Stomach swelling and digestive problems for instance which are common symptoms of the presence of ovarian can be easily dismissed and ignored. Stomach problems are something everyone experiences at various times in their life. Ovarian cancer afflicts more than twenty-two- thousand women annually in the U.S. If caught in the early stages this cancer is treatable as goes for many other cancers.If detected in its early stages, before it has spread from the ovaries a woman has a ninety percent chance of living for at least another five years. Unfortunately, less than twenty percent of ovarian cancer is detected in its early stage, Due to the fact that the symptoms of ovarian cancer don't involve the ovaries themselves the cancer many times can be overlooked as tests like stomach imaging can overlook the ovaries.This is not to say that every time a woman gets a stomach ache or pelvic pain she should dash off to be tested for ovarian cancer. In cases where problems are persistent though researchers have concluded that ovarian cancer should be considered. If tests have ruled out other causes than tests for ovarian cancer should be performed. Ovarian cancer is a relatively rare cancer in women, it afflicts a small part of the general population and makes up a small percentage of the cancers afflicting women in general.For the woman stricken with this form of cancer the statistics mean nothing though. So it appears from research findings that women have to take a greater part in the detection of this disease due to the nature of the symptoms and the elusive nature of this disease and with early detection so imperative in determining the survival rate of women afflicted with ovarian cancer.If tests have ruled out other causes for the symptoms than tests for ovarian cancer should be performed earlier in the diagnosis process. A womans early response to the persistent symptoms related to ovarian cancer can be the key to her survival. New research has discovered that ultrasound and the CA125 test were many times not effective in detecting ovarian cancer in its early stages even in women already at high risk for developing the disease.
Women at high risk include women with a family history of the disease and women predisposed to it due to genetic mutations that can make ovarian cancer more likely. Of the two tests the blood test has shown to be more effective in finding ovarian cancer but it can sometimes give false positive results. Statistics are not good for the early detection of the cancer so other means must be developed it seems.Experts agree that more research is needed in the area of detection of the disease as this seems to be so critical in determining the survival rate for ovarian cancer. The symptoms will always be the same though so for their part women must make themselves more aware of this cancer and its early detection. Tracking the symptoms can only be of help. Keeping an accurate record of your early symptoms and being persistent during the evaluation process can be the difference between surviving and not surviving ovarian cancer.
Lose weight. Eat healthy foods. Exercise daily. If you're like many people, you made these or similar pledges during the annual New Year's Day ritual of resolving to improve our health. Of course, resolutions are easy to start; the challenge is sustaining them. Now, during March National Nutrition Month, have you held true to your good intentions? Statistics show that, at the end of January, some 64% of resolvers are still hanging in there; six months later, that number drops to 44%. Making resolutions is the first step, but, experts say, you need a plan and a healthy dose of perseverance if you want to succeed.
* 1. Have a Realistic Eating Plan
Have an eating plan that has plenty of variety, yet is simple, interesting, and tastes good -- such as the Mediterranean-style diet with its "good carbs" from fruits, vegetables, and whole grains; healthy fats from nuts, fish, and olive and canola oils; and lean protein. According to a new study published in the journal Obesity, including protein from lean sources of pork in your diet could help you retain more lean body mass, including muscle, while losing weight. Purdue University researchers found that a reduced-calorie diet with a higher but healthy amount of protein – about 30% of total calories including 6 ounces of pork on average per day – helped overweight women preserve more lean mass while losing weight compared to women who consumed the same amount of calories but ate less protein.
* 2. Believe in Yourself
Seeing is believing; once you see you are capable of making changes in your behavior, it inspires confidence. Imagine practicing a particular behavior change two weeks out, two months out, two years out. If you can’t do it, then re-evaluate to make sure the goal is doable. Breaking down a lofty goal into smaller steps is often what is needed to gain the belief that you can do it.
* 3. Get Support Studies show that social support is critical, especially after the first few weeks when your motivation flags. Seek out someone who will be there for you long-term.
