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Soy may reduce breast cancer recurrance. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

A common question in my practice revolves around soy. Should you consumed or avoid it, especially for women who have breast cancer risk factors? It is a valid question, and the medical research has begun to debunk the myth that soy is detrimental. The form of soy is important; soy from food seems to be safe, but soy in high supplement form has shown mixed results.

Why are patients worried? Soy contains phytoestrogens (plant estrogens). The thought is that phytoestrogens have similar effects as estrogen produced by humans or other animals. However, the story is complex: soy may actually help prevent breast cancer and its recurrence. It may also have other positive health effects. In some cellular and animal studies, high doses of isoflavones or isolated soy protein stimulate cancer growth (1). 

Further research shows that these findings don’t translate to humans, most likely because humans metabolize these differently.

Breast Cancer

The Shanghai Breast Cancer Survival Study, an over 5,000 patient observational trial that followed patients for a median of 3.9 years, has had resounding effects on the way we think of soy in relation to breast cancer. The population consisted of women who had already had one occurrence of breast cancer that was in remission. The women who consumed the most soy from food, measured as soy isoflavones or soy proteins, had a 32 percent reduction in a second occurrence of breast cancer and a 29 percent reduction in breast cancer mortality, compared to those who consumed the least (2).

This inverse relationship was seen in both estrogen receptor-positive and estrogen receptor-negative women. It is more difficult to treat estrogen receptor-negative women; therefore, making these results even more impressive.

One prospective study followed over 6,000 women in the U.S. and Canada. It found that women who ate the highest amounts of soy isoflavones had a 21 percent lower risk of death compared with women with the lowest intakes (3). The Shanghai Women’s Health Study followed 73,223 Chinese women for more than 7 years and was the largest study of soy and breast cancer risk in a population with high soy consumption (4). It found that women who ate the most soy had a 59 percent lower risk of premenopausal breast cancer compared with those who ate the lowest amounts of soy. There was no association with postmenopausal breast cancer.

The study authors published a follow-up analysis from the same cohort seven years later to evaluate any association between soy foods and specific types of breast cancer, breaking out the results by type (5). In all cases, risk was lower with higher soy intakes.

Menopause

Soy and soy isoflavones may help improve cognitive function in postmenopausal women. This effect was seen only in women who increased their soy intake before age 65. There may be a “critical window” of therapeutic opportunity in early stages of post-menopause where soy has the greatest impact on cognitive function (6).

Soy is not the food with the greatest phytoestrogens, flaxseed is. In a randomized control trial, a daily flaxseed bar did no better at reducing vasomotor symptoms in postmenopausal women, such as hot flashes, than a fiber placebo bar. This took the study’s authors by surprise; preliminary studies had suggested the opposite (7). Reinforcing these results, another randomized controlled trial failed to show any beneficial effect of soy isoflavones on menopausal symptoms or on preventing bone loss (8). 

Lung Cancer

Soy isoflavones help to boost the effect of radiation on cancer cells by blocking DNA repair in these cells (9). They also protect surrounding healthy cells with an antioxidant effect. Soybeans contain three powerful components, genistein, daidzein and glycitein, that provide this effect. Pretreating lung cancer patients may promote better outcomes.

The risk of lung cancer was also shown to be reduced 23 percent in one meta-analysis of 11 trials (10). In subset data, when analysis was restricted to the five highest quality studies, there was an even greater reduction: 30 percent.

Cholesterol Levels

Soy may have modest effects in reducing cholesterol levels. Interestingly, people who convert a soy enzyme to a substance called equol, an estrogen-like compound, during digestion were considered the only ones to benefit; however, one study showed that equol non-producers also benefited with a reduction in LDL “bad” cholesterol (11). The equol producers maintained their HDL “good” cholesterol whereas the non-producers saw a decline.

What does all of this tell us? Soy is most likely beneficial for men and women alike, even in those with a risk of breast cancer. It does not mean we should eat a soy-based diet, but rather have soy in moderation – on a daily basis, perhaps. It is best to eat whole soy, not soy isolates. Also, soy supplements are not the same as foods that contain soy, so it is best to consume soy in food form.

References:

(1) Cancer Research. 2001 Jul 1;61(13):5045-50. (2) JAMA. 2009;302(22):2437-2443. (3) Cancer. 2017 Jun 1;123(11):2070-9. (4) Am J Clin Nutr. 2009 Apr 29;89(6):1920-6. (5) Int J of Cancer. 2016 Aug 15;139(4):742-8. (6) Obstet Gynecol. 2011;18:732-753. (7) Menopause. 2012 Jan;19(1):48-53. (8) Arch Intern Med. 2011;171:1363-1369. (9) J Thorac Oncol. 6(4):688-698, April 2011. (10) Am J Clin Nutr. 2011 Dec;94(6):1575-83. (11) Am J Clin Nutr. March 2012 vol. 95 no. 3 564-571.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

 

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James Riordan posing by a display of the Lunar Excursion Module used in Apollo 13. Photo from Jessica Frisina

By Rita J. Egan

When James Riordan, 82, died in 2016 after battling lung cancer, many would think his greatest contribution to the world was his involvement with the Apollo 13 space mission. But to his relatives, it was his sense of family and kindness that touched others most.

