Tobacco smoking is well known to cause lung cancer; however, Andersen et al. explored the association between tobacco smoking and breast cancer in Denmark.
A positive association between active tobacco smoking and breast cancer incidence was found for women older than 44 years. In particular, women who smoked heavily and for a long time were at the most risk. There was almost a 30% increase in risk of breast cancer in smokers compared to never smokers. This study adds to the growing evidence that active smoking increases the risk of breast cancer, with increased smoking duration and smoking intensity adding to the risk.
A systematic review and meta-analysis published by Thomas and colleagues searched for autopsy studies using terms such as “breast neoplasms”, “autopsy” and “breast diseases”. The study aimed to provide an updated estimate of the prevalence pool of incidental breast cancer and precursor lesions. Although the incidence of breast cancer is thought to be increasing, women may decide not to undergo mammography screening as there is the chance of overdiagnosis, the diagnosis of cancers which would never declare themselves during the patient’s lifetime.
The prevalence pool of incidental breast cancer and precursor lesions was concluded to be large across women of all ages. A large pool of undetected cancer in-situ and atypical hyperplasia (which do not advance or do so very slowly) found in the study leads the authors to suggest caution for screening programs. Therefore, there is a need for breast cancer detection methods to be improved to prevent overdiagnosis and unnecessary treatment.
Cancer survivors often suffer from higher levels of anxiety and depression than the general population. Inhestern et al. specifically looked at anxiety and depression in working-age cancer survivors using self-reported questionnaires in cooperation with the regional cancer registries of Hamburg and Schleswig-Holstein, Germany. Cancer survivors between the age of 25 and 55 at the time of diagnosis were included in the study.
The study concluded that around 40% of working-age cancer survivors can experience increased levels of anxiety and around 20% increased levels of depression. Higher anxiety was significantly associated with factors such as female gender, being younger in age, and poorer family functioning. Similarly, a number of factors heightened the chance of depression, for example, unemployment, no treatment being received and less social support being received.
Cancer survivors at working-age may require psychological screening for a number of years after diagnosis so that cancer survivors at risk are identified. There may be a need for changes to survivorship programs for those at working-age to deal with the challenges they face.
As we see a decrease in breast cancer mortality, there is a need for greater survivorship health care to improve quality of life. In particular, support for survivors with sexual health problems is needed. For example, breast cancer survivors face problems with body image, menopausal symptoms and satisfaction with partnership.
Oberguggenberger and colleagues investigated sexual health in breast cancer survivors compared to women with no previous or current breast cancer using a patient-reported outcome assessment. This included the Sexual Activity Questionnaire, Hospital anxiety and depression scale and Menopause-specific quality of life questionnaire.
The study concluded overall breast cancer survivors reported worse sexual health than the female general population. An interesting finding was that there wasn’t an association between sexual health in breast cancer survivors and any treatment-related variables, this differs from previous studies and further research is needed. There is a need for health care providers to break the taboo and address sexual health as part of routine survivorship care.
BMC Cancer deeply recognises the prominence of the aforementioned topics, which are central for the field of cancer research. BMC Cancer would like to further highlight and promote such topics and is thus launching a new section on “supportive therapy, survivorship and psychosocial oncology” under the trusted leadership of our new Consulting Editor Prof Daniele Santini, University Campus Bio-Medico, Italy. We would encourage submissions in the following topics:
- Physical symptoms associated with cancer and its treatment, including management of pain, fatigue, insomnia, nausea and other GI issues, appetite, anxiety, depression and stress management
- Orphan symptoms in cancer patients
- Optimal nutrition and physical activity during and after treatment
- Healthy lifestyle choices including smoking cessation, weight management and coping styles
- Evidence-based counselling regarding botanicals, supplements and complementary therapies
- Sense of control and well-being despite the diagnosis
- Emerging toxicities induced by new generation antineoplastic drugs
- Emerging toxicities induced by new generation immunotherapies