Take important steps to reduce cancer risks

Many friends expressed surprise about my diagnosis of breast cancer, as I revealed in my last column.

Perhaps when thinking of cancer, we imagine someone living an unhealthy lifestyle, a smoker or the elderly. Although some things increase your risk, most people diagnosed with cancer are not necessarily considered to be high risk for the disease.

One in eight women and one per 1,000 men are diagnosed with breast cancer. Dense breasts (as seen on mammograms) can make detecting breast cancer difficult and puts those women at a somewhat higher risk.

Early onset of periods and late menopause increase risk. Having high doses of chest radiation (such as that used to treat lymphoma) between the ages of 10 and 30 years old raises risk.

Pregnancy before the age of 30 and breast-feeding (especially for a longer period of time) decrease the risk of breast cancer.

Although having a relative with breast cancer increases your risk, only 15 percent of women with breast cancer have a first-degree relative (mother, sister or daughter) with the diagnosis.

In some families there are mutations to the BRCA1 and BRCA2 genes, which increase both breast and ovarian cancer in women and other types of cancer for men and women. Genetic testing is only recommended (after genetic counseling) for people with either a personal or strong family history of one of these cancers.

BRCA2 mutation increases breast cancer risk for men and women, and you can inherit this from either parent. Women carrying this mutation have a 60 percent lifetime risk of breast cancer compared to a 12 to 15 percent lifetime risk for other women.

Some women testing positive for BRCA mutations take medications to reduce their risk, others have more rigorous or earlier screening, and still others have a prophylactic (preventive) mastectomy and sometimes an oophorectomy (removal of ovaries).

It seems like there are many risks beyond our control, and you may be wondering what you can do. There are a number of options, and I recommend doing as many as are possible.

These recommendations may reduce the risk of breast cancer and/or improve survival:

• Maintain a healthy body weight, especially if you are much bigger around your abdomen compared to your hips. This is most important after menopause.

• Exercise. In one study from the Women’s Health Initiative, as little as 1.25 to 2.5 hours per week of brisk walking reduced women’s risk by 18 percent. Walking 10 hours a week reduced the risk a little more. Again, the biggest difference is after menopause.

• Limit your alcohol. One alcoholic drink (no matter what kind) per day for women results in a slightly higher risk of breast cancer, while two to five drinks per day increased the risk 1.5 times.

• Do not smoke, and avoid secondhand smoke.

• Avoid repeated loss of sleep. Sleep loss may increase the risk of several types of cancer.

• Talk with your health care provider about your risks and benefits before taking estrogen, progesterone, testosterone or DHEA. Hormone replacement has been associated with risk of breast cancer. Estrogen therapy alone may not increase the risk, but estrogen taken without progesterone can increase the risk of uterine cancer.

• Eat a diet high in vegetables, fruits, beans, lentils, whole grains (quinoa, buckwheat, wild or brown rice, etc.) and “healthy fats” such as olive oil, nuts, canola oil, avocados, cold-water fish and flaxseed (not flax oil by itself). Supplementing calcium and vitamin D prior to menopause may also decrease your risk.

Of course, I recommend getting your mammogram when due and performing regular self-exams. Although there has been debate about self-exams in the past year, the three women I sat with at chemotherapy (and myself) all found our own breast cancers. A cancer found earlier is easier to treat.

The recently launched “Every Woman Can” campaign in Spokane improves public awareness and availability of mammograms to people without insurance.

For most of us it is not possible to do everything perfectly. Even for those who come close, you may develop cancer anyway because the root cause of most cancers remains unknown.

However, it is worth it to do what you can to not only lower your risk, but to increase your chances of early diagnosis and survival.