A byproduct of cholesterol that acts like estrogen explains the link between high cholesterol and breast cancer

The link between high cholesterol and breast cancer can now be explained.

It is not the cholesterol itself, but a "byproduct of cholesterol (that) functions like the hormone estrogen to fuel the growth and spread of the most common types of breast cancer," researchers at the Duke University Cancer Institute report, according to Newswise.

Estrogen is known to "feed an estimated 75 percent of all breast cancers," Newswise reports. So basically, cholesterol creates a "byproduct" that acts like estrogen and "feeds" the breast cancer, the researches concluded.

This is the first time a link between high cholesterol and breast cancer has been explained, especially in post-menopausal women, according to the study, which also suggests that changes in diet or taking statins and other medication to reduce cholesterol may offer "simple ways to reduce breast cancer risk," Newswise reports.

Although studies have shown a connection between obesity and breast cancer, as well as high cholesterol and breast cancer, the reason for these connections had not been explained, said senior author Donald McDonnell, chair of the Department of Pharmacology and Cancer Biology at Duke: “What we have now found is a molecule – not cholesterol itself, but an abundant metabolite of cholesterol, called 27HC – that mimics the hormone estrogen and can independently drive the growth of breast cancer.”

The researchers also found that the more enzyme that makes the cholesterol byproduct that is present, the more aggressive the tumor.

When test animals took anti-estrogen drugs such as tamoxifen, or when they quit receiving the cholesterol byproduct, the cancer was inhibited, according to Newswise.

Nelson said in the article that there was also a potential association between the cholesterol byproduct and the development of resistance to the anti-estrogen tamoxifen. Data also suggest the cholesterol byproduct may reduce the effectiveness of commonly used breast cancer therapies.

These findings suggest that women who have breast cancer and high cholesterol who take statins will  have increased benefit, Newswise reports, because it will decrease their resistance to commonly used breast cancer therapies.

Further research will "include clinical studies to verify the suggested potential outcomes and to determine if this cholesterol byproduct plays a role in other cancers," McDonnel said.

Markey Cancer Center at UK gets National Cancer Institute designation, opening up new treatment options for patients

The University of Kentucky annouced Friday that its Markey Cancer Center has earned a prestigious National Cancer Institute designation. With this designation, the center becomes one of 68 in the U.S., and the only one in Kentucky, with special access to clinical trials, new treatments and new drugs for patients.

Kentucky ranks first in the nation in cancer deaths per 100,000 residents, and cancer is especially problematic in Appalachia, where the overall cancer rate is 12 percent higher than in the United States.

The designation signifies national excellence in clinical care and cancer research, a UK news release said. It allows Markey patients to join specialized drug or treatment trials that are open only to NCI centers, and it also opens up funding for researchers at UK, said Michael Karpf, UK's executive vice president for health affairs.

"It's the ultimate recognition for academic cancer centers," Markey Executive Director Mark Evers said. It will help UK battle cancers that plague the state, particularly lung and colorectal cancers, Evers said in a story by Linda Blackford of the Lexington Herald-Leader. To earn the designation, the center had to pass a rigorous review that began four years ago and will be renewed every five years, says the UK release.

UK officials said the designation will boost the state and local economy through research funding, and advanced cancer research could also generate more high-tech, health care jobs in the state.  "It strengthens Markey’s reputation as a frontrunner in cancer treatment and research," the UK release said.

Health care decisions by and for Medicare patients differ widely by place; Lexington big in back surgery, low in mastectomy

All medicine involves decisions and, according to a new series of nine reports published by the Dartmouth Atlas Project, those decisions differ drastically by location for Medicare patients. In the East South Central region -- Kentucky, Tennessee, Alabama and Mississippi), the variation between how things are diagnosed and treated can change when one crosses county lines.

