Baby’ aspirin may cut breast cancer risk, says study

Regular use of low-dose "baby" aspirin, a common pain reliever, may reduce the risk of breast cancer in women, a new research has found.

For the study, published in the journal Breast Cancer Research, researchers analysed data from more than 57,000 women who were part of California's Teacher's Study.

The researchers saw an overall 16 per cent lower risk of breast cancer in women who reported using low-dose aspirin at least three times per week.

"The study found an interesting protective association between low-dose aspirin and breast cancer," said lead author Christina Clarke from the Cancer Prevention Institute of California.

"We did not by and large find associations with the other pain medications like ibuprofen and acetaminophen. We also did not find associations with regular aspirin since this type of medication is taken sporadically for headaches or other pain, and not daily for prevention of cardiovascular disease," Clarke said.

This study differed from other studies that have looked at aspirin and cancer risk because it focused on the dose levels of the aspirin women had taken and tracked the frequency of the use of low-dose aspirin as opposed to regular aspirin.

It was also able to look in detail at subtypes of breast cancer.

"We already knew that aspirin is a weak aromatase inhibitor and we treat women with breast cancer with stronger aromatase inhibitors since they reduce the amount of estrogen postmenopausal women have circulating in their blood," said Leslie Bernstein of the Department of Population Sciences, Beckman Research Institute of City of Hope in Monrovia, California.

"We thought that if aspirin can inhibit aromatase, it ought to reduce the likelihood that breast cancer would develop and it could also be an effective way to improve breast cancer patients' prognosis once they no longer take the more potent aromatase inhibitors," Bernstein said.

"Aspirin also reduces inflammation, which may be another mechanism by which aspirin taken regularly can lower risk of breast cancer developing or recurring," Bernstein added.

The researchers said they chose to focus on low-dose aspirin, because not only is it inexpensive and readily available, but because there are already a lot of people taking it for prevention of other diseases such as heart disease and even colon cancer.

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Breast cancer drugs may put some cells into 'sleeper mode'

Breast cancer drugs may force some cancer cells into 'sleeper mode', allowing them to potentially come back to life years after initial treatment.

The research could open avenues for finding ways of keeping the cancer cells dormant for longer, or even potentially finding a way of awakening the cells so they can then be killed by the treatment.

The team studied human breast cancer cells in the laboratory and examined the effects of a group of breast cancer drugs called hormone treatments.

"For a long time scientists have debated whether hormone therapies - which are a very effective treatment and save millions of lives - work by killing breast cancer cells or whether the drugs flip them into a dormant 'sleeper' state," said the lead author of the study.

"This is an important question as hormone treatments are used on the majority of breast cancers. Our findings suggest the drugs may actually kill some cells and switch others into this sleeper state," she added.

"If we can unlock the secrets of these dormant cells, we may be able to find a way of preventing cancer coming back, either by holding the cells in permanent sleep mode, or be waking them up and killing them," she said.

In the study, the team studied around 50,000 human breast cancer single cells in the lab, and found that treating them with hormone treatment exposed a small proportion of them as being in a dormant state.


The 'sleeper cells' may also provide clues as to why some breast cancer cells become resistant to treatment, causing a patient's drugs to stop working, and their cancer to return, the researchers said.

Hormone therapies are used to treat a type of breast cancer called estrogen-receptor positive. These make up over 70 per cent of all breast cancers, and are fuelled by the hormone estrogen.

These cancers are usually treated with surgery to remove the tumour, followed by a course of targeted hormone therapy - usually either aromatase inhibitors or tamoxifen, which target estrogen receptors.

However, around 30 per cent of breast cancer patients taking hormone therapies see their cancer eventually return - sometimes as long as 20 years after treatment.

This returning cancer is usually metastatic, meaning it has spread around the body, and the tumours are often now resistant to medication.

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Breast cancer raises heart disease risk

Researchers have found that postmenopausal women with breast cancer are at greater risk of developing cardiovascular disease.

“Heart disease appears more commonly in women treated for breast cancer because of the toxicities of chemotherapy, radiation therapy and use of aromatase inhibitors, which lower estrogen,” said a Prof.

The cardiovascular effects may occur more than five years after radiation exposure, with the risk persisting for up to 30 years.

“Heart-healthy lifestyle modifications will decrease both the risk of recurrent breast cancer and the risk of developing heart disease,” she said.

The goal of the study was to compare and evaluate risk factors for cardiovascular disease in postmenopausal women who are survivors of breast cancer and women without breast cancer. 

