Cancer Archive

The purpose of treating ductal carcinoma in situ (DCIS)—the earliest, noninvasive form of breast cancer (often called "precancer")—is to prevent those lesions from becoming invasive and thereby greatly reduce the risk of dying from breast cancer. As mammography has become more precise, it has detected more DCIS, and more women get treatment with surgery and often radiation as well. An analysis published online by JAMA Oncology on Aug. 20, 2015, adds to increasing questions about the best way to manage DCIS in most women diagnosed with it.

Canadian researchers analyzed 20 years of data from 108,000 women with DCIS in a database maintained by the National Cancer Institute. Most women were treated with lumpectomy, often followed by radiation, or mastectomy. The researchers found that treatment with radiation or mastectomy did not lower the overall breast cancer death rate in women with DCIS. It remained at 3.3%—the average death rate from all breast cancers. However there were some groups—including African American women and women under 40—in whom the death rate was higher (7% to 8%).

Q. Some of my friends take saw palmetto supplements to reduce urinary problems caused by an overgrown prostate, which I was recently diagnosed with. My friends swear by it, but is there any good evidence this stuff helps? Is saw palmetto safe?

A. The short answer is that we don't have great scientific evidence that taking saw palmetto truly reduces male urinary problems. On the other hand, it doesn't appear to cause major side effects either.

Q. I am currently receiving annual chest CT scans to check for hidden lung cancer (I used to be a heavy smoker). Should I be concerned about the cumulative effects of radiation exposure?

A. Radiation from medical scans can cause cancer, but the level of exposure considered potentially dangerous appears to be many times greater than the average CT scan. In addition, cancer from medical scans takes decades to develop, which makes it less of a concern for men being screened for lung cancer, which is currently only recommended for current or former smokers ages 55 and older. Radiation from CT scans is a bigger concern for children and young adults, who have more time to develop cancer after exposure to medical x-rays.

You may drink coffee because it tastes good or helps you wake up. But the popular brew is also associated with health benefits, such as reducing the risk for heart disease, stroke, and type 2 diabetes. Now a study from Harvard-affiliated Dana-Farber Cancer Institute published Aug. 17, 2015, in the Journal of Clinical Oncology suggests that regular consumption of caffeinated coffee may be associated with a reduced recurrence of colon cancer, and even a reduced risk of death. The study included nearly 1,000 people with stage 3 colon cancer. They filled out questionnaires about their dietary patterns during chemotherapy, and then again six months after treatment was completed. People who drank four or more cups of coffee per day were 42% less likely to have cancer return than non-coffee drinkers, and were 34% less likely to die from cancer or any other cause.

This type of study doesn't prove that coffee drinking caused the lower chance of cancer recurrence and death. A randomized trial is needed to show cause and effect. But researchers are encouraged by the results. "Regular coffee intake has been associated with a reduced risk of type 2 diabetes, and it may be that through a similar mechanism, coffee may also improve outcomes for people with advanced colon cancer," says Dr. Charles Fuchs, senior author on the paper.

Among 400 postmenopausal women who were previously inactive, those who did 300 minutes per week of moderate or high intensity exercise had more success at reducing total fat after one year than those who exercised for 150 minutes per week.

Treatment decisions are complicated for men with low-risk prostate cancer that grows slowly. These cancers may never become deadly during a man’s expected lifespan. And there is no conclusive evidence showing that treatment in these cases extends survival. So cancer specialists have been leaning toward monitoring low-risk prostate cancer carefully and starting treatment only when it begins to spread. This approach was once used only in academic cancer centers, but new research suggests that this strategy is becoming more common in urology practices throughout the United States and other countries as well.

The PREDIMED study showed that the Mediterranean diet can statistically lower a person’s risk for cardiovascular disease, including heart attacks, strokes, and death from heart-related causes. The data also suggest that a Mediterranean diet is associated with a reduced chance of getting breast cancer. This small analysis has some limitations, but provides another reason to consider this already healthful way of eating.

Ideally, screening mammography detects small breast cancers so that they can be removed before they grow, metastasize, and kill. To tell whether screening is succeeding, researchers from Harvard and Dartmouth looked at the rates of mammography, the diagnosis of small breast cancers, large breast cancers, and breast cancer deaths in 16 million women 40 or older in the United States from 2000 through 2010. They found that when mammography rates increased 10%, the number of small cancers detected went up 25%, and the number of large cancers increased by 7%. There was no decline in breast cancer deaths. They concluded that mammography is finding—and women are being treated for—small cancers that may not progress to invasive disease or metastasize to other parts of the body.

The results, which were published online July 6, 2015, by JAMA Internal Medicine, echo those of earlier findings. They underscore a dilemma facing women and their doctors: To get annual mammograms and risk being treated for a tumor that may never become harmful, or have mammograms less frequently and risk missing a cancer until it is larger. The U.S. Preventive Services Task force recommends having a mammogram every one to two years for women ages 50 to 79. The American Cancer Society suggests annual mammograms beginning at age 40. You may want to discuss your personal risk profile, and your preferences, with your doctor.

Can a healthy diet help men with low-risk prostate cancer live longer? The authors of a new study say “yes.” A long-running Physicians’ Health Study, suggests that a diet that is good for the heart, brain, and other parts of the body may also help keep low-risk prostate cancer at bay. On the flip side, a diet rich in red meat and high-fat dairy foods appears to be hazardous for men with this kind of cancer. It isn’t clear why a diet that protects against heart disease would also protect against death from prostate cancer. Dr. Chavarro speculates that it’s because high-fat foods are easily broken down and absorbed by the digestive system, and so they might provide quick energy sources for growing tumors. Nevertheless, the results suggest that by eating healthily, men with prostate cancer can take a proactive step towards living a long life.

An analysis from the Women's Health Initiative (WHI) suggests not only that postmenopausal women who are overweight or obese have a higher risk of invasive breast cancer than women of normal weight but also that the excess risk increases as a woman's weight rises beyond obesity. The results were published online June 11, 2015, by JAMA Oncology.

A team of investigators from several medical centers studied data on 67,000 postmenopausal women who enrolled in the WHI between 1993 and 1998. They were followed for a median of 13 years. During that time, 3,388 invasive breast cancers were detected. The researchers analyzed the distribution of breast cancer among weight classes and calculated the risks for women who were overweight (body mass index, or BMI, of 25 to 30), obese (BMI 30 to 35), or very obese (BMI over 35) compared with women of normal weight (BMI 25 or less). They found that the increased risk of developing breast cancer ranged from 17% in women who were overweight to 59% in those with a BMI over 35. Among women who began the study at a normal weight, those who gained at least 5% of their original weight had a 12% higher risk of developing breast cancer than those who maintained their original weight. Neither losing weight nor using hormone therapy had a significant effect on risk for women of any weight.