* 4. Spell Out the Details
Devise a sensible plan for how you'll shop, cook, and fit in fitness. Think through how you'll deal with cravings, but don't deprive yourself. If you give yourself permission to eat what really matters to you, it puts you in control (instead of the diet), and empowers you to make a healthy decision.
* 5. Set Mini-Goals
Maybe you want to lose 50 pounds, but you'll be more motivated to succeed if you celebrate every 10 pounds lost. Realistic resolutions are ones you can live with. Setting the bar too high can be demoralizing. People who set attainable, realistic goals are more likely to succeed, says Norcross.
* 6. Manage Your Cravings
Cravings for foods are caused by swings in your blood sugar. If you eat the right kinds of foods and snack strategically, you can eliminate cravings.
* Women who ate the higher protein diet experienced increased measures of “global pleasure” from pre- to post-study, which may be related to their increased feeling of fullness compared to the normal protein group. The overweight women in the study who increased their dietary protein, with pork as the only source of meat, also experienced greater satiety or the feeling of fullness during dieting, decreasing cravings.
Stack the deck in your favor by eliminating tempting, fattening treats from your surroundings. Instead, stock the pantry and refrigerator with plenty of healthy foods. Surround yourself with people, places, and things that will help you change your behavior. Avoid those that invite problems, like going to happy hour or eating at a buffet restaurant.
* 8. Do the Opposite
Counter-conditioning: one needs to do the opposite of the problem behavior. The opposite of sedentary behavior is an active behavior. It is not good enough to diet; instead, you need to replace the unhealthy foods with more nutritious foods.
* 9. Reward Yourself
Reward yourself all along the way for continued motivation and success. Figure out what will work for you, and reward yourself whenever you achieve a mini-goal (such as losing 10 pounds or exercising every day for a week).
* 10. Anticipate Slips, and Deal with Them Constructively
Don't let a slipup derail your resolve to improve your health. Setbacks are inevitable; it's how you respond to them that matters. Successful resolvers use slipups to help them get back on track, serving as a reminder that they need to be strong.
Perhaps because nearly one in five men in the U.S. suffer from erectile dysfunction, according to a recent study in the American Journal of Medicine. Some researchers have estimated that as many as 40% of U.S. women have low libido or inability to reach orgasm. Most quick fixes simply don't work, and some, like Spanish Fly, a supposed aphrodisiac derived from beetles that can cause kidney damage, are harmful.
But modern medicine has found ways--both proven and experimental--to improve your sex life. One place to start: old-fashioned remedies, which some say work best. Regular exercise can actually improve erectile function in most men, says Andrew McCullough, a urologist at New York University Medical Center--and we're talking jogging, not the acrobatic feats found in the back of a magazine. Not particularly athletic? Therapists say that paying attention to your feelings is as important as any pill, nose spray or cream.
"Have a really wonderful role-play with your partner, have a really great dinner out or watch a romantic movie together," says Robert Dunlap, who has researched aphrodisiacs at the Institute for Advanced Study of Human Sexuality in San Francisco. "The greatest aphrodisiac is your mind."
Hope In A BottleBut that's not stopping the $600 billion global pharmaceutical industry from trying to think up new sex drugs. Viagra, the little blue pill Pfizer launched a decade ago, brings in $1.7 billion in sales every year. Cialis, the longer-acting imitator made by Eli Lilly, rakes in another $1 billion, with several hundred million more for Levitra, from Bayer and Schering-Plough. Other remedies increase blood flow, like the penis injection Caverject, and bring in $30 million more.
A product that could improve women's sexual function might bring in even more money, if it were truly effective. So far, though, companies have been unsuccessful. Viagra failed in tests on women. Procter & Gamble tried to push a testosterone patch for female sexual dysfunction through the Food and Drug Administration (FDA) but in 2004 the agency balked, citing a lack of long-term safety data.
