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

Self Breast Exam

Dear Dr. Bone,

I am a good patient who goes for annual mammograms, but I do not do breast self exam.I am afraid that I won’t know what I am feeling or that I will find something. I feel guilty about it but have heard various things about how important it is to do regularly. What do you think?

M.M.

Dear M.M.

If only I had a nickel for the number of times that I’ve heard those comments! You are not alone. There are many studies pointing stressing the importance of self exam to find cancers, especially ones that do not show up on mammogram and come up between mammograms (called interval cancers). Other studies show that breast self exam does not necessarily improve survival from breast cancer or long term outcomes. My feeling is that you should try to do them, but not beat yourself up about it if you do not do them regularly. There are now kits available to improve your technique by using silicone or other liquids between to layers to improve your skill. While these may be helpful, if you can just start with soap and water in the shower and try to cover all areas of the breast and armpit it is a good start. Remember, almost every woman has some lumps and bumps. Anything hard, stuck, and painless may be important. Try to examine during the week after your period is over when the breasts tend to be less sensitive. If you are postmenopausal, just pick the first of the month or your birthday number. I liken breast self exam to moving to a new city. In the first few months you don’t know your way around, but eventually, you know the streets well and would notice if there is a traffic detour. Once you make breast self exam a habit, any changes, even small ones, will probably stand out without a conscious effort.

Having said all that, don’t cancel your mammogram! Do them both.

Dr. Bone

Please take advantage of the following videos of Dr. Melanie Bone explaining both a stand up and laying down breast self exam.

Weirdest Cancer Ever

Dear Dr. Bone,

My cousin and I were trying to figure out what type of cancer is the weirdest. Is there really cancer of the fingernail? The hair?

J&J

Cousins

Dear J&J,

Yes, you can get cancer of the fingernail. While it is rare, it does happen. Fungal infections of the nail are very common and cause deformities that have been misdiagnosed as cancer. Traumatic injuries to the nail also cause a discoloration that can be confused with cancer. The most common cancer of the nail is melanoma. It looks like a change in the color of the nail, usually tan to black. Unfortunately it can be misdiagnosed as a nail injury and overlooked. A good rule of thumb (get it!) is to wait until the nail grows. If the lesion does not go away with the nail growth, get it checked out. I suggest seeing a dermatologist.

Hair does not get cancer, but the hair follicle from which the hair grows is susceptible to cancer. Remember, in order to get cancer, there needs to be live cells that divide and a blood supply to the area. Hair has neither of these.

Keep sending more questions.

Dr. Bone

Paps and Cancer

Dear Dr. Bone,

My gynecologist wants me to have a pap smear. I had a partial hysterectomy 3 years ago and no longer have a cervix. Do I really need a Pap smear to screen for cervical cancer if I don’t have a cervix?

A.M.

Dear  A.M.,

What a smart patient you are! The pap does screen for cervical cancer. If you don’t have a cervix, you probably do not need a pap smear. If your hysterectomy was done for pre-cancer or cancer of the cervix, then I would continue to screen you with pap smears. In my residency many years ago, we were taught to do yearly paps on everyone without a cervix to find vaginal cancer. I have never seen a case. We now know that the HPV virus is the cause of cervix cancer and warts. If you are in a stable, monogamous sexual relationship or are not sexually active, then I would no longer do a pap smear. On the other hand, if you have a new partner or there is a question about your spouse’s fidelity, then I would screen you with a pap and HPV every three years (unless one or the other are abnormal). I refer you to the American College of Obstetricians and Gynecologists website for more information (www.acog.org).

~Dr. Bone.

Plastic Bottles and Cancer

Dear Dr. Bone,

 I drink a lot of water everyday and got nervous when I was sent a message on-line that drinking water out of plastic disposable bottles, especially if they are hot after being left in the car, poses a risk for developing breast cancer. I even read that Sheryl Crowe thinks this might be why she got breast cancer. Is there any truth to this?

Heavy on H20

Delray Beach

Dear Heavy,

First let me remind you that although water is healthy to drink, Americans (and many of my patients!) think that they need to drink large amounts of water each day to cleanse and “detoxify” their systems. The truth is that the human body does not need quite as much water as one would think and those people that drink water only when they are thirsty are no less healthy. I do see women who are depleted of electrolytes because they drink too much water and urinate so much that they lose potassium and sodium along the way, so be careful.

