Reduce Your Lifestyle and Environmental Risks of Breast Cancer

Marisa Weiss, M.D.

Director of Breast Radiation

Oncology & Breast Health

Outreach

Lankenau Medical Center

President &

FounderBreastcancer.org

Joan Ruderman, Ph. D.

Nelson Professor of Cell

Biology

Harvard Medical School

U.S. National Academy of

Sciences

A Step by Step Guide

Think Pink, Live Green A global movement on breast cancer prevention through healthy environmental and lifestyle choices. Breastcancer.org Providing the world’s leading online and mobile resource for breast health and breast cancer expert information and support.

Harvard Medical School Building the science, epidemiology and public health foundation for prevention.

Lankenau Medical Center Championing Think Pink, Live Green through Step-By-Step booklets and related prevention programs.

(EWG) uses the power of information to protect public health and the environment.

Breast cancer was UNCOMMON 50-100 years ago.

Now, it’s THE MOST common cancer in women.

2013 Estimated US Cancer Cases*

29% Breast (230,480 cases)

14% Lung & bronchus

9% Colon & rectum

6% Uterine corpus

5% Thyroid

4% Non-Hodgkinlymphoma

4% Melanoma of skin

3% Kidney & renal pelvis

3% Ovary (21,990 cases)

3% Pancreas

22% All Other Sites

And the global incidence is projected to double by 2040.

And be diagnosed in even younger women.

2010

2040

Minimize “minimax”

Maximize

Prevention is the best solution! Risk reduction is the best strategy.

• Reduce the risk of new breast cancers.

• Reduce the risk of recurrence.

• Limit progression of

metastatic disease.

• Protect the next generation.

• Spare loved ones.

To prevent breast cancer, we first need to figure out WHY breast cancer has become so common.

It’s NOT just because mammography is finding many more cancers that weren’t visible before.

It’s NOT because of family history or inherited genes.

Only 10% of breast cancers are largely due to an inherited gene.

• These genes haven’t changed

for a long, long time.

• Inherited breast cancer genes

just increase RISK.

• They do NOT cause cancer

all by themselves.

Two examples: Same genes, but different lifestyles and environments.

• Higher rate and earlier onset of

breast cancer in BRCA1/2

families since the 1940’s.

• Asian immigrants’ rate of breast

cancer increases after they move

from Asia to the U.S.

So why is the breast the favorite place for cancer to occur in women?

• Well-established lifestyle

and environmental risk

factors.

• Emerging environmental

factors that may also

increase risk.

Two immediate discoveries:

• The breast is much more

vulnerable to cancer than

any other organ.

• Modern life is particularly

dangerous for the breast.

Breasts take much longer to develop than other organs.

Why are the breasts so vulnerable?

Each phase of breast construction is extra sensitive to lifestyle & environmental factors.

• First trimester of fetal

development – 3 months

of early breast formation

• Adolescence – 10 years

of further breast development

Making an organ is a very delicate process!

• When DNA is copied to make new breast cells, it is

prone to developing new genetic mutations.

• These genetic insults can increase

the risk of breast cancer later in life.

Breast development lays down the foundation of our future breast health.

What girls eat, drink, and breathe, and the many products they use and take build breast cells and direct their daily operations.

And, even after the breasts have formed, they take much longer to mature and do their job.

Their capacity to make milk

requires a full-term pregnancy.

In contrast, other organs get

right to work and are more

likely to stay out of trouble.

Why has modern life become so dangerous for our breasts? What’s so different about 2014 vs. 1914?

Turns out 12 new realities have changed the interplay between the environments inside and outside of our bodies.

More women are living longer. That’s good news for each of us in general, but aging is a double whammy for our breasts—more damage, less repair.

New Reality #1

Puberty and breast development are starting earlier and earlier.

New Reality #2

More women postpone or never have a pregnancy. Fewer women breastfeed.

They are missing the protective effects

of pregnancy and breastfeeding

against breast cancer.

New Realities #3 and #4

More women are physically inactive, drink alcohol, still smoke, are vitamin D deficient, are stressed and sleep deprived.

New Realities #5, 6, 7, 8 and 9

Obesity has become epidemic. Two-thirds of women are overweight or obese.

New Reality #10

More adolescents and older women take prescription hormones.

Many millions use oral

contraceptives and menopausal

hormonal replacement therapy.

New Reality #11

Women and girls are exposed to an increasing number of environmental pollutants which can turn on abnormal breast cell growth.

New Reality #12

Dramatic Increase

• Over the past century,

production of synthetic

organic chemicals has

increased exponentially.

• And these chemicals are

all around us everyday.

Pesticides®

Plasticizers and surface active agents

Tar and products from petroleum and natural gas

Elastomers

Rubber processing chemicals

To

tal syn

theti

c o

rgan

ic c

hem

ical p

rod

ucti

on

, lb

s.

Some of the most common herbicides are culprits.

• Atrazine – A weed-killer heavily used

in corn farming and landscaping,

can turn-on the production of

natural estrogen.

• Roundup – A soybean herbicide,

can disrupt normal hormonal balance.

And our food is often exposed to combinations of these chemicals.

• For example, 13 different

pesticides were detected

on well-washed,

conventionally-grown

blueberries.

Source: 2007 USDA Pesticide Data Program, American Cancer Society, 2009.

Hormones are still used in the beef and dairy cattle industry to increase production and save cost.

• Prices have dropped.

• More people consume them.

Hormonally active pollutants also come from other industries

Just one example:

• PBDE (polybrominateddiphenylesthers) – flame

retardants in polyurethane foam, electronics, textiles,

poultry, meat, dust, air.