Now the idea of using testosterone as a sex-booster for women is being pushed by Lincolnshire, Ill.-based BioSante Pharmaceuticals, Inc. Its LibiGel is rubbed on the upper arm daily, delivering testosterone, which is thought to increase libido, to the bloodstream over time. The company just began late-stage trials, and, after discussions with the FDA, will start a big safety trial before submitting data to regulators in 2009.
Palatin Technologies, of Cranbury, N.J., is trying to get in on the game, developing a nose spray, called bremelanotide, to treat men and women with sexual dysfunction. Applied 10 to 15 minutes prior to sex, it travels through the central nervous system to increase blood flow in the penile or vaginal tissue. The company hopes to get FDA approval for men in 2009 and women around 2011. "On the female front, we've got a chance to be first to market," says CEO Carl Spana. "People wonder how many women will come in for treatment, but my gut tells me they will come in."
What Really WorksRight now, the treatment available for women with female sexual dysfunction that has been reviewed by the FDA is a handheld vacuum that can be used with a doctor's prescription to increase blood flow to the clitoris. Called Eros Therapy, it is made by NuGyn of Minnesota. Devices such as this go through fewer hurdles than drugs; the Eros device has been tested in several dozen people, compared with hundreds for a pill such as Viagra.
Joy Davidson, a Manhattan-based certified sex therapist, worries that all this technology may cause some people to ignore important cultural factors that can cause sexual dysfunction. "There are agendas here that are not health-based, they're profit-based," she says. "If you're not looking at these elements--the emotional, psychological and cultural--then giving somebody a so-called magic pill is not going to solve the problem."
Future FixesMeanwhile, drug researchers keep coming up with even more out-there approaches. For instance, a gene therapy, which seeks to fix erectile function by altering the DNA of cells in the penis, then injecting them back in to the patient. It should work for six months, according to inventor Arnold Melman, the researcher at New York's Albert Einstein College of Medicine. He has co-founded a tiny biotech, Ion Channel Innovations, to develop the product, which even he doesn't expect to reach the market before 2012. No gene therapy has ever been approved.
"People always say gene therapy doesn't work, but at one point it will," says Melman. "We think this is the one."
The bottom line; men love breasts. And today, you're going to learn about all of the wonderful things you can do with the lovely pair that you are fortunate enough to have staring you in the face.
biology of the teet
Now that you've Mastered The Vagina, it's time to become the king of the Kinky Two. But before I reveal how you should go about taunting the twins, you have to understand what makes them tick.
When it comes to boobies, all ducts lead to the nipple, which is centered in the areola. The actual breast is composed of fat and breast tissue (slap on a nipple and the fat suddenly becomes beautiful). There is no muscle in the breast; the muscle lies underneath the breast, covering the ribs (commonly referred to as pecs).
There are thousands of nerve endings in breasts so the nipples shouldn't be the only aspect that you pay attention to. On that note, it's time to begin the worshipping.
playing with the girls
Women tend to be very proud of their breasts. Not only are they showing them off more than ever before, but they want you to pay serious attention to them during foreplay and lovemaking.
Simply grabbing a breast as though it were cookie dough and chewing on the nipple is going to get you nowhere fast. That is not impressive, to say the least. Like with the lovemaking experience as a whole, taking your sweet time is wise.
As well, before you rush to the bedroom to fondle away, keep in mind that although many women love it when you fondle their breasts, some find the too soft or too rough approach annoying. Always pay attention to her reaction whenever you perform any action.
When her breasts are exposed and begging to be touched, work your magic by using your hands to lightly outline the outer part of both breasts slowly. This will serve to give her the chills... and BAM! -- her nipples will become erect, kinda like you.
Lightly work your hands over them, smoothing your palms over her nipples ever so slightly. The idea here is to tease her and let her imagination run rampant imagining what it's going to feel like when your hot tongue finally does its duty.
You're going to suck, and what to do with implants...
