Do we have the full story about breast cancer Increase?

Friday 19 Oct 2012

  • A four fold increase in breast cancer puts the NHS at risk
  • Read about the main risks of developing breast cancer
  • Discover the legacy of HRT use and the risks involved to your health

Surely no-one can have missed the announcement on Tuesday about breast cancer – but in case you did, there is really bad news on the horizon.

Academics from King’s College London have announced that their research indicates a four fold increase in cases of breast cancer by 2040.

That means over 1.7 million women will be coping with the symptoms of this horrifying condition – which includes more than 1.2 million over the age of 65.

Perhaps more worrying is the fact that cancer charities are predicting that the NHS won’t be able to cope with such a demand, and therefore the levels of care offered will not be up to the standards expected.

Mike Hobday, of Macmillan Cancer Support, said, “The NHS is not going to be able to cope unless it learns new ways to provide treatment and support for women with breast cancer. The really big concern is around older people with cancer. That’s what’s going to challenge the NHS.”

I read these reports with increasing alarm, after all this is something that affects those who are nearest and dearest to us - mothers, wives and daughters.

By 2040 Lara will be 75, and my darling daughter nearly 40, and this statistic puts them both at risk – but don’t forget breast cancer is also on the rise in the male population too.

The numbers are really shocking I’m sure you will agree, however what I didn’t see in any of the reports was the reasons why this increase is being predicted.

The underlying story

The causative risks for breast cancer are fairly complex and involve genetic predisposition, environmental interactions, social factors and dietary considerations.

What is clear though is that this is a disease which is on the increase.

In the UK during 1999 there were 42,400 women newly diagnosed with the condition, which jumped to 47,700 in 2008.

This means there is currently about a one-in-eight chance of developing breast cancer for all women, which is much higher for those over the age of 65.

In some studies the research suggests that the improved detection programmes have led to this increase in diagnosis.

Which seems an odd way of looking at it.

The suggestion is that tumours are spotted long before they become symptomatic and are dealt with, however not all of these growths would have developed into a cancerous tissue.

I’m afraid that this argument doesn’t wash with me, after all who would like to play Russian Roulette with their lives? If there is an early sign of cancer then surely it is best treated then when all the research shows treatments are much more effective?

One aspect of increased risk is the exposure to raised levels of the female hormone oestrogen.

This is one area that I think needs further research, and quickly.

In the first instance we can look at diet, where the inclusion of so much poor quality fat and overloads of sugars and other carbohydrates in our food creates more body fat.

Body fat is surprisingly active, pumping out oestrogen and other hormones that affect how cells grow and divide. This source of oestrogen becomes increasingly important after the menopause when the ovaries stop producing the hormone.

So maybe one reason for this increase relates back to the rise in produced and pre-packed food rather than the use of good basic ingredients, a topic that you know I’m passionate about.

Another concern came to light in a project called ‘The Million Women Study’, conducted by several major cancer charities and the NHS through the University of Oxford.

As the name suggests, one million UK women aged over 50 completed an in depth health survey and the results helped understand the issues that confronted them.

This showed that alcohol consumption was increasing, and that this helped boost the amount of oestrogen in the blood. In fact they calculated that by drinking one extra unit of alcohol per day then the risk of breast cancer increased by ten percent.

Now both the food we eat and the alcohol we consume are completely in our control, so these are risks that we can manage.

However, what about other sources of oestrogen exposure?

Well it appears that we could be in contact with this hormone from some of the most unlikely of sources.

Another team from King’s College London in 2002 found appreciably high levels of a compound called Nonylphenol, a natural oestrogen in industrial products such as synthetic cleaners, paints, herbicides and pesticides.

Perhaps the commonest way that we are all exposed to oestrogen though is through drinking water.

Several studies have shown that the levels of the hormone are increasing within our rivers as a result of being excreted by women who take the contraceptive pill - this then passes unaffected through the purification processes in sewage works and arrives in our waterways.

Effects on fish have been widely reported, and there is growing evidence that supplies of drinking water drawn from surface sources may also be contaminated.

But are these factors enough to explain such a rapid growth in the presentations of breast cancer?

The legacy of HRT

Helping women cope with the symptoms of the menopause has been a challenge for the medical profession for many years, and hopes of a successful solution were raised in the late 1980’s with the advent of Hormone Replacement Therapy (HRT).

HRT promised to allow women to slowly adapt to the changes resulting from a cessation of their normal menstrual hormonal release and ease the troubling symptoms that resulted.

The usage of HRT rose dramatically between 1992 and 2001, with Cancer Research UK estimating that a quarter of all women aged 45-69 were using HRT, typically in the form of patches applied to the skin.

Around this time the strong association for HRT use and breast cancer was reported and usage dropped to lower levels, and is estimated to be around 2 million prescriptions per year now, having fallen from 6 million in 2001.

It has been shown that it takes about 5 years after cessation for the higher risk associated with HRT use to drop to normal levels, so the increased levels of diagnosis may be a legacy of the 2001 spike.

What is clear though is that the advice given to women about using HRT needs to be reviewed and account taken of the additional problems it may cause.

Dr Claire Knight from Cancer Research UK was recently quoted in a BBC article as saying:

“A recent comprehensive review funded by Cancer Research UK estimated that just over 3%, around 1,500 cases, of breast cancers in women a year in the UK are linked to using HRT.

"Women should still consult their GP... and discuss the benefits and harms with their doctor to decide what's right for them."

Perhaps, more importantly, there such be a wider ranging discussion and advice concerning the huge rise in detected breast cancer and how the level of risk for everyone can be reduced.

Yours, as always





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