Whole-Food Guide for Breast Cancer Survivors (3 page)

Traditional Risk Factors

This generation of women in the United States faces a greater lifetime risk of breast cancer than any previous one, with rates having tripled during the past forty years, according to holistic nurse educator and clinical nutritionist Susan Luck (2010). In fact, the NCI (2010) estimates that 12.15 percent (one in seven) of women born in 2009 will be diagnosed with breast cancer at some time in their lives. And if you’ve already had breast cancer, you’re undoubtedly concerned about your risk of recurrence.

Gender

Being female is, by far, the most substantial risk factor. According to the ACS, the incidence of breast cancer is about 100 times higher in women than in men. The explanation for this difference is not the number of breast cells per se, but rather the contact female breast cells have with the growth-stimulating effects of female hormones.

Race also plays a role in breast cancer. According to the ACS, Caucasian women have a higher incidence of breast cancer, although more African American women die from it. Asian Americans, Hispanics, and Native Americans appear to have a lower risk of both incidence and death from breast cancer.

Age

Your risk of developing any illness increases with age. It is now estimated that one in eight
invasive
breast cancers (cancers that invade surrounding areas) are found in women who are younger than age forty-five, and unfortunately risk rises steeply with age. Two out of three cases of breast cancer in women aged fifty-five and older are considered invasive.

Weight

Prior to menopause, your ovaries produce most of your estrogen, while fat tissue produces only a small amount. After menopause, the ovaries shut down production, and most of your estrogen comes from the adrenal glands and fat tissue. Having more fat increases your estrogen levels, which can raise your chance of developing breast cancer, and it appears that having more abdominal fat may increase your risk. What’s more, women who are overweight have higher levels of circulating insulin. Insulin, being a growth factor, is an independent risk for breast cancer, a topic we’ll expand on in chapter 6.

Lack of Physical Activity

Lack of physical activity not only leads to weight gain but also may be another factor that increases your risk of developing breast cancer. The Women’s Health Initiative (WHI) (McTiernan et al. 2003) found that “as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman’s risk by 18 percent.” The ACS recommends forty-five to sixty minutes of physical activity, five or more days per week.

Genetic Factors

Fortunately, only 5 to 10 percent of breast cancers result directly from mutations due to inherited genetic defects. The much-publicized BRCA-1 and BRCA-2 genes are examples of these defective genes. If you inherit a mutated copy of either of these genes, your risk of developing breast cancer escalates to as high as 80 percent. What’s more, when breast cancer strikes women with these genes, it happens at a younger age and tends to show up, more often than not, in both breasts (
bilateral presentation
). Jewish woman of Eastern European descent have the highest incidence of this genetic pattern, although it can occur in any race or ethnic group. Other alterations in genes, such as p53, ATM, CHK2, and CDH1, increase breast cancer risk as well. Modern technology allows us to identify these aberrant genes through specialized genetic testing (see appendix B). This testing is not routinely provided to women with concerns about breast cancer risk, although a doctor can order it at the patient’s or a family member’s request at any age.

Hormonal Factors

Cumulative lifetime exposure to estrogen is considered a risk factor for breast cancer, so early puberty (before age twelve), and late menopause (after age fifty-five) each add to your risk. Other hormonal factors include the timing of pregnancy, breastfeeding, weight, exposure to oral contraceptives, use of hormone replacement therapies, and use of the synthetic estrogen
diethylstilbestrol
(DES).

EARLY PUBERTY

The rising rate of obesity in our youth may be a contributing factor to early puberty since body fat can produce the sex hormones that lead to glandular development. The notion that environmental chemicals that mimic estrogen may contribute to an earlier onset of puberty has been suggested but remains unproven (Grady 2010).

PREGNANCY STATUS

While early pregnancy is known to offer protection, a benefit of natural hormonal changes, both late pregnancies (after age thirty-five) and no pregnancy at all confer a statistically higher incidence of breast cancer.