Give her some lip
While she's lying down and her body is at your disposal, use your lips to kiss around the outskirts of her breasts. Start kissing the outline with your moist lips slowly.
Another great thing you can do is lightly squeeze her breasts together and kiss down the middle. Make your way close to each nipple, and exhale over them so that she can feel the warmth of what's to come -- literally.
The tongue, I am convinced, was created for licking women's breasts. The beautiful mounds are designed perfectly so that a mouth can cover their tops. But there is plenty of time to get a little rougher.
For now, use the tip of your tongue to circle around the areola. Let your tongue glide over her nipples very lightly. If her body jerks or she lets a sudden moan escape from her lips, that's because she's virtually dying for you to take each nipple into your mouth, and suck and nibble away.
If her nipples are standing at erection, harden your tongue and flick it back and forth, and slowly take it into your mouth, at which point you will begin to suck and nibble simultaneously.
If her nipples are not hard, you can usually manipulate each one by sucking it and then releasing it from your mouth whilst inhaling so that it creates an icy sensation.
add some variety
Use your hands to hold her breasts while you suck on them, one at a time. You needn't squeeze or bring each nipple to your mouth. Instead, use your hands simply to cup them while you bring your mouth to one then the other (you know how jealous girls can get).
As well, don't just stick to the nipple. Lick that space between her breasts, lick right under her breasts -- don't limit yourself to the main feature. Because these areas don't get much attention, they are likely to be sensitive to the tongue.
And if you are mastered in the art of doing more than one thing at a time, then when you've already penetrated her, get into the side by side position (facing each other), suck on one nipple, and lightly pinch the other with your thumb and index finger. She'll be in orgasm heaven in no time.
What's even better is having her on top of you and placing her nipples in your mouth, one at a time. While you let the head of your penis tease her vagina, hold on to her breasts, placing each nipple into your mouth one at a time (and use the thumb and index finger pinch with the other).
Women with breast implants, just like women with natural ones, vary with the amount of sensation their breasts provide. While some say that implants have provided heightened levels of excitement, others admit to a slight loss of sensation.
But of course there are exceptions. If a woman had her procedure done via the nipple, then chances are she has lost up to 90% of the sensation in her nipples. As well, women who undergo the procedure via the armpit, under the breast, or even the navel, require anywhere up to a year to regain sensation in their mounds. So know your role.
Nevertheless, breast play should be something that's incorporated into your entire foreplay experience, so make the breast of an interesting situation and pay close attention to them. Remember, they're the closest things to her heart (at least the left one is).
CIB agents arrested three men and five women in Taipei County on Tuesday after being tipped off on the human smuggling operation late last year.
CIB said that the operation acted behind the front of a corporation named "Yiu Chia Li" in Taiwan to solicit men to engage in prostitution.
Mainland women who were told to enter into false marriages with Taiwan men in mainland China were brought into Taiwan on grounds of joining their husbands.
The highly organized operation collects a fee from the women for brokering the false marriages while paying for Taiwan men who are willing to use their names in the marriage documents.
The culprits then will operate under arrangement with hotels to locate its customers or directly send the women to the customer's residences.
The women were forced to give up all their earnings to the human smugglers who the CIB said had netted over NT$10 million over eight years.
Reports said that close to one thousand women engaged in illicit acts with Taiwan men in the operation including township councilors in the Taipei area.
On Tuesday, 40 police officers raided six locations across Taipei County and arrested five mainland women along with three men: Wang Lien-yi, Chang Chih-chang, and Wang Pao-shen.
CIB are still looking for the mastermind of the operation surnamed Tsan and his female accomplice who was in charge of communicating with hotels. CIB warned that mainland women entering into prostitution in Taiwan has become a growing problem in Taiwan and that the bureau will list human smuggling as its top priority.
Amidst the din of the celebration of International Women's Day on Thursday, sex workers in the capital yesterday opposed legalising their profession, saying it will spell disaster for the society.
