Keys to Survival

IF YOU heard a news report that a killer was stalking your neighborhood, would you take measures to protect yourself and your family? Likely you would lock and bolt your doors so as not to invite an easy entry. You would also keep on the watch for suspicious-​looking strangers and report them right away.

Should women do any less regarding a killer disease, breast cancer? What measures can they take to protect themselves and increase their chances of survival?

Prevention and Diet

It is estimated that 1 out of 3 cancers in the United States is caused by dietary factors. A good diet that will help maintain your body’s immune system may be your first line of defense. While no known food can cure cancer, eating certain foods and cutting down on others can be preventive measures. “Following the right diet could reduce your risk of getting breast cancer by up to fifty percent,” stated Dr. Leonard Cohen of the American Health Foundation in Valhalla, New York.

Foods rich in fiber, such as whole-​grain breads and cereals, may help lower the amount of prolactin and estrogen, possibly by binding to these hormones and flushing them out of the body. According to the journal Nutrition and Cancer, “these effects could suppress the promotional phase of carcinogenesis.”

Cutting down on saturated fats may reduce risk. Prevention magazine suggested that switching from whole milk to skim, reducing butter intake, eating leaner meats, and removing skin from chicken can bring saturated fat intake down to safer levels.

Vegetables rich in vitamin A, such as carrots, squashes, sweet potatoes, and dark leafy greens, as spinach and collard and mustard greens, may be a help. It is thought that vitamin A inhibits the formation of cancer-​causing mutations. And such vegetables as broccoli, Brussels sprouts, cauliflower, cabbage, and green onions contain chemicals that induce protective enzymes.

In the book Breast Cancer​—What Every Woman Should Know, Dr. Paul Rodriguez says that the immune system, which recognizes and destroys abnormal cells, can be strengthened through diet. He suggests eating foods rich in iron, such as lean meats, leafy green vegetables, shellfish, and fruits and vegetables high in vitamin C. Fruits and vegetables high in C reduce the risk of breast cancer, reports the Journal of the National Cancer Institute. Soybeans and unfermented soy products contain genistein, known to suppress tumor growth in laboratory experiments, but the effectiveness in humans has yet to be established.

Early Detection

“Early discovery of breast cancer remains the most important step in altering the course of breast cancer,” says the publication Radiologic Clinics of North America. In this regard three key measures are regular breast self-examination, annual examination by a doctor, and mammography.

Breast self-​examination should be done regularly each month, as a woman must be vigilant in looking for anything suspicious in the appearance or the feel of her breasts, such as a hardening or a lump. No matter how small her finding may seem, she needs to contact her doctor immediately. The earlier a lump is diagnosed, the more control she has over her future. A report from Sweden showed that if a nonmetastatic breast cancer was slightly over one half inch [15 mm] or smaller in size and was surgically removed, a life expectancy of 12 years was 94 percent possible.

Dr. Patricia Kelly comments: “If you haven’t heard from a breast cancer in 12 1/2 years, it’s very unlikely to come back. . . . And women can be taught to find breast cancers smaller than a centimeter [1/3 in.] in size just using their fingers.”

It is recommended that a physical exam by a clinician or physician should be done routinely each year, especially after a woman reaches the age of 40. If a lump is discovered, it would be good to get a second opinion from a breast specialist or surgeon.

The National Cancer Institute in the United States says that a good weapon against breast cancer is a regular mammogram. This form of X ray can detect a tumor perhaps up to two years before it can be felt. The procedure is recommended for women over 40. However, Dr. Daniel Kopans informs us: “It is far from perfect.” It cannot detect all breast cancers.

Dr. Wende Logan-​Young of a breast clinic in New York State tells Awake! that if a woman or her physician finds an abnormality but a mammogram shows no sign of it, the tendency may be to ignore the physical findings and believe the X ray. She says that this is “the biggest mistake that we see nowadays.” She advises women to have a certain reservation about mammography’s ability to detect cancer and rely heavily also on breast examination.

