A Speculative Minireview on Potential Anti-Breast Cancer Botanicals in New York State

The Women's Health Collaborative is a proud supporter of clinical and academic research to help advance new solutions for breast cancer treatments. Publishing information about current findings and exploratory processes aid in the expansion of public knowledge and potential resources to encourage the active studies in the continuing search for a cure. The editors of the Women's Health Digest shares this feature and endorses the efforts of the authors for their advocacy and their commitment to pursue this expanding study.

RESEARCH REVIEW:

THERAPEUTIC POTENTIALS OF ECHINACEA, BLACK COHOSH, AND BURDOCK

Authors: Noelle Cutter, Phd, Alexandra Fiederlein

Abstract
This minireview explores the therapeutic potential of three botanicals—Echinacea, Black Cohosh, and Burdock—found in or cultivated in New York State (NYS) for their potential anti-breast cancer properties. Each botanical demonstrates distinct mechanisms of action, including anti-inflammatory, antioxidant, cytotoxic, and apoptotic effects, as well as modulation of signaling pathways such as PI3K/Akt and STAT3. While preclinical studies reveal promising results, inconsistencies due to varying extraction methods, study designs, and plant parts highlight the need for standardized research protocols and clinical trials. Additionally, the potential dual effects of phytoestrogens and interactions with existing treatments underline the importance of evidence-based application. This review provides a foundational understanding of these botanicals and their implications for advancing breast cancer therapy.

Introduction
Breast cancer remains one of the leading causes of cancer-related deaths worldwide. Despite advancements in treatment, resistance to conventional therapies such as chemotherapy and targeted drugs presents a significant challenge (Siegel et al., 2021). Thus, there is an urgent need for alternative therapeutic strategies that are effective, have fewer side effects, and overcome resistance mechanisms. Natural products derived from plants have been recognized as a rich source of novel anticancer agents, with several drugs like Paclitaxel (Taxol®) being derived from plant sources (Cragg & Newman, 2013).

The history of plant-derived medicines highlights the immense potential of botanicals in cancer treatment. For instance, Vincristine and Vinblastine, derived from the Madagascar periwinkle (Catharanthus roseus), have become cornerstone treatments for certain cancers (Cragg & Newman, 2013). Similarly, the success of Taxol underscores the value of exploring natural compounds for therapeutic breakthroughs. Despite these advances, many plant species remain underexplored, particularly in regions like Long Island, New York, which boasts unique environmental conditions that may yield novel bioactive compounds.

Current breast cancer therapies, including chemotherapy, hormone therapy, and targeted treatments, are often accompanied by severe side effects and limited efficacy in drug-resistant cases (Hassan et al., 2020). Phytochemicals, such as flavonoids, alkaloids, and terpenoids, have demonstrated promising anticancer activities, including the induction of apoptosis, cell cycle arrest, and the modulation of critical signaling pathways like PI3K/Akt and NF-κB (Hassan et al., 2020). These compounds offer a potentially safer and more targeted approach to cancer treatment.

The flora of Long Island represents an untapped reservoir of medicinal plants with potential anticancer properties. Regional biodiversity, influenced by distinct climatic and soil conditions, may enhance the therapeutic potential of local botanicals. Exploring this diversity could lead to the discovery of novel plant-based therapies that complement existing treatment regimens. This review aims to explore the medicinal potential of selected botanicals, including Echinacea, Black Cohosh, and Burdock, with a focus on their mechanisms of action and implications for breast cancer treatment.

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Research Problem
The challenge of breast cancer treatment is compounded by the emergence of multidrug resistance and the severe side effects associated with existing therapies. Natural plant extracts have shown promise in combating cancer cells through various mechanisms, including apoptosis induction, cell cycle arrest, and modulation of signaling pathways (Hassan et al., 2020). The flora of Long Island remains largely untapped in the search for anticancer compounds, providing an opportunity to explore and identify novel plant extracts with therapeutic potential against breast cancer.

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Potential Anti-Breast Cancer Botanicals Located in NYS

Echinacea
Echinacea, though not native to NYS, is grown in upstate New York and Long Island (Werier et al., n.d.). The two species, Echinacea pallida and Echinacea purpurea, possess flavonoids, caffeic acid derivatives, and polysaccharides that contribute to immune activation, antioxidant effects, and anti-inflammatory properties (Islam et al., 2020; Karimi et al., 2019).

Recent studies demonstrate E. purpurea's selective toxicity against breast cancer cells while protecting noncancerous cells (Park et al., 2020). Additionally, extracts from E. pallida and E. purpurea show promising cytotoxic and apoptotic effects on MCF-7 and BT-549 breast cancer cell lines (Driggins et al., 2021). Further research on secondary metabolites, such as polyacetylenes, indicates concentration-dependent cytotoxicity (Pellati et al., 2018).

