Dr PRAVEEN DV  MD part - I [Repertory].
Under the guidance of Dr RITA CHAKRABORTY, HOD Repertory.
ABSTRACT
This work is about the dietary supplements for the people who suffers from breast cancer. Here the article is started with a small information about the breast cancer followed by a detailed information of the advisable diet. This work is done with two purposes, for the layman and for the physician as a brushup of their knowledge.
KEYWORDS
Cancer, Breast, Diet, Mammary gland, Tumors.

INTRODUCTION
Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, or a red scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin. Breast cancer is the most common cancer in women of high-income countries: however, over the past 20 to 30 years, data support a trend of increasing incidence and mortality from breast cancer in lower income countries.

Multiple risk factors have been identified for breast cancer and can be divided into those that cannot be modified and those that are potentially modifiable. Diet is part of the modifiable risk factors together with adiposity, physical activity, smoking, alcohol consumption, and use of hormonal replacement therapy.

DIET AND BREAST CANCER
A role for diet in cancer etiology has been suggested in part because of the large international variation in cancer rates and may be ascribed to the antioxidant properties of selected nutrients, their influence on inflammatory and immune response, on the progression of cells through the cells cycle and DNA repair, DNA mutations, DNA adducts, metabolic detoxification, the stimulation of growth factors and the potential anti estrogen influence of some nutrients. Some foods and nutrients have also been suggested to increase the risk for breast cancer through an increase in circulating levels of endogenous estrogen, insulin-like growth factor 1 or other growth factors.

EAT  MORE  FRUITS  AND  VEGETABLES:  Your daily diet should consist of two thirds plant-based foods and one third animal protein or dairy-based food. Whole grains, beans, fruits, and vegetables are low in saturated fats and rich in vitamins, minerals, phytochemicals, and antioxidants which are beneficial for maintaining good health and preventing chronic disease.
AVOID  FATTY  FOOD: A diet high in fat has been shown to reduce survival in both postmenopausal and premenopausal breast cancer patients. Consuming a lower fat diet will increase long-term survival, reduce the risk of recurrence of cancer, assist in weight reduction, and decrease risk of chronic diseases such as heart disease and diabetes. Strive to achieve a diet that provides 30% or less of total calories from fat. You can achieve this by consuming 1 gram of fat per kg of body weight and this translates into a diet that provides 30% fat. A few simple suggestions for lowering the fat content of your diet include: eating less meat, eating leaner meat, using lower fat dairy products and eating small amounts of oils and fats such as margarine, butter, vegetable oil, and mayonnaise. In addition to being concerned with how much fat you eat, it is also important to focus on the type of fat you eat. Diets high in “good fats” and low in “bad fats” can decrease risk of chronic disease.

AVOID  ALCOHOL  INTAKE: Alcohol intake has been linked with increased risk for breast cancer. The American Institute for Cancer Research along with the World Cancer Research Fund conducted a major review of the evidence and have published a book entitled “ Food, Nutrition, Physical Activity and the Prevention of Cancer : a Global Perspective”. (2009).
        They have concluded the evidence is convincing that alcoholic drinks increase the risk of premenopausal and post menopausal breast cancer. It is apparent that a dose response relationship exists meaning the more you drink the greater the risk. If you choose to include alcohol in your diet it is recommended alcohol should be consumed in moderation. This means women should limit consumption to 1 standard drink per day. A standard drink is considered to be 1.5 oz of liquor, 5 oz of wine, or 1 bottle of beer (12 oz).


VITAMINS  AND  MINERALS: Many vitamins and minerals are important for human health. Not all, but some vitamin and mineral supplements work in the body by antioxidant activity. These include Vitamin C, Vitamin E, Beta Carotene (Vitamin A) and Selenium. In human health under normal circumstances, free radicals are produced by normal body processes such as metabolism and by environmental factors such as pollution and UV light. Free radicals work by damaging healthy cells which can lead to the development of cancer or other chronic diseases. Antioxidants work by destroying free radicals so they cannot damage healthy cells. This scenario indicates that free radicals are “bad” and antioxidants are “good”.

When you are undergoing active treatment for your cancer, this scenario changes. Taking excess antioxidants from supplements is “bad” because it may decrease the effectiveness of your treatments (chemotherapy and radiation). The reason is because your treatments work by creating free radicals. The free radicals produced by your treatment have a job and that is to damage the cancer cell so badly that cancer cell death occurs.
Knowing antioxidants destroy free radicals the scientific community feels the best advice for people undergoing active treatment is to avoid taking antioxidants in high doses via pills, powders and supplements. Diets rich in antioxidants from food sources not supplements, is recommended to fight cancer.

If you choose to supplement your diet it is acceptable to take a one a day
multivitamin/mineral supplement appropriate for age as the levels of antioxidants are considered safe. Sometimes women taking a specific hormonal treatment known as Aromatase Inhibitors may be advised to take supplements. Aromatase Inhibitors are known to increase risk of osteoporosis so your Oncologist will advise you to take 1500 mg calcium along with 800 IU of Vitamin D daily. 
Currently there is very little scientific information in this area so it remains quite controversial whether taking herbals is safe or effective once you have been diagnosed with breast cancer. Some botanical supplements contain hormones or hormonal like substances that may affect disease progression or the effectiveness of hormonal treatments such as Tamoxifen. The following is a list of natural heath products which are known to contain hormonally active ingredients and therefore should be avoided during active treatment.


SOY: Current evidence suggests that there are no specific benefits or harmful effects when soy is consumed in moderate amounts as part of a healthy diet. Dietitians recommends that for “breast cancer survivors, soy remains a healthy food to add protein, fiber, and variety to a plant based diet”. Moderate soy consumption is acceptable and is defined as 1-2 servings a day of soy foods such as tofu, soy beverage, miso, tempeh, and soy nuts and no more than 3 servings per day. Soy supplements such as powders are not recommended because the high dose provided by concentrated sources may have estrogenic effects which could increase the risk for progression of estrogen receptor-positive breast cancer.

DIET  THERAPIES: Diet therapies that advocate fasting as a means of detoxification, or diets that promote juices as the primary source of nourishment, are not recommended. Although vegetarian and macrobiotic diets have healthful features, there is no evidence to suggest they are superior in preventing recurrence than following guidelines to healthy eating. Diet Therapies Promoted for Weight Loss: Many popular diet therapies exist today that promote quick and painless methods for weight loss. Some fad diets focus on reducing carbohydrates in the diet and increasing consumption of protein and fat. If this type of diet is maintained long term, it can lead to fatigue, nausea, muscle breakdown, kidney problems, constipation and negatively affect bone health. Diets such as these also increase the risk of heart disease and possibly some cancers.

AUTHOR:










Dr PRAVEEN DV  MD part - I [Repertory].
Basically from Madurai, Tamil Nadu.
Under graduation - Sarada Krishna Homoeopathic Medical College, Tamil Nadu, India.[2010-2016 batch]
Post graduation - Father Muller Homoeopathic Medical college, Karnataka, India.[2016-2019 batch]
Under the guidance of Dr RITA CHAKRABORTY, HOD Repertory.