An example, with numbers but without explanation: The total knee replacement rate in Harlan is 3.3 per 1,000 Medicare beneficaries; in Bardstown, it's 13.8. As the report goes on to note: "If you have heart disease and live in Huntsville, Ala., you are half as likely to undergo balloon angioplasty than if you live in Hattiesburg, Miss., and twice as likely to undergo back surgery if you live in Lexington, Ky." The greatest variation in the region was seen in mastectomy, ranging from a low of 0.3 percent per 1,000 female Medicare beneficiaries in Lexington to 2.1 per 1,000 in Tupelo, Miss.

The point, researchers say, is that providers and patients need to work together to determine care. The report looked at rates for early-stage breast cancer, stable angina, low back pain, arthritis of the knee or hip, carotid artery disease, gallstones, enlarged prostate, and early-stage prostate cancer. Read the report here.

Colorful fruits and vegetables linked to lower breast cancer risk

Come to find out, pink isn't the most important color when it comes to breast cancer. According to researchers in the Journal of the National Cancer Institute, women loading up on carotenoids, the  micro-nutrients found in red, yellow and deeply colored fruits and vegetables such as carrots, sweet potatoes spinach and kale, showed lower rates of breast cancer than those who didn’t eat as many of them.

Alexandra Sifferlin at Healthland Time magazine explains that Dr. Heather Eliassen, an assistant professor of medicine at Harvard Medical School, led an analysis of data collected in various studies about the carotenoids and their effect on blood and breast cancer rates. The studies included 3,000 participants and nearly 4,000 controls. Women with carotenoid levels in the the top 20 percent of measured ranges had a 15-20 percent reduced risk of breast cancer compared to those with carotenoid levels in the lowest category. “It looks like it is a linear relationship,” says Eliassen. ”The higher you go, the [lower] your risk is."

Why carotenoids work against breast cancer isn't clear. They may metabolize into retinol, which regulates cell growth. Or they may improve cell communication and enhance immune system function. Eliassen urged caution. Other research carotenoids, in the form of beta-carotene supplements, are linked to an increased risk for lung cancer. (Read more) 

The Kentucky Fruit and Vegetable Conference will be held Jan. 7-8 at the Embassy Suites in Lexington. Deadline for preregistration is Dec. 19. The block of rooms for the conference will be held until Jan. 4. Program and registration information are available here or through John Strang at (859) 257-5685 or jstrang@uky.edu, or Tim Coolong at (859) 257-3374 or timcoolong@uky.edu.

Experimental concentrated breast cancer radiation therapy offers new options for women who live far away from treatment facilities

A study at the University of Louisville James Graham Brown Cancer Center designed to make  radiation treatment more accessible to women who face obstacles such as distance, transportation problems and time constraints is proving promising. The idea is to cut daily trips to the cancer center to once a week, says Dr. Anthony Dragon, a radiation oncologist at U of L. It also has the added benefit of cutting treatment costs by better than half.

Laura Ungar of The Courier-Journal in Louisville reports that Dragun led a previous study that found that "about a third of Kentucky women with early-stage breast cancer didn’t get recommended radiation treatments after lumpectomy surgery. Among those least likely to get radiation were rural Kentuckians, the elderly, African Americans and women in the Appalachian region of the state. Women who did not get recommended radiation were 60 percent more likely to die during the time they were studied."

Dragun told Ungar that the folks at U of L were not satisfied with just gathering those numbers, they wanted solutions to the problem. Dragun said the new experimental regimen is yielding good results, with women who get weekly radiation reporting similar levels of side effects as those getting radiation every day. Ungar notes that some outside experts say the approach does seems promising, but one critic was concerned about breast appearance results after the once-a-week treatments.

According the National Cancer Institute, more than 3,070 new cases of breast cancer were diagnosed in Kentucky in 2009 and was responsible for 614 deaths.  (Read more) 

Horses and Hope Race Day set for Nov. 18 at Churchill Downs

The Fifth Annual Horses and Hope Race Day honoring breast cancer survivors will be Sunday, Nov. 18, at Churchill Downs. Hosted by First Lady Jane Beshear and the Kentucky Cancer Program at the University of Louisville’s James Graham Brown Cancer Center, it's a day for wearing pink and meeting some local celebs and scientists. Gates open at 11:30 a.m. First post time will be at 12:40 p.m.