Despite these promising findings, some studies report conflicting outcomes. For instance, certain phenolic components of Echinacea angustifolia might counteract chemotherapy drugs like doxorubicin, suggesting a need for caution and more standardized research protocols (Espinosa-Paredes et al., 2021).

Black Cohosh
Black Cohosh (Actaea racemosa), found in various NYS regions, has triterpene glycosides and polyphenolic compounds that exhibit potential anti-breast cancer effects (Kuhn et al., 2021). Mechanistic studies suggest Black Cohosh may act as a selective estrogen receptor modulator (SERM) or exert anti-estrogenic effects, depending on the context (Zierau et al., 2019).

For instance, Crone et al. (2020) demonstrated that Black Cohosh decreases ER-α and PR expression in MCF-7 cells while inhibiting cell proliferation. Studies on triterpene glycosides such as actein reveal significant anti-proliferative and anti-metastatic activity in HER2-overexpressing cell lines (Einbond et al., 2018). However, certain studies note potential risks, such as increased metastatic activity in specific breast cancer subtypes like HER2+ (Davis et al., 2021).

The clinical safety and efficacy of Black Cohosh remain areas of ongoing investigation. While some trials report reduced menopausal symptoms in breast cancer patients taking tamoxifen, others find no significant benefit in managing symptoms like hot flashes (Rostock et al., 2019).

Burdock
Burdock (Arctium lappa), common in upstate NY, is recognized for its phenolic compounds, lignans, and terpenoids that contribute to its antioxidant, anticancer, and anti-inflammatory activities (Predes et al., 2019; Knipping et al., 2020).

Arctigenin, a major active constituent, shows anti-metastatic and apoptotic activity in MCF-7 and MDA-MB-231 cell lines. Mechanistically, arctigenin inhibits MMP-2 and MMP-9 activity, reduces VEGF expression, and targets pathways such as PI3K/Akt and STAT3 (Lou et al., 2020; Maxwell et al., 2020). Synergistic effects of arctigenin with chemotherapy drugs like doxorubicin further enhance its therapeutic potential (Lee et al., 2021).

While arctigenin exhibits significant promise, its classification as a phytoestrogen raises concerns about its safety in hormone-sensitive breast cancers. Further clinical trials are necessary to evaluate its efficacy and address these safety concerns (Maxwell et al., 2020).

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Conclusion
The review highlights the therapeutic potential of botanicals such as Echinacea, Black Cohosh, and Burdock in breast cancer treatment. While preclinical studies offer promising results, inconsistencies in data due to varying extraction methods, study protocols, and plant parts underscore the need for standardized research and clinical trials. The dual effects of phytoestrogens and potential interactions with existing treatments emphasize the importance of cautious, evidence-based applications of these botanicals.

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Future Research

Future research should aim to address the following gaps and challenges:

1. Standardization of Extraction Methods: Establishing uniform protocols for plant part selection, extraction techniques, and phytochemical profiling to ensure consistency across studies.

2. Clinical Trials: Conducting randomized controlled trials to evaluate the efficacy and safety of these botanicals in diverse patient populations, including hormone-sensitive and resistant breast cancer subtypes.

3. Mechanistic Studies: Further exploring molecular pathways modulated by these botanicals to understand their anti-cancer mechanisms and interactions with conventional therapies.

4. Phytoestrogen Safety: Investigating the dual role of phytoestrogens to delineate their potential risks and benefits, particularly in hormone-sensitive breast cancers.

5. Synergistic Effects: Assessing the potential synergistic effects of these botanicals with chemotherapy or immunotherapy agents to optimize treatment outcomes.

6. Long-term Effects: Evaluating the long-term safety and efficacy of these botanicals in breast cancer prevention and recurrence.

7. Geographic Variation: Investigating how regional differences in soil and climate affect the phytochemical composition and therapeutic efficacy of these plants.

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References

Cragg, G. M., & Newman, D. J. (2013). Natural products: A continuing source of novel drug leads. Biochimica et Biophysica Acta (BBA)-General Subjects, 1830(6), 3670-3695.

Davis, E. L., et al. (2021). Evaluating metastatic risks of Black Cohosh in HER2+ breast cancer. Cancer Biology & Therapy, 20(4), 300-310.

Driggins, J., et al. (2021). The anti-proliferative effect of Echinacea pallida on BT-549 cancer cell lines. Herbal Medicine Research, 8(2), 145-160.

Espinosa-Paredes, E., et al. (2021). Synergistic effects of Echinacea angustifolia extracts with chemotherapy drugs. Cancer Treatment Reviews, 52, 45-60.

Hassan, S. S., et al. (2020). Plant-derived compounds as potential anticancer agents. Frontiers in Pharmacology, 11, 573196.

Islam, S., et al. (2020). Phytochemical properties of Echinacea species. Pharmacognosy Reviews, 14(4), 210-220.

Karimi, S., et al. (2019). Enhancing flavonoid content in Echinacea purpurea using ZnO nanoparticles. Plant Biotechnology Reports, 13(2), 180-195.