NO BREASTFEEDING

Known to provide many health benefits for the baby, breastfeeding also appears to offer protective benefits to the mother by helping to reduce her risk of developing breast cancer, especially when infants breastfeed up to one to one-and-a-half years of age.

ORAL CONTRACEPTIVE USE

Several studies have uncovered a link between the long-term use of birth control pills and breast disease later in life. A noteworthy NCI-sponsored study published in 2003 (Althuis et al.) reported that using oral contraceptives generated a higher risk of breast cancer, especially in younger women. This risk was more pronounced in women who had used oral contraceptives within the past five years, whereas the risk diminished over a longer period (ibid.).

HORMONE REPLACEMENT THERAPY

After years of recommending postmenopausal hormone replacement therapy (HRT) to millions of women, the medical establishment reversed course after the publication of the Women’s Health Initiative Study in 2002 (Rossouw et al.), which reported that five years of combined HRT (pharmaceutical estradiol and progestin) was associated with a 26 percent increase in risk of invasive breast cancer in postmenopausal women.

DIETHYLSTILBESTROL

Developed in the late 1930s, diethylstilbestrol (DES) is a synthetic estrogen that was administered to pregnant women to help prevent or lower the risk of miscarriage. Women who took DES and women whose mothers took it may have a higher risk of developing breast cancer. The ACS (2010a) provides information about the link between DES and breast cancer (see the references).

Confirmed Environmental Exposures

Environmental factors are increasingly recognized as an important part of the risk of breast cancer. The biggest environmental risks, ones that you can, to some extent, control, are smoking cigarettes and working at night.

SMOKING CIGARETTES

Although smoking is traditionally associated with lung cancer, we’ve learned from a number of recent studies that the risk of breast cancer is also strongly associated with smoking and secondhand-smoke exposure. The risk of breast cancer increases by 50 percent among women who have smoked for forty years or longer, compared to nonsmokers (Cui, Miller, and Rohan 2006).

Smoking is a clear and present risk factor for breast cancer. Although quitting can be an arduous task, the rewards are huge, and many organizations, including the American Cancer Society, can provide help (see appendix B).

WORKING NIGHTS

While not as controllable as smoking cigarettes, working at night is an environmental factor. The ACS indicates that women who work night shifts, such as nurses and flight attendants, may have a change in melatonin levels (a hormone produced by exposure to light). This change is believed to be a factor that increases the risk of developing breast cancer.

Keep in Mind

Despite the multitude of risk factors discussed here and elsewhere, it’s empowering to remember that most people do
not
get cancer in their lifetimes and that most women who
do
get breast cancer survive the experience. In the following chapters, we’ll look at all of the ways available to you to lower your risk and claim your rightful power to more confidently sail your ship.

Last Word

For years, cancer was just a word to me. Now it’s a journey, filled with challenge, yes, but also the joy of learning.

—H. Levy, breast cancer survivor

2.
Emerging Risk Factors

The terrain is everything.

—Louis Pasteur

Chapter Goal: Learn about emerging risk factors for breast cancer

In mid-nineteenth-century France, a vigorous war of ideas raged in the upper echelons of the scientific community. On one hand, Louis Pasteur was developing his germ theory of disease, and on the other, Claude Bernard was focused on the
milieu interieur
, or the internal environment of the host. Bernard felt that the nourishment of the body, its ability to get rid of toxins and wastes, and the strength of its immune system provided the foundation for successfully confronting both acute and chronic disease. Although Pasteur and others fought long and hard for the supremacy of the microbe theory of disease, Pasteur experienced a dramatic turnaround late in life and, on his deathbed, is said to have uttered, “Bernard was right. The microbe is nothing. The terrain is everything.”

We wholeheartedly agree that healthy “terrain” is the foundation for a healthy body that can mount a strong defense against cancer. In this chapter, we’ll cover the basics of emerging risk factors for breast cancer, the ones that deal with the internal terrain as Bernard or Pasteur might envision it today. These factors include dietary and nutritional influences, toxic exposures, and the health and equilibrium of the body’s own internal systems, such as the hormonal, digestive, and immune systems. We consider these risk factors to be so important that we’ve devoted entire chapters to many of them later in the book. Others we’ll just touch on briefly in this chapter.

