Saturday, December 18, 2010

Bone Loss / BDM / Osteoporosis

Overweight

Similarly, here is the situation about being overweight: AFTER menopause (and I honestly don't know about chemically-induced menopause), fat cells manufacture small levels of estrogen. To a significantly lesser extent pre-menopause, so do all fat cells. However, this is "overweight" not "healthy weight" -- so I don't know the BMI or anything.

Here it is, courtesy of Mayo Clinic:

BMI
25.0 — 29.9 Overweight
30.0 and higher Obese

The risk is overweight as measured by BMI, not by high fat diet:

Research shows that eating a diet rich in fruits and vegetables doesn't offer direct protection from breast cancer. In addition, a recent study of dietary fat and breast cancer showed only a slight decrease in the risk of invasive breast cancer for women who ate a low-fat diet.

Alcohol

Alcohol consumption did not influence the risk of hormone receptor-positive ductal carcinoma.

You have doubtless read some version of this from late this summer:

Women who averaged one alcoholic drink a day had almost double the risk of hormone-sensitive breast cancer of nondrinkers, data from the Women's Health Initiative (WHI) showed.

Alcohol consumption had a significant association with invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (P≤0.022), but the risk of receptor-negative breast cancer was unaffected.

The analysis, reported online in the Journal of the National Cancer Institute, also showed that the association between alcohol and hormone-sensitive breast cancer applied only to lobular invasive breast cancer and not to ductal invasive cancer.

Just a little lesson in journalism: log line: "almost double the risk" for ER+ cancers.

"Almost double" is a lot, for ER+ cancers: the vast majority of cancers of any type in premenopausal women.

Not until the third line do we learn does NOT apply to DCIS or anything originally arising in the duct, which over 90% of all cancers, and... invasive lobular... even fewer...

Oh, but look at this! It doesn't apply to anyone premenopause. And the findings are a bit klugy because they didn't correct for various types of hormone supplements and therapies. We know this only from the title of the real paper in the footnote:

Primary source: Journal of the National Cancer Institute
Source reference:
Li CI, et al "Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women's Health Initiative observational study" J Natl Cancer Inst 2010; DOI: 10.1093/jnci/djq316.

Going there we see the assumption that I am checking out:

Alcohol consumption is a well-established risk factor for breast cancer.

And some more facts -- again, for all postmenopausal women, not premenopausal women or postmenopausal women who have had breast cancer.

Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor–positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor–positive invasive ductal carcinoma.

So, a 2% risk increase in getting a type of cancer that one is...at 5%-8% (per 10000 years? so is that .01%?... risk of 11% risk of getting. It is -- I think -- "background" risk -- all women are subject to this risk.

This said, they are thinking that there are distinctions in ways cancers are made (etiology), and this points that this is a way that -- some cancer survivors could be making a different cancer from the initial one.

What I am receiving is that definitely this is a risk that is there, but that it is a risk that when measured between "never having had a drink" and "drinking moderately" is small. And, unavoidable if you drank ever, especially even in teens and 20s, and even moderately.

This, on the surface (I haven't read about the topic), seems to indicate that this might explain why red wine isn't quite as good for women as men.

From Mayo:

In fact, if you're a woman and drink alcohol, talk to your doctor about taking supplemental folate to help reduce the risk of breast cancer associated with alcohol use. UNLESS YOU DON"T WANT TO INCREASE YOUR RISK OF ER- BREAST CANCERS... FOLIATE has as a direct tie to ER- breast cancer.

Grilled Meat

The chemicals that are generated -- not by putting a nice char on something, but totally burning it -- are in tiny quantities (if at all) on beef and pork, and in higher quantities on fish and chicken.

Saturday, December 11, 2010

Monoclonal Breast Cancer Treatment

Monoclonal is antibodies that are antagonistic against the proteins, which are in or around cancer cells. They discern an invader such as a cancer cell and attack it.

