Kamis, 09 Juni 2011

Seven Secrets About Breast Cancer

Secret #1 The Money Spent On Research Into Breast Cancer Is Not Ensuring That Less Women Get Breast Cancer.
Secret #2 You Do Need To Act Against Getting Breast Cancer Before You Reach 50 And You Cannot Rely On Mammograms.
Secret #3 You Are At Risk Of Getting Breast Cancer Even If You Don't Have It In Your Family.
Secret #4 Most Of The Money Spent On Research Is Not Going Into Prevention To Ensure That Less Women Suffer The Devastating Effects Of Breast Cancer In The Future.
Secret #5 Most Women Are Not Breast Aware And Are Afraid Of Breast Cancer.
Secret #6 Women Are Not Given Lots Of Advice On How They Can Protect Their Breasts Against Breast Cancer.
Secret #7 Most Women Do Not Appreciate How Important Their Breasts Are And Do Not Do Everything They Can To Look After And Protect Them.

The above "secrets" are things which are not commonly known by most women and may be surprising to you. In this article, I intend to shed light on these facts and allow women to make up their own minds how they approach their breast health.

SECRET #1 THE MONEY SPENT ON RESEARCH INTO BREAST CANCER IS NOT ENSURING THAT LESS WOMEN GET BREAST CANCER.

The Pink Ribbon and Breast Cancer Awarenss Month was introduced in the US in 1985 and introduced to the UK in 1993. The Pink Ribbon Foundation is fronted by the Estee Lauder group of companies (known for cosmetics and skincare).

Since then the pink ribbon symbol has become synonymous with breast cancer and during the past 15 years billions of pounds have been raised in its name. Every October the world celebrates Breast Cancer Awareness Month and fund raising during that month is phenomenal. All the breast cancer charities vie with each other to see who can come up with the most innovative "pink" fundraising. They run pink parties and sell pink products in order to raise money. Many companies take part and do special promotions during October for their preferred charity. "Pink" is big business.

So with all this money being raised during October and also at other times during the year through events like charity runs and walks, is there an impact on the breast cancer rates in the UK and around the world? Are they coming down? Are fewer women suffering from the devastating effects of breast cancer?

Unfortunately, the answer is 'no'.

In the UK, from 1993-2004, breast cancer incidence has increased 18.5%, that is 1% per year. 1 in 9 women will get the disease during their lifetime with current projections of 1 in 7 by 2010. 45,500 women were diagnosed in 2005, which equates to 125 women every day. Worldwide more than a million women are diagnosed with breast cancer every year. It is also projected that breast cancer rates will rise most in developing countries, where women do not have access to top quality care and where they can also be treated as outcasts in certain societies.

Breast cancer survival rates have improved. Every year more than 12,300 women and 70 men die from breast cancer. Since the peak in the late 1980s breast cancer death rates have fallen by a third. Breast cancer drugs have helped to save women's lives but, as with any drugs, can have long-term side affects. Also the cost of these drugs puts great strain on the NHS. If breast cancer rates continue to increase as they have been doing, then, according to Professor Karol Sikora as reported in the Daily Mail on 09/09/08, "the next generation of drugs would keep patients alive longer, but could swallow half of the current NHS cancer budget within four years. (this refers to all cancer drugs at a cost of £50 billion).

With the billions being raised by people around the world in the name of breast cancer, is it right that actually more women are getting this devastating disease every year?

SECRET #2 YOU DO NEED TO ACT AGAINST GETTING BREAST CANCER BEFORE YOU REACH 50 AND YOU CANNOT RELY ON MAMMOGRAMS.

Women in the UK are offered breast screening by mammogram every three years from the age of 50. This is because breast cancer is still more common in women over 50 but also because the breast tissue of younger women is denser and, therefore, makes it more difficult for a mammogram to pick up on a potential breast lump.

However, this could be giving the message to younger women that they don't need to check their breasts themselves. Based on my experience during my breast health talks, very few younger women check their breasts. The main reasons for this are that no-one has shown them how to, they don't know what to do, they think that they only need to worry if breast cancer is in the family (see Secret #3) or they are afraid that they might find something.

