Cancer

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Being Supportive When a Friend or Loved One Has Cancer

Photo by Marin at FreeDigitalPhoitos.com

Photo by Marin at FreeDigitalPhoitos.com

The National Cancer Institute reports that in 2016, an estimated 1,685,210 new cases of cancer will be diagnosed in the U.S. Considering the statistics, there’s a good chance that you know or will know at least one person, who is battling cancer, in your lifetime. As a friend or relative of someone who has recently received a cancer diagnosis, you may be at a loss for words and unsure of how to show your support.

Although the news of cancer is always difficult to hear, it’s important to remember that your support can be valuable in one’s journey with cancer. If you don’t know where to begin, here are some tips:

Take a Little Time to Process

When a friend or loved one tells you that he or she has cancer, you may find yourself searching for the right words to say at that exact moment and if you fail to be articulate or feel overwhelmed with a range of emotions, it’s completely normal. Before you take action in helping out, it’s important to try to process the news in your own time. Although there’s no timeframe to processing and coping, your friend or loved deserves your attention. Try not to fill up a conversation and time with him or her with your grief and negativity.

Make Yourself Available and Ask What You Can Do

After you’ve taken a little time to let the news sink in, the first thing you should do is ask how you can help and make sure that your friend or loved one knows you are available. Every individual may have different needs and wants. While one may want you to jump in and help right away, another may be resistant to accept help. Be persistent in your offering, but never push too hard. Remember, he or she is processing and coping, too.

Be Prepared for Anything

When you tell your friend or loved one that you are available and willing to do anything to help, stand behind your words. If your friend wants you to go to an appointment with her and act as a second set of eyes and ears while she receives information about her cancer treatment drug or surgical procedure, bring a notepad and take notes. When a loved one calls you up and says she’s feeling lonely and upset, offer to bring over her favorite dessert and a funny movie.

As your friend or loved one continues on his or her journey with cancer, the help you give may be more intimate (such as helping out with personal care) and you may encounter some dark days. It’s important to be strong, be positive, and always listen.

Choose Your Words Carefully

 

Being a supportive person can be trying at times, particularly in difficult situations. Maybe you’ve run out of things to say, maybe you feel like a fake being “peppy and full of positivity.” When emotions are raw, it’s easy to say the wrong thing without knowing that you did. Rather than struggling to find the right words or worry that you may say something offensive, ask your friend or loved one what he or she wants (or doesn’t want) to hear. If you truly have a good relationship with him or her, he or she will likely be honest with you. When you are at a loss for words, simply say so; it may be more appreciated than you think.

There are no definite right or wrongs when it comes to showing your support to a friend or loved one with cancer, as it varies from one individual to the next. The best thing you can do is make your intentions known and make yourself available.

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Vitamin D may reduce the risk of some cancers

Vitamin D

Vitamin D

“Dose of sunshine exposure could cut the risk of cancer by a fifth,” reports The Daily Telegraph.

Researchers in Japan looked at whether people with higher levels of vitamin D – the so-called “sunshine” vitamin – in their blood were less likely to be diagnosed with cancer.

They found overall cancer risk was 22% lower among those with the highest vitamin D levels, compared with those with the lowest levels.

They also looked at figures for specific cancers, and found a lower risk of liver cancer for people with higher vitamin D.

The study was fairly large, including results from 7,345 people. People had their vitamin D levels measured once, and were followed for an average of 15 years.

Vitamin D is made by the skin when exposed to sunlight, but is also present in oily fish, egg yolks and red meat.

It’s widely available as a supplement and is already known to play a role in keeping bones strong. If taken at the recommended dosage, supplements are thought to be very safe.

Some groups of the population are at greater risk of not getting enough vitamin D and are advised to take daily vitamin D supplements.

Find out more about vitamin D and who may benefit from taking a daily vitamin D supplement.

Where did the story come from?

The research was carried out by a team from Japan, from the National Cancer Centre, Shiga University of Medical Science, and Fujirebio Inc, a company that makes tests for vitamin D, along with other medical tests.

It was funded by the National Cancer Center, grants from the Japanese Ministry of Health, Labour and Welfare, Practical Research for Innovative Cancer Control, and the Japanese Agency for Medical Research and Development.

It was published in the peer-reviewed British Medical Journal on an open access basis, so it’s free to read online.

The coverage in the UK media was reasonable, although the Mail Online cherrypicked the most arresting statistic for its headline: “Increasing levels of vitamin D can cut the risk of liver cancer by up to 50%”.

The Mail Online also said that the effect of vitamin D was more evident in men than women. This directly contradicts the research findings, which state there was “no evidence of a significant effect” between the sexes.

What kind of research was this?

This was a case cohort study, in which researchers include all people within a research cohort with the outcome of interest (cancer in this case) and a representative sample of the rest of the cohort to compare them with.

This allows them to focus on the outcome of interest without having to include the data from a very large initial cohort.

Cohort studies can find useful links between factors, such as vitamin D and cancer, but can’t prove that one factor directly causes another.

