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4:44 PMHow The Right Diet Helps Survive Breast Cancer + Free Ebook "25 amazing facts about food"
Not all cancers of the breast are the same. Some have a relatively good prognosis, and others have a very poor prognosis. For example, a tumor that is small and has not spread to the lymph nodes or other organs is less dangerous than a tumor that is larger and has already spread. (Lymph nodes are pea-sized collections of cells near the breast and other organs; they are important to immune function.) Hospital laboratories also determine whether a breast tumor has receptors for estrogen or progesterone hormones. If it does, the tumor is slightly less aggressive than a tumor lacking receptors.
These prognostic factors are not due to chance alone. Thirty years ago, Ernst Wynder of the American Health Foundation in New York observed that Japanese women are much less likely than American women to get breast cancer; in addition, when Japanese women do get the disease, they tend to survive longer. Their improved survival is independent of age, tumor size, estrogen receptor status, the extent of spread to lymph nodes, and the microscopic appearance of the cancer cells. And it is not that Japanese women have better health care, because the same pattern has been observed in Hawaii and California, where Japanese women live near other ethnic groups and have essentially the same health-care system.
Researchers have begun to look at whether diet plays a role in survival. It does. Our old enemy, fat in foods, rears its ugly head once again—the more fat in the diet, the shorter the survival time. In one Canadian research study, women with cancer were more likely to have lymph node involvement if they had a higher fat intake. This effect was found only for saturated fat and only for postmenopausal women.
Fat seems to have a measurable effect when cancer has spread to other parts of the body and little or no effect when the disease is localized. Researchers in Buffalo, New York, calculated what they believe to be the degree of risk posed by fat in the diet: For a woman with metastatic breast cancer (cancer that has already spread at the time of diagnosis), the risk of dying from the disease at any point increases 40 percent for every 1,000 grams of fat consumed monthly.
To understand what this means, compare three different diets, each of which contains 1,800 calories per day:
• On a low-fat vegetarian diet, about 10 percent of calories come from fat. This type of diet contributes about 20 grams of fat per day, or 600 grams per month.
• On a typical American diet, 35 percent of calories come from fat. This means about 70 grams of fat per day, or 2,100 grams per month.
• On a diet with more fat than average, say 50 percent of calories,
fat intake would be 100 grams per day, or 3,000 grams per month.
If the researchers’ finding holds, the typical American diet would lead to about a 60 percent higher risk of dying of breast cancer at any given point, compared to the low-fat vegetarian diet, and the high-fat diet would lead to a more than 95 percent increase in risk of dying. These figures do not mean that a woman’s risk of dying is 60 percent or 95 percent. They mean that the risk is 60 percent or 95 percent higher than it would otherwise have been, assuming the individual is comparable to those studied.
The Women’s Intervention Study (WINS) evaluated dietary fat intake breast cancer recurrence in postmenopausal women previously treated for breast cancer. A total of 2,437 women were enrolled in the study and were assigned either to a low-fat diet (20 percent energy from fat), or to a control group with no diet changes. After a 5-year follow-up, participants who had previously been treated for estrogen-receptor-negative breast cancer, and who then reduced their fat intake to 33 grams daily, had a 42 percent reduced risk in breast cancer recurrence compared with women who did not change their diets.
Women who had been previously treated for estrogen-receptor-positive breast cancer and who then changed their diets had a 15 percent reduced risk for breast cancer recurrence compared with women who did not change their diets.
Other parts of the diet play important roles. Diets high in fiber, carbohydrate, and vitamin A seem to help the prognosis, while alcohol slightly worsens it. Patients who have more estrogen receptors on their tumors—(which indicates a better prognosis)—tend to be those who had consumed more vitamin A. (Beta-carotene becomes vitamin A in the body.) For reasons that are not entirely clear, vegetables and fruits (and the vitamins they contain) help keep the cells of the body in better working order—one sign of which, for breast cells, is the presence of estrogen receptors. So vegetables and fruits are not only important in helping to prevent cancer, they also help improve survival for those who have cancer.
Higher body weight increases the risk of dying of breast cancer. Among postmenopausal women with breast cancer, slimmer women tend to have less lymph node involvement. Heavier women have more lymph node involvement, higher rates of recurrence, and poorer survival rates. Even among relatively slim women, it pays to avoid extra weight. A 2006 study from Shanghai, China, showed that women who had previously been diagnosed with breast cancer had greater survival rates if they were at the slimmer part of the normal weight range (body mass index below 23), compared with even slightly heavier women.
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