November 2009 Archives

Gratefully Well

Happy Thanksgiving to Everyone! I have so much to be thankful for, and I'm sure you do too. Did you know that research has shown that being grateful can improve your health?

Check out this information from a physician who is located in the Triad, NC. If you enjoy the information, stay tuned because he is going to do a seminar for us in the near future! Great Fully Well

Cranberry Recipe

I just finished making these last night and stirred in the ginger this morning. They are very tasty!! I hope you enjoy them!

Citrus Ginger Cranberries

Ingredients:

1. 2 12-ounce bags cranberries
2. 1 1/2 cups sugar
3. 1 cup orange juice
4. 1 cup water
5. 1 tablespoon grated orange peel
6. 1 teaspoon ground ginger
7. 1/2 cup (about 2 ounces) minced crystallized ginger
   

Preparation:

1. Combine first 6 ingredients in heavy medium saucepan.
2. Bring to boil, stirring until sugar dissolves.
3. Boil until cranberries pop, stirring occasionally, about 5 minutes.
4. Cool (I let it cool overnight).
5. Mix in crystallized ginger. (Can be prepared 3 days ahead. Cover and refrigerate).
   

Nutrition Benefits of Cranberries!

Cranberries, as well as blueberries have many cancer fighting properties. According to the American Institute for Cancer Research not only are cranberries a good source of fiber and vitamin C, they have many different cancer fighting phytochemicals!

Phytochemicals in Cranberries

For those of you who need a reminder, phytochemicals are the "cancer fighting" chemicals in plants that help our bodies fight disease and keep our immune systems strong. There are more than 900 different types and each plant food has a unique combination of phytochemicals along with vitamins and minerals.

Cranberries contains many different phytochemicals including:

• Catechins
• Triterpenoids
• Quinic Acid
• Hippuric Acid
• Anthocyanins

Results from a 2007 study published in the Journal of Nutrition showed that extracts from cranberries slow the growth of breast, colon, prostate, lung, and other tumors, as do other components identified in the fruit (flavonols, proanthocyanidin oligomers, and triterpenoids).

Keep in mind that this study was done in a lab, not in humans so further research is needed to know for sure how this interacts with an active tumor. However, there is certainly no risk in adding more cranberries to your diet!

This study also reported that the unique combination of phytochemicals found in cranberry fruit may produce synergistic health benefits. Possible cancer fighting mechanisms of action by cranberry phytochemicals include:

• death of tumor cells
• reduced spreading of prostate tumor
• anti inflammatory activities

So eat up!!
- Julie

Thoughts from Readers

I thought that readers might be interested in what other readers thought about the mammogram recommendations that came out this week. Remember, you can always feel free to comment (either by name, or anonymously) at the end of each of my posts. It's often great to hear -or more accurately, read -  what others are thinking!

Below I have pasted many of the comments that I have received so far this week. For your protection, they remain anonymous :).

"nice article. thanks!"

"I appreciated your mamogram post on facebook. I turn 40 this year and we have been talking about this some. It's nice to hear from someone we know/trust."

"Excellent recap. I listened to the report on this on NPR this morning as well.  I still remain unconvinced by the arguments to delay the initiation and reduce the frequency.  In the report it sounded like there are a number of people in the medical community who have concerns about this recommendation as well.  If you take this philosophy to the limit you would say people would have less mental stress if they never did a mammogram - the ignorance is bliss argument."

"Thanks for the info. All of this makes me angry.  We must emphasize that one size does NOT fit all. My first cancer [ at age 41] was found by self-examination and it did NOT show on the mammogram.  My second cancer [at age 59] did show on the mammogram but could not be felt on self-examination. So I will continue to advocate for self-exams and mammograms for all women starting at age 30."

"In the interest of objective blogging, you may want to seriously consider presenting the other side of this issue - those in the cancer treatment community who disagree with the recommendations of this panel and the reasons for it.  I think it is a volatile issue and these recommendations do not represent the collective view of breast cancer experts."

