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09-27-2007, 10:32 AM
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#1
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Senior Member
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
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Stressful Events May Increase BC Recurrence Rate
__________________
Kind regards
Becky
Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia
NED 18 years!
Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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09-27-2007, 12:19 PM
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#2
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Senior Member
Join Date: Sep 2005
Location: NYC
Posts: 250
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Thank you for posting this.
What do you think?
I wonder if the stressful events stopped these women from getting timely treatment? Maybe that is more the cause of the outcomes than stress hormones?
__________________
dx 4/05 @ 34 y.o.
Stage IIIC, ER+ (90%)/PR+ (95%)/HER2+ (IHC 3+)
lumpectomy-- 2.5 cm 15+/37 nodes
(IVF in between surgery and chemo)
tx dd A/C, followed by dd Taxol & Herceptin
30 rads (or was it 35?)
Finished Herceptin on 7/24/06
Tamox
livingcured.blogspot.com
"Keep your face to the sunshine and you cannot see the shadow." -- Helen Keller
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09-27-2007, 02:36 PM
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#3
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Senior Member
Join Date: Aug 2007
Location: Silicon Valley, CA
Posts: 76
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Stress & BCmets Recurrence
Hi, Becky & Saleboat,
I'm not ready to put much stock in this research, mainly because at least a third of the data was derived from self-reported history of trauma such as being sexually abused as a child, having been raped, life-threatening injury or suicide of a family member.
While these are "stressful events", they were a separate group in the 3-part study, and they had the shortest survival rate!!! It's not as though this kind of traumatic stress is something we can control for!!! So what good is it, even if there is a real correlation/ causality???
"Stressful events" included adoption (whose, the bc mets patient, or her child's?), a parent's death, living with a MIL, earthquake, divorce, imprisonment of a relative. Well, at least these are more measurable self-report events than just a Likert scale of how much stress is in one's life, but still...
I'd alternately hypothesize that the women in the trauma & stress history groups (no telling WHEN they experienced the trauma/stress event! in relation to when they were dx'd with bc or bcmets, or whether they'd received counseling or instrumental help with financial and other problems associated with the trauma, stress...) might, as a collective data source, have less motivation to aggressively seek dx and care for bcmets (due to lack of financial or social resources, lack of feelings of self-worth, being in a depressive state, etc.) or even to continue treatment, if the treatment added yet another layer of suffering to their plate. And we all know how important aggressively or assertively pursuing the best available oncological care and treatment often is, towards getting treatments that have the best shot at keeping us recurrence free!
So, I'm really skeptical - about the research design, data collection methods, and conclusions drawn. But if this research can be replicated with another set of about N=100 subjects, perhaps with more recent traumas/ and both good and bad stressful events - marriage, moving, job promotions, and caring for a new baby are all stressful life events that bring big changes requiring major adjustments - then I'd consider this an important line of inquiry warranting further investigation.
(((hugs)))
Sandy in Silicon Valley
__________________
1992 - age 44/ ER-/PR+ Stage II dx - mastectomy, CAF x 6 cycles; Tamoxifen
1997 - BRCA1 mutation dx'd
1998 - ovaries removed
1999 - off Tamoxifen, on Arimidex
2003 - dx'd Stage IV - lymph nodes & lungs. ER-/PR-/HER2neu+++.
Tx: Herceptin & Taxotere (6 cycles).
2005 - 2.9cm x 3.6cm brain tumor. Craniotomy, CyberKnife. 9 mo. staph aureus infection at incision site - 2nd craniotomy. Two small brain mets CyberKnife'd.
2006 - revisit Xeloda - dosage lowered to 2500mg/day, 5 cycles.
2007 - "spot" dx'd on qtrly brain MRI - same location as CyberKnife 7/05. > by 2-4mm per quarter - - radiation injury or re-growing cancer? Tykerb added to Herceptin - July, still "watching & waiting". Otherwise, fully functional...
"The majority of people are not only afraid of holding a wrong opinion, they are afraid of holding an opinion alone." Kierkegaard
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09-28-2007, 11:17 AM
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#4
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Senior Member
Join Date: Sep 2005
Location: Alaska
Posts: 2,018
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Subjective, objective, cause, and effect.... good questions...
But what is still interesting about it is the importance of the chemical endocrine changes.... if there are either natural or synthetic ways to interrupt that chain of events. Maybe if there is a way to reduce the changes in cortisol that trigger other things, for example, it can better one's chances.
