October is Breast Cancer month

October is Breast Cancer Awareness Month in Canada. Each year in Canada, October is recognized as Breast Cancer Awareness Month. Breast cancer is the most frequently diagnosed cancer among Canadian females, affecting thousands of women and their families each year. In 2008, an estimated 22,400 women will be diagnosed with breast cancer and 5,300 will die of it. One in nine women is expected to develop breast cancer - with the risk increasing significantly after the age of 50. One in 28 will die from the disease. Although, since the mid-1990s, the incidence of cancer and death has declined, it continues to be a life-threatening issue for thousands of Canadian women. The National Union of Public and General Employees (NUPGE) continues to encourage its 340,000 members to take an active part in the fight to end this disease. An estimated 170 men will be diagnosed with breast cancer and 50 will die of it. Breast cancer death rates have declined by 25% since 1986. Incidence and death rates for breast cancer have declined since 1969 in women aged 20-39. Survival has been improving gradually. Today survival ranges between 87% and 89% for women aged 40 and older. For women under 40, survival is 81%, excluding Quebec.

What you can do

Many women are alive and well today because their breast cancer was detected and treated early. The Canadian Cancer Society recommends that women: • Have a mammogram every 2 years if you are between the ages of 50 and 69. If you are between the ages of 40 and 49, discuss your risk of breast cancer and the benefits and risks of mammography with your doctor; • Have a clinical breast examination by a trained health professional at least every two years if you are between 40-69; • If you are 70 or older, talk to your doctor about a screening program for you; • Talk to your doctors about any changes. There is no single cause of breast cancer but there are certain factors that may appear to elevate the risk. These include: • Age – Risk of diagnosis increases as a person ages • Personal history – If a person has previously battled the disease • Family history – Especially if a mother, sister or daughter has encountered breast cancer • Family history of ovarian cancer • Taking hormone replacement therapy for more than five years• Dense breast tissue • Other possible risk factors – Poor diet, lack of exercise, smoking, and obesity Sometimes, women develop breast cancer without any of these risk factors. A lot of women affected by breast cancer don’t have a family history of the disease. Even more surprising, some women have risk factors and never encounter the disease. Unfortunately, because of this uncertainty, early detection means a lot. Health professionals recommend that you see them if you find any changes with your breasts such as: • Size and shape • If you find a lump on your breast or a lump in your armpit area • Skin changes on your breast (such as peeling) • Physical changes you find in the appearance of the nipple Here are 9 ways to change your life:

1. Eat Fruit

You can’t go wrong with this – almost all dietary advice comes down to the single instruction to eat more fruit and veg. Diet is thought to be a key factor in one in four cancer deaths – and animal fat in the diet is the suspect ingredient in breast cancer. The Japanese, who eat a diet of fish, rice and vegetables that is extremely low in animal fat, also have low rates of breast cancer. A high-fat diet increases the levels of the female hormone oestrogen in the blood, which encourages the growth of cancer cells. In populations with a high-fat diet, women tend to start their periods earlier and reach menopause later so they are exposed to high levels of oestrogen for longer, increasing their risk of breast cancer. Studies into what effect eating fruit and vegetables has on breast cancer have produced mixed results. One study found that, when combined with taking exercise, the results were dramatic. Published in the Journal of Clinical Oncology last June, it showed that women who ate their five portions a day and walked briskly for at least 30 minutes halved their risk of breast cancer.

2. Walk

It is enjoyable, simple and requires no equipment. Walking is good for all aspects of physical and mental health – and cancer is no exception. Brisk walking (or other exercise) for 30 minutes a day, five times a week, is all that’s needed. Currently only one in four women manages this. If all women did, Cancer Research UK estimates it would prevent 1,400 cases a year. Three large studies in Italy and the US showed that inactivity caused 11 per cent of cases of breast cancer. Exercise works best before the menopause, but it is effective afterwards, too. It is thought to alter oestrogen metabolism, resulting in a weaker version being made.

3. Avoid HRT

Hormone replacement therapy is seen as the principal avoidable risk for breast cancer. At the height of its popularity, in 2002, an estimated two million women were taking HRT in the UK, and millions more worldwide. Tens of thousands of women will have developed breast cancer, ovarian cancer and endometrial cancer (of the lining of the womb) as a result. Overall, women currently taking HRT are 63 per cent more likely to develop these three cancers than those who are not. Earlier hopes that these risks would be counterbalanced by a reduction in heart disease have not been borne out. Gynecologists recommend that women who wish to use it to ease the symptoms of the menopause do so for as short a time as possible. 4. Get screened

Women diagnosed with breast cancer at the earliest possible stage have a nine in 10 chance of a successful recovery. This is the rationale for screening – to detect a tumour by mammography when it is still too small to feel. Women aged 50 to 70 are invited for screening every three years – shortly to be extended to ages 47 to 73. It is estimated that the scheme saves 1,400 lives a years in England – one life for every 500 women screened. However, there is a downside in the shape of false alarms. Screening picks up abnormalities in the breast that look like cancer but turn out not to be. Several thousand women each year suffer the anxiety and discomfort of being recalled for further tests and undergoing biopsies of the breast to check for cancer – before being given the all-clear. Screening is now more accurate, since two views of the breast are taken, reducing the chances of cancers being missed.

