Colonoscopy Party!

Last week, I was able to check off something that has been on my to-do list for 19 years!

To be entirely truthful, as a more than mildly neurotic type A first-born physician daughter, it has been on my list of things to make my mother do for almost two decades.

She did make a few attempts to follow her doctor's advice to screen for colon cancer over those years. That was her explination for the dozen or so "stool test cards" that I found stashed in the back of her nightstand. She said she knew screening was important enough not to throw them away. Hmmm...

After all, her children co-authored the book "Avoiding Cancer One Day At A Time!" She has heard the statistics. According to the CDC, 60 percent of colon cancer deaths could be prevented through timely screening.

So - why now? She made the appointment before the recent news report that the cancer death rate is decreasing largely due to screening colonoscopies. I could argue that it was the influence of the cute young male physician she is seeing - who looks to be closer in age to her oldest grandson than her daughter (that's me.) It could be that she actually read our book cover to cover, and wants to hang around for her grandsons that adore her. But, knowing my Mom, it was a reason to break up the monotonous winter months with a celebration. Colonoscopy Party!

Sitting in the waiting room amidst other "designated drivers" was an experience unto itself. Unlike a typical doctors office where eyes seldom meet, it was more like a book club experience. Conversation flowed fluently. Watching people leave the waiting room with relief spread across their faces (both the patients and the drivers), reminded me of that solaceful look on kids faces as they throw their caps in the air at high-school graduation. Something was completed, and they could move on and forward to the next step in their lives. As for my mother, she looked like she had just competed her PhD! One small polyp later, she can move on. Ten years if it was a hyperplastic polyp, five if it was an adenomatous (pre-cancerous) polyp, before she has to let the thought of scheduling a colonoscopy clutter her busy mind again.

Perhaps if we recommended colonoscopies be followed with a celebration - like graduation - fewer people would be diagnosed with late-stage cancer, and many would have polyps removed even before they become cancerous. Just think, the greeting card industry could play a role in cancer prevention!

For more information on cancer prevention, visit our web site, and make sure to read our book, "Avoiding Cancer One Day At A Time: Practical Advice for Preventing Cancer."

No Fluoride Baby!

I wrote some time ago about the new recommendations regarding fluoride in babies, and was surprised to hear recently (not really surprised), that some health care programs in our country continue to teach about the importance of using fluoridated water for infants. News hits the headlines, but is quickly forgotten.

Last year, the American Dental Association (ADA) announced that infants from birth to a year of age should not be given formula mixed with fluoridated water. They concluded that not only does this fail to protect infants teeth - it can actually damage them, causing a cosmetic problem termed "fluorosis." Worse yet, it appears that infants given fluoridated water are more likely to develop osteosarcoma, a bone cancer most commonly seen in adolescent boys. Though osteosarcoma is rare, it is the second leading cause of childhood cancers following blood related cancers.

Action point: Talk to anyone you know that has an infant on formula and make sure they are aware of this. Formula should be mixed with bottled water, or tap water that has been filtered to remove fluoride. As for the bottle, choose glass or bisphenol A free plastic (available at stores such as Whole Foods.) More about that in another post.

See our blog entry Water,Water Everywhere, What Is Safe to Drink? for a discussion of other possible carcinogens in our water supply, and what we can do to protect our children. For further information on cancer prevention, visit our web site.

Cancer Proof Your Travels!

When we think of international travel hazards, thoughts drift to Montezuma's revenge and terrorism. Yet, another danger lurks beyond our boundaries. Whereas 10 percent of cancers in the US are caused by infection, that number increases to 25 percent worldwide. Many of these potentially cancer-causing infections can be avoided through knowledge and vigilance. A few to be aware of while enjoying your international adventures:

1. Schistosomiasis - bladder cancer due to the parasitic infection, schistosomiasis, is the leading cause of death in men aged 20 to 44 in Egypt. Schistosomiasis is an infection spread through snails in fresh water. The parasites can penetrate through unbroken skin, and cause chronic inflammation in the bladder that can lead to cancer. Regions where this is found include the Nile River valley in Egypt, Lake Malawi in Africa, as well as certain regions in Southeast Asia, Southern China, Northern South America, the Middle East, and the Caribbean. The parasites are not found in the ocean, and chlorinated water is considered safe.