For the findings, more than 90 postmenopausal breast cancer survivors were compared with 192 postmenopausal women.

The researchers found that postmenopausal women who are survivors of breast cancer showed a markedly stronger association with metabolic syndrome, diabetes, atherosclerosis, 
hypertriglyceridemia and abdominal obesity, which are major risk factors for cardiovascular disease.
The risk of cardiovascular mortality similarly increased to match death rates from cancer itself.

“Women should schedule a cardiology consultation when breast cancer is diagnosed and continue with ongoing follow-up after cancer treatments are completed,” she added.

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Gene 'switch' that helps breast cancer spread identified

Scientists have identified a genetic ' switch' that helps breast cancer spread through the body, an advance that may help combat the deadly disease.

The team showed that the 'switch' boosts the production of a type of internal scaffolding. This scaffolding is a type of protein- Keratin-80, and related to the protein that helps keep hair strong. Boosting the amount of this scaffolding makes the cancer cells more rigid, which the researchers say may help the cells clump together and travel in the bloodstream to other parts of the body. The researchers studied human breast cancer cells treated with a common type of breast cancer drug called aromatase inhibitors.

The team found the same switch is involved in breast cancer cells becoming resistant to the medication (meaning the drugs are no longer effective if the cancer returns). Targeting this switch with a different drug could help reverse this resistance, and make cancer less likely to spread, said the lead author of the study. Even worse, when the cancer comes back it has usually spread around the body, which is difficult to treat, he said.

The study suggests a type of genetic switch- called a transcription factor- can turn on genes that cause the cancer cells to not only become resistant to the treatment, but move into health tissue around the body. This research now needs to be followed up with larger studies, but if confirmed, targeting this genetic switch could prevent cancer cells from becoming resistant to the drugs, and from spreading to other areas of the body, he said. Aromatase inhibitors are used to treat a type of breast cancer called estrogen-receptor positive. These make up over 79 % of all breast cancers, and are fueled by the hormone estrogen. However, around 30% of breast cancer patients taking aromatase inhibitors see their cancer eventually return.

This returning cancer is usually metastatic, meaning it has spread around the body and the tumours are often resistant to aromatase inhibitors starve cancer cells of estrogen, some cells adapt by increasing production of cholesterol, which they then use for energy to survive. This means that if the cancer returns, it can no longer be killed by the same type of drugs.

In the latest research, which used human breast cancer cell cultures in the laboratory, the team found the witch that turns of genes that increase cholesterol production also activates genes that make the cells more rigid and prone to invade nearby tissues. The team also found that in women whose cancers had spread around the body, the cells contained higher amounts of keratin-80. The team said larger scale patient studies are now needed to confirm the findings, but the research could provide new avenues for helping treat breast cancer that returns and spreads around the body.

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Scientists have identified a genetic 'switch' that helps breast cancer spread through the body, an advance that may help combat the deadly disease. The team from Imperial College London and The Institute of Cancer Research in London showed that the 'switch' boosts the production of a type of internal scaffolding. This scaffolding is a type of protein, called Keratin-80, and related to the protein that helps keep hair strong. Boosting the amount of this scaffolding makes the cancer cells more rigid, which the researchers say may help the cells clump together and travel in the bloodstream to other parts of the body. The researchers, who published their work in the journal Nature Communications, studied human breast cancer cells treated with a common type of breast cancer drug called aromatase inhibitors. https://www.thehansindia.com/life-style/health/gene-switch-that-helps-breast-cancer-spread-identified-534226

https://www.thehansindia.com/life-style/health/gene-switch-that-helps-breast-cancer-spread-identified-534226

Risk of breast cancer returning lasts for years

Many women who follow initial breast cancer treatment with five years of hormone therapy to keep tumors at bay may still experience new malignancies up to two decades after their diagnosis, a study suggests.

Researchers examined data from 88 clinical trials involving 62,923 women with estrogen receptor (ER)-positive tumors. After treating ER-positive tumors with chemotherapy, radiation or surgery, women typically get five years of follow-up therapy with daily hormone-based pills – either tamoxifen or aromatase inhibitors. The goal of the adjuvant therapy is to destroy any lingering cancer cells not killed by initial treatment.

All of the women were cancer-free when they completed five years of adjuvant hormone-based therapy.

During the next 15 years, however, cancer returned for 41% of the highest-risk women in the study who originally had the largest tumors that had spread the most beyond the breast, the study found.

Even the lowest-risk women who originally had small tumors that hadn’t spread to the lymph nodes or other parts of the body still had 10% odds of cancer coming back during the study, researchers report.

