Breast cancer continues to plague us relentlessly. Despite the enormous amount of research done, modern medicine still cannot save many of those unlucky enough to have this modern-day disease, although some progress has been made. Now those with Stage 1 breast cancer can hope for over 90 per cent chance of cure.
I am a proponent of holistic integrative medicine (combining the best of modern, natural and complementary medicine) and I believe the prevention and management of breast cancer can benefit much from this approach.
So what are the natural means that can help mitigate the problem? Let us explore several simple but important modifiable factors that can help make a difference.
The importance of adequate sleep
A recent study on 412 post-menopausal women with breast cancer showed that lack of sleep (six hours or less a night) is linked to more aggressive breast cancers, and higher risk of recurrence (reported in August 2012 issue of Breast Cancer Research and Treatment).
The conclusion could also be read as having adequate sleep (more than six hours) gives better prognosis.
Although this study was on postmenopausal women, it still underlines the possible important role of having adequate sleep for all women with breast cancer, and extrapolating it further, the possible impact on other cancers as well as in cancer prevention. Let us hope that studies on other cancers are also carried out.
The authors concluded that: "Effective intervention to increase duration of sleep and improve quality of sleep could be an under-appreciated avenue for reducing the risk of developing more aggressive breast cancers and recurrence."
In 2010, based on experimental and epidemiological work, the International Agency for Research on Cancer (IARC) concluded that work schedules that disturbed the circadian rhythm probably increase cancer risk.
The circadian rhythm regulates our wakefulness and sleep, controls numerous biological functions, and is disturbed in people who work at night or who have irregular working hours.
One hypothesis is that exposure to light during the night eliminates the nocturnal melatonin surge, disturbing the functioning of the biological clock genes that control cell proliferation, and/or the immune system.
Researchers in France had examined the effect of night work on the health of 3,000 women in a major study carried out between 2005 and 2008. They found that the risk of developing breast cancer was 30 per cent higher in women who had worked nights compared to women who had never worked nights.
This increased risk was particularly marked in women who had worked nights for over four years, or in women whose working rhythm was less than three nights per week, because this led to more frequent disturbances between night and day rhythms.
The risk was highest for women who had worked at night prior to their first pregnancies. This has serious implications to our nurses and other female night-shift workers.
We already know that insufficient sleep is a risk factor for obesity, diabetes and heart disease. Sleep is the time that the body rests, recovers and repairs from the day's hectic work.
Each day, the body has to ensure thousands of metabolic processes run efficiently in the many organ systems. Much work is required to keep the body alive and healthy. With our unhealthy lifestyles, unhealthy diet and unhealthy environment, the body has much more work to do to keep the system going.
For example, each cell is bombarded by over 10,000 free radicals daily. There are toxic by-products of normal metabolism, as well as external toxins (including cigarettes and prescription drugs) which the body has to cope with.
Then there are the invading viruses, bacteria and parasites which are everywhere. Imagine how busy our defence/immune system must be.
During sleep, when there is no physical activity and eating (which consume most energy and produce most toxic by-products), the body's organ systems are able to recuperate and prepare for the following day's work. The only organs that do not rest as much are the heart and lungs, which have to continue working, although at slightly slower rates.
For some of us who dream often, the brain also remains active during sleep!
Now imagine if you are chronically deprived of adequate sleep. Even if each night, your deficit is only 5 per cent in terms of total replenishment and recuperation of your defence/immune system, over months and years, the cumulative deficit will take a toll on your body.
If you understand the power of compound interest, then you will understand my warning.
I had a first-hand experience of the importance of adequate sleep about 20 years ago. I had just recovered from a bad bout of "flu" and was asked to lead the Muslim night prayers (qiyamulail). I only slept for two hours and was up preparing for, and leading the prayers from 2am onwards till morning. By 6am, I had the full-blown "flu" again.
So the next time you catch the "flu", make sure you have adequate sleep, drink plenty of water, and gets lots of tender loving care!
Maintaining normal weight
Another study reported that women who are overweight or obese with hormone receptor-positive breast cancer (which means two-thirds of all breast cancers) have a higher risk of recurrence even though they received the best available cancer treatment.
Obesity is associated with about a 30 per cent higher risk of recurrence and a nearly 50 per cent higher risk of death despite the best cancer treatments.
The authors suggest that the extra fat tissues cause hormonal changes and inflammation that induce the higher recurrence despite adequate medical therapy (reported in CANCER journal of the American Cancer Society). The study was done across the US and was supported by the US National Cancer Institute.
Those who are overweight/obese are already known to face a higher risk of hypertension, heart disease, stroke, diabetes, lung disease, joint disease, and many types of cancer (oesophagus, breast, uterine endometrium, colon, rectum, kidney, pancreas, thyroid, gallbladder, and possibly other cancer types).
However, in my opinion, the risk for cancer (and possibly other diseases too) is highly misunderstood and underestimated.
For breast cancer, the evidence now shows that obesity only increases the risk in post-menopausal women, but the offending weight gain could have started when the women were younger. Since cancer is a slow-growing phenomenon (by the time the earliest stage of cancer is detected, it has probably undergone many years of mutations and abnormal cell divisions), we only see the results of what began many years before.
Thus, although the added risk (due to obesity) is seen only after menopause (80 per cent of breast cancers occur in post-menopausal women), the prevention should start much earlier.
Women should maintain normal weight when they are young to reduce breast cancer risk, and to improve their survival should they be unlucky to get breast cancer (the risk in Malaysia is one in 19).
A study of over 3,000 women (ages between 20-98) engaged in at least 10 hours of exercise per week showed they had about 30 per cent lower risk of developing breast cancer. The benefit was strongest among postmenopausal women.
Other studies had shown that weight loss through regular exercise increases the benefit further, but weight gain can nullify some of the benefits obtained through exercise.
Physically active women who gain more than 5kg after menopause are still at a higher risk of developing breast cancer, though it is lower than for those who gain a similar amount of weight but do not exercise.
Obese women who exercise have about the same risk as normal weight women who do not exercise at all. The best is to maintain normal weight and do lots of exercise.
Red meat and high-fat diets increase the risk of hypertension, heart disease, stroke, diabetes and several types of cancers (eg colon and prostate), but the link to breast cancer has not been proven.
Several studies have shown that breast cancer is less common in countries where the typical diet is low in total fat. However, studies in the US have not shown that eating a high fat diet increases the risk, nor eating less fat reduces it.
Although the benefits of a high fruits and veggies intake have not been established for breast cancer, studies have shown that such a diet is beneficial for cancers in general, and for many other health benefits.
Thus it is still recommended that we take a nutrient-dense diet rich in fruits and veggies, and limit red meats and unhealthy fats.
A recent study found that women with early stage breast cancer who were vitamin D deficient were more likely to have recurrence, and had a poorer prognosis.
Conference on holistic healing
If you want to know more about holistic healing for breast cancer, do attend this free conference to be held on Saturday, September 15, at the Sime Darby Convention Centre KL.
Speakers include medical doctors and other experts. It is organised by Cansurvive (www.cansurvive.org.my), a non-profit organisation that provides information, guidance and compassionate support for cancer patients, their families and friends.
For info and registration, please sms your name and email address to 012-3297566 or 0178812287; or email your name and mobile phone number to firstname.lastname@example.org.