2. Liver flukes - commonly found in East Asia and especially northeast Thailand, are a significant cause of bile duct cancer. Liver flukes are contracted by eating raw or undercooked freshwater fish that have been contaminated by the parasite. Avoid freshwater sushi when traveling in these regions.

3. H.pylori - infection with the bacteria H.pylori is considered the leading cause of gastric cancer. Gastric cancer has been declining in the US, but remains the fourth most common form of cancer worldwide. It is acquired through person to person contact and ingesting contaminated water and food. When traveling, choose water sources that have been treated with chlorine (and then filtered when possible) or "safe" bottled water. If you develop symptoms of peptic ulcer disease (80-90 percent of cases are due to H.pylori,) consult your health care provider.

4. Hepatitis B - is the leading cause of liver cancer worldwide, responsible for roughly 80 percent of cases. While many cases are sexually transmitted, often the source of transmission is unknown. It is much more contagious than HIV, and can be transmitted even by sharing a toothbrush. Consider immunization, and take precautions around any sources of blood products - even toothbrushes.

5. HIV - is well known for the cancers it can lead to - and its rising incidence, especially in Africa. Before traveling, and travel to Africa in particular, review "universal precautions" on the CDC website listed below.

6. HTLV-1 - Human T cell lymphotrophic virus (HTLV) is a virus rarely found in the US, but infects an estimated 15 to 20 million people worldwide. Of these, roughly 2 to 5 percent will develop adult T cell leukemia/lymphoma. HTLV-1 is most commonly found in Japan, but also occurs in parts of South America, the Caribbean, Papua New Guinea, and central and west Africa. The infection is transmitted through blood, sexually, and from mother to child through breastfeeding.

If you plan to travel internationally, check out the CDC's website to see what infections are endemic in that region and precautions to take. Here at home, as many are keenly aware of with the advent of the HPV vaccine, infections can predispose to cancer as well. Of the 10 percent of cancers in the US caused by infection, a significant number are related to sexually acquired infections. Practice safe sex wherever you are!

For further information on cancer prevention, visit our web site, or read "Avoiding Cancer One Day At A Time: Practical Advice for Preventing Cancer."

Recreation Reduces Breast Cancer Risk

A study due to be published in the March issue of "Epidemiology," entices us to find entertaining ways to exercise to reduce our risk of developing breast cancer. The researchers, noting that epidemiological studies have shown breast cancer risk to be reduced 30 to 40 percent in highly physically active women, evaluated the effect of moderate to vigorous recreational activity on breast cancer in Polish women.

The results: Total adult lifetime activity decreased the risk of breast cancer.

The breakdown was as follows:

- Moderate to vigorous recreational activity 26 % reduction
- Outdoor activites 19 % reduction
- Heavy physical work 40 % reduction
- Combined high intensity exercise 25 % reduction

And, according to the study, it is never too late to begin. Women who increased their recreational activity in their 50's, had a significantly lower risk of developing breast cancer.

Action point: Find a recreational activity you enjoy, preferably one you can share with your partner, friends, or children. A few ideas:

- Tennis
- Hiking (my favorite, many hiking trails worldwide makes this a lasting hobby)
- Rock climbing
- Kayaking/canoeing
- Dancing
- Gardening
- Skiing
- Any game that can be played with children

The best exercise is something you enjoy, even crave, and return to again and again for fun and enjoyment.Reference: Peplonski, B. et al. "Adult Lifetime Physical Activity and Breast Cancer." 2008. Mar; 19(2):226-236.