Like the article Hopeful posted... even though (as Sandy said) we may not be able to control the stressful events or their impact on us... it may be important to change our perception of whatever it is. I'm thinking again that maybe it is our sense of establishing some kind of control in the situation that is important. It may be more worthwhile than we know to find some natural or synthetic way that helps a person to break loose of one's situation and stand back (hopefully lowering the chemical changes).... whether a person picks exercise, or yoga, or quilting, or one of the drugs that breaks concentration, or marijuana, etc.
With traumatic situations it is really difficult to "let go" mentally (sort of like sucking on a sore tooth over and over). It may be that those who have learned to practice some effective personal ways of "getting past it" (whatever "it" happens to be) or even just "putting it aside" briefly or more frequently might have have some survival advantage over others just in changing the chemical endocrine sequence.... As long as it doesn't turn into steady avoidance of dealing with the practical issues involved.
A.A.
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09-28-2007, 02:08 PM
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#5
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Senior Member
Join Date: Mar 2006
Posts: 1,843
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I wrote a considered response to this which I must have forgotten to hit the post button.
In essence it is a mix of chemistry and emotion.
One negative is bad, two is worse.
A body in balance will likely allow those inflicted with such dreadful burdens to deal with them more effectively.
Trials show norepinephrine a stress hormone is reduce by DHA
More widely omega six derived chemicals play a big part in immune response and stress response, as well as some wider emotional responses.
AA is a long chain fat which is made from omega six which is the parent of a host of inflammatory agents. As always it is a question of balance.
You don't have to understand it just get the drift as to how influential the fats are in your body.
RB
http://cat.inist.fr/?aModele=afficheN&cpsidt=15926742
ABSTRACT
Titre du document / Document title
The immunostimulating and antimicrobial properties of lithium and antidepressants
Auteur(s) / Author(s)
LIEB Julian ;
Résumé / Abstract
Eicosanoids are products of arachidonic acid (AA), an essential fatty acid. They include prostaglandins (PGs), prostacyclin (PG12), thromboxanes (TXs), leukotrienes (LTs) and hydroxy fatty acids. AA is derived enzymatically from membrane phospholipids and to a lesser extent the diet. Eicosanoids self-regulate every cell, including those synthesizing serotonin, norepinephrine and dopamine and those subserving immune function, such asT-cells, B-cells, natural killer cells, macrophages, monocytes and dendritic cells. There is objective evidence that prostaglandins regulate the physiology of the hypothalamic-pituitary-adrenal axis (HPA). Elucidation of the structure and metabolic pathways of eicosanoids galvanized researchers into illuminating their role in physiology, pathology and pharmacology. Striking contradictions arose: eicosanoids were shown to activate and suppress microorganisms, potentiate and suppress immunity and possess pro- and anticancer properties. As prostaglandins are the most heavily studied eicosanoids in the context of mood and immunity I will focus on them in this article. I will present evidence of the immunostimulating and antimicrobial properties of lithium and antidepressants and propose that these properties are linked to the antiprostaglandin actions of these compounds.
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09-28-2007, 02:18 PM
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#6
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Senior Member
Join Date: Mar 2006
Posts: 1,843
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This trial make the point effectively.
RB
1: Biofactors. 2000;13(1-4):41-5.Click here to read Links
Anti-stress effects of DHA.
Hamazaki T, Itomura M, Sawazaki S, Nagao Y.
Department of Clinical Application, Institute of Natural Medicine, Toyama Medical and Pharmaceutical University, Japan. hamazaki@ms.toyama-mpu.ac.jp
DHA is abundant in the brain. Deficiency of DHA changes behavior in animals. The purpose of the present studies was to clarify the effect of DHA intake on hostility and plasma catecholamines. In study 1, forty-one students took either DHA-rich oil capsules containing 1.5-1.8 g DHA/d (17 females and 5 males) or control oil capsules containing 97% soybean oil plus 3% fish oil (12 females and 7 males) for 3 mon in a double blind fashion. They took a psychological test (P-F Study) at the start and end of the study. Study I started at the end of summer vacation and ended in the middle of mental stress of final exams. In the control group, hostility measured by P-F Study was significantly increased at the end of the study as compared with that measured at the start (+58%), whereas it was not significantly changed in the DHA group (-14%). In a similar double blind two-mon study (study 2), we measured plasma catecholamines and cortisol of students (3 females and 4 males for the DHA group and the same numbers for the control) at the start and end of the study. In study 2 the students were under a continuous stress of final exams that lasted for two mon throughout the whole study period. The plasma cortisol did not change in either group, but the norepinephrine concentration was significantly decreased in the DHA group (-31%), whereas it stayed at the same level in the control group. These effects of DHA intake may be applied to people under psychological stress.
