BRCA Testing: When Negative Results May Still Mean High Risk
Coping with Risk and Family Dynamics
Diet & Other Lifestyle Factors
by Drea Thew
Presenter: Nagi Kumar, PhD, RD, FADA, Director of Nutrition Research, Associate Professor, Department of Interdisciplinary Oncology, University of South Florida College of Medicine
Women with increased potential for hereditary breast and ovarian cancer often wonder if dietary and lifestyle choices can reduce their risk. Dr. Kumar discussed known causes of cancer in the general population, including tobacco, diet, obesity, and a sedentary lifestyle. She summarized studies that show diet influences risk. In particular, Western cultures, as in North America, where the typical diet is 45-75 percent meat, dairy and sugar, have a much higher incidence ofcancer than Africa, Asia, and other cultures where fruits, vegetables and whole grains account for 50-90 percent of the average diet.
Cancers don’t develop overnight. Their multistep evolution takes several years: from normal cells to irregular cells and eventually to cancer. Dr. Kumar described the current understanding of “carcinogenesis,” how cancer develops and disrupts the normal cycle of cell maturation, differentiation and apoptosis (programmed cell death). “Mutagenesis” occurs when genetics or external factors (smoking, sun exposure, etc.) cause cells to divide uncontrollably. Advances in molecular oncology and genetics suggest cancer may be preventable, even with a genetic predisposition. So we may have time to intervene during development and stop or reverse cellular damage. “We consume food every day. We know that nutrients can affect this process of carcinogenesis,” said Dr. Kumar.
Dr. Kumar shared good news about her research of how obesity and body fat distribution may affect breast cancer risk: fat concentrated in the upper body, usually described as “android” fat distribution or an “apple-shaped” body, was found to increase breast cancer five-fold. This was associated with a poorer prognosis among those who were diagnosed with breast cancer. Weight loss, however, had a significant positive impact. Dr. Kumar found with minimal weight reduction, even 10-15 pounds, most weight was lost in the upper body, meaning this android risk factor may be modifiable.
Dr. Kumar offered eight suggestions for women with hereditary risk for breast and ovarian cancer:
Examples of nutrients & nutrient-derived agents which may safeguard against the
carcinogenic process include:
Antioxidants
Pro-apoptotic agents
Anti-inflammatories
Many of these agents and others are being investigated in clinical intervention trials.
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