Breast Cancer Awareness Month 2020

Breast Cancer Awareness Month 2020

Breast cancer 

It’s October and breast cancer awareness month. Breast cancer can be traced right back to ancient Egypt, with the earliest recorded case described on the 1600 BC Edwin Smith Papyrus. In 2020, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 48,530 new cases of non-invasive (in situ) breast cancer.

About 2,620 new cases of invasive breast cancer are expected to be diagnosed in men in 2020. A man’s lifetime risk of breast cancer is about 1 in 883.

What is cancer?

  • Cancer is a broad term for a class of diseases characterized by abnormal cells that grow and invade healthy cells in the body. Cancer begins in the cells which are the basic building blocks that makeup tissues. Sometimes, the process of cell growth goes wrong and new cells form when the body doesn’t need them and old or damaged cells do not die as they should.   
  • These cells can spread by breaking away from the original tumor and entering blood vessels or lymph vessels, which branch into tissues throughout the body. When cancer cells travel to other parts of the body and begin damaging other tissues and organs, the process is called metastasis.

What Is A Tumor? Benign vs. Malignant tumors

  • A tumor is a mass of abnormal tissue. There are two types of breast cancer tumors: those that are non-cancerous, or ‘benign’, and those that are cancerous, which are ‘malignant’.
  • Malignant tumors are cancerous and aggressive because they invade and damage surrounding tissue. When a tumor is suspected to be malignant, the doctor will perform a biopsy to determine the severity or aggressiveness of the tumor.

What Causes Breast Cancer Growth?

The cancer spreads in three important ways:

  1.  Damaged cells replicate, creating more damaged cells and tumor growth. When the cell’s DNA (the cell’s wiring) is damaged, mutated cells begin to rapidly reproduce without following the pre-wired plan.
  2. Our body’s hormones and chemicals can accelerate the growth of some tumors. Cancer cell growth is often fueled by normally healthy chemicals of the body, like estrogen, progesterone, and HER2/neu gene (a growth hormone).
  3. Lymph and blood vessels can carry cancer to other areas of the body, and lymph node examination can help pinpoint the progression of the disease. The lymph system, which is part of the immune system, is a network of lymph vessels and lymph nodes running throughout the entire body. Similar to how the blood circulatory system distributes elements throughout the body, the lymph system transports disease-fighting cells and fluids. 

What grade is breast cancer?

Cancer cells are given a grade according to how different they are to normal breast cells and how quickly they are growing.

Grade describes how different the cell is from the original

There are three grades of invasive breast cancer:

  • Grade 1 – looks most like normal breast cells and is usually slow-growing
  • Grade 2 – looks less like normal cells and is growing faster
  • Grade 3 – looks different to normal breast cells and is usually fast-growing

What are breast cancer stages?

Stages 1-4. The stages take into account: the size of cancer, whether the lymph nodes are affected, and if cancer has spread to other parts of the body. 

Most common breast cancer

Invasive ductal carcinoma (IDC), sometimes called infiltrating ductal carcinoma, is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas.

Invasive means that cancer has “invaded” or spread to the surrounding breast tissues. Ductal means that cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobules to the nipple.

Although invasive ductal carcinoma can affect women at any age, it is more common as women grow older. According to the American Cancer Society, about two-thirds of women are 55 or older when they are diagnosed with invasive breast cancer. Invasive ductal carcinoma also affects men.

Breast Cancer Breakthroughs

  • atezolizumab (Tecentriq®)
    • In March 2019, the FDA approved the first checkpoint inhibitor immunotherapy drug, an anti-PD-L1 antibody called atezolizumab (Tecentriq®), in combination with chemotherapy, for the treatment of triple-negative, metastatic breast cancer in patients whose tumors express the PD-L1 protein.
    • Triple-negative breast cancer (TNBC) accounts for about 10-15%  of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don’t have estrogen or progesterone receptors and also don’t make too much of the protein called HER2. (The cells test “negative” on all 3 tests.) These cancers tend to be more common in women younger than age 40, who are African-American, or who have a BRCA1 mutation.
    • Triple-negative breast cancer differs from other types of invasive breast cancer in that they grow and spread faster, have limited treatment options, and a worse prognosis (outcome)
  • A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it.
  • Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. An increased ovarian cancer risk is also associated with these genetic mutations.

