AACR Frontiers in Cancer Prevention Research Post #3 Obesity

OBESITY

Obesity is epidemic in our country. Over 60% of the US population is overweight, 30% are obese. John Hopkins School of Public Health in a press release estimates that by the year 2015, 75% of adults will be overweight; 41% will be obese.

It has been found that obesity increases the risk of cancer death and that higher grade tumors (more aggressive tumors) are more common in those who are obese. Obesity has been especially associated with colon, breast and prostate cancers. Ovarian cancer studies have shown that ovarian cancer recurs sooner and that life expectancy is shorter in women who are obese. Weight gain following a breast cancer diagnosis greatly decreases a woman’s chances of surviving the disease.

Obesity is associated with insulin resistance. When our bodies become insulin resistant, we produce more insulin in an attempt to compensate. Higher levels of insulin and a substance called insulin-like growth factor are found in those who are obese. Insulin-like growth factor causes cells to reproduce and prevents cells from dying, which can contribute to cancerous growth. Vitamin D is also sequestered in fat cells. It is also thought that fat cells produce hormones or compounds that make cancer grow more aggressively.

Overall, research shows that increased weight is associated with increase cancer recurrence and decreased cancer survival…recurrence rates are doubled and there is a 60% increase in cancer death rate associated with obesity. The drug Tamoxifen, used to treat breast cancer, is less effective in those who are overweight.

A higher body mass index is associated with a higher cancer risk.
A healthy BMI is 18.5 to 24.9. A BMI of 25 or higher is considered overweight. A BMI of 30 is considered obese. You can calculate your BMI at this NIH link: Calculate your Body Mass Index

AACR Frontiers in Cancer Prevention Research Post #2: Vitamin D

VITAMIN D:

I was privileged to attend a wonderful session on Vitamin D presented by Dr. Michael Holick, PhD, MD, and Professor of medicine, physiology and biophysics. Dr. Holick has been studying Vitamin D for 30 years and was granted General Clinical Research Center Excellence in Clinical Research Award by the National Center for Research Resources at the NIH in 2006.

Vitamin D has long been used to prevent the bone disease rickets in children and to promote bone health. Current research now links vitamin D to reduced cancer risk. Dr. Holick presented extensive research evidence to support his claims of a vitamin D-cancer connection. A recent study, the Creighton Study showed a 60% decrease in cancer risk over four years in middle-aged women taking 1100 units of Vitamin D3 daily. Vitamin D is now known to regulate 200 different genes and to inhibit cancer cell growth. As it turns out, the most aggressive and dangerous form of skin cancer, melanoma, occurs most on areas of the skin not exposed to sunshine and is a cancer has been found to be a associated with a vitamin D deficiency.

Vitamin D is actually a hormone. All cells in the body have receptors for Vitamin D. Vitamin D deficiency is very common as it is almost impossible to obtain adequate Vitamin D from the foods we eat. Our body’s main source of vitamin D is sunshine. Fourteen different cancers have incident rates inversly proportional to the amount of ultraviolet radiation(rays found in sunlight)in the environment. These cancers occur more frequently in areas with less sunlight and less frequently in areas with greater sunlight. As early as 1941 it was discovered that cancer incidence was higher in the northern United States. Vitamin D deficiency is being associated with several types of cancer including breast, colon and prostate. There is much evidence that Vitamin D affects the immune system.

We live in an age where sun exposure is avoided as it has been thought to promote skin cancer and cause wrinkles. In the US Vitamin D deficiency is most pronounced for those who live in the northern United States (anyone living north of Atlanta, Georgia) as we do not have enough sun exposure in northern winter months to create Vitamin D; the sun’s rays in the winter are not sufficient for producing Vitamin D. We are also a generation that stays indoors and out of the sun as we spend so much time in front of our televisions and computers. When we do venture out, we are wearing sun screen, which prevents our skin from manufacturing Vitamin D. Our body can produce enough Vitamin D to meet our needs with just 15-20 minutes of summer sun exposure to arms and legs 3 times a week. It is now recommended that you put your sun block on in the summer after you have been outside for 15-20 minutes.

Sixty percent of us are also overweight, so may not be able to utilize the Vitamin D we do take in as vitamin D tends to become trapped in the fat cells. Also among those at particular risk for vitamin D deficiency are those with dark-skin and the elderly as darkly pigmented and elderly skin does not as easily manufacture Vitamin D from sunlight. A 70 year old only makes 1/4 as much vitamin D as a 20 year old exposed to the same amount of sunshine. Current vitamin supplementation through multivitamins is less than what is felt to be sufficient, Dr. Holick suggests about 1000 units per day. Additional supplementation may be recommended in the winter in northern latitudes or for those over 50 years of age.

