In honor of October being Breast Cancer Awareness Month, I am writing a blog about breast cancer.  In reality, BCAM annoys me.  So do all the pink ribbons, the Susan G. Komen Foundation and all the Facebook invites to join this or that breast cancer group.  Now before people start to get their dander up, let me explain.  One of my big missions is to do whatever I can to prevent breast cancer.  I, like everyone else, have dear friends and patients who have suffered from this horrible affliction.  So the impact of breast cancer, and actively doing something about it, is very near and dear to my heart.  But frankly, I think breast cancer fund-raising is one big racket.  You can hardly open the pages of a magazine without seeing pink bracelets, t-shirts, pins, earrings, for goodness sake, I just saw a pink cutting board and kitchen gadgets.  Why is this?  Because breast cancer has touched almost everybody, either personally or through a close friend or family member.  So you almost feel guilty not buying that yogurt because it has the pink lid.  It almost screams at you…DON’T YOU CARE ABOUT BREAST CANCER????  GIVE YOUR MONEY, PEOPLE, OR MORE WOMEN WILL DIE!!!!   Yeah, well, all these well-funded campaigns have not reduced the rate of breast cancer in this country, instead, it keeps going up, now at a truly dismal, 1 out of 8 women striken. 

So where has all the money gone, besides to these expensive, slick marketing campaigns?  Some people were a little concerned that the Susan G. Komen foundation was giving grants to Planned Parenthood.  Oh, yeah,  SGK said the money was for providing “breast services”….I’m sorry what other organization could get away with saying that…and not abortions.  We know PP isn’t doing mammograms, so that supposedly means breast exams.  And since I doubt people go into PP just wanting a breast exam, that means they are going there to get birth control pills or an abortion.  Well, of course, SGK certainly don’t want people to think that the organization that is supposed to be saving women’s lives is supporting ending them, so this little PR problem was swept under the rug and now you can be sure that any money flow is, um, more discrete. 

But, really, where is all this money going?  My favorite is when they say that the money is going to increase breast cancer “awareness,” as if there is a soul left in our multimedia world that doesn’t know about breast cancer.  Some of the money is supposed to be going to increase screening rates.   I was a little surprised when my local newspaper carried an October ad for mammograms claiming they prevented breast cancer.  Sorry folks, imaging prevents nothing, merely diagnoses something that is already there.  In the case of mammograms, they don’t “diagnose” cancer until it’s been there for 10-15 years.  Many of us support a different approach to breast screening utilizing breast ultrasound and thermography; read here about a wholistic radiologist who is also a regenerative physician and doesn’t do mammograms.  However, thermography is not widely available and so mammography screening remains the standard of care.  So there is nothing “preventative” about getting a mammogram.  Our throwaway journals bemoan the problem of not getting anywhere with reducing breast cancer rates and tells everyone to take “chemopreventatives,” see my earlier blog about iodine.  That’s drugs folks, with real side effects, so not truly a solution to the problem.   So here I would like to outline my approach to defeating breast cancer, acknowledging that we will likely continue to uncover factors that relate to whether or not one individual gets breast cancer and also that sometimes people do everything right and still get cancer.  I am not focusing on those patients that have a known breast cancer gene like BRCA, but rather average people, those with or without a family history of breast cancer, really anyone concerned about modifying their risk.  I am also not suggesting that people not pursue traditional therapies if they are diagnosed with breast cancer although I think you should do your own research about whatever options are presented to you so that you can try to be as informed as you can be.

Lifestyle factors:

One of my pet peeves is people who live moment to moment and do not think about the impact of daily decisions on long term health.   This is why I have long urged women to quit pouring synthetic hormones in their bodies in the form of birth control pills.  What are we trading for convenience?  As someone who deferred child-bearing to pursue a career, I certainly am not telling women to get pregnant when they are not ready, but I am saying that you should have a mind for the future if child-bearing is your desire.   There is protection in getting pregnant before age 30 although this isn’t always a possibility for career, relationship or fertility reasons.  Consider abstinence until circumstances are right to welcome a pregnancy (responsibility, no?), openness to the idea of the possibility of pregnancy if it occurs, or non-hormonal options for contraception:  condoms, diaphragms, fertility awareness methods or natural family planning (NOT the rhythm method, easy, you learn a lot about your body).  If we change our philosophy to one of welcoming pregnancy when it comes, we can find more than just health benefits.  If you do have an unplanned pregnancy, please don’t get an abortion!  Set aside all religious and moral and philosophical arguments.  Let’s just talk biological.  Whatever you might believe, there is mounting evidence that abortion increases your subsequent risk of breast cancer (and preterm birth in subsequent pregnancies).  There are plenty of people who have tried to discredit the literature about this link, although they usually have a reason for discrediting it…they don’t want to endanger their beloved abortion procedures by medical evidence of harm.  Let’s say you don’t buy the ABC link (Abortion-Breast-Cancer).  The point is that pregnancy is protective against breast cancer and stopping a pregnancy does not confer protection.   The recent rash of young childless celebrities getting breast cancer in their 30s and 40s makes one wonder if abortion did not play a role, either that or continuous hormonal birth control.  But then let’s remember Sheryl everyone-should-only-use-two-squares-of toilet-paper Crow apparently partly blamed hers on plastic water bottles, which may have played a role (keep reading) but I doubt it was the only factor.   Then if you do become pregnant, breastfeed as long as possible.  Breastfeeding is also protective against breast cancer, among the  many other benefits to mother and child.  The hormones in pregnancy and lactation including hCG (human chorionic gonadotropin) and progesterone cause there to be differentiation in the breast that is protective.  The biologic mechanism of the ABC link is that abortion cuts off the differentiation of the breast tissue at a very immature stage that later predisposes the breast to abnormal cellular development.

