The Angelina Effect

BRCA Gene Mutations And Pre-Emptive Surgery

The Angelina Effect. Healthy Living Magazine

The Angelina Effect. Healthy Living Magazine

Angelina Jolie Pitt made headlines again when she announced on March 24, 2015 in a New York Times op-ed that she had just had her ovaries removed to prevent ovarian cancer.

The Oscar-winning actress has the BRCA1 genetic mutation, which substantially raises the risk of breast and ovarian cancer.

Read: Mammograms Save Lives?

Two years ago, Angelina chose to have double mastectomies to prevent breast cancer. Because she had watched her mother, aunt and grandmother die from cancers related to the BRCA1 gene, she was understandably fearful that she might too. For that reason, she made the difficult decision at age 39, to also have her ovaries removed. She explained, “I know my children will never have to say, ‘Mom died of ovarian cancer.’

Jolie chose surgery, but stated that surgery is not the only choice for women with her condition.

Read: Perfume For Breast Cancer

“I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally."

Before I discuss what the alternative options are, I’d like to give you some background information about the BRCA genes—what they do, and the risks they carry when they are abnormal.

what bRCA genes do

The BRCA1 and BRCA2 genes are classified as tumor-suppression genes. The acronyms come from the full names of the genes: Breast Cancer Susceptibility Gene 1 and Breast Cancer Susceptibility Gene 2. They give instructions for proteins to suppress tumor growth and to help repair damaged DNA. Your DNA is a frequent target for assaults from a variety of sources, especially from oxygen free radicals and toxins. Because injuries are common, the body keeps a repair crew on call to fix the damage.

Other Known Risk Factors for Ovarian Cancer:

-Older Age

-Hormone Replacement Therapy (53% Higher With >5 Years)

-Fertility Drugs Taken Longer Than One Year

-Talc-Based Powder;25-35% Higher

-Smoking; 30-50% Higher

-Ionizing Radiation

-Overweight and Obese

-Endometriosis (27-80% Higher)

-Diabetes (20-50% Higher)

-Personal History of Breast Cancer

-High Fat Diet

But, if the crew lacks the right tools to repair the DNA—as it does with BRCA 1 and 2 gene mutations—misinformation can be passed on that may lead to cancer. Specific types of mutations of the BRCA genes are associated with a significantly higher risk of breast and ovarian cancer. These abnormal genes also increase the risk of other cancers including those of the cervix, uterus, pancreas, colon, stomach, gallbladder, and skin (melanoma). Men can also have a BRCA1 mutation and they are at a higher risk for developing prostate cancer at a younger age.

The lifetime risk for these cancers in those with a BRCA

mutation according to the National Institutes of Health is:

-40-80% for breast cancer

-11-40% for ovarian cancer

-1-10% for male breast cancer

-Up to 39% for prostate cancer

-1-7% for pancreatic cancer

Most women do not carry the BRCA mutations. In fact, more than 99% of us do not. Only about five to seven% of women diagnosed with breast cancer have this defect. This means that for the vast majority of women, the major risk factors for developing breast cancer are not genetic, but come from influences under our control, such as diet and lifestyle. These same diet and lifestyle factors also impact the risk of breast cancer in women with malfunctions in their BRCA genes.

Read: Age At First Period

should you be tested for BRCA1 and 2?

Because problems in the BRCA genes are uncommon, testing is not routinely recommended. Women with a strong family history of breast and ovarian cancer, especially diagnosed at younger ages, may want to seek genetic counseling. There are many controversial issues regarding genetic testing that you should fully explore with your doctor before you consent. After consent if you decide to be tested for the BRCA genes, make sure you educate yourself as much as possible about all of your options.

is surgery the best choice?

Although surgical removal of the breasts and ovaries does substantially lower the risk of developing cancer in these organs—a reduction of 80-89% of ovarian cancer and 90-95% of breast cancer—surgery is never without risks. General risks include all those associated with any major surgery which range from bleeding and wound healing problems, to more serious complications, including death.