While mammography can detect tumors, it cannot really diagnose whether they are benign (noncancerous) or malignant (cancerous). That can only be done by means of a biopsy. Consider the case of Irene, who went for a mammogram. Based on the X-ray film, her doctor diagnosed her lump as a benign breast disease and said: “I’m absolutely sure you don’t have cancer.” The nurse who did the mammogram was worried, but Irene said: “I felt that if the doctor was sure, maybe I was being paranoid.” Soon the lump grew larger, so Irene consulted another doctor. A biopsy was taken and showed that she had inflammatory carcinoma, a fast-​growing cancer. To determine whether a tumor is benign (as about 8 out of 10 are) or malignant, a biopsy must be performed. If the lump looks or feels clinically suspicious or is growing, a biopsy should be performed.

Treatment

At present, surgery, radiation, and drug therapy are the conventional treatments for breast cancer. Information about the type of tumor, its size, its invasive quality, whether it has spread to lymph nodes, and your menopausal status can help you and your doctor determine the method of treatment.

Surgery. For decades radical mastectomy, the removal of the breast along with underlying muscles and lymph nodes, has been widely used. But in recent years breast-​conserving treatment that includes removal of only the tumor and lymph nodes, plus radiation, has been used with survival rates that equal those of mastectomy. This has given some women more peace of mind when deciding to have a small tumor removed, that being less disfiguring. But the British Journal of Surgery says that younger women, those with cancer in several locations in the same breast or with tumors larger than one inch [3 cm], have a higher risk of recurrence with conservation treatment.

An important factor in recurrence-​free survival is noted by the Cleveland Clinic Journal of Medicine: “Blood transfusion does have an adverse effect on the survival and recurrence rate . . . after modified radical mastectomy.” The report showed that the five-​year survival rate was 53 percent for one group who received blood transfusion, as opposed to 93 percent for the no-​blood group.

Another aid to survival is reported in The Lancet, where Dr. R. A. Badwe stated: “The timing of surgery in relation to phase of menstrual cycle has a large impact on long-​term outcome for premenopausal patients with breast cancer.” The report said that women who underwent tumor excision during a phase of estrogen stimulation fared worse than those operated on during other phases of the menstrual cycle​—54 percent survived ten years versus 84 percent for the latter group. The optimal timing of surgery for premenopausal women with breast cancer was said to be at least 12 days after the last menstrual period.

Radiation Therapy. Radiation therapy kills cancer cells. In the case of breast conservation treatment, tiny cancer seeds may escape a surgeon’s knife as he tries to preserve the breast. Radiation therapy can clean up lingering cells. But with radiation comes a slight risk of inducing secondary cancers in the opposite breast. Dr. Benedick Fraass recommends minimizing radiation exposure to the opposite breast. He states: “With a few simple maneuvers it is possible to reduce significantly the dose received by the opposite breast during primary breast irradiation.” He suggests that a one-​inch-​thick [2.5 cm] lead shield be placed over the opposite breast.

Drug Therapy. Despite efforts to eradicate breast cancer by surgery, 25 to 30 percent of women with newly diagnosed breast cancer will have hidden metastases too small to produce symptoms at first. Chemotherapy is a treatment that uses chemical agents to attempt to kill those cells that invade other parts of the body.

Chemotherapy is limited in its effect because cancerous tumors are made up of different types of cells that each have their own sensitivities to drugs. Those cells that survive treatment may spawn a new generation of drug-​resistant tumors. But the January 1992 issue of The Lancet gave evidence that chemotherapy increased by 5 to 10 percent a woman’s chance of surviving an extra decade, depending on her age.

