Soy Foods Linked to Fewer Fractures in Younger Breast Cancer Survivors

A new paper in JNCI Cancer Spectrum, published by Oxford University Press, is the first study to find that diets high in soy foods are associated with a decreased risk of osteoporotic bone fractures in pre-menopausal breast cancer survivors.

Breast cancer is the second most common cancer among women in the United States, with 1 in 8 women diagnosed with it during their lifetime. Many treatments for breast cancer can cause premature menopause and decrease bone mineral density. This leads to a higher incidence of osteoporosis-related fractures among survivors compared to healthy women in the same age range, and yet many factors connected to this increase in fracture risks are understudied.

Researchers here studied the impact that BMI, exercise, and soy food consumption had on bone fracture rates among breast cancer survivors. The study used data from the Shanghai Breast Cancer Survival Study of 5,042 newly diagnosed breast cancer survivors between the ages of 20 and 75. Researchers collected detailed information at enrollment, including cancer diagnosis and treatment history, medication use, dietary habits, exercise and other lifestyle factors. About 52% of women in the study were postmenopausal. Patients then had follow-up visits at 18 months, and 3, 5, and 10 years after their diagnosis to update exposure and outcome information.

Throughout the 10-year study period, 3.6% of survivors reported an osteoporotic bone fracture. Higher soy intake was associated with a 77% reduced risk of osteoporotic fractures in younger women, and exercise showed a significantly reduced risk of fractures among older women.

Consistent with prior studies, the extended use of tamoxifen, a drug that is prescribed for breast cancer patients showed a 37% reduced risk of fractures in the overall study population. Tamoxifen is a selective estrogen receptor modulator, or SERM, that causes an increase in bone mineral density. Soy based foods, which are rich in isoflavones, provide a natural SERM.

“The menopausal transition is known to be a period of high risk for bone loss, and given the relative scarcity of data related to fracture risk among younger women with breast cancer, this study marks an important contribution to this body of literature,” said the paper’s lead author, Evelyn Hsieh. “Our findings, in particular regarding the protective effects of soy food consumption provide novel insight into how future interventions can be best tailored to different risk groups.”

Source: Science Daily


Breast Cancer and DDT: Timing of Exposure May Matter

Exposure to high levels of the pesticide DDT increases breast cancer risk — but when the cancer surfaces depends on when women first came in contact with the chemical, researchers say.

“What we have learned is that timing really matters,” said lead author Barbara Cohn, from the California-based Public Health Institute.

“We know that if harmful exposures occur at times when breast tissue is rapidly changing, such as during puberty, they impact breast development in ways that can later result in cancer,” added Cohn.

The breast cancer diagnoses tended to occur about 40 years after exposure to DDT, her team concluded.

DDT was widely used in agriculture until it was banned in the United States in 1972, and banned in many countries in the 1970s. Many women and girls in the United States were exposed to the pesticide. The youngest of them are now reaching the age of increased breast cancer risk.

For this study, researchers looked at more than 15,500 women in California who participated in the institute’s Child Health and Development Studies for nearly six decades. Levels of DDT exposure were determined by analyzing stored blood samples taken from them between 1959 and 1967. The researchers analyzed data on breast cancer cases that occurred up until age 54.

All women who were exposed to high levels of DDT had an increased risk of breast cancer through age 54, the study found.

But those exposed to DDT before age 14, particularly in infancy and early childhood, were most likely to develop premenopausal breast cancer (before age 50). Those exposed after infancy were at increased risk of postmenopausal breast cancer (ages 50-54).

Among the specific findings:

  • DDT exposure during childhood and puberty (ages 3-13) was a risk factor for both premenopausal and postmenopausal breast cancer.
  • A doubling of DDT was associated with an almost tripled increased risk of postmenopausal breast cancer for those first exposed to the pesticide after infancy.
  • Women at increased risk for premenopausal breast cancer were first exposed to DDT in utero and during infancy through puberty, but not after age 14. The highest risk was associated with first exposure before age 3.
  • Women first exposed to DDT after age 14 only had an increased risk of breast cancer after menopause, and were not at increased risk for breast cancer before age 50.

“The research suggests that DDT affects breast cancer as an endocrine disruptor, that the period of time between first exposure and cancer risk seems to be around 40 years — and that other endocrine-disrupting chemicals could potentially simulate this kind of risk pattern,” Cohn said in an institute news release.

