a late age (after age 55) have a slightly higher
  risk of breast cancer.

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Benign Breast Diseases

• Having a history of non-cancerous breast disease
  increases breast cancer risk.
• Examples include
• Lobular carcinoma in situ.
• Fibrocystic changes
• Inflamed breast tissue

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Post Menopausal Hormone Replacement Therapy

• A study in the July 2006 issue of the Archives of
  Internal Medicine concluded
• Women using estrogen and testosterone therapies
  have a significantly increased risk of invasive
  breast cancer.

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Post Menopausal Hormone Replacement Therapy

• Another study reported in the cancer edition of
  BioMed Central stated
• The relatively feasible lifestyle changes of
  discontinuing EPRT use, reducing alcohol
  consumption, increasing physical activity, and
  lengthening breastfeeding duration could lower
  population breast cancer incidence
  substantially.
• EPRT Estrogen/progestin ReplacementTherapy

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Post Menopausal Hormone Replacement Therapy

• The International Journal of Cancer reported in
  August of 2006 that
• Higher serum concentrations of estrogens were
  associated with increased breast cancer risk in
  postmenopausal women.

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Effect of HRT

• Increased breast cancer risk associated with
  testosterone may be because enzymes in breast
  tissue convert testosterone to estradiol, an
  estrogen-like hormone that could contribute to
  the development of breast cancer. Higher levels
  of testosterone alone have also been linked to
  increased breast-cancer risk in postmenopausal
  women.

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Checking Your Estrogen Levels

• There are a variety of ways to have your hormonal
  status evaluated. The most accurate measures are
  done via blood, urine, or saliva samples. Not
  all women will have similar circulating levels of
  estrogens, even if they are the same age, race,
  etc. This concept is called Biochemical
  Individuality.

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Checking Your Estrogen Levels

• Researchers at Rockefeller University have found
  that the body metabolizes estrogens into several
  different metabolites that can impact cancer
  development. One metabolite, 2-hydroxyestrone
  (2-OHE1), tends to inhibit cancer growth.
  Another, 16-a-hydroxyestrone (16-a-OHE1),
  actually encourages tumor development. A womans
  "biochemical individuality" determines which of
  these metabolites predominates. Studies have
  shown that measuring the ratio of these two
  metabolites provides an important indication of
  risk for future development of estrogen-sensitive
  cancers. The studies also show that this risk is
  modifiable!

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Identifying Hormone Status

• If you are over 40, and especially if you have a
  family history of breast cancer, its a good idea
  to have your estrogen levels checked. Most
  laboratories offer blood testing for estrogen,
  progesterone, and testosterone. Although some
  are better than others.

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Chemical Exposure and Breast Cancer Risk

• Animal cancer bioassays conducted by the National
  Toxicology Program indicate more than 40
  chemicals can induce mammary tumors, and most of
  these are still in production.
• How much exposure is too much?
• Nobody Knows.
• What are all the chemicals that can have a
  negative effect?
• Nobody Knows.

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Chemicals that Cause Cancer

• Xenoestrogens- These are synthetic agents that
  mimic the action of estrogens. Chronic exposure
  to xenoestrogens may be partially responsible for
  the world-wide increase in breast cancer.
  Xenoestrogens are found in pesticides, fuels,
  plastics, detergents, and prescription drugs.

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Xenoestrogens

• Bisphenol-A (BPA) one of the most pervasive
  chemicals in modern life. Used to make
  polycarbonate plastic.
• Diethylstilbestrol (DES) Drug prescribed to
  prevent miscarriges. Banned in 1971after causing
  breast cancer in daughters.
• Polyvinyl Chloride (PVC) Used in plastic
  products such as food packaging, medical
  products, appliances, cars, toys, credit cards,
  and rainwear.
• Dieldrin Pesticide, banned in 1987.
• House Hold Products Cleaners, solvents, and
  pesticides.

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Solvents

• Solvents are a class of chemicals that are used
  to dissolve other substances.
• Elevated rates of breast cancer have been found
  in women with exposure to
• Electronics Manufacturing
• Fabricated Metals
• Lumber
• Furniture
• Textiles
• Clothing Industry

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Aromatic Amines

• Are a class of chemicals found in the plastic and
  chemical industries, in air and water pollution,
  diesel exhaust, tobacco smoke, and in grilled
  meats and fish.
• One type, o-toluidine, is known to cause mammary
  tumors in animal studies.

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Know the Facts

• State of the Evidence Report
• http//www.bcaction.org/PDF/StateofEvidence.pdf

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Diet and Breast Cancer

• Its been estimated that diet contributes to up
  to 80 of cancers of the colon, prostate, and
  breast. Diet also negatively affects the risk
  factors of other cancers such as pancreatic,
  lung, stomach, and esophagus.

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Saturated Fat Intake

• Elevated saturated fat intake is associated with
  higher breast cancer risk.
• Diet during puberty influences sex hormone
  levels, possibly breast cancer risk.
• Journal of the National Cancer Institute.
  January 2003.
• The study found that girls who had a modest
  reduction in fat intake had significant lower
  rates of sex hormones including estradiol,
  estrone, and testosterone.
• The European Prospective Investigation into
  Cancer and Nutrition (EPIC)
• Public Health and Nutrition. February 2006
• This study found that a daily intake of 35 grams
  of saturated fat doubles the risk of breast
  cancer compared to women with a daily intake of
  10 grams or less. This study had over 500,000
  participants.