For a younger woman it is even more important to check her breasts from her mid-twenties as breast cancer in younger women is usually much more aggressive as the breast cancer cells can multiply more rapidly than in older women. If girls were taught by their mothers to check their breasts from their mid-twenties, they would not be afraid - it would just be part of their general regime of looking after themselves. Also they would feel confident about what to do. Breast self-examination is easy to do once you have been shown how and there are even devices on the market which can help you do so with confidence and greater accuracy.

Breast cancer is the biggest killer of women aged 35-54, which means it makes sense for women in this age bracket to do everything they can to protect their breasts.

Furthermore, I do not believe that we should rely on mammograms either. Women are only screened every three years and, usually, a mammogram can only detect a breast tumour once it has been growing for 8 years. By the time the tumour reaches 10 years, it could be too late. The other thing to remember is that a mammogram can only screen the part of the breast which can be put into the "clamp". It cannot screen under the armpit or between the breasts for example.

Lastly, there is growing concern over the safety of mammograms. The following are extracts from an article written by Peter Leando PhD.

"Controversy has raged for years as to whether the risks related to the radiation exposure suffered from mammography are justified by the benefits gained ...... new evidence relating to the particular type of radiation used and the hard evidence relating to the clinical benefits of mammography have caused a serious re-evaluation of the justification of mammography as a screening test.

Radiation from routine mammography cannot be directly compared to other types of X-ray like chest X-ray etc because they are very different types of radiation.

The comparisons that have been used between a chest x-ray and mammography, 1/1,000 of a rad (radiation-absorbed dose) for a chest X-ray and the 1 rad exposure for the routine four films taken of both breasts for a mammographic screening exam results in some 1,000 times greater exposure. (This refers to the US, where they do four-way screening. In the UK typically only two-way screening is offered.)

This is considered a significant risk factor when extended over a ten year screening period and a potential accumulative dose of 10 rads. Unfortunately this is not the major risk posed by the particular type of radiation used by mammograms, mammography X-rays use a low energy form of ionising radiation that causes greater biologic damage than the high energy X-ray. The very low energy electrons affect the density of ionisation tracks that pass through the tissue, which can cause complex damage to the DNA and carcinogenic changes.

The radiation used by mammography is almost 5 times more effective at causing cancer." So, women do need to start checking their breasts from their early twenties and we cannot rely on mammograms 100%, particularly for younger women who would have a greater exposure to radiation during their lifetime if they were offered mammograms from a younger age. Also mammograms do not detect Inflammatory Breast Cancer (IBC) which is a much rarer form of the disease and does not involve a lump. This would only detected by a woman looking for changes to her breasts and reporting them to her doctor.

SECRET #3 YOU ARE AT RISK OF GETTING BREAST CANCER EVEN IF YOU DON'T HAVE IT IN YOUR FAMILY.

Amongst the hundreds of women I have talked to about breast health, the vast majority were under the false impression that breast cancer is primarily hereditary. They were surprised to hear that fewer than 10% of cases occur to women who have breast cancer in the family.

In fact, every woman is at risk and should take control of her own breast health to give herself the best possible chance of prevention or early detection.

The other most common acknowledged risk factors are:

* Age - breast cancer is more common in women over 50
* Early puberty - it is worrying that puberty is starting younger, with most girls starting their periods at primary school
* Late pregnancy - many woman are opting to have children later
* Late onset menopause
* Not having children and not breastfeeding - this was known as early as the 18th century when a doctor in Italy noticed that nuns had higher levels of breast cancer than the general population
* Being overweight - this applies mainly to post-menopausal women
* Alcohol - over-consumption increases the risk of breast cancer

Acknowledged risk factors account for around 50% of breast cancer cases. For the remainder, there are no definite reasons.

There are a growing number of scientists, commercial companies and individuals who believe that this remaining 50% is due to the rise of the number of chemicals which have been introduced over the past 50 years. They are used in our food, in our toiletries, in the workplace, in our clothes, in our furnishings - in fact, in every aspect of our lives. Many of these chemicals are endocrine disrupting chemicals (EDC's), also known as hormone disruptors or oestrogen mimickers. In simple terms, they act like oestrogen in our bodies and could be responsible for changing our delicate hormone balance which controls events like pregnancy, puberty, menopause.