The mission of the Horses and Hope program is to increase breast cancer awareness, education, screening, and treatment referral among Kentucky’s horse industry workers and their families. The day's participants will get lunch and a chance to tell Louisville fashion designer Gunnar Deatherage just what you thought of his work on Season 10 of Lifetime Television's "Project Runway." Also on hand for the more important stuff will be James Graham Brown Cancer Center Ambassador Jessica Rizzo and State Rep. Joni Jenkins, sponsor of 2005's HB 7 which created the state's Breast Cancer Research and Education Trust Fund.

Cost to attend Horses and Hope Race Day is $28 for adults and $18 for children, age 12 and under, and includes admission to the Downs, parking at Gate 10, seating on Millionaires Row Four and the luncheon buffet. Tickets can be purchased from Churchill Downs online or by phone at 502-636-4400. For more information about Horses and Hope Race Day, contact the Kentucky Cancer Program at 877-326-1134 or 502-852-6318.

Breast cancer awareness: Testing urged, guidelines explained, misconceptions explored

Women with BRCA1 and BRCA2, the
genes most commonly involved in breast
cancer, have up to an 80 percent chance
of getting the disease.

October is Breast Cancer Awareness Month. Although Kentucky's breast cancer rate is slightly lower than the nationwide rate, almost 600 women die every year from breast cancer in the Commonwealth. The American Cancer Society predicts approximately 3,160 new cases of breast cancer will be diagnosed in Kentucky this year. Early detection and prompt treatment can significantly reduce suffering and death from the disease.

According to the Cabinet for Health and Family Services, all health plans serving Kentuckians must, by law, cover mammograms. Medical guidelines strongly recommend that women older than 40 have annual mammograms and women younger than 40 with a family history of breast cancer should also have regular screenings. Through local health departments, the Kentucky Women's Cancer Screening Program provides breast cancer screenings, mammograms and Pap tests to eligible women in every county. During the 2011 fiscal year, KWCSP provided breast cancer screenings to 14,212 women. Services are provided to low-income women through the Kentucky Department for Public Health. Those women must be uninsured with incomes less than 250 percent of federal poverty guidelines.  For more information about breast cancer or screening services, call your local health department.

There are many misconceptions about the risks of developing breast cancer. Genetics, of course, is a well-documented factor but lifestyle issues have gotten a lot of talk. So what's true? Wendy Chen, MD, MPH, a breast cancer expert at Dana-Farber Cancer Institute in Boston, a principal teaching affiliate of Harvard University, tackles some of the more common questions here:

1) Soy may increase the risk of breast cancer returning.
False. Chen, who was part of a study that looked at over 9,500 American and Chinese breast cancer survivors who ate soy every day, says that eating soy may be linked to a lower risk of recurrence of breast cancer.

2) Alcohol consumption can increase the risk of breast cancer.
True. Dana-Farber researchers found that women who consume one alcoholic drink a day may increase their risk for breast cancer.  Chen and her colleagues analyzed data from over 105,000 women in the Nurses’ Health Study. Those who consumed three to six glasses of wine a week were 15 percent more likely to receive a diagnosis of breast cancer. Those who drank fewer than three drinks a week had no increased risk.

3) Fertility treatments increase a woman’s risk of breast cancer.
False. According to a recent study from the National Institutes of Health, ovulation-inducing fertility treatments like Clomid and follicle stimulating hormone (FSH) do not significantly increase a woman's risk of developing breast cancer.

4) Wearing deodorant can increase the risk of breast cancer.
False. According to the National Cancer Institute, there is no conclusive research linking underarm deodorants to breast cancer.

