Hot Flashes and Headlines (Sujatha)

Here we go again. The headline reads "Study Ties Hot Flashes to Lower Breast Cancer Risk". The article goes on to blabber thusly:

'Here's some good news for women ever bothered by hot flashes and other menopausal symptoms: Your risk for breast cancer may be reduced as much as 50 percent, researchers from the Fred Hutchinson Cancer Research Center in Seattle report.'

I imagine the next step would be 'Grin and bear it, it's all for the good.' to soothe the women asking for medication to alleviate the symptoms. I recall similar annoying headlines about the 'benefits of being a migraine sufferer is reduced breast cancer risk', when studies on that association were published a couple of years ago .

It's merely good sense to assume that natural drops in estrogen levels, that act as triggers for migraines, hot flashes and other typical menopausal symptoms, would occur in women who are at reduced risk for high-estrogen related conditions like breast cancer. 

So, of course, we need another dozen studies to confirm this for us, so that we can have scientific proof, feed a group of researchers who would otherwise be twiddling their thumbs without work, maybe even paving way for public policy that tells healthcare providers to stop plugging HRT, as it may actually do more harm than good.

HRT has already been derided for its links to increased risk of breast cancer.

"Women who start hormone replacement therapy (HRT) as they begin to go through menopause have a higher risk of breast cancer than women who start taking the drugs later, researchers reported on Friday.

The findings, published in the Journal of the National Cancer Institute, help answer lingering questions about just who is and who is not at greater risk of side-effects from taking HRT."

Each study generates its own screaming headline, but there are rarer looks in the popular media at the whole data set. They end up missing the wood for the trees. HRT is good for reducing cardiovascular disease risk, says one. HRT increases the breast cancer risk says another. Estrogen good for heart, bad for breast.  The Pill good for ovaries,  bad for breast.

Why can't we just let the hormones be what they were naturally without messing around and tilting the balance every which way via medications to alleviate symptoms? Would placebos help, even if we knew that they were placebos?

We will just have to wait for the day when epidemiological articles like these yield media headlines as illuminating as 'It's your environment and lifestyle, stupid!- The causes of Breast cancer unravelled' *.

*Not an actual headline, but one can always hope.

In any case, a picture is always worth a thousand words, so this one below ought to be quite illuminating, even if the data is about 7 years old. The numbers represent the age-standardized rates of breast cancer incidence. (Click on the picture for a larger version.)

 

 

 

Comments

[narayan]

red = predominantly red meat eating?

[Sujatha]

Holy cow, you may have hit upon the one cause! (pun intended)It would indeed make a wonderful screaming headline.
Seriously, there is a link, but it's not the only factor, even though it might account for some increase in the cases of breast cancer in those countries.
http://www.sciencedaily.com/releases/2007/04/070407174018.htm
I imagine that the graph, if it were to be redrawn today, might show India and China in pale green or even yellow in some areas. It's unlikely to be the increase in eating beef that would be the contributor there.

[Elatia Harris]

Well, in Japan alone, the rise in the consumption of red meat has been accompanied by a spike in cancers associated with high red meat consumption...

[Sujatha]

Red meat does have some associations with an assortment of cancers which affect various organs. A possible mechanism was suggested in this study:
http://www.sciencedaily.com/releases/2008/11/081113181428.htm

[narayan]

I wonder if balance and paucity in diets are what's common to the countries shaded green.
I have this crackpot theory that most ailments arise from people's instinctive refusal of aliments that lie outside their 0.33-sigma preferences. Everything in nature's 3.0-sigma cornucopia of comestibles must have a purpose, I reason - from the lowly (no dessert till you finish your ...) green peas to (what the British refer to indelicately as) offal (... contrast with American euphemisms like giblets, chitterlings and mountain oysters). I myself draw the line at 1.57.
Has anyone else read Marvin Harris' Good to Eat?

[Sujatha]

Rather than just the food habits, I think that other factors might be in play. It may be a combination of environmental exposures, first age at childbirth, average number of pregnancies and a whole host of other gender specific issues. Diet is an obvious choice for investigation, being much easier to control and hence the plethora of studies linking all kinds of foods to less or more incidence of cancers. The 'other factors' that I mentioned above are much harder to track and control for.

[Don]

I'm curious why the comment I left yesterday disappeared. It wasn't offensive and, I thought, contributed to this thread.

It basically said that I agreed with Sujatha - cancer causes are far to complex to assign one causative factor. Red meat may exacerbate conditions which encourage certain types of cancer development. I even posted a link to research that directly addressed that question yesterday, but I don't have the time to dig it up again.

I related that I'm very familiar with a family in which each of the women has developed breast cancer, each a very different type. They believe, as do researchers who have examined this and other similar cases, that there is a genetic propensity to breast cancer in these sorts of cases. Has nothing to do with red meat.

Don

[Sujatha]

Don,

I have no idea why your original comment disappeared, maybe it was a Typepad problem that caused it to be lost. Sorry for the inconvenience.

Genetics are definitely high up on the risk factors, but I am particularly intrigued by the possibility that it is the degree of 'lobular involution' that determines the occurrence of malignant vs. benign breast cancer. See here for a more technical look.
http://jnci.oxfordjournals.org/content/98/22/1589.full

Basically, it states that the changes in the structure of breast cells over the various phases of a woman's life play a role in determining the kind of cancer that could occur. This study was released in 2006, but I don't know if any headway has been made in achieving the end result suggested:
"Results of the Mayo study provide a new paradigm for breast cancer research and prevention. Age has always seemed the opponent because of the increasing risk of breast cancer with age, but age may now become an ally. The challenge will be to unravel the natural history of involution and the normal process of aging in the breast. Eventually, involution could become a useful surrogate endpoint for research in breast cancer prevention. A possible approach to prevention may be to develop strategies that achieve complete involution as early as possible after childbearing is completed. "