Knipping, K., et al. (2020). Anti-inflammatory and anticancer properties of burdock root. Journal of Medicinal Plants Research, 14(5), 300-312.

Lou, Z., et al. (2020). Anti-metastatic effects of arctigenin on human breast cancer cell lines. Molecular Carcinogenesis, 59(8), 905-915.

Maxwell, S., et al. (2020). Arctigenin inhibits the activation of the mTOR pathway. Breast Cancer Research, 22(5), 102-115.

Park, K., et al. (2020). Selective cytotoxic effects of Echinacea purpurea on breast cancer cells. Phytotherapy Research, 34(10), 2723-2730.

Pellati, F., et al. (2018). Secondary metabolites from Echinacea species: Cytotoxic effects on breast cancer cell lines. Journal of Ethnopharmacology, 213, 165-175.

Predes, F. S., et al. (2019). Burdock’s cytotoxic effects on breast cancer cell lines. Phytomedicine, 62, 152-160.

Rostock, M., et al. (2019). Black Cohosh use in breast cancer patients: A systematic review. Supportive Care in Cancer, 27(9), 3585-3597.

Siegel, R. L., Miller, K. D., & Jemal, A. (2021). Cancer statistics, 2021. CA: A Cancer Journal for Clinicians, 71(1), 7-33.

Werier, D., et al. (n.d.). The flora of New York: A survey of native and non-native species. New York Flora Atlas. Retrieved from https://newyorkfloraatlas.org

Zierau, O., et al. (2019). Black Cohosh: Anti-estrogenic or estrogenic effects? Phytotherapy Research, 33(7), 200-212.

"BOTH MY PARENTS HAD CANCER... I NEED TO TEST!

INTRODUCTION'

According to the NIH, "About 8% to 10% of all cancers in children overall are caused by an inherited pathogenic variant (harmful alteration) in a cancer predisposition gene, although the percentage varies across cancer types (7–9)" [1]. As cancer rates remain prevalent in certain geographic areas and demographic groups, gene testing and functional genomics are some of today's most helpful tools that help support early detection and prevention.  To find comprehensive answers about one's health, subscribing to a personalized gene testing program is advantageous especially with familial links to cancer.  The concept of "TEST, DON'T GUESS" is the rallying message from the cancer care community, and with today's highly advanced diagnostic and testing solutions available, staying proactive is the key to health success.

We thank the Women's Health Collaborative (cancer care group), BardDiagnostics and the Integrative Cancer Resource Society for their outreach work in spreading the message about personalized gene testing in the next generation of parents have had a bout with cancer.

SAMANTHA'S TEST

Originally published in Health Resource Digest (5/1/2024)

Samantha Hunt, 24 is a young cancer awareness advocate due mostly to the upbringing of two cancer survivors who are outspoken about environmental cancers and proactive testing ("Get Checked NOW!" program).  She is in a graduate program for social work and grew up in a household in support of prevention and early detection.

Since she was 9 years old, Samantha took on personal studies on breast cancer when she watched her mother (Jennifer) undergo a bilateral mastectomy for early-stage breast cancer.  Samantha's father was diagnosed with early-stage prostate cancer, and her maternal aunt also had breast cancer. By her late teens into her college years, Samantha was convinced that she needed to have early screening, which is when she discovered she had dense breast tissue- a condition that is present in over half of women in the U.S.  [12]

Though currently testing negative for cancer, Samantha continues to undergo early detection through gene testing, ultrasound screening and maintains a significantly strict lifestyle of prevention (eating healthy/organic foods, no sugar, exercise, organic foods etc).  Early in life, she learned the value of staying proactive and getting a second opinion- never resting on reassuring words from physicians.  "Early on, my gyno didn't express any real sense of urgency about me getting an ultrasound test but gave me the referral just to make me happy...", stated Ms. Hunt.  "Even today (and sometimes even in the past with other breast exams), I often feel like they do it so quickly and carelessly, and I feel stressed out after...  I'm not convinced that I'm getting a proper examination!"

Samantha has received a total of 4 biopsies due to the "abnormally dense" breast tissue- a concern that scientists are now linking to breast cancer. [13] At an early age, Samantha took on a significant leadership role in her health to approve the biopsies despite the risk and concerns from her parents. "After my first sono, they found me to be 'very lumpy' and called on me to get a biopsy.  None of us were excited about this but if I was going to get any peace of mind, I made a decision to go for it and I'm glad I did. Honestly think I'd be more anxious knowing there's something that a doctor recommended that I should get a biopsy on!"

EPILOGUE
To pursue gene testing in the younger ages (of parents who struggle with or have survived cancer) is a matter of choice and one that is not necessarily to be taken as an emergency alert. Samantha's story is her own- and her journey to explore her own genetic makeup comes from a proactive young woman whose decision is partly based on other findings like dense breast tissue.  Samantha's parents (both cancer survivors and public advocates) highly support their daughter to "get the test" as a road to getting peace of mind.  Their pursuit for a proactive lifestyle encourages a smarter, healthy diet and a preventive life strategy that continues into their next generation.   

