******

Stress Fuels Breast Cancer Metastasis to Bone

ScienceDaily (July 17, 2012) — Stress can promote breast cancer cell colonization of bone, Vanderbilt Center for Bone Biology investigators have discovered.

---

The studies, reported July 17 in PLoS Biology, demonstrate in mice that activation of the sympathetic nervous system -- the "fight-or-flight" response to stress -- primes the bone environment for breast cancer cell metastasis. The researchers were able to prevent breast cancer cell lesions in bone using propranolol, a cardiovascular medicine that inhibits sympathetic nervous system signals.

Metastasis -- the spread of cancer cells to distant organs, including bone -- is more likely to kill patients than a primary breast tumor, said Florent Elefteriou, Ph.D., director of the Vanderbilt Center for Bone Biology.

"Preventing metastasis is really the goal we want to achieve," he said.

Elefteriou and his colleagues knew from their previous studies that the sympathetic nervous system stimulated bone remodeling, and that it used some of the same signaling molecules that have been implicated in breast cancer metastasis to bone.

"We came to the hypothesis that sympathetic activation might remodel the bone environment and make it more favorable for cancer cells to metastasize there," Elefteriou said.

Evidence from the clinic supported this notion. Breast cancer patients who suffered from stress or depression following their primary treatment had shorter survival times. Both stress and depression activate the sympathetic nervous system.

To explore this possible link, the researchers studied cancer cell metastasis in mice. They followed fluorescently "tagged" human breast cancer cells that were injected into the mouse heart to model the stage of metastasis when breast cancer cells leave the primary site and move through the circulation.
They found that treating the mice with a drug that mimics sympathetic nervous system activation caused more cancer lesions in bone. Using physical restraint to stress the mice and activate the sympathetic nervous system also caused more cancer lesions in bone. Treating the restrained mice with propranolol, one of a family of blood pressure medicines called "beta-blockers," reduced the number of bone lesions.

The investigators demonstrated that sympathetic nervous system activation increases bone levels of a signaling molecule called RANKL, which is known to promote the formation of osteoclasts -- bone cells that break down bone tissue. RANKL has also been implicated in cell migration, and Elefteriou and colleagues were able to show that breast cancer cell migration to the bone depends on RANKL.
The findings suggest that beta-blockers or drugs that interfere with RANKL signaling, such as denosumab, may be useful in preventing breast cancer cell metastasis to bone. Propranolol and other beta-blockers are inexpensive, well characterized, and safe in most patients. They may be a good choice for long-term treatment if future studies in patients with breast cancer confirm their ability to block cancer cell metastasis to bone, Elefteriou said.

"If something as simple as a beta blocker could prevent cancer metastasis to bone, this would impact the treatment of millions of patients worldwide," he said.

Efforts to reduce stress and depression in patients with cancer may have unappreciated benefits in terms of metastasis prevention, he added

Sisters and Girlfriends = Good Medicine

******

My sister, who has lived in Florence Italy for the last 25 years, emailed this to me this morning. It made me want to hop on a plane so we could hit the gym, do pilates, hike the Tuscan hills, then relax with a smooth bottle of Sangiovese!

Life isn't about surviving the storm; but how you dance in the rain.

They teach this course at Stanford:

In an evening class at Stanford the last lecture was on the mind-body connection - the relationship between stress and disease. The speaker (head of psychiatry at Stanford) said, among other things, that one of the best things that a man could do for his health is to be married to a woman whereas for a woman, one of the best things she could do for her health was to nurture her relationships with her girlfriends. At first everyone laughed, but he was serious.

Women connect with each other differently and provide support systems that help each other to deal with stress and difficult life experiences. Physically this quality “girlfriend time" helps us to create more serotonin - a neurotransmitter that helps combat depression and can create a general feeling of well being. Women share feelings whereas men often form relationships around activities. They rarely sit down with a buddy and talk about how they feel about certain things or how their personal lives are going. Jobs? Yes. Sports? Yes. Cars? Yes. Fishing, hunting, golf?Yes. But their feelings? Rarely.

Women do it all of the time. We share from our souls with our sisters/mothers/daughters, and evidently that is very good for our health. He said that spending time with a friend is just as important to our general health as jogging or working out at a gym.

There's a tendency to think that when we are "exercising" we are doing something good for our bodies, but when we are hanging out with friends, we are wasting our time and should be more productively engaged—not true. In fact, he said that failure to create and maintain quality personal relationships with other humans is as dangerous to our physical health as smoking!

So every time you hang out to schmooze with a gal pal, just pat yourself on the back and congratulate yourself for doing something good for your health! We are indeed very, very lucky. Sooooo… let's toast to our friendship with our girlfriends. Evidently it’s very good for our health.

