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How Les Brown Cured Prostate Cancer

How Les Brown Cured Prostate Cancer

Whether or not you can think you can survive prostate cancer, it’s very important for you to have an open mind that you can. I understand how horrible prostate cancer can be, but it’s still not as much a killer disease as the rest of the world has made it to seem. Yes, it has killed lots of people all over the world, young and old. Yes, it’s still killing lots more people all over the world. Yes, and all the other yess, but the fact remains that there are still lots of people that continue to survive prostate cancer each and everyday.

If other people have survived prostate cancer, then it’s very possible that you can survive it as well. Nothing makes the people who have survived it more special than you. I am very sure that the most important ingredient to their surviving the prostate cancer wasn’t mostly the treatment itself, but mostly in their BELIEF that they would survive it. Yes, you read that right. More important than the treatment itself is YOUR BELIEF in your ability to heal yourself.

Nature, or God (depending on the term you wish to use), has blessed every person with the inert ability to heal themselves, but lots of people don’t know about this ability. Even those who “suspect” the potential of this ability do nothing much about it. That’s mostly why lots of people don’t get cured when others do get cured, especially when both of them have the exact same condition.

That’s why I always tell many people to STAY OPEN. As far as prostate cancer or any other cancer or disease is concerned, it’s best o stay open and believe that a cure is possible, instead of giving up and expecting death to come. I don’t care if you have been given a very limited prognosis by the doctors and you are now waiting on death to come, a miraculous cure for your prostate cancer might just be around the corner.

Finally, it’s not just about staying open. You should try to learn all you can about other people that have survived prostate cancer and find out what they did, then do the same thing. You might just about get the exact same results, especially if you have the right BELIEF that you will survive it too, and if you have the right mindset! I am sure within a very short time, you will begin to see incredible improvement in your situation. Trust me, it can happen if your belief in your ability to heal yourself is strong enough!

Imrt In Breast Cancer

Imrt In Breast Cancer

Worldwide breast cancer is the most common malignancy in women. In the developed world, it is responsible for 18 percent of all cases of cancers seen in women. One million new cases of breast cancer are registered worldwide every year and it is the single commonest cause of death among women in the 40- 50 years age group. In India breast cancer is the second commonest cancer seen in the women after carcinoma cervix. Its prevalence is higher in urban women and it accounts for 20% of all cancer related diseases. In Mumbai and Delhi, it is the commonest malignancy seen in women. In India it has an incidence of 17-40 cases per 1, 00,000 population and the 5 years survival is 42.3 percent to 46.8 percent.

Conventionally radiotherapy in early breast cancers is done by the whole breast technique which utilizes two tangential ports. Upper margin of the radiotherapy field lies at the first intercostals space, and the lower margin lies 2 cm below the inferior mammary line. Medial margin is in the midsternal line and the lateral margin is at the mid axillary line. A total dose of 50 Gy in 25 fractions is given over 5 weeks by conventional fractionation followed by boost of 10-20 Gy. This technique is easy to setup, and avoids the junction dose. Computerizes planning is done for dose optimization. Standard 2d treatment (conventional radiotherapy) techniques utilizes a simplistic view of patient anatomy and it creates hot spot because lung transmission is not accurately included and thinner regions of breast (superior and inferior) are modeled like the thickest slice of the breast. Thus conventional radiotherapy has limitations in the treatment of breast cancer and these include.

Dose inhomogeniety due to change in the contours of the breast 1520 percent of dose inhomogenicity in the superior and the inferior planes of the breast occurs. The medial and lateral aspects of the breast get higher doses of radiation.

Radiation accompaniments i. e. radiation effects on normal tissues in the field are seen uncommonly but they do occur in the lungs and the heart. Newer techniques are able to minimize them.

The newer techniques are used to

Improve dose homogeneity within the tumor volume.
Avoid radiation to normal tissues in the area.
Reduce side effects related to the radiation treatment.
Improve local tumor control and overall survival of the patient.
In an attempt to address the above mentioned parameters a number of newer radiotherapy techniques have been introduced for the treatment of early breast cancer. These include IMRT, external beam RT using 3D conformal RT, Intraoperative Electron Beam RT, Mammosite Ballon Branchytherapy and interstitial branchytherapy. Gated radiotherapy is also available.