For further information on cancer prevention, visit our web site, or read "Avoiding Cancer One Day At A Time."

Copyright 2008, Turtle Lake Publications.

Stress May Raise Cervical Cancer Risk: Should We Worry?

In a society where we are all "stressed out," we can add another entry to our worry list.

Stress may increase the risk of developing cervical cancer. A study published this month in "Annals of Behavioral Medicine," found that women who felt more stressed had a poorer immune response to HPV, the virus that causes the inflammation that can lead to cervical cancer. Before losing sleep for a night, let's look at the study. There is something we can do!"

But...but...but, my life is stressful!!!"

It is true that many stressors are beyond our control. Job changes happen. Relationships change. Illness occurs. Financial pressures abound in the current market. But, this study did not find a difference in the objective levels of stress in a woman's life. The difference was in how stressed women "felt!"A study some time back in Sweden showed a similiar scenario with breast cancer. There was no difference in breast cancer based on objective measures of stress in women's lives, but those who "felt" more stressed had an increased incidence.

Even if we can't change our life situations, we can try to find them less stressful. Here are a few tips:

- Try to arrive everywhere you go ten minutes early

- Set limits, don't be afraid to say no

- Play music that relaxes you and brings back pleasant memories

- Try yoga

- Go to sleep. Issues that seem insurmountable at night can often be solved in the light of day

- Declutter your life

- Try visualization. Imagine yourself beyond the current stressful event, in your ideal situation

Life is stressful enough, without worrying that it will raise our risk of cancer! For further information on cancer prevention, visit our web site, or read "Avoiding Cancer One Day At A Time".

Copyright 2008, Turtle Lake Publications

A New Cancer Risk From Cell Phones?

We have all heard the debate about cell phones and brain tumors, but could cell phone use increase the risk of another type of cancer? A study published this week in the "American Journal of Epidemiology" suggests this is the case.

This study, led by researchers in Israel, found that heavy cell phone use increased the risk of benign (non-cancerous) and malignant (cancerous) salivary gland tumors, in particular of the parotid gland. The parotid gland is a salivary gland located in front of the ear, and is best known as the gland that swells - causing the characteristic appearance of an individual with mumps.

The study, unlike many other epidemiological studies, compared "heavy use" of cell phones rather than "ever use" of cell phones to come to their conclusions. Those who were in the highest category of cell phone use, based on number of calls and total call time, had a 58 percent increased risk of developing parotid gland tumors on the side of the head where they held the phone. There was no increased risk of tumor development on the side of the head where they did not hold the phone.

With 90 percent of individuals in Western countries using cell phones, what should we do with this information?

Sadetzski, the lead researcher in this study, suggests that parents be vigilant about their children's use of cell phones, limiting the number of calls and time spent on the phone. Many European countries have already taken actions to protect children, and recommend children use cell phones only for necessary calls to parents. This is not based on documented studies at this time, but on the theoretical risk to developing brains. The latency period (time between exposure and cancer) for many cancers is long. If tobacco came out when cell phones did, we may not see an increase in cancer...

In the USA, we may want to consider the European approach to cell phone use in children. After all, even if cell phones are given a green light in 30 years, many of our children are replacing time spent exercising and doing homework with time on their cell phones. With childhood obesity skyrocketing and test scores declining, we would be wise to take note.

Reference: Sadetzski, S. et al. 2008. "Cellular Phone use and Risk of Benign and Malignant Parotid Gland Tumors -- A Nationwide Case-Control Study." American Journal of Epidemiology." 167(4)457-467.

For further information on cancer prevention, visit our web site or read "Avoiding Cancer One Day At A Time: Practical Advice for Preventing Cancer."

You can also register for our free cancer prevention newsletter and learn more about the latest information to minimize your risk.

Could New Acne Treatment Cause Cancer?