Read: Get Armed Against Cancer Risk

Surgical removal of the ovaries, especially at a younger age, can have devastating consequences because the hormones they produce are vital to a woman’s health. An oophorectomy is a castration and causes sudden and severe menopause. Hormone replacement therapy helps, but does not eliminate all of the associated side effects. In addition, the long term consequences from this surgery go far beyond just menopausal symptoms. They include:

-Premature death: All-cause mortality is 170% higher in women who have this procedure before age 45

-Cardiovascular disease: The risk is seven times higher compared to women with ovaries

-Cognitive impairment or dementia

-Parkinson’s disease

-Osteoporosis and bone fractures

-Decline in psychological well-being

-Decline in sexual function

how to dodge the BRCA bullett

Read: Disrupt Cancer's Metabolism

The most important point to know is this: Not everyone who has a BRCA gene mutation develops breast cancer and/or ovarian cancer. Estimates currently are about 80% of women with this defect will develop breast cancer if they live to be 80 years of age—20% will not. When the family lineages for those who carry the BRCA gene mutations have been traced back in time, 100 years ago the risk of breast cancer was found to be three times lower.

With this news, two important questions may have popped up for you: Why do some women with the gene mutations avoid cancer? And why was the risk much lower in the past? The answers may be linked to diet, lifestyle and environment—just as they are for women who do not have this genetic defect.

keeping your immune system strong

As Jolie Pitt stated in her op-ed, “It is not possible to remove all risk, and the fact is I remain prone to cancer. I will look for natural ways to strengthen my immune system.”

Keeping the immune system strong is one of the most important aspects to preventing any type of cancer. You can keep your immune system robust in a number of ways: eating a healthy mostly plant-based diet, getting optimal sleep by going to bed by 10 pm and getting up before 6 am, minimizing stress, exposure to pollution and pesticides and avoiding junk food—especially sugar—are just a few.

A simple, easy, but very effective approach that you can do today to strengthen your immune system is to take a mushroom formula. Medicinal mushrooms are powerful supporters of the immune system and have potent anticancer effects as well. I recommend a mushroom formula called active hexose correlated compound (AHCC), which has been studied extensively in Japan and in the United States. It has been found to support every cell type in the immune system and helps to lower the risk of many different types of cancers. Very exciting recent research from the University of Texas MD Anderson Cancer Center in Houston documented that AHCC is also effective at killing the human papillomavirus responsible for cervical cancer.

Read: Anti-Cancer Brazil Nuts

risk-reducing recommendations

There are several factors that have been found to lower the risk of ovarian cancer, especially in those with BRCA1 mutations. They include:

-Having more children

-Breastfeeding (24% lower)

-Using oral contraceptives which cut the risk in half in BRCA1/2 carriers—but, can cause a number of serious side effects including increasing the risk of breast cancer

These recommendations are, at best, not practical for most women. However, there are published studies that show certain foods and nutritional supplements may lower the risks. They include:

Selenium

This less-recognized mineral has several anticancer properties, including helping to repair oxidative DNA damage. A 2006 double-blind, placebo-controlled study of 200 women with the BRCA1 mutation investigated the effects of selenium supplementation and the risk of breast cancer. The women were given either selenium supplements or a placebo. After two years, those taking selenium supplements had an incidence of breast cancer that was two times lower than those taking the placebo.

Omega-3 Fatty Acids

This type of fat—found in generous amounts in wild caught salmon, flaxseeds and walnuts—has many health improving properties, including profoundly reducing inflammation and positively influencing the BRCA1 gene. According to a 2007 French study, omega-3 fatty acids may reduce the incidence of BRCA-related tumors by 30%.

Read: Vitamin D Attacks Cancer Cells

Vitamin D

A study published in the Journal of cell Biology found that vitamin D plays a significant role in turning off a pathway that can cause an activation of the mutated BRCA1 gene and stops the growth of breast and prostate tumors.

Ginkjo Bibola

n a 2011 study published in the European Journal of Cancer Prevention, Chinese researchers discovered that ginkgo may prevent BRCA1-associated ovarian cancer. Another study estimated that ginkgo may reduce the risk by 60% to 67%.

Flax Seeds

A 2013 study found flax seeds, which contain the highest amount of omega-3 fatty acids of any known edible plant, decrease the risk of ovarian cancer by decreasing inflammation—a known risk factor. Another study published in the British Journal of Nutrition found that the lignans in flaxseeds also protect against ovarian cancer.

Read: Mediterranean Diet's Gift

Soy

A Chinese study published in 2014 found that those who regularly consumed soy dropped their risk of ovarian cancer by up to 70%. There appears to be a dose-response relationship—meaning the more soy a woman consumes, the lower her risk of ovarian cancer.

Tea

A 2013 study from China showed up to an 80% reduction of ovarian cancer in regular tea drinkers. The more tea women drank the lower their risk.

