What You Need to Know About Breast Cancer

Breast Cancer is Everyone’s Business!

October is National Breast Cancer Awareness Month, so here's important information for both women and men from UIC Pharmacy.

About Breast Cancer

Breast cancer is the second most common cancer in US women.  According to the American Cancer Society, an estimated 230,480 new cases of invasive breast cancer were diagnosed in 2011.  The exact cause of breast cancer is unknown, but several factors have been linked with changes that cause normal breast cells to become cancer cells.  Some of these risk factors include:

·       Being female.

·       Older age.

·       BRCA1 or BRCA2 gene mutations.

·       Family history of breast cancer.

·       High breast density (less fat tissue in the breast).

·       History of radiation therapy.

Other possible risk factors include race or ethnic background, environmental factors, and lifestyle choices.  For example, more Caucasian women get breast cancer than African American women.  Use of birth control pills and getting your first period at an age younger than 12 years both slightly increase the risk of breast cancer.  Talk to your doctor about possible risk factors you may have and things you can do to decrease your risk.

To learn more about risk factors and the strength of the scientific evidence for each factor, go to:

http://ww5.komen.org/BreastCancer/BreastCancerRiskFactorsTable.html

For a list of questions you can ask your doctor about breast cancer, go to:

http://ww5.komen.org/BreastCancer/QuestionstoAsktheDoctorPDFDownloads.html

Breast Cancer in Younger Women

Although older women have a higher risk of breast cancer and make up most of the patients with breast cancer, younger women may also be at risk.  Of the 70,000 patients aged 15 to 39 years who are diagnosed with cancer each year, 15% have breast cancer.  Breast cancer  in younger patients tends to be more aggressive than in older women.  The most common cause of cancer-related death in women aged 15 to 54 years is breast cancer.  Rates of breast cancer in African American women under the age of 35 are twice the rate in Caucasian women of the same age. 

To learn more about breast cancer in younger women, go to:

http://www.youngsurvival.org/breast-cancer-in-young-women/learn/statistics-and-disparities/

Breast Cancer in Men

Although rare (less than 1% of all breast cancer cases), men can get breast cancer.  An estimated 2,140 men in the U.S. will develop breast cancer in 2011.  Most cases of breast cancer in men are found in patients aged 60 to 70 years.  Risk factors and survival rates are similar in men and women, but breast cancer in men is usually more advanced at diagnosis, possibly because screening in men is less common.

To find out more breast cancer in men, go to:

http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/patient

What are Warning Signs for Breast Cancer?

The most common warning signs are changes in the look or feel of your breast or nipple and nipple discharge.  It is important to know how your breasts look and feel normally so that you can recognize any changes.  Normal breasts can be lumpy.  If lumps are felt throughout both sides of the breast, they are most likely normal breast tissue.  Lumps that are hard or feel different from the rest of the breast tissue need to be checked by a healthcare provider.  Nipple discharge may occur for reasons other than cancer (such as infection), and should be evaluated by a healthcare provider in all cases.

To learn more about warning signs for breast cancer, go to:

http://ww5.komen.org/Content.aspx?id=5236&terms=symptoms

What are the Current Recommendations for Breast Cancer Screening?

Currently, a mammogram is the most effective and reliable diagnostic tool for breast cancer.  Self-exams and breast exams performed by a doctor have not been shown to reduce the risk of dying from breast cancer; however, not all cancer cells can be found through mammograms.  Therefore, the combination of regular self-exams, breast exams performed by a doctor, and mammograms is the best option for screening.

Visit this website to learn how to perform a breast self-exam: http://ww5.komen.org/BreastCancer/DownloadBSECards.html

Current recommendations for mammography for average risk women differ among organizations, but screening should generally start at age 40 and be repeated every 1 to 2 years.  Breast exams performed by a doctor in average risk women should start at age 20 and be repeated every 3 years until age 40, then every year after age 40.  The State of Illinois offers free mammograms, breast exams, and other screening tests to eligible women. 

To find out more about free breast cancer screening in Illinois, go to:

http://cancerscreening.illinois.gov/index.htm

For breast cancer screening resources in other states, go to:

http://apps.nccd.cdc.gov/cancercontacts/nbccedp/contacts.asp

Choices to consider

Maintaining a healthy weight through exercise and diet and limiting alcohol consumption to less than one drink per day can lower your risk for breast cancer.  Choosing whole grain foods, eating 5 servings of fruits and vegetables every day, and eating less meat are also healthy lifestyle choices that can lower your chances of getting breast cancer.  Your doctor may be able to suggest other lifestyle changes that you can make based on your specific breast cancer risk factors.

