By Debbie Saslow, PhD

There are a limited number of things that women can do to lower their risk of breast cancer, including getting regular physical activity, limiting alcohol, and maintaining a healthy weight. Breastfeeding has often been included in the protective behaviors against breast cancer, but the research has been inconsistent.

Looking at the research on breastfeeding and breast cancer risk, it is clear that this has been a difficult area to study. If breastfeeding does lower risk, the level of protection is small and depends on women breastfeeding for a long time.  In countries such as the U.S., most women who breastfeed their babies stop after several months, or they breastfeed less frequently as they start to supplement with formula and baby food. Women who have many children and breastfeed each baby for a long time seem to be at somewhat lower risk of breast cancer than women who have smaller families and breastfeed for a shorter time. Studies that have found that breastfeeding does lower breast cancer risk have also found that protection builds up over time (that is, duration of breastfeeding) and number of children that are breastfed.

The major study (Collaborative Group on Hormonal Factors in Breast Cancer; Lancet, 2002 Jul 20; 360 (9328): 187-95) that supports breastfeeding as protective against breast cancer was published in 2002. The researchers analyzed 47 studies in 30 countries; these studies had information about 50,000 women with invasive breast cancers and 97,000 women without breast cancer.  The study authors found that the rate of breast cancer diagnoses was slightly lower among women who had breastfed and among women who had breastfed for longer periods of time. More...

By Daniel Mark Siegel, MD, MS

Winter is ending and the temptation to shed some layers comes alive.

But if you do show off your body, pay attention -- particularly if you are a mole-y person with dozens of moles, especially funny looking irregular ones all over the place. You may have a condition called "dysplastic nevus syndrome" or "familial atypical multiple mole-melanoma syndrome," which makes you more likely to develop melanoma.  Nevus is the fancy Latin word for "mole," which is a benign growth, but melanoma is a skin cancer that if not diagnosed and treated early can be lethal.

The difficulties of diagnosing melanoma

Fortunately, there are a lot more nevi (not nevuses) than melanoma.  So how do you tell them apart? Sometimes it is easy for your doctor to reassure you, but other times, even with the use of the skilled eyes of the dermatologist and added magnification, dermoscopy, and other evolving imaging techniques, it's still not clear. In such cases, a biopsy is needed.

A biopsy is where all or part of a mole is removed, sent to the lab, and a report of the analysis comes back. Sometimes the report is straightforward and says "benign mole" with no need for further treatment. Other times it reports a melanoma with descriptive staging terms that guide further therapy. More...

By Ted Gansler, MD, MBA, MPH

An article in the April 8 New York Times titled "Scientific Articles Accepted (Personal Checks, Too)" caught my attention. It describes the growing availability of free online medical journals that use questionable tactics to gather and publish research of questionable quality.

The article piqued my interest because the experiences of some researchers described in it are similar to my own. I am also an editor of CA: A Cancer Journal for Clinicians, one of the American Cancer Society's medical journals, so I have an interest in the world of journal publishing.

But more importantly, I wanted to write about this topic because this is an issue that can affect cancer patients, survivors, and their loved ones, all of whom increasingly seek out information from medical journals. More...

By Durado Brooks, MD, MPH

Suppose that, during your next doctor's visit, you look at your medical record and your doctor has written "53- year-old diabetic white female, here today for a check-up." Would you be bothered by that description? Probably not. Your doctor is just discussing your medical condition, right? But what if, instead of "diabetic" the note read "53-year-old obese white female?" How would you feel now? Hurt? Angry? Sad? Would you think, "Why is my doctor being so mean?"

For many, the term "obese" brings to mind a massively overweight individual (like "Fat Albert" in the old Saturday morning cartoons). In reality most obese people don't look like Albert.

Obesity is a medical term

Obesity is actually a precise medical term that is based on a measure of body fat called the Body Mass Index (BMI). The BMI is calculated from a person's height and weight. In general, a higher BMI indicates a higher amount of body fat. Adults with a BMI between 18 and 25 are in the "healthy" body fat/weight category. People with a BMI between 25 and 30 are considered overweight, and a BMI greater than 30 signifies obesity. Many people who view themselves as having a "normal weight" (or at most "pleasingly plump") are shocked when they do this calculation and realize that 180 pounds on their 5 feet 6 inch frame means they are medically obese.  

Our obsession with body image creates an emotional context for obesity that doesn't exist for most other medical issues. But make no mistake about it - obesity is a medical condition, and like other medical problems it has important long-term implications for health and well-being.  More...

By Lewis E. Foxhall, MD

It's almost impossible to get through the holiday season without gaining a few pounds, and for many of us that means we are even more likely to be over our ideal body weight.  Sure, we all want to look good in our clothes, but being obese is not just a condition that affects our appearance.  And in March, during National Nutrition Month, it's a good chance to talk about it.

Weight gain happens when we take in more calories from food (energy) than we use up through our basic biological requirements and exercise. After a while, enough fat stores up and makes us obese. Our bodies are very efficient at taking in energy and storing it for times when it is hard to find, but in our modern environment this is working against us and our health.  For most of us it is easy to get as much food as we want, and most of us do not need to exert ourselves much for work or daily living activities.

Link between obesity and cancer

The problem with being overweight or obese, as measured by weight and height, is that it raises our risk of chronic diseases like diabetes and heart disease.  But did you know that being obese can actually increase our risk of getting cancer and may even worsen our chances of surviving after a cancer diagnosis?  In fact, the American Cancer Society Cancer Prevention Study II showed significant increases in cancer occurrence in people who are the most overweight.  This link is stronger in some cancer types --including breast cancer after menopause, and cancers of the colon and rectum, pancreas, kidney, esophagus, and endometrium -- and can be associated with a major increase in risk. More...

