(June 3, 2009 - Insidermedicine) Dr. William Goodson, MD, discusses what lifetsyle changes might help to reduce the risk of the recurrence of breast cancer. Dr. Goodson is a Senior Clinical Research Scientist at the California Pacific Medical Center Research Institute.
At the 2008 San Antonio Breast Cancer Symposium we spoke with Dr. William Goodson, senior clinically research scientist at the California Pacific Medical Center Research Institute
What lifestyle changes will reduce the risk of recurrence of breast cancer?
Dr. Goodson: The first study I was ever involved with in dealing with breast cancer was looking at whether or not coffee caused breast lumps. Great mythology about that, makes no difference at all. Vitamin E, great mythology, makes no difference at all; matter of fact there is data now suggesting that high doses of Vitamin E may actually increase overall mortality. I've looked at this very carefully over a long time, and in my mind I've come down to three things that I think are really reliable.
The first thing is keeping your weight down. Weight gain and being overweight are two things that really work against somebody with breast cancer. The interesting thing is that inactivity and lack of exercise also works against people with breast cancer. You actually increase the risk of cancer if you are inactive. The third thing that ties into this is alcohol consumption. Every study that has ever looked at alcohol consumption and breast cancer finds that the more alcohol one consumes the more the greater the risk of breast cancer. The point where it really starts to make a difference is at about 10 - 11 grams of alcohol a day. Most people will say that "I'm not drinking more than that...", but 10 grams of alcohol a day is 12 oz of beer, 1 shot (1 oz) of hard liquor assuming 80 proof, and about 3 oz of wine. One can make an argument that there is small benefit of having some alcohol in terms of heart, cholesterol, and things like that, but you get that benefit at 4 - 5 glasses a week. You don't need to go beyond that. The point that I always tell people is that we'll make the trade off, but please don't drink more than 4 or 5 drinks of alcohol a week. So you have weight, exercise, and alcohol.
The curious thing is that they are probably all related. And the mechanism relating these three is they all have to do with how the body handles glucose, how the body handles sugars, and these are things that have to do with things as once becomes obese, inactive, or consumes a lot of alcohol, all of these things lead to higher levels of insulin in the body and here I am totally on theory and I know that. But in my mind there is enough evidence to suggest that probably what is going on is that tumor cells have what are called IGFs, insulin-like growth factors. They are called that because these factors on tumor cells respond to insulin. If you are overweight, if you are inactive, if you drink alcohol your body has more insulin in it all the time. And it you have more insulin running around those cells are stimulated. I don't think that is good for anybody.
The forth thing that I always ask patient about is I try to get some sort of assessment of how much Vitamin D they get . Certainly it is important to get adequate Vitamin D in terms of bone health. But there is also some data that is developing that suggests that adequate Vitamin D is important for apoptosis. For chemotherapy, for radiation, for most things that are being used to treat cancer apoptosis is how the body gets rid of cells that are not supposed to be there. Its a natural cell destroying mechanism that gets triggered by radiation, that gets triggered by chemotherapy, and that mechanism doesn't work as well in somebody who is deficient in Vitamin D. If you live in an area where you are fairly far north, if you wear sunscreen when you are outside and dont drink milk, and don't take a specific supplement, chances are you may in fact be Vitamin D deficient. The easiest thing to do is to get a blood test. Don't change anything, get a blood test. If you are normal then you know that whatever you are doing is okay. If you are deficient you know that you need to increase your Vitamin D intake for the rest of your like.
Dr. Goodson: If I had breast cancer and was in remission, I think the most important things to do would be to keep my weight at ideal weight as number one. Number two, exercise. And by exercise I mean the equivalent of three and a half hours of brisk walking per week. That doesn't mean walking the dog, that means really brisk exercise. I would keep my alcohol intake less than 4 or 5 glasses a week. And I personally would choose to check my Vitamin D level, and figure out whether or not I am getting adequate vitamin D or not.