Breast cancer prevention: the Barbara Andersen study

Barbara Andersen's study published in 2008 in the journal "Cancer" (1) did not trigger media thunder. And yet, this survey, spread out over a decade, showed that improvements in health behaviors had very real effects on the number of relapses and deaths. After treatment , women in the first group were left on their own, and women in the second group were "accompanied" (2) by two psychologists who helped them to better follow their treatment. They also received healthy lifestyle advice (sports, nutrition, etc.) and learned relaxation techniques. Results: after four months, they were better than women in the control group (less depressed, more adapted to stress); after twelve months, their cancer immunity was improved; and after twenty months, they already had fewer relapses.

"Eleven years later, those who had followed at least 20% of the accompanied program had half as many recurrences as the others," enthuses Dr. Jean-Loup Mouysset, an oncologist in Aix-en-Provence, and the reduction in mortality. in this group reached 68%. These results have not been matched to date by any chemotherapy. This does not call into question its effectiveness, but rather means that its effects are reinforced by this program. These results should not make patients feel guilty that they might think it is their fault if they relapse, but instead encourage carers to better accompany them. The future is there: in the support of the sick, as important as care . "

The first demonstration of the influence of lifestyle on cancer was carried out on small English chimney sweepers in ... 1775. By the age of 5, boys were sneaking into chimneys and impregnating coal, especially along the rope that rubbed against their scrotum. At the age of 30, these men had scrotal cancer. It was enough for the Chimney Sweeps Guild to take a daily bath rather than an annual bath - the standard at the time - for this professional cancer to disappear.

The impact of the environment on breast cancer is also proven, although the demonstration is more delicate, this cancer being caused by several causes. Asians, who know little about this type of tumors at home, catch up with Westerners one or two generations after migrating, probably because of the change of diet . New fact: a 2007 US study (5) also blamed pollution on PCBs (chlorinated chemical derivatives, better known as pyralene) and hydrocarbons, which in some (2) would be two to four times more likely to have breast cancer.

(1) "Psychological intervention improves survival for breast cancer patients": study on 227 patients, statistically significant. 4. For four months, once a week; then once a month for eight months. 5. "Environmental pollutants and breast cancer", supplement to "Cancer", June 15, 2007 / vol. 109 / NB12.

(2) 10 to 15% of white women, and more in black women (genetic polymorphism).

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Breast cancer prevention: tip # 1, get tested and put yourself to sport

We know that cancer is first and foremost a story of cells that degenerates. Every day, we produce one hundred billion, and we walk constantly with a million mutant cells, "abnormal" but not yet cancerous. Fortunately, we have very effective cell repair mechanisms. With age, the altered cells increase, and the more we expose them to unfavorable environmental factors, the higher the risks of moving to the stage of cancer cells and then organized tumors.

Organized screening must continue well beyond 50 years . Organized screening at age 50, with a mammogram every two years, can detect about 6 cancers per 1,000 women. In 2008, there were 2.2 million women screened, 13,200 cancers identified! And among them, 35 to 40% were less than 10 mm - small, so very good prognosis. Without screening, the proportion of small tumors discovered falls to 25%. Should we still be tested if we had three or four normal mammograms afterwards? Yes, of course, because the tumor may appear later. And beyond age 74, age when organized screening stops? We continue more than ever because the risk is increased.

At this stage, if the tumor is formed, it is the early detection that will make the difference. Overview of ways to prevent a potential risk .