All this junk gets in the water we drink, the food we eat, the air we breathe, and the products we use. Plus they concentrate as they move up the food chain.

These new and changed realities urge us to Think Pink and Live Green.

The good news: we now have the proof:

Changing our lifestyle

and environment can

lower our risk.

But we have to re-think how we live.

• What we eat

• What we drink

• The air we breathe

• The medicines we take

• The personal products

we use

• How much sleep we get

• Where and how we live

and work

• Our weight

• Our physical activity

• Our reproductive choices

Already, we’ve identified 15 Steps you can take to Think Pink, Live Green in your everyday life, guided by the Precautionary Principle: “It’s better to be safe than sorry.”

Get to and stick to a healthy weight.

Eat small meals, eat real foods,

avoid processed foods, limit alcohol,

drink water, avoid soda and stay

physically active!

Step #1

Exercise At least 3-4 hours per week,

but 5-7 hours is better.

Step #2

Avoid or take breaks from prescription hormones.

• Or use the lowest dose for the shortest

periods of time.

• Switch to non-hormonal types of contraception,

such as the ParaGard IUD.

Step #3

Reduce alcohol consumption.

• Less is best.

• Stick to the limit 2-5 drinks per week.

Step #4

Stop smoking. Get fresh air.

• Avoid second-hand and third-hand smoke.

• Open the windows.

• Get outside.

Step #5

Avoid unnecessary radiation, particularly as an adolescent or young woman.

• Use full body and thyroid shield during dental X-rays.

• Ultrasounds are most safe, only have CT Scan if necessary.

• Only have radiation therapy if necessary as a girl or young women.

Step #6

Get enough vitamin D. • Sunshine

• vitamin D3 supplements

• and oily fish are the best sources.

Step #7

Eat mostly a plant-based diet. • Fruits, tomatoes, broccoli, kale, carrots, celery, rhubarb, cabbage.

• Fiber and whole grains, beans, nuts, seeds, ginger, garlic, chilies, cilantro, basil, mint, parsley.

• Spices; tumeric, curry, chilli powder and paprika.

Step #8

Select your food and beverages carefully.

Step #9

Look for labels that matter. • USDA organic label.

• PLU (Price Lookup Code)

• Organic code starts with

“9” and is 5 digits. In example:

94407.

Step #10

Don’t be misled by meaningless labels.

• “No hormones or antibiotics added” – these are given to the animal,

not the food.

• “Kosher” – just covers how animal is killed, and the absence of

shellfish, pork, or meat and milk together.

• “Natural, real, pure, simple, fresh, local” – these terms have no

official definition and are unregulated.

More smart choices

Meat and Poultry

• Buy organic/hormone-free beef (look for “never”).

• Avoid processed meats (bacon, salami, spam, canned ham).

• Limit beef consumption.

• Remove skin and fat.

More smart choices

Buy organic, hormone-free, nonfat dairy products.

More smart choices

Fish and sushi • Choose small, young fish

• Limit consumption of tuna and other big fish.

• Wild sources > farmed.

• Remove skin and brown meat.

More smart choices

Whole foods are safer than concentrated extracts.

For example,

OK to use tofu, soymilk, edamame.

Avoid concentrated protein soy

powders.

More smart choices

Know your packaging. More smart choices

• Buy food fresh, frozen, dried in bags or glass jars.

• Limit your use of canned goods.

• Only use plastics 1, 2, 4, and 5.

Use safe cookware, storage containers, and serving items.

More smart choices

Don’t cook in plastic. Avoid Teflon and other non-stick surfaces.

More smart choices

Drink filtered tap water.

• Use a glass or metal

water bottle.

• Limit use of plastic

bottled water.

More smart choices

Choose safe personal care products.

• Avoid hormonally active

ingredients, like estrogen,

parabens preservatives,

phthalates, and fragrances.

More smart choices

Sleep well.

• Sleep in a dark room in

a secure a quiet setting.

• Avoid or manage

interruptions

and limit caffeine and

other stimulants.

Step #11

Once you’re mature, ready, and in the right situation, consider earlier pregnancy and breastfeeding, if and when possible.

Step #12

Know your personal and family history. • Get pathology reports of past

“benign” breast biopsies.

• List all cancers and age at

diagnosis of all blood relatives

on your mother and father’s

side of your family. Share

and discuss with your doctor.

Step #13

Consider extra steps to reduce high risk.

• Genetic counseling

and genetic testing.

• Risk reducing medications

and prophylactic surgery.

Step #14

Vote!

• At the register, by choosing healthy

products.

• At the polls for environmentally

responsible laws and regulations.

Step #15

It’s going to take a movement to prevent breast cancer.

Just think how successful other campaigns have been.

Smoking and lung cancer

Sun exposure and melanoma

Pap smears and HPV infections and cervical cancer

Mothers Against Drunk Driving

“If everyone does one thing, they are likely to do two things, then three things. Then they are likely to influence friends and family, and that’s how you build a movement.”

- Laurie David

Producer of Inconvenient Truth

and Fed Up

Author: The Family Cooks

Believe in yourself. Start now and try your best. Lead by example.

Join the Movement.

Imagine a world

without breast cancer.

Imagine the life-saving

difference we can

make together!

Take Action.

• Follow Think Pink, Live Green on Breastcancer.org

• Be an ambassador

• Share this information

• Share your ideas and expertise

For more information visit Breastcancer.org Lower Your Risk section for a Step-by-Step guide. Thank You!

Thank you!