Get Involved: Things You Can Do About Breast Cancer Right Now

·       Send an E-card to people you care about to raise awareness about mammograms.

http://www2c.cdc.gov/ecards/message/message.asp?cardid=198

·       Post links about breast cancer awareness on your Facebook or Twitter page.

·       Become a friend of the Susan G. Komen Breast cancer Foundation on Facebook.

http://www.facebook.com/susangkomenforthecure?ecid=vanityurl%3A8

·       Find local events and ways to help people with cancer through the American Cancer Society.

http://www.cancer.org/InYourArea/index

Soojin Jun

Doctor of Pharmacy Candidate 2013

UIC College of Pharmacy

What You Need to Know About Cholesterol

At UIC Pharmacy we want to keep you informed, being knowledgeable about cholesterol and it’s impact on our body is critical in order to promote optimum health outcomes. It is interesting to note that in 2005, 50% of Americans had total cholesterol levels that exceeded 200 mg/dL. With such an astonishingly high number, Americans need to be aware of the dangers of elevated cholesterol levels. For a normal, healthy adult, total cholesterol levels should be less than 200 mg/dL. Elevated levels of cholesterol are known to cause problems like stroke, myocardial infarction (heart attack), and can increase the risk of death.

Here are some facts about cholesterol:

•Cholesterol is one of the major lipids in the body.

•Cholesterol is essential for cell membrane composition and serves as a starting point for hormone synthesis.

•Keeping cholesterol under control may help to reduce the risk of heart attack or stroke that can result from hardening and narrowing of the blood vessels.

•The two major forms of cholesterol are LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein).  

•The main target for cholesterol management is focused on lowering LDL.  Other goals include reducing total cholesterol as well as increasing HDL.

How often should I get my cholesterol checked?

According to the National Cholesterol Education Program (NCEP), individuals that are 20 years or older should get their cholesterol levels checked at least once every 5 years. Generally, the target goals for cholesterol levels are:

• Total Cholesterol < 200 mg/dL

• LDL < 160 mg/dL*

• HDL > 60 mg/dL

• Triglycerides < 150 mg/dL

*Additionally, if there are other risk factors such as diabetes or heart disease, the LDL goal can be as low as 100 mg/dL and for some, less than 70 mg/dL.

Can I test my cholesterol from home?

While it is advisable to see a licensed health practitioner, home cholesterol test kits are available to patients. CholesTrak and Cardiochek ST are two products that can assist in home cholesterol monitoring. Be sure to follow-up with your doctor to review these results.  

What about Lifestyle Modifications?

Lifestyle modifications are a great way to help improve cholesterol levels. Some examples of lifestyle modifications include:

 • Smoking cessation

•  Weight loss

•  Dietary improvements

 • Exercising with moderate intensity at least 30 minutes per day

For smokers, many products are available to help kick the habit. Over the counter products that contain nicotine are available in a variety of forms such as gums, patches, and lozenges. These products work by releasing nicotine into the body to assist with withdrawal symptoms associated with quitting smoking. Additionally, the prescription products Chantix and Zyban may be beneficial for some patients.

Diet and exercise can be very important steps in taking control of cholesterol. The American Heart Association recommends dietary interventions to help lower cholesterol levels such as increasing your daily intake of fruits and vegetables, drinking skim milk or 1% dairy products, and eating lean meat and poultry. In addition, the therapeutic lifestyle change diet has even more specific recommendations, which include:

Total fat being 25-35% of total calories

Saturated fat being less than 7% of total calories

Carbohydrates being 50-60% of total calories

Cholesterol intake of less than 200 mg per day

Dietary fiber intake of 20-30 grams per day

 What Treatments are Available?

While the first step in managing elevated cholesterol is to promote changing diet and exercise habits, drug options are also available for when cholesterol is still not controlled. These drugs may work to lower LDL, raise HDL, or a combination of the two. For instance, a drug class referred to as the statins work to decrease LDL; examples include atorvastatin (Lipitor) and simvastatin (Zocor).

An additional drug that focuses solely on decreasing LDL is ezetimibe (Zetia). Ezetimibe prevents the absorption of cholesterol in the gut. Other classes of drugs include the bile acid sequestrants (e.g., cholestyramine, colestipol, colesevelam); niacin; and fibric acid derivatives (e.g., fenofibrate, gemfibrozil).

Summary

First line therapy is to promote lifestyle changes to patients. If after lifestyle changes have been promoted and cholesterol levels are still not under control, pharmacologic therapy is recommended with statins usually being the drug of choice to help in decreasing LDL levels. Ultimately, it is up to the patient to combine a healthy lifestyle with drug therapy in order to reach optimum cholesterol levels.

Written by:

Naeil Elhaj, Pharm.D. candidate, Class of 2013

UIC College of Pharmacy