All these techniques need a CT scan based treatment planning system and require the use of tissue compensators.

IMRT

IMRT is an approach to conformal therapy that not only delivers high dose to the tumor tissue but also ensures low dose to the surrounding normal tissue. The dose is varied depending on the tumor volume. A higher dose of radiation can be delivered to the areas with high tumor volume, a small dose where tumor volume is not so high and a minimal dose is delivered to surrounding normal tissue. By these means a higher tumor control probability and minimal or no side effects of radiotherapy are achieved, resulting in improved therapeutic ratio and better patient care.

Important normal structures that need to be examined and protected while IMRT for breast cancer is being planned include

Heart
Ipsilateral lung
Contralateral lung
Contralateral breast
Tissues outside the breast planned tumor volume (PTV)
Dose specifications in IMRT are as follows:

Breast volume receiving 105% of prescribed dose should be
Breast volume receiving 110% of prescribed dose should be 55
Breast receiving 115% of prescribed dose should be

Skin Cancer Treatment

Skin Cancer Treatment

When it comes to cases of skin cancer, the Long Beach dermatologist is part of the treatment team that includes the oncologist, the radiologist, the chemotherapists and others. Skin cancer, or melanoma, is a potentially serious disease that is extremely aggressive and metastasizes quickly. If you are at risk, you should have one of your local Long Beach skin doctors examine you frequently, because like most forms of cancer, the various Long Beach skin cancer treatment options are most effective when the disease is caught in the earliest stage.

What Causes Skin Cancer?

Although this disease can happen to anyone, there are certain risk factors that make a person more predisposed to the disease. These include:

-excessive exposure to sun (natural or artificial) -fair skin (people of Nordic ancestry are particularly at risk) -scars or burns -radiation treatments -arsenic exposure -taking immunosuppressive drugs -chronic skin inflammation or ulcers

People with a condition known as actinic keratosis, which is marked by thick, scaly and/or crusty patches of skin. This condition is not malignant by itself but can be a precursor to the disease.

What Are The Symptoms?

Signs of skin cancer may manifest themselves as any or all of the following:

-small, raised, smooth and shiny patches of skin that have a waxy texture -small, raised, red or brown marks -unusual scaling or bleeding -sores that refuse to heal

These signs do not necessarily mean that you have a melanoma; however, you should not take any chances. There are many Long Beach skin doctors who have experience in this area, and they can tell you whether or not your condition is malignant.

How Is Skin Cancer Diagnosed?

If there is a patch of skin that looks suspicious, the Long Beach dermatologist will need a sample, known as a biopsy. A small piece of the area is cut away and sent to a pathologist who will examine the sample under a microscope to determine whether or not cancer is present. Fortunately, melanoma is one of the easier forms of cancer to detect.

What are the Treatment Options?

If caught in the earliest stage, skin cancer is actually one of the easiest to treat – the offending tissue is simply cut away. This may not be the end of it though because there is always a chance that the cancer will recur; patients usually require ongoing monitoring to make sure that a few outlaw cells have not spread to other parts of the body.

If there is metastasis, chemotherapy and radiation treatments may be required. Long Beach skin doctors can educate you of what to expect and refer you to an oncologist for further treatment.

Colon Cancer Symptoms – How To Spot The Signs

Colon Cancer Symptoms – How To Spot The Signs

Colon cancer symptoms range from very mild, to extremely severe. There are often cases of colon cancer that are virtually without symptoms until the latest stages. Once you’ve developed colon cancer symptoms, the disease has presumably entered middle or late stages, and there is a much better chance that it has spread to other areas of your body.

Colon cancer symptoms are not always clear and are often so subtle that they are mistaken for less serious conditions. Colon cancer symptoms are often silent and so they go undetected. As the symptoms are usually confused with less deadly conditions it allows the cancer to progress further before diagnosis and treatment. Colon cancer symptoms are very serious indeed and lead to colon cancer, which is in the top three of the most life-threatening forms of cancer in men.

Symptoms of colon cancer commonly do not give early warning signs of cancer, but through medical history, professional examination and testing, a colon cancer symptoms diagnosis or determination of the presence of cancer may be determined. Symptoms of colon cancer often do not lead straight to the underlying diagnosis and many symptoms can be misleading. Symptoms can remain dormant for as long as five years, by which time the cancer will have moved long past the treatable stage.

