I am a 58-year-old woman, the daughter of parents who both died of cancer when they were in their 60s. My mother had breast cancer (which was diagnosed when she was 59) and my father skin cancer. Now that I am getting older, I worry that my genetic background may put me at a higher risk of cancer myself. Is this true, and what can I do to lower the risk if it is true? M.K., Montreal, Canada
Dr. Olga Raz, head of the clinical nutrition department at Ariel University in Samaria, responds:
Cancer is not a single disease but a whole range of different diseases, the treatment of which is different, the treatment is different, and the prognosis is different. The process of DNA damage that causes uncontrolled division of the cells can begin for various reasons, not always known and clear. It may persist for years, so that the outbreak of the disease is already a relatively late stage in a long and sometimes imperceptible process.
Among the reasons for the development of cancer, genetics play a respectable part, but there are also many other factors not related to the genes, such as environment in which one lives and even negative emotional states, especially in childhood. Like other cancers, breast cancer is not a uniform disease but occurs in different types. Women whose first-degree relatives developed breast or ovarian cancer at a young age should undergo genetic testing, but this is not the case with your mother.
Among the risk factors is age. Before menopause, the risk increases with age, and after menopause, the risk decreases. If menstruation begins at an age younger than the norm or ends at an older age, there is a higher risk of breast cancer. None of this is under a woman’s control. A woman who does not give birth to a first baby before the age of 30 is at a somewhat higher risk.
Ionizing radiation is also a factor that is under our influence. Try to avoid exposure to it from certain electronic devices.
Although nutrition plays a secondary role in the initial process of breast cancer, there is evidence that a diet high in vegetables and fruits and dietary fiber can help reduce the risk. Physical activity is a protective factor of all ages, especially under the age of 65. Weight loss reduces risk both before and after menopause; obesity is considered a significant risk factor, especially after menopause.
More importantly, there is a link between obesity and breast and other cancers. Obesity after menopause increases the risk by up to two times. This has not been proven in pre-menopausal women, but more studies are needed.
Drinking alcohol excessively is associated with increased risk for malignancies of the breast and other organs.
Eating food rich in animal fat (saturated fat) and trans-fat is still considered a risk factor, although there are few studies that show lack of context. If you consider that inflammatory conditions may be a cause of breast cancer, and animal fat is known to increase inflammation, it is wise to avoid overeating foods with high saturated fat (meat of any kind, sausages and the like.
Increased consumption of sugars increases inflammation and also increases weight. Consumption of soy products and coffee drinking has not shown an increase in risk.
It is believed that the factors associated with difficult experiences, especially in childhood – such as abandonment – are associated with an increased risk of developing breast cancer at an older age, but this too is not under our control.
An excellent example of the environmental impact of breast cancer is Japanese women who moved to Hawaii. The incidence of breast cancer among them has risen to the level of Hawaii residents within one or two generations. This change is explained by a change in lifestyle, including nutrition, which characterizes the local population and is more similar to American lifestyle.
In principle, it is important to eat healthful; food, with lots of vegetables, olive oil and complex carbohydrates that contain fiber and also to maintain a normal weight.
As for skin cancer, from which your father suffered, it is vital to avoid exposure to the sun during the day’s most intensive hours of solar radiation, wear broad-brimmed hats, protect your skin with long sleeves and sunscreen creams and get your skin checked periodically for changes. As you live in Montreal, much of the year it is cold, cloudy, rainy and snowy, so your risk is lower.
Cancer is usually discovered quite a long time after the process begins in the body. The reasons for this are unclear, although the inflammatory situation and a decrease in immune response in the body seem to have an important role.
I am a 75-year-old woman. My MRIs show extensive disc degenerative disease especially lower back. I receive radiofrequency ablation injections every six months, but they no longer are effective. The cartilage in my left shoulder is practically nonexistent so I receive Effexor injections, which also do not help alleviate the pain. I am not able to sleep much, as the pain is constant. Ibuprofen helps only a little. I do not wish to take anything stronger. I am active, do medical missions, have a full-time job and take classes online from Israel. What options are possible? I am willing to travel to Israel or anywhere to relieve the pain and be able to function more freely. Dr. M.S., by email.
Prof. Meir Liebergall, chairman of the orthopedic surgery complex at Hadassah University Medical Center in Jerusalem, answers:
There is nothing rare about this problem and thus no reason to come to Israel because of it. Apparently, you suffer from a wasting away of cartilage and problems in the joints. You should go for competent medical advice from an orthopedist and pain specialist and carry it out. One must understand what is the main cause of your suffering and what is the therapeutic direction for dealing with the symptoms. You may need different medications or perhaps surgery. A medical specialist who has time to listen to you can help you cope with this common problem. I cannot do it via email.
If you want an Israeli expert to answer your medical questions, write to Breaking Israel News health and science senior reporter Judy Siegel-Itzkovich at firstname.lastname@example.org with your initials, age, gender and place of residence and details of the medical condition, if any.