What You Should Know About Breast Cancer

Breast cancer is the most common malignancy in women and the second leading cause of cancer death, exceeded only by lung cancer in 1985. One woman in eight who lives to age 85 will develop breast cancer at some time during her life.

At present there are over 2 million women living in the United States who have been treated for breast cancer. About 41,000 women will die from the disease. The chance of dying from breast cancer is about 1 in 33. However, the rate of death from breast cancer is going down. This decline is probably the result of early detection and improved treatment.

Breast cancer is not just a woman’s disease. The American Cancer Society estimates that 1600 men develop the disease yearly and about 400 may die from the disease.

Breast cancer risk is higher among those who have a mother, aunt, sister, or grandmother who had breast cancer before age 50. If only a mother or sister had breast cancer, your risk doubles. Having two first-degree relatives who were diagnosed increases your risk up to five times the average.

Although it is not known exactly what causes breast cancer; sometimes the culprit is a hereditary mutation in one of two genes, called BRCA1 and BRCA2. These genes normally protect against the disease by producing proteins that guard against abnormal cell growth, but for women with the mutation, the lifetime risk of developing breast cancer can increase up to 80 percent, compared with 13 percent among the general population. In effect, more than 25 percent of women with breast cancer have a family history of the disease.

For women without a family history of breast cancer, the risks are harder to identify. It is known that the hormone estrogen feeds many breast cancers, and several factors – diet, excess weight, and alcohol consumption – can raise the body’s estrogen levels.

Early Signs

Early signs of breast cancer include the following:

– A lump which is usually single, firm and most often painless is detected.

– An area of the skin on the breast or underarm is swollen and has an unusual appearance.

– Veins on the skin surface become more prominent on one breast.

– The affected breast nipple becomes inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.

– A depression is found in an area of the breast surface.

Types and Stages of Breast Cancer

There are many different varieties of breast cancer. Some are fast-growing and unpredictable, while others develop more slowly and steady. Some are stimulated by estrogen levels in the body; some result from mutation in one of the two previously mentioned genes – BRCA1 and BRCA2.

Ductal Carcinoma In-Situ (DCIS): Generally divided into comedo (blackhead), in which the cut surface of the tumor shows extrusion of dead and necrotic tumor cells similar to a blackhead, and non-comedo types. DCIS is early breast cancer that is confined to the inside of the ductal system. The distinction between comedo and non-comedo types is important, as comedocarcinoma in-situ generally behaves more aggressively and may show areas of micro-invasion through the ductal wall into surrounding tissue.

Infiltrating Ductal: This is the most common type of breast cancer, representing 78 percent of all malignancies. On mammography, these lesions can appear in two different shapes — stellate (star- like) or well circumscribed (rounded). The stellate lesions generally have a poorer prognosis.

Medullary Carcinoma: This malignancy comprises 15 percent of breast cancers. These lesions are generally well circumscribed and may be difficult to distinguish from fibroadenoma by mammography or sonography. With this type of breast cancer, prognostic indicators estrogen and progesterone receptor are negative 90 percent of the time. Medullary carcinoma usually has a better prognosis than other types of breast cancer.

Infiltrating Lobular: Representing 15 percent of breast cancers, these lesions generally appear in the upper outer quadrant of the breast as a subtle thickening and are difficult to diagnose by mammography. Infiltrating lobular can involve both breasts (bilateral). Microscopically, these tumors exhibit a linear array of cells and grow around the ducts and lobules.

Tubular Carcinoma: This is described as orderly or well-differentiated carcinoma of the breast. These lesions make up about 2 percent of breast cancers. They have a favorable prognosis with nearly a 95 percent 10-year survival rate.

Mucinous Carcinoma: Represents 1-2 percent of carcinoma of the breast and has a favorable prognosis. These lesions are usually well circumscribed (rounded).

Inflammatory Breast Cancer: This is a particularly aggressive type of breast cancer that is usually evidenced by changes in the skin of the breast including redness (erythema), thickening of the skin and prominence of the hair follicles resembling an orange peel. The diagnosis is made by a skin biopsy, which reveals tumors in the lymphatic and vascular channels about 50 percent of the time.

Stages of Breast Cancer

The most common type of breast cancer is ductal carcinoma. It begins in the lining of the ducts. Another type, called lobular carcinoma, arises in the lobules. When cancer is found, the pathologist can tell what kind of cancer it is – whether it began in a duct (ductal) or a lobule (lobular) and whether it has invaded nearby tissues in the breast (invasive).

When cancer is found, special lab tests of the tissue are usually done to learn more about the cancer. For example, hormone (estrogen and progesterone) receptor tests can help determine whether hormones help the cancer to grow. If test results show that hormones do affect the growth of the cancer (a positive test result), the cancer is likely to respond to hormonal therapy. This therapy deprives the cancer cells of estrogen.

Other tests are sometimes done to help predict whether the cancer is likely to progress. For example, x-rays and other lab tests are done. Sometimes a sample of breast tissue is checked for a gene, known as the human epidermal growth factor receptor-2 (HER-2 gene) that is associated with a higher risk that the breast cancer will recur. Special exams of the bones, liver, or lungs are done because breast cancer may spread to these areas.

A woman’s treatment options depend on a number of factors. These factors include her age and menopausal status; her general health; the size and location of the tumor and the stage of the cancer; the results of lab tests; and the size of her breast. Certain features of the tumor cells, such as whether they depend on hormones to grow are also considered.

In most cases, the most important factor is the stage of the disease. The stage is based on the size of the tumor and whether the cancer has spread. The following are brief descriptions of the stages of breast cancer and the treatments most often used for each stage. Other treatments may sometimes be appropriate.

Stage 0

Stage 0 is sometimes called non-invasive carcinoma or carcinoma in situ. Lobular carcinoma in situ (LCIS) refers to abnormal cells in the lining of a lobule. These abnormal cells seldom become invasive cancer. However, they are an indicator of an increased risk of developing breast cancer in both breasts. The treatment for LCIS is a drug called tamoxifen, which can reduce the risk of developing breast cancer. A person who is affected may choose not to have treatment, but to monitor the situation by having regular checkups. And occasionally, the decision is made to have surgery to remove both breasts to try to prevent cancer from developing. In most cases, removal of underarm lymph nodes is not necessary.

Ductal carcinoma in situ (DCIS) refers to abnormal cells in the lining of a duct. DCIS is also called intraductal carcinoma. The abnormal cells have not spread beyond the duct to invade the surrounding breast tissue. However, women with DCIS are at an increased risk of getting invasive breast cancer. Some women with DCIS have breast-sparing surgery followed by radiation therapy. Alternatively, they may choose to have a mastectomy, with or without breast reconstruction (plastic surgery) to rebuild the breast. Underarm lymph nodes are not usually removed. Also, women with DCIS may want to talk with their doctor about tamoxifen to reduce the risk of developing invasive breast cancer.

Stage I and II

Stage I and stage II are early stages of breast cancer in which the cancer has spread beyond the lobe or duct and invaded nearby tissue.

Stage I means that the tumor is about one inch across and cancer cells have not spread beyond the breast.

Stage II means one of the following:

The tumor in the breast is less than 1 inch across and the cancer has spread to the lymph nodes under the arm.
The tumor is between 1 and 2 inches (with or without spread to the lymph nodes under the arm).
The tumor is larger than 2 inches but has not spread to the lymph nodes under the arm.
The treatment options for early stage breast cancer are breast-sparing surgery followed by radiation therapy to the breast, and mastectomy, with or without breast reconstruction to rebuild the breast. These approaches are equally effective in treating early stage breast cancer. (Sometimes radiation therapy is also given after mastectomy.)

The choice of breast-sparing surgery or mastectomy depends mostly on the size and location of the tumor, the size of the breast, certain features of the cancer, and how the person feels about preserving the breast. With either approach, lymph nodes under the arm usually are removed.

Chemotherapy and/or hormonal therapy after primary treatment with surgery or surgery and radiation therapy are recommended for stage I and most frequently with stage II breast cancer. This added treatment is called adjuvant therapy. Systemic therapy sometimes given to shrink the tumor before surgeries called neoadjuvant therapy. This is given to try to destroy any remaining cancer cells and prevent the cancer from recurring, or coming back, in the breast or elsewhere.

Stage III

Stage III is also called locally advanced cancer. In this stage, the tumor in the breast may exhibit the following:

More than 2 inches across and the cancer has spread to the underarm lymph nodes.
The cancer is extensive in the underarm lymph nodes.
The cancer is spreading to lymph nodes near the breastbone or to other tissues near the breast.

Inflammatory breast cancer is a type of locally advanced breast cancer. In this type of cancer, the breast looks red and swollen (or inflamed) because cancer cells block the lymph vessels in the skin of the breast.

Patients with stage III breast cancer usually have both local treatment to remove or destroy the cancer in the breast and systemic treatment to stop the disease from spreading. The local treatment may be surgery and/or radiation therapy to the breast and underarm. The systemic treatment may be chemotherapy, hormonal therapy, or both. Systemic therapy may be given before local therapy to shrink the tumor or afterward to prevent the disease from recurring in the breast or elsewhere.

Stage IV

Stage IV is metastatic cancer. The cancer has spread beyond the breast and underarm lymph nodes to other parts of the body.

The treatments for stage IV breast cancer are chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. Patients may have surgery or radiation therapy to control the cancer in the breast. Radiation may also be useful to control tumors in other parts of the body.

Recurrent Cancer

Recurrent cancer means the disease has returned in spite of the initial treatment. Even when a tumor in the breast seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment.

Most recurrences appear within the first 2 or 3 years after treatment, but breast cancer can recur many years later.

Cancer that returns only in the area of the surgery is called a local recurrence. If the disease returns in another part of the body, the recurrence is called metastatic breast cancer. The patient may have one type of treatment or a combination of treatments for recurrent cancer.

For more information, see “Nine Ways to Reduce Breast Cancer Risk” on this site.

An Overview of Lung Cancer

General Information on Lung Cancer

Lung cancer, or carcinoma of the lung, is one of the most common forms of cancer today. It is one of the most frequent causes of cancer-related mortality in the United States today. In the United States, another form of cancer that is becoming increasingly common is breast cancer, which is the development of malignant tissue in the breast. Breast cancer is seen mostly in women, though this does not mean that men are immune to it. A small percentage of men too contract breast cancer. The numbers are small, 1 man with breast cancer against a 100 women with it, but its there. However, there is one major difference between breast cancer and lung cancer. One can see the symptoms of breast cancer at an early stage, while in the case of lung cancer, the symptoms are not detected early, primarily because they match the symptoms of other lesser ailments. In this article, we will discuss lung cancer.

A person is said to suffer from lung cancer when a growth of malignant cancer cells is detected in the lungs. Depending on the stage at which lung cancer is detected, it can be classified as being in the:

o Early stages

o Mid-stages

o Advanced stages

Today, there is a vast amount of information on lung cancer available. Patients or relatives of patients can access information over the Internet, which has an almost limitless number of websites dedicated to different aspects of lung cancer – types, causes, symptoms, diagnosis, treatment, etc. For example, if you are from the United Kingdom and want to research information on lung cancer treatment, facilities, etc in your country, you can simply log onto the website of Cancer Research UK, UK’s leading cancer charity, and collect whatever information you want from their site.

Earlier on, treatment of lung cancer was not an easy thing to do, owing to the huge amount of expenses in the form of medical bills, hospital stays fees, etc. However, nowadays with the availability of insurance, things have become easier. Lung cancer insurance is available easily, as is insurance covering other forms of cancer.

Types of Lung Cancer

Two main types of lung cancer exist today. Both of these are seen in the epithelial cells of the lungs. They are:

o Small cell lung cancer (SLCC)

o Non-small cell lung cancer

There is another type, called mixed small cell/large cell lung cancer. In this type you can find both kinds of cells in the cancerous tissue.

Besides these two types, there is another form of cancer of the lung area, called mesothelioma or mesothelioma cancer or cancer of the mesothelium. However, this is not considered a primary form of lung cancer, as its target area is not the lobes of the lung, but the pleural membrane covering the lung.

Small Cell Lung Cancer

This is the rarer of the two basic forms of lung cancer. One out of every five lung cancer patients suffer from small cell lung cancer.

Non-Small Cell Lung Cancer

Non-small cell lung cancer, or non-small lung cancer, is the more common of the two basic forms of lung cancer. Four out of five lung cancer patients suffer from this type of cancer.

Based on the cell type/area in which the carcinogenic cells proliferate in the lungs, non-small cell lung cancer is further categorized into three types. They are:

o Squamous cell carcinoma

o Adenocarcinoma

o Large Cell Carcinoma

o Bronchioalveolar Carcinoma (BAC)

Squamous Cell Carcinoma

This is the most common type of lung cancer. It occurs in the cells lining the airways inside the lungs. This form of cancer occurs mostly due to nicotine ingestion through smoking.

Adenocarcinoma

This form of cancer is seen in the mucus cells within the airways in the lung.

Large Cell Carcinoma

This is also called undifferentiated lung cancer. In large cell carcinoma, the proliferating cells are round and much larger than the cells seen in adenocarcinoma or squamous cell carcinoma.

Bronchioalveolar Carcinoma (BAC)

This form of cancer is seen in the bronchioalveolar region of the lung.

What Causes Lung Cancer?

The main cause of lung cancer is exposure to tobacco. This is primarily through smoking. About 80% of lung cancer patients are smokers. Smokers may be cigarette smokers, cigar smokers, or pipe smokers; it doesn’t matter. The risk of contracting lung cancer is equal in all the three cases.

A person may inhale smoke directly. A person can also inhale smoke passively or involuntarily. This smoke is also called secondhand smoke. Secondhand smoke is of two types:

o Mainstream – This is the smoke exhaled by the smoker, and amounts to more than 50% of all secondhand smoke.

o Sidestream – This is the smoke emanating from the burning end of a cigarette/cigar/pipe/hookah.

Passive smokers too stand a high chance of contracting lung cancer. The chances of passive/secondary smokers contracting lung cancer is 30% higher than people who do not inhale smoke either actively or passively.

However, there have been instances of even total non-smokers suffering from lung cancer. This indicates that smoking is not the only cause for lung cancer. It is the primary cause, yes, but not definitely the only cause. The following are some of the other causes of lung cancer:

o Air pollution

o Inhalation of asbestos fibers

o Exposure to radon, a radioactive substance formed by breaking down uranium

o Inhalation of marijuana fumes by smoking

o Exposure of the chest area to radiation therapy during cancer treatment

o Hereditary reasons

o Presence of arsenic in drinking water

o Diet with low fruit and vegetable content (this increases the risk of lung cancer in smokers)

A combination of exposure to tobacco along with any of these causes greatly increases the chances of a person contracting lung cancer.

Lung Cancer Symptoms

The following are some of the common symptoms of lung cancer. They do not usually manifest in the early stages. Even if they do, they are usually mistaken for some other ailment. These symptoms are:

o Persistent coughing

o Reddish or muddy brown spit

o Loss of breath

o Loss of appetite

o Persistent or repetitive infections of the bronchial tract

o Hoarseness of voice

o Renewed wheezing

In its later advanced stages, when the lung cancer is said to be in metastasis, the symptoms are:

o Numbness in the arms or legs

o A jaundiced appearance

o Tumorous growths near the skin surface

o Seizures

o Bone pain

o Dizziness

Lung Cancer Detection and Diagnosis

It is very rare to be able to detect lung cancer in its early stages. There are no specific symptoms of early stages of lung cancer. This is one of the reasons why lung cancer is usually detected in its later stages.

The use of a proper screening technique would greatly increase the chances of early lung cancer detection. However, there is no such proper and totally effective screening technique yet. Research is on to see if one can be formulated soon. As of now, a new technique called spiral CT seems to be the best option for early detection.

Once lung cancer is detected, the next step is to determine the stage it is in. This is done using the AJCC system. Roman numerals are used to mark the different stages of lung cancer, numerals from 0 to IV. Sometimes the stages are further divided into substages, using denotations A and B. The general rule of thumb is that the lower the denomination, the less serious the condition.

Lung Cancer Treatment

Lung cancer treatment options are usually the same as prostate cancer treatment options or colon cancer treatment options. What I mean is that all forms of cancer have the same treatment options. However, lung cancer tests may be different from colon cancer tests. The standard treatment options for lung cancer are:

o Surgery

o Radiation Therapy

o Chemotherapy

What matters is the combination of methods being used. The more serious the cancer, the more chances that different treatment options will be used in tandem, or one after the other.

Seven Secrets About Breast Cancer

Secret #1 The Money Spent On Research Into Breast Cancer Is Not Ensuring That Less Women Get Breast Cancer.
Secret #2 You Do Need To Act Against Getting Breast Cancer Before You Reach 50 And You Cannot Rely On Mammograms.
Secret #3 You Are At Risk Of Getting Breast Cancer Even If You Don’t Have It In Your Family.
Secret #4 Most Of The Money Spent On Research Is Not Going Into Prevention To Ensure That Less Women Suffer The Devastating Effects Of Breast Cancer In The Future.
Secret #5 Most Women Are Not Breast Aware And Are Afraid Of Breast Cancer.
Secret #6 Women Are Not Given Lots Of Advice On How They Can Protect Their Breasts Against Breast Cancer.
Secret #7 Most Women Do Not Appreciate How Important Their Breasts Are And Do Not Do Everything They Can To Look After And Protect Them.

The above “secrets” are things which are not commonly known by most women and may be surprising to you. In this article, I intend to shed light on these facts and allow women to make up their own minds how they approach their breast health.

SECRET #1 THE MONEY SPENT ON RESEARCH INTO BREAST CANCER IS NOT ENSURING THAT LESS WOMEN GET BREAST CANCER.

The Pink Ribbon and Breast Cancer Awarenss Month was introduced in the US in 1985 and introduced to the UK in 1993. The Pink Ribbon Foundation is fronted by the Estee Lauder group of companies (known for cosmetics and skincare).

Since then the pink ribbon symbol has become synonymous with breast cancer and during the past 15 years billions of pounds have been raised in its name. Every October the world celebrates Breast Cancer Awareness Month and fund raising during that month is phenomenal. All the breast cancer charities vie with each other to see who can come up with the most innovative “pink” fundraising. They run pink parties and sell pink products in order to raise money. Many companies take part and do special promotions during October for their preferred charity. “Pink” is big business.

So with all this money being raised during October and also at other times during the year through events like charity runs and walks, is there an impact on the breast cancer rates in the UK and around the world? Are they coming down? Are fewer women suffering from the devastating effects of breast cancer?

Unfortunately, the answer is ‘no’.

In the UK, from 1993-2004, breast cancer incidence has increased 18.5%, that is 1% per year. 1 in 9 women will get the disease during their lifetime with current projections of 1 in 7 by 2010. 45,500 women were diagnosed in 2005, which equates to 125 women every day. Worldwide more than a million women are diagnosed with breast cancer every year. It is also projected that breast cancer rates will rise most in developing countries, where women do not have access to top quality care and where they can also be treated as outcasts in certain societies.

Breast cancer survival rates have improved. Every year more than 12,300 women and 70 men die from breast cancer. Since the peak in the late 1980s breast cancer death rates have fallen by a third. Breast cancer drugs have helped to save women’s lives but, as with any drugs, can have long-term side affects. Also the cost of these drugs puts great strain on the NHS. If breast cancer rates continue to increase as they have been doing, then, according to Professor Karol Sikora as reported in the Daily Mail on 09/09/08, “the next generation of drugs would keep patients alive longer, but could swallow half of the current NHS cancer budget within four years. (this refers to all cancer drugs at a cost of £50 billion).

With the billions being raised by people around the world in the name of breast cancer, is it right that actually more women are getting this devastating disease every year?

SECRET #2 YOU DO NEED TO ACT AGAINST GETTING BREAST CANCER BEFORE YOU REACH 50 AND YOU CANNOT RELY ON MAMMOGRAMS.

Women in the UK are offered breast screening by mammogram every three years from the age of 50. This is because breast cancer is still more common in women over 50 but also because the breast tissue of younger women is denser and, therefore, makes it more difficult for a mammogram to pick up on a potential breast lump.

However, this could be giving the message to younger women that they don’t need to check their breasts themselves. Based on my experience during my breast health talks, very few younger women check their breasts. The main reasons for this are that no-one has shown them how to, they don’t know what to do, they think that they only need to worry if breast cancer is in the family (see Secret #3) or they are afraid that they might find something.

For a younger woman it is even more important to check her breasts from her mid-twenties as breast cancer in younger women is usually much more aggressive as the breast cancer cells can multiply more rapidly than in older women. If girls were taught by their mothers to check their breasts from their mid-twenties, they would not be afraid – it would just be part of their general regime of looking after themselves. Also they would feel confident about what to do. Breast self-examination is easy to do once you have been shown how and there are even devices on the market which can help you do so with confidence and greater accuracy.

Breast cancer is the biggest killer of women aged 35-54, which means it makes sense for women in this age bracket to do everything they can to protect their breasts.

Furthermore, I do not believe that we should rely on mammograms either. Women are only screened every three years and, usually, a mammogram can only detect a breast tumour once it has been growing for 8 years. By the time the tumour reaches 10 years, it could be too late. The other thing to remember is that a mammogram can only screen the part of the breast which can be put into the “clamp”. It cannot screen under the armpit or between the breasts for example.

Lastly, there is growing concern over the safety of mammograms. The following are extracts from an article written by Peter Leando PhD.

“Controversy has raged for years as to whether the risks related to the radiation exposure suffered from mammography are justified by the benefits gained …… new evidence relating to the particular type of radiation used and the hard evidence relating to the clinical benefits of mammography have caused a serious re-evaluation of the justification of mammography as a screening test.

Radiation from routine mammography cannot be directly compared to other types of X-ray like chest X-ray etc because they are very different types of radiation.

The comparisons that have been used between a chest x-ray and mammography, 1/1,000 of a rad (radiation-absorbed dose) for a chest X-ray and the 1 rad exposure for the routine four films taken of both breasts for a mammographic screening exam results in some 1,000 times greater exposure. (This refers to the US, where they do four-way screening. In the UK typically only two-way screening is offered.)

This is considered a significant risk factor when extended over a ten year screening period and a potential accumulative dose of 10 rads. Unfortunately this is not the major risk posed by the particular type of radiation used by mammograms, mammography X-rays use a low energy form of ionising radiation that causes greater biologic damage than the high energy X-ray. The very low energy electrons affect the density of ionisation tracks that pass through the tissue, which can cause complex damage to the DNA and carcinogenic changes.

The radiation used by mammography is almost 5 times more effective at causing cancer.” So, women do need to start checking their breasts from their early twenties and we cannot rely on mammograms 100%, particularly for younger women who would have a greater exposure to radiation during their lifetime if they were offered mammograms from a younger age. Also mammograms do not detect Inflammatory Breast Cancer (IBC) which is a much rarer form of the disease and does not involve a lump. This would only detected by a woman looking for changes to her breasts and reporting them to her doctor.

SECRET #3 YOU ARE AT RISK OF GETTING BREAST CANCER EVEN IF YOU DON’T HAVE IT IN YOUR FAMILY.

Amongst the hundreds of women I have talked to about breast health, the vast majority were under the false impression that breast cancer is primarily hereditary. They were surprised to hear that fewer than 10% of cases occur to women who have breast cancer in the family.

In fact, every woman is at risk and should take control of her own breast health to give herself the best possible chance of prevention or early detection.

The other most common acknowledged risk factors are:

Age – breast cancer is more common in women over 50
Early puberty – it is worrying that puberty is starting younger, with most girls starting their periods at primary school
Late pregnancy – many woman are opting to have children later
Late onset menopause
Not having children and not breastfeeding – this was known as early as the 18th century when a doctor in Italy noticed that nuns had higher levels of breast cancer than the general population
Being overweight – this applies mainly to post-menopausal women
Alcohol – over-consumption increases the risk of breast cancer

Acknowledged risk factors account for around 50% of breast cancer cases. For the remainder, there are no definite reasons.

There are a growing number of scientists, commercial companies and individuals who believe that this remaining 50% is due to the rise of the number of chemicals which have been introduced over the past 50 years. They are used in our food, in our toiletries, in the workplace, in our clothes, in our furnishings – in fact, in every aspect of our lives. Many of these chemicals are endocrine disrupting chemicals (EDC’s), also known as hormone disruptors or oestrogen mimickers. In simple terms, they act like oestrogen in our bodies and could be responsible for changing our delicate hormone balance which controls events like pregnancy, puberty, menopause.

An interesting example of the levels of oestrogen of British women was examined in a collaborative study undertaken in the late 80’s between Oxford University, the Chinese Academy of Preventive Medicine Beijing, Guys, and the Dept. of Preventive Medicine, L.A., California. They compared blood-serum concentrations of hormones linked to breast cancer between women in rural China and in Britain. The results showed that British women who are exposed to toxic chemicals in their everyday lives had increasingly higher levels of oestradiol (oestrogen) than women living a rural lifestyle in China (see table below).

On this theme, the Guardian online reported on 22/05/07 that ‘Beijing blames pollutants for rise in killer cancers’.

Oestradiol levels higher in British women by: Age 35 – 44 36% Age 45 – 54 90% Age 55 – 64 171%

SECRET #4 MOST OF THE MONEY SPENT ON RESEARCH IS NOT GOING INTO PREVENTION TO ENSURE THAT FEWER WOMEN SUFFER THE DEVASTATING EFFECTS OF BREAST CANCER IN THE FUTURE.

As we know, billions of pounds are raised every year worldwide in the name of breast cancer and most of this money is received by the mainstream breast cancer charities. In my opinion, the areas which should be targeted by these funds are prevention, treatment and care. You would probably expect these areas, at least, to be treated with equal importance and the funds available allocated accordingly.

Let’s first take a look at the mainstream breast cancer charities in this country, namely Cancer Research UK (who obviously deal with all cancers), Breakthrough Breast Cancer, Breast Cancer Campaign and Breast Cancer Care.

Cancer Research UK has done a huge amount of research into breast cancer and their website has a wealth of useful information with a lot of detail on breast cancer. Their slogan is ‘Together We Will Beat Cancer’. The charity offers funding schemes to scientists. Their research strategy is directed at reducing mortality from cancer and more women are surviving breast cancer than ever before. Cancer Research UK is looking trying to prevent breast cancer in women known to be at high risk of developing it (approx 10% of sufferers). Doctors have looked into using tamoxifen and other hormone blocking drugs such as anastrozole (Arimidex) to lower the risk of breast cancer in women with a strong family history. This work has to be done very carefully. These women are healthy and the treatment aimed at preventing breast cancer must not risk their health in other ways.

Breakthrough Breast Cancer supports a programme of cutting-edge biological research to reach their vision of ‘a future free from the fear of breast cancer’. Breakthrough set up the UK’s first dedicated breast cancer research centre in 1999, the Breakthrough Toby Robins Breast Cancer Research Centre. Breakthrough is funding The Generations Study whosepurpose is primarily to investigate environmental, behavioural, hormonal and genetic causes of breast cancer, and secondarily to investigate the causes of other cancers and diseases, by means of a UK cohort study to be established of more than 100,000 women in the UK aged 18 years and older at entry.

However, when you look at environmental factors as a possible risk factor, it seems to be dismissed because it is too difficult to research due to the huge amount of chemicals to which we are exposed in our everyday lives. You can read more at their website under “risk factors”.

As I have mentioned, I am one of the many people who believe that certain chemicals which act like oestrogen in our bodies are a contributing factor in rising breast cancer rates. I am disappointed to see that Breakthrough are not even including this as a possible risk factor, particularly as we know that excessive oestrogen has been linked to breast cancer cell growth.

Breast Cancer Campaign cites its mission is to beat breast cancerby funding innovative world-class research to understand how breast cancer develops, leading to improved diagnosis, treatment, prevention and cure. The charity is supporting 97 projects worth over £12.8 million in 41 locations throughout the UK. Over the past 13 years, Campaign has awarded 232 grants with a total value of over £23 million to universities, medical schools / teaching hospitals and research institutes across the UK. Campaign’s breast cancer research gap analysis document has been published by the open access journal Breast Cancer Research. The document entitled ‘Evaluation of the current knowledge limitations in breast cancer research: a gap analysis’ is the product of two and a half year project. It involved around 60 of the key breast cancer scientists in the UK.

Through their website, they sell products of various types and the companies who own those brands donate part of their profits to the Campaign. They include things like lip gloss, perfume, toiletries, clothing and stationery. Some of us would say that many of the products include harmful ingredients and are not actually contributing to the breast health of the ladies buying them! I was also disappointed that, although they mention prevention in their mission statement, I have one of their leaflets that shows prevention only receives 1% of their budget.

Breast Cancer Care, as its name suggests, is primarily concerned with the care and treatment of ladies going through breast cancer. It provides invaluable information and support.

I applaud all of these organisations who are dedicated to their work to help us understand and treat breast cancer.

However, I still believe that the risk factor of certain chemicals affecting our delicate hormone balance should be taken seriously and that all the available research should be studied. It is important to note that only 50% of breast cancer cases can be put down to one of the acknowledged risk factors. What is this remaining 50%? What has changed in our world over the past 50 years? It is also interesting that other countries are recognising the dangers of these chemicals and banning substances. I also believe in adopting the ‘precautionary principle’, which means that if there is a doubt over the safety to public health, then we should not wait until it is too late but take action as soon as possible. It has also been proved that there are alternatives to these potentially harmful chemicals when we see the growing number of companies who are selling safer food, cosmetics and toiletries.

This is why I am an active supporter of Breast Cancer UK, the only charity whose main focus is primary prevention. We are determined that breast cancer should be a ‘preventable’ disease not an ‘inevitable’ one. There is lots of research available on the link between endocrine disrupting chemicals and breast cancer. It is time that this was taken into account when looking at breast cancer risk factors.

SECRET #5 MOST WOMEN ARE NOT BREAST AWARE AND ARE AFRAID OF BREAST CANCER.

Despite the huge focus on being breast aware, particularly during Breast Cancer Awareness month in October, the majority of women are not breast aware. In fact, most women pay little attention to their breasts and do very little to look after them, except maybe during breastfeeding. Our breasts represent our femininity – they make us feel sexy and they nourish our children. Yet most women don’t even know what their breasts feel like, let-alone check them for anything unusual.

It is so important that women take control of their own breast health by undertaking monthly self-examination to check for any changes. If they find a lump and go to their doctor straight away, the chances are the lump will be benign (80% are) or, if it is cancerous, they are giving themselves the best possible chance of recovery. At Stage One, women have around a 95% chance of surviving beyond 5 years. At Stage One the lump is less than 2cm and has not spread to the lymph nodes or anywhere else in the body. At Stage Four this survival rate drops to 1 in 10. The average size of lump discovered accidentally by women who don’t check their breasts regularly is approximately 3.6 cm.

I have spoken with hundreds of women through my breast education work and most women do not check their breasts because they don’t know what to do, they don’t realize that all women are at risk, they don’t know about the four stages of breast cancer and the corresponding survival rates, they don’t really think about the need to do anything to look after their breasts or they are afraid that they might find something.

According to research by Breast Cancer Campaign, breast cancer is the most feared disease amongst women. Fear is usually due to a lack of knowledge. This is certainly the case here. If women understood everything detailed here, they would want to give themselves the best chance of survival should they get the disease. The current approach to women’s breast health obviously isn’t getting through, which is why I believe it is time to get women to take control themselves and empower other women to do the same.

SECRET #6 WOMEN ARE NOT GIVEN LOTS OF ADVICE ON HOW THEY CAN PROTECT THEIR BREASTS AGAINST BREAST CANCER.

In the past, GP surgeries used to run Well Woman clinics where any woman could go and see a doctor or nurse and be given advice about looking after herself with practical information like being shown how to check her breasts. Very few surgeries offer these clinics now. This is one of the reasons that I started my Breast Health Presentations. I talk to women in the workplace or in other gatherings and empower them with information, which helps to remove some of their fear. I also show them how to check their breasts and talk to them about their bra-wearing habits, how to avoid harmful chemicals in their everyday lives and how to benefit from detoxifying breast massage.

As we know, breast cancer is the most feared disease amongst women and understanding how it develops, the risk factors and, most importantly, how to protect against it, will make women feel more in control and positive towards their breast health.

During October and other events during the year, the focus is on breast cancer rather than breast health. I am one of those people who believe that the more you focus on something negative, the more you will get of it. This is why it is time to change that focus.

I believe that it is definitely time for women to take their breast health into their own hands, which is why I have launched my new campaign “Healthy Breasts For Every Woman”. You can read more at www.healthybreastscampaign.co.uk.

SECRET #7 MOST WOMEN DO NOT APPRECIATE HOW IMPORTANT THEIR BREASTS ARE AND DO NOT DO EVERYTHING THEY CAN TO LOOK AFTER AND PROTECT THEM.

As I mentioned before, most women give very little thought to their breasts. They get up in the morning and they may give them a wash in the shower. They then shove them into a cage we call a bra (and most women wear a bra that doesn’t fit them properly) and forget about them for the rest of the day. It is amazing that we live in a society which is obsessed with breasts and women do very little to protect this most precious part of their body. It is also amazing that women spend a fortune on looking after every other part of their body with creams and lotions and forget about their breasts! I know that once women understand more about breast health and don’t feel so helpless in the face of breast cancer that they do want to be proactive and take control of their breast health.

Why Should You Always Try and Stay in a Five Star Hotel?

Let’s be honest, not everyone can afford five star, which is why so many people book into three and four star hotels. But before you start shopping around and book the first affordable hotel you find, there are a few things you should really know about.

The first thing is that every country has their own hotel rating system, which means a five star in London is not necessarily the same as a five star hotel in Australia or the United States. Every country has it’s own rating system, which could result in some confusion. In the United Kingdom stars are awarded on facilities, service and customer service, In France they focus on the quality of the rooms and in Italy they focus on cleanliness. Which means knowing the star rating system in the UK can help you look for hotels in other countries offering the same facilities, services and customer service, even if they are not awarded with five stars.

In the United Kingdom, facilities and services are taken very seriously and any hotel which is lucky enough to be awarded a five star status, must provide guests with exploratory facilities and services. They must also have experienced, qualified and excellent staff who focus on providing guests with the highest level of customer service, working to exceptionally high quality standards at all times.

The hotel should provide the finest level of cleanliness, it should be well-maintained and offer the delivery of any services to the highest of standards. In most instances a five star hotel will provide you with some benefits such as a fitness center and on-site wellness center, which should provide you with a range of quality treatments provided by qualities therapists. In addition to this, the hotel should also provide you with a twenty our hour reception desk for added convenience.

It is always advisable when visiting a new city or country, to choose a five star hotel with a concierge service. The concierge has a wealth of local knowledge and experience. They can make recommendations and suggestions on what to see and do, they will book a taxi for you or assist you with public transport. They can also make theater bookings on your behalf or make dinner reservations at a top hotel, saving you time and energy and reducing what you need to do when on holiday.

Further, they should provide a butler service. If you have hired a suite and have guests coming to visit you for an evening meal, then a butler could be the ideal way to spend the evening, enabling them to handle the dinner, serve the meal and clear the plates, while keeping glasses filled.

Most five star hotels will have a choice of public areas. They should have a full on-site restaurant that serves evening meals and maybe even breakfasts, they should also have a lounge bar or relaxed area where you can sit and chill out, maybe with a coffee or dinner cocktail, light snacks should be served here during the day. In addition to this, they should also provide you with twenty four hour room service to quality as five star.

FAQS About Public Defenders

When you are learning about public defense, the first question you are likely to ask is, “What is a public defender?” So let’s not waste anytime answering this question, and many more frequently asked questions about public defense lawyers. A public defender is a criminal defense lawyer that works for the state and paid by the government. They provide free legal representation to defendants that are facing criminal charges that are punishable by jail time. Continue reading to read more common questions and answers just like this one!

Do Defendants Have to Pay for a Public Defender?

No, clients do not pay. However, a judge must decide that a defendant qualifies for public defense before one is appointed to them. In cases that a person is fully capable of paying for a private representation, they may be denied state assistance.

Is a Public Defender Less Qualified Than a Regular Criminal Lawyer?

No, both public defenders and private criminal attorneys are equally qualified in terms of education requirements, certifications, and licensing. The only difference is the level of skills and experience of each person.

Should I Use Public Representation or Hire My Own Lawyer?

Although public defenders are equally qualified doesn’t mean they are the most promising option for defense. Since they work for the state, their case loads are extremely rigorous and overflowing. This means they only have a limited amount of time to spend on each case. A private attorney can provide personalized representation to ensure you avoid the maximum penalties if convicted of your charges. Whether you are facing a petty charge like shoplifting, or a major charge like manslaughter, private counsel is the best choice, no matter the price. You can’t put a price on freedom, after all.

Can a Public Defense Lawyer Reject My Case?

If you are indigent and cannot pay your bills as they come due, it would be both unethical and illegal to have your case rejected since it is a violation to your Constitutional rights. Although a case can be handed over from one lawyer to another, it cannot be rejected and ultimately “skipped over” or denied. A person who is entitled to free representation will get it, no matter what.

Can I Request a New Lawyer?

If you are found to be eligible for state defense, you will be assigned a lawyer by the court. If this lawyer does not meet your expectations or recover the plea arrangement that you wanted, you do not have any options. Unless you can prove to a judge that your current lawyer is somehow violating your right to adequate representation, you cannot switch or be appointed a new one. Inadequate representation includes scenarios like missing appointments, failing to meet deadlines, forcing you to a certain plea, not informing you of case status and court dates, and ignoring critical evidence. And if you choose to appeal your conviction, you must hire private representation anyway, so asking to switch at that point wouldn’t be necessary.

Posted in Law

The Top 10 Benefits and Uses of Essiac Tea

Essiac tea is an alternative health drink that is getting a lot of attention lately. It’s a tea that is comprised of several herbal elements include burdock, rhubarb, elm bark, and many other elements. It has been traced to being a major drink of indigenous tribes in North America. Researchers have been studying the drink for some time, and it has been shown to help the body in a number of ways. Drinking this on a regular basis could very well help with the following 10 benefits.

Liver Health

The first major benefit is in regard to the liver. The blend of herbs helps with cleaning the liver of toxicity. It can flush toxicity through the liver, and process it through the urine. With this tea, some individuals may see a reversal of issues related to jaundice. Which is a disease of the liver. While it’s not a miracle cure, it does support liver function, enzymes, and the removal of toxicity that can end up traveling through the body’s digestive tract. It can help boost immune system, and waste management, with a boost to the liver outright.

Ease Constipation

For individuals that are dealing with bowel movement issues, specifically constipation, this tea can help. The herbs can help soften the stool, and can help bring through enough fiber to help with intestinal distress. This is an easy laxative to take as it works with the body’s natural systems. It’s not a chemical stimulant, or harsh fibrous element. The herbs help the body manage waste, and assist with constipation with ease. There is no pain, or issue when taking this tea, as it helps the body within a few hours of drinking it, assuming the individual is struggling with constipation.

Iron Supplement

Essiac tea has a few key vitamins and minerals. One of the most common is iron. Iron is a very critical part of the body’s natural systems. With iron supplemented through tea drinking, you’ll find that the proteins in the blood help form red blood cells, and even help with reversing anemia. This strengthens circulation, and assists with proper production of hemoglobin. Staving off anemia is a great thing, and can help people that are struggling with diet and exercise, get a small boost in the right direction. It helps directly with the circulatory system, promoting heart health.

Blood Pressure Regulation

Those dealing with blood pressure issues, specifically high blood pressure, will find that the tea can help with circulation. It can help with lowering pressure, and regulating heartbeat. Those that utilize this as a calming drink, will find that it can help with a variety of different elements in the body. It can lower pressure, and even help with stress. It begins working within the first time taking it, and works as one drinks more of it through several days. Studies have shown that in a few days, pressure can significantly drop to safer levels.

Bone Health

Much like calcium, this tea can help with bone health. While it’s not the same compound as calcium, it does help with strengthening bone structure, and delivers a powerful mix of vitamins and minerals that the body utilizes to strengthen bone structure. There is a calcium element in this, but not as much as milk, but enough to help boost the body’s natural resources to help with strengthening bones that are susceptible, or may be weakening from injury, or malnutrition.

Energy Boost

While Essiac tea is not caffeinated like a cup of tea, there is an energy level boost given to drinkers of this tea. It’s done through an increase of vitamin-C, and B elements. By helping the body’s natural systems get a boost in vitamins, waking up becomes easier, and getting a little natural energy delivers on the premise that coffee does, without the crash. That’s right, there’s no crash, there’s no sleepiness after drinking this, instead, energy becomes natural, without stimulants. It has a balance that works with the body.

Helps Digest Food

Having problems digesting food? Upset stomach? Nausea? Well, the benefit that this tea gives the digestive system is immense. It helps bring about the right pH levels of the body. By stimulating the stomach to produce the right enzymes, and bile production from the glands, you’ll find that digestion is much easier. That means that eating will not be a chore, and you’ll reduce heart burn, acid reflux, and much more. This helps by adding a helping hand to the stomach’s acid, so that it stabilizes a bit easier. It becomes easier to enjoy your favorite foods, that’s for sure.

Regulate Sugar Levels

While this is not a cure for diabetes, it has been shown to help with insulin production. It can help with insulin secretion, and management. This can help lower blood sugar spikes, and help keep levels lower, although it’s not a replacement for any diabetes treatment. It can help people that are susceptible to blood sugar spikes. This can also help with boosting the pancreas’s levels as well. For those that are diabetic, the tea can help with kidney function, and help with reducing toxicity. It helps with urination, frequency, and quantity as well.

Help The Skin

Researchers exploring the benefits of Essiac Tea have found that it can help with skin care. Used as a topical solution it can help with anti-septic, and anti-inflammatory elements. It also helps from the inside out, providing skin care elements, reduction of acne, and even fine lines. Those that are looking to help with the signs of aging will see a boost in overall skin care in a few days. It helps the body with hormonal secretions and balance, helping the skin heal from the rays of the sun, to the interior of the dermal layers.

Promotes Weight Loss

The last major thing that you’re going to find with this tea is that it helps with losing weight. By helping the body’s digestive system, you may get a boost of metabolic ratio. That means that you will burn calories, even when asleep. Pushing the metabolic rate is a great thing, and can lead to faster weight loss, and sustained management in time.

Strategies for Improved Efficacy of Construction Project Management Software

The ever-changing digital technology is gradually making life on earth easier and less hassle-free. Benefits of digitization encompass the construction industry as well. These days, a range of efficient construction project management software is readily available to make things easier for those, who are involved with the industry.

The assortment of software applications comes with many innovative features that help managing:

 All communication with your subcontractors and crew

  • Every electronic correspondence
  • Project schedules
  • Budget estimation
  • Timesheets
  • Site photos and much more

Extra spadework is required

However, if you’re planning to get such a helpful software tool to drive your projects to successful completion, here’s a word of caution! Just procuring construction project management software will not help you achieve your goal. After all, it’s not any magic wand that will do wonders. You need to do some extra spadework, like preparing a foolproof plan, regularly monitoring the work progress, facilitating personal interaction with both the stakeholders and team members. Moreover, it is important to take care of the cash flow to ensure your project(s) wind up on time. To put it in simple words, the more efficient you’re in handling your responsibilities in the construction industry, the more efficiency you can expect from the range of software tools.
The core competencies
Now, at this juncture you must be wondering if there’s any core competence of the modern software tools. As far as the building and construction industry is concerned, project management software applications help you in the following ways:

  • Accessing critical information right at your fingertips
  • Having everyone on the same plane, so that there’s no missed information or error
  • Alternative plans ready at hand to keep the workflow moving
  • Ensuring systematic progress of every project right from the word ‘go’
  • Facilitating communication with the peers, colleagues, stakeholders and team members even from remote locations

Considering all these benefits the range of software offers, it’s obvious that there’s hardly any necessity to rework on a module. Thus, project management software helps successful winding up of construction projects right within scheduled deadlines.

Just like any other commercial sphere, the construction industry too expects you to thread in the latest version of technology to achieve greater heights of success faster. However, you should have realistic expectations from technology to help your business grow bigger. Use the web to update your knowledge pool about the benefits these virtual resources offer. This will help you stay at-par with the best performers in the industry.

Types of Custom Promotional Merchandise

As a smaller business, you don’t have the unlimited budget of a large corporation when it comes to your custom promotional merchandise, which means you need to look for branded merchandise that is affordable and will work into your budget. Just because you are a smaller company, doesn’t mean you should ignore this amazing branding opportunity.

We have put a list of the top custom promotional merchandise options for the smaller business, that will work into your budget and provide clients with a branded item that they can use, boosting your brand visibility on a daily basis.

The first and probably the most popular of all the custom promotional merchandise that you can buy is T-Shirts. Ensure when you choose to brand t-shirts with your company logo that you choose a good quality garment, such as a polo shirt, which can be worn by men and women. Whether you are getting your team to wear the t-shirts to promote your business wherever they go or you are looking for promotional t-shirts you can give or sell to your clients, never ever compromise on quality.

Another great opportunity for the smaller business is branded pens. Everyone uses pens and they are cheap. You can buy a high volume of pens branded with your logo at a price that works into your budget and you can use them in-house and hand them out to clients, so that your company name is being seen throughout the day every day.

Further you may want to look at coffee mugs. Almost everyone has their own coffee mug at the office and drinks at least one cup of coffee while at work. The benefit of these mugs is that they are branded with your company name and logo, along with any other important information you want to put on them, what this means is every sip of coffee or tea your client takes, your name is seen and remembered, not only by them but the others in the office.

Key chains are another great branding opportunity when looking for affordable custom promotional merchandise. Have some key chains printed with your company name, logo, address and phone number. Clients can use the key chain on their keys and in the event they are lost, hopefully someone has contacted your company or dropped them off. In addition to branding these are a great opportunity to add a bit of added value to your service.

If you have a store, then you definitely want to look at reusable bags that your clients can take away from your store and use time and time again when they do their basic shopping. The great thing with reusable bags is that your clients can use them for anything and at any time and what that means is your company name is being seen by a variety of people every time your client leaves their home with your bag in hand.

If you are on a very tight budget, then take a look at lanyards. Lanyards hang around your neck, with your branding of course, but the benefit is that clients can use them to hang their access card for the office or even their keys to reduce the risk of losing them. They can be used for all types of applications, boosting your brand in the process.

Other options can include the credit card wallet, because these days with the number of credit cards, debit cards and loyalty cards you receive, they cannot all fit into your wallet easily. The credit card wallet can free up your clients purse or wallet, enabling them to keep all their cards in one handy place.

Brandz is a United Kingdom based company specializing in promotional products. This well-established company provides a complete turnkey service from the initial stages through to completion. They provide their customers with an experienced team who focus on helping their customers improve their branding with a range of promotional products to meet their requirements and marketing budget. Brandz offers a twenty four hour service, the highest quality products and affordable prices. Samples are available on request to help their customers identify the best promotional products to choose from based on the extensive range available on their easy to use and secure website.

Office Design for Improving Productivity

Sometimes, adding chalkboards and whiteboards can seem handy, but there is more than you can do to improve your office space. Here are just a few office design tips to help improve your overall productivity.

1. Idea Storage

One of the worst things that can happen for creative people is that they have a great idea but do not have anywhere to write it down, and they lose it. There is also the chance that you will end up doing a huge amount of research on a topic that you are not going to use. Whiteboards and notebooks are a great option for writing your ideas down, so you can continue to work on your main task for the day.

2. Remove the Clutter

It is important that you are regularly cleaning your office. Clutter comes from your creative mind working, but it can make focusing and getting your work done difficult. You should make sure that you have enough storage for all your items and that you have access to your most used objects.

3. Bring in Some Nature

We are biological creatures, so we should be spending some amount of time outside every single day. However, being inside all the time has a huge effect on our work. While it would be nice to spend a lot of time outside, for most jobs, this is not really possible. If you cannot take your work outside, why not bring nature to you? Try opening the shades and letting fresh air. This could help you feel more energized and help you get more done. Plants can also be a great option to add to your office, you just have to remember to water it.

4. Table and Chairs

We have all experienced having to sit at a table and having to consistently having to readjust to be comfortable, so we could focus on our work. This is why you should take the time to find a desk and chair that both fits your body and the way that you sit. This can take some adjusting to if you are working on an office where you do not have control over when items are ordered. If you are working at home, try to sit in chairs that you are thinking about buying for around 30 minutes to find out if they are comfortable for you.

Best Expense Management Solution By Thinking Outside The Box

This is how not to handle expense management in your business. Whilst a substantial part of managing expenses can be compartmentalized into how people make claims, and how those claims are processed, there are times when you’d benefit from thinking outside the box.

To illustrate the point, I’m going to look at telephones, the way your business uses them, and the way changing that can be part of an expense management strategy. Many years ago, in another life, I asked a senior manager how much he spent on line rental and calls for the fax machines in his business. He didn’t know, and asked his secretary to being in the relevant invoices.

She appeared carrying two large ring binders. Looking at them, he asked her for just the fax machine invoices. She pointed at the binders. “Those are the fax machine invoices,” she said.

He had no idea at the scale of the costs involved, and we immediately set about reducing them. And there’s the lesson: Show me any cost you’re not controlling, and I’ll show you an unnecessary expense.

Of course, fax machines are consigned to history with quill pens and carbon paper, but let’s stick with telephones; we still use those. Here are some areas in which you might be spending too much for mobiles, (and here’s the important part) without being aware of it.

1. Data roaming: Set up a company policy that it should be turned off except for short periods to allow emails to be delivered or sent, rather than being on 24/7. Data roaming charges can be high, and can mount significantly if you have a large number of employees travelling

2. Use one company: Don’t have a series of providers. Restricting services to just one allows you to negotiate better deals for new handsets and connectivity

3. Go for VOIP: For office phones there are lots of ways to use the internet to make calls, giving the traditional desktop phone a new lease of life. VOIP stands for Voice Over Internet Protocol, and means there’s no need to have a traditional phone contract, so long as you have good broadband connectivity. Providers of phone systems like this will usually deal with you on a rolling monthly contract, and their systems are extremely, so you can add or subtract handsets almost at will.

4. Be careful with perks. If employees are able to use company phones for personal use (and we’re back to mobiles here), then that permission should be restricted. OK, make short personal calls, but talking for hours to an aunt in Australia, or streaming a box set to a hotel room in Berlin could soon set you back a considerable – and unwelcome – amount.

5. Don’t leave legacies. When an employee leaves the company, make sure to cancel or transfer their part of the phone number, and don’t toss the handset into the back of a drawer. Re-use it, or send it for recycling _ once you’ve cleared any company data from it.

More than just number reduction

Consider the benefits that come alongside mobile phone use, and blurring the distinction between company and private life. When you’ve automated your expenses by implementing a solution based on business expense management software using an app, everyone’s going to need a phone so they can use your system.

Allowing an employee to make personal calls, to that agreed cost limit, might have a payback in loyalty. It might mean they’re more amenable to taking a work-related call out of hours, as part of a bit of give and take – but make sure that you track the benefit so that all the necessary tax is paid. There’s no future in saving money by cheating the taxman.

Applying this kind of thinking to all aspects of your business can make a significant difference to your bottom line, and be a useful ally to your business expense management software.