Breast Cancer

As health groups across the country ramp up education and fundraising campaigns for Breast Cancer Awareness Month, traditionally observed in October, new research has surfaced on the occurrence and survival rates of the disease as it relates to environment, diet and economics.

American Cancer Society epidemiologists estimate there will be 1,437,180 new cancer cases overall and 565,650 cancer deaths in 2008. Compared with white women, African-American women are less likely to get cancer, but when they do get it, they’re more likely to die from it, the group says.

“Cancer is a multifactorial disease.  It is more than what you inherit; it is your lifestyle and environment, as well. In most cities, minorities usually live next to power lines, waste stations and other hubs of toxic spewing carcinogens,” says Tiva T. VanCleave, research coordinator at the Kidd Molecular Epidemiology Laboratory at the James Graham Brown Cancer Center in Louisville, Ky.

And indeed, a recent study of 230 Black women with newly diagnosed breast cancers, who live in predominantly Black Chicago neighborhoods, concluded that the women experience stress from dealing with situations they cannot control, from seeing crime in their neighborhood, being afraid to go out and not being able to form casual relationships with neighbors that might make them feel safe. The study was led by Sarah Gehlert, director of the Center for Interdisciplinary Health Disparities Research at the University of Chicago.

Too often, VanCleave says, Black women postpone visits to a doctor and by the time their cancer is caught, it has already metastasized or advanced to a terminal stage.  “As Black women we need to be more proactive and start engaging in a dialogue between doctors and ourselves.  We need to be better informed as to what treatment options are out there, genetic counseling, understanding what is going on with our bodies, and possible prevention,” VanCleave says.

While good nutrition is encouraged to help keep cancers at bay, new research suggests that vitamin A may further the progression of cancer. Researchers at Georgetown University Medical Center report that vitamin A, when applied to breast cancer cells, turns to genes that can push stem cells embedded in the tumor to morph into endothelial cells — the cells that cover blood vessels. These cells can then build blood vessels to link up the body’s blood supply, promoting further tumor growth.

“The use of beta carotene, the most important dietary precursor of vitamin A and the chemical that makes carrots orange, has been found to increase lung cancer progression in a large clinical trial,” says Stephen W. Byers, Ph.D., professor of oncology and cell biology at the university’s Lombardi Comprehensive Cancer Center, and author of the relevant study. “None of this means that people should avoid foods rich in vitamin A, or should refuse their vitamins. What led us to this study is that previous research on retinoids implied that they may be effective in a preventative setting, but may actually have a negative effect after tumor initiation and during progression,” he says.

The cost of treatment is also a major factor in survival rates among cancer patients. High out-of-pocket costs have led many patients to forgo certain therapies. One study found that treatment-related expenses consume 27 percent of the annual income among low-income cancer patients. An article in the August 2008 issue of Scientific American notes that, with an increasing number of cancer patients suffering economic hardship as a side effect of expensive therapy, most oncologists are finding that cost needs to be considered as part of treatment options.

Neal J. Meropol, M.D., an oncologist at Fox Chase Cancer Center in Philadelphia, worries about the social impact of pricey treatments. Considering that many patients are Medicare beneficiaries, expensive drugs are devouring federal health-care dollars, often for only minimal survival gains, he argues. “The overall goal is to make recommendations and develop tools to assist oncologists in dealing with issues of cost as they relate to quality oncology care,” he says.