Vitamin D deficiency is felt to be epidemic in our society, and is now also being associated with the development of diabetes and several autoimmune disorders such as MS and rheumatoid arthritis.

Interesting, I have a new oncologist. I asked him his thoughts on vitamin D and cancer. He said he is now testing his patients for vitamin D deficiency, and almost 50% of his cancer patients have a severe vitamin D deficiency.

The blood test to determine if you are vitamin D deficient is 25-hydroxyvitamin D. Normal levels should be at least should be at least 30-60 ng/mL. Toxic levels are those above 150 ng/ml.

For more information, you can go to the website The UV Advantage

You can view Dr. Holick’s excellent lecture online at The Vitamin D Pandemic and its Health Consequences

AACR: Frontiers in Cancer Prevention Research Post #1 Epigenetics

I was once again privileged to be invited to an American Association for Cancer Research conference as part of their Survivor<->Scientist Program. This conference, Frontiers in Cancer Prevention Research took place in Washington DC in November. At the AACR conferences, those of us who are survivors and advocates are able to access the great minds of scientists from all over the world who have devoted their lives to searching for a cancer cure. We are also able to meet other survivors and advocates from around the world. We attend sessions and listen to presentations about the latest discoveries in the field from the scientists doing the research. I am inspired when I attend these meetings. I become very hopeful when I see the progress being made against this monster of a disease.

I want to share here what I learned at this most recent conference. This particular conference inspired me to make many personal changes in my own life. I will share here what I learned from attending many of the sessions in a series of blog posts over the next several days.

EPIGENETICS: Epigenetics is a new field in cancer research. While we often hear that cancer is a genetic disease, or find many people who feel that cancer is “in your genes” and therefore unavoidable, in reality only about 10% of cancers result from the genetic defects inherited from our ancestors. In a long term study of identical twins, when one twin had cancer, only 15% of the identical twins developed the cancer. If cancer were a disease inherited in our genes, 100% of identical twins would share a cancer history.

Different genes in our DNA have been discovered that promote cancer or protect against cancer. Some genes can cause unrestricted cell growth characteristic of cancer (this may be helpful when organs are being formed before birth or when tissues are being repaired). Other genes are protective against cancer and destroy cancerous cells before they can metastasize or form tumors. It has been discovered that these genes can be turned on or off, so that a gene protective against cancer no longer protects, or a gene that causes uncontrolled cell growth can be turned on when it shouldn’t be. This occurs because of a biochemical process called methylation. These changes are referred to as epigenetic changes.

In research it has been discovered that the DNA of identical twins becomes less and less similar as the twins age, which accounts for the differences in the appearances and health issues of identical twins as they grow older. When you compare their genetics at birth, they are identical. When you compare their genetics as they age, though, they become genetically very different from each other. I personally worked with two identical twin sisters for a few decades. When I first met them they truly looked identical, now they are no longer identifiable as identical twins, their appearances have changed a lot over the years. I’m not sure if you would even notice a sister resemblance in them now. Epigenetics have caused their genetic expression to become different as they have aged.

The field of epigenetics has implications in the treatment and prevention of cancer. It is believed epigenetic changes occur based on our behavior…that things like smoking and exposure to environmental toxins can cause epigenetic changes that promote cancer or that effectively “handcuff” genes that protect against cancer. Our diet may alter our epigenetics in good or bad ways. This offers great potential for prevention of cancer. It also offers a great potential for cancer treatment. It is much easier to turn genes on and off through epigenetics and demethylation than to correct a mutated gene that is inherited. Currently there is an ongoing clinical trial using drugs that correct epigenetic changes in cancer patients.

To learn more, you can view this link to a NOVA program about epigenetics.

Nova Science Now: Epigenetics

In this NOVA video about epigenetics, two mice who are clones with identical DNA have had certain genes silenced or turned on. They have had epigenetic changes created by scientists. The result is identical twin mice that have totally different body structures and hair color:

My words of wisdom to a newly diagnosed cancer patient.

I learned tonight that a family member I am close to, who supported me through my own cancer journey and who is my age, in her 40s and with a daughter still in high school, has just been diagnosed with cancer. Her mother died of cancer when she was a young child. She lost her father to cancer before he was able to meet his first grandchild. She more recently lost her step-mother to cancer. Then I was diagnosed with cancer. Cancer has traumatized her life already. Now cancer is back to terrorize her, this time on a personal and very intimate level. So far she is not accepting phone calls…but as soon as she is, I need to talk to her, to be there to support her as she supported me.