Inheriting his sense of generosity, the former Stony Brook resident’s family participated in the American Lung Association Fight for Air Climb April 1 for the second straight time, raising $1,512 for the cause in his memory. This year’s event included 600 participants climbing the 55 flights of stairs at One Penn Plaza, a New York City skyscraper, the equivalent of 1,210 steps.

Granddaughter Jessica Frisina, of Rocky Point, organized Team Apollo in honor of her fond memories of the aerospace engineer with the Northrop Grumman Corporation.

Jessica Frisina, on right, with her aunt Kathy Bern, stepfather Bob Riordan and stepbrother Matt, who started Team Apollo to raise funds for the American Lung Association in the memory of her grandfather James Riordan. Photo from the American Lung Association

“He was completely humble,” she said. “He was so willing to help anybody and everybody. He just wanted to lend a helping hand to anyone that was willing to take it — just a generous and kind person. He didn’t have a mean bone in his body.”

Riordan, who lived in Stony Brook with his wife Ruth since 1964, was an integral member of the Apollo 13 mission. Due to his work helping to direct the team on the construction of the Lunar Excursion Module and its safe return, he received the Presidential Medal of Freedom from President Richard Nixon in 1970 along with his fellow members of the Apollo 13 Mission Operations Team.

His son Bob Riordan, Frisina’s stepfather, said while growing up he and his siblings didn’t realize just how important their father’s job was. It wasn’t until they were going through their father’s books, or hearing from friends who worked at Grumman, that they realized just how much he had accomplished.

He said they were amazed that their father was in the control room during the Apollo 13 mission and treasure the book “Race to the Moon,” where James Riordan is pictured in a control room with astronaut Neil Armstrong.

“We can’t believe we had a father who did this for a living,” Bob Riordan said.

The son said he isn’t surprised his father didn’t talk much about his work though, because of his modesty.

“He never cared about keeping up with the Joneses,” he said. “All he ever cared about was his family.”

James Riordan suffered from chronic obstructive pulmonary disease, the early stages of emphysema, and about a year before his passing, he was diagnosed with stage 0 lung cancer. His son said his father smoked for decades, starting as a teenager.

Frisina said she got the idea to start the Fight for Air Climb team after her grandfather’s death, and Riordan said he wasn’t surprised.

“He was so willing to help anybody and everybody. He just wanted to lend a helping hand to anyone that was willing to take it — just a generous and kind person.”

—Jessica Frisina

“I was so proud of her for doing that, but that’s the kind of person Jessica is,” he said.

Frisina said while the Riordans are her stepfamily, she considers them family all the same. Riordan said his father and stepdaughter hit it off as soon as they met when she was 7 years old.

“They took a liking to each other the first day they met,” Riordan said. “I always felt kind of emotional when those two were together. He was the type of man that any children who came into his life just took to him — that’s just the type of guy he was.”

While joining the Fight for Air Climb was a last-minute decision in 2016, with only a few relatives being able to come out and cheer them on, this year she said almost a dozen family members came out to show support for her, Riordan, her stepbrother Matt Riordan and her aunt Kathy Bern, who traveled from North Carolina.

Frisina said she looks forward to participating in the event again next year and knows participation from the family will only continue to grow.

Her uncle Jim Riordan was on hand this year to show support. He said Frisina always had a great appreciation for his father.

“She is by every definition a grandchild in this family,” he said.

Bob Riordan said he was in better shape for this year’s event after finding out how difficult the climb was last year.

“The first time I did it, I thought I was going to join my father,” Riordan joked.

Frisina said climbing the 55 flights of stairs is supposed to simulate how it feels to have a lung ailment, and once you pass flight 10, it becomes more and more difficult to breathe.

“It initially feels amazing to complete something like that,” Frisina said. “But in reality, it makes you think as you’re doing it. [My grandfather] had to deal with this every day — feeling like this and overcoming walking and not being able to breathe. It makes you put yourself in somebody else’s shoes who’s dealing with it.”

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Hugo Rizzo who raises money for research in their memory. Photo from Hugo Rizzo

One Northport resident found inspiration through loss.

Hugo Rizzo lost two brothers to lung cancer, and has since devoted his time to raising money for lung cancer treatment research.

“Mothers don’t deserve to bury their children,” Rizzo said through tears in a phone interview. “I had to tell my mother both times that her sons died. It has been up to me both times. Nobody deserves to get lung cancer.”

Rizzo said his family’s struggle is what makes him so passionate about being involved in cancer research organizations.

Carlos Rizzo who died from lung cancer at 60. Photo from Hugo Rizzo
Carlos Rizzo who died from lung cancer at 60. Photo from Hugo Rizzo

He also touched on the stigma he believes is associated with lung cancer patients, and how he wants to help change that.

“The stigma is that ‘you brought it on yourself,’” Rizzo said, “that it’s a smoker’s disease.” He said he feels this assumption is unfair, and “lung cancer patients share the same fears as colon and brain cancer patients.”

