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Keeping Breast Cancer Risks on the Move

Exercise. Physical activity. Moving. Along with a clean and colorful diet, there’s almost nothing better you can do for your body than move. The fact is we have to keep moving to keep moving, and here’s another reason why.

Even mild physical activity can decrease a woman’s breast cancer risk. Moving is especially important during the childbearing years and after menopause. Gaining weight, though, will negate these benefits.

Move every day — a little or a lot.

Maintaining a healthy weight and staying physically active are the two key ways to keep the risk of breast cancer at bay, according to a recent study led by Lauren McCullough, MSPH, of the University of North Carolina Gillings School of Global Public Health.

Adam Brufsky, MD, PhD, professor of medicine at the University of Pittsburgh School of Medicine, told dailyRx, “This is very interesting and suggests that even moderate amount of exercise may be enough.”

A number of studies have demonstrated that exercise reduces the risk of new and recurrent breast cancer, but without analyzing the different types of activities or exercise frequency, intensity and timeframes.

McCullough and colleagues looked for the relationship between breast cancer risks and engaging in recreational physical activity at various times throughout a woman’s life.

The study involved 1,504 women with breast cancer, including 233 who had non-invasive and 1,273 with invasive breast cancers. The women ranged in age from 20 to 98.

Here’s what the study uncovered:

  • Exercising during a woman’s childbearing years or after menopause reduced the risk of breast cancer.
  • Women who exercised 10-19 hours a week had a 30 percent reduced risk.
  • All types of exercise performed at all intensity levels offered benefits.
  • Exercise appeared to be particularly helpful in lowering the risk of hormone receptor positive (estrogen and progesterone – ER+ and PR+) breast cancers, which are the most common in American women.

“The observation of a reduced risk of breast cancer for women who engaged in exercise after menopause is particularly encouraging given the late age of onset for breast cancer,” said McCullough.

A personal trainer in New York City, Amie Hoff, CPT, NASM has seen the results of exercise and has helped women with breast cancer achieve them.

“The benefits of exercise are amazing. Besides building strength, my breast cancer clients also increase their flexibility, develop greater balance, re-claim confidence and develop a stronger cardio level.” Hoff told dailyRx in an email.

“Exercise gives them a sense of control over their bodies when they feel they have none,” she adds. “The smile on their faces and sense of accomplishment after the session makes exercise one of the best medicines!”

After dancing with breast cancer, it’s exceedingly important to keep on dancing, according to Randy Blackburn, DO, MBA, director of radiation oncology at Onslow Memorial Hospital in Jacksonville, North Carolina.

There are no boundaries on type and intensity.  “There should be no restrictions that your body does not tell you about. Range of motion exercises need to be life long especially if your have had axillary dissection and /or nodal radiation,” Dr. Blackburn told dailyRx.

All is not rosy, though. Along with exercise, it’s essential that a woman maintain her weight.

Researchers found that women who gained “a significant amount of weight,” especially after menopause had increased risks of the disease.

This finding suggests that packing on the pounds can negate the benefits of exercise in lowering the risk of breast cancer.

So move your way into a new body. Find something you love to do — walking, yoga, Zumba, tai chi, running — whatever makes you happy. Just move and stay out of the food junk drawer, and you’ll see and feel and love the changes you experience.

This study was published in Cancer, a peer-reviewed journal of the American Cancer Society.

By http://www.DailyRX.com

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Healthy living can cut chance of developing diabetes

Living a healthy lifestyle can cut your risk of diabetes by as much as 80 percent, researchers from the U.S. National Institutes of Health report.

It has been clear that diet, exercise, smoking and drinking have an impact on whether one is likely to develop type 2 diabetes, but how each individual factor affects the risk had been unclear.

“The lifestyle factors we looked at were physical activity, healthy diet, body weight, alcohol consumption and smoking,” said lead researcher Jarad Reis, a researcher from the U.S. Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute.

“For each one of those, there was a significant reduction in risk for developing diabetes,” he said. “Having a normal weight by itself reduced the risk of developing diabetes by 60 to 70 percent.”

For example, eating a healthy diet reduced the risk by about 15 percent, while not smoking lowered the risk by about 20 percent, he said.

The more healthy lifestyle factors one has, the lower the risk for developing diabetes, Reis noted. Overall, risk reduction can reach 80 percent, he said.

“Our results confirm our public health efforts to get individuals to attain and maintain a healthy diet, physical activity, an optimal body weight, not smoking, and drinking in moderation,” he said.

The report is published in the Sept. 6 issue of the Annals of Internal Medicine.

For the study, Reis’ team collected data on 114,996 men and 92,483 women 50 to 71 years of age who took part in the National Institutes of Health–AARP Diet and Health Study. None of these individuals had diabetes, cancer or heart disease at the start of the study.

Over 10 years of follow-up, 9.6 percent of the men and 7.5 percent of the women developed diabetes, the researchers found.

However, for each additional healthy lifestyle factor the risk of developing diabetes was reduced 31 percent for men and 39 percent for women, Reis’ group found.

Reis noted that it helps to start living a healthy lifestyle at any age. Even in middle age, it will reap benefits in lowering your risk for diabetes, he said. “It’s never too late.”

Diabetes expert Dr. Spyros G. Mezitis, from New York Presbyterian Hospital in New York City, said that “we have known that lifestyle factors affect prevention, development and management of diabetes.”

Mezitis noted that the combination of lifestyle factors can reduce the risk of developing diabetes. “We need to look at these factors and how by modifying them you can really reduce the risk of diabetes,” he said.

