WOMENS HEALTH NEWS UPDATES

Depo-Provera a Serious Health Risk: November 2004

In November the U.S. pharmaceutical company Pfizer issued a warning about a serious health risk to women who use their long-acting, injectable contraceptive drug, Depo-Provera. They warn doctors, women and adolescents who use Depo-Provera that the drug may cause a significant loss of bone mineral density, that the loss increases with duration, and that the loss may not be completely reversible.

This is not news – evidence that the contraceptive had this effect has been known for some thirteen years but Depo-Provera has nevertheless been widely prescribed to young women. Whether this loss of bone density increases the risk of fractures is not known, but there are real concerns that long-term use may seriously compromise bone health. Read more at the website of the Canadian Women's Health Network

Estrogen therapy now linked to higher risk of dementia

June 22, 2004
In a lengthening list of serious risks associated with HRT use, we are now told that older women taking estrogen are more likely to develop dementia than women who aren't on any hormones. These are findings from the Women's Health Initiative Memory Study.
The memory study focused on 7,479 women 65 to 79. About 4,500 were given either estrogen plus progestin or a placebo, the remainder received estrogen or a placebo. None of the women had dementia at the study's start.
Women on estrogen alone were 50 percent more likely to develop dementia than those on placebo, says a report in the June 22nd Journal of the American Medical Association. The actual number of cases was 28 in the estrogen group and 19 in the placebo group. About half appeared to have Alzheimer's disease. The researchers report that women on estrogen are also more likely to experience a decline in thinking
Over the years several observational studies had suggested that estrogen protected against dementia. Hormones were even prescribed for this purpose, but there had never been any definitive evidence. The Women’s Health Initiative trial has provided some long overdue definitive answers on the dangers of HRT use including increased breast cancer, heart disease and stroke risk.
Previously in May 2003, researchers reported that women on estrogen plus progestin had double the risk of developing dementia as those on placebo.

Breast Cancer and Parabens

A recent British study has identified intact parabens in breast cancer tumours, raising concerns that regular use of cosmetics with paraben content could be influencing breast cancer development. Parabens are known to have a weak oestrogenic action. The hormone oestrogen is known to increase the risk of breast cancer.

Parabens are used as preservatives in many thousands of cosmetic, food and pharmaceutical products including underarm deodorants, shampoos, conditioners, hair styling gels, nail creams, foundations, facial masks and skin creams. Parabens can be an ingredient in baby lotions, shampoos, and other personal care products for children. They are known to be readily absorbed through the skin. They are produced from a petroleum derivative, toluene which is obtained originally from coal tar. Parabens are also produced from gum benzoin but rarely used in cosmetics as this is far more costly. They are also present in some plants.

Philip Harvey, an editor of the Journal of Applied Toxicology, which published the new research says "… it is not possible to say whether parabens actually caused these tumours, but they may certainly be associated with the overall rise in breast cancer cases. Given that breast cancer is the largest killer of women and a very high percentage of young women use underarm deodorants, I think we should be carrying out properly funded, further investigations into parabens and where they are found in the body, "

Cosmetic companies claim their studies show parabens to be non-toxic and safe. The New Zealand company Living Nature conducted independent laboratory testing of parabens and found they are not toxic (which means they don’t cause the cell membrane to break) but that they do cause intense cell oxidative stress and severe DNA damage. This means that parabens may be causing long-term damage that women are not alerted to because the products they use don't irritate the skin or create a toxic effect. Because the damaged DNA can still replicate, this combined with oxidative stress which damages the cell could cause abnormalities in cell reproduction. This creates the potential for cancerous cells to form.

The study used 20 breast tumour samples and found high concentrations of para-hydroxybenzoic acids (parabens) in 18 of the samples. The researchers are calling for more investigation into whether paraben accumulation from currently permitted levels in cosmetics, foods and pharmaceuticals is acceptable. Meantime as consumers it is advisable to carefully check product labels and use cosmetics that are paraben free .

Reference: Darbre, P. D. et al A. Concentrations of Parabens in Human Breast Tumours. Journal of Applied Toxicology. Jan 2004;24.

Breastfeeding May Reduce Heart Disease Risk Later in Life

A report of a study published in the May 15th issue of The Lancet finds that breastfeeding seems to cut the risk of cardiovascular disease later in life. Individuals who were fed breast milk as babies had significantly lower C-Reactive protein levels and better LDL to HDL ratios when they reached adolescence than their peers who received milk formula.
" The findings of our prospective study suggest that infant nutrition permanently affects the lipoprotein profile later in life, and specifically that breastmilk feeding has a beneficial effect," lead author Dr. Atul Singhal and colleagues, from the Institute of Child Health in London, note.
Based on these findings, "the hypothesis that infant nutrition has a key role in the development of later atherosclerotic cardiovascular disease is plausible, will have major public-health implications, and now merits further consideration," the researchers write. Lancet 2004;363:1571-1578.