Put yourself to sport

Not only does it reduce the risk of breast cancer (from 20 to 40%), but also the risk of recurrence. But what activity? Is it true regardless of age? "At all ages of life, the activity is protective, with a peak of overprotection between 14 and 20 years, during the period of differentiation of breast tissue, says Dr. Carole Maître, gynecologist and sports physician . Years later, the risk of breast cancer will be reduced in pre- and post-menopause. The activity started at age 50 is beneficial, but more slowly. "

The recommendations of the Nutrition Santé program are half an hour of moderate activity (brisk walking), at least five times a week, or twenty minutes of high physical activity (jogging), three times a week. The anti-cancer virtues of sport? It improves the capture of sugar by muscle cells. It reduces insulin resistance - yet this chronic resistance induces the production of IGF1 (a growth factor), which promotes cell proliferation. It calms the climate of chronic inflammation, which is also conducive to cell proliferation. In addition, by decreasing fat , it reduces the amount of estrogen in the blood (since fats are converted into estrogen). As for the prevention of relapse, studies show that walking at a moderate pace for three to five hours a week could reduce the risk of death by 30%.

Make you pamper .... Beauty in the hospital

Put a nail polish, make a facial, test a new make up ... twelve hospitals today enjoy free aesthetic care in cabins installed in the institutions or directly at the bedside patients. In 1992, the Cosmetic Executive Women (CEW) created the first CEW beauty center in a hospital setting at the Gustave-Roussy Institute (Villejuif). Thanks to this association, over the last five years, more than 50,000 patients have been able to reconcile with their image. An initiative that contributes to comfort and healing. Particularly in women undergoing chemotherapy, who discover specific care, makeup and styling techniques that help them maintain their desire to be beautiful. www.cew.asso.fr

Breast cancer, prevention: tip 2 fruits and vegetables at will

They are rich in antioxidants, anti-inflammatory and phytochemical substances, synthesized to withstand the hostile conditions of their environment. "For this reason, more than half of the chemotherapy drugs used today are directly derived from plants," says Dr. Richard Béliveau (7), chairholder in cancer prevention and treatment at the Université du Québec à Montréal. . Tens of thousands of phytochemicals slow down the progression of cancer. "

The anti-cancer plate includes crucifers (Brussels sprouts, cauliflower, etc.), foods of the garlic family (with onions, chives and leeks), with anti-proliferative properties. Fungi stimulate the immune system and prevent the growth of breast cancer cells. They block aromatase, an enzyme that plays a key role in the production of estrogen. Green tea, with its "cathechines", can block angiogenesis, that is, the formation of blood vessels essential for tumor growth. According to a study published in 2009 and cited by neuropsychiatrist David Servan-Schreiber during the conference "Another look at cancer": "The risk of breast cancer can be reduced to 89% if women consume mushrooms regularly and three cups of green tea a day. The doctor does not hope to oppose a flawless line against cancer - everyone is biologically different - but given such results, what is the risk of trying?

A study conducted in the United States in 2008 on rats shows that with a concentrate of broccoli, the effects of environmental pollution could be reduced. "The first group absorbed the concentrate, the second group, and both groups were then exposed to nitrosamines," says Dr. Mouysset. Conclusion: 95% of the unprotected rats developed tumors, and only 36% of the rats in the broccoli group did so. So yes, the contents of his plate can change the situation. But let 's stay realistic: you can eat organic , eat pounds of fruits and vegetables, do not drink alcohol and still have breast cancer. The good news: these measures are also used to prevent obesity, cardiovascular diseases, diabetes, Alzheimer's ...

Breast cancer prevention: tip # 3 zoom on good reflexes

Studies demonstrating the protective effects of fruits and vegetables have been done in real life, with foods possibly containing pesticide residues. And so far, they have never shown an increased risk of cancer . "The potential risk of these chemicals on human health is much lower than the huge benefits of regular consumption of fruits and vegetables," say Richard Béliveau and Denis Gingras in "The anti-aging diet". And the two researchers to push the nail: our body has developed mechanisms of detoxification and purification that protect us. In practice: wash fruits and vegetables, and remove the skin if necessary.

The cooking mode?

In all forms: raw, cooked, fresh, frozen ... because, depending on the product, it is not the same compound that is good. The raw crushed garlic will release protective substances but, cooked, it will lose this faculty. For tomatoes, cooked juices and sauces more easily diffuse their protective lycopene. Broccoli is more beneficial "al dente". A tip : eat varied, with delight, you will find yourself inevitably.

