A new study has provided a partial explanation for why African-American women tend to have more aggressive breast cancer with poorer outcomes than Caucasian women. African-American women have lower breast cancer rates than Caucasian women. However, when African-American women do get breast cancer, they are more likely to have advanced disease at diagnosis and are less likely to survive. The reasons for the survival disparity are not well understood.
Insulin-like growth factor II (IGF-II) regulates fetal development and breast cancer cell survival, among other activities, in part by regulating anti-apoptotic proteins that prevent cell death. The authors hypothesized that IGF-II plays a role in the survival disparity by stimulating accelerated tumor growth, inhibiting apoptosis, and promoting metastasis. In the study, IGF-II expression and regulation of the anti-apoptotic proteins in African-American and Caucasian breast cancer cell lines were investigated. The expression of these proteins was also compared in paired breast tissue samples from African-American and Caucasian women. IGF-II expression was found to be significantly higher in African-American cell lines and tissue samples than in Caucasian cells and tissues. Importantly, IGF-II expression and regulation of two anti-apoptotic proteins in breast cancer cell lines was found to correlate with their expression in the paired breast tissues. The authors conclude that differences in the expression of IGF-II and related anti-apoptotic proteins between African-American and Caucasian breast cancer patients may contribute to the differences in survival observed between the two groups.
What to do with the information
Reasons for the survival disparity include well-documented differences in treatment between African-American and Caucasian women, even among those with similar access to health insurance. However, it is clear from studies of women in Africa that significant genetic differences do exist. The study above suggests that a difference in expression of a gene may contribute to reduced survival in African-American women. The following strategies appear warranted:
- Find out exactly what type of breast cancer you have and how aggressive it might be. Order the pathology report from your surgery and discuss it with your oncologist. Switch oncologists if you have an aggressive form of breast cancer such as triple negative disease and do not have the sense that everything appropriate and possible is being done to treat it (but do not let this translate into any missed treatments). You are best off at a university affiliated breast cancer center that serves a substantial population of African Americans
- Avoid any delays in treatment and make treatment your top priority. Don't take a detour into alternative cancer cures such as the raw food diet. It will cost you valuable time and time is of the essence in the case of aggressive cancer
- Follow a bland but healthy diet during chemotherapy and radiation (if they are part of your treatment), reduce stress to the extent possible, perform regular light to moderate exercise, and try to avoid catching the flu or other infectious illnesses
- Commit to making permanent changes in your lifestyle and eating habits to optimize your prognosis. This website offers detailed information on recommended foods and foods to avoid for breast cancer, as well as articles on specific types of breast cancer
- Get the emotional and spiritual support you need. Let go of those who disappoint you and embrace the ones who step forward.
Taking the steps above has the potential to make a significant difference in length of survival for some women with aggressive breast cancer.