Understanding colon cancer symptoms is important, as you can use this knowledge to work with your doctor to uncover out the cause and take care of your long-term health. Some of the more popular local symptoms of colon cancer include changes in your bowel habits, such as bowel movements that are either more or less frequent than normal, constipation (difficulty having a bowel movement or straining to have a bowel movement), Diarrhea (loose or watery stools), Intermittent (alternating) constipation and diarrhea and bright red or dark red blood in your stools or black, dark colored, “tarry” stools.

Stools that are thinner than normal (“pencil stools”) or feeling as if you cannot empty your bowels completely, abdominal discomfort, bloating, frequent gas pains, or cramps. If you experience any of
these for two or more weeks, call your doctor right away to discuss your concerns and arrange for tests to get to the bottom of your symptoms.

90% of colon cancer symptoms are discovered in those 50 years of age or older. It is important to note that in the beginning stages, colon cancer symptoms are rarely noticeable, so it is only people who
regularly go in for a colonoscopy or other colon exam that will be able to catch the disease early. No one likes the thought of a colon exam, as they are certainly unpleasant, but late stage colon cancer symptoms are definitely worse. A doctor is the only one who can determine if your colon cancer symptoms are actually the result of colon cancer.

Skin cancer treatment without surgery with BEC5 Curaderm

Skin cancer treatment without surgery with BEC5 Curaderm

Skin cancer that is non-melanoma can be easily and more importantly effectively be treated with BEC5 which is also branded as Curaderm. BEC5 Curaderm cream is particularly powerful when spread over Basal cell carcinomas. Consisting of a specially purified plant extract means BEC5 Curaderm is successful on Basal cell carcinomas ( BCC ) or Squamous cell carcinomas ( SCC ) which are the most widespread forms of skin cancer. Curaderm cream applications are also effective on benign tumours such as age spots, Keratoses, sun spots and Keratocanthmoas.

Taken from Solanum Sodomaeum this is a plant that is discovered in Australasia. This plant includes an important extract – Solasodine Glycosides. This is an active ingredient that is also discovered in smaller quantities in the eggplant and aubergine salosodine Glycosides and has been established as being very effective for treating cancerous skin conditions. As a result it is incorporated into BEC5 curaderm cream. BEC5 curaderm cream is a renowned sun spot cream, age spot cream that treats skin cancer at the source. Regressing non-melanoma skin cancers It is calculated that more than 80,000 people have applied BEC5 cream, with numbers continuing to grow as a lot more people are trying non-invasive treatment. Clinical trials carried out in Great Britain and Australia have investigated and established BEC5’s power to treat and regress skin cancer that is non- melanoma. One particular study showed how 72 patients being treated with curaderm BEC5 cream ended in the regression of all treated lesions that included 29 SCCs, 39 BCCs and 56 actinic keratoses. Within 1 to 13 weeks of treatment they were healed 100%. Recently 10 UK hospitals discovered how using BEC5 cream twice a day was able to offer total remission to 78% of the patients in as little as 8 weeks. The remainder 22% of patients had improved but required a slightly prolonged treatment time of 13 weeks. This was all made easy without radiotherapy, surgery or chemotherapy.

Royal London Hospital dermatologists have cited the efficacy of BEC5 curaderm cream as being -safe and effective’ skin cancer treatment along with being a perfect therapy for outpatient treatment. This is thanks to BEC5 being affordable and versatile. Approximately 95% of skin cancer are not the Melanoma type and eliminate the need for invasive and expensive operations. For both secondary and primary skin cancer this is proving a highly practical treatment.

Healing Cancer Has To Come From Within Your Body

Healing Cancer Has To Come From Within Your Body

We are not helpless if we have been diagnosed with cancer; there are many lifestyle changes we can make because it’s the way we are now living that is causing it. To survive the cancer, we don’t need to submit to the toxic treatments which are only treating symptoms and not treating the real problem. We all have a built in repair system called the immune system and it’s through this system that you can remove cancer cells and heal the body.