To date, Samantha's gene test reports have concluded no alarming traces of cancer predisposition.  She continues to maintain a proactive life, staying on top of physical checkups and an all-natural lifestyle.

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Thursday, March 14, 2024

CANCER PREDISPOSITION, HEREDITY & GENE TESTING

NYCRA NEWS- Genetic Predisposition (Vol. 1- Spring Issue 2024)

By definition, diseases like CANCER are not directly hereditary. Unlike genetic traits and characteristics passed down to children like blood type and eye color, chronic diseases like cancer are recognized to be contracted through the environment (external impact). However, as cancer is a form of genetic mutation, genetic changes that increase the risk of cancer CAN be passed down or inherited.  

When a specific cancer type is prevalent in one side of the family, the cancer is recognized as a FAMILIAL cancer. Most of them are caused by genetic mutation in a gene related to cancer susceptibility. In addition, a term called "family cancer syndrome" (or "hereditary cancer syndrome") is a rare disorder in which family members have an above-average chance of developing a certain type or types of cancer. Family cancer syndromes are caused by inherited genetic variants in certain cancer-related genes. [1]

It is reported that up to 10% of all cancer cases may be caused by inherited genetic mutation or changes. These are called CANCER PREDISPOSITION genes. Individuals who carry a mutant allele of these genes have an increased susceptibility to cancer. It is now widely identified that an accumulation of genetic or epigenetic alterations affect the conversion of normal cells to cancer cells. [2]

 GETETIC MUTATIONS

Oftentimes, researchers of hereditary cancers will reference breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2).  Specific alterations in these genes disable their function such that, inheriting such mutations may preclude you to contract breast (and other) cancers. Having a strong history of breast cancer may often be linked to acquiring a BRCA1 or BRCA2 mutation. Family members with BRCA1 or BRCA2 mutations often share the same mutation. [3]

Another predisposition scenario is Lynch syndrome; according to the CDC, carrying this condition holds a 1 in 2 (50%) heredity chance of your children also having Lynch syndrome. Genetic testing for Lynch syndrome can be considered once your children reach adulthood.  Similarly, the most common are hereditary breast and ovarian cancer (HBOC) syndrome. Anyone with HBOC syndrome holds a higher risk for breast and ovarian as well as advanced and pancreatic cancers. [4]

GENE TESTING FOR CANCER RISK

Today's advancements in genetic tests can determine the possibility of an elevated risk of cancer. For those who come from a family with a history of breast and ovarian cancer make screening and treatment decisions. Not everyone needs to get genetic testing for cancer risk. Your doctor or health care provider can help you decide if you should get tested for genetic changes that increase cancer risk. They will likely ask if you have certain patterns in your personal or family medical history, such as cancer at an unusually young age or several relatives with the same kind of cancer.

Physicians may recommend genetic testing. It is advised to start with a genetic counselor who presents the potential risks, benefits, and drawbacks of genetic testing in your situation. Genetic counselors are also trained to review genetic test results with patients and/or their families and provide guidance in decision-making from those results. There are at-home genetic tests that one can order directly. Thanks to Dr. Google, there's more information on the types of consumer-accessible tests on the market- but these tests may have drawbacks or limitations when it comes to the prospect of genetic predisposition and genetic changes that increases cancer risk. Genetic counselors may be a helpful resource for identifying these test products as well.

For more information on what tests are available and who may want to consider them, visit the NIH/NCA Genetic Testing for Inherited Cancer Susceptibility Syndromes. https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet

REFERENCES

1) The Genetics of Cancer: NIH- https://www.cancer.gov/about-cancer/causes-prevention/genetics#:~:text=A%20family%20cancer%20syndrome%2C%20also,in%20certain%20cancer%2Drelated%20genes.  The Genetics of Cancer |  2) Cancer predisposition genes: molecular mechanisms and clinical impact on personalized cancer care: examples of Lynch and HBOC syndromes - Published online 2015 Nov 30. doi: 10.1038/aps.2015.89 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753377/#:~:text=Up%20to%2010%25%20of%20cancers,an%20increased%20susceptibility%20to%20cancer. |  3) Family Health History and the BRCA1 and BRCA2 genes/ CDC Centers for Disease Control and Prevention- https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/fam_hist_genes.htm#:~:text=Normally%2C%20the%20BRCA1%20and%20BRCA2,%2C%20ovarian%2C%20and%20other%20cancers. |  4) Family Health History and Cancer: Which Hereditary Conditions Raise My Chances of Getting Cancer? / CDC Centers for Disease Control and Prevention-  https://www.cdc.gov/cancer/family-health-history/index.htm#:~:text=Several%20hereditary%20conditions%20can%20raise,advanced%20prostate%2C%20and%20pancreatic%20cancers.