Side effects of chemotherapy may include nausea, vomiting, hair loss, bleeding, heart damage, immune suppression, sterility, and leukemia. John Cairns, writing in Scientific American, commented: “These may seem like relatively minor hazards for a patient who has an advanced and rapidly growing cancer, but they would be serious considerations for a woman who has a small [1/3 inch] [1 cm] and apparently localized cancer of the breast. Her chance of dying of her cancer within five years is only about 10 percent even if she receives no additional treatment after surgery.”

Hormone Therapy. Antiestrogen therapy cuts off the growth-​stimulating effects of estrogen. This is achieved by reducing estrogen levels in premenopausal women either by surgical removal of the ovaries or by drugs. The Lancet reported a ten-​year survival rate for every 8 to 12 women out of 100 treated with either measure.

Follow-​up care for any woman with breast cancer is a lifelong endeavor. Close surveillance needs to be maintained, for if one regimen fails and relapse occurs, other types of treatment may provide the needed weapon.

Another type of cancer therapy that takes a different approach revolves around a syndrome called cachexia. The journal Cancer Research explains that two thirds of all cancer deaths are caused by cachexia, a term used to describe the wasting away of muscle and other tissues. Dr. Joseph Gold, of Syracuse Cancer Research Institute in the United States, tells Awake!: “We feel that a tumorous growth cannot extend itself through the body unless the biochemical pathways for cachexia are open.” One clinical study, using the nontoxic drug hydrazine sulfate, showed that some of these pathways can be blocked. Stabilization was achieved in 50 percent of the late-​stage breast-​cancer patients involved.

Alternatives known as complementary medicine have been looked to by some women to provide noninvasive or nontoxic treatment for breast cancer. Therapies vary, some using diet and herbs, as in the Hoxsey therapy. But published studies enabling one to assess the efficacy of these treatments are few.

While this article is designed to present keys to survival, it is not the policy of Awake! to underwrite any treatment. We encourage all to look circumspectly at these different avenues in the treatment of this disease.​—Proverbs 14:15.

Stress and Breast Cancer

In the journal Acta neurologica, Dr. H. Baltrusch explains that extreme or prolonged stress may reduce the body’s antitumoral defenses in the immune system. Women who are fatigued, suffer depression, or lack emotional support may have their immune system compromised by as much as 50 percent.

Thus, Dr. Basil Stoll, writing in Mind and Cancer Prognosis, emphasized: “Every effort should be made to minimize the inevitable physical and psychic trauma sustained by cancer patients during and after treatment of their disease.” But what kind of support is needed?

[Blurb on page 7]

While no known food can cure cancer, eating certain foods and cutting down on others can be preventive measures. ‘Following the right diet could reduce your cancer risk by up to fifty percent,’ stated Dr. Leonard Cohen

[Blurb on page 8]

“Early discovery of breast cancer remains the most important step in altering the course of breast cancer,” says the publication “Radiologic Clinics of North America.” In this regard three key measures are: regular breast self-​examination, an annual examination by a doctor, and mammography

[Blurb on page 10]

Women who are fatigued, suffer depression, or lack emotional support may have their immune system compromised

[Box on page 9]

Self-​Examination​—A Monthly Checkup

BREAST self-​examination should be done four to seven days after the menstrual period. Postmenopausal women also need to check every month on the same day.

Signs to Look for Every Month on the Same Day

• Lump of any size (tiny or large) or thickening in the breast.

• Puckering, dimpling, or discoloration of the skin of the breast.

• Drawing back or turning in of the nipple.

• Rash or scaling of the nipple or escaping fluid.

• Enlarged glands under the arm.

• Changes in moles or incisions of the breast.

• Marked asymmetry of breasts that is a change from normal.

Self-​Examination

While standing, raise the left arm. Using the right hand and beginning at the outer edge of the breast, press the flat part of the fingers in small circles, moving slowly around the breast and toward the nipple. Give attention also to area between underarm and breast.

Lying flat, position a pillow under the left shoulder, and place left arm over or behind the head. Use the same circular motion as described above. Reverse for the right side.

Gently squeeze the nipple to check for any discharge. Repeat for the right breast.