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New hope for breast cancer prevention — 5 simple ways to create optimal breast health by Dixie Mills, MD, FACS

Tuesday, June 22, 2010 @ 02:06 PM Karen Hood

As a breast health specialist for 20 years, I am thrilled to see how women have propelled breast cancer research forward by sharing their stories, asking questions, and seeking answers about the disease. We now know much more about the powerful roles our environment, genetics, and individual metabolisms can play, and we are finding out more every day. We’re also learning about specific strategies for achieving hormonal balance that may further reduce a woman’s risk for developing breast cancer — and offer new hope for preventing recurrence.
While it’s true that breast cancer still poses a major women’s health threat, and we don’t know what causes it, every day, fewer women are losing their lives to the disease, and there is more cause for hope than ever before. Whether breast cancer will occur or recur is based on any number and combination of factors such as our age, race, genetics, gender, and even our culture and environment — each one of us is completely unique in terms of risk level. On top of this, we all respond differently to treatments, whether preventative or restorative.
Some of these factors we can influence, and some we can’t — but the great news is that there is a lot that every woman can do, right now, to create better breast health. Research shows that following through on even just one of the below points will likely reduce our risk. So if you have a personal or family history of breast cancer, are concerned about the role our modern environment plays, or just want to practice the very best breast health possible, I’d like to share with you my top five strategies for becoming your own best breast health advocate.
1) Regular, low-impact exercise — you don’t have to go to extremes
I like to tell my patients to start by thinking about exercise in a completely new way: become a lifelong mover. A regular exercise and/or movement program is not only the best way to maintain a healthy weight, it’s also one of the most powerful protective practices against breast cancer incidence and reoccurrence for all women. A few hours of walking a week can actually delay the “natural evolution” of tumor-growth, making a big difference not only for women looking to prevent breast cancer, but also for those who have been diagnosed, and are looking to heal.
And here’s a piece of really good news: a recent report from the World Health Organization tells us that there is a 20–40% decrease in the risk of developing breast cancer for women who are physically active — this is my favorite part — “regardless of menopausal status, type, or intensity of activity.” In other words, we can never be too old or too young to reap these amazing benefits. Taking two stairs at a time, parking further from your destination, practicing yoga or Zt’ai chi, or even just walking instead of riding whenever you can, are a few small changes which can assist in prevention. It’s fun to use a pedometer to see how far you walk each day, and many of us at Women to Women follow the “bursting” technique — walking for a while, then running for a few seconds or minutes, then walking again. You can build your own program one step at a time, challenging yourself at your own pace – it’s all good.
2) Fatty fish, omega-3’s and breast cancer
At Women to Women, we’ve been promoting the benefits of omega-3’s (the natural, polyunsaturated fats like EPA and DHA) for years. While we’ve seen some mixed reports about breast cancer risk and fish consumption, new research shows that women who consume more omega-3’s are statistically less likely to develop breast cancer — especially women who are postmenopausal.
While unraveling the mystery of what’s behind the protective effects of omega-3’s is proving difficult — even for experts — much of the evidence reveals that omega-3’s reduce what some researchers are calling the “seventh hallmark of cancer”: inflammation. Within the microenvironment of tumors, including breast cancers, there is a smoldering inflammatory component that assists their growth and spreading in the body. Several studies suggest omega-3’s tamp down these “fires” and therefore inhibit breast cancer growth.
And the great thing about including more omega-3’s in our diets is that it doesn’t mean we have to launch a complete dietary overhaul. Even making one consistent change at a time can make a tremendous difference. Like replacing damaging fats (like trans fats found in many processed foods) with “good fats” found in foods like ecologically-safe fatty fish. Wild-harvested Pacific salmon (coho) is one of the best sources of omega-3’s, so if you’re a fish-lover, you may already be ahead of the game! But if you’re just not a fan of seafood, worried about contaminants, or have allergies, you can take an omega-3 supplement (also known as “fish oil”, purified so it’s free of toxins), or include other foods like flaxseed, walnuts, and free-range eggs for maximum benefit.
3) Vitamin D and breast cancer protection
Another key nutrient that prevents inflammation in the breast is vitamin D. We’ve been hearing a lot about vitamin D recently, and it’s being investigated for its power to prevent breast cancer and other types, too. (Even — paradoxically — some skin cancers ). Countless studies show that women with higher vitamin D levels are less prone to develop breast cancer, and have lower risk of recurrence — regardless of their menopausal status. So I think it’s time we start thinking about sunlight differently.