Part 2: CANCER PREDISPOSITION & THE ROLE OF GENETIC TESTING

By: Roberta Kline, MD 

Cancer comes from one of two ways. One is that you have inherited genetic mutations that significantly increase your risk for specific types of cancer. But overall, that's a minority of cancer cases. The majority of cancers occur because of an interaction between your individual genes and the environment that they've been exposed to throughout your lifetime. Both of them can be tested for.  And if you know what you're dealing with, you can create a plan that's specific for you that enables you to be proactive. This enables you to have that locus of control that you know what's going on in your body, but you don't know if you don't test. Therefore, TEST- DON'T GUESS!  And then you can create your roadmap that works for you.

Especially with breast cancer, we know that 90% of the cases are not due to known inherited genetic mutations like BRCA1. The majority of them are due to very small changes in your DNA that interact with your environment over your lifetime that predispose you to developing breast cancer. But if you don't know that you have these predispositions, you can unknowingly be exacerbating the problem. If you've been tested and you know what your genes are doing, you can proactively create a plan to minimize your risk throughout your lifetime. 

"INHERITING CANCER & GETTING THE RIGHT TEST"

We understand genetic mutations to cause severe diseases, predominantly causing certain types of cancers. But rather than living in fear of what you may or may not have inherited from your parents, and whether you may or may not develop the same diseases that they carried- get tested, so you won't find yourself guessing.  Through gene testing protocols, you can precisely identify where you need to focus your resources, your attention- and when you can let go of that (unnecessary) fear.

Because genetic testing can be very specific, one of the biggest challenges for proactive people about their health is to know WHAT to test for. What test do you use? Is there a test that's better for you than others? These are important questions and the amount of information available (while great) can be quite overwhelming. The best suggestion is to speak to a trained medical professional or a genetic specialist who can help you navigate through the vast collection of available tests to find what is right for you.  What you want is a test that has value. And in order to have value, it needs to answer your questions and provide you a roadmap for what you can do proactively for your health for the future. 

DNA REACTIONS FROM ENVIRONMENTAL TOXINS:

So when you look at the issue of breast cancer in Long Island and how it is tied to these environmental toxins, what you're seeing is these environmental toxins can potentially, if it's a large enough dose, create mutations in somebody's DNA, but what is most likely happening (and this I do have to check on,) what is most likely happening is it's overwhelming the body's ability to process these toxins. When your body processes any kind of chemical, including these toxins, it produces oxidative stress. When you have too much oxidative stress for your body to handle, this has a tendency of creating DNA breaks. So it's not the toxin directly causing DNA breaks necessarily, it's that your body can't get rid of that toxin fast enough or efficiently enough. And so its own biological processes that are supposed to deal with this are the ones that actually cause the DNA breaks (mutation) and the changes in the DNA that increase the risk of breast cancer. 

 This is the second part of that pathway by which estrogen as well as other chemicals can cause breast cancer.  Conventional medicine pays attention to the binding of estrogen to the estrogen receptor causing proliferation. Excessive proliferation can lead to a higher chance of DNA breaks. Every time that DNA replicates, (which is what happens when you create proliferation) when the cells grow, every time that DNA replicates, there's a chance that it will cause an error in that replication and leave a mutation in the DNA. Now, we have lots of processes that are built in to safeguard against that. We have DNA repair mechanisms, we have all sorts of machinery that is designed to catch breaks in the DNA before they get integrated into the person's biology. If you overwhelm that, those breaks stay. 

To note, estrogen itself is a toxin, even though we produce it ourselves. Studying the other part of estrogen metabolism, which is the same process that happens with all of these toxins is that it goes through what we call DETOXIFICATION or BIOTRANSFORMATION. You're transforming something that's potentially toxic, ultimately into a molecule or a chemical that is non-toxic and gets eliminated from the body. Within that process, you are often creating even more toxic chemicals in the intermediary stages, and that's what requires a high level of antioxidant defense as well as other biological systems to keep those contained and keep them in check and funnel them quickly into the benign molecules out of the body. This is the second way that you can create DNA damage that you can create cancer because you are overwhelming the body's ability to neutralize those toxic compounds that your body is creating as a result of whatever it's taking in. This has to do with oxidative stress, which is linked to INFLAMMATION, which we know underlies almost every cancer process. 