Bee Propolis May Improve Infertility Associated With Mild Endometriosis by Emma Hitt, PhD

Oct. 17, 2003 Bee propolis appears to be effective for the treatment of infertility associated with mild endometriosis, according to the findings of a small randomized trial. Propolis is derived from plant resins collected by honeybees. According to Ali F. M. Ali, from the Ain Shams University, in Cairo, Egypt, and colleagues, the substance has "many pharmacologic actions," including inhibition of C aromatase and vascular endothelial growth factor as well as strong anti-inflammatory activity. Dr. Ali and colleagues presented their findings this week at the 59th annual meeting of the American Society of Reproductive Medicine in San Antonio, Texas. The researchers conducted a study of 40 patients with primary infertility for at least two years and endometriosis diagnosed with laparoscopy. Patients were randomized to receive 500 mg of bee propolis twice daily or a placebo and were followed for nine months. Of the patients taking bee propolis, 12 women (60%) became pregnant compared with four (20%) in the placebo group(P < .001).
" The compliance of patients was satisfactory with no reported side effects," the authors note in their abstract.
The researchers conclude that "bee propolis is an effective line of treatment for infertility associated with mild or minimal endometriosis." They point out that their research was a pilot study with a limited number of patients, but that the results indicate that a "multicenter prospective trial of bee propolis is warranted." ASRM 2003 Annual Meeting: Abstract O-84. Presented Oct. 13, 2003. Reviewed by Gary D. Vogin, MD

Pesticide Exposure Linked to Breast Cancer

NEW YORK (Reuters Health) Apr 24 2004 - Women with breast cancer are more than 5 times as likely as their healthy peers to have measurable serum levels of DDT and hexachlorobenzene (HCB), according to a report published in the May issue of Occupational and Environmental Medicine. Previous studies have yielded conflicting results regarding a link between exposure to organochlorine pesticides and breast cancer, lead author Dr. C. Charlier and colleagues, from Sart Tilman University Hospital in Liege, Belgium, note. Therefore, further investigations are justified, they add.In the new study, serum levels of total DDT and HCB were measured in 159 women with breast cancer and in 250 presumably healthy control subjects. The average patient age in both groups was approximately 54 years.

The researchers found that the mean serum levels of both pesticides were significantly higher in breast cancer patients than in controls. Compared with control subjects, breast cancer patients were 5.64- and 9.14-times more likely to have measurable levels of DDT and HCB, respectively.Among women with breast cancer, DDT and HCB levels were not influenced by estrogen receptor status, the investigators point out.

"These results add to the growing evidence that certain persistent pollutants may occur in higher concentrations in blood samples from breast cancer patients than controls," the researchers state. Still, "these data warrant further analysis, and consideration of possible exposure routes or dietary intake," they add.

Occup Environ Med 2003;60:348-351

Antibiotics and breast cancer

A recently published study has found a direct correlation between the increasing use of antibiotics and the risk of breast cancer. More than 10,000 women participated in a 17 year study which was published in the Journal of the American Medical Association. The study found that those who took antibiotics twenty-five times or more had double the risk of breast cancer to those who had not used antibiotics. It found the highest risk of cancer in the group had the highest consumption of antibiotics.

The study's authors speculate that the detrimental effect antibiotics have on the beneficial bacteria that normally live in the human gut could be the explanation. There are normally about 500 gut bacteria, weighing one kilogram in total, in the human gut, and they play an important role in metabolising drugs, and breaking down hormones (including oestrogen) and carcinogens that pass through the gut.

In a healthy gut, the delicate balance of 'friendly' bacteria helps keep potentially harmful bacteria in check and prevents illness. But broad spectrum antibiotics destroy all bacteria in the gut, including 'friendly' bacteria, and this, in turn, reduces the synthesis of nutrients that normally occurs in a healthy gut.

While further research is planned to investigate the link, it is prudent to consume foods which contain friendly bacteria such as yoghurts with Lactobacillus acidophilus and bifidus, since these bacteria provide protection from salmonella, yeast infections and the bacteria responsible for many urinary tract infections. A proliferation of friendly bacteria also reduces the amount of oestrogen that is re-circulated back into the bloodstream from the gut.

After a course of antibiotics, probiotic supplements of Lactobacillus acidophilus, or Bifidobacterium infantis will help to re-establish the equilibrium of the gut.

A high fibre, balanced diet is another way of ensuring healthy gut bacteria.

Chemicals and Breast Cancer: A Backgrounder

There is significant international concern about the role that environmental factors may be playing in the breast cancer epidemic. There is scientific evidence implicating hundreds of chemicals and more than 50 percent of breast cancers cannot be explained by known risk factors.
Dr Meriel Watts, Environmental health researcher and author of ‘The Poisoning of New Zealand questions why there has been an official silence on the likely environmental causes of breast cancer in this article. More...

