Ganz said that understanding the biology of stress and inflammation at the cellular level is critical, as healthy lifestyle behaviors such as exercise and stress reduction techniques also may influence the same biological pathways in the tumor microenvironment. Those strategies might also be employed to help prevent recurrence.

"There is an increasing interest in the relationship between host lifestyle factors and the outcomes of cancer treatment," the study states. "Behavioral factors, comorbid conditions and non-cancer-related pharmaceutical exposures may affect breast cancer outcomes."


Ganz currently is working with researchers in Denmark and Canada to examine these same medications and their relationship to recurrence in much larger samples of breast cancer patients. She hopes to confirm the findings in this study within the next year to have a clearer picture of the effects of beta blockers and ACE inhibitors on the risk for recurrence. If beta blockers do prove to be protective in these additional studies, it may lead to prevention trials in women at high risk for recurrence, such as those treated for triple negative breast cancer, for which few effective therapies exist beyond chemotherapy.

"If giving beta blockers could help reduce risk of recurrence, that would increase the tools we have to fight this deadly form of breast cancer," Ganz said. "There is only so much that treating the cancer cells can do. Up until recently, there's been a lot of focus on the cancer cell, but we need to understand that these malignant cells live in a microenvironment of growth signals and fat cells, insulin and inflammation, and these things may affect the way they behave."

Ganz also is launching a Phase II randomized trial in younger women with breast cancer focusing on stress reduction with mindfulness meditation to evaluate its effects on stress, healthful behaviors and the immune system.

"Instead of focusing on the cancer cell, what I'm doing is looking at the host lifestyle factors and how amenable those are to modification in an effort to prevent recurrence," Ganz said. "These cancer cells are not living in isolation."

Funding for this study came from the Jonsson Cancer Center Foundation, the Breast Cancer Research Foundation and the National Cancer Institute.

UCLA's Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation's largest comprehensive cancer centers, the Jonsson center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2010, the Jonsson Cancer Center was named among the top 10 cancer centers nationwide by U.S. News & World Report, a ranking it has held for 10 of the last 11 years. For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.

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