PMID: 11237197 [PubMed - indexed for MEDLINE]
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09-28-2007, 04:07 PM
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#7
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Senior Member
Join Date: Aug 2007
Location: Silicon Valley, CA
Posts: 76
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I don't see the connection to the articles R.B. cited
Hi,
As far as I could understand, there isn't any connection between the research about stressful events and the two physiological/chemical response articles cited by R.B. Of those two articles, the first, by Julian Lieb, an author who writes about bipolar disorder, is about lithium and other mood chemistry-altering drugs. It is largely theoretical, and not based on experimental research, but rather, from what little I can tell, appears to be anecdotally-and-petrie-dish-based.
The second study, of DHA "biofactors", is so small a study (41 subjects in all) as to be virtually insignificant, and in fact, no P= (significance) levels are given for any of the data. Plus, it seems to me a very tenuous line to extrapolate generalizations of scientific knowledge between these 3 studies.
I'm not dismissing that there may be some deeply embedded commonality among long-term trauma or more recent/current "stressful" life experiences (the one I loved was "living with a MIL"!) and their effects on bcmets recurrence rates, bipolar disorder drugs, and DHA manipulations of mood, but if these phenomena have anything clear in common, it is NOT demonstrated in these three articles, IMO.
(((hugs)))
Sandy in Silicon Valley
__________________
1992 - age 44/ ER-/PR+ Stage II dx - mastectomy, CAF x 6 cycles; Tamoxifen
1997 - BRCA1 mutation dx'd
1998 - ovaries removed
1999 - off Tamoxifen, on Arimidex
2003 - dx'd Stage IV - lymph nodes & lungs. ER-/PR-/HER2neu+++.
Tx: Herceptin & Taxotere (6 cycles).
2005 - 2.9cm x 3.6cm brain tumor. Craniotomy, CyberKnife. 9 mo. staph aureus infection at incision site - 2nd craniotomy. Two small brain mets CyberKnife'd.
2006 - revisit Xeloda - dosage lowered to 2500mg/day, 5 cycles.
2007 - "spot" dx'd on qtrly brain MRI - same location as CyberKnife 7/05. > by 2-4mm per quarter - - radiation injury or re-growing cancer? Tykerb added to Herceptin - July, still "watching & waiting". Otherwise, fully functional...
"The majority of people are not only afraid of holding a wrong opinion, they are afraid of holding an opinion alone." Kierkegaard
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09-28-2007, 06:16 PM
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#8
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Senior Member
Join Date: Mar 2006
Posts: 1,843
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The body is so complex you are never going to prove these links in the same way as you will never prove smoking is bad for you. The is a great deal of indicative evidence smoking is bad fro you but not absolute proof in the sense you can isolate smoking from every other variable.
I know this is hard to believe but IMO there is growing evidence for stress and chemical factors.
I cannot argue a very complex subject in two or three paragraphs.
I have read very fairly on this subject and you will just have to take my word or go and spend many hours searching and reading that there are links at a chemical level that are capable of accounting for links between chemicals involved in the fats pathways and stress.
There is masses of experimental research on fats and neurological conditions. It is not conclusive but it is growing in weight and quantity.
The lithium trial says "As prostaglandins are the most heavily studied eicosanoids in the context of mood and immunity I will focus on them in this article." "T here is objective evidence that prostaglandins regulate the physiology of the hypothalamic-pituitary-adrenal axis (HPA)."
"The hypothalamic-pituitary-adrenal axis (HPA axis) is a complex set of direct influences and feedback interactions between: the hypothalamus, a hollow, funnel-shaped part of the brain; the pituitary gland, a pea-shaped structure located below the hypothalamus; and the adrenal or suprarenal gland, a small, paired, pyramidal organ located at the top of each kidney. The fine, homeostatic interactions between these three organs constitute the HPA axis, a major part of the neuroendocrine system that controls reactions to stress and regulates various body processes including digestion, the immune system, mood and sexuality, and energy usage." http://en.wikipedia.org/wiki/Hypotha...y-adrenal_axis
The student trial says "the norepinephrine concentration", which relates to stress. This effect has been observed in other trials. "Norepinephrine is released when a host of physiological changes are activated by a stressful event." http://en.wikipedia.org/wiki/Norepinephrine There are a number of trials that make the link to stress reduction occuring where DHA intake rises.
RB
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09-29-2007, 04:51 AM
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#9
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Senior Member
Join Date: Mar 2006
Posts: 1,843
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Thanks for starting this thread.
Questions make me go off and look for answers and so all always useful.
I do not mean to be strident but it is hard when you can see patterns building that have serious health implications but cannot communicate what you see.
Some have been banging the omega six drum for decades. William Lands in one such pioneer.
RB
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09-30-2007, 03:21 PM
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#10
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Senior Member
Join Date: Mar 2006
Posts: 1,843
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