A study found two cosmetics chemicals damage DNA of breast cells at low doses

  • A new approach to studying the effects of two common chemicals used in cosmetics and sunscreens found they can cause DNA damage in breast cells at surprisingly low concentrations, while the same dose did not harm cells without estrogen receptors.
  • The two compounds — examined in cells grown in the lab and in the mammary glands of mice were the ultraviolet filter benzophenone-3 (BP-3), also known as oxybenzone, and propylparaben (PP), an antimicrobial preservative found in cosmetics and other personal care products.

Clinical Trial: Evaluating Bioactivity in Breast Cancer Tumor Tissue After Intratumoral Administration of PVSRIPO

Researchers are conducting a pilot study to examine PVSRIPO bioactivity in tumor tissue after intratumoral administration of PVSRIPO in women with invasive breast cancer. PVSRIPO is the live attenuated, oral (Sabin) serotype 1 poliovirus vaccine containing a heterologous internal ribosomal entry site (IRES) derived from the human rhinovirus type 2 (HRV2).

The researchers hypothesize that the administration of PVSRIPO in the tumor causes inflammation, which will stimulate innate and adaptive immune activation in women with invasive breast cancer. The researchers are seeking to enroll 6 women with invasive breast cancer.

References

https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm

https://www.sciencedaily.com/releases/2020/01/200115090957.htm

Is Saturated Fat Unhealthy?

Is Saturated Fat Unhealthy?

Saturated Fat isn’t as bad as once thought

Studies are showing that there is not a link between saturated fats and a higher incidence of cardiovascular disease, type 2 diabetes, and stroke. 

It was once thought that saturated fats were leading to heart attacks, diabetes, and strokes. It’s looking more like a myth than a fact. 

Saturated fats are fats that are solid at room temperature like the fat in meats, butter, lard, etc…

https://www.healthline.com/nutrition/5-studies-on-saturated-fat#:~:text=Results%3A%20Saturated%20fat%20intake%20wasn,who%20ate%20less%20saturated%20fat.

Study 1

https://pubmed.ncbi.nlm.nih.gov/26068959/

This study includes 15 randomized controlled trials with over 59,000 participants.

Each of these studies had a control group, reduced saturated fat or replaced it with other types of fat, lasted for at least 24 months, and looked at hard endpoints, such as heart attacks or death.

Objectives: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate, polyunsaturated, or monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomized clinical trials.

Results: The study found no statistically significant effects of reducing saturated fat in regard to heart attacks, strokes, or all-cause deaths.

Although reducing saturated fat had no effects, replacing some of it with polyunsaturated fat led to a 27% lower risk of cardiovascular events (but not death, heart attacks, or strokes).

Study 2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532752/

This systematic, observational review of studies looked at the association of saturated fat and heart disease, stroke, type 2 diabetes, and death from cardiovascular disease.

The data included 73 studies, with 90,500–339,000 participants for each endpoint.

Objective: To systematically review associations between intake of saturated fat and trans unsaturated fat and all-cause mortality, cardiovascular disease and associated mortality, coronary heart disease, and associated mortality, ischemic stroke, and type 2 diabetes.

Results: Saturated fats are not associated with all-cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes. Trans fats are associated with all-cause mortality, total CHD, and CHD mortality.

People who consumed more saturated fat weren’t more likely to experience heart disease, stroke, type 2 diabetes, or death from any cause, compared with those who ate less saturated fat.

Study 3

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095759/

This systematic review assessed the effects of the amount and type of dietary fat on body weight and the risk of type 2 diabetes, cardiovascular disease, and cancer.

Participants included both people who were healthy and those with risk factors. This review included 607 studies, including randomized controlled trials, prospective cohort studies, and nested case-control studies.

Objective: To assess the effect and grade of the evidence of the amount and type of dietary fat as well as biomarkers of the quality of dietary fat on risk factors, body weight, and risk of non-communicable diseases, that is, T2DM, CVD (including CHD and stroke), and cancer.