An interesting example of the levels of oestrogen of British women was examined in a collaborative study undertaken in the late 80's between Oxford University, the Chinese Academy of Preventive Medicine Beijing, Guys, and the Dept. of Preventive Medicine, L.A., California. They compared blood-serum concentrations of hormones linked to breast cancer between women in rural China and in Britain. The results showed that British women who are exposed to toxic chemicals in their everyday lives had increasingly higher levels of oestradiol (oestrogen) than women living a rural lifestyle in China (see table below).

On this theme, the Guardian online reported on 22/05/07 that 'Beijing blames pollutants for rise in killer cancers'.

Oestradiol levels higher in British women by: Age 35 - 44 36% Age 45 - 54 90% Age 55 - 64 171%

SECRET #4 MOST OF THE MONEY SPENT ON RESEARCH IS NOT GOING INTO PREVENTION TO ENSURE THAT FEWER WOMEN SUFFER THE DEVASTATING EFFECTS OF BREAST CANCER IN THE FUTURE.

As we know, billions of pounds are raised every year worldwide in the name of breast cancer and most of this money is received by the mainstream breast cancer charities. In my opinion, the areas which should be targeted by these funds are prevention, treatment and care. You would probably expect these areas, at least, to be treated with equal importance and the funds available allocated accordingly.

Let's first take a look at the mainstream breast cancer charities in this country, namely Cancer Research UK (who obviously deal with all cancers), Breakthrough Breast Cancer, Breast Cancer Campaign and Breast Cancer Care.

Cancer Research UK has done a huge amount of research into breast cancer and their website has a wealth of useful information with a lot of detail on breast cancer. Their slogan is 'Together We Will Beat Cancer'. The charity offers funding schemes to scientists. Their research strategy is directed at reducing mortality from cancer and more women are surviving breast cancer than ever before. Cancer Research UK is looking trying to prevent breast cancer in women known to be at high risk of developing it (approx 10% of sufferers). Doctors have looked into using tamoxifen and other hormone blocking drugs such as anastrozole (Arimidex) to lower the risk of breast cancer in women with a strong family history. This work has to be done very carefully. These women are healthy and the treatment aimed at preventing breast cancer must not risk their health in other ways.

Breakthrough Breast Cancer supports a programme of cutting-edge biological research to reach their vision of 'a future free from the fear of breast cancer'. Breakthrough set up the UK's first dedicated breast cancer research centre in 1999, the Breakthrough Toby Robins Breast Cancer Research Centre. Breakthrough is funding The Generations Study whosepurpose is primarily to investigate environmental, behavioural, hormonal and genetic causes of breast cancer, and secondarily to investigate the causes of other cancers and diseases, by means of a UK cohort study to be established of more than 100,000 women in the UK aged 18 years and older at entry.

However, when you look at environmental factors as a possible risk factor, it seems to be dismissed because it is too difficult to research due to the huge amount of chemicals to which we are exposed in our everyday lives. You can read more at their website under "risk factors".

As I have mentioned, I am one of the many people who believe that certain chemicals which act like oestrogen in our bodies are a contributing factor in rising breast cancer rates. I am disappointed to see that Breakthrough are not even including this as a possible risk factor, particularly as we know that excessive oestrogen has been linked to breast cancer cell growth.

Breast Cancer Campaign cites its mission is to beat breast cancerby funding innovative world-class research to understand how breast cancer develops, leading to improved diagnosis, treatment, prevention and cure. The charity is supporting 97 projects worth over £12.8 million in 41 locations throughout the UK. Over the past 13 years, Campaign has awarded 232 grants with a total value of over £23 million to universities, medical schools / teaching hospitals and research institutes across the UK. Campaign's breast cancer research gap analysis document has been published by the open access journal Breast Cancer Research. The document entitled 'Evaluation of the current knowledge limitations in breast cancer research: a gap analysis' is the product of two and a half year project. It involved around 60 of the key breast cancer scientists in the UK.