Caffeinated Coffee

Drinking several cups a day can drop the risk for those with the BRCA1 gene mutation by as much as 70%.

Read: Coffee On The Beach

Melatonin

Melatonin has a direct effect on the BRCA genes reducing the risk of related cancers. Going to bed by 10 pm helps your melatonin levels to rise to their highest levels.

BRCAS on-the-blink means choices

If you carry the BRCA gene mutations, there are many options to lower your risk. Numerous considerations go into determining what course of action may be best for each individual. Surgery may be the superior approach in certain situations. However for most women, effective safe alternatives to surgery that include a healthy diet and lifestyle, along with key nutritional supplements may be wiser. As a former surgeon, I recommend you consider them first. Your circumstances are unique, so make sure you educate yourself as much as possible to determine which path is right for you.

Read: Lower Breast Cancer Risks by 14%

Christine Horner, MD is a board-certified surgeon. she spearheaded legislation in the 1990s that made insurance companies cover breast reconstruction following mastec-tomy. she is the author of the book Waking the Warrior Goddess: Dr. Christine Horner’s Program to Protect Against and Fight Breast Cancer.ReferencesEilati e. et al. Long term consumption of flaxseed enriched diet decreased ovarian cancer incidence and prostaglandin e2in hens. Gynecol Oncol. 2013 sep;130(3):620-628. doi: 10.1016/j.ygyno. 2013.05.018. e-pub 2013 May 23.Evans DA, shelton e, Woodward, et al. Penetrance estimates for BRcA1 and BRcA2 based on genetic testing in the clinical cancer Genetics service setting: risks of breast/ovarian cancer quoted should reflect the cancer burden in the family. BMccancer. Vol. 8. (May 2008): 155.Gigert R, Hanf V, emons G, et al. Membrane-bound melatonin receptor MT1 down-regulates estrogen responsive genes in breast cancer cells. Journal of Pineal Research Vol. 47. (Aug 2009): 23-31.Hill, s, frasch T, Xiang s, et al. Molecular mechanisms of melatonin anticancer effects. Integrative cancer Therapies Vol. 8. (Dec 2009): 337-346Jiang W, Qiu W, Wang Y, et al. Ginkgo may prevent genetic-associated ovarian cancer risk: multiple biomarkers and anticancer pathways induced by ginkgolide B in BRcA1-mutant ovarian epithelial cells. european Journal of cancer Prevention Vol. 20. (Nov 2011): 508-517.Jourdan MK, Maheo, A, Barascu, et al. Increased BRcA1 protein in mammary tumours of rats fed marine omega-3 fatty acids. Oncology Reports Vol. 17. (Apr 2007): 713-719.Liort GM, Peris I, Blanco. “[Hereditary breast and ovarian cancer: primary and secondary prevention for BRcA1 and BRcA2 mutation carriers].” Medicina clinica Vol. 128. (Mar 2007): 468-476.Pijpe AN, Andrieu D, easton, et al. exposure to diagnostic radiation and risk of breast cancer among carriers of BRcA1/2 mutations: retrospective cohort study (GeNe-RAD-RIsK). British Medical Journal Vol. 345. (2112): e5660Tomasz H, Tomasz B, Gronwald J, et al. A lowering of breast and ovarian cancer risk in women with the BRcA 1 mutation by selenium supplementation of diet. Hereditary cancer in clinical Practice Vol. 4. (Jan 2006): 58.Jourden ML, et al. Increased BRcA1 protein in mammary tumours of rats fed marine omega-3 fatty acids. Oncol Rep. 2007 Apr;17(4):713-719.Lee AH, et al., soy and isoflavone intake associated with reduced risk of ovarian cancer in southern chinese women. Nutr Res. 2014 Apr;34(4):302-307. doi: 10.1016/j.nutres.2014.02.005. e-pub 2014 feb 22.Ye B, et al., Ginkgo biloba and ovarian cancer prevention: epidemiological and biological evidence. cancer Lett. 2007 Jun 18;251(1):43-52. e-pub 2006 Dec 27.Huzarski T, et al. A Lowering of Breast and Ovarian cancer Risk in Women with a BRcA1 Mutation by selenium supplementation of Diet. Hered cancer clin Pract. 2006 Jan 15;4(1):58. doi: 10.1186/1897-4287-4-1-58.Nagle cM et al. Tea consumption and risk of ovarian cancer. cancer causes control. 2010 sep;21(9):1485-1491. doi: 10.1007/s10552-010-9577-7, e-pub 2010 May 20.
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