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Not all fats are bad

• International Journal of Cancer
• March 2002
• Data based on fatty acids levels in breast
  adipose tissue suggest a protective effect of n-3
  fatty acids on breast cancer risk and support the
  hypothesis that the balance between n-3 and n-6
  fatty acids plays a role in breast cancer.
• The best ratio is 31 omega-6 to omega-3 fatty
  acids. The typical western diet is about 151.

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Sources of Omega 3 and 6 Fatty Acids

• Omega-3
• Flax Seed, Walnuts, Chinook Salmon, Scallops,
  Cauliflower, Cabbage, Sesame seeds.
• Omega-6
• Safflower oil, sunflower oil, hemp oil, wheat
  germ oil, evening primrose oil.

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Other Dietary Risk Factors

• Alcohol
• 2-5 drinks per day increase risk 1.5 times over
  that of women who dont drink.
• Excessive Red Meat Intake
• Increased inflammation, source of carcinogenic
  substances ie. heterocyclic amines.
• Excess Sugar/Calories
• Sugar intake is a strong risk factor that
  contributes to higher breast cancer rates,
  particularly in older women. Sugar containing
  foods cause and increase in insulin and
  insulin-like growth factor- which can promote
  cancer growth. Annals of Oncology, February,
  2006.

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Exercise

• The positive effects of exercise cannot be
  overstated. Regular physical activity can impact
  the body in a variety of ways, and there are
  several hypothesized biological mechanisms for
  the physical activity--cancer association. These
  mechanisms include changes in hormone levels,
  reduced percentage of body fat, enhancement of
  the immune system, and alteration in free radical
  damage by scavenger systems.

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Quick Review- What Do We Know?

• We know that women who have elevated hormone
  levels can have a 2-3-fold increased risk of
  cancer. Exercise can decrease hormone levels.
• We know that elevated saturated fat intake, and
  an increased body fat content can double breast
  cancer risk. Exercise can decrease body fat.
• We know that a decreased immune system is a risk
  factor for cancer, we also know that it is a big
  problem for people undergoing cancer therapy.
  Exercise stimulates the immune system.
• 4. We know that chronic exposure to free
  radicals can increase cancer risk. Exercise can
  help to neutralize free radicals.

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Journal of the National Cancer Institute, Sept.
1994

• Our results suggest that implementation of
  regular physical exercise programs as a critical
  component of a healthy lifestyle should be a high
  priority for adolescent and adult women.

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How Much Exercise?

• The available data indicate that 30-60 minutes
  per day of moderate-to-vigorous physical activity
  is needed to be protective against breast cancers.

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Heavy Metal Exposure

• The documented effects of heavy metals
• Depletion of immune system activity.
• Disruption of the haematopoiteic system.
• Accumulation in breast cancer tissue.
• Increased breast cancer risk.
• Increased cardiovascular risk.

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What are heavy metals?

• Metallic chemicals like cadmium, arsenic,
  copper, mercury and zinc that can be harmful
  pollutants when they enter soil and water. These
  chemicals are put into animal feed to help make
  animals grow faster. Heavy metals are present in
  human and animal waste and can enter the
  environment if waste is released without being
  treated. Animal waste is never treated to remove
  heavy metals. Once in the environment, heavy
  metals are almost impossible to get rid of
  because they do not decompose.

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Sources of Heavy Metal Exposure

• Water
• Food (animals and plants)
• Make-up and Cosmetics
• Air pollution
• Smoking

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Assessing Heavy Metal Loads

• The best way to determine your heavy metal
  exposure is through a timed urinary collection.
  To correctly assess exposure over long periods of
  time it is necessary to use a provoking agent
  such as EDTA, DMPS, or DMSA. These chemicals are
  called chelators, and they claw onto heavy
  metals and promote their excretion.

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Removing Heavy Metals

• Chelation Using chelators either IV, orally, or
  as suppositories.
• Sweating Saunas can be used- the skin is the
  largest eliminative organ in the body
• Detoxification Targeted supplementation, diet,
  exercise, IR heart.

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Melatonin

• Melatonin is a natural hormone that is found in
  nearly all living creatures. Melatonin is the
  hormone that regulates our sleep cycle.
• Additionally, melatonin levels can stimulate the
  immune system, and act as an antioxidant.

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The Melatonin Hypothesis

• Melatonin synthesis can be modulated by sleep
  cycle and exposure to artificial lighting. The
  hypothesis is that with decreased melatonin in
  our bodies we may be increasing our cancer risk
  through increased stress, decreasing the
  effectiveness of the immune system, and increased
  anti-oxidant burden. Increased melatonin levels
  have even been shown to decrease breast cancer
  growth.

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Pesticide Exposure

• Pesticide exposure is recognized as an important
  environmental risk factor associated with cancer
  development. Maternal exposure to pesticides can
  have harmful effect on the fetus.
• It is important to take steps to decrease
  exposure and bodily burden.

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Minimizing Pesticides

• The best way to avoid pesticides is to eat
  organic foods. Its important to wash your
  produce thoroughly- the best way is to fill up
  your sink with water and then add 1 cup hydrogen
  peroxide. Add your produce and allow to soak for
  15 minutes. Rinse and eat. This will help to
  eliminate waxes, pesticides, and any
  micro-organisms may be on your foods.

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Removing Pesticides/Residues

• A good detoxification program that targets fat
  tissues, as well as stimulation of the
  detoxification processes liver can help to move
  these chemicals out of the body.

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Stopping Breast Cancer

• Remember that roughly 85 of breast cancer cases
  are due to environmental and dietary causes.
  Making some simple lifestyle changes can have a
  profound impact on the prevalence of breast
  cancer.