"What is the need to legalise this profession? Do you wish the human body to work like a machine? Legalising it will add to more confusion and trouble for everyone including us," said Rajshri, a representative of the sex workers of the red light district of G B Road area.
"Many girls may choose to take up flesh trade and end up in these cages."
The sex workers said all they want is a better life for their children.
"All we want is that our children should be taken out from here. There needs to be some arrangement for their growth away from here," Rajshri said.
"What Women's Day? What help would be this reservation? Can you guarantee that we would do better if women rule? All we want is that the government should help us free our children from these cells," she said.
"This day is celebrated by rich women. We are not supposed to be celebrating," said Salma.
Home to more than 1,000 women from different parts of India and also some neighbouring countries, life on G B Road continued as usual on Women's Day.
"It's a daily fight. We compete with each other for customers. There are no celebrations for us," said Papiha.
"We are destined to live without any identity. We don't tell our real names to people. Leave us where we are. Help our children if you can," said another sex worker.
Harry Jackson Jr.
St. Louis Post-Dispatch
ST. LOUIS - Andrea Riggs was ready to take on the competition when she opened her personal training studio in Black Jack, Mo.
The niche for Body Beautiful was to help black women get into shape, be healthy and look good.
The competition she ran into, however, wasn't Bally or Gold's or 24 Hour Fitness. Instead, her greatest competition came from attitudes about exercise and diet from the people she wanted for her clients: black women.
"They told me they didn't want to lose weight," Riggs said, recalling her efforts to recruit clients. "It's cultural expectations and pressures. African-American women seem to say, `We want meat on our bones, and we all want to be bootylicious and appeal to African-American men.'"
People who battle health disparities in African-Americans agree with Riggs. But they admit the topic rarely is broached because of fear of political incorrectness. Still, that well-meaning sensitivity may contribute to killing people.
African-Americans aren't the only people to feel the effects of cultural impediments, but they're at the top of many lists for having bad health.
The American Obesity Association says that cultural factors related to diet, exercise and weight among African-Americans play a role in interfering with weight-loss efforts.
The association also says that 78 percent of black women are overweight, and that includes the 50.8 percent who are obese.
Providers of health care know that being overweight or obese is a path to life-threatening diseases.
The Centers for Disease Control and Prevention reports that black women suffer higher percentages of diabetes, hypertension, cardiovascular disease, cancer and premature death. And, the CDC says, when they get these diseases, they have more severe cases than white women.
Yet compared with overweight white Americans, overweight black Americans are two to three times more likely to say their weight is average - even after they've been diagnosed as overweight or obese by a doctor, according to womenshealth.gov.
"There's been less pressure for blacks to lose weight because of a cultural acceptance of higher body weight and heavier body shapes," the site reports.
Dr. Michael Railey, medical director of the St. Louis County Health Department, says that health disparities are reaching a crisis level for black women and that it's time health officials take gender into consideration for any health concerns because one size doesn't fit all.
For example, Railey says, "For black women to exercise, there needs to be a social connection. Studies tell us that black women will work out in groups, but not alone. Men are more likely to work out alone."
Also, to get black women to exercise and adopt healthful lifestyles, you must take hair and appearance into consideration, Railey says.
"If a woman spends hours in a (salon) chair and spends $60, she's out of the gym for at least two days," Railey says.
"Black women who want to build relationships with black men are still forced to try to catch a man by looking the best they possibly can," says Railey. "Until a (black) woman is in a culture where the man says, `I love you just like you are; I love your kinky hair and I select against long hair ...'"
That's not the message that's going out, he says.
"And who's going to make our black women feel beautiful but us?"
Some experts say African-American women often are unhealthy because they want to:
_Fit in with their social circle.
_Protect their hairstyles from sweat and heat.
_Eat traditional foods, many of which are unhealthful, or in unhealthful amounts.
_Appeal to men who tell them not to lose weight.
EASIER SAID THAN DONE
Lori Jones, an instructor in nutrition and dietetics with St. Louis University, agrees that cultural norms can be a route to bad health.