Considering the patterns observed, working backward to determine when a woman first came into contact with DDT could help aid early detection and treatment of DDT-associated breast cancer, Cohn added.

The study was published in the Journal of the National Cancer Institute.

Source: HealthDay

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Healthy Lifestyle Lowers Odds of Breast Cancer’s Return

There’s more evidence that when a survivor of early stage breast cancer takes up healthy eating and regular exercise, the odds of the disease returning go down.

The key is sticking with such programs, said study lead author Dr. Wolfgang Janni.

Healthier lifestyles “might improve the prognosis of breast cancer patients if adherence is high,” said Janni, who directs obstetrics and gynecology at the University of Ulm in Germany. His team developed and implemented a new program to help keep those lifestyle changes on track.

The findings were presented at the annual San Antonio Breast Cancer Symposium.

In the study, Janni’s team tracked outcomes for nearly 2,300 early stage breast cancer patients who’d been treated with chemotherapy. Half of these cancer survivors were randomly assigned to two years of ongoing telephone-based, personalized healthy living advice. The other half (the “control” group) received standard, general advice on a healthy lifestyle.

Those in the personalized lifestyle intervention group were coached in areas such as improving their diet, reducing fat intake, and increasing physical activity.

After two years, people in the intervention group saw an average weight loss of 2.2 pounds, while those in the control group experienced an average weight gain of 2.1 pounds, the findings showed.

But the real difference was in cancer outcomes, Janni’s team said. The rate of disease-free survival among the nearly 1,500 patients who completed the lifestyle intervention was 35 percent higher than that of those who didn’t complete the program. And it was 50 percent higher than women who didn’t get the intervention at all.

The findings shouldn’t come as a big surprise, Janni said.

Prior research “has shown that obesity and low physical activity are associated with higher risks of developing breast cancer, as well as an increased risk of recurrence and reduced survival,” he noted in a meeting news release.

One U.S. expert agreed.

Many women who’ve survived breast cancer may feel helpless, but “it is great to be able to tell patients that, yes, there is something they can do to help prevent a recurrence,” said Dr. Alice Police. She is regional director of breast surgery at the Northwell Health Cancer Institute, in Sleepy Hollow, N.Y.

She said sometimes women need a little nudge, though, to stay healthy.

“This is a very specific and focused look at the issues and includes information on exactly how a program of diet and lifestyle changes should look and function,” Police said, “and that makes it very important.”

Dr. Lauren Cassell is chief of breast surgery at Lenox Hill Hospital in New York City. Looking over the new study, she agreed that the new program appears to have merit.

“By providing the patient with a systematic telephone lifestyle intervention program — which was not difficult to develop and implement — they were able to increase patient compliance and as a result improve outcomes,” Cassell said.

“I believe patients want to help themselves,” Cassell said. “Sometimes they just need a little extra support.”

Source: HealthDay

Breaking Into Breast Cancer, Immune Therapy Shows Wider Promise

Naomi Kresge and Tim Loh wrote . . . . . . . . .

Drugmakers are honing in on which cancer patients will benefit from new immune therapies — and finding many more than skeptics had thought.

For the first time, a clinical trial showed that a treatment with one of the new generation of drugs designed to unleash the body’s own immune system against tumors can help some women with the most aggressive type of breast cancer live longer. The study was unveiled by Roche Holding AG at Europe’s biggest cancer conference.

These medicines, led by Merck & Co.’s blockbuster Keytruda, are sold for more than a dozen different cancers, and pharmaceutical companies are obsessively working to expand their applications with newer versions and treatment cocktails. There are some 1,300 immune-based treatments in human studies, according to the Cancer Research Institute, largely financed by drugmakers angling for a chunk of a market forecast to exceed $100 billion annually by 2024.

“This is just the tip of the iceberg,” said Axel Hoos, oncology research and development chief at U.K. pharma giant GlaxoSmithKline Plc, which is trying to break back into oncology after selling its existing products to Novartis AG in 2015. “There’s a little bit of hype, but there’s a lot of substance.”

Cold Tumors

At the European Society for Medical Oncology’s meetingover the weekend, Roche disclosed the results of a study that showed one group of patients whose breast tumors tested positive for a protein called PD-L1 lived an average of 25 months when they got an immune therapy called Tecentriq — about 10 months longer than others who got only chemotherapy.

