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Descobertas Importantes

Estima-se que uma em cada oito mulheres americanas terão câncer de mama invasivo em suas vidas, e cerca de 40 000 vão morrer da doença este ano.

Saiba mais sobre as pesquisas realizadas ao redor do mundo e publicadas recentemente. Elas têm o potencial de salvar vidas.

O “efeito Angelina” é real

angelina jolie

Angelina Jolie causou furor em maio de 2013 quando optou por uma mastectomia dupla preventiva após um teste genético que indicou a mutação BRCA1. Essa mutação aumenta muito as chances de que a pessoa venha a desenvolver câncer de mama.

Este ano, um estudo publicado na revista Breast Cancer Research revelou que o anúncio de Jolie pode ter sido responsável por uma onda de consultase testes genéticos.

No Reino Unido, os pedidos de exames mais que dobraram depois de Jolie vir a público com sua cirurgia. A maioria foi realizada por mulheres que tinham bons motivos para estar preocupadas; muitas tinham histórico da doença em suas famílias, como Jolie.

Num futuro próximo, um simples exame de sangue poderá prever o risco de câncer de mama

O teste da mutação BRCA1 não é a única maneira de identificar um risco elevado de desenvolver a doença. Um simples exame de sangue está sendo desenvolvido por pesquisadores da University College London.

A ideia é que ele seja capaz de indicar a probabilidade de uma mulher ter câncer de mama com base em uma certa assinatura epigenética – a maneira como certos genes se expressam, ou como eles são “ligados” e “desligados” – presente em mulheres que tiveram câncer de mama, mas não apresentavam a mutação BRCA1.

O teste já estava sendo avaliado em testes com humanos quando foi anunciado, em junho.

Imagens 3D podem ser o futuro da detecção do câncer

Um novo tipo de exame de imagem 3D chamado tomossíntese pode aumentar a precisão da busca por tumores. Um estudo publicado no Journal of American Medical Association apontou que em 170 000 exames que usaram tanto a mamografia digital como a tomossíntese os médicos foram capazes de aumentar o índice de detecção de tumores, ao mesmo tempo diminuindo retornos de pacientes causados por leituras inconclusivas.

Os pesquisadores indicam que o uso combinado de mamografia e tomossíntese é mais eficaz do que apenas a mamografia (o padrão hoje), a uma taxa de 5,4 por 1.000, ante 4,2 por 1.000. A combinação das duas técnicas tambémdetectou cânceres invasivos a uma taxa de 4,1 por 1.000, contra 2,9 por 1.000. Em relação aos retornos para mais exames, a combinação de mamografia e tomossíntese reduziu as taxas de 107/1.000 para 91/1.000.

Certos anticoncepcionais podem aumentar o risco

birth control pills

Mulheres que haviam tomado certos tipos de anticoncepcionais por via oral – especialmente pílulas com alto teor de estrogênio – tiveram um risco 50% maior de câncer de mama do que mulheres que nunca tomaram contraceptivos ou que pararam de tomá-los.

Mas os resultados devem ser interpretados com cuidado, diz Elisabeth F. Beaber, do Centro de Pesquisa de Câncer Fred Hutchinson, em um comunicado de imprensa sobre seu estudo.

“O câncer de mama é raro entre mulheres jovens, e existem vários benefícios associados ao uso de contraceptivos orais”, disse Beaber. “Além disso, estudos anteriores sugerem que o risco associado ao uso recente desses medicamentos decai após a interrupção do tratamento.”

Em vez de pedir que as mulheres relatassem quantos anticoncepcionais haviam tomado, a regra nesse tipo de estudo, Beaber levantou informações sobre marcas de remédios, doses e períodos de compras em farmácias. Ela analisou dados de 1.102 mulheres com câncer de mama e os comparou com 21.952 mulheres. Beaber descobriu que as pílulas de alto estrogênio aumentavam em 2,7 vezes o risco de câncer de mama, enquanto as pílulas de diacetato de etinodiol aumentavam o risco em 2,6 vezes. Remédios com baixo estrogênio não aumentam o risco de câncer. O estudo foi publicado na revista Cancer Research.

Remédios comuns para fertilidade não aumentam os riscos

Mulheres que usam remédios comuns de fertilidade como Clomid ou gonadotropinas (como Pregnyl, Novarel, Profasi) não precisam se preocupar com um maior risco de desenvolver câncer de mama. Um estudo que acompanhou mulheres ao longo de 30 anos apontou que esses remédios não aumentam o risco da doença.

A exceção foi um pequeno número de mulheres que tomou Clomid por 12 ou mais ciclos: elas tinham um risco 1,5 vez maior de contrair a doença em comparação com mulheres que nunca usaram remédios para fertilidade. Mulheres que não conseguiram engravidar depois de tomar Clomid ou gonadotropinas tinham quase o dobro do risco de desenvolver câncer de mama em comparação com aquelas que nunca tomaram esses remédios, o que sugere que a condição responsável pela infertilidade pode ter contribuído para o câncer.

Os médicos hoje recomendam tomar somente seis ciclos de Clomid, numa dose máxima de 100 mg por dose, antes de partir para outros tratamentos. No passado, aponta Brinton, os médicos costumavam prescrever até 250 mg por dose, durante vários anos. A pesquisa analisou dados de mais de 12 000 mulheres que fizeram tratamento de fertilidade entre 1965 e 1988. O estudo foi publicado na revista Cancer Epidemiology, Biomarkers & Prevention.

A diabetes pode aumentar o tamanho dos tumores de mama

Diabetes que se manifestam na vida adulta podem ser responsáveis por tumores maiores e de crescimento mais rápido. Um estudo apresentado na Conferência Europeia de Câncer de Mama indica que pacientes com diabetes tipo 2 têm maior probabilidade de ter tumores avançados quando são diagnosticadas com a doença.