I’m trying to think of what exactly I want to tell her….so far I’ve thought of these things. They apply to all of us with a new cancer diagnosis, so maybe they will help someone else here:

*I know you feel like the bottom has fallen out of your life, that the future as you had planned it now seems insignificant, lost. Your normal, everyday life as it was before you received your cancer diagnosis was taken away from you the moment you became a cancer patient. You want your normal life back, even with it’s trials and troubles…the life you at least felt you had some control over.

*I know you are terrified and angry and fearing the worst…thinking of all you stand to lose, thinking of all of the people who will be hurt by your diagnosis, thinking of the fear and pain this will cause your husband and children. I know you are terrified of abandoning your husband and children.

*I know your thoughts are not positive, and that you fear that the fact that your thoughts are not positive will condemn you (they won’t).

*I know that the word cancer, to you, means a likely death sentence, as it was for your own parents. You fear causing in your own children the sense of loss you felt when your parents succumbed to this disease.

But I think of these things I have learned through my own journey that I need to also tell her:

*Your mother and father were diagnosed with cancer decades ago…so much has changed since then. In some cases cancer can be cured now, in others it can be a chronic disease for decades and not a death sentence. We live in an era where there are new and amazing advances being made against this disease every day. My own involvement in the Scientist-Survivor Program has given me a new hope for those of us fighting this disease.

*Many people, like myself, who were once considered beyond hope and help, survive many years cancer free. There is no one cancer that has killed ALL of it’s victims. There are survivors of every type and stage of cancer. There’s no reason why you can’t be one of the survivors

And then the more practical things….

*Become educated and knowledgeable about your cancer, bring a written list of questions to your appointments, expect answers to your questions. If you don’t feel your questions or intelligence are respected, get a new doctor who will work with you as part of your team and value your concerns.

*Chemo isn’t as bad as it’s reputation…nowadays they medicate and premedicate you to prevent many of the side effects that used to give chemo such a bad reputation (I was on chemo for 7 months and was nauseated only once, never threw up, GAINED weight and enjoyed eating (and athletic training)while on chemo. My Tuesday “Chemo Group” was fun, we laughed a lot and had a kind of “gallows humor” only cancer patients can enjoy. I drove myself to and from chemo and went grocery shopping on the way home from chemo. My life on chemo was pretty normal.

*Not everyone loses their hair to chemo, but if you are expected to lose your hair to chemo, make sure to get a prescription for a “hair prosthesis” (so your insurance will pay for a wig if you need one). See a stylist to help you find a wig that matches you current hair color, texture and style BEFORE you lose your hair..which will likely be after the first few treatments. And when your real hair grows back it may be different..a different color, a different texture, and maybe even naturally curly (or straight if it used to be naturally curly). Also, if you lose your hair, you lose ALL of your hair, not just the hair on your head.

*Don’t suffer any chemo side effects you may have as “expected”…most of them can be treated so that you can live a pretty normal life while on chemo. Don’t assume nausea and vomiting and feeling terrible are normal chemo side effects. I communicate with a woman who has advanced cancer that is surgically untreatable and who is on chemo who is still running marathons and working full time.

*Being in the cancer community can be a blessing…you meet very “real” people who share a lot with you and your new cancer values and perspectives and who inspire you. It’s a great growth opportunity. You get the great feeling of belonging to an almost sacred society.

*If you can’t sleep after chemo, maybe steroids are causing you insomnia, see if they can tweak the steroids or give you a sleeping pill for chemo days

*Seek peace of mind and emotional well-being through whatever and all channels work for you…support groups, counseling, antidepressants, a cancer survivor buddy, art, music, poetry…do whatever you need to do to keep your sanity and protect your mental health..your mental health is every bit as traumatized by a cancer diagnosis as your body and deserves equal treatment. We are our mind and our body and our soul and our spirit…to only treat your body and to disregard all of the other parts of our being is wrong.

*Find a way and allow yourself to express the anger that you are justified in feeling. Watch the movie Griffin & Phoenix if you need examples of justified anger and the need to release it.

*Be careful with over-the-counter healthful supplements…some can interfere with the effectiveness of chemo…everything “herbal” and “natural” may not be not good for you.

*Set limits if you are overwhelmed with too many well-meaning people…sometimes well meaning people can say and do the really wrong things…just let that roll off your back and avoid them next time if you can

*Nurture your spiritual side in whatever way is most helpful…writing, singing, praying, making music, yoga, Tai Chi, meditating, hanging out with people who inspire you

*Treat yourself to something special…a weekend or week away all by yourself or with a friend to help you regroup.

*Let yourself feel whatever you need to feel while going through the process. There are no wrong feelings, only honest feelings

*Don’t expect your life to eventually get back to your “old normal” life…it won’t, and that’s okay…sometimes the “new” after cancer normal is richer and more meaningful…and less full of insignificant things you find don’t matter after all