4. Give birth

Having children, especially before the age of 30, helps protect against breast cancer. It is down to those hormones, again. Over the last century, economic progress has led to delayed childbirth and smaller families as women with their own careers have sought to balance the demands of work and home. But researchers estimate that delaying childbearing increases the risk of breast cancer by 3 per cent for each year of delay.

5. Breast-feed

Breast-feeding protects against breast cancer, as well as being best for the baby. But smaller families and the rise in the number of working mothers has meant the time spent breastfeeding has reduced. Breast-feeding for six months reduces the risk, experts say. Yet many women never get that far. In England, 77 per cent of mothers start breast-feeding but more than a third switch to bottle-feeding in the first six weeks.

6. Lose weight

Obesity increases the risk of breast cancer – but only after the menopause. A large European study called Epic found postmenopausal women who were obese had a 31 per cent high- er risk of breast cancer than women with a healthy weight. Reducing obesity could save 1,800 cases of breast cancer a year. Obesity increases the risk of other cancers including those of the bowel, womb, kidney and oesophagus. Overall it is estimated that 7. per cent of cancers in women and 3 per cent in men are due to being obese or overweight. In the UK, 12,000 people might avoid getting cancer each year if they maintained a healthy body weight.

7. Get a stressful job (really)

A 2005 Danish study published in the British Medical Journal found high levels of daily stress reduced the risk of the disease by 40 per cent. The researchers suggest that stress may be beneficial by reducing levels of oestrogen. They draw a distinction between daily stress of the sort experienced by women in high-pressure jobs and stressful life events such as bereavement, which have previously been linked with an increase in cancer. Stress can have other damaging effects, too – on the heart, for example, and by increasing the risk of compensatory behaviour.

8. Live somewhere clean

It has long been claimed that exposure to pollutants used in the manufacture of products from plastics to cosmetics has an “endocrine disrupting” effect. A report from the World Wide Fund for Nature last year claimed their role in breast cancer had been neglected. It pointed out that less than half of new breast cancer cases can be explained by genetic and lifestyle factors and chemicals in the environment could be the missing link. Other studies have contradicted this suggestion and experts point out that compared with the natural levels of oestrogen in a woman’s blood, the level of the chemicals is too small to have significant impact. Still, moving to an unpolluted region is unlikely to do harm and could encourage tother beneficial changes, such as eating healthily, exercising more, and drinking less. Don’t be nervous or anxious about finding changes in your breasts. Often these changes may not be related to cancer – but it’s worth- while to tell your doctor as soon as possible New results from breast cancer clinical trial show non-breast cancer related causes account for most deaths. New findings from a landmark breast cancer clinical trial involving the drug letrozole show that, in this group of patients, women were more likely to die from non-breast cancer-related causes than from breast cancer-related causes. The research team found that non-breast cancer related causes accounted for 60% of deaths. The top causes of death included: cardiovascular disease including stroke (15%), other malignancies (15%), infection (6%), multiple causes (5%), and non-cardiovascular organ failure (4%). The results were particularly striking for older women. Among women aged 70 years or older, non-breast cancerrelated causes accounted for 72% of deaths. The new results are published in the February 12 issue of the Journal of the National Cancer Institute. The original study results were first published in The New England Journal of Medicine in October 2003 and involved 5,170 post-menopausal breast cancer survivors with a median age of 62 years (range 32 to 94 years). It determined that women who took letrozole for up to five years following 5 years of tamoxifen therapy experienced a significantly reduced risk of cancer recurrence. The clinical trial was coordinated by the National Cancer Institute of Canada Clinical Trials group and was funded in part by the Canadian Cancer Society. Routine use of mammography and improved treatment for breast cancer will mean that more women will survive breast cancer at older ages, at which time they might have a higher risk of death from causes other than breast cancer, says Dr Judith-Anne Chapman, lead author of the study. “The study findings show that we are successfully treating women with breast cancer. However, the study also underscores the need to pay more attention especially to older women and the potential for death from other causes,” Dr Chapman says.