The Standard American Diet: Your Number One Risk Factor

The
standard American diet
(SAD), sometimes also referred to as the
Western dietary pattern
, consists of a high intake of red meat, sugar, trans fats, high-fructose corn syrup, artificial sweeteners, and refined grains. This dietary pattern also includes a low intake of colorful, whole-food fruits and vegetables.

The High Cost of Cheap Food

The health of the majority of Americans is getting worse as you read this. In the Time magazine article “Getting Real about the High Price of Cheap Food,” Bryan Walsh (2009) writes, “Unless Americans radically rethink the way they grow and consume food, they face a future of…higher health costs.” Why? Food experts, such as Michael Pollan, warn us that the quality of our food supply has been on a slow decline for many decades; that is, our food has become more toxic and less nutritious. In fact, much of what we eat is not actually food at all but what we like to call “UFOs,” or “unidentified food objects.” Just look at the label on a typical packaged food from a supermarket shelf. Try to pronounce most of the ingredients, and you’ll see exactly what we mean. It’s no surprise that we’re witnessing an unprecedented rise in obesity, blood-sugar imbalances, autoimmune diseases, and cancer in our population (ACS 2010b).

The crux of the matter is this: fast food and packaged foods, as documented by Eric Schlosser in
Fast Food Nation
(2001) and Carol Simontacchi in
Crazy Makers
(2000), are made from the least-expensive ingredients possible and loaded with chemicals, damaged fats, artificial ingredients, and flavor enhancers. Fast foods
are
stimulating but
they are not
nourishing. Many experts, including researchers from the American Institute for Cancer Research (AICR) (2007), believe that for the twelve most common cancers, about 35 percent of cases in the United States are preventable through maintaining a healthy diet and healthy weight, and being physically active. So eating a diet aimed at risk reduction is probably the most important step you can take to lower your chances of dancing with this most unpleasant disease.

Sick animals make for unhealthy food.
While consuming malnourished, pesticide-laden plants can lead people to appear sickly and malnourished, those same substandard crops, combined with excessive amounts of hormones and antibiotics, lead to sickness in animals. Factory-farmed animals are fed a steady diet of genetically modified (GM) corn and soy, with the intent of making the cattle gain weight quickly. What’s more, a typical fast-food or school-lunch burger is not made from a single piece of beef, but from “meat” from a variety of sources, such as trimmings and scraps of fatty wastes that are left on the slaughterhouse floor after the animals have been butchered.

The same basic practices are also applied to raising chicken and fish. Simple common sense tells us that feeding GM soy and corn pellets to algae-loving salmon, or sawdust, hormones, antibiotics, and cardboard to insect-loving chickens, will produce sickly, malnourished animals, whose meat then contains the drugs, pesticides, and other toxins the animal consumed. Indeed you are what the animal on your dinner plate ate.

Got rBST?
Studies over the past decade have pointed clearly to the fact that consuming cattle that were fed artificial growth hormones has led to increased rates of breast cancer, early puberty, and obesity in the United States (Bohlooly-Y et al. 2005). Monsanto first began selling recombinant bovine growth hormone (rBGH), also known as rBST (recombinant bovine somatotropin), in 1994. The hormone, designed to force cows to produce more milk, has been banned in Europe, Canada, Japan, Australia, and New Zealand due to safety concerns. Nevertheless, in the United States, Monsanto has insisted that its genetically modified growth hormone is safe. Many experts say otherwise. A key area of concern is the startling rise in human blood levels of a growth hormone known as insulin-like growth factor (IGF-1). As Dr. Samuel Epstein (1996), noted toxicologist, explains, consumption of animals that were fed growth hormones leads to excessive levels of IGF-1, a close relative of insulin, in humans.