A cancer growth is only a sign the something has gone wrong and it’s not where the growth is, it’s with the entire body. To survive cancer you need to make some important changes, there is no other way. Doctors are only removing growths but if you haven’t removed the reasons why it grew in the first place then no matter how much treatment you have or how much money you spend on treatments, it will only come back again and that’s when it becomes dangerous.

We put our faith in our medical care system when we have a life threatening problem such as cancer but unfortunately money and artificial drugs now dominate our treatments. Man does not have a cure for cancer but only expensive ineffective treatments which damage the body and seldom cure. Only nature has a cure and that means living a more natural lifestyle by eating food that nature has produced and that man has not interfered with.

Cancer is only a modern day problem whereas 50 years ago when cancer was a rare disease we were all eating food that had been grown without the chemicals and without the processing that is common today. Human beings are designed to eat food that has been produced by nature and is fresh as it keeps us free of all medical problems. Only fresh food which is full of vitamins, minerals and other compounds and are designed to keep us healthy and free of diseases such as cancer.

We are living longer nowadays but it’s not because of modern medicine. It’s because of laws that are in place that state that our food and water must be free of bacteria or substances that in the past have caused us harm. Also in all Western developed countries public hygiene has improved vastly, especially in areas of sanitation. But while we are now mainly eating clean food, we are eating mostly processed food and that food is no longer fresh because of its processing. Modern day supermarkets are the biggest contributing factors to cancer.

Cancer in all cases is a disease of the immune system and the immune system is the bodies system that keeps us free of all health problems. The way to become cancer free is to enhance the immune system. That will allow the body to strengthen and the body is then able to remove the cancer slowly and naturally and without any side effects.

Cancer wasn’t a problem many years ago so what has changed and the answer is our food. The food industry has been taken over by business people and it’s all about profit. Also these business people know that human beings have a weakness for foods that contain sugar, fat and salt and processed foods today are full of it. Remember, it’s only man and his pets that get cancer and that is because we are not eating our natural food. Animals in the wild don’t get cancer.

There are many foods that are classed as super foods because of their ability to help the body recover from a serious disease such as cancer. What you have to do is change your internal environment to one that creates health and not cancer and you do that by choosing the foods that cure.

Alan Wighton is an experience health researcher and has specialized how a natural approach to cancer can have a far better outcome than our current way of treating the disease. To learn more about how the body can overcome health problems such as cancer go to; www.cancerhealed.com http://www.cancerhealed.com

Fight Breast Cancer With Calcium D-glucarate And Other Nutritional Supplements

Fight Breast Cancer With Calcium D-glucarate And Other Nutritional Supplements

Most likely, there is nothing more frightening for a woman than the discovery of a lump in her breast. Her mind is quickly flooded with cancer and all of its consequences. Most women have a friend, a sister, or a coworker who has been diagnosed with the disease and know how difficult dealing with it can be. Fortunately, 80% of all breast lumps are not cancer, as most are cysts or a benign clump of tissue. From puberty on, a womans breasts undergo many changes. Because of these continual changes, breast tissue requires adequate nutrition. Although everyone benefits from a healthy diet, there are additional nutrients which can specifically benefit women including B vitamins, calcium D-glucarate, broccoli extract, green tea, maitake mushrooms, and iodine.

Because scientists can learn a lot about diseases from simply observing it, they have learned that certain cultures have a very low incidence of breast cancer, among these being China and Japan. As compared to women in America, Canada, and parts of Europe, the Asian cultures have a much lower breast cancer rate and it seems likely that something in their diet could be protecting these women from the disease. As Asian women adopt a western diet their breast cancer rates climb. It has also been recognized that certain types of vegetables play a large role in the prevention of all types of disease, including cancer. Based on this, scientists have carried out many studies to determine what it is about these nutrients that can prevent breast cancer.

Deficiencies in vitamin B12 can result in a serious type of anemia, as well as nerve damage, and is now being researched to see if these deficiencies can also, in part, cause breast cancer. A scientific study proved that women who had the lowest levels of B12 in their blood had the highest rates of breast cancer. Another study discovered that when B12 was applied directly to cancer cells, it actually stopped cancer cells from growing. The researchers conducting this experiment believe that giving B12 to women with breast cancer as a part of a chemotherapy regime might help to keep cancer in check.