Mammograms and breast cancer

(Summarised from NZ Green Party MP Sue Kedgely's Environmental Health Newsletter)
There are concerns about the possible adverse effects of cumulative exposure to radiation from mammograms, and the need for research into alternative, non radiation techniques for diagnosing breast cancer. Radiation exposure is a known cause of breast cancer, and international research indicates that cumulative exposure to mammograms is a risk factor. According to the International Agency for Research on Cancer, for women beginning breast screening at age 40, there would be 100-200 radiation induced deaths from breast cancer for every million women.

There are a significant rate of false positives and negatives with mammograms, and there is a need for research into alternative screening methods. Mammography detects about 85 per cent of breast cancers for women 50-60 years, which means it has a 15 per cent failure rate, and only about 60 per cent of breast cancer in women aged 40-49. A significant number of biopsies following suspicious mammograms are found to be benign.

The benefits of screening among younger age groups have been oversold, andt many women are under the illusion that if they were screened, all breast cancer would be detected and at an early stage, ensuring that they would not die from the disease. Many people oppose extending breast screening to women under 50 on the grounds that the harms of doing so would outweigh the benefits.

Fortunately, there are some promising non-radiation alternatives emerging to mammograms such as thermography or ultrasound In New Zealand scientist Dr Ray Simpkin has developed a technique to detect breast cancer with the use of a radar-imaging system. With this technology, tumours can be detected much earlier and when they are much smaller than current techniques, such as mammograms and ultrasounds.

Malignant tissue interacts more strongly with a radar wave than benign tissue, and therefore shows up clearly on a three-dimensional radar image. Previous research into this technology has encountered difficulty because skin usually weakens radar waves. Dr Simpkin, however, has developed a method that overcomes this. Furthermore, radar waves are longer than x-rays, and are apparently not damaging to the patient. This technique does not require physical contact with the breast, which some women undergoing mammography find uncomfortable.

New methods to detect breast cancer show promise

03.05.2004 Washington. New tests that measure water, oxygen and other breast tissue properties could be more effective than mammograms in diagnosing breast cancer, scientists said on Monday. Researchers at Dartmouth Medical School used several types of electromagnetic waves to also gauge how normal breast tissue absorbed or scattered light.
By first measuring healthy breasts, the new techniques can eventually help researchers better understand and detect changes that could signal cancer, said the study's lead author, Steven Poplack.
" It's very important to know what normal is before you can begin to characterise what abnormal is," Poplack, a radiology professor at Hanover, New Hampshire-based Dartmouth, said in an interview.
The three types of energy waves tested included infrared light, microwaves and low-level electrical currents, according to the study published in the May issue of the journal Radiology.
Mammograms, the standard test for breast abnormalities, use X-rays to take pictures of breast tissue.
Experts say mammograms do not work as well on dense breasts and can make it easy for doctors to miss very early-stage cancer in some women. Mammograms can also fail to distinguish between cancerous tumours and other thick matter, raising the risk of false positives, they say.
The new techniques measured normal tissue levels of oxygen and haemoglobin, which carries oxygen in the blood. Breast cancer tissue is "more active" Poplack said, and uses more oxygen and blood to survive.
Scientists also measured cell membrane structure and the tissue's ability to conduct and store electrical charges.
Poplack's team used the alternative technologies on 23 white women ages 40 to 79 who had a history of normal mammograms, the study said. The five-year, US$7 million ($11.30 million) study funded by the National Institutes of Health's National Cancer Institute is part of a larger effort to find alternative ways to create images of the breast, principal investigator Keith Paulsen said.
The researchers, who are seeking another US$10 million in National Cancer Institute grants, are working on a second study using the new techniques on women who have had abnormal mammograms.
Poplack said another 5 years of intensive study was needed before broader studies could be done with more women, including those of different races. Commercial versions of the tests are at least 10 years away, he said.
Barbara Croft, head of the cancer institute's Cancer Imaging Programme, said there was "a big need" to find alternative ways to look inside the breast. A number of breast cancer groups also said the limitations of mammogram technology can lead to unnecessary biopsies and missed cases of breast cancer.

Silicone Breast Implant Action Alert
National Women's Health Network Fact Sheet

.On October 14-15 2003 the Food and Drug Administration (FDA) held a meeting to consider the approval of a new silicone gel breast implant. The FDA removed silicone gel implants from the market in 1992 because there wasn't enough scientific evidence to show that these devices were safe for women over the long-term. Now Inamed is hoping to bring a new silicone gel implant to market. But there's still no long-term data about what happens to women who have these products inside their bodies More...