New treatment choices provide added hope for gastric cancer patients, Mayo Clinic doc says

An increase in recent treatment options has given new hope for patients of stomach cancer, aka gastric cancer.

A recent article by Jason Howland of the Mayo Clinic News Network quotes Dr. Mohamad Sonbol, an oncologist at the clinic as saying that "I tell patients who have recently been diagnosed with gastric cancer that there is definitely a hope because we've gotten significantly better in the last decade, and more specifically, really, in the last year or two."

Dr. Mohamad Sonbol

Options depend on the cancer's location in the stomach, its size and stage, Howland's story indicates, "but can include surgery, chemotherapy, radiation and immunotherapy."

If you're a man, the piece also says, you're at higher risk for stomach cancer than if you're a woman. 

Other risk factors include obesity, smoking, and drinking alcohol.

Still other risk factors, says Sonbol, "are some hereditary syndromes or things that we inherit from our parents."

Early signs of stomach cancer vary, the story notes, "and can include abdominal pain, blood in the stool or just feeling tired."

Stomach cancer, the piece maintains, is relative rare in the United States, so it's frequently diagnosed at later stage of the disease "when symptoms like nausea, heartburn and feeling bloated are more pronounced."

More information about disease risks can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Columnist suggests three strategies that could possibly reduce your risk of contracting cancer

By employing three strategies, you may reduce your cancer risk. 

That, at least, is the opinion of Dr. Jerry Saliman, whose Senior Life column in an earlier-this-month edition of j. the Jewish News of Northern California, focused on those strategies — being on the lookout, catching symptoms early, and paying attention to risky behavioral factors.

Dr. Jerry Saliman

Regarding the first strategy, Saliman writes that unfortunately only four types of cancer screening have received a high-level record recommendation from a U.S. task force: colon, lung, breast, and cervix.

As to the second line of reasoning, the columnist, a Bay Area physician who retired from Kaiser South San Francisco after a 30-year career and now is a volunteer internist at Samaritan House Medical Clinic in San Mateo, suggests that "by catching cancer early, the survival rates may be four times higher compared with later-stage detection."

Saliman adds, about the last strategy, that the American Cancer Society's prevention studies have been crucial in detailing risk factors — including, in the 1950s, being the first to identify smoking as a major reason for cancer. The ACS has since, via its ongoing research, "found that older age and smoking have the highest relative risk for developing any cancer for both men and women."

Additional risks for men, his column says, "are family history of cancer, red meat consumption, alcohol intake, and physical inactivity."

More information on risks can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Neither bras nor caffeine cause breast cancer

Article details risk factors for breast cancer while outlining preventive measures and dispelling myths

Are the causes of breast cancer known?

No, according to a feature story by Dr. Lizellen La Follette in the Marin Independent Journal that I've kept around quite a while because it's a good summary.

Both the article and its headline note, however, that although the roots of breast cancer aren't clear, the risk factors are.

Dr. Lizellen La Follette

La Follette details those factors: gender (being a woman); age ("two out of three with invasive cancer are diagnosed after age 55"); family, personal health, menstrual and reproductive histories; dense breast tissue; radiation to the chest; genetic changes; poor diet and alcohol consumption; obesity; lack of physical activity; smoking; and exposure to DES, a medication to prevent miscarriage that was heavily prescribed from the '40s through the '60s. 

Also, looking for dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin or nipple/areola area, or discharge of secretions from the nipple.

La Follette also dispels some myths about the disease — including the biggie, that it's contagious. It's not.

Other myths include that the disease can be caused "by wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic food serving items, microwaves or cellphones."

The article also suggests what women can do as prevention: having monthly breast cancer exams, checking for changes in breast tissue (such as in size), and feeling a palpable lump.

As for the risks, La Follette writes that a woman's "risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed" with it — "and her risk increases if a relative was diagnosed before the age of 50."

Furthermore, she notes, "studies show about 5 to 10 percent of breast cancers can be linked to one mutations inherited from one's mother or father."

Regarding smoking, the columnist contends that smoking is a danger "particularly when it's long-term, heavy and among those who started before their first pregnancy." Meanwhile, the risk "is about 1.5 times higher in overweight women, and two times higher in obese women than in lean women." 

In addition, La Follette maintains that "numerous studies confirm on average alcohol consumption increases the risk of breast cancer in women by about 7 to 10 percent for each drink consumed," and she writes that "women who have two to three alcoholic drinks a day have a 20 percent higher risk…compared with non-drinkers."

Finally, she postures that "early menstruation (before age 12), mate menopause (after 55), having first child at older age or never having given birth can be risk factors."

La Follette also takes a moment to mention males, citing statistics that while the average man's lifetime risk is about 1 in 1,000, African-American men "are hit harder by breast cancer than their white counterparts and after diagnosis are three times more likely to die" from it than white men.

