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Breast cancer on the increase
It used to be that breast cancer was something you began to think about in your late 40s and early 50s. That’s changing alarmingly: in South Africa large numbers of young women - some barely in their 20s - are getting this disease. And the National Cancer Registry tells us that breast cancer has now also overtaken cervical cancer as the most common cancer affecting women in our country.
Suddenly it’s become critical that we do all we can to protect ourselves against the disease from an early age. On the plus side, there’s the research which proves that if detected early, the survival rate can be as high as 95%.
Eating
We know for a scientific fact that to take care of our hearts and to prevent diabetes, we need to eat healthily - low-saturated fat, lots of fresh fruit and raw vegetables, high fibre, moderate alcohol and the right amounts of protein and carbohydrates.
Although no studies have been done in SA to conclusively prove the link between diet and cancer (and international studies remain conflicted), we do know, for example that frying food in the same fat repeatedly is carcinogenic and realistically we must accept that the fast food joint on the corner isn’t going to change its fat every day.
So, in cancer terms, best we stick to the same low fat, high fruit and veg intake plan as for other diseases. Research shows that vegetables like carrots, broccoli and spinach contain chemicals which are protective against disease and that the phytoestrogens (plant oestrogens) in soya, dried beans and peas are also beneficial.
There is strong evidence to suggest that women whose breast tissue has high levels of omega-3s (the fatty acids found in vegetable oils), have a 60% lower risk of breast cancer. Omega-3s are found in soya, rapeseed and in fatty fish like salmon and sardines.
What is conclusive is that excessive alcohol intake has a distinct influence on breast cancer patterns - more than 40 studies worldwide have proved this. The Cancer Association of South Africa quotes Professor Walter Willet, of the Harvard School of Public Health in the US, who says: “Consuming about two drinks per day increases risk of breast cancer by approximately 25%.”
Oestrogen
Traditionally, oestrogen was viewed as the number one enemy in breast cancer but while scientists continue to see oestrogen as a risk factor, inconclusive research results have modified attitudes.
What is accepted is that longer exposure to oestrogen could increase risk: the longer you wait to have children and the older you are when you reach menopause, the more oestrogen you’re exposed to. Also, mothers are encouraged to keep their girls at a healthy weight - obesity and related pre-adolescent oestrogen fluxes are risk factors in later life. And what about HRT? “New HRTs pose a minimal risk,” says Benn. The good news is that exercise may lower cumulative exposure to oestrogen.
Exercise
Crawling out from under the duvet at 5am in mid-winter to go to the gym might feel hazardous to your health but the long-term effects of exercise, particularly if you start young, do have a positive effect on breast cancer prevention.
A study published in the New England Journal of Medicine concluded that there was a 37% decrease in the incidence of breast cancer among women who exercised for four or more hours a week.
“The results of this and various other studies support the idea that physical activity protects against breast cancer in premenopausal and newly-postmenopausal women,” says Dr Carol-Ann Benn, head of the breast clinics at the Chris Hani/Baragwanath and Johannesburg hospitals.
“Precise assessment of the type and frequency of exercise needed is not known, but what is known is that exercise has a significant impact on decreasing breast cancer risk,” she says.
Dr Leslie Bernstein, a preventive medicine specialist at the University of Southern California’s Keck School of Medicine, recommends that women start exercising no later than adolescence, when breast tissue is developing. “The earlier you begin exercising, the more likely it will become a lifetime habit. However, we do see a risk reduction among women who didn’t exercise until their 20s or 30s, so it’s never too late to start.”
Empowerment
No-one should be more intimate with your body than you are, yet too many women still don’t examine their breasts regularly for unusual lumps or bumps. And if they do notice something different, many are too shy to ask their doctors about it.
Given that if detected early enough breast cancer has a survival rate of more than 95%, this is outrageous.
Benn says this reluctance to get involved is carried through to treatment options. Too many women accept whatever treatment their doctor puts forward without discussing the options available. If a lump is found, for example, it is not immediately necessary to have it surgically removed to determine whether it’s cancerous or not. Needle biopsies for diagnosis are less invasive and all women should insist on them, says Benn. “Less than 5% of cases should require surgical diagnosis of breast cancers.”
Mammography is also not the only screening programme (early mammography screening is believed to reduce mortality rates by as much as 20%). The Biofield Diagnostic System or BDS measures electrical impulses in the breast in much the same way as an electrocardiogram or ECG. A disruption in impulses usually indicates cell transformation and carcinogenesis. Dr David Long, inventor of the BDS, says 70 out of 100 lumps are benign.
However, if breast cancer is detected and mastectomy is the only treatment option, then discuss reconstruction immediately, suggests Benn. “The idea that you wait six months to a year before reconstructing is considered archaic,” says Benn, yet in South Africa this is still the norm. In Europe, all women having mastectomies have immediate reconstructions, which cuts down on the number of surgical procedures women must endure and saves costs.
Genes
A family history of breast cancer on either a mother or father’s side (this could be your grandmother, aunt, sister or any close family member) is a risk factor but it’s very small - less than 10%. However, if your family has a history of variable cancers (uncle with prostate cancer, cousin with breast cancer, grandmother with ovarian cancer etc), it is advisable that you have regular checkups. And Benn suggests that women with a family history of breast cancer get screened 10 years before the age at which their relative presented.
Exams
Most breast lumps are found by women themselves so don’t wait for your annual checkup with the GP or gynaecologist. Get to know your breasts intimately, their shape, size and feel. Your breasts may change size and may be tender and sore during your period, so the best time to examine them is the week after your period. That’s when they are softest and least tender, making a lump easier to find. It’s easiest to examine them while you shower. Visit the Cancer Association of South Africa’s (Cansa) website at www.cansa.org.za or www.breasthealth.co.za for detailed how-to diagrams.
Warning signs may also include nipple discharge, encrustation of the nipple, retraction of the nipple and local accumulation of tissue fluid. If you detect anything unsual, see your doctor, and have him check your breasts when you go for your pap smear. Doctors report a 76% cure rate when cancer is confined to the breast.
For information on reducing your cancer risk the natural way, read Rosy Daniel's The Cancer Prevention Book (Jonathan Ball). Dr Daniel's well-documented holistic approach to cancer healing led to successful research on holistic cancer prevention. For more on breast health, contact your nearest Cansa regional office or toll-free at 0800 22 66 22; or call the Netcare Breastcare Centre of Excellence at (011) 480-4226 or e-mail:breasthealth@netcare.co.za
Smoking
Tobacco causes 29 diseases, including several cancers, says Cansa. It is also associated with cancer of the breast, cervix, stomach and kidneys. The tar in cigarettes contains a number of carcinogenic substances. “Cancers may begin to develop in people as young as thirty, if they have been smoking for 10-15 years,” Cansa says.
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