Category Archives: Prevention & Early Detection

The HPV vaccine could do even more

EDITOR’S NOTE: The President’s Cancer Panel has released a report that says increasing HPV vaccination is one of the most important opportunities in cancer prevention. The report calls for re-energized efforts to promote vaccination and reach the HPV vaccines’ potential to save lives by preventing avoidable cancers in men and women. It explores underuse of HPV vaccines, identifies key barriers to increasing vaccine uptake, and provides actionable recommendations for overcoming these obstacles. To coincide with the release, here is our recent blog on the subject.

 

By Debbie Saslow, PhD

The HPV vaccines (Gardasil and Cervarix) have been recommended for girls in the US for nearly 10 years. They protect against human papillomavirus (HPV), the virus that causes most cases of cervical cancer, and Gardasil also protects against nearly all cases of genital warts. Uptake of HPV vaccination has been slow in this country, though; less than 35% of girls have gotten all 3 recommended doses.

Despite low vaccination rates, we have already seen HPV infections (related to the types of HPV targeted by the vaccines) drop by 56% in the United States. In countries that have higher vaccine rates, there are even larger drops. Indeed, data published last year suggest that higher vaccination rates could reap great benefits.… Continue reading →

Should women at high risk for breast cancer take drugs to prevent it?

By James C. Salwitz, MD

Breast cancer will kill more than 450,000 women worldwide this year, and in the United States alone, 232,000 will be newly diagnosed. Two important recent events shift the conversation from disease treatment to prevention. The most public was the stunning statement of actress Angelina Jolie that she had both her breasts removed because she carried a breast cancer gene (BRCA1). This announcement served to greatly increase awareness and discussion of choice in preventing the disease. 

Second, was the decision by the U.S. Preventative Services Task Force (USPSTF) to recommend the use of medications for prevention of breast cancer in women who are at increased risk.

Many factors influence breast cancer risk


In order to prevent breast cancer, we must first understand its causes. While we do not know all, we do understand that certain factors increase the chance of getting breast cancer. Some of these risk factors can be reduced through improved lifestyle, but not all.

Most breast cancer occurs not because of known genetic mutations, but because of a combination of risk factors. One important risk factor is increasing age, with most breast cancers occurring in women 55 years of age and older.

Some risk factors include an early age for a first period (start of menses), a late first pregnancy, and no pregnancy at all.… Continue reading →

New cancer genes: should I run to be tested?

By Mia M. Gaudet, PhD

Scientists have long cautioned that a family history of cancer increases your personal risk of cancer. Some genetic changes (mutations) that are found in only a few families but tremendously increase risk of cancer (e.g., BRCA1/2) have been known since the 1990s.  These mutations are already used by doctors to identify high risk men and women. However, there is still much of the genetic component of cancer that is unknown. Advances in genetics and technology now allow scientists to look at common changes in the genetic code to see if these changes are related to risk of cancer. 

Researchers are trying to answer these questions. Recently, an international group of cancer investigators linked 74 genetic regions to cancer. These newly identified genetic regions contain common changes in their code (called polymorphisms) that have only small effects on the risk of cancer. But when you combine many polymorphisms, that risk increases.

These new polymorphisms were found by studying the genetic make-up of more than 200,000 people. Women with and without breast cancer, women who had mutations in BRCA1 or BRCA2, women with and without ovarian cancer, and men with and without prostate cancer participated in the studies.… Continue reading →

The obesity-cancer connection, and what we can do about it

By Lewis E. Foxhall, MD

It’s almost impossible to get through the holiday season without gaining a few pounds, and for many of us that means we are even more likely to be over our ideal body weight.  Sure, we all want to look good in our clothes, but being obese is not just a condition that affects our appearance.  And in March, during National Nutrition Month, it’s a good chance to talk about it.

Weight gain happens when we take in more calories from food (energy) than we use up through our basic biological requirements and exercise. After a while, enough fat stores up and makes us obese. Our bodies are very efficient at taking in energy and storing it for times when it is hard to find, but in our modern environment this is working against us and our health.  For most of us it is easy to get as much food as we want, and most of us do not need to exert ourselves much for work or daily living activities.


Link between obesity and cancer

The problem with being overweight or obese, as measured by weight and height, is that it raises our risk of chronic diseases like diabetes and heart disease.… Continue reading →

Does Being Overweight Cause Breast Cancer?

The Relationship between Weight and Breast Cancer

By Lauren Teras, PhD

 

Breast cancer is the most common cancer among women today. More than 1 million women world-wide are diagnosed with this cancer each year, mostly in the 50 and older age group.  Breast Cancer Awareness Month highlights this international public health problem, and it is a good time to consider ways in which we can reduce our risk of this cancer.  While many factors beyond our control contribute to risk, like age and family history, we do know of a few ways we can lower the risk of breast cancer.

Worldwide obesity has more than doubled since 1980. Once considered a problem only in high income countries, being overweight and obese is now dramatically on the rise all over the world, particularly in urban areas. As of 2008, the World Health Organization estimated that 1.4 billion adults were overweight, including 300 million obese individuals.  In the year 2000, for the first time in human history, the number of adults worldwide who were overweight was greater than the number of adults who were underweight. In fact, approximately 65% of the world’s population lives in countries where being overweight and obese kills more people than being underweight.… Continue reading →

Can Removing Fallopian Tubes Prevent Cancer ?

