Prevention begins with recognizing the causation of chronic illness, including cancer, heart disease, diabetes and respiratory illness. There are five controllable factors related to health and disease prevention and one uncontrollable factor, which is genetics. The five controllable factors include smoking status, nutrition, stress management, exercise and sleep. The first one is easy; it has been well documented and widely publicized that smoking cigarettes causes cancer—not just lung cancer but breast cancer, cervical cancer and a variety of other carcinomas. It should be clear by now that you shouldn’t smoke and that you should avoid second-hand smoke, which has been thought by some to be more dangerous that the act of smoking.
Poor diet is a major cause of cancer due to food additives, preservatives, pesticide residue, processing and poor food choices, including high-fat foods, fried foods, processed foods and hydrogenated oils like margarine. Commercially produced meats contain hormones and antibiotics, and processed meats contain nitrates, glue, preservatives and a variety of artificial ingredients. Foods high in sugar stress the insulin-glucose system, eventually leading to glycemic resistance, a condition where the cells do not readily uptake glucose due to excessive amounts in the blood stream. This eventually leads to type II diabetes. In the short run, excess sugar is converted to glycogen in the liver and then stored as fat. Foods to avoid include hydrogenated oil, sugar, high fructose corn syrup (HFCS), wheat-processed soy, margarine (including canola), processed foods, salt, chemicals, artificial sweeteners, bread, wheat and crackers. Healthy foods to enjoy include butter, eggs, avocados, raw nuts, olive oil, coconut oil, sprouted-grain bread, sweet potatoes, rice, quinoa, fruits and vegetables. Fresh fruits and vegetables also contain cancer-fighting antioxidants such as beta carotene, vitamin C and vitamin E. Green, leafy vegetables are particularly important because of their folic acid content. Folic acid has been shown to be effective in breast cancer prevention. The chlorophyll in fresh greens also has a detoxifying effect. Fermented foods such as miso are known to have anticancer effects, as do shitake and mitake varieties of mushrooms. Meats should be whole, fresh and organic. Ground meats are problematic because of the bacteria that get inside the meat as it is ground. Cases of mad cow disease were primarily associated with ground beef.
The effects of stress on health have been well documented. Hormones secreted during the stress response increase blood pressure, heart rate and respiratory rate. Chronic stress can lead to a variety of physical diseases, including cancer, as well as mental disorders. Stress is considered by some to be the number one cause of chronic illness and heart disease. Stress management is about taking control of your life and monitoring the way you respond to causes of stress. Stress cannot be avoided, but it can be handled. An important step is finding balance in your life, which involves not letting any single aspect of life (like work or a relationship) overshadow other enjoyable aspects of being. Stress management strategies include yoga, breathing techniques, meditation, fellowship, spiritual pursuits and taking a mental time-out in the face of a stressful event. Meditation has many benefits, including stress reduction; according to the Mayo Clinic, meditation may also assist with healing. Research conducted at the University of Massachusetts Medical School showed that persons who meditated for four weeks had a pronounced shift in activity to the left frontal lobe, indicating a calmer and happier state than before meditation was practiced. Yoga is also known to reduce stress, as well as increase circulation, lower heart rate and blood pressure and provide a sense of focus and well-being.
An exercise plan should include three or more days of cardio training like jogging, cycling, swimming and brisk walking, as well as two days a week of resistance or free-weight training. Cardio work burns more calories, and resistance training burns calories longer by increasing your basal metabolic rate (BMR). It is good to mix and match your workouts. For one thing, it makes the workout more interesting and fun, and for another, your body acclimates to routine, so mixing it up can increase benefits without increasing effort.
Depending on your exercise goal, you can choose activities that provide a variety of intensity as measured by calorie burn. Forty-five minutes of running can burn up to 600 calories; the same time on the elliptical burns about 500 calories, and power yoga burns about 300 calories. Forty-five minutes of hatha yoga is not only relaxing, it burns about 125 calories, while a relaxing walk with a friend burns about 150 calories.