Rizzo said lung cancer is one of the most underfunded cancers in terms of research. According to LUNGevity Foundation, lung cancer is the leading cancer death, but only receives six percent of federal research dollars. That comes out to $2,366 per life lost, compared to $24,167 per life lost to breast cancer, and $14,510 to prostate cancer. LUNGevity also reported 60 to 65 percent of all new lung cancer diagnoses are among people who have never smoked or are former smokers, and 10 to 15 percent of lung cancer patients have never smoked in their lives.

This year marks the first time Rizzo is part of the organizing committee for non-profit Free to Breathe’s Lung Cancer 5K in New York City and Brooklyn. The event is on Sunday, Oct. 30, starting at 10:30 a.m. at Cadman Plaza Park in Brooklyn. Rizzo said he is proud to help and wants to make sure the event is fun.

“This shouldn’t be a morose event, it should be hopeful, hopeful that we find better treatment,” he said.

The event includes a 5K run, walk, and kids run, as well as other activities, including face painting, a magic show and a yoga warm-up. There will also be guest speakers and a heroes wall to help show young children they are just as much heroes for being involved as the superheroes they read about.

Rudy Rizzo, who died from lung cancer at 64. Photo from Hugo Rizzo
Rudy Rizzo, who died from lung cancer at 64. Photo from Hugo Rizzo

Free To Breathe is a nonprofit organization made up of lung cancer survivors, advocates, researchers, health care professionals and industry leaders, all working to raise money for lung cancer research, increase the number of lung cancer patients participating in clinical trials, and build and empower the lung cancer community.

Rizzo said the nonprofit donates 83 percent of the money it raises to research and the development of programs.

“Before I get involved, I make sure [an organization] fits well with me,” he said. “And they give back such a high amount of what they fundraise.”

This year Rizzo said they are expecting between 400 and 500 participants, and are hoping to raise between $45,000 and $60,000. He said they were able to raise more than $40,000 last year.

“This is a movement that is growing,” he said. “If I can do my part to help others, to make sure they don’t go through what my brothers went through, then that is time well invested.”

To find out more information on Free to Breathe’s Lung Cancer 5K or to donate, visit www.freetobreathe.org.

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Daniel Stratton (center) speaks at a press conference about a resolution to ban smoking at athletic fields with Legislator William Spencer, (left) and Councilman Mark Cuthbertson (right). Photo from Jennifer Mish

By Wenhao Ma

It’s official: You can no longer smoke on any athletic field in the Town of Huntington.

The town board unanimously passed legislation at an Aug. 16 meeting to prohibit smoking on athletic fields across Huntington.

Councilman Mark Cuthbertson (D) originally brought up the resolution in June and was supported by Suffolk County Legislator William “Doc” Spencer (D-Centerport).

“I am pleased that we have passed a common-sense measure to limit exposure to secondhand smoke at our athletic fields,” Cuthbertson said in an email.

Smoking in town parks and beaches has been banned for years — but athletic fields have not been specifically addressed in town laws. The new legislation, according to Spencer’s office, is a response to residents who have expressed concerns about being exposed to secondhand smoke at sporting events.

“Our youth, parents and coaches all deserve to breathe air free from secondhand smoke when visiting local sports fields,” Spencer said in an email. “This is critical to protecting the health of our residents and I applaud Councilman Cuthbertson and the rest of the town board for moving quickly to close this apparent loophole in the smoking policy.”

According to the legislation, no person shall smoke a tobacco product, herbal product, marijuana, cigarette, electronic cigarette, pipe, cigar, vapors, e-liquids or other legal marijuana derivatives in an outdoor playground or athletic field that is town-owned property.

Facts from the American Lung Association show how secondhand smoke affects children’s health.
Facts from the American Lung Association show how secondhand smoke affects children’s health.

Spencer thanked Cuthbertson for drafting the new legislation, which he called “a bold step” in helping to reduce the rate of smoking among the youth and ensuring clean air for all who visit the town’s sports fields.

“Everything counts,” Spencer said in a statement. “Even a child becoming conditioned to see cigarettes out in public or out at a ball field has an impact. [The legislation] is something that in the long term will save lives.”

Daniel Stratton was one of the concerned residents, and he said he brought the proposed code amendment to Cuthbertson’s attention.

“I noticed some of my children’s coaches leaving the dugout to smoke a cigarette just outside the fence of the field,” Stratton said in an email. “Aside from this being an obviously unhealthy behavior to model for the children, it seemed very counterintuitive when we are trying to get our children outside to be active and healthy.”

Stratton, who is a former health teacher, said he started researching laws and regulations for smoking at athletic fields and that is how he got involved with Cuthbertson.

“I discovered [there] was already a ban at Huntington beaches and playgrounds and I saw that this was spearheaded by Councilman Cuthbertson. So I contacted him to find out if there was already a law that encompassed [athletic fields] and if not, how I could pursue a resolution to this situation,” Stratton said.

“This new regulation extends my no-smoking legislation to include playgrounds, beaches and athletic fields,” Cuthbertson confirmed.

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