And turmeric, soy ?

A recent editorial of the National Cancer Institute explains that turmeric is both interesting in prevention and during chemotherapy. "Thanks to its powerful anti-inflammatory effect, it potentiates certain treatments," explains Dr. Mouysset. In pure prevention, small daily quantities are enough. In prevention of relapses, one to two tablespoons a day are useful, or dietary supplements, more concentrated. "

And soy? Opinions differ: some experts believe that it can help prevent breast cancer, provided it is consumed from childhood; others, on the other hand, consider that soy contains phytoestrogens, which are potentially harmful since they are chemically close to female hormones. In case of breast cancer, all the opinions come together: even if it is to calm the hot flashes of the menopause, it is no longer a question of consuming soya.

Breast Cancer Prevention: Tip # 4 Control Your Body

Check the balance

The risk of cancer is minimal when the body mass index (8) is normal, between 18.5 and 25. "Those who follow a treatment and who want to improve its tolerance, those who want to prevent relapses as much as possible must take the advice of their oncologist or a nutritionist , advises Dr. Mouysset. Unfortunately, all oncologists are not yet competent in nutrition, nor even aware of the usefulness of such an approach. "

Juggle with your hormones

The risk of breast cancer seems to be related to the total impregnation of female hormones in the course of life. Obviously, you do not have any action on the age of your first period (after 12 years, it's better) or the one of the occurrence of your menopause (before 51 years is better); but you can take care of the grain otherwise. For a chouïa of risk less, it would be necessary to have his children well before 29 years old, age of the national average. Easier to write than to do! With the pill, experts are reassuring, the over-risk disappears ten years after stopping the contraceptive and seems minimal. For hormone replacement therapy (HRT) of menopause, the risk of over-risk is clearer. According to the authors, the annual number of breast cancers that would be directly attributable to it varies between 1 and 12% of cases observed. However, as shown by the French E3N study, in 2005, the combination of estrogen combined with micronized progesterone "does not seem to be linked to an increase in risk, at least when the duration of use is less than four years. . In the longer term, the data are insufficient to conclude, "says researcher Françoise Clavel-Chapelon, Institut Gustave-Roussy. Therefore, use HRT only if necessary (hot flushes), after discussion with your gynecologist, in the absence of other risk factors, and as short a time as possible, until the studies specify the periods optimal use.

Omega 3, obviously

To reduce harmful chronic inflammation, omega 3 in oily fish (sardines, mackerel, etc.) and in organic eggs are excellent natural antidotes. Recent research suggests that foods high in omega 3 taken with certain antioxidants would also help chemotherapy to be more effective.

Alcohol in moderation

The figures have fallen: a glass of red more per day is 10% risk of breast cancer. The reason: in our body, alcohol turns into acetaldehyde, carcinogenic. In addition, it increases the level of circulating sex hormones that stimulate tumor growth. Yet, no question of demonizing the national drink. "Red wine is still the best alcohol because of its richness in polyphenols, nuance Valérie Magnin, oncologist and radiotherapist in Marseille. It must be consumed a little (one drink a day for women, two for men) and during meals. On an empty stomach, ethanol is metabolized to acetaldehyde, with possible alteration of the cell's DNA; so as an aperitif, think of the small raw vegetables! "

Breast cancer prevention: tip # 5 slow sugars and fatty acids to focus

Prefer slow sugars

The hunt for quick sugars (confectionery, sodas, but also white bread) is useful here too. As Dr. Magnin points out: "These are responsible for repeated insulin spikes that lead to an increase in breast cancer . So, eat sugars with low glycemic index (whole wheat bread, whole grains ...). Another tip from the specialist: forget about the sweetie in the coffee in the microwave. Aspartame should never be heated. "Its metabolism leads to a toxicity with the formation of formaldehyde which, it has been said, is a powerful carcinogen. "

Limit trans fatty acids

According to a study published in 2008 by Inserm and the Institut Gustave-Roussy, the risk of breast cancer is almost doubled in women with high blood levels of trans fatty acids (in pizzas and industrial cakes, chips ...) Several members have proposed last April that their quantity must be mentioned on the labels.