Immune therapies exploded onto the scene about eight years ago when Bristol-Myers Squibb Co.’s Yervoy became the first medicine of its kind to extend the lives of people with melanoma, a lethal skin cancer. Successes in kidney and lung cancers followed shortly thereafter.

When immune therapies work, the effect can last for years, one of the reasons they’re regarded as revolutionary. But in most patients, nothing helpful happens — even in skin and lung tumors where some of the most dramatic effects have been seen.

“There are some cancers where the immune system just can’t recognize it,” said Mace Rothenberg, chief development officer for oncology at U.S. pharma giant Pfizer Inc. Flying under the body’s protective radar, scientists refer to them as “cold tumors.”

Companies are starting to rethink their strategy for the toughest cases, said Dan O’Day, Roche’s pharma chief. Testing patients’ tumors for specific proteins and genes will help identify those most likely to benefit, he said.
“We want to get away from this concept of giving cancer immunotherapy to 80 percent of the patients and only half of them respond,” he said in an interview. “Let’s find the other treatment options for the other patient types.”

Roche’s breast cancer study helped support the idea that there are ways for doctors to identify more cancers that will submit to immune therapy. The drug used in the study, Tecentriq, blocks the protein called PD-L1 that hampers the immune system’s attack on cancers, and only women whose tumors had high levels of the protein were helped.

Search for Responders

Another signpost in the search for responders could be the sheer number of mutations in a tumor as a whole, O’Day suggested. It’s a strategy that may extend the reach of immune therapies even further, as indicated by studies presented at the conference. Studies of cancers of the colon and rectum, which have been less responsive to immune therapy, showed that tumors with severe genetic damage may offer better targets for drugs such as Bristol’s Opdivo and Yervoy.

“They’re doing trials in every different tumor that you can imagine,” said Richard Gaynor, research and development chief of Neon Therapeutics Inc., an immune-oncology startup. “There will be subsets of patients within each group that may benefit.”

And in many cases, immune therapy may need help. The question is how to nudge the body’s protective system to act against certain tumors, said Incyte Corp. Chief Executive Officer Herve Hoppenot. His company tried the strategy earlier this year, combining its experimental epacadostat with Merck’s Keytruda, and it failed.

Still, Incyte and other drugmakers are persisting in their search for ways to track down tumors that have eluded immunotherapy.

“We’re scratching the surface,” said Luciano Rossetti, head of global research and development for biopharma for Germany-based Merck KGaA. “We have a first wave of real excitement.”

Source : Bloomberg

Weight Loss Linked to Lower Breast Cancer Risk for Postmenopausal Women

In a study of postmenopausal women, participants who lost weight had a lower risk of developing invasive breast cancer than those who maintained or gained weight. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that weight loss may help lower postmenopausal women’s breast cancer risk.

In a study of postmenopausal women, participants who lost weight had a lower risk of developing invasive breast cancer than those who maintained or gained weight. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that weight loss may help lower postmenopausal women’s breast cancer risk.

Although obesity has been strongly related to breast cancer risk, studies examining whether weight loss might reduce postmenopausal women’s risk have provided mixed results. To examine the issue, Rowan Chlebowski, MD, PhD, of the City of Hope National Medical Center in Duarte, California, and his colleagues analyzed information on 61,335 women participating in the World Health Initiative Observational Study who had no prior breast cancer and had normal mammogram results. The women’s body weight, height, and body mass index were assessed at the start of the study and again 3 years later.

During an average follow-up of 11.4 years, there were 3,061 new cases of invasive breast cancer diagnosed. Women with weight loss ≥5 percent had a 12 percent lower breast cancer risk compared with stable weight women, with no interaction by body mass index. Weight gain of ≥5 percent was not associated with risk of breast cancer overall but was associated with a 54 percent higher incidence of triple negative breast cancer.

“Our study indicates that moderate, relatively short-term weight reduction was associated with a statistically significant reduction in breast cancer risk for postmenopausal women,” said Dr. Chlebowski. “These are observational results, but they are also supported by randomized clinical trial evidence from the Women’s Health Initiative Dietary Modification trial where, in a randomized clinical trial setting, adopting a low-fat dietary pattern that was associated with a similar magnitude of weight loss resulted in a significant improvement in breast cancer overall survival. These findings, taken together, provide strong correlative evidence that a modest weight loss program can impact breast cancer.”

October is Breast Cancer Awareness Month.

Source: Wiley

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