Similarly, low folic acid intake is linked to the development of all cancers because folic acid is crucial to the making and continual repair of DNA. A recent study discovered that high intakes of folic cancer may actually reduce the risk of breast cancer, as women who eat lots of foods that contain folic acid have much lower rates of breast cancer. Although there is no clear-cut, single cause of breast cancer, many factors are required for the disease to appear, including estrogen. Studies have shown that women who have higher levels of estrogen tend to develop breast cancer more often. This means that women who got the periods before age eleven or entered menopause after the age of fifty-five have a higher risk of breast cancer. Another factor affecting breast cancer is the consumption of alcohol. Since alcohol raises estrogen levels, a woman who consumes even moderate amounts of alcohol increases her risk of breast cancer. However a recent study has shown that folic acid can overtake this link between alcohol consumption and breast cancer as those women who drink one alcoholic drink a day and have high levels of folic acid have the same rate of breast cancer as those women with high folic acid intakes who did not drink.

While women need estrogen to soften skin, thicken hair, and fill out hips and breasts, estrogen can also nourish breast tumors and help them to grow bigger, stronger, and more deadly. Thanks to good nutrition, American women get their periods early and go through menopause later in life. Today, women also have fewer pregnancies, with the average number of children being one or two. Each of these factors increases the time in which womens bodies are exposed to estrogen, meaning increased opportunities for estrogen to cause trouble. We are also continuously exposed to cancer-causing chemicals and toxins, coming from contaminants in the food we eat and pollutants in the air we breathe. Although the body does have a system that eliminates some of the excess estrogen and toxic chemicals before they cause harm, an enzyme called beta-glucuronidase can interrupt the excretion process, allowing the hormone or toxin to continue to cause harm. Fortunately, scientists have discovered a natural substance found in foods, calcium d-glucarate (CDG), which can stop the activity of beta-glucuronidase. CDG, which is found in fruits and vegetables, has been shown in experimental studies to significantly slow breast cancer growth. There are also many other trials currently underway studying its ability to decrease the breast cancer risk in women at high risk for the disease.

Iodine, which is the trace element in a hormone found in the thyroid gland and is involved in several metabolic functions, functions as a protection of breast tissue from cancerous cells. A study exposing breast cancer cells and breast tissue without any cancer to a type of seaweed containing high amounts of iodine concluded that the seaweed killed all of the cancerous cells and did not harm the normal breast cells. Researchers believe that it is because many Japanese women eat this kind of seaweed, containing great amounts of iodine, that they have very low rates of breast cancer.

For a great deal of time, cruciferous vegetables including broccoli, cabbage, and cauliflower, have been observed by scientists for their ability to reduce the risk of diseases including cancer. It appears that the phytochemical sulforaphane, found in broccoli, is one of the chemicals responsible for this beneficial ability. Sulforaphane increases certain enzymes in the body called phase 2 enzymes, which deactivate cancer-causing chemicals. When breast cancer cells were exposed to sulforaphane in a lab experiment, the compound inhibited the growth of the cancer cells up to eighty percent.

There is a good amount of research that has concluded that green tea beverage consumption is associated with a lower incidence of breast cancer. Researchers have long noted the low rates of breast cancer in Japan, where green tea is consumed at great amounts. The active compound found in green tea that is responsible for breast cancer inhibition is EGCG, which stops the cells from growing, causes them to lose their ability to replicate, and die.

For many years, maitake mushrooms have been linked to good health in all that eat them, partly because they contain an important compound called D-fraction. D-fraction not only stops the growth of cancerous tumors, but it also alerts and stimulates immune cells to fight the disease. Due to its success, maitake is now being used in clinical trials of women with breast cancer, improving many symptoms including reduction of the tumor.

These nutrients should not be used in place of traditional treatment for breast cancer, as none of these nutrients can cure breast cancer. However, they can be a part of plan of treatment. If you have breast cancer, talk to your healthcare practitioner about these nutrients and remember that nutritional supplements are supplements to your food, medication, and treatment, to enhance and prevent, not a replacement. Supplements like B vitamins, calcium D-glucarate, broccoli extract, green tea, maitake mushrooms, and iodine can be found at your local or internet health food store.