ABOUT THE AUTHOR

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/

RECURRENCE EXPLAINED

RECURRENCE IN REVIEW
Transcript by Dr. Roberta Kline

There is a constant debate in the cancer community about the term "CANCER FREE". Cancer recurrence continues to be a major concern as reported in annual medical reports- identifying its tendency to “return with a vengeance". [1, 2]

Medical research has identified the major reasons why cancer recurs.  A widely reported cause for this is attributed to a deficiency in treatment performance. [2] This means the therapy induced did not successfully remove or kill all of the cancer cells, possibly due to the patient's level of drug resistance.  During treatment, Cancer cells can enter a dormant state to protect themselves from treatment and other stimuli. Over time, these dormant cells can reactivate. The cause of this may be a spike in chronic stress or the release of toxins from oxidative stress from environmental factors like smoking or repeat exposure to reactive chemicals. [3]

Inflammation has also been linked to the activation of immune cells called neutrophils. [4] Cancer cells that have spread to other areas of the body after successful treatment of the original tumor can remain dormant for years or decades before recurring as metastatic cancer. Further activators of these dormant cells have also been linked to one's personal Epigenetics. [5] This determines how your environment and lifestyle affects your cell function- including the dormancy state of your cancer cells. 

Another known cause for recurrence are Cancer stem cells or CSC's.  These are a small group of cells in tumors that have the ability to self-renew, differentiate, and give rise to all cell types in a tumor. [6] Most stages of tumor progression, including tumorigenesis, promotion, progression, and recurrence are accompanied by epigenetic alterations, some of which can be reversed by epigenetic drugs. [6]

DETECTION MONITORING: After cancer surgery, there are many preventive measures to support a safe and healthy recovery and to reduce the risk of recurrence.  A logical and preventive strategy as part of postop maintenance is called RECURRENCE PREVENTION SCANS. Through the use of affordable, real-time medical imaging such as the 3D Doppler Ultrasound, post-cancer surgery patients can subscribe to a personal monitoring regimen to scan for any potential lesions and micro-tumors that may have fallen under the radar.  Proactive monitoring can also address complications such as post-surgical Infections, recurring pain, swelling, neuropathy from nerve damage, scarring, fluid buildup or blood clots. In less than 20 minutes per visit, you earn peace of mind from a comprehensive scan by seasoned specialists trained to support postop patient management.

DR. ROBERTA KLINE is an ObGyn physician, an award-winning author, an educational advocate, and an inspirational speaker for the professional and women’s communities. She holds a combined mission to upgrade how we approach health and deliver healthcare for women through education, globalized communication, research, and advocacy.  Dr. Kline develops and teaches CME programs, consults on gene expression project designs, and leads collaborative projects designed to advance the direction of women’s health. She is also a clinical advisor in integrative medicine and functional genomics to many health organizations including the Integrative Health Research Center.  In addition to her mentorship programs for women physicians, Dr. Kline is Director of Educational Programs for the Women's Health Collaborative, Editor of the Women’s Health Digest, and on faculty at the University of Western States. 

(1.) Butow P, Sharpe L, Thewes B, et al. Fear of Cancer Recurrence: A Practical Guide for Clinicians. Oncology (Williston Park). 2018 Jan 15;32(1):32-8.   (2.) Mahvi DA, Liu R, Grinstaff MW, et al. (2018). Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies. CA: A Cancer Journal for Clinicians, 68(6), 488. https://doi.org/10.3322/caac.21498 (3.) Payne KK. Cellular stress responses and metabolic reprogramming in cancer progression and dormancy. Seminars in cancer biology 2022 Jan Vol. 78, pp. 45-48. (4.) He X-Y, Gao Y, Ng D et al. Chronic stress increases metastasis via neutrophil-mediated changes to the microenvironment. Cancer Cell 2024:42(3);474-486. DOI: https://doi.org/10.1016/j.ccell.2024.01.013  (5.) Costa S, Alves Sales SL, Pinheiro DP, et al. (2023). Epigenetic reprogramming in cancer: From diagnosis to treatment. Frontiers in Cell and Developmental Biology, 11. https://doi.org/10.3389/fcell.2023.1116805 (6.) Yu X, Zhao H, Wang R, et al. (2024). Cancer epigenetics: From laboratory studies and clinical trials to precision medicine. Cell Death Discovery, 10(1), 1-12. https://doi.org/10.1038/s41420-024-01803-z

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WHAT'S NEXT AFTER CANCER?

The Importance of Maintaining a Healthy Lifestyle and Monitoring

Written by: Dr. Leslie Valle-Montoya 

Cancer recurrence can occur months or even years after initial treatment, and it’s important to be aware that cancer can return in different tissues, not just where it was originally diagnosed. While this is a challenging possibility, there are proactive steps you can take to reduce the risk and protect your health.

Staying vigilant with regular check-ups, lifestyle adjustments, and continued screenings is essential. Early detection of any signs of recurrence greatly increases the chances of successful treatment. Maintaining a healthy lifestyle after being declared “cancer-free” is not always easy, but it’s vital. We are constantly exposed to environmental toxins in our food, water, and surroundings, so addressing the root causes of disease and making healthier choices is crucial. A nutritious diet, physical activity, and stress management all support overall wellness and strengthen the immune system. I often guide patients in addressing lingering dental infections and maintaining a healthy internal environment, whether by enhancing the microbiome or reducing bodily acidity, which cancer thrives on.

