ENCORE #30 – “HOLD ON THERE BABA LOUIE!” – Exercise “reduces cytokines in adipose tissue” might be PURE HYPE!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in May of 2012…

Doctors harp on exercise.

Despite the harping – or in my case, perversely because of it – I avoid exercise like the plague.

Even so, as I read more and more sites promoting the “exercise makes you better if you have breast cancer” meme, I found that almost none of them give any kind of evidence as to WHY exercise fights cancer and promotes healing.

So I dug into the sites and finally found some evidence supporting this wild, “Do this one weird thing…” kind of meme. This week, it’s number:

1. Increased levels of pro-inflammatory factors and decreased levels of anti-inflammatory factors have been linked with increased cancer risk. Physical activity might reduce systemic inflammation alone or in combination with reduction in body weight or composition through reducing inflammatory cytokines in adipose tissue.
   
   

What are pro and anti-inflammatory factors?

 

Let’s start with CYTOKINES and let me warn you, even researchers are a bit fuzzy about these molecules, which explains the “might” in the paragraph above. We’ll take this subject as a “details at 11” kind of thing – it’s changing every day, but TODAY and to the best of our knowledge, we can say that we’re pretty sure that cytokines are small molecules that are given off by numerous cells and are used to communicate with each other. Cytokines are a large and diverse family of molecules with many jobs. One thing we are pretty sure they do to control the immune system – that collection of white blood cells and chemicals that spring to work when you’re hurt or sick and the body has to fight off an infection. The line between cytokines and hormones is also pretty blurry but PROBABLY, cytokines come from lots of places and there are only set amounts in the blood – though that amount can leap up during trauma or infection. Hormone levels are steady. Many cells produce cytokines. Most hormones come from specific glands (adrenal, pancreas, etc). Also, while usually specific, some cytokines act like hormones to have an effect on the entire body. Last of all, some cytokines act outside the immune system and affect the development of the human body.

As to breast cancer, at least one cytokine affects both the presence of and severity of breast cancer: “In a study published in the January 15th issue of Cancer Research…researchers showed that activation of the CXCR4 [cytokine] receptors [on the cancer cells] resulted in increased tumor growth and metastasis…and less dependent on estrogen for continued growth…to become metastatic and resistant to endocrine therapy…[in] A second study published in the current issue of Surgery…authors reported that all benign breast tissues had no detectable CXCR4 levels, whereas all 101 breast cancer patients showed at least some level of this cytokine receptor.  Of these breast cancer patients, 79 had low levels of CXCR4 and 22 had high levels of CXCR4.  These high CXCR4 levels were linked with increased breast cancer recurrence and worse chances of survival…overexpression of CXCR4 cytokine receptors is linked to worse breast cancer outcomes…blocking this pathway might become a valuable breast cancer treatment for patients overexpressing this cytokine receptor.”

 

The big “might” up above has given breast cancer, cytokines and exercise a high level of interest. The third reference below cites a study that, as of my referencing of it, was still recruiting participants.

So – I’m going to label THIS particular aspect of exercise and breast cancer as a big MAYBE, LET’S WAIT AND SEE. So don’t go spreading the word that exercise reduces cytokines and decreases breast cancer.

Nobody knows enough yet to say one way or the other.

Resources: http://en.wikipedia.org/wiki/Cytokine, http://breastcancerfightnowbydraarontabor.blogspot.com/2011/01/cytokine-receptor-cxcr4-worsens-breast.html, http://clinicaltrials.gov/ct2/show/NCT00851812

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT #21: Gilda’s Club

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

I had never heard of Gilda’s Club until a month or so ago.

Then  my daughter interviewed there for a position as a sort of “field test” or “pre-internship” in her master’s degree program in art therapy.

According to Wikipedia, “Gilda's Club was founded by Joanna Bull, Radner's cancer psychotherapist along with Radner's widower, Gene Wilder (himself a cancer survivor) and broadcaster Joel Siegel (who died after a long battle with the disease). The first club opened in New York City in 1995, after a long fundraising campaign that included movie trailers featuring Wilder in theaters around the country. The organization took its former name from Radner's comment that cancer gave her "membership to an elite club I'd rather not belong to".”