I'll look this up.

Friday, December 10, 2010

Radiation Risks

Also new to the known carcinogen list are three types of radiation: X-rays, gamma radiation, and neutrons. Studies have shown that exposure to X-ray and gamma radiation is most strongly associated with leukemia and cancer of the thyroid, breast, and lung.

This risk is real, but reportedly minimal, and in this case, these induced secondary cancers IN THE SAME AREA are rarely fatal, but have significantly larger and long-term side effects to treat. I.e., the cure isn't going to kill *breast cancer patients* although -- other cancer patients? It might contribute...

Nutrition

OK, I have a pretty long history of weird nutrition, allergies, and dumbkopf nutritionists. I assign this to the fact that I'm in LA, and that my needs are specific.

So are yours, if you're reading this.

If you are young, despite your cancer, I am assuming that you, like me, are in relatively good shape, have a relatively good diet, quit smoking years ago, and etc.

I get to do this because I am not a medical professional. I also get to do this because I am a woman. Brushes with anorexia, bulemia, and hormonally-induced obesity: yes, I share your pain. And frankly, if you're female and overweight, YOU KNOW IT and it has been something that has caused at least some psychological pain, even if you have Grave's Disease, or never lost your baby weight, or hate sweating, or your husband enjoys ample curves. And, unfortunately, it is not time to "go on a diet" -- it is time to commit to being slim(mer) for the rest of your life.

For me, part of the nutritionist-world is that most of these people can't cook, don't really deeply CARE about delicious food or the social aspects of food and drink, view food as medicine, and are being very judgmental in an area that we, as women, are of course super-sensitive. I have had female nutritionists (I think most are).

So:

First of all, if you're not going through chemo, you should not suddenly become lactose intolerant, celiac, or suffer from IBS. If you think this is happening to you, it is totally cool to say, look, I seem to be suffering from something, and I want to be recommended to a gastroenterologist, immunology/allergy person, and tested, BEFORE doing radical things and trying to get through a serious health event without the comforts of Cheddar Cheese.

Corollary: if you are doing chemo at stage II or less, it is probably optional. SO -- ask your oncologist if s/he is open to you protecting your immune system and gut from chemo side effects, especially since the necessity of really slashing & burning isn't there in your case. My oncologist, speaking before we knew if chemo was even on the table or not, said, SURE. SAVE YOUR GOOD CELLS. YOU DON'T NEED TO DO THE MOST EXTREME CHEMO IN ANY CASE.

Secondly, though I haven't read deeply in the Greek, I assure you that Hippocrates didn't say sick people should become caffeine-free vegans because there's nothing harmful in becoming an ascetic. Unfortunately, when asked point-blank, in the U.S., your doctors have no choice to make recommendations (generally, consult a nutritionist/CYA/pass the buck) or to make "harmless" recommendations. No one is ever going to tell you to eat steak and chocolate cake. Although, I have heard of cancer patients with a chronic cancer -- towards the end of their lives -- being recommended an occasional glass of white wine, especially if they have loss of appetite. [Note, this blog isn't for people with anything more than Stage 2 breast cancer!]

Look at this bobo rec:

If you have been diagnosed with cancer (or just want to eat a healthy diet) it is prudent to eat about 25% of your calories from fat predominantly from fish or plant sources.

It is probably also not prudent to live in the street, sheltered only by the buzz you hang from bum wine and doritos. Duh.

Thirdly, the biggest stat -- i.e., from a nutritionist cancer site -- about nutrition and cancer is that 30% of cancers are impacted in some way by nutrition. Awfully vague and unscientific, huh? "In some way"? Like, I dunno, how many cancers are influenced by barometric pressure? We know lymphodema is influenced by altitude...

Another search about the relationship between saturated fat and breast cancer returned NO RESULTS that stated there was ANY TESTED CONNECTION and two results that reported that saturated non-transfat actually HELPS some cancers by boosting "good" cholesterol.