By Debbie Saslow, PhD

 

I’ve seen a few articles recently about removing the fallopian tubes to prevent ovarian cancer, a procedure called “prophylactic bilateral salpingectomy”. And not just in women who are at high risk for ovarian cancer, which is already recommended by gynecological medical societies in the United States, but for all women who are not planning to have any more children and who are about to undergo abdominal surgery for any reason.

I can see the appeal given that many, if not most, ovarian cancers actually originate in the fallopian tubes. In fact, it is more common to find microscopic fallopian tube cancer than microscopic ovarian cancer in women with a BRCA1 or BRCA2 mutation when they have their ovaries and fallopian tubes removed. (These mutations put them at higher risk for ovarian and breast cancer.) And unfortunately we don’t yet have an accurate test to screen women for ovarian cancer, so these cancers are usually found at a late stage when they are often fatal. 

It is common for women to get their “tubes tied” (i.e. tubal ligation) as a form of permanent birth control, and we know this reduces the risk of ovarian cancer. But removing the fallopian tubes is a more invasive procedure, and the potential benefits and potential harms are largely unknown.… Continue reading →

Expert Voices blog: Cancer Vaccines — Fulfilling the Promise

By William H. Chambers, PhD

 

Vaccines are not new. In fact, there is evidence that the ancient Egyptians and Chinese used them many centuries ago.  Vaccines work by preparing your own immune system to attack invading pathogens, thus preventing disease. Vaccines have helped us make great inroads against many deadly diseases over the past 60 years, when they became used more widely.

Using vaccines against cancer is relatively new, though. Cancer researchers have been trying to make vaccines for tumors, just like others have made vaccines for measles, mumps, and tetanus. [more]


Preventive vaccines

In the case of diseases like measles, the vaccines are made to be given before the disease ever starts. They prevent the disease. And this is one approach researchers have taken with vaccines to prevent cancer.

We now know that about 20% of cancers are started because of infections, mostly from viruses. One virus that causes cancer is the human papilloma virus (HPV), which causes cervical cancer, as well as anal cancer, some head and neck cancers, and genital cancers.

Because researchers have been able to identify strains of HPV that cause the cancers, they have also now been able to develop vaccines that are highly effective in preventing these HPV infections, and thus prevent many of the cancers they cause.… Continue reading →

What we can learn from the Cancer Prevention Studies

By Alpa Patel, PhD

How often do you see someone battling cancer and wish there was something tangible you could do to make a difference?

 

During the past 50 years, more than 2 million volunteer participants have joined the American Cancer Society’s Cancer Prevention Studies and have been making a difference simply by giving a little time to fill out surveys and share information about their behaviors, lifestyle, family and personal medical history, and other information. In 1959 and 1982, adult men and women voluntarily joined the Cancer Prevention Studies I, and II, respectively. Their simple actions as study participants have helped us understand much of what we know about how cancer develops in the population.

 

Today, a new generation can do the same, by joining the Cancer Prevention Study-3 (CPS-3), the Society’s newest Cancer Prevention Study. [more]

 

Teasing out lifestyle risks

 

So, how can simply providing information about how you live help researchers understand the causes of cancer and how to prevent it?

 

Studies like CPS-3 enroll large numbers of adults who have never been diagnosed with cancer. These individuals provide information about themselves at the start of the study. Researchers “follow” study participants over time by periodically sending follow-up surveys that ask about changes in lifestyle or behaviors, and about any new health outcomes (like cancer).… Continue reading →

Mom, Dad, Let’s Talk about Colon Cancer

By Durado Brooks, MD

 

How often do you think a family conversation about cancer occurs? The truth is, not nearly often enough.

Colorectal cancer (often called simply “colon cancer”) is cancer that develops in the colon or the rectum, and it’s the third most common cancer in the U.S.  While most people diagnosed with colon cancer do not have a family history the disease, people who have this cancer in their family have a significantly higher chance of being diagnosed.  The good news is that colon cancer is one of the most preventable cancers, and this prevention can work even for people who are at high risk of the disease. [more]

Colon cancer is preventable because it usually starts as a non-cancerous growth called a polyp.  Not all polyps will progress to cancer, but for those that do the transformation usually takes a number of years.  Cancer can be prevented by finding and removing these polyps with colon cancer screening tests during this transition period.   

People who have a history of colon cancer or polyps in a close family member (parent, sibling, or child) may have twice the risk of developing the disease compared to those with no family history.  This is especially true if cancer appears in the relative before age 60.  If there are multiple family members with colon cancer, the risk may be even higher. 

Polyp detection and removal is best accomplished by regular screening – recommended to start at age 50 for people at average risk for developing colon cancer.  However, screening recommendations may be quite different for those with an affected relative.… Continue reading →

Is a Pap test necessary every year?

By Debbie Saslow, PhD

When it comes to screening for cancer, a common belief held by doctors as well as patients is “more is better.” It seems only logical that more frequent screening with the newest technologies translates to more cancers detected at the earliest possible time and, ultimately, more lives saved.

Cervical cancer is an example of why this is not necessarily so. Dating back to the late 1940s, the Pap test has been detecting not only early cervical cancers, but changes in the cervix (“pre-cancers”) that when treated or removed lead to actual prevention of cancer in addition to early detection. For decades, the majority of women in this country have scheduled their doctor appointments around their “annual Pap.”  As a result of widespread Pap testing, mortality rates dropped by 70% and the Pap test became the biggest success story for cancer screening in history.

In the late 1980s, it was discovered that cervical cancer is caused by HPV, the human papilloma virus. Studies of the natural history of HPV and cervical cancer showed that it takes, on average, 10-20 years from the time a woman is first infected with HPV until the time a cervical cancer might appear.… Continue reading →