"Julie, This is great!  I really like the way you presented the information."

"Julie, can we trust the government to make good decisions?  Are they after reducing medical expenses or saving lives?  It is never easy.  I just hope my doctors will give me good advice."

"Thank you for such a good summary and perspective - I sent on to all my sisters."

"Awesome review, Julie!  I love how you convey a professional message, with a personal touch!" 

More Expert Opinions

Here are some other links to more opinions on the topic. I had a breast cancer support group this week and it was interesting to hear from the women who made it. Almost all of them had been diagnosed as a result of mammogram, and many had concerns that the recommendations were made primarily for saving money.

Feel free to share your thoughts!
- Julie

Annual Screening Mammography Continues to be Recommended in Updated NCCN Guidelines for Breast Cancer Screening and Diagnosis

Dr. Susan Love Research Foundation (See her blog for comments).

American Cancer Society Responds to Changes to USPSTF Mammography Guidelines

American College of Surgeons Voices Strong Support for American Cancer Society Screening Mammography Guidelines

I'm sure by now you have all heard about the new report that came out suggesting that mammograms between the age of 40 and 50 may not be necessary. We've been having a lot of discussion among my co-workers at Cancer Services, and I know there's been a lot of opinions shared on the news as well as in social circles.

I think there are a few important things to know about the most recent review process as well as the recommendations. And most importantly, STAY CALM! The decision on when and how to screen is still a decision between you and your doctor. Recommendations are not rules that will be enforced.

What are the new Recommendations?
Here is an overview of the recommendations released on Monday:

• For women between the ages of 50 and 74 years, the USPSTF recommends mammography every two years (rather than every year).
• The USPSTF notes that there is insufficient evidence to assess the benefit and harms of screening in women over the age of 74.
• The USPSTF recommends against teaching breast self-exam.

You will note that the recommended age to start mammogram is at 50 rather than 40, is recommdended every two years instead of every year, and we need more data on women getting mammograms over the age of 74.

Who Made These Recommendations?
These recommendations were made by the US Preventive Services Task Force (USPSTF). USPSTF is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. It is funded and appointed by the government of the United States.

The mission of the USPSTF is to evaluate the benefits of individual services based on age, gender, and risk factors for disease; make recommendations about which preventive services should be incorporated routinely into primary medical care and for which populations; and identify a research agenda for clinical preventive care.

NOTE that the aim for this group is to objectively review data and they are only funded by the government, not any industry.

Weighing the Risks and Benefits
What you may not realize is that there has ALWAYS been debate about whether mammography for women in their 40s was worth recommending. YES, there are risks to having a mammogram. Risks include:

1. False-positive tests:  if you've ever thought you might have cancer, the worry and stress of having to go through extra tests is NOT a piece of cake!
2. False-negative tests:  I know many breast cancer survivors who had normal mammograms and come to find out that they had cancer that the mammogram missed.
3. Overdiagnosis:  I think many people don't realize that there are some cancers that will never cause health problems during the life of a patient. In the case where someone has a cancer, but it's not going to cause any health problems, treatment would be unnecessary. When would this happen?  Possibly it is extremely slow growing or the patient has more pressing health concerns. Cancer treatment is not a piece of cake either! You don't want to take it unless it's necessary.

The expected benefit from mammogram is that it would reduce breast cancer mortality. The data shows that mammograms under age 50 simply aren't worth the cost to America's women.  These researchers have looked at all the data (studies to date) to compare results and determine: is there reduced mortality for people getting mammograms every year starting at the age of 40, and does the amount of decrease outweigh the risks stated above.

What Does This Mean for Me and My Loved Ones?
 
Again, I'm going to remind everyone to STAY CALM! These recommendations are not saying that you can't have a mammogram before the age of 50. They are just saying that for women at average risk, it may not be necessary to screen every single woman every single year starting at age 40.