January 2011 love forecast for Cancer-Astrology predictions 2011

January 2011 love forecast for Cancer-Astrology predictions 2011

January will be more vibrant than you ever wanted. With the Sun (until 20), Mars (until 15) and Mercury (from 14) in your solar seventh House, you should not have a complaint, unless you belong to the second ten days. Either way though, your concern for your mates will be increased, you will have the desire to improve your relationship, but it should not be a selfish move, believing that you possess the absolute truth. Favorable days for chats – hugs and kisses among you will be the first week. From 15th onwards the bond holders(married) will have ups and downs, which might be due to economic reasons. !2th and 26th of this month might be critical and somewhat difficult.

If your partner is

If Aries is born in the second ten days, will have many troubles with the job, try not to add other.

Taurus- Gradually becomes very erotic and possessive.

Gemini- The first half of the month will show you something interesting about your relationship and they will be more possessive, even jealous.

Cancer says if something has run its course, then say goodbye to it instead of crawling behind it. Life goes on.

Leo The first week will show more positive elements may then be absorbed by the job. After 20th will begin to shift his interest in you again.

Scorpio may likely feel that the most important problem is your provocative behavior. If you are under the same roof, you will have enough opportunities to sort it out.

Sagittarius This month will be very unselfish and dative to you, although probably quite curious.

Capricorn- Height and depth of the relationship depends on the foundations you lay.

Aquarius- Aquarius will be more consistent this January. They will probably have many water sign features that will bring you closer.

Pisces- The balance in your daily workload and his own aspirations for the job and the opportunity to chat without the tensions will comprise the month of January. Future of your relationship will be determined by this month.

Any adept astrologer can easily tell you about the following- AN OVERVIEW OF EACH LOVER EACH LOVER’S RELATIONSHIP POTENTIAL WHAT EACH OF YOU REQUIRE FROM A PARTNERSHIP PERSONAL NEEDS IN A LOVING SEXUAL RELATIONSHIP THE WAY YOU ACT TOGETHER HOW EACH PERCEIVES AND EXPERIENCES THE OTHER SPECIFIC CONNECTIONS BETWEEN YOU AND YOUR PARTNER THE STRENGTHS OF YOUR RELATIONSHIPS

We have with us most experienced of the astrologers who have gone through thousands of horoscopes collectively before making any predictions for you. Check us out and explore yourself at Astrology predictions 2011. To directly get into lover’s astrology section click here “>http://www.astroans.com/kundali_match.aspx”> Birth compatibility.

Related Articles – Astrology predictions 2011, birth compatibility,

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Cancer Love 2012 Horoscope

Cancer Love 2012 Horoscope

This year is going to be a lucky for all the single crabs as they are chances of you meeting your loved ones. So, be ready for the surprise in your life. If you feel that there is someone who is special to you, try and spend much time so that you understand each other well. When you feel that the other person also, feels same, then you can express your feelings. Crabs usually have no difficulty with getting connected with anyone they like as they also, get committed to a relationship, which is very important. When love with commitment is there in a relationship then the bond becomes stronger. For all the single crabs you might take your relationship to the next level this year. Which, mean there are chances for the crabs to get married this year. So, if you are seeing somebody, then this year is a perfect time to exchange rings and make some promises. This year luck favors you in terms of marriage so, take advantage and let the wedding bells ring for you. Crabs are very flexible, adjustable and committed, which will make life easy for them with their partners.

On the love front this year might have in store few movements of intense love with your partner, which will increase the love. Crabs are very sentimental and emotional and when they love anyone they love the person with extreme passion and immense love.

Crabs are great lovers and they are very attached to their family which is good. However, you need to avoid unnecessary arguments and anger, which sometimes makes things worse. If, something goes wrong in a relationship, then try to fix things rather than exaggerating it.

To make the love last you need lots of patience and understanding. You must try to understand the relationship, your partner and yourself. Small things might bring your relationship down or even break it. So, never point out the imperfections of your partner. Try to compromise with things and adjust rather trying to change a person.

One thing that can make your relation happy is feel good about your relationship and let the love blossom day by day. If there are problems fix them with love and passion. Feel like you are newly married and there are lot of things you need to discover about your love. Go on dates, candle light dinner, dance with your partner, go to movies, cook for your partner, go on a holiday , go on long drives and do every possible things that can increase love and keep doing these forever. And your relationship will become special and strong.

