Why does breast cancer come back? How to prevent recurrence?

Health Teknoiot - As a breast cancer survivor, you need to be wary about tracking any change that may happen in your body. Even after initial treatment is completed and tests like PET scans show no evidence of disease, there is a chance that breast cancer may return. Even women with early breast cancer often develop local recurrence within the first five years of treatment. On average, around seven to 11 percent of women with early breast cancer experience local recurrence during this time. For patients with a family history of breast cancer or BRCA1 or BRCA2 mutation, the rate is even higher.

Types of recurrence

The recurrence is usually of three types: Local, when it comes back to the same breast, regional, when it comes back in the nearby areas in the chest wall and distant recurrence, which is also called metastatic cancer, when cancer cells from the original tumor in the breast travel to other parts of the body via lymphatics or bloodstream. These may reach bones, liver, lungs, and brain.

Why does breast cancer return?

Cancer returns because some cancer cells may be still present but dormant and may not be seen on microscopy or on imaging like PET scan or mammography but become apparent with time. Some cancer cells could have already spread from the original tumor site and reached other parts of the body but lie in a state of dormancy, meaning they are able to grow and divide with certain triggers. Sometimes, many years after the initial cancer treatment, dormant cells can reawaken and give rise to new tumors in different parts of the body. These tumors may also be of a different kind compared to the original one — for example, they may have different receptors that make them more aggressive.

Usually, this happens within the first three or four years but sometimes in hormone receptor-positive cancers, it can come back even after 10 to 12 years. Rarely will it be new cancer developing in the breast rather than a recurrence of original cancer?

What are the signs and symptoms of recurrence?

It all depends upon where cancer recurs. You might not see or feel any sign of local recurrence and if you do, it will probably be a slight change in and around your breast or underarm area. More often than not, it may be a finding by the physician during a physical exam or a mammogram.

A distant recurrence will typically produce some symptoms but because many of those breast cancer symptoms are related to other health problems, it can be hard to tell if they are due to recurrence or something else, so one must discuss the symptoms with your cancer specialist, especially if they last for more than two or three weeks. Beware of the following symptoms:
1) Weight loss without trying
2) Headaches
3) Bone pains or any new or different pain that you can’t explain
4) Shortness of breath or wheezing
5) Seizures
6) Fever, chills, or a cough that won’t get better 7) Jaundice
8) Easy bruising or bleeding
9) Digestive issues like nausea, vomiting, diarrhea, loss of appetite, or trouble swallowing
10) Blood in urine or stones
11) Any lumps or areas of swelling

How can you prevent cancer from coming back?

1) First of all, follow the treatment your physician recommends to a T.
2) Eat a balanced diet, full of fruits, vegetables, and fibre.
3) Avoid too much oily and sugary food to avoid obesity.
4) Exercise on most days of the week.
5) Have a strong support system with a circle of friends and family.
6) Don’t skip follow-up care. The follow-up may not prevent cancer from coming back but can help detect it at an earlier stage than when you become symptomatic, which might be too late.

Treatment protocols

If it’s a local recurrence after a lumpectomy, most probably you would need a mastectomy. If it’s a regional recurrence, it will require the excision of the nodes or chest wall nodule. If it’s a distant recurrence, the patient will need only systemic therapy and local treatment like surgical excision will be for symptomatic care only.

Theories about the factors that may reawaken them range from exposure to stress at the cellular level, the erosion of a kind of collagen “blanket” that surrounds dormant cells, and the protective effect of the micro-environment.

Ref: Indianexpress

Which supplements are good for heart health, which are not?

Health Teknoiot - With a substantial rise in several cardio-metabolic diseases over the years, questions regarding which food supplements to take and which to avoid have become relevant, diet and nutrition being two of the most important factors in causing and preventing several long-term ailments. And it all begins with demolishing the devil called cholesterol.

Cardiometabolic diseases are a variety of common yet preventable ailments, including cardiovascular events like heart attack, stroke and metabolic disorders like diabetes, insulin resistance and non-alcoholic fatty liver disease among others. 

These present some of the most serious health challenges for the global healthcare system in the 21st century with cases rising rapidly every year. But research, technology and treatment modules have also evolved at a brisk pace over the years, making the conditions not only curable but also preventable.

Several studies have suggested that diets rich in antioxidants, minerals and vitamins lower the risk of cardiovascular diseases (CVD) and Type-2 diabetes. On the contrary, diets rich in saturated fat and sodium up the threat quotient. Micronutrients consist of various vitamins and minerals like Omega-3 and Omega-6 fatty acids, which tend to reduce the risk of CVD mortality, heart attacks and other heart diseases due to their anti-inflammatory effect while folic acid decreases the risk of strokes by lowering the blood total homocysteine (tHcy) concentrations. 

Being a key family of polyunsaturated fats, Omega-3 fats not only prevent heart diseases and strokes but also help in controlling lupus, eczema and rheumatoid arthritis while playing a major role in cancer and other conditions.

Polyphenols like curcumin, genistein and quercetin have shown health benefits for preventing cardiovascular diseases as well as reducing HbA1c (a measure of longer-term blood sugar levels) and fasting blood insulin levels. 

And although several micronutrients have various health benefits, others like vitamin C, E and selenium have a neutral effect on cardiovascular and metabolic diseases. It is also worth noting that Vitamin D reduces oxidative stress and improves cardiometabolic outcomes but still studies have been inconclusive about whether it can prevent heart disease.

In fact, Johns Hopkins researchers say that consuming too much of certain vitamins can be harmful. Too much calcium and vitamin D are associated with an increased risk of cardiovascular disease.

Nutrients like magnesium play a major role in muscle and nerve functioning. The heart is a muscle which requires a large amount of magnesium to keep the contractions and rhythms going. 

Magnesium supplements are known to boost everyday wellness along with better sleep, increased energy levels and improved mood. These also have specific health benefits like lower blood pressure, reduced risk of heart disease and improvement in migraines.

Prescription fish oils are used but they are more effective, according to Johns Hopkins researchers, for triglycerides than cholesterol. Omega-3 therapy with prescription fish oil can reduce triglycerides by 30 to 50 per cent in those with levels that are at 500 mg/dL or more, and who are at an increased risk of pancreatitis. Besides, over-the-counter fish oil supplements may contain large amounts of other unwanted saturated fats, which could increase your bad cholesterol.

But micronutrients like Beta-carotene, when taken in a supplement form, are known to raise the risk of CVD mortality. Beta-carotene is a precursor of Vitamin-A. The human body converts beta-carotene into Vitamin A when needed. Antioxidants like Beta-carotene, Vitamin C and E help in preventing the cell membrane from weakening, protecting it against rogue compounds trying to get inside. Oxidative damage can indirectly lead to diet-related chronic disease like CVD.

Also, beta-carotene is known to increase the risk of cardiometabolic diseases under certain circumstances. For example, if a person consumes higher than normal levels of beta-carotene, it becomes dangerous and can result in higher mortality. 

Also, beta-carotene is known to have a different effect on male and female patients, smokers and drinkers. Another reason could be that it runs the risk of converting into a pro-oxidant and becoming harmful for the body.

As beta-carotene supplements are also linked with an increased risk of lung cancer, especially among smokers, it is suggested that micronutrients should be taken as a whole food instead of a supplement. The human body can have several benefits when nutrients are consumed as a whole food compared to when they are isolated and put into a supplement form.

But as these studies are relatively new and done among a fixed number of people, it is important to characterise specific dosage.

Ref: Indianexpress