Notes from LBBC's Annual Fall Conference in November 2009

LBBC’s Annual Fall Conference 2009

What Today’s Research Means for Tomorrow

• Herceptin for HER2 +; Tykerb for HER1 and HER2 +
• PARP Inhibitors in clinical trial phase II with chemo or chemo w/Parp; so far those with the chemo w/Parp are living 2x as long; future use may be for BRAC/Previvors for ovarian and breast cancer
• Avastin to target VEGF which may improve the delivery of chemo; clinical trial are being used for earlier stages of cancer

Hormone Therapies

• Tamoxifen and AI is better than TAM alone for post menopausal women; can switch to AI after 1,2,3 or 5 years of TAM offers benefit beyond TAM alone though some studies show varying benefits of AI over TAM from the start
• Ovarian ablation of Lupron or Zoladex for premenopausal women
• Side effects of TAM & AI includes increase cholesterol, liver enzyme abnormalities (not liver disease,) lower white blood count
• Avoid hormone replacement therapy, topical estrogen creams okay, low fat diet, exercise, alcohol in moderation and avoid high soy content like concentrated powders

The Impact of Weight Training

• Speaking to a physical therapist before surgery can be helpful for range of motion
• 2x a week slow progression strength training safe for those with and w/o lymphedema; be sure to warm up and use resistance with core stability
• Significant risk factors for lymphoma: arm infection, injury and elevated BMI and NOT occupational and leisure-time physical activity
• Risk of lymphedema flare-ups decreased by half and strength & body image improved

Integrative Oncology: Complementary Therapies, Herbs and Dietary Supplements

• 1. Keep body fat in check BMI 21-23 ideal, 2. 30 minutes of physical activity a day, 3. Avoid sugar and fast food, 4. Eat at least 5 servings of nonstarchy fruits and vegetables, mainly plant based, 5. Limit red meat to 2x a week, go organic and avoid grilled and processed meats, 6. No more than 1 alcoholic drink a day, 7. Meet your nutritional needs through diet alone and is not recommended for cancer prevention 8. Avoid salty and process foods (bacon, sausage, lunch meats)
• Mediterranean Diet is ideal since it’s anti-inflammatory with 3-5 fruits and vegetables a day, 2+ protein of (legume and nuts,) whole grains, extra virgin olive oil, calcium between 1000-1500 mg between food and supplements and Vitamin D3 1000-2000IU
• Avoid antioxidants while on chemo and radiation
• Herbs and other botanicals are tricky. Concern with contamination, toxicity, drug interaction and concern that it may have hormonal impact. Great website www.mskcc.org/aboutherbs
• Acupuncture, acupressure, massage therapy, mind/body practices like yoga, meditation, tai chi, qi-gong and hypnosis all helpful