5) The bigger the baby the bigger the risk of getting breast cancer.
Possibly true. “This is a tough one because the research is still evolving,” says Chen. "But the latest research shows that women who have larger babies have more than twice the risk of developing breast cancer than mothers who give birth to smaller infants. Researchers say that having a heavier baby may create a hormonal environment in pregnancy that could lead to the future development of breast cancer. They found that during pregnancy in women who have heavier babies, the ratio of estrogen to anti-estrogen is unusually high. The greater the level of estrogen, the higher the risk of breast cancer. However, Chen emphasizes, women who have larger babies should not panic. There is definitely a need for further research.” (Read more)

First lady didn't donate to breast cancer fund; Gov. Beshear announces collaboration to fight many cancers

Though First Lady Jane Beshear made headlines Monday when it was discovered neither she nor Gov. Steve Beshear had checked off a donation box to support breast cancer research on their state income tax returns — something the first lady has encouraged taxpayers to do — the governor announced Tuesday the formation of a foundation exclusively committed to reducing the rates of several types of cancer.

Gov. Beshear, who was treated for prostate cancer in 1994, joined members of the newly-formed Kentucky Cancer Foundation to announce their plans

to reduce lung, colon, breast and cervical cancer rates. To do so, foundation members will raise private funds and pursue grants to pay for services like mammograms, pap smears, smoking cessation programs and colon cancer screenings.

The public-private collaboration would focus first on screening 4,000 uninsured Kentuckians for colon cancer. Beshear has put $1 million for the screenings in his current budget proposal.

"Our most recent information shows more than 24,000 new cases of cancer in Kentucky each year and of those, more than 9,500 Kentuckians die from these cancers," Beshear said. "This is a real problem in our state that is affecting the lives of every family. As a cancer survivor, I know firsthand that screenings and an early diagnosis will help save our citizens from this horrible disease." (Read more)

As for the tax gaff, the Lexington Herald-Leader's Jack Brammer reports the 2010 returns show the Beshears did opt to check the box to donate at least $2 of their taxes to the Kentucky Democratic Party.

Diane L. Brumback, a Northern Kentucky breast-cancer survivor and Democrat who participated in a news conference with Beshear in January to promote the state-run Breast Cancer Research and Education Trust Fund, said Monday the first lady should stop promoting the cause "if she is not going to do as she says."

A Beshear spokeswoman underscored that the governor and first lady are very charitable. "On their 2010 tax return, you'll see they donated nearly $19,000 of their gross income — that's more than 11 percent of their before-tax income," said spokeswoman Kerri Richardson. "Not only do they donate money to many worthy causes, including those that support breast-cancer research, but they give their time and energy to promoting those charities and non-profit organizations." (Read more)

New technology at UK allows for more comprehensive breast imagery, especially for women with much dense or fatty tissue

Technology that will enable radiologists to see individual breast structures without overlapping tissues obstructing their view will begin being used at the breast care center at the University of Kentucky Markey Cancer Center. It will be the only center in the state to use the 3-D technology known as tomosynthesis.

"In addition to providing the traditional top and side images of the breasts taken during a regular mammogram, tomosynthesis also allows the technician to take multiple X-ray pictures of each breast from many angles," a UK press release said. "A computer than combines all this information into one 3-D image."

The technology is expected to be especially useful for women who have dense or fatty breast tissue. More than 50 percent of women under the age of 50 have dense tissue and more than 30 percent of women over 50 have dense tissue. (Read more)

UK expert available for interviews today on National Mammography Day

A University of Kentucky expert is available for interviews this afternoon to discuss the importance of mammograms. The opportunity is in honor of National Mammography Day, which is today.

Dr. Margaret Szabunio, associate medical director for the UK Markey Cancer Center's Comprehensive Breast Care Center and division chief of women's radiology for UK HealthCare, is available for interviews from 11:30 a.m. to 1 p.m. and 2:45 to 4:30 p.m.