My first reaction was, “WHERE THE F…WAS THIS PLACE WHEN WE STARTED THE HIDEOUS JOURNEY THROUGH CANCER?”

Yeah, my reaction, in my head, really WAS that strong.

The main reason we didn’t know about it was that it wasn’t here. Gilda’s Club opened here in 2014. We started our journey in March of 2011. We’ll be “celebrating” the fifth anniversary of that date this year.

I confess, I still have bitter (VERY) feelings about the lack of support we got at the beginning. My daughter shared something of the same sense after she started working at Gilda’s Club a few weeks ago. In fact, she mentioned that this experience AS a therapist intern might actually BECOME therapeutic for her. When I was on the GC page, I happened to see this:

Current Social Opportunities Offerings are:

•Coloring Club

•Knits Wits

•Euro Cafe Social

•Greet & Eat: Male Caregivers Cooking for Guys Who Can’t Cook – w/ Jack’s Caregiver Coalition

•Open Circle Choir Performance

I confess I teared up. What I would have given to have discovered this group five years ago...it wasn’t there for me, and so I created this blog.

It’s still been a lonely slog. I KNOW I have nearly 30,000 hits here over the past five years, yet I still don’t talk to any other “male caregiver” about the journey. Even though one of the men I work with and chat with on occasion is also a “male caregiver”. The atmosphere at work isn’t conducive to talking at depth.

And so I continue on pretty much in silence, except for these blog entries.

Anyway, it’s GOOD to know that others won’t have to go it alone anymore. Gilda’s Club has twenty-something affiliates in places like New York, Chicago, Seattle, Palm Desert, Fort Lauderdale, Davenport, and besides here, another fifteen or so places. If you want a place near you, click on the link below in Resources. If you’re in the Twin Cities, email me and I can give you a little bit of info.

I’d like to try going to GC, but I still haven’t decided if I want to wallow in my bitterness a little longer or maybe find other men willing to talk about being a caregiver of a breast cancer survivor. I’ll keep you posted.

Resources: http://www.cancersupportcommunity.org/,

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #29! – NORMAL LIFE Exercise Reduces Insulin Resistance!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in May of 2012…

Doctors harp on exercise.

Despite the harping – or in my case, perversely because of it – I avoid exercise like the plague.

Even so, as I read more and more sites promoting the “exercise makes you better if you have breast cancer” meme, I found that almost none of them give any kind of evidence as to WHY exercise fights cancer and promotes healing.

So I dug into the sites and finally found some evidence supporting this wild, “Do this one weird thing…” kind of meme. This week, it’s number:

1. Insulin resistance, hyperinsulinaemia, hyperglycaemia and type 2 diabetes have been linked to increased risk of breast, colon, pancreas and endometrial cancers. Physical activity decreases insulin resistance, reduces hyperinsulinaemia and reduces risk for diabetes, which could explain the link between increased physical activity and reduced risk for these cancers. I talked about the connection between insulin and breast cancer earlier (http://breastcancerreaper.blogspot.com/2012/03/exercise-reduces-estrogen-in-blood-and.html), so I’ll talk more about EXERCISE here.
   But before I go on, I’d like to say something about “non-exercise exercise”. My wife and hero works with kindergartners all day long: teaching reading, going out to recess, going to lunch, chasing down stragglers and generally corralling the little munchkins so much that she comes home with aching feet.
   My question has always been: at what point does what I DO in everyday life become exercise?
   There are advocates of daily exercise that explain: “We don't expend energy doing anything. We've actually engineered regular daily physical activity out of our lives…He says a lot of things stop us from burning calories…We come to work in almost any vocation and we sit. And we sit for eight hours and then we get up and we sit in the motorcar, you know, in automobile and we go home. When we arrive at home, we sit in front of the television. We have frozen TV dinners. We have pre-prepared, prepackaged food that doesn't require energy to collect it. We don't hunt, cook it. It's mostly just put in microwaves and simple systems…We don't even chop vegetables anymore. Bauman says that's very different from the way life used to be. He cites research by a colleague who studied people living and working in a historical Australian village, recreating life in the 19th century…Their energy expenditures were three to five times the amount that people spend today. And that was just a regular person going to and from work. It wasn't a lumberjack or someone who was working on the land or someone who had a huge heavily physical job…And, of course, three to five times more energy expenditure burns a lot more calories… Physical inactivity is a major risk factor for death and for illness. It contributes to about one-sixth of heart disease, cardiovascular disease, about the same for diabetes, about 12 percent for falls in the elderly, and about a tenth of all breast cancer and colon cancer are attributable to being physically inactive.” (Interview, Bauman/Silberner)
   But what if my wife isn’t DOING that? Is what she DOES every day considered “exercise”?
   YES!
   “Even if you don’t have a 15 or 30 minute window to dedicate to yoga or a bike ride, that doesn’t mean you can’t add physical activity to your day. If you're not ready to commit to a structured exercise program, think about physical activity as a lifestyle choice rather than a single task to check off your to-do list. Look at your daily routine and consider ways to sneak in activity here and there. Even very small activities can add up over the course of a day: Clean the house, wash the car, tend to the yard and garden, mow the lawn with a push mower, sweep the sidewalk or patio with a broom; bike or walk to an appointment rather than drive, banish all elevators and use the stairs, briskly walk to the bus stop then get off one stop early, park at the back of the lot and walk into the store or office, take a vigorous walk during your coffee break. Walk while you’re talking on your cell phone; walk or jog around the soccer field during your kid’s practice, make a neighborhood bike ride part of weekend routine, play tag with your children in the yard or play exercise video games. Walk the dog together as a family, or if you don’t have your own dog, volunteer to walk a dog from a shelter. Organize an office bowling team, take a class in martial arts, dance, or yoga with a friend or spouse; gently stretch while watching your favorite show, do push-ups, sit-ups or lift light weights during the commercial breaks—you'll be amazed at how many repetitions you can fit in during the commercials of a half hour show! Better still, once a week turn off the TV and take a walk outside instead”
    
   And the benefit of all they movement?
   The very same ones as ANY form of exercise provides, and in this particular case, it results in an increased effectiveness of insulin in those who are insulin resistant!
   So MOVE! If we can do it, so can you!
   Resources: http://www.npr.org/templates/story/story.php?storyId=127525702,
   http://www.helpguide.org/life/exercise.htm
    

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #41: A Return To “Translating The Doctors” – What is Venlafaxine and WHAT’s It Do? (Part 1)

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: http://www.mayoclinic.org/drugs-supplements/venlafaxine-oral-route/description/drg-20067379

“Venlafaxine is used to treat depression. It is also used to treat general anxiety disorder, social anxiety disorder, and panic disorder.”

It seems logical to me that anyone who has faced a life-threatening, long-term, life-changing, potentially debilitating disease might have something to be depressed about.

As a high school counselor who deals with students who are under regular treatment for depression, I am familiar with the regimen of both diagnosis and treatment of depression. I am also familiar with the stigma of both depression and the treatment of depression.

You would think that since “Major depressive disorder is one of the most common mental disorders in the United States. Each year about 7% of U.S adults experience major depressive disorder” that there would be a general acceptance that it is an issue in this society.

But among breast cancer survivors, “...who had survived at least 2 years after a cancer diagnosis [and] were considered long-term survivors…researchers found that depression was about 14% more common [and] anxiety was about 29% more common in long-term survivors compared to undiagnosed people.”

Breastcancer.org characteristically does NOT recommend drug therapies. It notes: “Research suggests there are several factors that seem to be associated with a greater chance of good emotional health: Having a good support network; being and staying in good physical shape; having an excellent relationship with your doctor, [possibly] aromatherapy, guided imagery, hypnosis, journaling, massage, meditation, yoga, tai chi...”

