Breast cancer victims Can Cut Risk With Diet, Study Says

[Guest guest]

Victims Can Cut Risk With Diet, Study Says

By Rob Stein

Breast cancer victims can cut the chances their tumors will come back by

adopting low-fat diets, according to the first study to produce direct

evidence that a lifestyle change can fend off any type of tumor.

The study of more than 2,400 middle-aged and elderly women found that those

who reduced the fat in their diets after undergoing standard treatment for

early breast cancer were significantly less likely to suffer a recurrence in

the next five years, researchers reported today.

The findings indicate that low-fat diets, which are also being tested to

protect women against getting breast cancer in the first place, could become

a standard weapon for fighting the disease -- the most common cancer among

women, researchers said.

" Many breast cancer survivors are looking for things they can do to improve

their chances, " said Rowan T. Chlebowski of the Harbor-UCLA Medical Center

in Los Angeles, who led the study. " Now we have evidence women can play a

role in the management of their disease. "

The study provides the most powerful evidence yet that people can influence

their risk of cancer by making a lifestyle change such as eating better and

exercising more, experts said. Previous research has suggested that might be

the case, but the new study is the first to show a benefit from carefully

changing a single behavior -- other than quitting smoking-- in a large

number of patients and following them to see what happens.

" For the first time, we have scientific data about what patients can do for

themselves as a lifestyle change that can significantly improve their

chances, " said Balch, executive vice president of the American

Society of Clinical Oncology, which is sponsoring the meeting in Orlando,

Fla., where the findings were unveiled. " This is a highly significant

advance. "

Although Chlebowski and other experts said the findings needed to be

confirmed by additional research, they added that breast cancer patients

might consider reducing their fat intake in the meantime since such a step

could have other health benefits as well.

" I think women with their physicians can consider taking this step along

with their standard care, " said Greenwald, director of the division of

cancer prevention at the National Cancer Institute.

Some experts and patient advocates, however, worried that the findings

could create the impression that people have more control over whether they

get cancer or suffer recurrences than they do, prompting feelings of guilt

and blame.

" People should not take this study as an indication that if someone with

breast cancer had just done this, they wouldn't have cancer, " said Barbara

Brenner of Breast Cancer Action, a patient advocacy group.

The findings come from the Women's Intervention Nutrition Study, a

federally funded study of early-stage breast cancer patients ages 48 to 79

in 37 states that began in 1994. For the study, 975 postmenopausal women

went through eight weeks of nutritional counseling about how to cut fat in

their diets after undergoing standard treatment of surgery, radiation,

chemotherapy and sometimes hormone treatment. Another 1,462 similar women

received counseling for how to eat a well-balanced diet but no specific

guidance about reducing fat intake.

On average, the women who received the low-fat counseling reduced the

percentage of their daily caloric intake that consisted of fat from 29

percent to 20 percent, whereas the women in the other group did not

significantly lower their fat intake. The women on the low-fat diet consumed

about 33.3 grams of fat per day, while the women in the other group consumed

about 51.3 grams.

After an average of five years, 96 women on the low-fat diet -- 9.8 percent

-- had experienced a recurrence, compared with 181 -- 12.4 percent -- of

those on a standard diet, with the women on the low-fat diet experiencing

about a 24 percent reduction in risk.

Surprisingly, the risk reduction was even greater for women whose cancers

were not sensitive to the hormone estrogen. Their risk fell by about 42

percent. That finding was especially encouraging because those women

currently have no other way to reduce the risk of a recurrence. Women whose

cancers are sensitive to estrogen can take hormone-blocking drugs like

tamoxifen, which lowers their risk by about the same amount.

" It's a very strong signal that lifestyle change may play a role in risk

reduction, " Chlebowski said in a telephone interview before his

presentation.

Chlebowski noted that the diet tested in the study was designed to be

practical for most people.

" It doesn't require eliminating meat from the diet or any drastic steps.

It's mostly just substituting one food for another -- like eating cereal in

the morning instead of a sweet roll for breakfast, cutting back on butter on

bread and reducing portion sizes, " he said.

Researchers are uncertain why low-fat diets might reduce the risk of

recurrence, but some evidence has suggested that reducing fat in the diet

may cut the amount of the hormone insulin in the blood, Chlebowski said. In

addition to controlling blood sugar levels, insulin may also promote cancer

growth.

Other researchers questioned whether the scientists adequately accounted

for other changes that may have played a role, such as whether the women on

the low-fat diets lost weight, ate more fruits and vegetables, exercised

more or reduced their overall caloric intake.

Chlebowski acknowledged that the women in the study who cut their fat

intake also lost about four pounds on average, and probably consumed more

fruits and vegetables. But the women did not increase their exercise

significantly or sharply reduce their overall caloric intake, he said.

" The point is if you do this intervention, this is the result you

apparently get, " Chlebowski said. " So in that way the exact mechanism isn't

important. "