What I did find was the connection between fats and colon cancer. C'est someone else's vie. PASS THE CHEDDAR.

Lympedema Update!

1) Compression sleeve and (perhaps) glove

Health Insurance

First lesson from cancercareers.org, which a flyer from the compression bandage place told me about:

if you get a new job with health coverage, you

1) cannot be treated within six months of "opting in" for a pre-existing condition in order for it to be covered

2) your employer may make all new employees wait as much as 12 months to be covered

these times overlap, so the max is 12 months but note -- no treatments! Obviously, I will be looking into this more. I'm assuming maintenance scans don't count, although I can see an employer doing a "whaddaya mean" with annual MRIs rather than mammograms...

Wednesday, December 8, 2010

Off-Label Lupron from Breast Cancer, On Label for Endometriosis. Prostate Cancer?

n two data collection studies performed by the Endometriosis Research Center, women were asked to share feedback about their experience with Lupron®. The results (both data collections were limited to Lupron® users only):

27.71% found Lupron® to be tolerable and helpful at symptom relief;
7.23% found Lupron® to be tolerable, but not helpful at symptom relief;
16.87% found Lupron® to be intolerable, but nonetheless helpful at symptom relief;
48.19%, almost half of the participants, indicated that Lupron® WAS INTOLERABLE AND NOT HELPFUL AT SYMPTOM RELIEF.

Because I am not concerned with relief of Endometriosis relief, I still read 16.87 + 48.19 = 65.06% = INTOLERABLE side-effects.

These impartial and unbiased results are strikingly different from the experiences propagated throughout the medical community and TAP's various websites.

In a second study, patients were asked for feedback regarding their POST-Lupron® experience. The results were even more startling:

21.67% did not suffer any lasting effects from Lupron®;
26.67% suffered lasting effects for up to 6 mos. after Lupron®;
10.00% suffered lasting effects for up to 1 year after Lupron®;
5.00% I suffered lasting effects for up to 2 years after Lupron therapy®;
6.67% suffered lasting effects for up to 3 years after Lupron therapy®;
6.67% suffered lasting effects for up to 4 years after Lupron therapy®;
23.33%, a staggering amount of participants, suffered lasting effects for UP TO 5 OR MORE YEARS after Lupron®.

"Effects" included but were not limited to seizures, cardiac problems, and fibromyalgia. Yet, these effects are largely unrecognized in the medical literature. Again, such effects continue to be ignored and invalidated by healthcare providers at large.

The Endometriosis Research Center strongly maintains: the long-term effects of Lupron® (and GnRH medications in general) is not known. The application of GnRH therapy to those women who have not been surgically diagnosed must stop. More research must be given to the long-term effects of GnRH therapy on a woman - and possibly her offspring. Indeed, GnRH medications have a place in Endometriosis treatment; however, caution must be exercised to avoid the cookie-cutter approach to therapy. What works for one patient will not work for another. Subjecting patients to potential negative effects that outweigh the benefits of treatment is unethical. Patient needs and the uniqueness of each case must be thoroughly considered before any therapies are offered.

More Lupron

Raise risk of heart attack in men:

an article by Carla K. Johnson of the AP, dated August 26, 2009 noted a recent study that found that this prostate cancer drug is very risky especially for men with heart problems. ... Women with Endometriosis also suffer significant side effects. Also, in June 2009 the label was changed again to warn about "convulsion" in the post-marketing surveillance. The label shows that 98% of women had adverse events including 65% suffering headache/migraine, 31% depression, 31% insomnia, and 25% Nausea/vomiting. Many other adverse events are listed in the label. See full label at FDA.gov. The label also notes that women with no history of depression or psychiatric illness reported suicidal ideation and attempt. Additionally leuprolide therapy in conjunction with radiation has been shown to result in a statistically significant shortening of the penis.