Yet with depression and anxiety resulting from chemical imbalances in the brain, why does this site (one people constantly refer to), eschew a medical rebalancing of a chemistry traumatized by both invading cells and combative drugs?

This subject is clearly complex and fraught; so I will leave us here for now and return later to continue what may very well be a series of essays on this issue.

Resources: http://www.breastcancer.org/research-news/20130612-2

Image: https://upload.wikimedia.org/wikipedia/commons/1/17/Angelina_Jolie_at_Davos.jpg

ENCORE #27! – Exercise Reduces Sex Hormone Levels!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog. The article below appeared on March of 2012.

Doctors harp on exercise.

Despite the harping – or in my case, perversely because of it – I avoid exercise like the plague.

Even so, as I read more and more sites promoting the “exercise makes you better if you have breast cancer” meme, I found that almost none of them give any kind of evidence as to WHY exercise fights cancer and promotes healing.

So I dug into the sites and finally found some evidence supporting this wild, “Do this one weird thing…” kind of meme. This week, it’s number 11:

"Physical activity may decrease risk for various cancers by several mechanisms, including decreasing sex hormones"

My first reaction to this was, “Huh????”


On second examination and with a little reading, it’s become more obvious.


Most of us know that “Many breast cancers are sensitive to the hormone estrogen. This means that estrogen causes the breast cancer tumor to grow. Such cancers have estrogen receptors on the surface of their cells. They are called estrogen receptor-positive cancer or ER-positive cancer."


My wife has to take a five year regimen of anastrazole pills that scavenge estrogen from her blood. I wrote about that here: http://breastcancerreaper.blogspot.com/2011/12/next-five-years-anastrazole-whats-it-do.html


But are there OTHER sex hormones that affect the growth of breast cancer tumors and can be lowered with exercise? “Exercise affects hormone production in both females and males. According to the December 2009 issue of "Sports Medicine," exercise suppresses production of luteinizing hormone (LH), follicle stimulating hormone (FSH) and hormones produced by the ovaries. A study published in the June 2010 issue of "Journal of Sports Science and Medicine" indicates physical activity inhibits production of sex steroid hormones including estrogen.”


According to recent research, “...LH[RH] agonists [a chemical that binds to a receptor of a cell and triggers a response by that cell...often mimic the action of a naturally occurring substance.]...suppress ovarian function and sex steroid production; the reduction in sex steroids is predicted to lead to the prevention of breast cancer... Ovarian hormones (estrogens and progestogens) are critical factors in the genesis of human breast cancer. During the premenopausal years breast cancer risk increases steeply, but after menopause it increases at a much lower rate. Epidemiologic studies have clearly demonstrated that early menopause...substantially reduces breast cancer risk.”


I covered the effects of estrogen both in the essay linked above and in the first one of this series. What effect does LH and FSH and “hormones produced by the ovaries” have on breast cancer? In a recent study, researchers found that: “the more potent hydroxylated tamoxifen metabolite 4OHNDtam (endoxifen) was the only tamoxifen metabolite positively associated with FSH levels suggesting anti-estrogenic effect on the pituitary. This may explain the observed positive association between a better prognosis and FSH levels during tamoxifen therapy.”


All of this means...WHAT????


Exercise suppresses the production of LH, FSH and “other ovarian hormones” like estrogen and progestogens. At MUCH lower levels, exercise can mimic the effect of the anti-cancer drug, tamoxifen. It does NOT mean “QUIT ALL DRUGS, EXERCISE WILL CURE BREAST CANCER!”!!!!!!! It DOES NOT MEAN “Quit all drugs, exercise will cure breast cancer!”


There IS no miraculous, take-a-pill, jump-on-a-treadmill, move-to-Arizona-and-soak-up-sun cure for breast cancer.


It’s hard. It’s ugly.

A breast cancer survivor needs all the help she can get. Exercise helps.

So, just do it!

References: http://www.livestrong.com/article/476775-hormonal-imbalances-exercise/#ixzz1qhGvuOID, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC138786/

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg