Whether your area of breast cancer interest or expertise lies in "spreading the word" (Public Relations) or connecting with other people (Communications), we have a way for you to help. If learning or telling others about this disease (Education) is your cup of tea, join us so we can expand our efforts. If representing the patient's point of view with decision-makers is what you would like to do (Advocacy), let us know. If changing or influencing the creation of laws about health care, insurance, etc. (Legislation) is what you are interested in, let us help you get keyed in to the right people. If you would like to interact with others in your community with similar breast cancer interests (Geographic Organization), we can connect you. If you have a "Midas touch" or a flair for finance, we need your ideas.

Jamie Konarski is organizing our annual workshop. Two speakers are already confirmed. This year we will hold a "Celebrate Today" Reception on Friday with the workshop on Saturday. Plans also include exhibitors at the reception! This is a huge effort and Jamie is looking for help. Two areas with immediate needs are: 1) locating & contacting potential sponsors/exhibitors, and 2) coordinating exhibitors. Please call Jamie at 919/758-1161 if you are interested.

On May 4-6 the National Breast Cancer Coalition will hold their annual Advocacy Training Conference in Washington, DC, where hundreds of breast cancer advocates from across the country gather to share information, learn the latest in breast cancer research & policy, and enrich their breast cancer advocacy skills. Other events include Lobby Day (when advocates meet with their Senators & Representatives), a Congressional Awards Ceremony, and a rally at which the President & Congress will be presented with the 2.6 million petition signatures from Campaign 2.6.

The Piedmont Chapter (Burlington, Greensboro, High Point, Mebane & surrounding areas) has organized and will spearhead or participate in BCCNC activities at a local level. Projects already in progress include A Woman’s Day on April 11-12, Women’s Only Run on May 3, Triad Breast Cancer Benefit on May 10.

Meetings are held the 3^rd Saturday of each month from 10-12. Call Dana Litaker at 910/548-3436 if you would like to know more!

By Dr. Susan Delaney

It is through research in epidemiology that medicine has begun to examine the beneficial effects of dietary soy in the prevention of cancer, especially cancer of the breast. Dr. Cathy Read in her book, Preventing Breast Cancer, The Politics Of An Epidemic, states "the scientific evidence suggests the protective effect of a diet high in soy proteins may at least partly explain the low rates of breast cancer in China and Japan". It is also noted that when Japanese women move to this country and consume the Western diet, their rates of breast cancer increase, becoming similar to the rates of cancer among American women eating the Western meat-based diet. Evidence that diet may significantly contribute to this change is found in a study done by Lee et al., 1991. In this study he assessed the diets of 200 women with breast cancer and 420 women without breast cancer. It was found that women with the highest intake of soy foods had less than half the risk of breast cancer development as compared with those who had a low intake of soy foods. This study shows an increase in the prevalence of breast cancer with a diet low in soy and high in animal proteins. Dr. Barns of the University of Alabama showed that adding a modest amount of soybeans to the diet of rats reduced the incidence of breast cancer by 50%. In animal studies it has been shown that animals given a soy-based diet have substantially fewer breast tumors compared to those on a control diet which does not contain isoflavones from soy.

So what is an isoflavone? It is one of the anti-carcinogenic agents found in soy products, according to Dr. Mark Messina, who presented overwhelming evidence to its effect at the National Cancer Institute in Washington in 1990. Isoflavones are biological compounds that comprise a category of a larger class of compounds known as phytoestrogens. Phytoestrogens are compounds of plant origin that have effects similar to the female hormone estrogen. What is of interest is how these compounds effect the body. Phytoestrogens are of concern to some physicians because they contain estrogen-like compounds. For women who have breast cancer, this concern is particularly heightened.

Though isoflavones have a chemical structure similar to that of naturally-occurring estrogens, they are very weak in their estrogenic effects. Research by Dr. Messina has shown that compared to synthetic compounds, the estrogenic effect of phytoestrogens is one hundred times less potent. Plant estrogens, however, are capable of binding to estrogen receptor sites of the cell, thereby preventing the cell from binding with and responding to stronger estrogen compounds.

This was shown to be true in a study by Setchell et al., in 1984. In this study soy isoflavones were given to study subjects along with synthetic estrogenic compounds. The normal effect of the estrogenic compounds was significantly reduced when given along with soy isoflavones and related compounds. It appears that the phytoestrogens bind to the estrogen receptors on the cell, preventing the synthetic estrogens from binding to the receptors and exerting their effect upon the cell. By this mechanism of receptor binding, isoflavones in soy reduce the overall effect of estrogen on tissues and effectively act as a partial or complete antagonist to estrogen. It is this effect that may result in the reduction of breast cancer in the Chinese and Japanese women who eat a soy-rich diet.