 

It's the Little Things...

******
"Don't Sweat the Small Stuff"

"Stop and Smell the Flowers"


"It's the Simple Things in Life"
...each of these are absolutely correct (albeit trite) adages.


I have had my own epiphany. A variation on these age-old themes, if you will, since my diagnosis with Invasive Lobular Carcinoma. If I appear to wax in a rambling poetic manner (a la Jabberwocky), or a perpetrator of TMI, please indulge and forgive - it is not intentional...at least the poetic part.

For me, it truly has been the little things that I have noticed since dealing with my diagnosis of breast cancer.


I noticed that I did NOT know that there are two types of breast cancer: Lobular & Ductal.

I noticed that I did NOT know that there are subsets to Lobular & Ductal, i.e. Invasive and Non-Invasive.

I noticed that I felt strangely compelled to look up the definition of invasive ten times.

I noticed that not knowing these things was only the proverbial tip of the iceberg.

I noticed the irony that the lobules in the breast are the source of the most nutritious food you can provide your newborn child. I breast-fed three - the last one just 7 years ago.

I noticed the irony that breast feeding is supposed to be a prophylactic against breast cancer.

I noticed that when I was going through all of the diagnostic measures I was always the youngest in the waiting room. (I do acknowledge that being in Arizona means I reside in one of the retirement capitals of the nation.)

I noticed that each and every med-pro that I interrogated started each and every conversation with the unquestioning assumption that because I was young (so relative) that I was going to jump into the toxic-soup. As they stood outside the pot--in their protective gear, holding the ladle.

I noticed that even as an organic, rarely meat-eating, fruit, nut, veggie-consuming type I had no idea of the nutritional deficiencies that can contribute to breast cancer. E.g. a lack of Vitamin D.

I noticed the irony that I live in a climate that has triple-digit sunshine weather 9 months out of the year. Hell, we can export Vitamin D.

I noticed that the my medical issues over the years have been "stressed-related": migraines, miscarriages, pre-term labor, cancer ...THINK (?)

I noticed that I was immediately aware of and repulsed by the ridiculous amount of "pink-ribbon" merchandising that is thrust upon us by retailers - especially during my birthday month.

I then noticed that I had been a good little consumer of some of these pink trinkets (under the misconception that I was contributing to the CAUSE...I mean...CURE somehow??).

I noticed that the CAUSE is making millions for pharmaceutical companies, so there really is no true motivation for a CURE.

I noticed that for some reason I cannot don my pink-ribbon running cap...and forget the Race for the Cure this October...I am so not going to be there. First, and permanent, absence in 15 years.

That's when I noticed that I really am not a good card-carrying member of this exclusive, yet expansive, club of "breast cancer survivors."

I noticed that I am having a hard time coming to terms with the concept of "survivor."

I noticed that I might have subversive tendencies. (If W were in office I might be more concerned that my blog would be monitored for typing (and pinging) the word S-U-B-V-E-R-S-I-V-E.)

I noticed that people are surprised by my appearance. Not because that I appear sickly, its because I don't.

I noticed that my 8-year old has a hard time taking his eyes off the "d-bombs." Even though I have tried to conceal them in a jewelry gift-bag that I lace through a pirate belt I sport at my hips.

I noticed that I am obscenely fascinated by the red-stringy stuff that gets sucked out by, and stuck in, the "d-bombs" (OOOOO, I DID HEAR THE COLLECTIVE 'EWWWWW' CHIME FROM MY LAPTOP.)

I noticed that in the sometimes awkward conversations regarding my recent mastectomy and diagnosis people are really "punny" (pronounced: pun-nee).

I noticed how much better I felt in just having the surgical oncologist remove the operative tape that covered the stitches from my sentinel node biopsy. The underarm is really an "ouch" area.

I noticed what a thrill it was to find out that without the surgical tape my shower-mobility increased two-fold -- no more Bohemian pits. (THERE'S THAT 'EWWWW' AGAIN.)

I noticed that I am thrilled with the bizarre and sometimes painful feel of nerve-endings firing in my surgical area.

I noticed that most everyone you meet or speak with has had their life touched by cancer.

I noticed that for me (so far) a breast cancer diagnosis has not been my emotional "rock bottom." It dawned on me that dealing with my child's eating-disorder diagnosis years ago was way more emotionally, psychologically and physically draining.

I also noticed that at times I cannot bear to hear yet another cancer story.

I also noticed that I listen nonetheless, because I know that they are retold for all the right reasons: to demonstrate courage; because humans believe in the power of healing by sharing; and that connecting through communication is essential for us as a species -- even those of us in the subversive subset.