Cancer people are also; very romantic this will increase the love between you and your lover and will keep the love alive. Crabs are very caring as well and when they love someone they love them from the bottom of the heart. Crabs are also, very protective and sensitive and emotional when it comes to their relationship.

Read more: Cancer 2012 Horoscope and Horoscope in 2012

How To Calculate Your Risk For Breast Cancer

How To Calculate Your Risk For Breast Cancer

Using known risk factors for breast cancer, mathematical models can be developed to help answer important questions. These mathematical models are useful tools for researchers and for patients as follows:

1.Research on risk factors The Claus risk assessment model was used to discover the subpopulation of people who had an autosomal dominant genetic allele that increased their risk from 10% to 92%. This led to the discovery of the BRCA genes associated with breast, ovarian, and prostate cancer.
2.Clinical trial eligibility The Gail risk assessment model was developed to help researchers determine who to enroll in the NSAPB Breast Cancer Prevention Trials
where chemoprevention was shown to reduce breast cancer risk.
3.Guidelines for doing BRCA testing BRCA testing is very expensive and practically worthless if done on everyone (because it is so rare to be homozygous for BRCA1 or BRCA2). Mathematical models such as the BRCAPRO, BOADICEA, and Tyrer-Cuzick models can help determine what patients should undergo BRCA testing. The decision for testing is usually made when one of these models predicts a 10% or greater chance that there is a mutation of the BRCA1, BRCA2, or both genes.
4.Guidelines for doing MRI screening for breast cancer – MRI screening for breast cancer is not a cost effective screening test for the general population, but in specific groups, there are clear cut reasons to do so. In general, screening MRI is recommended for women with 20-25% or greater lifetime risk of breast cancer. The BRCAPRO and Tyrer-Cuzick models have been used to help make clinical decisions about ordering MRIs for breast cancer screening.
5.Guidelines for breast cancer therapy The Gail model is used clinically to help
determine who should be put on tamoxifen or raloxifene for chemoprevention. Other models have been used to help make decisions about breast cancer risk reduction with prophylactic mastectomy.

For these reasons, it is important to understand these models. These models are collectively refered to as risk assessment tools. The following paragraphs summarize the most popular and most widely used risk assessment tools. Keep in mind that none of these risk assessment tools apply to breast cancer survivors. No mathematical model has been widely accepted to determine cancer risk in cancer survivors.

General Risk Assessment Tools

Gail Model: The Gail model is a validated risk-assessment model that focuses primarily on nonhereditary risk factors, with limited information on family history. It was developed by scientists at the National Cancer Institute and the National Surgical Adjuvant Breast and Bowel Project (NSABP) to assist health care providers in discussing breast cancer risk to determine their eligibility for the Breast Cancer Prevention Trial. The tool allows one to project a woman’s individual estimate of breast cancer risk over a five-year period of time and over her lifetime. It also compares the woman’s risk calculation with the average risk for a woman of the same age. The Gail Model is an on-line quiz that has 13 questions and is interactive. This calculator is based on published risk statistics and methods gathered from peer-reviewed journals, and has been extensively tested for its validity.

The major limitation of the Gail model is the inclusion of only first-degree relatives, which results in underestimating risk in the 50% of families with cancer in the paternal lineage and also takes no account of the age of onset of breast cancer. It may underestimate risk in certain groups, such as obese patients.

National Cancer Institute Model: The NCI risk assessment tool is essentially a simplified Gail Model that also factors in race. Race is a factor in determining breast cancer risk but is excluded when determining eligibility for clinical trials. This tool is probably the most popular risk assessment tool available to the public as an on-line, interactive risk calculator. The on-line quiz is a shorter, nine-point questionnaire that includes multiple factors, giving a woman her future five-year risk of breast cancer and her lifetime risk of breast cancer.

The NCI tool does not account for a lot of risk factors that can be modified. For this reason, it is difficult to use this test as a motivation tool to show people how lifestyle can alter their risk of breast cancer. It also cannot be used in breast cancer survivors, in patients with DCIS, LCIS, or people who carry one of the BRCA genes.