Isoflavones possess other beneficial properties which may also contribute to the anti-carcinogenic effects seen in people eating a soy-based diet. Genistein and daidzein are two components that show other positive anti-cancer effects. A study done by Fotsis et al., 1993, shows that genistein appears to block the process known as angiogenesis (new blood growth), a requirement for tumors to grow. Flavinoids in soy show multiple effects in the body. In the prevention of cancer they act as potent anti-oxidants, free-radical scavengers, and metal chelators (Kandaswami & Middleton, 1994).

As yet, there are no studies showing that the intake of soy products will prevent the recurrence of breast cancer, though the evidence for initial prevention of breast cancer by eating a soy-based diet is substantial. Using the model of cardiovascular disease, it has long been known that reducing fat and increasing fiber, fruits and vegetables will prevent a heart attack. It is now known that once you have cardiovascular disease, these same recommendations will not only decrease chances of a recurrence, but will actually reverse the damaging changes seen in cardiovascular disease. Similarly, preventative diet, exercise and vitamin supplementation for osteoporosis also effectively treat the syndrome. Though the data is not yet available to confirm soy as a treatment for breast cancer, it is absolutely one of the dietary cornerstones of treatment that I recommend for women living with breast cancer.

Along with adding soy to the diet, I also recommend reducing the intake of protein from animal sources. A vegetarian diet is the best, but for meat lovers I suggest a gradual reduction of meat products to not more than four ounces a day (including fish and chicken). The next phase is to reduce meat intake to three times a week. Plant sources, primarily beans and soy, can be used to provide adequate daily protein. Other suggestions include lowering fat intake to less than 20% of the daily diet, which is no easy task. That completely excludes Ben & Jerry! Pizza should be considered a rare treat, if consumed at all.

Whole grains are extremely important. Pasta does not count! Oatmeal, rice, millet and wheat berries (to name a few) are excellent and provide good sources of protein as well. Fiber has also been shown to reduce the levels of estrogens in the body by preventing their re-absorption and encouraging their elimination in the stool. Beans and legumes are also excellent sources of fiber and many, like soybeans, contain isoflavones as well. A serving of each of these is essential every day. Five fruits and vegetables a day are considered minimal, including 2 fruits and 3 vegetables, one of which should be green & leafy.

Exercise is essential and has been shown to lower estrogen levels in women. A study done in 1994 of pre-menopausal women showed that those who exercised four hours a week had a 60% lower rate of breast cancer than women who did not (Family Practice News, Nov. 1994). That translates to 35 minutes a day and should be possible for most women. If not, we need to reexamine our lives and wonder why! Reducing alcohol intake to less than three drinks a week has also shown to be helpful as well. For women with breast cancer, total avoidance or special occasion use is preferable.

The approach for preventing the recurrence of breast cancer is multifaceted, including psychological and emotional support. Diet is a cornerstone of the treatment and cannot be overlooked. Surgery, chemotherapy and radiation may deal with the local effects of the imbalance. But cancer is truly a disease of the immune system which has been ineffective in maintaining order in the body. A whole system approach is advised.

For those unfamiliar with eating soy, I suggest that you start with soy milk. Any health food store should have it. Put a tablespoon of flax seeds and 10-15 almonds in a blender. Grind them up until they appear the consistency of cornmeal. Add a banana, apple or any fruit you have in season. Top with 8 ounces of soy milk and you have a very healthy and quick breakfast! Add honey or vanilla for additional flavors.

Next, try baking tofu. First, marinate overnight or longer in soy sauce, lemon juice, rice vinegar (available at Oriental markets) and grated fresh ginger (about 1 teaspoon). I really can’t give you exact amounts, so play around with the ingredients. I love mine very gingery! Bake it for 35-45 minutes in a baking dish at 350°. Cool and eat it with your rice and vegetables or put it between two slices of bread with lettuce, mustard, onions, or whatever you like. Makes a great sandwich! Soy can be really delicious! Explore the many cookbooks out there incorporating soy. You will grow to enjoy it, and the health benefits are enormous.

In closing, I would like to recommend a soy-based diet to any woman confronted with breast cancer in her life. Conventional medicine has begun to consider diet and nutrition as part of a way to prevent disease. The evidence clearly shows reduced rates of breast cancer among women eating a soy-based diet. Soon research will likely show its benefits as a adjunctive therapy in the treatment of cancer. Until then, keep eating your soy!