As for the association between plastic water bottles and cancer, the answer is a bit complicated.  There are different plastic bottles. The pliable ones that are designed to be disposable are made of PET (polyethylene teraphthalate), or a #1. This type of plastic is used in many different products and appears to be safe. The hard plastic bottles (like Nalgene or Lexan) are made out of BPA (bisphenol A). There is controversy about this compound. Some scientists believe that BPA acts biologically like estrogen and could promote estrogen-related cancers.

Until more definitive studies are done, it is best not to take any chances. The “green” advice is to use glass, or an old-fashioned thermos (lined with glass). It is better for the earth and, to my knowledge, glass has not been associated with any particular health hazards.

Dr. Bone

Prevention

Dear Dr. Bone,

With all the time, money and effort spent on finding cures and treatments for cancer, why is there not the same done to prevent? If we never got cancer in the first place, we wouldn’t have to cure it! You really don’t need to reply.

Reader

Dear Reader,

That is the million-dollar question. I hope to devote an entire column to it soon. Suffice to say that cancer is not just one disease. The causes are numerous. Each person’s body deals with cancer cells differently so each person would probably require a different prevention strategy. Lastly, there are already a lot of medical and charitable dollars spent on prevention. Open the paper and you will read about the dangers of excess alcohol consumption and cancer. Still, a large percentage of the population drinks too much. I don’t even need to discuss the risks of smoking. Yet we are not a smoke-free nation. The challenge for public health experts is to get America to adopt more healthy lifestyles that would not only decrease cancer, but heart disease, lung disease, diabetes and a host of life-threatening ailments.

Dr. Bone

Deodorant and Cancer

Dear Dr. Bone,

I read that underarm deodorant can cause breast cancer. Is this true?

~Sweaty

Dear Sweaty,

I remember getting an email many years ago about the hazards of deodorant. Actually, it was about antiperspirants, not deodorants.  What is the difference? Deodorants prevent or control odor related to perspiration, whereas antiperspirants work to prevent perspiration in the first place. A major concern about antiperspirants surrounded the aluminum content found in these products. Aluminum was thought to be linked to Alzheimer’s disease. The relationship between aluminum and breast cancer came later and still is hotly debated. Aluminum deposits are found in greater concentration in the areas of the breast where most cancers are diagnosed, and aluminum, like cadmium, has estrogenic-like activity on breast cancer cells.  A further risk involves the ingredients called parabens, which are used throughout the cosmetic industry. When absorbed through the skin sometimes from underarm shaving cuts, these parabens might conceivably accumulate in the fat cells of the breast or in the lymph nodes near the breast.

Despite these associations, there is no definitive study proving that deodorant or antiperspirants cause cancer. However, it makes sense that you should avoid unnecessary exposures that might be related to cancer, even if remotely. I advocate using only deodorants, not antiperspirants. Sweating is a natural mechanism to help us rid our bodies of toxins. Instead of trying to prevent sweating, I prefer to use a deodorant that eliminates odor naturally. The crystals in Naturally Fresh Deodorant products are pure, aluminum-free and paraben-free, and are hypoallergenic.  They are perfect for people working to prevent cancer, for cancer patients, and for cancer survivors.

And, in addition to their original fragrance-free line, Naturally Fresh now has lovely scented products, including lavender, papaya fusion, ocean breeze, and tropical breeze to appeal to men and women everywhere.

~Dr. Bone

Cancer Quiz

Quiz/statistics/ poverty

Cancer Quiz

1.      What is the most common kind of cancer worldwide?

2.      Which cancer is considered the most curable? 

3.      Which causes more deaths in the United States: cancer or heart attack and stroke?

4.      Which cancers are most preventable?

5.      What percentage of cancer is probably preventable?

6.      What is the biggest risk factor for cancer?

Answers

1.      The most common cancer worldwide is lung cancer, causing over 1.2 million deaths each year. While 85% of the patients with lung cancer are smokers or were smokers, more and more lung cancer is occurring that is unrelated to smoking. In developing countries where smoking is more common and pollution is not as well regulated as in the United States, the incidence of lung cancer is rising.

2.      Many cancers are curable at an early stage. Skin cancers, breast cancer, testicular cancer, and prostate cancer all have excellent prognoses when detected early. Skin cancer is easy to detect and treat if you are having regular skin checks, reputation the reputation of most curable. 

3.      Though they are neck-and-neck, the combination of heart disease and stroke causes more deaths than cancer in the US, according to the Centers for Disease Control.

