Strange ?--did your original surgery and/or recurrence occur during fall/winter/dark

[Lani]

months.

It seems to me just by following the posts on this board that more people are tending to recur during the fall/winter. Perhaps I am wrong in this and perhaps this is merely coincidental. But perhaps this may be because they were diagnosed in fall/winter.

Without herceptin the natural history of her2+ breast cancer is, according to Dr. Slamon, that there is a big peak of recurrence starting around 24 months and that, once they've recurred, survival averages 12 months (vs 24 months for metastatic her2- breast cancer) Now herceptin (when it works) hopefully will have changed all this, but many cancers, including prostate cancer, tend to occur in geographic regions that have less sunshine and correspondingly long dark winters(thought to be related to Vitamin D)

I am wondering, for those of you who have recurred: How long did it take for you to recur after surgery, did you have Herceptin initially, and what season did you have your surgery and did you recur in?

A study being lead by Dr. David Feldman of Stanford for patients with recurrent prostate cancer has shown that they can keep the cancer from progressing and the PSA levels low in a substantial number of cases just by
treating the patients with high doses of vitamin D (not reproducible with supplements and given in a certain time-course to minimize the development of kidney stones) and normal doses of Aleve. They are planning to start a similar trial in breast cancer soon.

Just food for thought in these dark days of winter...

[Lauriemn]

Hi Lani, I have not recurred but I live in Minnesota and had my surgery in March of 2005. I have seen claims that tanning beds can help your body produce vitamin d? do you know if this is true? I have been contemplating going a few times this winter, eventhough I would have never went in the past because of concerns about skin cancer.

D you know if it is possible to get enough vitamin d from your diet, or is the sun needed to help your body process the vitamin d it receives from food?


what dr slamon said really scares me as I am at 22 months and it will still be winter in Mn when I hit 24 months. I did do a year of herceptin, which ended in April, 2006.

Thanks,

Laurie

diag 3/21/05, 37 years old
Stage 2b
4.5 cm, 2+ nodes
er/pr-

[Lani]

Dr. Slamon said nothing about the dark(that part was my musing/questioning based on my observation that more posts seem to appear discussing recurrence during the dark months). Dr. Slamon. just quoted the natural history of her2+ breast cancer before herceptin was used.

Herceptin is certainly changing the behavior of her2+ breast cancer, but it is not effective in everyone and resistance can occur.

Thanks for your input!

PS I don't know about the tanning beds--will let you know if I read something

[sassy]

I remember reading back some time ago about season of diagnosis possibly being of significance--can't remember where the info was. Does this ring any bells for anyone else?
________
Katerine live

[Lani]

Links
[Seasonal patterns of breast tumor growth in Far North residents]

[Article in Russian]
Borisenkov MF,
Bazhenov SM.
Earlier, we established a relationship between sex hormone receptor concentration in tumor and 5-year survival, on the one hand, and seasonality, on the other. The parameters showed a distinct 6-month cycle. That pointed to certain environmental factors which could synchronize hormone-dependent tumor process in the breast of women living in the North. The present study is concerned with a relationship of 6-month rhythm of tumor growth and latitude of residence. Said rhythm was reliably identified as a parameter of 5-year survival in the Far North (68 deg. northern latitude, p < 0.001). Maximum values of 5-year survival were registered in those diagnosed with cancer in winter or summer, while those diagnosed in spring or fall had unfavorable prognosis. Northern magnetic storms recur at 6-month intervals and most frequently in spring and fall. Electromagnetic radiation is known to suppress melatonin production and, that might have stimulated tumor process. Therefore, it is most likely that solar electromagnetic radiation might synchronize hormone-dependent tumor process in women resident in the North.
PMID: 17037040 [PubMed - indexed for MEDLINE]

[Lani]

Breast Cancer Res Treat. 2006 Sep 21; [Epub ahead of print] Links
Changes in risk of death from breast cancer with season and latitude : Sun exposure and breast cancer survival in Norway.

Porojnicu AC,
Lagunova Z,
Robsahm TE,
Berg JP,
Dahlback A,
Moan J.
Department of Radiation Biology, Institute for Cancer Research, Montebello, 0310, Oslo, Norway, a.c.porojnicu@usit.uio.no.
The Norwegian counties can conveniently be divided in three groups with different annual UV exposures and different incidence rates of squamous cell carcinoma (SCC) of the skin. In view of the hypothesis that latitude and season of diagnosis may play a role for breast cancer progression, the prognosis of breast cancer as determined for summer and winter diagnosis, were evaluated in the three residential regions. Two age groups were analysed separately (stratification at 50 years). For all regions, and for all ages, the prognosis was best for women diagnosed in the summer season (Relative risk (RR) of death was 15-25% lower for summer diagnosis versus winter diagnosis). There was no significant seasonal variation of the number of new cases. For women diagnosed before the age of 50, a geographical gradient in cancer prognosis was also found (RR of death 0.6, 95% CI: 0.5-0.7 for cases diagnosed in southeast Norway and RR of death 0.8, 95% CI: 0.6-1.1 for diagnosis in the north of Norway). This is in agreement with a 1.5 times larger annual UV exposures and 3-4 times larger incidence rates of SCC in the southeast region when compared with the north region. For women diagnosed after the age of 50, no significant difference was found between the three regions. Despite a 17% higher vitamin D intake from food in north of Norway no difference in cancer survival was found for diagnosis during winter (when no significant differences in the levels of UV exposure can be detected between regions).The overall data support our earlier hypothesis that season of diagnosis and therapy start improves the survival for breast cancer.
PMID: 17028983 [PubMed - as supplied by publisher]

[Lani]

Int J Cancer. 2006 Oct 1;119(7):1530-6. Links
Cancer survival is dependent on season of diagnosis and sunlight exposure.

Lim HS,
Roychoudhuri R,
Peto J,
Schwartz G,
Baade P,
Moller H.
King's College London, Thames Cancer Registry, London, United Kingdom. hyunsook.lim@kcl.ac.uk
Sunlight is essential for the production of vitamin D in the body. Evidence exists to suggest that vitamin D metabolites may have a role in tumor growth suppression. In this large study, involving over a million cancer patients from the United Kingdom, we have analyzed the role of season of diagnosis and sunlight exposure in cancer survival for cancers of the breast, colorectum, lung, prostate and at all sites combined. We used population-based data from the Thames Cancer Registry to analyze cancer survival in periods 0-1 and 0-5 years after diagnosis. The analysis was performed using Cox proportional regression analysis adjusting for age and period at diagnosis and including season of diagnosis and sunlight exposure in the preceding months as factors in the analysis. We found evidence of substantial seasonality in cancer survival, with diagnosis in summer and autumn associated with improved survival compared with that in winter, especially in female breast cancer patients and both male and female lung cancer patients (hazard ratios 0.86 [95% CI 0.83-0.89], 0.95 [95% CI 0.92-0.97] and 0.95 [95% CI 0.93-0.98] respectively). Cumulative sunlight exposure in the months preceding diagnosis was also a predictor of subsequent survival, although season of diagnosis was a stronger predictor than cumulative sunlight exposure. We found seasonality in cancer survival to be stronger in women than in men. Our results add to a growing body of evidence that vitamin D metabolites play an important role in cancer survival. Copyright 2006 Wiley-Liss, Inc.
PMID: 16671100 [PubMed - indexed for MEDLINE]