National Mammography Day is part of national Breast Cancer Awareness Month. The purpose of the day is to encourage women to get or make an appointment for a mammogram, which can sometimes detect a tumor up to three years before it can be felt.

A mammogram is an X-ray of the breast tissue. For every 1,000 women screened, about 80 will be called back for more evaluation. Of those, 15 will be recommended for a biopsy, and about one third of those women will be diagnosed with breast cancer.

To set up an interview, contact Allison Perry at 859-323-2399 or allisonperry@uky.edu or Teri Timmons at 859-323-2406 or teri.timmons@uky.edu. (Read more)

Public health champion bravely fights cancer, inspires many

Dr. Rice Leach, who has championed public health in Kentucky for decades, is inspiring many by the upbeat way he is battling cancer. "He has talked about it at Lexington-Fayette County Board of Health meetings and at Rotary Club meetings. His hat of choice, a gift his son John bought at Cracker Barrel, reads 'I'm having a no hair day,'" the Lexington Herald-Leader's Mary Meehan reports.

Leach was Kentucky's commissioner for public health from 1992 to 2004. He is now commissioner of Fayette County's health department, which has undergone a tumultuous transition after the very public replacement of Dr. Melinda Rowe. "I've really admired his dedication to the job," Geoff Reed, a senior adviser to Mayor Jim Gray, told Meehan. "He's just that kind of person who shows real passion in everything he does."

Leach, 71, has lymphoma, a cancer of the lymph nodes for which he is being treated with several rounds of chemotherapy and radiation. Meehan reports how Leach drew inspiration from the example set by his daughter, Mary Leach Whitcomb, who bravely fought breast cancer until her death in 2007. "If that 37-year-old can handle that big mess, you better believe I can handle this," he said. Meehan's piece provides a good example of how to write sensitively and informatively about a difficult subject. (Read more)

Nine breast cancer programs get total of $360,000 from Komen

Nine programs in Central and Eastern Kentucky will share $360,000 for breast cancer screening, treatment, education and patient navigation.

The grants go to breast cancer-specific projects of the Lexington-Fayette County Health Department; the Kentucky Pink Connection; Central Baptist Hospital; St. Joseph Breast Center; King's Daughters Medical Center; Mountain Comprehensive Health Corp.; Our Lady of Bellefonte Hospital; Dayspring Family Health Center; and North Central Area Health Education Center. Programs chosen were determined to have the greatest impact on underserved women in a 58-county service area, the Lexington Herald-Leader reports.

The grants were awarded by the Lexington affiliate of Susan G. Komen for the Cure. Another $100,000 raised in Kentucky went to the Susan G. Komen for the Cure National Grants Program to fund research. (Read more)

Play about breast cancer set for premiere at UK April 22

A woman dealing with her faith after being diagnosed with breast cancer is the subject of a new play that will premiere at the University of Kentucky this month.

"Nevertheless: A Story of Resolve" is a story of faith, hope and perseverance. "I want to engage the audience with a meaningful story that will impact their lives," said playwright Lisa A. Brown, left. "Each of us has been affected by breast cancer. We either have a personal history with it or we know someone who has," said Brown, who works in the UK School of Journalism and Telecommunications. "Breast cancer does not discriminate based on race, economic status, political affiation or even gender."

The play will premiere April 22 and also be presented April 23, April 29 and May 1 at UK's Memorial Hall. Tickets are $20 in advance and $25 the day of the performance and are available online at www.ticketmaster.com, by phone at (859) 257-TICS or by visiting the UK Student Center Ticket Office, room 253.

The performances on April 22 and May 1 will include a question and answer session with the cast and playwright. The April 29 performance will include sign interpreters and special seating will be designated for the hearing impaired. To further raise awareness about breast cancer, a local representative of the Susan G. Komen Foundation will be at each performance to hand out information about the disease. (Read more)