Avoiding smoking, limiting alcohol, and maintaining a healthy weight are also key to lowering the risk of recurrence. By focusing on what you can control—your health and regular monitoring—you empower yourself to stay well and ensure long-term health.

CONTRIBUTOR:

LESLIE VALLE-MONTOYA, MD is the Founder of Biomed Life and the Santa Barbara Longevity Center. After medical school, Dr. Valle focused on managing chronic disease starting with its links to poor nutrition and then introducing them into the world of energy frequencies.  She explores and includes non-invasive modalities such as: frequency therapies (including biofeedback), PEMF, proper detoxification, nutritional guidance and binaural beats as needed. - visit: www.biomedlifesb.com

Announcing the TSCCC (TriState Cancer Care Community)- a professional  network comprised of community leaders, legislators, health specialists & educators. We are backed by the AngioInstitute (501c3) and are aligned by cancer foundations centralized in the NY, NJ and CT. We assemble the latest information, current news events, research reports, technologies and success stories about the battle against cancer and the luminaries who wage them.

Click to play video CANCER RECURRENCE IN THE MOST RARE CASES: "LIGHTING STRUCK TWICE WITH MALE BREAST CANCER!"-- “I contracted Male Breast Cancer TWICE, just when I thought it was gone the first time. I learned that cancer doesn't give up - so neither should you! Stay smart, be proactive and follow a RECURRENCE PREVENTION plan to KEEP CANCER AWAY.” MARC FUTTERWEIT- Survivor/Senior Ambassador for Male Breast Cancer Coalition Doctors will never guarantee that your cancer is gone forever, even after the remission period. The American Medical Community suggests that all survivors of cancer should subscribe to proper health and nutritional standards to support continued prevention. Take the right steps to OUTSMART CANCER TODAY by learning how recurrence works. Start by managing a healthy (and organic) lifestyle, support a regular fitness regimen and schedule an annual monitoring program with an advanced imaging professional or physician specializing in cancer diagnostics to maintain regular screening protocols for early detection or to help prevent cancer recurrence.

9/10/2024- A NEW TOUCHDOWN IN THE FIGHT AGAINST BREAST CANCER- DENSE BREAST DISCLOSURE LAW CONFIRMED

9/10/2024- The Dense Breast Disclosure Law was officially confirmed at the Legislative Building in the CT State Capitol, hosted by the ‘Are You Dense Advocacy’ organization.  The conference was emceed by Mr. Joe Cappello, co-founder and executive director, establishing both a celebration and an historical landmark for the 20+ year crusade for a national legislation.  The law affirms the vision of the late Dr. Nancy Cappello for a public educational advocacy to protect women from misinformation about their breast health.  This initiative enacted national support for legislative action to enforce patient disclosure about tissue density.   (See full report)

AT LAST! "ARE YOU DENSE ADVOCACY" LANDS 20-YEAR TOUCHDOWN:
Congresswoman DeLauro Celebrates National Support for Women’s Health 

Click to see Sen DeLauro's Video

Room #5100 of the Legislative Office Building was filled with supporters from many areas of the 20+ year dense breast advocacy crusade 'raised the roof' of this national movement in support of women's health.  The lineup included Mr. Anthony D'Amelio (former CT House Rep), Dr. William Pizzuto, Sandy Cassenelli (founder of Breast Friends Fund & Metastatic Breast Cancer Survivor) and Mary Deming (President of Seymour Pink) are among the list of supportive speakers. The audience was also filled with an array of executive directors from the national breast cancer community including the American Breast Cancer Foundation.  - See areyoudense.org for complete list of speakers and their transcripts.

A powerful voice in national Women's Health advocacy resonated from the back of the room, where a familiar face from the big-screen took center stage. The highly-beloved CT Congresswoman Rosa DeLauro transmitted a compelling video message from Washington and received a rousing applause with many tears of loving support.  “Today we celebrate the launch of the Food and Drug Administration's Breast Density Notification Rule. I am a 35 year cancer survivor. I'm alive today thanks to the grace of God, the care of hardworking medical professionals, the power of biomedical research and early detection. In 2009, this law was championed by my dear friend Dr. Nancy Capello, who passed away several years ago due to breast cancer...Had Nancy been notified of her status earlier, she may have been here today to celebrate with us. Nancy's husband (Joe) carried on her fight and their story inspired me. I want to thank you again for inviting me to join you today. I urge you to keep up the fight.” 

Thanks to the power of web-streaming technology, an unconfirmed count of breast cancer orgs nationwide (and their respective members) accessed the live feed of the Are You Dense? event.  Donna Johnson, president of ‘Are You Dense?’ mentioned about an upcoming virtual (seminar-style) event which will launch sometime in mid-October- bringing in some of the top names in public advocacy as well as leaders from the medical community.  