What did the research involve?

Researchers used information from a large Japanese public health study involving 140,420 people.

Adults aged 40 to 59 were invited to take part in 1990 and 1993, and were followed until the end of 2009.

At the start of the study, they filled in questionnaires about their health and lifestyle and gave blood samples, which were later tested for vitamin D levels.

Researchers selected people who’d been diagnosed with cancer during the study and for whom data was available (3,301).

They then randomly selected an additional 4,044 people from the cohort not diagnosed with cancer during the study and for whom data was available.

They divided everyone into 4 quarters, from lowest to highest vitamin D levels.

They looked at how likely people were to have been diagnosed with cancer, compared with those in the group with the lowest vitamin D levels.

Vitamin D levels are higher in the summer and autumn than in spring and winter, so the researchers adjusted people’s vitamin D results to account for the time of year they were taken.

They also adjusted their figures to take account of:

age

sex

body mass index (BMI)

leisure time physical activity

smoking

alcohol

family history of cancer

history of diabetes

For the analysis of breast, ovarian and womb cancer, they adjusted figures for:

the age women started their periods

number of children

use of female hormones

menopausal status

age at menopause

What were the basic results?

People with higher levels of vitamin D were less likely to get cancer. Those in the highest group had a 22% lower chance of having been diagnosed with cancer than those in the lowest group (hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.67 to 0.91).

When researchers looked at individual cancers, such as gastric, colon and prostate cancer, they found no statistically significantevidence that vitamin D was linked to lower cancer rates.

The one exception was for liver cancer, where they did find a statistically significant difference in risk.

People with the highest vitamin D levels were 55% less likely to be diagnosed with liver cancer than those with the lowest (HR 0.45, 95% CI 0.26 to 0.79).

But there was some uncertainty in this result, as seen by the wide confidence interval.

The researchers found some evidence that breast cancer before the menopause might be affected by vitamin D levels, but the numbers were too small to be sure the results weren’t down to chance.

Interestingly, the biggest differences in overall cancer risk were seen between the lowest and second-lowest groups for vitamin D levels.

The highest group didn’t show any improvement over the third group. This suggests that, above a certain level, additional vitamin D doesn’t reduce cancer risk.

How did the researchers interpret the results?

The researchers say their results “support the hypothesis that vitamin D may confer protection against the risk of cancer”.

They say the figures “seem to show a ceiling effect”, and more studies are needed to work out the best level of vitamin D for protection against cancer.

Conclusion

The study adds some evidence in favour of the theory that vitamin D may protect against cancer, in addition to its known role in helping the body absorb calcium and keeping bones strong. Previous studies have been inconsistent, with no clear results.

But this study’s findings aren’t conclusive. It has a number of limitations:

it was carried out in Japan, and vitamin D concentrations vary by ethnicity as well as by region

the results may not be particularly relevant to people outside Japan

the study only measured vitamin D levels once, and they may vary over time

cohort studies can’t prove that one factor directly causes another – researchers may not have accounted for all potential confounding factors

Guidelines in the UK suggest that people take vitamin D during the autumn and winter, when it’s hard to get enough vitamin D from the sun in the UK, while some people should take them year-round.

Find out more about whether you should take a vitamin D supplement.

Analysis by Bazian
Edited by NHS Choices

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Ultra-processed foods linked to cancer

Ultra-processed foods may be linked to cancer

Ultra-processed foods may be linked to cancer

“Ultra-processed foods may be linked to cancer, says study,” The Guardian reports.

The term ultra-processed has been taken from the recently introduced NOVA classification system, which classifies foods based on the nature, extent and purpose of food processing.

These are defined as foods where complex processing has taken place using chemicals almost never found in kitchens, as opposed to more straightforward processing techniques like salting meat or putting vegetables or fruit into cans.

Examples include mass-produced breads and cakes, snacks and sweets, fizzy drinks, and ready meals.

Researchers in France studied the diets of more than 100,000 people for 7 years.

They found small increases in the overall rate of cancer and breast cancer after the menopause in those who had the highest proportion of ultra-processed food in their diet.

But because of the wide range of foods included in the ultra-processed category, it’s difficult to establish which specific foods might be responsible for the increased cancer risk, and why.

The increased risk could be caused by eating more high-sugar, high-fat processed food.

Or it may be that some people who eat more ultra-processed foods tend to be unhealthy in other ways, too.

We know people who eat more ultra-processed food are also more likely to smoke, take less exercise and take in more calories.

The researchers also discussed the hypothesis that while the individual chemicals used in food processes are thought to be safe, they may be interacting with each other in unpredictable ways.

If you want to cut your risk of cancer, you should quit smoking if you smoke, eat a healthy, balanced diet that includes plenty of fruit and vegetables, drink less alcohol, and get plenty of exercise.

Read more advice about how to prevent cancer.

Where did the story come from?

The study was done by researchers from several Parisian research institutions working together as the Nutritional Epidemiology Research Team, as well as the Institut National de la Recherche Agronomique and the University of Sao Paulo in Brazil.

