Milk and Cancer

Dear Dr. Bone,

Is it true that there is a difference in the risk for cancer if you drink whole milk instead of skim or 2%? My friends and I were discussing it at lunch. I thought the benefits of lower fat were all related to heart disease, but they say that whole milk also contributes to cancer. Who is right?

D.L.

Dear D.L.

The relationship between milk and cancer is complex. Countries whose inhabitants do not consume much milk seem to have lower incidences of certain cancers. For example, in Japan and Mongolia there is less breast cancer than in the United States. One of the reasons posited for this phenomenon is the presence of hormones in milk. In order for cows to produce more milk they are kept pregnant for prolonged periods of time. Milk from pregnant cows naturally has a higher estrogen content. Farmers also inject the cows with hormones. One in particular, recombinant Bovine Growth Hormone (rBGH), results in milk that contains higher amounts of Insulin-like Growth Factor, known as IGF-1. IGF-1 can be absorbed from the milk and stimulate cancer cells. Since hormones in milk are fat soluble, it would seem safer to drink low fat milk. On the other hand, conjugated linoleic acid, a natural anti-cancer molecule, is found at its highest concentration in whole milk as is calcium, a necessary building block for our bones.

The popular book called The China Study looks into the relationship between diet and cancer. I have many friends who became vegan after reading it because they were convinced that dairy consumption can be dangerous, not just for cancer, but for heart disease and other ailments too. A moderate by nature, I suggest that each person find their comfort level after assessing the data. It is unlikely that an occasional glass of milk or ice cream will cause cancer, but dietary modifications along with exercise, decreasing alcohol consumption, and controlling stress, should results in a longer, healthier life.

~ Dr. Bone

Chicken Nuggets

Dear Dr. Bone,

My mother hates it when I eat McDonald’s food. She says that the chicken nuggets are loaded with chemicals. Would I be more likely to get cancer from eating too many chicken nuggets? If so, what kind of cancer?

Junk Food Junkie 

Dear Junk Food Junkie,

Hard question to answer. I won’t single out one fast food chain. Most chicken nuggets bought at a fast food restaurant are made with combinations of chicken meat and what are called by-products. These are other parts of the chicken including the tendons that attach muscles to bones. They grind the meat into a paste and add food starch, dextrose, and other flavorings. There is no documented evidence that the contents of nuggets cause cancer and it is highly unlikely that eating nuggets now and again will cause cancer. However, a diet rich in vegetables and fruits will help to prevent cancer. So, if you are going to eat chicken nuggets and fries, you’d be smart to order the apple slices or carrot sticks to go along with them!!!

Dr. Bone

Juicing and Cancer

Dear Dr. Bone,

I just read an article about the power of juicing and a raw diet to prevent cancer. What do you think?

Health Nut

Dear Health Nut,

I am so happy that bring up prevention as a topic. Cetainly we wouldn’t need to work so hard on treating cancer if we could prevent it in the first place! I may sound like a broken record, but cancer is not just one disease. If it were, then we could probably come up with the right way to prevent it. Instead, there are so many reasons people get cancer, that no one behavior will guarantee that you won’t get cancer. Eating organic, or raw, or juicing is a healthy thing to do because you get the recommended daily intake of various fruits and vegetables. Whether those choices really prevent cancer has not been proven. My personal opinion is that moderation and personal happiness is the key. That would translate to some raw, some cooked. Juicing, but not necessarily every day. Red meat on occasion, but not as a staple.  I applaud people who take an interest in their food choices because they usually exercise and maintain their weight as well – both of which seem to be correlated with a lower risk of many diseases including cancer.

Dr. Bone

Convincing A Friend To Quit Smoking

Dear D. Bone,

I know this is not exactly a question about cancer, but I thought you might help. My sister died of lung cancer after smoking for 40 years. My nephew is now a grown man with children. He smokes like a chimney! He watched his mother die but won’t quit. Is there anything that can be done to convince him that he needs to stop smoking now?

Frustrated

Dear Frustrated,

It is hard to believe that someone who has watched a loved one die of a smoking related cancer still smokes themselves. Remember, smoking is an addiction, and a lesson learned from Alcoholics Anonymous is that you cannot change a person who is addicted. They must want to change themselves. All you can do is love and support them. His own family can make rules that he cannot smoke inside the house because of the risk of exposure to second-hand smoke, but more aggressive intervention will probably not work. Until he is ready to quit smoking, any nagging, warning, prodding, or begging is in vain. I suggest that you simply make him aware that you are available if that time should arrive. Then, there are medications, support groups, hypnotism, laser, acupuncture, etc. to make it easier.

By the way, for those of you inclined to quit smoking, there is an urban legend that for each year you quit smoking, your risk of lung cancer goes down. Unfortunately, former smokers make up a considerable portion of lung cancer patients. The risk remains high for a very long time. Please, please use that as motivation to quit NOW.

Dr. Bone

Elective Second Mastectomy

Dear Dr. Bone,

I just celebrated 5 years out from my breast cancer. I had a mastectomy and implant reconstruction with a matching augmentation implant to the other side for symmetry. This week I had a suspicious mammogram on my remaining real breast. I am a wreck waiting for the biopsy. I don’t think I can go through it all again. Do you think the surgeon would be wiling to remove my breast regardless of the biopsy result? I think it will be the only way I will sleep peacefully.

Anxiously waiting,
Jupiter

Dear Anxious,

If only I had a penny for every patient in your shoes...Your situation is not unusual. There is no question that the prospect of having another cancer is almost unthinkable. The good news is that statistically it should not be a cancer. My advice is to take it one day at a time and not try to predict your reaction ahead of time. If you wish to have a mastectomy regardless of the biopsy results, you should discuss it with the surgeon. As I have mentioned many times, I have never heard a woman regret that she had bilateral mastectomies, only that she didn’t! If your insurance company does not feel that it is a procedure they want to pay for, you will need to address that issue. The cost-benefit analysis would seem to fall in favor of the surgery over years of imaging with follow-up extra views, sonograms, MRIs, and even biopsies. Should you get a second cancer, it would then be very costly for your insurer to pay for surgery, radiation therapy and/or chemotherapy. Having said all that, it can be tough to convince some insurance companies that they should pay for the prophylactic surgery.

Good luck.
Dr. Bone                                

How To Convince A Friend To Get Genetic Testing

Dear Dr. Bone,
My friend was diagnosed with fallopian tube cancer. I remember reading your column that mentioned it could be hereditary. I want to tell my friend that she should ask her doctor to be tested, but I worry that I am invading her privacy. What do think?

E.R.


Dear E.R.,

I can see how your situation is a sticky one. On one hand you are concerned for your friend’s health and the health of her family members. On the other hand, discussing personal issues like genetic testing can seem too private. There is no one right answer. However, if you put yourself in your friend’s shoes, you might be able to figure out what to do. If she tests and is positive, she will be able to help save her children, siblings, and grandchildren from going through what she is experiencing now. If she tests negative, she will know that she did not pass on a very high risk to develop fallopian tube and other cancers related to it. Since she already has cancer, there is little downside to getting her tested.

So how do you broach the subject? It can be difficult to bring it up in a face-to-face conversation. Perhaps you can include a pamphlet on genetic testing in a greeting card. Your note should explain that you are offering this information because you care so much about her. After that, I would drop the subject and let her decide on her own what to do. To that end, I am sending you some pamphlets and you can decide on your own what to do.

Best of Luck,
Dr. Bone