“Acreditamos que a hiperinsulinemia – quando há níveis elevados de insulina no sangue – possa incentivar o crescimento das células cancerosas providenciando grandes quantidades de glucose”, disse Caterina Fontanella, principal autora do estudo. “Portanto acreditamos que um controle estrito dos níveis de açúcar no sangue seja essencial para o tratamento do câncer de mama.”

Faça o teste da saia!

Um “tamanho de saia” que só aumenta significa mais chances de câncer de mama pós-menopausa, segundo um estudo publicado no British Medical Journal.

Analisando resultados de quase 93 000 mulheres, os pesquisadores descobriram que aumentar um número no tamanho da saia a cada dez anos corresponde a um risco 33% maior de desenvolver câncer de mama.

Se a saia aumentar dois números, o risco é 77% maior. A medida do “tamanho da saia” não é a mesma coisa que o peso; na realidade a associação é com a circunferência da cintura. Os pesquisadores já sabem que, quanto maior a cintura, maiores os riscos de câncer de cólon e de útero, além de problemas como obesidade, diabetes e doenças cardiovasculares.

O estudo não estabelece causa e efeito, mas os pesquisadores especulam que, como a gordura abdominal é mais “metabolicamente ativa” que a de outras partes do corpo, ela pode estar aumentando os níveis de estrogênio, que, por sua vez, pode levar ao crescimento das células cancerosas.

Um bom sono é realmente importante para a recuperação

sleep cancer

Uma boa noite de sono não é importante só para fortalecer o sistema imunológico: ela também pode indicar uma melhor recuperação para pacientes com câncer de mama.

Pesquisadores da Universidade Stanford descobriram que a “eficiência do sono”, ou o tempo que se passa efetivamente dormindo durante a noite, tem relação com asobrevida de pacientes em estágios avançados do câncer de mama.

Ajustando para fatores como idade e tratamento em um grupo de 97 mulheres em estágio avançado da doença, eles descobriram que as que tinham um sono mais eficiente viviam em média 68,9 meses. As mulheres com sono de menor qualidade tinham sobrevida média de 33,2 meses.

Outro estudo demonstrou como a melatonina, hormônio que nos faz dormir à noite, é essencial para o sucesso do tamoxifen, um remédio amplamente usado no combate ao câncer de mama. O único problema é que a exposição noturna à luz da TV, do celular ou do computador interrompe a produção de melatonina, o que por sua vez pode enfraquecer o tamoxifen.

“Altos níveis de melatonina à noite colocam as células cancerígenas ‘para dormir’, desligando mecanismos chave de seu crescimento”, explicou o pesquisador David Blaks, da Universidade Tulane, num comunicado à imprensa. “Essas células são vulneráveis ao tamoxifen. Mas, quando há luzes acesas e a melatonina é suprimida, as células cancerígenas ‘acordam’ e ignoram o tamoxifen.”

Níveis de vitamina D podem indicar a sobrevivência de pacientes de câncer

Pacientes com altos níveis de vitamina D têm duas vezes mais probabilidade de sobreviver ao câncer de mama do que mulheres com baixos níveis dessa vitamina, de acordo com um estudo publicado na revista Anticancer Research.

Pesquisadores da Universidade da Califórnia em San Diego analisaram cinco estudos prévios de pacientes com a doença, um total de 4.443 pessoas. Mulheres que tinham mais chances de sobrevivência registravam uma média de 30 nanogramas de vitamina D por mililitro, enquanto as que tinham menores chances de sobrevivência tinham em média 17 nanogramas por mililitro. Infelizmente, a média das pacientes que sofrem de câncer de mama nos Estados Unidos tem uma média mais próxima do último número.

Vacinas contra o câncer de mama podem ser realidade um dia

Uma vacina experimental chamada GP2 pode ser uma opção importante paraprevenir a volta da doença em quem sobreviveu ao câncer de mama. Os pesquisadores dividiram 190 sobreviventes em dois grupos. O primeiro recebeu apenas um estimulante imunológico, e o grupo experimental recebeu o mesmo estimulante, além da vacina. Este segundo grupo teve uma taxa de reincidência da doença 57% menor em comparação com o grupo de controle.

“O objetivo final é ter uma ferramenta preventiva que minimize a reincidência em mulheres que já tiveram câncer de mama e para quem as terapias padrão não funcionaram”, escreveu Elizabeth Mittendorf, da Universidade do Texas.

Nunca é tarde para mudar os hábitos

Dois estudos do Centro de Câncer de Yale apontam que sobreviventes de câncer de mama que começam a se exercitar regularmente e a comer de forma mais saudável podem reduzir os riscos de reincidência e de morte, além de apresentarem melhoras na qualidade de vida.

O primeiro estudo dividiu sobreviventes da doença obesas ou acima do peso em dois grupos: aquelas que receberam ajuda e aconselhamento para perder peso, e aquelas que receberam simplesmente uma brochura. Além de perder mais peso, as mulheres que tiveram ajuda mostraram uma redução na proteína C reativa, que está ligada a maiores chances de reincidência do câncer de mama.

O segundo estudo dividiu as sobreviventes da doença em dois grupos: aquelas que fizeram exercícios com pesos duas vezes por semana e duas horas e meia de atividades aeróbicas por semana, e aquelas que não se exercitaram. Depois de um ano, as ativas mostravam uma redução significativa na proteína C reativa em comparação com o grupo controle – além de perda de peso e menor índices de gordura corporal.

Fonte: Brasil Post

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