Diet and breast cancer

It has been highlighted that patients diagnosed with cancer feel a lack of control and have strongly expressed the importance of taking a proactive role in their treatment. One way in which this is possible is through diet and lifestyle [1]. The evidence increasingly indicates that there is a link between cancer and lifestyle and diet [2],[3],[4],[5]. The motivation behind creating the cookbook was to enable cancer patients to gain some of that control in the form of diet and lifestyle choices and supported by evidence. However, the cookbook is not restricted to just cancer patients, it is aimed towards anyone effected by breast cancer wanting to make a difference. The benefit of making changes to both lifestyle and diet can be immediate.

The incidence of females developing breast cancer in Northern Europe is approximately three times greater than that of women in East Asia [3]. Research has indicated that those who have migrated from traditionally low cancer risk area, such as Japan, to that of higher risk, such as the USA, appear to increase their risk of cancer within a couple of generations [6]. Thus, demonstrating the influence of lifestyle, diet and environment on risk of development of cancer. An 11 year study, including approximately 330,000 women from 10 European countries, indicated that a Mediterranean diet, with the exclusion of alcohol, may reduce the development of breast cancer [7].

In order to appreciate the complexity of cancer, one needs to understand the intricacies of the body. The body consists of hundreds of different cells which make up the number of organs and tissues, of which the breast is one [8]. In each of these cells DNA is found. DNA is involved in controlling the cell [8]. . When the cell is healthy, development is normal [8]. . However, in the case of cancer, the DNA has lost this ability to communicate effectively with the cell [8]. . The DNA in this instance has mutated and is out of control. During cancer, the cell continues to grow and multiply when it should not [8].

Breast cancer

Breast cancer is globally the most common cancer in women with more than 1.5 million females annually diagnosed [9]. . Although the risk of cancer increases with age, there are also a number of other contributing factors of which lifestyle and diet are included [2],[10] . Therefore, what we eat can influence our health. This appears to support the research that approximately 30% of cancers may be linked to lifestyle [2]. These factors relate to diet, weight (body mass index), fruit and vegetable intake, exercise, tobacco use and alcohol consumption [2],[11],[12].

There are foods with health properties to protect against cancer, to reduce the recurrence rate of cancer and foods to boost the immune system to help support the body through treatment of cancer [5]. The recipes for the breast cancer cookbook have been designed to incorporate the current research in order to support treatment and to encourage healthy diet and lifestyle.

Breast cancer risk factors

As with many cancers there is not one specific factor or influence. There are a number of potential factors such as genetic, biological, environmental, dietary and lifestyle [2],[10],[13]. The main factors that appear to influence the risk of breast cancer are surrounding reproductive history [10]. These include the number of menstrual cycles, the use of HRT (hormone replacement therapy), number of biological children, duration of breast feeding, weight, alcohol consumption and inheriting a mutated gene [10].

Treatment for breast cancer

There a number of different methods used in the diagnosis and treatment of breast cancer depending on the individual and the cancer [14],[15].

The options include:

• Surgery - removal of the lump, referred to as a lumpectomy, or the breast, known as a mastectomy [14], [15]
• Radiotherapy - the use of high energy x-rays in order to kill cancer cells [14], [15]
• Hormonal treatment - drugs are administered in order to target the hormone, oestrogen, from encouraging cancer growth. [14], [15]
• Chemotherapy - killing cancer cells through the use of drugs [14], [15]. There are a large number of different drugs which can be used individually or in combination [14], [15]. Side effects of chemotherapy such as loss of appetite, soreness of the mouth or disrupted bowel movements [14], [15]. Therefore, the recipes of the breast cancer cookbook were designed in order to support the immune system throughout treatment.

Bibliography

1. Velentzis, L, S., Keshtgar, M, R., Woodside, J, V., Leathem, A, J., Titcomb, A., Perkins, K, A., Mazurowska, M., Anderson, V., Wardell, K., and Cantwell, M, M. (2011) Significant changes in dietary intake and supplement use after breast cancer diagnosis in a multicenter study. Breast Cancer Research and Treatment. 128(2): 473-82
2. Parkin, D, M. (2011). The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. British Journal of Cancer 105, S2–S5 
3. Ferlay, J., Shin, H, R., Bray, F., Forman, D., Mathers, C.,and Parkin, D, M. (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Journal of Cancer. 127(12): 2893-2917 
4. Mourouti, N., Kontogianni, M, D., Papavagelis, C., and Panagiotakos, D, B. (2015). Diet and breast cancer: a systematic review. International Journal of Food Sciences and Nutrition. pp 1-42 
5. Aragon, F., Perdigon, G., and de Moreno de LeBlanc, A. (2014). Modification in the diet can induce beneficial effects against breast cancer. World Journal of Clinical Oncology. 5(3): 455-64 
6. Ziegler, R, G., Hoover, R, N., Pike, M, C., Hildesheim, A., Nomura, A, M, Y., West, D, W., Wu-Williams, A, H., Kolonel, L, N., Horn-Ross, P, L., Rosenthal, J, F., and Hyer, M, B. (1993). Migration Patterns and Breast Cancer Risk in Asian-American Women. J Natl Cancer Inst 85(22): 1819-1827 
7. Buckland, G., Travier, N., Cottet, V., González, C, A., Luján-Barroso, L., Agudo, A., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Peeters, P, H., May, A., Bueno-de-Mesquita, H, B., Bvan Duijnhoven, F, J., Key, T, J., Allen, N., Khaw, K, T., Wareham, N., Romieu, I., McCormack, V., Boutron-Ruault, M.,Clavel-Chapelon, F., Panico, S., Agnoli, C., Palli, D., Tumino, R., Vineis, P., Amiano, P., Barricarte, A., Rodríguez, L., Sanchez, M, J., Chirlaque, M, D., Kaaks, R., Teucher, B., Boeing, H., Bergmann, M,M., Overvad, K., Dahm, C, C., Tjønneland, A., Olsen, A., Manjer, J., Wirfält, E., Hallmans, G., Johansson, I., Lund, E., Hjartåker, A., Skeie, G., Vergnaud, A, C., Norat, T., Romaguera, D., and Riboli, E. (2013). Adherence to the Mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study. International Journal of Cancer. 132(12): 2918-2927 
8. NCBI (National Centre for Biotechnology Information). (2011). How do cancer cells grow and spread? [online]. Available at:[Accessed 7th January, 2016] 
9. Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D, M., Forman, D., and Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from:< http://globocan.iarc.fr > [Accessed on 7 January, 2016] 
10. Lewis, M., Davies, I., and Cooper, J. (2008). Multi professional management of patients with breast cancer. Chichester: John Wiley and Sons pp.47-68  
11. WHO (World Health Organisation). (2015). Cancer: Fact sheet No. 297. [online]. [Accessed on 7 January, 2016]  
12. Emaus, M, J., Van Gils, C, H., Bakker, M, F., Bisschop, C, N., Monninkhof, E, M., Bueno-de-Mesquita, H, B., Travier, N., Berentzen, T, L., Overvad, K.,Tjønneland, A., Romieu, I., Rinaldi, S., Chajes, V., Gunter, M, J., Clavel-Chapelon, F., Fagherazzi, G., Mesrine, S., Chang-Claude, J., Kaaks, R., Boeing, H., Aleksandrova, K., Trichopoulou, A., Naska, A., Orfanos, P., Palli, D., Agnoli, C., Tumino, R., Vineis, P., Mattiello, A., Braaten, T., Borch, K, B., Lund, E., Menéndez, V., Sánchez, M, J., Navarro, C., Barricarte, A., Amiano, P., Sund, M., Andersson, A., Borgquist, S., Olsson, A., Khaw, K, T., Wareham, N., Travis, R, C., Riboli, E., Peeters, P, H., and May, A, M. (2014). Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study. International Journal of Cancer. 135(12): 2887-2899  
13. Marmot, M., Atinmo, T., Byers, T., Chen, J., Hirohata, T., Jackson, A., and James, W. (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. (WCRF/AICR Expert Report ). World Cancer Research Fund / American Institute for Cancer Research: Washington DC, US. 
14. Maughan, K, L., Lutterbie, M, A., and Ham, P,S. (2010). Treatment of breast cancer. Am Fam Physician. 81(11): 1339-46.
15. Cancer Research UK. (2014). Types of Treatment for Breast Cancer. [online]. Available at: Accessed 6 January, 2016]