It was funded by 10 different research institutions and published in the peer-reviewed British Medical Journal on an open access basis, so it’s free to read online.

The study was widely reported on in the UK media. Much of the reporting overstated the risk – the Mail Online said that cancer “is claiming more lives because of the popularity of ready meals”.

The Times claimed that, “Eating factory-made food, including cornflakes, pizza and chocolate bars, every day increases the risk of cancer by a quarter” – but the data doesn’t bear this out.

Some of the reporting suggested that the specific foods listed added to the risk, although the study considered all ultra-processed foods in one category, so we don’t know specifically which foods contributed to the potential risk.

What kind of research was this?

This cohort study followed what happened to a large group of adults who volunteered to fill in health and diet questionnaires over several years.

This type of observational study can spot links between factors, but can’t prove that one factor (such as a diet high in processed foods) causes another (cancer).

What did the research involve?

Researchers recruited adult volunteers to join the online study from 2009.

Participants filled in questionnaires about their health and background, as well as a questionnaire about all the food they had eaten in the past 24 hours.

The food questionnaire was repeated every 6 months up to January 2017.

Researchers used results from the 104,980 people who’d filled in at least 2 questionnaires during that time.

They categorised people’s diets according to the proportion that was ultra-processed.

After adjusting their figures to take account of potential confounding factors, they looked at whether people with a diet high in ultra-processed foods were more likely to get any type of cancer, or breast, prostate or colorectal cancer specifically.

Factors taken into account included:

age and sex

body mass index and height

physical activity

smoking and alcohol intake

overall energy intake in calories (excluding alcohol)

family history of cancer

educational level

nutritional content of diet (fat, salt and carbohydrate) and “western dietary pattern”

For breast cancer, they also took account of:

number of children

menopausal status and use of HRT

oral contraception use

What were the basic results?

There were 2,228 cancers over an average 5-year follow-up period among the 104,980 participants in the study.

Most of the people whose records were used in the study were women (78.3%).

After taking account of potential confounding factors, each 10% increase in the proportion of ultra-processed food in the diet was linked to:

a 12% increase in risk of any cancer (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.06 to 1.18)

no increase in risk of prostate cancer

no increase in risk of colorectal cancer

an 11% increase in risk of breast cancer (HR 1.11, 95% CI 1.02 to 1.22) – but this only held true for breast cancer after the menopause

How did the researchers interpret the results?

The researchers said there are “several hypotheses” that could explain their results.

These include:

the “generally poorer nutritional quality” of ultra-processed food

the “wide range of additives” in some ultra-processed food, including the whitening agent titanium dioxide

contaminants such as acrylamide, produced through heat treatment of some ultra-processed food

contaminants from packaging of some ultra-processed foods, including the plastic softener bisphenol A (BPA)

Overall, they say, “Rapidly increasing consumption of ultra-processed foods may drive an increasing burden of cancer and other non-communicable diseases”, and governments should consider taking action such as taxation and marketing restrictions on these foods.

Conclusion

It shouldn’t be news to anyone that eating a healthy, balanced diet that includes plenty of fresh fruit and vegetables is good for our health.

This study suggests that eating too much ultra-processed food as part of your regular diet may slightly increase your risk of some types of cancer.

Ultra-processed foods are defined according to a scale that classifies foods by the way in which they have been prepared.

They tend to have additives and flavouring added to them during the manufacturing process to improve taste and extend shelf-life.

The study was carried out carefully, with a large number of people taking part, and the researchers did their best to take account of other confounding factors.

But it has limitations that make it difficult to draw any firm conclusions.

The way foods were divided into ultra-processed or other foods seems rather arbitrary. Is bread made in a manufacturing plant and wrapped in plastic very different from homemade bread or bread handmade in an artisan bakery?

Despite the authors’ efforts, it’s very hard to separate someone’s diet from the rest of their lifestyle.

We know people who ate more ultra-processed food were more likely to smoke, take less exercise, be less educated and take in more calories.

Other unmeasured aspects of their lives – such as deprivation and access to healthcare – might also have affected the results.

All the questionnaires were filled in online, rather than being verified by researchers, so we can’t be sure of their accuracy.

The people who took part in the study were mainly women and tended to be more educated than the average person in France.

They also decided to take part in a health and diet study themselves, so were likely to be interested in their health.

So many things affect cancer risk, from inherited genetic susceptibility to lifestyle and environment. A small increase in risk from one factor may be easily cancelled out by others.

That said, ultra-processed foods tend to be high in fat, salt and sugar, so you should make sure your diet isn’t based on them.

Make sure you get your recommended 5 a Day of fruit and vegetables.

Analysis by Bazian
Edited by NHS Choices

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What is male breast cancer?

What you should know about male breast cancer

Many men may be surprised to learn that they can get breast cancer. Although breast cancer in men is uncommon, it is important to know the risk factors, as well as the signs and symptoms, of the disease.