Avoidance of synthetic hormones

I have already touched on the health dangers of synthetic hormones in other blogs.  The fact that you may not get breast cancer from taking synthetic hormones doesn’t mean they are safe.  First, the pill.  Anyone who doubts that the pill is associated with an increased risk of pre-menopausal breast cancer needs to read this journal article.  The greatest concern is actually for those women who use the pill 4 or more years before a first full-term pregnancy, young women, and those who use OCPs for the long-term.

Synthetic hormones in the form of traditional HRT were exposed as a breast carcinogen  to a worldwide audience with the Women’s Health Initiative, but this was by no means the first time the association was identified in the literature.  As with politics, when something bad happens (like WHI), people like to look back and say “how come we didn’t know this was going to happen?”  Meanwhile, the warning signs were there all the time.  The culprit in WHI was actually not estrogen but synthetic progestin.  So that man-made chemical that was supposed to mimic the breast-cancer fighting qualities of natural progesterone, actually did the complete opposite and caused abnormal breast tissues changes that can lead to cancer.  Low dose estrogen therapy seems to actually be protective against breast cancer but estrogen dominance (high levels of estrogen not balanced by progesterone) is also a factor with breast cancer.

Iodine

The breast stores and uses iodine for the purposes of facilitating lactation.  In the female, iodine sufficiency is essential for optimal functioning of the breast, the ovary, and the thyroid.  There is an association between thyroid disfunction and breast cancer.  Because iodine can actually decrease or alter gene expression in breast cancer cells, it is clear that there is an anti-estrogen effect of iodine in the breast.  What we have also seen is a great increase in the amounts of toxins like bromide (found in bakery products, sodas like Squirt and Mountain Dew) and percholorate (rocket fuel).  These toxins displace iodine from the thyroid leading to iodine deficiency and subsequent thyroid and breast problems.  When patients take iodine, they will then, in reverse, displace these toxins from the thyroid.  Although a good thing, people can have detox reactions because they are so overloaded with the chemicals.  Those people that are more toxin-loaded are more likely to be at risk for cancers.  All of the breast cancer patients I have tested for iodine levels are extremely deficient and many of them have concurrent thyroid problems like goiters, nodules or hypothyroidism.  The website www.breastcancerchoices.org has plenty of information about iodine supplementation in breast cancer, discussion forums and tips for dealing with detox reactions.

Optimizing Vitamin D

There is becoming more and more evidence of the protective effect of Vitamin D on the breast.  It seems a no-brainer to optimize such an essential vitamin that is easily measured and easily supplemented.  Vitamin D deficiency is also related to an increased risk for recurrence in those who have had breast cancer.  It continues to amaze me that those who have not familiarized themselves with the extensive literature on this subject, always express concern for people running out and supplementing with Vitamin D all willy-nilly.  “Too much Vitamin D causes toxicity,” they scream.  Of course people should have their 25-OH-Vitamin D level monitored to avoid overdosing, but as Dr. Joseph Mercola says of the naysayers of the Vitamin D deficiency epidemic, this is like telling a person in the middle of the desert that they might drown.  For more info on Vitamin D, see my blog on the subject.

Dietary factors

Unfortunately, there’s been a lot of focus on the association of fat in the diet with breast cancer, but little emphasis on what types of fats (trans, hydrogenated and rancid vs. healthy fats like olive oil, coconut oil, avocados) and the additional impact of excessive carbohydrates, highly refined and preservative-laden foods.  Also there is quite a bit of evidence that the Brassica family (cauliflower, broccoli, brussel sprouts) have anti-estrogen and cancer-protective effects.  Obviously, avoiding foods like milk and meat with artificial hormones (recombinant bovine growth-hormone) and antibiotics are a good idea.  I’ve been happy to see how much easier (and cheaper) it has been to find organic, hormone-free products than it used to be.  Alcohol has also been linked to breast cancer but this factor is likely due to the effect of liver metabolism of alcohol, which is also where oral estrogens are metabolized.  The benefits of polyphenols in wine mean it is fine in moderation, but excessive consumption of alcohol (especially if you are on birth control pills) is not a good idea for breast protection as well as social reasons (nobody likes a sloppy drunk).  The negative effect of alcohol on the breast may be mitigated by folate.  Flaxseed lignans, released by grinding whole flaxseeds, are great estrogen-binders.