Through their website, they sell products of various types and the companies who own those brands donate part of their profits to the Campaign. They include things like lip gloss, perfume, toiletries, clothing and stationery. Some of us would say that many of the products include harmful ingredients and are not actually contributing to the breast health of the ladies buying them! I was also disappointed that, although they mention prevention in their mission statement, I have one of their leaflets that shows prevention only receives 1% of their budget.

Breast Cancer Care, as its name suggests, is primarily concerned with the care and treatment of ladies going through breast cancer. It provides invaluable information and support.

I applaud all of these organisations who are dedicated to their work to help us understand and treat breast cancer.

However, I still believe that the risk factor of certain chemicals affecting our delicate hormone balance should be taken seriously and that all the available research should be studied. It is important to note that only 50% of breast cancer cases can be put down to one of the acknowledged risk factors. What is this remaining 50%? What has changed in our world over the past 50 years? It is also interesting that other countries are recognising the dangers of these chemicals and banning substances. I also believe in adopting the 'precautionary principle', which means that if there is a doubt over the safety to public health, then we should not wait until it is too late but take action as soon as possible. It has also been proved that there are alternatives to these potentially harmful chemicals when we see the growing number of companies who are selling safer food, cosmetics and toiletries.

This is why I am an active supporter of Breast Cancer UK, the only charity whose main focus is primary prevention. We are determined that breast cancer should be a 'preventable' disease not an 'inevitable' one. There is lots of research available on the link between endocrine disrupting chemicals and breast cancer. It is time that this was taken into account when looking at breast cancer risk factors.

SECRET #5 MOST WOMEN ARE NOT BREAST AWARE AND ARE AFRAID OF BREAST CANCER.

Despite the huge focus on being breast aware, particularly during Breast Cancer Awareness month in October, the majority of women are not breast aware. In fact, most women pay little attention to their breasts and do very little to look after them, except maybe during breastfeeding. Our breasts represent our femininity - they make us feel sexy and they nourish our children. Yet most women don't even know what their breasts feel like, let-alone check them for anything unusual.

It is so important that women take control of their own breast health by undertaking monthly self-examination to check for any changes. If they find a lump and go to their doctor straight away, the chances are the lump will be benign (80% are) or, if it is cancerous, they are giving themselves the best possible chance of recovery. At Stage One, women have around a 95% chance of surviving beyond 5 years. At Stage One the lump is less than 2cm and has not spread to the lymph nodes or anywhere else in the body. At Stage Four this survival rate drops to 1 in 10. The average size of lump discovered accidentally by women who don't check their breasts regularly is approximately 3.6 cm.

I have spoken with hundreds of women through my breast education work and most women do not check their breasts because they don't know what to do, they don't realize that all women are at risk, they don't know about the four stages of breast cancer and the corresponding survival rates, they don't really think about the need to do anything to look after their breasts or they are afraid that they might find something.

According to research by Breast Cancer Campaign, breast cancer is the most feared disease amongst women. Fear is usually due to a lack of knowledge. This is certainly the case here. If women understood everything detailed here, they would want to give themselves the best chance of survival should they get the disease. The current approach to women's breast health obviously isn't getting through, which is why I believe it is time to get women to take control themselves and empower other women to do the same.

SECRET #6 WOMEN ARE NOT GIVEN LOTS OF ADVICE ON HOW THEY CAN PROTECT THEIR BREASTS AGAINST BREAST CANCER.

In the past, GP surgeries used to run Well Woman clinics where any woman could go and see a doctor or nurse and be given advice about looking after herself with practical information like being shown how to check her breasts. Very few surgeries offer these clinics now. This is one of the reasons that I started my Breast Health Presentations. I talk to women in the workplace or in other gatherings and empower them with information, which helps to remove some of their fear. I also show them how to check their breasts and talk to them about their bra-wearing habits, how to avoid harmful chemicals in their everyday lives and how to benefit from detoxifying breast massage.

As we know, breast cancer is the most feared disease amongst women and understanding how it develops, the risk factors and, most importantly, how to protect against it, will make women feel more in control and positive towards their breast health.

During October and other events during the year, the focus is on breast cancer rather than breast health. I am one of those people who believe that the more you focus on something negative, the more you will get of it. This is why it is time to change that focus.

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