For more info. on this press release, contact ‘Are You Dense Alliance’ (multimedia dist.) / Alexandra Fiederlein: editor.prevention101@gmail.com or call 516-522-0777

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Click to see Den. Anwar's Videos

SEN. SAUD ANWAR
CONNECTICUT STATE SENATE ADVOCATES FOR UNDERSERVED WOMEN

7/13/2024 ‐ The  Women's  Health  Collaborative  proudly celebrates the dedicated commitment and support of STATE SENATOR SAUD ANWAR (D‐South Windsor) of District 3 for his legislative work in health initiatives for women. A pulmonary physician  by  profession,  Sen.  Anwar  joined  public  office  in 2013 as mayor  of South Windsor,  CT  (until 2015, and 2017‐2019).  Senator  Anwar  is  involved  in  humanitarian  and  peace initiatives  nationally  and  internationally.  He  is  frequently invited  to  consult  for  our  government  and  has  organized medical  missions  for  disaster  relief.  His  efforts  have  been recognized  at  the  state  and  federal  levels  and  by  several  professional  organizations.  He  has  received  numerous citations for his service to the State and is an expert on international affairs.[1] 

WOMEN’S HEALTH COLLABORATIVE GOES TO ALBANY

May 21, 2024, leading members of the NY Cancer Resource Alliance (NYCRA) held a special meeting with State Senator Patricia Canzoneri‐Fitzpatrick (of Senate District 9) to discuss critical issues associated with women's cancers. This initial meeting of the minds offered cancer updates from the field, including statistics, diagnostic trends and the continuing battle with restrictive insurance coverage.

TRIBUTE TO A GLOBAL CRUSADER (Play Video-L) The NY Cancer Resource Alliance gives loving tribute to Dr. Nancy Cappello, co-founder of "Are You Dense" and chief crusader of the mission to bring change to the protocols and standards of Early Detection.   Her organization embarked in a global advocacy project to win legislation for dense breast scanning and to bring awareness to the need for better technologies and imaging interpretation. Today, her loving husband Joe continues her unending fight to save more lives through awareness, advocacy and her crusade for change.

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ADVOCACY & JOINING HANDS TO MAKE A DIFFERENCE
By: Geri Barish -  Hewlett House (Cancer Resource)

When I first met Joe Cappello, I admitted that I knew about his wife Nancy for years prior. Nancy Cappello was a force of nature and an inspiration to anyone willing to advocate for change in the breast cancer movement. I myself have been a 3x breast cancer survivor and a staunch supporter of public screening with the Women's Health Collaborative and the "Ultrasound Coalition" - but joining with Joe’s organization truly added so much validity to national research and public connectivity. Dr. Robert Bard (our lead radiologist) spoke about Are You Dense? as champions that pushed for government intervention to mandate the disclose of patients’ tissue density.  This is a landmark achievement that I reference in my own presentations about women’s health at the NY State Senate and the Dept. of Health in support of early detection and prevention programs. To date, Joe and Are You Dense? has become a permanent part of our coalition to battle breast cancer.  His work reflects on the healing factor of public awareness, forging a more powerful presence to educate and promote clinical testing.

EXTRA: 2024 UPDATES ON DENSE BREAST RESEARCH

3/2024- Dr. Noelle Cutter of Molloy University and an associate of Bard Diagnostics/Are You Dense? partnerships conducted an observational study exploring the functional phenotypic differences that make dense breast tissue. Because it is widely noted that women with dense breasts have a greater likelihood of developing cancer, understanding the  pathways and changes in gene expression may offer the first avenue for the enzymes enrolled and drug targets for personalized medicine in pursuit of developing better treatment options. “The proposed role of senescence in dense breast tissue metastasis involves creating a tumor-promoting microenvironment, facilitating immune evasion, and promoting angiogenesis, all of which contribute to the progression and spread of cancer cells.”- For full report, visit: www.pinksmartnews.com

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The 2024 Women's Health Resource Network Launches Ultrasound Screening Initiative for Underserved Communities

Density under mammograms conceal tumors & cysts. Ultrasound is the suggested screening complement

In support of the underserved and underdiagnosed women, the WHC was originally founded to bring early detection and public education about the many women’s health disorders that many find to be lacking in access and information. This doctrine united women’s health advocates like Geri Barish (Hewlett House), Joe Cappello (co-founder of the Are You Dense? Foundation), Dr. Robert Bard (IHRC / Integrative Health Research Center), Dr. Noelle Cutter (Molloy University Research on Ovarian and Breast Cancer research programs) and Nancy Novack (of nancyslist.org). “It’s time we wake up lawmakers and the medical community to re-evaluate the existing gold standards (like mammography),” stated Mr. Cappello during a Key to the City speech honored by Waterbury mayor Neil O’Leary. “We are finally picking up great steam in our national push to have all clinicians adopt the advanced results of ultrasound technology… as a sustainable and affordable solution for ALL women!”