"There is some truth to that in our culture," says Jones, who is black. "Black women with a little more meat on them seem (attractive), and that's not a bad thing. A little bit of hips, being curvier, is appealing, and sometimes you do have men telling their girlfriends and wives not to lose weight because they like the curves, the extra softness."
Some American food traditions "date back to slavery - eating what's available rather than what's healthy," Jones says.
And food becomes a center of celebrations.
"So we value food (as something) more than just an energy source," she says. "And that's not just us. Many cultures have a historical basis for their food."
Still, traditions can be altered while not being abandoned, she says. For example, a soul food dinner could be made using a smoked turkey wing instead of a ham hock. Figure preferences aren't going to change overnight, if at all, but that doesn't mean people can't be healthy.
"We're not all meant to be the same size," Jones says. "While being overweight or obese puts you at risk for more chronic diseases, you don't have to be (vulnerable) to those diseases. You can be at higher weights and be healthy."
Meanwhile, St. Louis has many exercise programs available to black residents. Programs range from YMCAs to municipal recreation centers to small health clubs and church health ministries.
The Rev. B.T. Rice, minister of New Horizon Seventh Day Christian Church, heads health programs for the St. Louis Clergy Coalition.
He says more than 60 percent of St. Louis' 130-plus churches have health ministries. The number has been steadily rising for nearly 20 years. Also, churches are actively working with agencies such as the American Cancer Society and American Diabetes Association to promote healthier habits and screenings, he says.
Women overwhelmingly are the largest population at the activities, Rice said. Even so, the majority of participants in health programs attend only after their health is threatened.
"They've had heart attacks or they've been told they have diabetes," Rice said.
"It's not about being thin; it's about health," Riggs says. "What we're fighting are choices. We don't want to be thin; and the barriers that keep African-American women from working out, silly stuff ... our hair? Your need to save a hairdo lessens your desire to perspire and perform physical activities?
"We all want to look good, but to sacrifice your health doesn't make sense."
There’s no one big way to reduce your risk for breast cancer, but a combination of approaches could make a difference.
In recent years the statistical picture of breast cancer has brightened, thanks to early detection and advances in treatment. More tumors are being caught at an early stage; the rise in incidence of the disease has slowed; and the death rate has dropped. Nevertheless, breast cancer is still the most commonly diagnosed cancer in women and the second most likely (after lung cancer) to take their lives.
Data aside, breast cancer looms large in our health concerns because most of us know it personally. Some of us have had the disease ourselves, and others have experienced it through friends or relatives. Particularly unsettling is its seeming randomness: Nothing seems to explain why one woman develops breast cancer and another doesn’t. Granted, family history and certain gene mutations can substantially increase risk. But such factors aren’t involved in most breast cancers. Moreover, we can’t do much about them, or about many of the other risks associated with the disease, including older age (the 10-year risk of developing breast cancer jumps from 1 in 48 at age 40 to 1 in 26 at age 60), early menarche (first menstrual period), having no children (or bearing the first at a later age), and late menopause.
Researchers have found associations between certain nutritional factors and breast cancer risk, although not all associations have resulted in risk-reducing strategies. For example, the American Institute for Cancer Research has found there just isn’t enough evidence to recommend for or against many of the things that once seemed promising, such as eating more soy or taking supplements like vitamin E, vitamin C, or selenium. Researchers have found little support for the common assumption that dietary fat increases breast cancer risk, and the evidence that fruits and vegetables are protective is weaker than was once thought.
But evidence is accumulating that we can lower our risk through certain healthy lifestyle choices, such as increased exercise, and clinical studies suggest some medical strategies. Medicine had much less to offer as recently as 1996, when the best we could say was, “Unfortunately, there is little we can do to reduce our risk of breast cancer.” New information is developing all the time, but for now, here are seven factors that could affect your risk and what you can do about them:
1. Weight gain
Many studies show that weight gain is a risk factor for breast cancer after menopause. An American Cancer Society study found that women who gained 20–30 pounds during adulthood (that is, after age 18) were 40% more likely to develop breast cancer after menopause than women who gained no more than 5 pounds. The link is estrogen, which is believed to promote the development of breast cancer. Fat tissue converts precursors in the body into estrogen, keeping the hormone in circulation even when ovarian production stops at menopause.