My mother always says "look beneath the skin." Great advice from a child psychologist turned stay-at-home mom for evaluating relationships, but keen advice for evaluating well-respected journalism as well.

Browsing Yahoo Health, an article from Reuters caught my eye. "Drug Combo treats severe acne in women: study." Knowing the emotional turmoil those tiny spots can inflict on the composure of otherwise self-confident women, I rapidly clicked, and even more quickly became alarmed.

This study, published in the January 2008 Journal of the American Academy of Dermatology, cites the combination of the birth control pill Yasmin(r) and spironolactone (a diuretic) as a safe and effective treatment for acne. In this study, recipients had an 85 percent chance of either being free from their acne or having excellent improvement. And complications were low. There was no significant weight gain or menstrual cycle irregularites and no problems with elevated potassium levels.

But, what about the long run? Most of these women are young!

We know that oral contraceptives, such as Yasmin, are associated with a small increase in the risk of pre-menopausal breast cancer. How small? In the worst case scenario in the studies, using these for four years before the birth of a first child conferred a relative risk of 1.4. Simply said, if we consider the current risk of breast cancer to be one in seven women (some may argue one in eight or nine), this risk would now be one in five. This risk can often be justified. Going through pregnancy and delivery could definitely be considered riskier. But acne?

And then add in spironolactone. This is a great drug in certain conditions. It can help with fluid retention in those with heart failure and cirrhosis, and be a life saver for those with a condition called primary aldosteronism. Yet, as with many potentially life-saving treatments, that treatment can come at a cost. Spironolactone is listed in California's Proposition 65 under chemicals associated with a risk of cancer.

Shocking - but not really. Looking back at the treatment of acne over the years, we laugh at our ignorance as we raised cancer risk while treating a cosmetic nuisance. First it was X-rays, now known to increase the risk of thyroid cancer. Then it was sun (UV ) exposure. Will we look back in thirty years and question why we considered a combination of a known and a probable carcinogen an acceptable treatment for something only skin deep?

Myself - I plan on listening to my mother's advice. "Look beneath the skin." With the alarming incidence of breast cancer in our country, and one in three women expected to develop some form of cancer in addition to skin cancer, I think I'll opt for safer alternatives.

And for my kids it serves as an internet lesson. Unlike the TV ads as of late portraying the wonderful advantages of a multitude of meds, a laundry list of potential problems did not follow this article, nor was I able to find a direct way to contact anyone to discuss our concerns.

Get extensive information on cancer prevention by reading "Avoiding Cancer One Day At A Time: Practical Advice for Preventing Cancer" to learn more.

Breast Cancer Prevention: What to Eat, What Not To Eat

Our book Avoiding Cancer One Day At A Time was conceived as we tried to share what we know about cancer prevention with those we love.Do you know someone who has had breast cancer, or are you a breast cancer survivor yourself? Every time I hear of another family member, friend, acquaintance, or friend-of-a-friend who has been diagnosed with breast cancer, my heart aches to know the causes. Even with my loved ones who are cancer free, and thriving as breast cancer survivors - it pains me to think of what they went through - just to be here.

Many factors contribute to the development of breast cancer. The environment, genetics, lifestyle, and diet all play a role. Thankfully, diet is something we can do a lot about - if we know the foods that may increase or decrease risk. Much remains to be studied, but consuming - or avoiding - the following foods, may alter your risk of developing breast cancer based on credible studies.

The "Good" Foods

Apples: Apples, especially the skin, have been shown to offer protection against breast cancer, although the amount in the study was equivalent to five apples per day. An apple a day (we recommend organic since apples are one of the foods with the highest pesticide residue), may keep the oncologist away. Apple cider is preferable to apple juice since it includes the skin.

Green tea: Studies have shown a protective effect against many cancers, including breast cancer, with the consumption of green tea. Interestingly, green tea extract is being evaluated in clinical trials for those with cancer at several major cancer centers.