Lupron cannot be given more than twelve injections per life time because it hasn't been tested for longer. It DEFINITELY causes irreversible bone density loss.

Merck:

Pituitary apoplexy: Rare cases of pituitary apoplexy (frequently secondary to pituitary adenoma) have been observed with leuprolide administration (onset from 1 hour to usually <2 weeks); may present as sudden headache, vomiting, visual or mental status changes, and infrequently cardiovascular collapse; immediate medical attention required.



raloxifene
faslodex & femara are mentioned only for post-menopausal women, but they are not AIs

Lupron

Side effects that have been associated with the use of Lupron Depot frequently include hot flashes and night sweats, and less frequently palpitations, syncope, and tachycardias. Other side effects include generalized pain, headaches, vaginitis, nausea/vomiting, fluid retention[, weight gain, acne, hirsutism, joint pain, loss of sexual desire, depression, dizziness, nervousness, and breast changes such as tenderness and pain. There have been no deaths directly related to therapy with Lupron Depot.

Severe side effects include jaundice and coffee-grounds-like liver-driven vomiting.

LUPRON DEPOT given with norethindrone acetate may lower your HDL-cholesterol level (the “good” cholesterol). You should not take norethindrone acetate with LUPRON DEPOT if you currently have or have previously had any clotting disorder, heart disease, stroke, liver disease or breast cancer.

Tell your health care provider before beginning treatment with norethindrone acetate if you currently have or have previously had high cholesterol, migraines, epilepsy, depression, or smoke.

During treatment with LUPRON DEPOT and norethindrone acetate, immediately tell your doctor if you have a sudden loss of vision, double vision, or if migraine headaches occur. You should notify your doctor if you experience fluid retention, epilepsy, asthma or worsening of asthmatic symptoms, heart or kidney problems.

Thinning of the bones may occur during therapy with LUPRON DEPOT alone, which may not be completely reversible in some patients. Since some conditions may increase the possibility of bone thinning, you should tell your doctor if you smoke, use alcohol in excess, have a family history of osteoporosis (thinning of the bones with fractures), or are taking other medications that can cause thinning of the bones. You should be aware that repeat treatment with LUPRON DEPOT alone is not advisable if you have these conditions.

After beginning LUPRON DEPOT, your estrogen levels will increase for 1 or 2 weeks. During this time, you may notice an increase in your current symptoms. You should notify your doctor if you develop any new or worsened symptoms after beginning LUPRON DEPOT treatment.

LUPRON DEPOT is not a method of birth control. Even though you may not have periods, unprotected intercourse could result in pregnancy. You should use non-hormonal birth control such as condoms, a diaphragm with contraceptive jelly, or an IUD to prevent pregnancy. If you think you have become pregnant while on LUPRON DEPOT, talk to your doctor immediately.

There is a possibility of the development or worsening of depression and/or the occurrence of forgetfulness.

Patients who have a history of depression should be carefully observed during treatment.

The most common side effects of LUPRON DEPOT include hot flashes, vaginal dryness, headaches, changes in mood, decreased interest in sex, depression and/or the occurrence of forgetfulness.

No deaths! Take that, Tamoxifen!

Femara (letrozole) -- another thing to look up, and also buserelin (Suprefact, Suprecor), goserelin (Zoladex), histrelin (Supprelin), nafarelin (Synarel)

serotonin levels -- the antinausea medicine which touches the liver (so I won't take it with pain pills with tylenol in them)

Tuesday, December 7, 2010

Elizabeth Edwards and Late Childbirth Risk

WASHINGTON (KABC) -- Elizabeth Edwards has passed away after a six-year-long battle against breast cancer. She was 61.

Related Photos

Looking back on Elizabeth Edwards' life
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The wife of former presidential candidate John Edwards died at her North Carolina home surrounded by family members. A family friend said Edwards died at 10:15 a.m., but they did not announce it because her children were at school.