This has NOTHING to do with the decision that you make with your doctor! If you are at high risk because of a genetic condition (BRCA1 and BRCA2 positive), family history, your race (African Americans women have lower rates of breast cancer than Caucasian Americans, but higher rates of breast cancer under 40 and higher rates of aggressive breast cancer), or just because you are worried, the choice to get a mammogram is totally up to you and your doctor.

Also, it's important to remember that women should be having a clinical breast exam (done by a trained nurse or doctor) at least every 3 years starting at 20, and every year starting at age 40. Usually, women get this done at their annual GYN appointment.

You will also note the recommendation against teaching self breast exam. There has always been a lot of debate on this topic as well, and I'm going to have to leave that for another day!!

What Will Julie Do?
Well, I'm 30 at this point.  By the time I'm 40, they may have data which pushes the recommendation a totally different direction. Maybe we'll even have better screening than a mammogram, who knows. If I were 40 right now, I would probably talk with my doctor, do clinical breast exams and possibly get a baseline mammogram.

Remember that 1 in 3 women will be diagnosed with cancer in their lifetime (all types), 1 in 8 will be diagnosed with breast cancer. Mammograms do not prevent cancer, they just detect it.

You can make a difference with your everyday choices. It is estimated that 30 - 40% of cancer can be prevented if people ate healthy and exercised. So get to the farmer's market, eat your veggies and take a walk!

- Julie

For more info on the new recommendations, check out these two articles by the Susan G. Komen for a Cure Foundation. I think they are excellent reviews!

Making Sense of New Mammography Recommendations
Susan G. Komen for the Cure Recommends No Impediments to Breast Cancer Screening

I apologize up front for not finishing part two before the end of October! I feel slightly guilty about providing Breast Cancer information during Lung Cancer Awareness Month, but I'm sure that you don't mind! I will focus on Lung Cancer during my next post.

In my last post (Breast Cancer Prevention Diet) I promised the practical tips on what you can do every day to reduce your risk for breast cancer. I got these from the University of California at San Francisco's Cancer Center. They have a really great publication summarizing the research on breast cancer and food, you can find it here: http://cancer.ucsf.edu/crc/nutrition_breast.pdf

12 Things To Do EVERY DAY to reduce risk for breast cancer:

1. Eat 8 to 10 colorful fruit and vegetable servings daily

• Two to three pieces of fruit
• One cup or more of vegetables with lunch and dinner
• 8 fl oz vegetable juice

2. Consume 30 to 45 grams of fiber daily

• You will likely meet your fiber goal if you eat 8 to 10 servings of fruits and vegetables plus one serving of beans/legumes or at least two servings of whole grains daily.
  

3. Avoid processed and refined grains/flours/sugars
4.  Keep WHITE off your plate: bread, pasta, rice, cream sauces, cakes, and more.
5.  Limit meats and whole milk dairy products
6.  Include healthy fats like cold-water fish, flaxseed, walnuts, soybeans, olive oil, Avocados
7.  Eat 2 Tbsp ground flax daily
8.  Limit alcohol consumption
9.  Drink 1 to 4 cups of green tea daily
10.  Maintain serum 25 (OH)-vitamin D levels above 35 ng/mL
11.  Drink plenty of fluids, water or non-caffeinated beverages, daily to help meet fluid needs
12.  Engage in daily physical activity to help achieve and maintain a healthy weight

And, by popular demand comes a very simple AND tasty recipe for you to try! I'm not sure what to call this recipe... do you have any suggestions? Please share!

Garbanzo Bean & Green Pepper Salad

Ingredients:

• 1 can garbanzo beans
• 1 medium green (or yellow, or red) pepper
• 1 clove garlic
• 1 Tbsp balsamic vinegar
• 1 Tbsp olive oil
• Salt & Pepper to taste
• Optional: poblano or jalapeno pepper - if you like some spice!

Procedure:

1. Rinse garbanzo beans
2. Dice pepper
3. Mince garlic
4. Mix all together with vinegar, oil, salt and pepper and allow to marinate in fridge for at least 1 hour. Overnight is even better!

That's it!! And really, there are endless possibilities for how you can personalize this one.

Enjoy!
- Julie