To learn more about other causes of the disease, get a copy of  "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Disease rates plummet to lowest point since 1988

Where does Marin, once home of the worst breast cancer rate in the world, stand now?

I've been waiting a year for yet another shoe to drop.

That, I learned long ago, is what happens with almost every bit of research, but especially those concerning breast cancer. 

Flip-flopping in the cancer industry has become de rigueur.

The most recent shoe drop came at the tail of 2015 when a then-new report indicated breast cancer rates in Marin County — which previously had been believed to be a cluster of the disease — had plummeted to their lowest level since tracking began in '88.

That decreased rate, a county report had noted, matched (instead of topping) the statewide average.

That study, of course,  contradicted earlier reports dating back to the first fallen clodhopper in 1994. The Marin rate then was called the highest in the world, according to a study by the Northern California Cancer Center (since renamed the Cancer Prevention Institute of California).

Marin's rate actually peaked in 2001, when the numbers for non-Hispanic white women had climbed 60 percent. 

Since that year, it's dropped 31 percent.

Why? 

Well, risk factors for Marin's white women have been listed as outgrowths of their being affluent — including higher alcohol consumption and the delayed age of childbearing, not necessarily in that order. 

And, until 2002, a heightened use of hormone therapy (especially an estrogen/progestin combination).

When those hormones were abandoned as treatment, the cancer rates began to descend. 

Quickly.

Despite the obvious connection, few would risk verbally pinpointing why the severe dips had occurred — or why the rates had actually been so high in the first place.

Dr. Mary Mockus, a principal researcher with the Marin Women's Study, long-term, county-led breast cancer research involving nearly14,000 women, did say she thought earlier detection and increased patient awareness had helped.

At the same time, authors of the study discounted any influence changes in mammography screenings might have had. 

Rose Barlow

The decade-old Women's Study, according to its website, is currently researching established risk factors, effects of pregnancy, adolescent risk factors, environmental agents and risk prediction.

That research organization, not incidentally, won a reprieve last year after my adopted home county chose not to finance additional work.

Dr. Mark Powell of Greenbrae rescued it by leaning on crowdfunding and the Avon Foundation — and partnering with several groups, including Zero Breast Cancer, a Marin nonprofit headed by Rose Barlow that I wholeheartedly endorse. 

Still, there's been no updates from the researchers recently, so I wait.

And wait. And wait.

I have a vested interest in knowing if there's a root cause in Marin — monolithic or not — because here's where my wife was diagnosed with the disease more than two decades ago.

Meanwhile, frequent flip-flopping results stemming from cancer research are well documented in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Mortality disparity up between blacks and whites

Breast cancer incidence among African-American women in U.S. jumps to a new high

Blacks have lower mammogram follow-up rate.

A new study says breast cancer incidence among African-American women in the United States has equaled whites, according to a story by Tara Parker-Hope in The New York Times.

That's bad news because it's been less common (although deadlier) in the past.

The report, from the American Cancer Society (ACS), showed "that advances in diagnosis and treatment that have dramatically improved survival rates from breast cancer and saved countless lives [in whites] have largely bypassed African-American women."

Over all, Parker-Hope's Well blog in the Times said, "a black woman given a breast cancer diagnosis is 42 percent more likely to die from the disease than a white woman with breast cancer."

It also noted that in some major U.S. cities, according to an analysis published last year in "Cancer Epidemiology," the rate is even worse. In Los Angeles, for example, a black woman is "70 percent more likely to die," and in Memphis the risk rate is double that of a white woman.  

Why the disparity?

Black women, the report said, are more likely than white women "to be given a diagnosis with later stage, and less treatable tumors" — and twice as likely as whites "to be found to have an aggressive form of the disease called triple negative breast cancer, which has a poorer prognosis."

According to the Times, "researchers say…rising obesity rates among African-American women may explain some" of the jump — in contrast with a stabilized rate of 33 percent for Caucasians.

Obesity has been connected to a larger "risk of estrogen-receptor positive breast cancers," the type of tumor now being found more in black women, the Parker-Hope piece indicated.

The obesity rate in blacks leapt from 39 percent between 1999 and 2002 to 58 percent from 2009 to 2012.

But other reasons for "the racial divide in breast cancer mortality may be due to…disparities in the quality of care available to black women, who may have less access to quality screen and treatment."

Carol E. DeSantis

In addition, "lower rates of follow-up after a mammogram, cultural distrust of doctors, and lack of insurance coverage among black women may also play a role," Parker-Hope writes.

The Times writer quotes Carol E. DeSantis, senior epidemiologist at the ACS and lead author of the report, as predicting "the widening mortality disparity is likely to continue."

Comparisons between different groups of women can be found in the VitalityPress book I aimed at male caregivers, "Rollercoaster: How a man can survive his partner's breast cancer."