Ristorando Blog

Posts Tagged ‘Breast Cancer’

There are mounting evidence that alcohol increases the risk of many type of cancers including mouth cancer, oesophagus, larynx, pharynx, liver (especially in men), and also breast cancer.

Regardless of the type, alcohol consumption increases the risk of cancer. Whether it is in the form of beer, wine or spirits, it is the alcohol itself that does the damage. Our upper-respiratory tract has sensitive tissues that are directly exposed to alcohol; consuming alcohol will cause damage to our body cells and may lead to cancer. After many years, alcoholic liver cirrhosis will eventually develop and will finally lead to liver cancer.

To lower your risk of getting cancer, you should opt to not drink any alcohol at all or if you have to drink, you should drink in moderation only. Moderate drinking differ from men to women. The recommended amount for women is not more than a drink per day; a drink is equal to a bottle or a can of beer (12oz). For men, the recommended amount is an average of not more than 2 standard drinks per day. The different limit for men and women is because men can metabolize alcohol quicker than the women as they have more muscle. Muscle tissue holds more water than fat, so that more alcohol can be diluted. As woman’s body has less muscle and more fat, the alcohol will stay in their bloodstream longer than a man’s.

Of course, not everyone who drinks alcohol will develop cancer. But, cancer is more common in people who drink alcohol than people who don’t drink. People who stop their consumption of alcohol can significantly reduce their cancer risk. Other than reduce your intake of alcohol, you should also eat in moderation, exercise daily and lead a healthy lifestyle.

Albert Einstein, the Great Man of Science wrote: “It is theory that decides what we can observe.” If our mind is set (biased by the theory that we have learnt in school) then “that is all” that we can see – we can’t see anything beyond what we have learnt or been taught! It needs an open-minded person to “see” what others do not want to see or fail to see.

For twenty-six years, I devoted two lectures in my physiology class to teaching university students understand the Scientific Method. The first step for any scientific discovery is OBSERVATION of a phenomenon. If you cannot or don’t want to “see” how can you ever discover anything new?

After more than a decade working with cancer patients there is one phenomenon that I had observed: ” breast cancer patients tend to suffer metastasis (spread) to their lungs, bones, etc. pretty soon after undergoing medical treatments.” Of course, some doctors may scream at such a suggestion! I wonder if this “hunch” is an illusion? The answer came on 7 April 2007, in the form of a small, insignificant column in The Star. It had this heading: “Study: Treatment may fuel cancer’s spread.” The study reported in the Journal of Clinical Investigation by Dr. Carlos Arteaga and colleagues at Vanderbilt University, USA, showed that treating cancer with surgery, chemotherapy or radiation may sometimes cause tumours to spread. In their work they used doxorubicin (a common chemo-drug used for breast cancer) or radiation and found that these treatments raised levels of TGF-beta, which in turn helped breast cancer tumours to spread to the lung. The researchers wrote: “The repopulation and progression of tumours after anti-cancer therapy (such as radiotherapy, chemotherapy and surgery) is a well-recognised phenomenon.”

How many of us (doctors and patients alike) know this? If doctors know, do they tell their patients? If patients know, what is their response?

After reading this report, I spent a whole morning surfing the web to learn more about this phenomenon. This is what I learnt. The key to our understanding is a biological protein called Transforming Growth Factor beta (TGF-beta). TGF-beta exists in at least five (iso)forms, known as TGF beta 1, beta 2, beta 3, beta 4 and beta 5. The roles of TGF-beta in cancer are very complex and often confusing indeed. TGF-beta controls cell proliferation, differentiation, apoptosis (cell death) and motility. At the early stage of carcinogenesis (cancer process) TGF-beta is a potent inhibitor of cell proliferation but at later stages of carcinogenesis the levels of TGF-beta increase with tumour progression. It is not known how TGF-beta switches it role from being a tumour suppressor to being a promoter during the course of cancer progression.

Many disease processes are associated with loss of normal TGF-beta function, such as cancer, atherosclerosis, autoimmune and inflammatory diseases. Excessive TGF-beta production have been implicated in the formation of scar tissues or fibrosis (in lung and liver), development of pulmonary edema (fluid in lung), immunosuppression and successful parasite infection.

TGF-beta has been said to cause chronic pulmonary (lung) fibrosis in rats and mice exposed to chemo-drugs, bleomycin or cyclophosphamide, and in the development of hepatic (liver) fibrosis in rats exposed to radiation.

TGF-beta has been shown to promote breast cancer metastasis by acting directly on the tumour cells. TGF-beta is also shown to enhance parathyroid-hormone-related protein (PTHrP) and subsequently resulted in bone destruction in breast cancer patients. Advanced breast cancer patients have been shown to have increased plasma TGF-beta levels after chemotherapy and TGF-beta is positively associated with disease progression.

Dr. Carlos Arteaga and colleagues showed that when mice infected with human breast cancer were treated with radiation or doxorubicin, they had higher levels of TGF-beta in their blood. They also had more tiny tumour cells in their blood and these cells spread to the lungs. When the mice were treated with antibody that suppresses TGF-beta, the spread stopped. The spreading process did not occur at all in mice bred to lack TFG-beta.

Comments: What are the implications of the above? When you are asked to do chemo or radiation, ask first what is the main objective of such a treatment – to cure? to prevent cancer from spreading? or what. This study showed that treatments like chemotherapy or radiation cause the spread of cancer. This report is a direct opposite of what you are often told about the purpose of chemotherapy or radiotherapy – i.e., to kill the cancer cells or stop them from spreading!