Results: Consuming saturated fat wasn’t linked to an increased risk of heart disease or an increased risk of type 2 diabetes.

The researchers found that partially replacing saturated fat with polyunsaturated or monounsaturated fat may lower LDL (bad) cholesterol concentrations.

It also may decrease the risk of cardiovascular disease, especially in men.

However, substituting refined carbs for saturated fat may increase the risk of cardiovascular disease.

Are Fish Oil Supplements Healthy

Are Fish Oil Supplements Healthy

Are Fish Oil Supplements Healthy For us?

How food, and its component molecules, affect the body is largely a mystery. That makes the use of supplements for anything other than treating a deficiency questionable. Fish oil is the fat or oil that’s extracted from fish tissue.

Omega-3 fatty acids play important roles in brain function, normal growth and development, and inflammation. Deficiencies have been linked to a variety of health problems, including cardiovascular disease, some cancers, mood disorders, arthritis, and more. But that doesn’t mean taking high doses translates to better health and disease prevention.

Fish oil supplements have been promoted as an easy way to protect the heart, ease inflammation, improve mental health, and lengthen life. Such claims are one reason why Americans spend more than $1 billion a year on over-the-counter fish oil. 

A study on Fish oils and Prevention of Cardiovascular Disease and Cancer

Funding source: The U.S. National Institutes of Health.

A study reported in the New England Journal of Medicine found that omega-3 fatty acid supplements did nothing to reduce heart attacks, strokes, or deaths from heart disease in middle-aged men and women without any known risk factors for heart disease. 

Who: 25,871 healthy, racially diverse individuals, including 12,786 men ages 50 and older and 13,085 women ages 55 and older.

What: A daily 1-gram omega-3 prescription supplement that included a combination of two omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A 1-gram dose was chosen because it is a moderate amount that is unlikely to produce side effects. A control group took a placebo.

It’s more than likely that we need the entire fish with fats, vitamins, minerals, and supporting molecules, rather than the lone molecules of EPA and DHA. 

If you’re already taking fish oil at a recommended over-the-counter dose, and you’re doing well on it, there’s no research that says you should stop. 

If you’re not taking fish oil, try to get it from your plate first. The American Heart Association recommends two servings — that’s about 7 ounces — of fish a week. Preferably the fatty kind that’s rich in omega-3s.  

Key takeaways:

  • Omega-3 supplements likely won’t benefit people who eat at least 1.5 servings of fish per week.
  • Omega-3 supplements may benefit people with low fish consumption or those with African American heritage.

https://www.nejm.org/doi/full/10.1056/NEJMoa1811403

Drug Overdoses During COVID-19

Drug Overdoses During COVID-19

“Overdose-related cardiac arrests rose sharply during April 2020, reaching 74.1 per 100 000 EMS activations (123.4% above baseline) by May 4. Overdose-related cardiac arrests subsequently decreased but remained elevated, reaching 48.7 per 100 000 EMS activations (53.7% above baseline) by July 27. Overall, through August 1, overdose-related cardiac arrests in 2020 totaled 49.5 per 100 000 EMS activations (48.5% above baseline).”

https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html

Why the giant spike in overdoses?

The majority of US citizens are staying at home and working from home. On the side of prescribed medications, most physicians are doing facetime or zoom appointments unless it’s a serious emergency, or needs to be hands-on. Some patients are not being fully assessed and prescribed their medication. Pain and sleep medications can easily be overused or misdiagnosed.

More social isolation leading to more solitary use of drugs. Usually, drugs are seen as something done at parties or with groups but with gathering being banned it’s harder to catch overdoses. Not required to actually go into a place of employment opens and easier access to drugs.  

https://www.usnews.com/news/health-news/articles/2020-12-03/cardiac-arrests-tied-to-overdoses-have-surged-during-covid-19

Gut Microbe Disturbance Linked to Major Depressive Disorder

Gut Microbe Disturbance Linked to Major Depressive Disorder

A team of researchers from institutions in China and the U.S reports a link between human Gut microbiome disturbances and major depressive disorder. 