The second annual "A Woman’s Day" Conference & Exposition will be held at the Koury Convention Center in Greensboro on April 11-12. This event focuses on women’s personal and professional concerns and will feature national speakers such as Carole Simpson of ABC News, Deborah Norville, and Ellen Fein & Sherry Schneider, authors of "The Rules: Time Tested Secrets for Capturing the Heart of Mr. Right".

BCCNC is proud to sponsor speaker Marcia Wallace, comedian and actress. Known as Carol, the witty receptionist from "The Bob Newhart Show", Marcia is also a breast cancer survivor. In her presentation "A Voice of Hope: Marcia Wallace Fights Back", Marcia inspires and invokes thoughts about the implications of being diagnosed with breast cancer.

Also, BCCNC’s Dana Litaker will give a 30-minute talk on breast cancer, and several members will model in a breast cancer survivor fashion show. The BCCNC display booth will be available throughout the two-day conference and will feature Beth Walker’s popular computerized Cancer Risk Assessment. We need help with the booth on Friday & Saturday. Contact BCCNC or Catherine Andrews if you want to help.

North Carolina Triangle
Race For The CureÒ

Medical waste incinerators have been identified as a top source of the highly carcinogenic environmental contaminant dioxin, which is 300,000 times more carcinogenic than DDT! According to the EPA, burning of certain plastics can produce dioxins which can damage our reproductive and immune systems and developmental systems of children. Some hospitals burn dioxin producing plastics on-site while others transport to incineration sites.

BCCNC is working to encourage hospitals to act responsibly in their use and disposal of plastics. To do this, we are suggesting an "Adopt-a-Hospital" approach for BCCNC members to use in their communities. Here are suggested action plan steps:

Zeta Tau Alpha Alumni & Applebee’s of Wilmington are again working together to help support BCCNC. On April 1^st from 5-9pm, 10% of all checks from dinner will be donated to BCCNC.

Here are some questions that seem to come up whenever breast cancer survivors who have developed lymphedema come together and talk about their experiences with this condition: When did you notice that the arm on the side of your mastectomy was swollen? When you saw your doctor, what did he/she say about the swelling? Did you see your surgeon, oncologist, gynecologist or family practitioner? Were you told about your chances of developing lymphedema when discussing breast cancer surgery with your health professionals?

In February, the Greensboro Lymphedema Support Group was formed for people with lymphedema or those interested in learning more about this condition. As members shared their stories, they realized that they had learned a lot about lymphedema through experience, but still needed to know much more. Because of this, they are asking others diagnosed with lymphedema, or those who suspect they may have developed lymphedema, to share information with them. The group wants to share the compiled information with medical professionals to ask for help in (1) trying to decrease the incidence of lymphedema following surgery, and (2) diagnosing and treating lymphedema if it develops independently as a primary condition.

The women who had lymphedema following breast surgery all indicated they felt more threatened by the lymphedema than they did the breast cancer. It is not difficult to hide the scars from cancer surgery, but it is hard to hide lymphedema. When one arm is larger than the other, lymphedema sufferers must wear a compression sleeve that is ugly and hot. They say that in the winter the compression sleeve can be hidden under blouses and sweaters, but in the summer there is no hiding it. "You wear the sleeve, or you have one arm larger than the other," one school teacher said. She added, "My students like to laugh at me when they notice the difference in my arms." Additionally, when the sleeve is removed, many women wrap their affected limbs each night before going to bed. There can be as many as seven layers to a wrap, and the process can take up to 30 minutes.

Oh yes, lymphedema affects legs as well as arms. If lymphedema of the legs goes untreated, it can develop into elephantiasis. When lymphedema develops after surgery or radiation, it is termed "secondary"; but it can also develop in many people for no apparent reason and is then classified as a "primary" condition. There are treatments available however they are only concerned with lowering the swelling and do not address the cause or cure. Currently, the most popular treatment is a combination of massage from a physical therapist, nightly wrapping of the affected limbs, and wearing a compression sleeve. Compression pumps are also available and are recommended by many doctors; however, pumping has recently become controversial, and more information is needed before a consensus on its effectiveness is reached. There are clinics in Charlotte, Asheville, Raleigh and Duke Medical Center which utilize the above treatments.

As you can see by this newsletter, we have many plans for 1997. We appreciate your support in the past and hope you will join us again this year so we can continue our work in North Carolina.

If you have not already renewed your annual membership for 1997 (check your mailing label for "exp"), please take a minute and fill out this form.

If you want to join BCCNC and participate in our fight to eradicate breast cancer, please fill out this form & send it to the address below.