Adequate sleep is essential. Studies indicate getting five or fewer hours of sleep per night more than doubles your risk of heart disease. Appetite-related hormones are also balanced during sleep. Adequate sleep increases the appetite suppressant hormone called leptin, while insufficient sleep increases the appetite-stimulating hormone grehlin. The result is that imbalance of these hormones from insufficient sleep are causative factors for obesity, which increases risk of cancer, diabetes, heart disease and other chronic diseases.
An essential component of prevention is early detection. In 2009 the U.S. Preventive Services Task Force (USPSTF), a group of health experts that reviews published research and makes recommendations about preventive health care, issued revised mammogram guidelines. Those guidelines recommend that for women over 50, screening mammograms should be done every two years. A mammogram, or X-ray of the breast, is a method of detecting breast cancer tumors that cannot be felt. Mammograms are done with a special type of X-ray machine used only for mammograms that produces a picture of the breast on film. According to the National Cancer Institute (NCI), early detection of breast cancer with screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50. The NCI also reports that false-negative results miss up to 20 percent of breast cancers that are present at the time of screening. The NCI explains that the main cause of false-negative results is high breast density. Apparently breast density among women is highly variable. In fact there is a standardized classification system that is used for assessing and reporting breast density in mammography called the BIRADS (American College of Radiology Breast Imaging Reporting and Data System), which describes four different categories: entirely fat, scattered fibro glandular densities, heterogeneously dense and extremely dense. The BIRADS classifications are routinely used as a part of a radiologist’s mammographic assessment; however, most women are unaware of their breast density classification. Fatty tissue appears dark on a mammogram, making the detection of a tumor, which appears as a bright white spot, relatively easy. Dense breast tissue, on the other hand, appears white because of the fibrous tissue, making it very difficult to distinguish between the fibrous tissue and a tumor. This is the main cause of missed tumors or so-called false-negative tests.
An improvement in imaging is the digital mammogram machine, which uses compression and X-rays to image the breast, but instead of capturing the image on film as with traditional mammography, the image is captured to a computer as a digital image file. The National Cancer Institute did a study comparing film and digital mammography and concluded that digital mammography is more accurate than film at finding cancer in women less than 50 years old and women who have dense (not fatty) breast tissue. Digital mammography uses less radiation than traditional film mammography, reducing lifetime exposure to X-rays. According to new research, there is a better method than even digital mammography for detecting breast cancer in women with dense or fibrous breasts using gamma imaging. Research on gamma imaging is being led by Dr. Deborah Rhodes, a physician and researcher for the Mayo Clinic. Her research focus is the evaluation and management of women at increased risk for breast cancer. In her research on breast cancer detection she has collaborated with several physicists, including Michael O’Connor (a nuclear physicist). Their research team has begun to study a new gamma camera for breast imaging. The gamma device has the ability to detect small cancers in dense breast tissue, and thus may be better suited than mammography in screening and evaluating high-risk women. According to Dr. Rachel Brem, a professor of radiology at The George Washington University Medical Center in Washington, D.C., gamma imaging can detect cancer cells that escape the notice of mammograms and physical exams. The gamma imaging technique, which is expected to complement (not replace) mammography, is sensitive enough to pick up a mass two-ﬁfths of an inch in diameter. Gamma imaging or molecular breast imaging requires patients to be injected with a radioactive drug, but it is much more comfortable than the vise-grip mammogram and is expected to cost only slightly more. Women with fatty breasts would continue to be evaluated with traditional or digital mammography, while women with more fibrous or dense breasts and women in high-risk categories would be evaluated with the gamma technique. Dr. Rhodes recommends that all women should know their breast density and urges that they ask for their density report during routine exams. Women with dense breast tissue should seek the gamma technique where available or at least insist on digital mammography studies. In addition Rhodes recommends that premenopausal women schedule their mammogram in the first two weeks of their period when their breasts are less dense.
Prevention is obviously the first line of defense against breast cancer. Prevention can be successful when one recognizes the five controllable factors that cause disease and acts on them by willfully making lifestyle choices that enhance health and well-being while mitigating risks of cancer and other chronic illness. Early detection is equally essential as early treatment gives one the best chance of full recovery.