4.      Lung cancer is highly preventable by avoiding smoking. Having regular colonoscopies should reduce the diagnosis of colon cancer dramatically because precancerous growths can be removed before they turn into cancer. Cervical cancer, a major worldwide risk in developing countries, could be reduced dramatically by the HPV vaccine and by implementation of global screening for this sexually-transmitted virus.

5. A full 30% percent of cancer could be prevented by not smoking, eating fruits and vegetables, and maintaining a normal body weight through regular vigorous physical activity. Unfortunately there are many socioeconomic barriers to attaining these goals.

6. Tobacco smoking is the highest risk for cancer.

These answers may seem obvious, but I was amazed at the number of people who thought that breast cancer was the most common and most deadly worldwide. We take it for granted that people all over the world know the dangers of cigarette-smoking, but data show that people living in other countries are unaware of the health hazards of smoking.

Few people realized how rare some cancers are in the US. For example, there are only about 11,000 cases of cervical cancer diagnosed in the US annually, but this cancer is a leading cause of death in Sub-Saharan Africa. Again, lack of effective public health.


~ Dr. Melanie Bone

Veterans and Cancer Survivors much alike

A few years ago Eric and I were strolling along Fifth Avenue in New York City. A commuter bus passed us displaying an advertisement on its side that was unforgettable. It was a picture of three bald heads. Under the first was the word MILITARY. Under the second was the word FASHION. Under the third was the word CANCER. Neither Eric nor I could recall what organization ran the ad - he thought it was the American Cancer Society but I wasn't so sure - but it was a powerful image. Eric remembered that it was about breast cancer during October; he thought the first two heads were male and the third was a female, making it even more poignant.

Dr. Melanie Bone's Family

To this day my memory is not what it was before chemotherapy (or is it my age?), and I'd forgotten completely about that bus until I found myself back in Manhattan for a weekend getaway. I thought the weekend after the marathon would be perfect. Not as hectic and still not too cold to walk in Central Park. Somehow it escaped me that it was Veterans Day weekend. We planned out our day to visit Occupy Wall Street and make it back uptown in time to catch the parade. A veteran in uniform marched by. He had a shaved head. Out of nowhere, a memory of the bus flashed into my head.

Instead of thinking about the image as an advertisement for cancer, I tried to think about it from the perspective of the veteran. After all, veterans and cancer survivors have a lot in common.

Going to war as a soldier and "fighting" a battle against cancer are analogous. The experience, often scary and overwhelming, is one not easily understood if you have not been through it. Soldiers develop a camaraderie during war in much the same way that cancer patients do. They are subjected to difficult and challenging situations and always are aware of the imminent threat of loss of life or limb.

There is a certain mysteriousness to the "secret lives" of soldiers and cancer patients. They are assumed to see, hear, feel, and do things that most of us would never see, hear, feel, or do. At the other end, most are left with strong memories, be they good or bad, and some with nightmares that can be long-lasting.

Having survived war or cancer earns you the title of "veteran" or "survivor." With these titles come an identity and certain expectations. Many vets and survivors forever remain identified by their status. They hold onto it for a multitude of reasons.

Some are empowered to use their status to raise awareness and others to help those that come after them. Some just feel that they are forever changed and are at a loss to reinvent themselves as anything else. Post-traumatic stress disorder abounds as does guilt that they have made it and other soldiers or cancer patients died.

I am certain there are many veterans who have returned home and moved on just as there are cancer survivors who are cured and moved on. Why don't we remember them as often? Because their status as veteran or survivor is now a part of their persona, but not the central, identifying component of it.
I am known for trying to take the war and battle analogy out of the cancer experience. I support the concept of approaching cancer sensibly and thoughtfully. In war there are winners and losers. Even the winners suffer.

With cancer, many patients are cured. They are the winners, but are always left with scars. For those that die or live with cancer as a chronic disease, is it right to label them losers? I don't think so. Unlucky yes, but the connotation of the word loser is not one that should be associated with people who are not cured of their cancer.

As we boarded the Jet Blue plane home, I had one of those once-in-a-lifetime experiences. There on the wall of the jetway were the exact pictures of the bald heads we'd seen a few years earlier. What are the chances of that happening?! One read SOLDIER, the second STYLE, and the third SURVIVOR. They were being used as part of a bank advertisement. Eric and I looked at each other with disbelief. I knew this column was destined to be!

Please take a moment to visit Cancer Shop USA It's a great resource for cancer patients and professionals.

Answers to six common questions about cancer

Dr. Bone's Cancer Quiz:

1. What is the most common kind of cancer worldwide?

The most common cancer worldwide is lung cancer, causing over 1.2 million deaths each year. While 85 percent of the patients with lung cancer are or were smokers, more and more lung cancer is occurring that is unrelated to smoking.