Brain-gut-microbiota

The gut microbiota interacts with the host via neuroimmune, neuroendocrine, and neural pathways. These pathways are components of the brain-gut-microbiota axis and preclinical evidence suggests that the microbiota can recruit this bidirectional communication system to modulate brain development, function, and behavior.

Gut bacterial microbiome has gained great attention. It has been hypothesized to play a critical role in the onset of various neuropsychiatric disorders such as Parkinson’s disease, autism, and bipolar disorder.

What is Major Depressive Disorder (MDD)?

Depression is a mood disorder that causes persistent feelings of sadness and loss of interest. MDD is clinical depression, it affects how you think, feel, and behave, which leads to a variety of emotional and physical problems. 

The gut microbiome, a vital and direct environmental contributor to central nervous system development, consists of a vast bacterial and viral community that can significantly influence host health and disease.

It is believed that depression is simply from having too much or too little of certain brain chemicals. In this new effort of research, the researchers suggest they have found evidence that links MDD symptoms with the gut microbiome. 

Fecal Transplantation Experiment

Using fecal transplantation experiments, one study has further shown that transplanting the “MDD microbiota” into germ-free mice or microbiota-depleted rats can induce depression-like behaviors in recipient animals, which clarifies a causal role of gut microbiome in MDD onset

Results

The research involved 311 Fecal samples from 156 people with MDD and 155 people that did not have the disorder. 

Each sample underwent genetic analysis (whole-genome shotgun metagenomic and untargeted metabolomic methods) to identify microbes and other material found in samples. Metagenomic analysis, gas chromatography-mass spectrometry (GC-MS)–based fecal metabolomics analysis was also performed. 

What was found: 3 bacteriophages, 47 bacterial species, and 50 fecal metabolites showing notable differences in abundance between MDD patients and healthy controls. Patients with MDD were mainly characterized by increased abundance of the genus Bacteroides and decreased abundance of the genera Blautia and Eubacterium. These multilevel omics alterations generated a characteristic MDD coexpression network.

A gene co-expression network (GCN) is an undirected graph, where each node corresponds to a gene, and a pair of nodes is connected with an edge if there is a significant co-expression relationship between them.

The team also noted that higher levels of Bacteroides in the microbiome might help to explain why so many MDD patients have heightened levels of cytokines and associated inflammation compared to the general populace. 

Currently, we diagnose MDD in patients throughout the interview process, is it possible in the future we can test the presence of certain elements in the gut microbe as a part of screening efforts to confirm the disorder.

https://advances.sciencemag.org/content/6/49/eaba8555#ref-14

https://www.sciencedirect.com/science/article/abs/pii/S0022395616301571

 

Let’s Talk About Vaccines

Let’s Talk About Vaccines

Let’s talk vaccines

Pfizer released their emergency vaccine to the public, those being first responders last week. Nurses and healthcare officials flood vaccine centers in their hospitals, how do we know? It’s all over Instagram, with nurses showing their support for the CN-19 vaccine.
Moderna has now released its vaccine with government approval to the public as part of President Trump’s operation warp speed. Both vaccines require 2 doses, Pfizer 21 days apart and Moderna 28 days apart.

Do vaccines work?

Data documenting the number of cases of disease before and after the introduction of a vaccine, however, demonstrate that vaccines are responsible for the largest drops in disease rates. Measles cases numbered anywhere from 300,000 to 800,000 a year in the United States between 1950 and 1963, when a newly licensed measles vaccine went into use. By 1965, U.S. measles cases were beginning a dramatic drop. In 1968 about 22,000 cases were reported (a drop of 97.25% from the height of 800,000 cases in just three years); by 1998, the number of cases averaged about 100 per year or less. A similar post-vaccination drop occurred with most diseases for which vaccines are available.

https://www.historyofvaccines.org/content/articles/misconceptions-about-vaccines

Flu Vaccine effectiveness:

 

Year Vaccinated Percentage effective
2004 10%
2005 21%
2006 52%
2007 37%
2008 41%
2009 56%
2010 60%
2011 47%
2012 49%
2013 52%
2014 19%
2015 48%
2016 40%
2017 38%
2018 29%
2019 45%