However, Mezitis thinks changing these behaviors can be hard for people to do, especially without support from society at large.

“We really need to be thinking of prevention early, and we need the help of government and business and others to achieve these goals,” he said.

By Steven Reinberg, HealthDay

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Treatment May Help Ease Effect of Cancer

As some surgeons crowded into an operating room at New York Eye and Ear Infirmary and others watched a live video broadcast, Dr. Corinne Becker, the French doctor who pioneered the procedure, harvested lymph nodes from a patient’s groin to transplant to her underarm, where nodes had been removed earlier during cancer treatment.

“Voila!” she exclaimed, motioning to her colleagues as she rubbed a small piece of tissue between thumb and fingertips to check for the presence of the small, pearl-shaped lymph nodes. “Look what is here — a wonderful node.”

She warned that extracting too much tissue could injure the patient, even causing lymphedema in another limb. Using the French word for ‘greedy,’ she said, “It’s better not to be ‘gourmand’ — aggressive.”

This innovative procedure, called an autologous vascularized lymph node transfer, is used to treat lymphedema, a common side effect of breast cancer treatment. Removal of the lymph nodes under the arm closest to the affected breast is believed to stem the spread of cancer, although new research suggests it can be avoided in many cases. But the loss of lymph nodes often leads to chronic swelling and soreness in the arm.

In the new experimental surgery, the missing lymph nodes are replaced with a handful of healthy nodes transplanted from elsewhere in the patient. If all goes according to plan, the lymph nodes make themselves at home in their new location and connect with lymph vessels and start doing their job, filtering waste and draining fluid that has accumulated in the arm.

But the operation is controversial and not without risk, and though it is reported to have cured some patients and improved the condition in many others, it is seldom performed in the United States. Even proponents say it should be reserved for patients who don’t respond to conventional treatment.

The first randomized clinical trial of its effectiveness is just getting underway, led by Dr. Constance Chen, a New York City plastic surgeon who specializes in muscle-sparing reconstructive breast surgery that uses the patient’s own tissue.

Even in the absence of good data, however, demand for the procedure is bound to grow. More than 2 million women in the United States have been treated for breast cancer, and some studies suggest lymphedema develops within five years in up to 40 percent of women who have undergone breast cancer surgery. While the condition can be managed with constant care and physical therapy, it often severely restricts activity and is generally considered incurable.

In the absence of better data about the benefits of lymph node transfer, however, insurers may balk at covering the procedure, which involves expensive, complex microvascular surgery to connect tiny blood vessels.

“From just a plumbing standpoint, it makes sense — someone took out the lymph nodes, you put them back in,” said Dr. Babak Mehrara, a reconstructive plastic surgeon at Memorial Sloan-Kettering Hospital in Manhattan. “The problem is that some of the science doesn’t support it. It probably works for some people and doesn’t for others.”

Prior to transferring nodes to their new location, Dr. Becker aggressively clears away dense scar tissue under the arm that may be “clogging up” the lymphatic channels and preventing fluid circulation. That is one of the riskiest aspects of the surgery, because nerves and blood vessels leading to the arm could be affected.

“We worry that if a person already has a compromised lymphatic surgery, you can go in there and do further damage. We always say the less surgery the better,” said Saskia Thiadens, executive director of the National Lymphedema Network.

But, she added, “Obviously we’re eager to see what the outcomes are.”

Dr. Chen, who co-organized the symposium hosting Dr. Becker with Dr. Joshua L. Levine, director of breast reconstructive services at New York Eye and Ear Infirmary, agrees that more scientific evidence is needed. But she is optimistic the surgery will benefit patients and says the toll lymphedema takes has not been fully appreciated by the medical community.

“Treatment for lymphedema generally doesn’t end,” Dr. Chen said. “Women will say managing their lymphedema is worse than coping with breast cancer — now they have to deal with an every day affliction that affects their day to day lives.”

She is launching the first double-blinded randomized clinical trial of lymph node transfer, a multicenter study that will enroll 88 patients with lymphedema in one arm. Half will be randomly assigned to lymph node transfer, while the others will undergo a dummy surgical procedure. The patients will be followed for two years after the operation to see if their quality of life improves.

“There are naysayers with every single surgical innovation that comes along,” Dr. Chen said.

Dr. Becker claims to have had enormous success, but while she has operated prolifically in Europe and other parts of the world on patients with cancer as well as those with congenital lymphedema, she has published only sporadically.

In a 2006 paper in Annals of Surgery, she reported that 90 percent of patients improved after surgery and almost half were cured, but the sample included only 24 women and there was no control group.

One of the patients operated on by Dr. Becker and Dr. Chen during the daylong symposium, Jennifer Miller, 40, a portfolio manager at an investment firm in Manhattan, said she has already felt a dramatic improvement.

“I used to have this pain that was like my whole arm had a headache, and that’s gone,” Ms. Miller said.

Ten days after surgery the swelling in her right arm was reduced by half, compared with measurements taken 10 days prior to the operation, and she has been able to bare her arm, which she used to keep covered in a compression treatment sleeve most of the day.

Though her right arm is still swollen and larger than her left, she said, “It already feels more manageable, and I’m still recovering from surgery. Even if this is all the improvement I get, I’m happy.”

But whether the change is a true effect of the transfer or a placebo effect of undergoing treatment is not known. Doctors say it is unlikely the transplanted nodes are already functioning, and it’s possible some other aspect of the surgery is having a beneficial effect, Dr. Chen suggested.

RONI CARYN RABIN , BCBS Association

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