BRCAPRO model: This is a statistical model available as a computer program that uses two different algorithms to evaluate family history and helps a doctor determine the likelihood of finding either a BRCA1 mutation or a BRCA2 mutation in a family. The results of this can be used to determine if BRCA testing is indicated. This is very useful in light of the high cost of BRCA testing ($3,000). None of the nonhereditary risk factors can yet be incorporated into the model, however. In a comparison of four different methods for estimating breast cancer risk in patients with a family history of breast cancer, the BRCAPRO model was the least accurate. It predicted only 49% of the breast cancers that actually occurred in the screened group of patients with a family history of breast cancer.
Harvard Center for Cancer Prevention Risk Assessment Tool: This is another breast cancer risk assessment tool that includes more lifestyle factors than the NCI or Gail Model tools. It has not been studied as extensively as the Gail Model or the simplified NCI model, but it is promising in that it includes many lifestyle factors that people can do to modify their risk of developing cancer. It is also an on-line questionnaire that can be used by both women and men to estimate their breast cancer risk.

Making all this practical

Now after a thorough and confusing discussion of all these statistical models, its time to make all this information practical. What is the best way to help a patient accurately assess her risk of breast cancer and if possible, show her what positive factors are reducing her risk and what negative factors can be changed to reduce her risk? If possible, it would also be great to show the patient the value and indications for testing, imaging, chemoprevention, and in some cases surgery. A discussion of the practical aspect of each of these is addressed in a Q & A format below:

Q: What (free) online programs can be used to help a patient assess their risk of breast cancer?

A: Several of the risk assessment tools mentioned above can be accessed for free by the public. Here are the tests and their websites:

1.Your Disease Risk English version: http://www.diseaseriskindex.harvard.edu
Spanish version: http://www.diseaseriskindex.harvard.edu/spanish
This is a great interactive questionnaire that calculates five-year and lifetime risk of breast cancer developed by the Harvard Center for Cancer Prevention and made public online in 2000. In 2005, they launched the Spanish version of the site, Cuidar de su Salud. The risk calculator includes lifestyle factors such as weight, dietary vegetables, alcohol intake, as well as Jewish ethnicity. It does not include other ethnicities, however, and is not accurate for BRCA mutation carriers or breast cancer survivors. Despite these issues, this is by far the best free online risk calculator since it is very interactive and gives you a personalized description of your risk in the form of a colored bar graph, which they can electronically manipulate to experience “virtual” risk reduction. The bar graph is a seven-level scale that compares users to a typical man or woman your age. Users learn where to focus their prevention efforts and how to make lifestyle changes by “clicking on” personalized strategies. With each click, the bar graph shrinks, and the user watches his/her predicted risk drop. This is a great concept to motivate people to participate and comply with lifestyle modification measures.

2.The NCI Risk Assessment Tool regular web: http://www.cancer.gov/bcrisktool
Mobile web: http://www.cancer.gov/bcrisktoolmobile
This is the easy to use, on-line questionnaire based on a modified Gail model that also includes ethnicity. It does not factor in a personal history of breast cancer, DCIS, or LCIS. It does not account for other factors such as BRCA status, hormonal replacement therapy, lifestyle factors, breast feeding, menopause, or mammographic density. Despite these issues, it is a very useful tool that gives a woman her five-year and lifetime risk of breast cancer. It is the only risk assessment tool that can be used via mobile handheld devices (any type). A version of this can be downloaded for PDAs with Windows Pocket PC operating system as well.

Q: What programs can be used to help a doctor make decisions about ordering a breast MRI?

A: The American Cancer Society has developed some very good guidelines for breast cancer screening with MRI. It should be emphasized that MRI is an adjunct to mammography, not a replacement. Four programs can be used to help in clinical decision making. They are as follows:

1.A Cancer Journal for Clinicians http://caonline.amcancersoc.org/cgi/content/full/57/2/75

2.BRCPRO ver.4.3 available @ http://www4.utsouthwestern.edu/breasthealth/cagene/default.asp

3.Claus Model available as a palm based software product version 1.0 at
http://www.palmgear.com/index.cfm?fuseaction=software.showsoftware&prodID=29820

4.IBIS – Breast Cancer Risk Evaluation Tool, RiskFileCalc version 1.0. This is the Tyrer-Cuzick model that includes hereditary and nonhereditary risk factors. Contact: