What Is Radiation?

Radiation is the transmission of energy through space or a medium. The transmission is in the form of waves or particles. Some radiation is naturally created, while others are artificially made. 

There are two types of radiation depending on how they affect other atoms and molecules.

Non-ionizing radiation: This is the type of radiation that human beings are regularly exposed to. The radiation is not strong enough to affect atoms and molecules in the body. 

Types of non-ionizing radiation 

• Microwaves
• Global Positioning Systems (GPS) signals
• AM and FM signals
• Cellular signals
• Television signals
• Infrared signals

Ionizing radiation - This radiation is strong enough to ionize atoms and molecules. Ionization is the process of removing an electron from an atom and making it positively charged. Ionization causes electron/proton imbalance in the atoms, and this affects the cells in the body. 

Sources Of Ionizing Radiation

There are two categories of ionizing radiation sources - natural and artificial.

Natural Sources Of Ionizing Radiation

According to the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), there are four natural sources of ionizing radiation.

1. Cosmic radiation - These rays reach the earth’s surface from the sun and other solar system elements. People living in higher altitudes are more exposed to cosmic radiation. 
2. Terrestrial radiation - Minerals like uranium, thorium, and potassium, when decayed, release a small amount of ionizing radiation. Some of these minerals are found in materials used for building construction, and hence people may be constantly exposed to minimal amounts of terrestrial radiation in closed spaces.
3. Radiation exposure through inhalation - Radiation gases like radon, actinon, and thoron are produced due to radioactive mineral decay. Though harmless generally, some closed spaces like mines may have an excess of these gases. 
4. Radiation exposure through ingestion - Minimal amounts of radioactive minerals are found in drinking water and food cultivated in soil. These reach the human body through ingestion. 

Artificial Sources Of Ionizing Radiation

1. Medical radiation - Radiation is a standard method to diagnose various health conditions. X-ray machines, Computerized Tomography (CT) scan devices, and particle accelerators are all types of equipment that use ionizing radiation. About 98% of all the artificial sources of ionizing radiation are generated in the medical industry. According to the World Health Organization (WHO), 3600 million diagnostic radiology treatments happen globally using some kind of radiation. 
2. Nuclear power plants - Nuclear power plants use nuclear reactions to create electricity. Such plants produce ionizing radiation. 
3. Industries and agriculture - Many industrial and agricultural practices make use of radiation in their everyday processes.

Radiation Exposure As A Breast Cancer Risk Factor

Radiation exposure can cause breast cancer in different ways.

1. It can alter DNA and lead to abnormal growth and multiplication of cells.
2. It causes genome instability (changes in genes that can lead to problems in cell growth and multiplication)
3. It can affect how breast cells interact, multiply, and grow. 

Researchers studied the effect of radiation exposure on Japanese women who survived the atomic bombing of 1945. The study identified 807 first-time breast cancer cases and 20 second-time breast cancer cases in the survivors. The study reported the following:

• People who were exposed to a higher dose of radiation had a higher risk of developing breast cancer.
• Women under 20 years during the bombing had a higher risk of breast cancer than women older than 40 during the bombing.

Does Mammography Increase Breast Cancer Risk?

Mammography is a diagnostic procedure that uses X-rays to check for breast cancers. In a diagnostic mammogram, a minimum of two X-ray films of the breasts is taken at two different angles. On average, the dose of radiation for these two pictures is 0.42 mSv (millisieverts). Dosage is the amount of ionization that occurs due to radiation exposure.

According to the National Breast Cancer Foundation, women over 40 years are advised to get their annual mammographic screening done. In addition, doctors may recommend more frequent screening in the following cases.

• The woman has a family history of breast cancer.
• The woman has dense breasts, making it challenging to identify lumps.

According to a study, women with large, dense breasts who undergo repeated mammography may be at higher risk for radiation-induced breast cancer and breast cancer death.

The researchers projected that "annual digital mammographic screening of 100,000 women (aged 40 to 74) would induce 125 cases (~0.1%) of breast cancer, and that there would be 16 deaths (0.016%)."

However, this number appears to be almost negligent when compared to the 968 breast cancer deaths (9.7%) that would have been averted by early detection from screening.

The Genetic Angle

The H19 Gene

The H19 gene helps produce a molecule called the non-coding RNA. The non-coding RNA is considered to be a tumor suppressor and is protective against different kinds of cancers. Certain changes in this gene can encourage the growth and multiplication of radiation-damaged cells. This can lead to tumors. 

rs2107425 is a single nucleotide polymorphism or SNP in the H19 gene. A particular study reports that people with the A allele of this SNP, are at a higher risk for developing breast cancer when exposed to high doses of radiation. 

The ERCC2 Gene

The ERCC2 gene helps make a protein called XPD (Xeroderma Pigmentosum complementation group D). It plays a role in repairing damaged DNA. 

rs13181 is an SNP in the ERCC2 gene. In people with the wild AA genotype of this SNP, there is an association between occupational radiation exposure and breast cancer. 

However, this association is not seen in the AC and CC genotypes.

Non-genetic Factors Influencing Radiation Exposure And Breast Cancer Risk

Age

Studies show that women under 20 are at the highest risk for developing breast cancer due to radiation exposure. According to these studies, women above 50 years have minimal or no recorded risk for radiation-induced breast cancer. 

Excess Exposure to Radiation 

Few women may have undergone radiation therapy in the past, increasing the risk of breast cancer. Some women who are in the high-risk category include:

• Women with childhood cancer and extended periods of radiation therapy
• Women with a prior breast cancer diagnosis who have undergone radiation therapy 
• Women with a history of  tuberculosis or scoliosis that were diagnosed and monitored with X-rays
• Breastfeeding women who were treated with X-rays for breast inflammation (postpartum mastitis)

Reproductive History

The periods of pregnancy bring down the risk of radiation-induced breast cancer. Women who have an early full-term pregnancy are more protected against breast cancer. 

According to some studies, during pregnancy and breastfeeding, the number of weak breast cells affected by radiation is lesser, bringing down breast cancer risk.

Family History

Family history affects the relationship between radiation exposure and breast cancer. The Family history affects the relationship between radiation exposure and breast cancer. The BRCA1 and BRCA2 gene changes lead to inherited breast cancer. 

Women with changes in these genes are already at a higher risk of developing breast cancer. Radiation exposure can increase the risk. 

Limiting Radiation Exposure To Reduce Breast Cancer Risk

Get A Mammogram Only When Absolutely Needed

According to the American Cancer Society, women between the ages of 40 and 44 can start screening for breast cancer but don’t have to get mammograms unless their doctors instruct. Women between 45 and 54 need to get one mammogram a year. Women older than 55 should get two mammograms done a year. 

If you are younger than 40, talk to your doctor and only get a mammogram if necessary. While mammogram screening helps identify tumors early and treat breast cancer early, getting unnecessary mammograms may trigger breast cancer in a few. 

Check Your Occupational Exposure To Radiation

Occupational radiation exposure happens in workplaces when the person handles radioactive sources or works with equipment generating radiation. 

• Talk to your management about the risks of radiation exposure
• Understand the dosage of radiation you are exposed to every day
• Increase your distance from the radiation source
• Use the right shielding equipment and protective gear to bring down the risk of radiation exposure

Control Other Factors That Lead To Breast Cancer

Lifestyle habits like smoking and drinking, excessive weight gain, the types of food you choose, and exposure to other environmental carcinogens can all lead to breast cancer. 

Unhealthy lifestyle choices, along with radiation exposure, increases breast cancer risk drastically.

• Quit smoking and have alcohol in moderation.
• If you are overweight or obese, work on bringing down body fat.
• Limit consumption of charred meat, processed foods, and sugars and include a lot of fresh fruits, vegetables, grains, and legumes.

Opt For Genetic Testing

Genetic testing will help identify how harmful radiation exposure is for your breast cells. You can also know if you are at risk for developing inherited breast cancer because of the abnormal functioning of the BRCA1 and BRCA2 genes.

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Summary

1. Radiation is the transmission of energy through space or a medium. Non-ionizing radiation is harmless and does not affect the human body. 
2. Ionizing radiation causes cellular-level changes and can lead to cancer.
3. Radiation exposure can alter DNA, cause genome instability, affect the way breast cells interact, and lead to breast cancer.
4. Mammography is a radiation procedure to identify tumor cells in the breasts. Women who undergo excess mammography procedures under the age of 40 may be at a higher risk of developing breast cancer in the future.
5. Mammography also seems to retrigger second breast cancer in some women who have gone through first breast cancer and radiation therapy before the age of 45. 
6. Changes in the H19 and ERCC2 genes can increase the risk of breast cancer upon radiation exposure. 
7. Younger women are at higher risk for developing breast cancer on exposure to radiation. Pregnancy and breastfeeding periods are protective against breast cancer.
8. Avoiding mammography unless required, using protective shields and gear while working near radiation, and following a healthy lifestyle can all bring down breast cancer risk. 
9. Genetic testing helps know if a person is at higher risk for breast cancer because of radiation exposure. 

References

• https://www.who.int/news-room/fact-sheets/detail/ionizing-radiation-health-effects-and-protective-measures
• https://www.cdc.gov/nceh/radiation/what_is.html
• https://www.epa.gov/radiation/radiation-sources-and-doses
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1064116/
• https://www.nature.com/articles/s41467-018-05266-6

The multi-tasking woman of today, who takes pride in juggling both domestic and professional commitments simultaneously, has unwittingly allowed stress to get the better of her. While it’s true that everyday life has become a hassle to many, a woman’s response to the demands of modern life often takes a heavy toll on her mind and body.

Stress and its impact

Stress can be defined as the response of an individual to a stimulus. The response, be it positive or negative, has an impact on the mental and physical well-being of the individual. During the process of a physical response to a situation that is loaded with threat or danger, the nervous system triggers the defence mechanisms through release of hormones like adrenaline and cortisol in one’s body as it prepares for an emergency action.

We have heard it often – that stress is not always bad and in fact it helps an individual to perform better and motivates him to excel. However, in the context of modern life accompanied by challenges of unrealistic goals and deadlines, broken relationships, unhealthy competitions and frustrations, stress is more often recognised as a negative response that demands a heavy price from one’s mind and body.

“Stress is like spice – in the right proportion it enhances the flavour of a dish. Too little produces a bland, dull meal; too much may choke you”, says Donald Tubesing, the famous writer who has authored several books on stress management.

Even as stress helps individuals to rise up to the occasion and meet challenges, beyond a certain point it unleashes a negative impact that damages the physical, mental and behavioural aspects of life and dilutes its quality. Response to stress varies from individual to individual. The variation in is more pronounced between men and women. A woman caught in the nightmarish whirlpool of work-life balance, gradually gets used to a stressful routine on a daily basis thereby enabling chronic stress caused due to factors related to family, finance, work, relationships etc., to creep on her. Compounding to the negative impact is the stress caused by internal factors like pessimistic attitude, low-esteem, unreasonable expectations etc., Unable to bear the overload of stress, a woman’s body and mind wilt under the pressure, releasing warning symptoms.

Watch out for these manifestations

• Stress manifests in the form of physical symptoms like aches, obesity, nausea, dizziness, palpitation, pains, indigestion, insomnia, hair loss, irregular periods, frequent infections like common cold, skin conditions and reduced sexual drive.Over exposure to stress hormones leads to all these health conditions.
• The hormones released by the body in response to stress has a negative impact on the woman’s immune systemand makes her vulnerable to short term and long term ailments.Hormonal imbalances could lead to uterus problems like fibroids. endometriosis and irregular periods.
• Women are more vulnerable to stress-related conditions as the effect of the brain chemical, oxytocin, released during stress is enhanced by the estrogen hormone.
• Chronic long-term stress,that results in over production of the stress hormones, leads to weakening of the immune system, infertility and an increased risk of major diseases like high blood pressure, heart disease, stroke and cancer.
• At the emotional level, a woman experiences low self esteem, depression, loneliness, moodiness, restlessness and a sense of being overwhelmed by agitation and unhappiness. The hormone cortisol, released during stress, often leads to stress-induced depression or behavioural disorders.
• These manifestations at the emotional and physical levels take a toll on her behaviour and impair her cognitive abilities. She tends to either eat more or less,sleep too much or too little, neglects her responsibilities,isolates herselfand develops unhealthy habits like smoking and alcoholism.She also experiences memory problems, and suffers from poor judgment and lack of concentration.
• Increase your tolerance level

Instead of crumbling under the pressure of stress, what can a woman do to shield herself against the damages caused by stress? Always remember that an individual’s ability to withstand stress and overcome its pressures is hugely dependent upon factors like her general outlook on life, emotional intelligence, her relationships and genetics.

It is imperative for women to understand that stress management is all about acquiring control over the physical, mental and emotional aspects of their lives. A woman, who intends to decrease her stress level, if not totally eliminate it, should take concrete steps to improve the quality of her life.

• She should develop a strong support group consisting of her friends and family who can shield her in times of stress.
• She should cultivate a positive outlook towards life that will help her face the challenges and take stress in her stride.
• Sense of humour will go a long way in de-stressing one’s mind.
• Learning relaxation techniques like yoga, meditation and breathing exercises will infuse one’s mind and body with energy and serenity that can enable the stressed mind to relax and achieve clarity.
• Engaging in physical activities like walking, jogging, dancing, swimming etc., isanother great way to keep stress away.

The genetic angle

Genetic studies now indicate that acute stress can alter the activity and control of one’s genes by altering the methylation of DNA. The stress-induced genetic expressions that are responsible for making an individual prone to illnesses are also likely to be passed on to the next generation through a process known as epigenetic inheritance. It is of paramount importance that a woman understands all the implications of becoming a victim of stress. Stressful experiences not only affect her mind and body, but also affect her genes which she, in all probability, would transmit to her children. Researchers say that epigenetic inheritance can make individuals predisposed to stress and make them less resilient in their response to stress. This leads to the onset of chronic diseases.

The all important key to one’s happiness in life depends on his or her ability to overcome stress. As a woman, if you feel that stress is inevitable in your life, you have a choice as to whether you want to let it impact your health or not. By adopting the right attitude one can convert the negative impact of stress into a positive one. Undue worry and stress not only add to tomorrow’s woes but also wipe away the peace and happiness that one is blessed with today!