You may already have read that vitamin D isn’t really a vitamin, but a pro-hormone produced in our skin upon exposure to sunlight — providing conditions are right. Ideally, we are supposed to get the D we need by spending time outdoors (as reflected by the lack of dietary sources naturally rich in vitamin D). I encourage all women to have vitamin D testing twice yearly, as it turns out that most of us have suboptimal levels.
Why would this be the case? To start, few of us spend the kind of time out in the sun that our ancestors did. Women used to spend most of the daylight hours working and living outside, reaping the natural benefits of the sun all the while. Things have certainly changed over the centuries, and now our modernized “indoor” lifestyle is taking its toll. And, even if we do get out in the sun, several other factors can limit our natural vitamin D production and conversion, including genetic factors, skin thickness and tone, age, and body fat.
So how much D do we need? The specific amount varies between individuals, and also depends on where they live, but we all need to have ample D over time, as nature intended, to reap its protective benefits: and that’s a level of 50–70 ng/mL. Taking an additional 1000–2000 IU per day is the general recommendation, but for countless women this simply won’t be enough to obtain or sustain optimal levels. Getting tested helps us figure out how much we need to get to where we want to be.
As with most things, finding the right balance is key. And this leads me to our next breast cancer prevention strategy: just as our bodies need natural sunlight to make vitamin D, we also require darkness to create enough melatonin.
4) A good night’s sleep can put breast cancer cells to rest
Our mothers said we “could do anything,” and now so many women are literally trying to do it all. As a result, women are sacrificing sleep to balance their work and home lives. We may simply be unable to sleep due to stress or anxiety — our brains can feel like they’re spinning, keeping us awake at night. That’s why when women approach me about breast cancer prevention, I ask not only how much sleep they’re getting at night, but what kind of sleep they usually have.
Current research shows that variation in our nighttime production of melatonin (a hormone that helps regulate our sleep-wake cycle) may be a predictor for whether or not we might develop breast cancer. The same melatonin which makes us all feel sleepy, actually makes breast cancer cells “sleepy” too – in fact, melatonin was shown to slow breast cancer cell growth by 70% in one recent study.
Of course, the mandate to “get more sleep!” is easier said than done. Sleeping well isn’t about just lying down and closing one’s eyes — instead, you can think about re-training your body how to sleep, particularly if you’re troubled by insomnia. (Our article on insomnia in women offers suggestions to help you get back to sleep.) Here are a few simple behaviors you can adopt that favor optimal melatonin production in your brain:
• Dim the lights and find the darkness. Dimness or darkness signals your brain that it’s time to promote healthy melatonin production. So close the blinds, turn off the TV and computer an hour or two before bed, or sleep with a comfortable eye mask — anything that prevents ambient light from stimulating the retina.
• Aim for eight hours of sleep. How much sleep each woman needs varies, but we usually need 7–9 hours. Tuning in to your body’s natural circadian rhythm will help you create maximum wellness on all levels. If stress is interfering with your ability to get regular, sustained rest, give some consideration to the suggestions we offer in our article on adrenal imbalance and insomnia.
• Have your melatonin levels checked if there is a concern. Women who work at night, do shift work, cross time zones frequently, or have difficulty sleeping in general tend to have lower levels of melatonin. Levels also decrease naturally as we age. So if you’re a night owl, seek out an integrative healthcare practitioner to discuss evaluation and how to restore your melatonin to healthy levels. Definitive clinical trials on the effects of supplemental melatonin in breast cancer patients have yet to be conducted, but melatonin supplements are available (the usual recommendation is 1–3 mg, but check with your practitioner).
Now that you’re moving, eating, and sleeping better, there is another key hormone involved in breast cancer prevention, and our ability to metabolize it can affect our risk of incurrence and recurrence — it’s time to talk about estrogen.
5) Enhance your estrogen metabolism — and your detoxification pathways
There has long been hot debate over which hormones at which levels most affect our risk for breast cancer. (See my articles on the estrogen controversy and breast cancer and progestagens.) One of the strongest associations concerns higher levels of circulating estrogens in a woman’s body, particularly after menopause. What leading-edge research seems to point toward is how well we metabolize — that is, convert and excrete — estrogen metabolites in the body. And this means effectively transforming both the estrogens that naturally occur in our bodies and xenoestrogens, or those that your body encounters every day through your diet and environment.