“We know that adjuvant (hormone-based) therapy for 5 years substantially reduces the risk of recurrence and mortality,” said senior study author.

“We now have good evidence that extending adjuvant (hormone-based) therapy beyond five years continues to suppress and reduce recurrence and mortality,” author said.

Doctors have long known that five years of tamoxifen reduces recurrence by approximately half during treatment, and by nearly a third over the next five years. Aromatase inhibitors, which work only in post-menopausal women, are even more effective than tamoxifen at reducing recurrence and death from breast cancer.

Some recent research suggests an additional five years of hormone-based therapy is even more effective, but the side effects make some women reluctant to continue. Life-threatening side effects are rare, but women taking these hormones can have menopause symptoms like hot flashes and vaginal dryness.

The data suggest that women with ER-positive breast cancer should at least consider continuing adjuvant therapy beyond five years, the authors conclude.

“Breast cancer cells can travel from the primary tumor to the lymph nodes and can circulate throughout the body undetectable with current screening (methods) and over time, these circulating cancer cells can attach to other organs in the body and this is generally when there is a detectable cancer recurrence,” said a cancer researcher.

“One way that adjuvant breast cancer treatment works is to kill and/or stop the undetectable cancer cells from growing and dividing,” a researcher said.

Even though the study suggests some women may have more risk of recurrence based on their original tumor characteristics, it can still be hard to predict and women need to remain vigilant, said the Dr.

“Breast cancer can be dormant for many years, so that women can have no apparent disease, but can still recur years later if the tumor becomes active again,” said another researcher. “We do not know why some cancers become active again after years of dormancy.”

Women need regular checkups and breast screenings, as well as annual mammograms, said a Dr.

“If a woman is high risk for breast cancer, such as a lady with a gene mutation, she may need both mammograms and breast MRIs,” a Dr. added.

“Additionally, women should maintain a healthy weight, exercise, stop smoking, and limit alcohol consumption to reduce their risk of recurrence.”

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Side effects of breast cancer drugs can be reduced by exercising

A combination of weight training and 150 minutes of moderate aerobic activity — such as brisk walking or jogging — every week may help mitigate the side-effects of hormone-therapy drugs that significantly reduce the risk of breast cancer recurrence in post-menopausal survivors, shows a recent study. Because most breast cancers are hormone receptor-positive — that is, they use estrogen or progesterone to grow and spread — survivors often rely on hormone therapy, such as Aromatase Inhibitors (AIs), to keep the disease from returning. However, this AIs treatment can be a double-edged sword because they often lead to bone loss or severe joint pain, especially if the survivors are obese or overweight. ‘These changes put women at risk for frailty fractures and osteoporosis, not to mention further risk for comorbid chronic disease and cancer reoccurrence,’ said Gwendolyn Thomas, assistant professor at Syracuse University in New York, US. Hence, nearly 40 per cent of survivors stop taking AIs long before their customary five-year treatment period expires and increase the chances of their breast cancer re-occurring, Gwendolyn said.

Interventions that address obesity in women taking AIs can help them continue this necessary treatment, the researchers continued. For the study, participants did two sessions of weight training and 150 minutes of moderate aerobic activity, such as brisk walking or jogging, every week for a year. ‘We noticed a drop in per cent body fat and body mass index, as well as a significant increase in their lean body mass. These changes have clinical benefits, but also suggest that exercise should be prescribed in conjunction with AIs, as part of a regular treatment regimen,’ Thomas said. 
The study was published in the Obesity Journal.

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This depression drug can reduce joint pain in women with breast cancer

Researchers have developed a drug which is typically used to treat depression but can also come handy in reducing joint pain in women suffering with breast cancer.
 
The researches conducted a trial to test whether duloxetine, a depression and anxiety drug, could alleviate pain caused by aromatase inhibitors, a common breast cancer treatment that`s particularly effective with postmenopausal women.

"We`ve shown that this treatment is a potential option for women," said N. Lynn Henry, a SWOG investigator from Huntsman Cancer Institute at the University of Utah in the US.

SWOG is the international cancer clinical trials network funded by the US National Cancer Institute (NCI).

"Taking this drug may help them tolerate their breast cancer treatment. And it`s important for their health that they stick with their treatment," Henry noted.

Tens of thousands of postmenopausal women each year are treated with aromatase inhibitors (AIs), pills that stop the production of estrogen and essentially starve hormone receptor-positive breast cancer cells.

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