By Durado Brooks, MD, MPH

Thousands of men are diagnosed with prostate cancer each month. These men and their loved ones often turn to the internet to learn about their disease and treatment options, and these searches may lead to medical centers offering proton beam therapy.  These centers espouse the benefits of this treatment approach, and some include glowing testimonials from men who have undergone the treatment.

So is proton therapy the "magic bullet" for prostate cancer? 

The difference between proton therapy and traditional radiation

Proton therapy is a type of radiation treatment. Traditional radiation therapy has been used to treat cancers for a century using radioactive energy rays called "photons."  When radiation is directed at a cancerous tumor inside the body the rays must pass through normal, healthy tissue in order to reach the cancer cells. In doing so, photons often cause harm to these healthy cells in their quest to get to the tumor. 

In the case of prostate cancer, the radiation beams must pass through the skin, the bladder and the rectum on the way to the prostate gland, and once they reach the gland they encounter normal prostate cells and the nerves that control penile erections.  Damage to these tissues can lead to the complications that often accompany radiation treatment for prostate cancer, including bladder problems, rectal leakage or bleeding, and difficulty with erections.

Proton therapy is a new way to deliver radiation to tumors using tiny, sub-atomic particles (protons) instead of the photons used in conventional radiation treatment. Proton therapy uses new technology to accelerate atoms to 93,000 miles per second, separating the protons from the atom. While moving at this high-speed, the particles are "fired" at the patient's tumor. These charged particles deliver a very high dose of radiation to the cancer but release very little radiation to the normal tissue in their path.  In theory, this approach minimizes damage to healthy organs and structures surrounding the cancer.  More...

By Carol DeSantis, MPH

In conjunction with Black History Month, the American Cancer Society has released Cancer Facts & Figures for African Americans, statistics published every 2 years. The 2013 issue reveals encouraging cancer trends for African Americans, as well as areas where significant disparities remain or are growing. Cancer disparities, or health inequity, are caused by a number of societal problems that result in greater suffering and more people dying from cancer.

Death rates drop, but inequity remains

The great news is that overall cancer death rates have steadily decreased for African American men and women. In fact, the most recent data show that death rates dropped faster for African American men than men in any other racial or ethnic group. That's caused the disparity in cancer death rates between African American and white men to shrink considerably. Cancer death rates among African American women are declining at a similar rate as those of white women. 

Despite these declines, however, death rates for all cancers combined remain 33% higher in black men and 16% higher in black women, compared to white men and women. African American men also have higher death rates for most of the major cancer sites (including lung, prostate, colon/rectum, liver, pancreas, and others). Notably, the higher overall cancer death rate in African American women compared to white women occurs despite lower incidence rates for all cancers combined and for breast and lung cancer.

For African American men, the drop in cancer death rates is mostly due to decreases in lung cancer; other smoking-related cancers like oral cavity, pharynx, larynx, esophagus, pancreas, bladder, and kidney; and prostate cancer. Remarkably, the disparity in lung cancer death rates among black and white men has been cut in half for men overall, and has been eliminated in younger adults (ages 20-39). This progress is mostly due to the fact that more African American men are quitting smoking, compared to white men. Although African American men have historically higher smoking rates compared to white men, over the last decade smoking rates have become more similar. In addition, smoking rates are lower among African American than white high school students. It is believed that if current smoking trends persist, racial differences in lung cancer death rates will be eliminated in the next 40 to 50 years. More...

By Debbie Saslow, PhD

A lot has happened in the area of cervical cancer this past year. The American Cancer Society, the U.S. Preventive Services Task Force and the American College of Obstetricians and Gynecologists all released virtually identical screening guidelines, leading to less confusion and higher acceptance from health care professionals and the public.

Thanks to screening, cervical cancer is not very common in the U.S., with about 12,340 new cases of invasive cervical cancer expected to be diagnosed in 2013. Unfortunately the same is not true around the world, where more than half a million women are diagnosed with cervical cancer each year.  It is actually the 2nd largest cancer killer among women in most low- and middle-income countries.

Sadly, this disease threatens to undermine the important gains worldwide that have been made in sexual and reproductive health, maternal and child health, HIV/AIDs and other infectious diseases. For women in many countries in Africa, Asia, and Latin America, cervical cancer is often detected late, when there is little hope for successful treatment. And it can be devastating to the whole family, both emotionally and financially.

The good news is that a lot has been happening in global cervical cancer.  Indeed, many underserved societies have been actively advocating for improved cervical cancer control policies. In response, governments are increasingly making the HPV vaccine available through their health systems and are supporting new cervical cancer screening methods appropriate for their needs and resources. More...

By Charles (Karl) Saxe, PhD

Something patients do not want to hear and physicians do not want to say is "your cancer has metastasized."

Metastasis is the process whereby cancer cells spread from the site of the original tumor to one or more other places in the body. And with upwards of 90% of all cancer suffering and death associated with metastasis, it is the single most significant challenge to management of the disease.

It's no wonder, then, that a major goal of cancer research is to understand what causes metastasis and how it happens. More...

By Otis W. Brawley, MD, FACP

This week the American Cancer Society announces its lung cancer screening guidelines. In short, we recommend that health care professionals with access to high-quality lung cancer screening and treatment centers should discuss screening with healthy patients aged 55 years to 74 years who have at least a 30-year history of pack-a-day cigarette smoking and who currently smoke or have quit within the past 15 years. The health care professional and patient should discuss all the known benefits and known harms associated with lung cancer screening.

These guidelines were developed after a meticulous process in which a group of cancer screening and treatment experts reviewed all the major lung cancer screening studies that have been published over the past several decades.  More...