"Today we have lost the comfort of Elizabeth's presence but, she remains the heart of this family," the family said in a statement. "We love her and will never know anyone more inspiring, or full of life. On behalf of Elizabeth we want to express our gratitude to the thousands of kindred spirits who moved and inspired her along the way. Your support and prayers touched our entire family."

In 2004 after an exhaustive year on the campaign trail, Elizabeth Edwards learned she had breast cancer.

After undergoing treatment, the cancer went into remission in June 2006. But the following year, the cancer was back and terminal. Elizabeth Edwards chose to remain on the campaign trail, supporting her husband.

Edward's health had taken a turn for the worse in recent days, with doctors saying that there would be no further benefit from continuing her treatment. She was told last Wednesday she would have two to eight weeks to live.

Family members say Edwards was not in pain in her final days and she was never unconscious. But in the end, it was her liver that failed.

Elizabeth Edwards posted on her Facebook page recently thanking those who have supported and inspired her.

"Michelle and I were deeply saddened to learn of the passing of Elizabeth Edwards," President Barack Obama said in a statement. "In her life, Elizabeth Edwards knew tragedy and pain. Many others would have turned inward; many others in the face of such adversity would have given up. But through all that she endured, Elizabeth revealed a kind of fortitude and grace that will long remain a source of inspiration. Our thoughts and prayers are with her family and friends."

President Bill Clinton also released a statement.

"With the passing of Elizabeth Edwards, America has lost a symbol of strength, hope, and humanity, a tireless advocate for health care for all Americans, and determined crusader for cancer cures," Clinton said. "Her children have lost a loving mother, her friends a wise counselor. My prayers are with them. She was a remarkable woman who dealt with the challenges her life dealt her with courage and grace."

California first lady Maria Shriver called Elizabeth Edwards a "mighty warrior."

Shriver said she and Gov. Arnold Schwarzenegger were deeply saddened to learn about Edwards' death.

""I was deeply saddened to learn of the passing of my dear friend, Elizabeth Edwards. My heart goes out to her loving family," Shriver said. "I hope her children know their mother was an inspiration to women everywhere -- a truly great woman."

Elizabeth Edwards made her last public appearance in September at the "Stand Up to Cancer" event in Los Angeles.

In an interview with Eyewitness News, Edwards said, "I'm doing well. I'm always going to have cancer. Right now I'm in chemo, but I'm still here and still fighting."

Edwards faced struggles in her personal life over the years.

In 1996, her life and marriage were rocked by the death of her first born, Wade, when he was killed at age 16 in an auto accident.

Edwards vowed to have more children in addition to her then teenage daughter, Kate.

In 1998 at age 48, Edwards gave birth to Emma Claire. Two years later, she had son, Jack.

Friday, December 3, 2010

Parabens

How to find parabens in items ... that aren't required to list ingredients!!!!

Understand that companies say they use some form of parabens to prevent bacterial and fungal contamination. Many don't consider it harmful and have no qualms about adding it to their ingredients label. However, there is also evidence that parabens may disrupt the body's hormone systems by duplicating the effects of estrogen. These "preservatives" are in our salad dressing, mustard, mayonnaise, jam, soft drinks, candy and more.

2
Check your product labels for these terms: Methylparaben, Ethylparaben, Propylparaben, Butylparaben, Benzyl-parahydroxybenzoic acid, Methyl-parahydroxybenzoic acid, Ethyl-parahydroxybenzoic acid, Propyl-parahydroxybenzoic acid, Butyl-parahydroxybenzoic acid, Parahydroxybenzoic acid and Parahydroxybenzoate. They are all forms of parabens. If possible, get rid of everything in your house with those ingredients.


5
Be educated. Household cleaning products aren't required to disclose ingredients unless they contain antimicrobial pesticides, like disinfectants. Makers of cosmetics are required to list their ingredients unless it is fragrance and that is exempt as a "trade secret."