A Nurses’ Health Study (NHS) investigation published in the July 12, 2006, Journal of the American Medical Association concluded that weight gain since age 18 or since menopause increases the risk of breast cancer in postmenopausal women, except those who are using postmenopausal hormone therapy. (In women taking hormones, the external source of hormones is much higher than what can be made by body fat, so the fat doesn’t contribute to increased risk.) The NHS researchers also found that losing 22 pounds or more after menopause decreased the risk of breast cancer.
What to do? Do all you can to avoid gaining weight as an adult, and try to enter menopause at a healthy weight. If you’re overweight, try to lose weight.
2. Activity level
Many studies have shown that women who engage in regular physical activity have a lower risk of developing breast cancer compared with women who are sedentary. You may reduce your risk by 20%–30% by getting three to four hours of weekly exercise, from moderately intense (brisk walking and yoga, for example) to vigorous (such as jogging, cross-country skiing, and aerobic dance). Exercise also reduces the risk of recurrence if you have been treated for breast cancer.
Regular exercise works in several ways. It can help you achieve and maintain a healthy body weight; it may influence circulating hormones and reduce the exposure of breast tissue to estrogen; and it can influence levels of insulin and insulin-like growth factors, which have been linked to the growth of breast cancer cells.
What to do? To reduce breast cancer risk, the American Cancer Society recommends moderate to vigorous activity for 45–60 minutes on at least five days of the week. (This is a step up from the 30 minutes of moderate activity most days of the week that’s recommended for reducing chronic disease risk in adulthood.) Formal exercise (such as walking programs, swimming laps, cardio-fitness workouts, or aerobics classes) is a good way to get a sustained workout. But you can also do housework or gardening activities — as long as you breathe as hard as you would during a brisk walk or jog.
Women who consume even a few drinks per week have an increased risk for breast cancer. It’s not known exactly why. Alcohol may raise estrogen levels, an important player in the development of breast cancer. It may interact with carcinogens or inhibit the body’s capacity to detoxify them.
Several studies, including the Nurses’ Health Study, suggest that the increased risk for breast cancer associated with alcohol occurs mostly in women who don’t get adequate amounts of the B vitamin folic acid. The same is true for colon cancer risk, which is more common among people who drink. According to Harvard School of Public Health nutrition expert Dr. Walter Willett, people who drink alcohol and get 600 micrograms (mcg) or more of folic acid every day aren’t at increased risk.
What to do? Women at average risk for breast cancer should limit their intake of alcohol to one drink per day. Women who have had breast cancer or are at increased risk for it for other reasons may want to avoid alcohol altogether. If you drink, make sure you get enough folic acid (at least 400 mcg per day), either in your multivitamin or in the form of folate in foods such as leafy greens, peas, dried beans, or enriched cereals and whole-grain products.
4. Vitamin D
There’s mounting evidence that vitamin D helps protect against several types of cancer, including breast cancer. For example, one study found that women who got plenty of vitamin D in early life — either in their diet or by spending time outdoors, where sun exposure triggers vitamin D production in the skin — had a lower risk for breast cancer. Another investigation linked high blood levels of vitamin D with a 50% reduction in risk for breast cancer. Reaching those levels requires more than the recommended intake of 400 International Units (IU) of vitamin D per day for women ages 50–70.
What to do? Experts have already begun to recommend 800–1,000 IU of vitamin D per day for adults, partly out of concern that we aren’t getting enough of the vitamin from sunlight to protect our bones and partly because of its association with reduced cancer risk. Natural food sources of vitamin D are limited, and not everyone can get the amount of sunlight needed to trigger adequate vitamin D production in the skin. The best bet is supplemental vitamin D. A standard multivitamin usually supplies 400 IU; you can get an extra 400 IU in a vitamin D supplement or in a calcium supplement containing vitamin D.