Seaweed/kelp: Seaweed appears to be protective against breast cancer, and is considered one of the reasons for the lower incidence of breast cancer in Japan. Miso soup is a great way to get seaweed in your diet, is easy to prepare, and even this 100 percent Swedish author by heritage, craves this Asian staple.

Pomegranates: Pomegranates appear to be protective against breast cancer, and are delicious when purchased fresh. They can also keep kids busy for a long time - giving mom the opportunity for a few healthy deep breaths.

Cruciferous vegetables: Cruciferous veggies appear to offer protection against breast cancer. Studies show this effect with a fairly high consumption - e.g. a head of cauliflower or broccoli a day. Look for other vegetables in the cruciferous category for variety. Examples include: cabbage, brussel sprouts, Chinese cabbage, bok choy, mustard greens, kale, collard greens, kohlrabi, turnips, rutabaga, arugula, wasabi, radishes, and horseradish.

The "Bad" Foods

Acrylamide: Recently, a new study reported an increased risk of breast cancer in those with higher blood levels of acrylamide. Acrylamide is a chemical formed when starchy foods are heated. The most common sources are potato products (esp. fries and chips) and bread products. Avoid overcooked potatoes and bread products. A listing of the acrylamide content of various foods is available on the Internet.

Red meat: Women who eat red meat seven days per week were shown to have an elevated risk of breast cancer. Processed meats should also be minimized.Grapefruit: Does anyone remember the grapefruit diet? I do. In high school my mother and I would do the two week grapefruit diet to stay trim. We thought we were healthy! Not so. Women who consumed a quarter of a grapefruit daily, were 30 percent more likely to develop breast cancer in a recent study. Grapefruit interferes with an enzyme in the liver, resulting in higher serum levels of estrogen.

Special Circumstances

Flax: Flax may be protective against breast cancer, but can interfere with chemotherapy. If you have breast cancer, consult your oncologist about the use of flax.

The Soy Issue: Soy appears to lower the risk of premenopausal breast cancer slightly, but the benefit seems to be limited to those who consume during adolescence, when breast tissue is differentiating. On the reverse side of the equation, breast cancer cells grown in a dish, grow more rapidly when fed soy. Use soy in moderation after adolescence and avoid soy supplements.

For further information on cancer prevention, visit http://www.avoidcancernow.com/, or read "Avoiding Cancer One Day At A Time: Practical Advice for Preventing Cancer."

The Secret History Of The War On Cancer - On CSPAN

Tune in to C-SPAN 2 this weekend!

Many of our blog entries and a large section of our book speak of the environmental risks for cancer -and what we can do to lower those risks. Not a small concern, since roughly 90 percent of cancers are caused by the environment rather than genetics. This - and the fact that one in two men and one-third of women will develop cancer in their lifetime.

Thankfully, there are people like Dr. Devra Davis, Director Of Environmental Oncology at The University of Pittsburgh, who have exposed the errors - at multiple levels - in our war against cancer. Through her work, and the foundation she has begun, we have new hope, that fewer of us will have to hear those awful words: "you have cancer."

Tune in to C-SPAN 2 this weekend on Saturday evening or Sunday morning!Devra will be discussing her new book "The Secret History of the War on Cancer" on Book TV on C-SPAN 2 this weekend on Saturday at 10 PM (EST) and on Sunday at 6 AM (EST).

Further information on the work Dr. Davis is doing, and general information on the environment and cancer risk is available online. Unlike the funding to study chemotherapy drugs, funding to evaluate the role of the environment in causing cancer is lacking. The Center for Environmental Oncology has a donation program where you can contribue to this important cause. You can see our friend Rich Pagen, who took this to another level this summer, paddling for the cause.

Devra Davis has been called the Rachel Carson of this era. Speaking with her today, she was very humble in her response. Yet, the impact of her work could make the impact of pesticide awareness from that era pale in comparison.

For information on simple, daily things you can do to lower your risk of developing cancer, read on.