Pamper your vitamin D

Many studies have suggested the role of vitamin D deficiency in increasing the risk of breast cancer or in prognosis after cancer; also international experts recommend, in case of insufficient dosage, an additional 200 to 1000 IU per day. Vitamin D is produced by the action of the sun on the skin. In autumn and winter , you will find your vitamin D on the fish shelf (tuna and salmon).

Limit the poisons of the environment

Current knowledge does not provide a clear answer on the role of estrogen in the development of breast cancer, however the doubt is persistent. Launched in Côte-d'Or and Ille-et-Vilaine, the Cecile study is preparing to evaluate the impact of pesticides, PCBs and other environmental pollutants on 1,200 women with cancer and 1,200 control cases. In the meantime, as Helen Lynn (9), a Canadian chemist and environmental researcher, advises, start eating organic as often as possible; avoid drinking in plastic cups; to cook, to preserve food and for the microwave, avoid plastic. For the home, avoid synthetic perfumes and deodorants, prefer essential oils. Use natural household products ; avoid clothes that require dry cleaning; garden green avoiding pesticides, fungicides and insecticides.

Breast cancer prevention: the heartbreaking testimony of Sophie Davant

At 20, Sophie lost her mother to breast cancer. In "Beyond ... Growing up after the loss" * , she gives us an overwhelming testimony. And here we explain an illness that, she admits, scares her ...

MC: Since the disappearance of your mother, are you very concerned about prevention for yourself?

Sophie Davant: Yes, especially since I lost my paternal aunt to lung cancer. I was so traumatized that my blood pressure went up to 16 or 18 when the gynecologist had to examine me. So I am very concerned about prevention, even though my mother had tested herself very early and it did not save her. But thirty years ago, therapies did not have the efficiency of today. I do a mammo once a year. It may be a little too much because of the rays, but it helps me to fight my anxiety. I'm also very careful about my diet, but I do not stop living.

But I am outraged that in terms of announcing the diagnosis, accompanying patients, so little progress has been made since the death of my mother. Professor Khayat has put in place a training plan for doctors, but, even trained, some practitioners remain humanly incompetent and not all of them interpret the images correctly. This sometimes has irreversible consequences.

(*) ed. Michel Lafon.

Three key appointments

Monday, September 28, 2009: Symposium of the Europa Donna association, at the Palais du Luxembourg in Paris. Theme: Accompanying care. www.europadonna.fr.

Sunday, October 4, 2009: "Odyssea Paris", organized race for the benefit of the Gustave-Roussy Cancer Institute (Villejuif). www.igr.fr/cancer.

In early 2010, the Ressource association will propose a new support program (communication workshops with caregivers, stress management, nutrition, etc.). www.association-ressource.org, tel: 04 42 22 54 81.

And speaking of appointments, take yours for a free mammogram, if you are between 50 and 74 years old, at Cancer Info Service: 0810 810 821 (price of a local call).

Books that do good

"Family history and breast cancer, which screening? , A guide to the genetic risk of breast cancer. And also "Everything you need to know about breast cancer screening", two downloadable brochures on www.europadonna.fr . l "Life to love one another", this novel by oncologist David Khayat (Plon ed.), takes us to the other side of the mirror, in the head of the doctor and that of his patient ... l "After breast cancer, a feminine to rebuild "by Elise Ricadat and Lydia Taïeb (eds Albin Michel), psychologists. l "Recover the pleasure of taste", recipes of great chefs to help the sick. To download free of charge from www.bioalliancepharma.com or to request from [email protected] .

Are you concerned by this subject? This file prompted you to get tested? React by bringing your testimonials on the forum.