5. Medical risks
Lifetime exposure to estrogen is a risk factor for breast cancer, so there is some concern about women’s use of oral contraceptives and postmenopausal hormone therapy.
The Nurses’ Health Study found that women taking birth control pills have a slightly increased risk of breast cancer, but it falls to average within 10 years of stopping. An analysis published in the Mayo Clinic Proceedings found that premenopausal women who use birth control pills have a slightly increased risk of developing breast cancer before age 50, especially if they started taking them before having their first child.
The Women’s Health Initiative trial showed that long-term use of combined hormone therapy (estrogen and progestin, as Prempro) slightly increases breast cancer risk, although the level of risk drops back to normal five years after stopping the hormones. Estrogen therapy alone does not seem to increase the risk.
Studies have shown that women who took the drug diethylstilbestrol (DES) during pregnancy (to reduce the chances of a miscarriage) have a higher risk of developing breast cancer. Research suggests that the daughters of women who took DES are also at increased risk.
What to do? Birth control pills and hormone therapy have risks as well as benefits. Discuss them with your clinician before deciding whether to take them or for how long. If you know your mother took DES when she was pregnant with you, or if you took DES yourself, let your clinician know so you can discuss a screening schedule.
6. Breast density
Breasts are regarded as dense if they have less fat and more connective and glandular tissue. These features are more common in younger women’s breasts, but they are also found in many older women, especially those taking combined hormone therapy (estrogen and progestin). Breast density is also partly a heritable trait.
For reasons that aren’t fully understood, women with dense breasts are at increased risk for breast cancer. In fact, breast density is trumped only by age and the BRCA1 and BRCA2 gene mutations in the hierarchy of risk factors. One possibility is that dense breast tissue contains more cells and is therefore more influenced by growth factors and hormones that make cells divide.
What to do? Unfortunately, breast tumors (both cancerous and noncancerous) can be difficult to distinguish against a background of dense breast tissue on a mammogram. That’s because tumors and dense tissue appear white; fatty tissue, on the other hand, looks darker and provides a contrast to the tumors. Digital mammography has been shown to improve cancer detection in women with dense breasts, because it allows the radiologist to fine-tune images so that tiny abnormalities stand out better. Ultrasound or MRI can also help answer questions raised by a suspicious mammogram. Much more needs to be learned about breast density before official recommendations can be made. In the meantime, if you have dense breasts, talk to your clinician about screening with digital mammography.
Lifestyle choices that show possible, probable, or convincing benefits for reducing breast cancer risk
- Increasing vegetable and fruit intake
- Increasing physical activity
- Avoiding overweight
- Limiting alcohol use
- Taking folic acid supplements
In 1998, the 13,000-woman Breast Cancer Prevention Trial demonstrated that taking the anti-estrogen drug tamoxifen (Nolvadex) for five years cut the incidence of breast cancer by 49% in women at increased risk for the disease. Another prevention trial, the Study of Tamoxifen and Raloxifene (STAR), reported in 2006 that raloxifene (Evista) — already approved for preventing osteoporosis in postmenopausal women — works as well as tamoxifen in reducing the risk of invasive breast cancer. Newer drugs called aromatase inhibitors, which are approved for the treatment of breast cancer, are in trials as preventives, but results won’t be known for several years.
What to do? If you have an elevated risk for breast cancer due to family history, age, genetic mutations, or other factors, talk to your clinician about whether tamoxifen or raloxifene might be appropriate for you. Both pre- and postmenopausal women can take tamoxifen; only postmenopausal women can take raloxifene. Both drugs can have serious side effects — for example, tamoxifen increases the risk for endometrial cancer — so you’ll need to weigh the decision carefully.