Although we now know that heavy exposure to xenoestrogens can increase some women’s risk for developing breast cancer, we also know that one of the best means we have to change that risk is through our body’s natural detoxification pathways. We have the capacity to metabolically “cleanse” our own bodies, as well as the power to alter that capacity — for better or worse.
Most environmental toxins are flushed out through the gut, lymph system, and liver. But if toxins like xenoestrogens build up, they can block those natural transformational pathways and provoke a cascade of health issues, including weight gain, inflammation, and hormonal imbalance — which can in turn affect a woman’s risk of developing breast cancer. Should reactive toxins accumulate in our bodies, we may feel perpetually exhausted, bloated, irritable, or just generally unwell. Ridding the body of these toxins can be of huge benefit for breast cancer prevention.
So in addition to the suggestions we’ve discussed so far, here are some additional measures you can put in place to help prevent the incurrence or recurrence of breast cancer:
• Move. Deep breathing, regular exercise, massage, and especially lymph drainage massage can all help the lymphatic system to clear out the body’s flotsam and jetsam.
• Drink pure water. Go to the source to learn about your local water. Check your local water district website or call to request information, and have your water tested, to see if there are any unwanted chemicals in your well water or tap water. Address any concerns with a filtration system, or purchase bottled spring water. (For added antioxidant benefits, use your clean, pure water to make green tea!)
• Avoid “bad” plastics. Storing and microwaving food in plastic containers can cause xenoestrogens and other toxins to contaminate your food and drink. Consider switching to glass or stainless steel containers, and if you do use plastics, avoid those containing PVC, BPA or polystyrene.
• Eat lots of cruciferous vegetables. Certain vegetables contain very powerful cancer-preventing compounds. In particular, crucifers (broccoli, kale, and cabbage, and their relatives) are naturally high in compounds shown to promote liver function and inhibit cancer development.
• Quit smoking and reduce or eliminate alcohol intake. If a woman is trying to prevent breast cancer, finding a program to help you leave cigarettes and alcohol behind is essential. It’s hard for your body to flush out stored toxins when it’s constantly receiving new toxins like tar and other carcinogens, and excess alcohol can devastate the liver’s detox function.
• Consider gentle phytotherapy. Read our article on phytotherapy to learn more about the time-honored use of foods and medicinal herbs to achieve and maintain hormonal balance.
If you have a strong family history of breast or other cancers, you may wish to look into your methylation capabilities through DNA testing, if practical. There are hundreds of methylation-dependent processes in the body, but in terms of your DNA, this reaction is important for maintaining the integrity of genetic information and its expression, and people with certain genetic variants may be at higher risk of certain cancers. If you can’t get such a test, the National Cancer Institute offers a simple risk assessment tool for breast cancer. If you do find that you are at higher risk for developing breast cancer or have been diagnosed, I always remind women that it’s not your fault, you haven’t done anything wrong. Take a deep breath. Address those things you can influence, and be at peace with those you cannot. Believing in this distinction is one of the surest paths to better breast health.
Finally, I’d like to encourage all women to find a place of peace and calm for yourself at least once a day. We each possess a unique mind-body-spirit connection which, when balanced, favors optimal wellness. In order to stay as closely in tune with this connection as possible, open yourself up to reconciling negative emotions — doing so can be especially valuable for women with breast cancer, to help decrease symptoms and better manage the illness. Research shows that mindfulness-based stress reduction improves our immune function, quality of life, and yes, our ability to cope with breast cancer.
This can be one of the most difficult — but most rewarding — strategies for healthy living. While it’s often easier said than done, you can learn to cultivate ways to ease or eliminate feelings of stress, anxiety, or helplessness.
Will following these guidelines guarantee that I won’t get breast cancer, or that breast cancer won’t return?
While there may be no guarantees in life, I like to think some measure of uncertainty can be a good thing. Whether you’re concerned about developing cancer or want to prevent a recurrence, a woman’s body (your body!) is truly miraculous, capable of amazing strength and power. Yes, there is a higher risk for breast cancer as we grow older, but statistics should never be applied as a prediction for any woman’s experience. There is just no such thing as “typical” breast cancer, and women of all ages are continuing to defy the odds every day!
And we need not leave so much to chance. If just one of the above steps can make a difference, imagine what can happen when we put one or more into place: “The whole is greater than the sum of its parts.” Deliberately changing how we move, eat and sleep, balancing our hormone levels, and knowing how to create a safer environment for ourselves sets a true course to better breast health.

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