In developing countries where smoking is more common and pollution is not as well regulated as in the United States, the incidence of lung cancer is rising.

2. Which cancer is considered the most curable?

Many cancers are curable at an early stage. Skin cancers, breast cancer, testicular cancer, and prostate cancer all have excellent prognoses when detected early. Skin cancer is easy to detect and treat if you are having regular skin checks. This has earned it the reputation of most curable.

3. Which causes more deaths in the United States: cancer or heart attack and stroke?

Though they are neck-and-neck, the combination of heart disease and stroke causes more deaths than cancer in the U.S., according to the Centers for Disease Control and Prevention.

4. Which cancers are most preventable?

Lung cancer is highly preventable by avoiding smoking. Having regular colonoscopies should reduce the diagnosis of colon cancer dramatically because precancerous growths can be removed before they turn into cancer. Cervical cancer, a major worldwide risk in developing countries, could be reduced dramatically by the HPV vaccine and by implementation of global screening for this sexually transmitted virus.

5. What percentage of cancer is probably preventable?

A full 3 percent of cancer could be prevented by not smoking, eating fruits and vegetables, and maintaining a normal body weight through regular vigorous physical activity. Unfortunately there are many socioeconomic barriers to attaining these goals.

6. What is the biggest risk factor for cancer?

Tobacco smoking is the highest risk for cancer.

These answers may seem obvious, but I was amazed at the number of people who thought that breast cancer was the most common and most deadly worldwide. We take it for granted that people all over the world know the dangers of cigarette-smoking, but data show that people living in other countries are unaware of the health hazards of smoking.

Few people realized how rare some cancers are in the U.S. For example, there are only about 11,000 cases of cervical cancer diagnosed in the U.S. annually, but this cancer is a leading cause of death in sub-Saharan Africa. Again, lack of effective public health education about the risks of HPV along with lack of easy access to health care, pose an enormous obstacle to prevention, early diagnosis and virtual elimination of this cancer.
I used to think cancer was an equal-opportunity disease, but I am beginning to see that it isn't. Members of the lowest socioeconomic class are more likely to get cancer and to die of it. A large portion of the population worldwide can't afford fruits and vegetables, let alone organic ones. They survive on a starch staple like rice. If they eat vegetables, they are not a variety of bright-colored ones, but rather whatever they can afford. Regular exercise is a luxury; millions of people who work 16- to 18-hour days just to eke out an existence will never jog or go to the gym. For those of us naive enough to think that poverty alone was bad, now we have to add susceptibility to cancer to really appreciate how fortunate we are.

 For a variety of products that can help you maintain a well balanced diet visit the nutritional section at Cancer Shop USA.

Welcome To Cancer Shop USA

Welcome to the first and only patient requested-doctor approved on-line store to offer products to help with the side effects of chemo and radiation.

Cancer Shop USA is one of a kind! Founded by Dr. Melanie Bone, Cancer Shop USA offers a myriad of over 300 practical and appropriate products to comfort those undergoing treatment and on their journey to recovery.

Many of the specialty products Cancer Shop USA has to offer are actually designed by cancer survivors. Survivors know best  because they already rode much of the path to recovery. Cancer Shop USA helps survivors get their products into the hands of cancer patients.

One of the many products Cancer Shop USA offers that is designed by a survivor, includes the Chemo Port Cover. This beautiful handmade creation was designed by an Ovarian cancer survivor who was tired of hiding behind old baggy shirts and jackets. She decided to create something that was durable and could easily clip onto any strap thus hiding her chemo port. Cancer Shop USA now offers Chemo Port Covers in over 16 styles and 20 different colors.

Dr. Melanie Bone is a mother of 4, practicing physician, and published author. Maybe you have read her syndicated column Surviving Life, or perhaps you read her book Cancer: What's Next. You may have even "Asked The Expert" on her foundation's page. These are all resources Dr. Bone creates for patients to eliminate the fear associated with cancer. 

Please visit our video bar and Twitter updates to the right --->.

You can browse all the unique items Cancer Shop USA has to offer by click the "Shop Now" tab above. 10% of profits get donated to different foundations monthly. To submit your foundation, please email arielle@cancershopusa.com for more information. We are currently getting ready for Ovarian cancer month in September. If you would like to nominate a foundation please email Arielle our Director of Marketing. 

"It's not the years in your life that count.  It's the life in your years."  ~Abraham Lincoln