Other nutritional supplements

Indole-3-Carbinole/DIM is a concentrate of the Brassica family that enables you to get the benefit of large amounts of cruciferous vegetables in a capsule, especially good if you are obese and/or estrogen dominant.  CoQ10, long regarded as a cardioprotective supplement, has actually been shown to be good for women with breast cancer.  Iodine, of course, is essential in any breast cancer prevention/treatment program.  Curcumin, the cancer-fighting ingredient in turmeric, is a good choice.  A group from my alma mater, University of Missouri-Columbia, found that curcumin reverses some of the negative effects of synthetic progestins in the breast cancer cells of rats.   Since curcumin also increases glutathione synthesis in your body, it augments your body’s detoxification mechanisms.  Your omega-3 fatty acids in the form of purified/toxin-free fish or flaxseed oil, I think should be a part of everyone’s supplement regimen, but definitely anyone who is trying to treat or prevent cancer.  You should address folate and B12 deficiency, especially since these key vitamin deficiencies are common.  It also makes sense in anyone, but especially those wanting to treat/prevent cancer, to increase their anti-oxidant intake:  Vitamin C, E (mixed natural tocopherols, not the fake stuff), resveratrol, grapeseed, EGCG (epigallocatechin gallate, found highest in green tea).

Body composition

A woman I know who was treated for breast cancer stopped going to her oncologist appointments because every time she went, they would tell her if she didn’t lose weight, her cancer would recur.  Besides being an outrageous and fear-mongering thing to say to a breast cancer survivor, I find it very telling that in the world of breast cancer treatment, the so-called experts have resorted to “blaming the victim” since they can’t give her any better answers about why she got, in her case, pre-menopausal breast cancer.  What I think is way more productive, since there is an association between obesity and breast cancer, is to help the patient understand how obesity can be associated with breast cancer and what she can do about it.  There are two main concerns from a physiological standpoint:  insulin resistance and estrogen excess/dominance.  Basically what happens is that insulin resistance, which is frequently occuring in the face of normal or even low blood sugars, is caused by excessive sugar and refined carbohydrate intake in conjunction with synthetic hormones or hormone imbalance, and genetic predisposition also playing a role.  What happens next is weight gain, predominantly middle abdominal and visceral weight gain.  More adipose tissue results in increased peripheral estrogen conversion which leads to the second problem:  estrogen dominance.  In general, heavier women are estrogen-rich and thinner women are estrogen deficient.  So the solution to this is your healthy, lower-carb diet such as the Mediterranean diet rich in protein, healthy fats, lots of veggies and minimal refined carbohydrates.   Also for additional reading, I suggest checking out Dr. Diana Schwarzbein’s and Drs. Mary and Michael Eades’ books for dietary guidelines.  Also recommended, targeted training with weights/resistance/bands, to increase lean muscle mass and improve fat-burning.  I am not a big cardio fan unless your cortisol levels are normal.  I see so many people with adrenal fatigue from chronic stress, which cardio worsens.

Detoxification

The problem of living in a polluted environment may not seem like such a big factor to some people, especially those who consider themselves healthy:  eating right, not smoking and taking care of themselves…but I’m sorry, nobody gets off easy.  Effects from toxins and pollutants are universal even if people are not acutely ill.  We are as a world experiencing unprecedented rates of cancers, auto-immune disease, infertility, autism, developmental and behavioral disorders.  The fact that almost everything from food to water to hormones to even vitamins is contaminated is the reason why detoxification is pretty much an obligation to achieve true wellness and good health in our modern society.  Xenoestrogens are foreign substances that act in a hormonal fashion but are actually what are called endocrine disruptors, which means they interfere with normal hormone functioning in the human body.  So yes, Sheryl Crow’s water bottles are a factor.  When plastics and phthalates, styrene and benzenes, are an everyday part of our food intake through packaging, these plasticizers are released into the food or drink and disrupt hormone receptors or accumulate to toxic levels in our organs, leading to chronic illness and cancer.  Heating plastics (through microwaving in plastic containers or dishwashing your plastic baby bottles or leaving your water bottles in the car) accelerates this process.  So switch to porcelain or glass containers, take your drinks in reusable stainless steel or glass containers and try to get as much of your food as possible fresh and whole to mimize contact with chemicals.  Due to the high levels of hormones in municipal water supplies from people being on hormones and those hormones not being eliminated during treatment processing, we have the problem of escalating rates of precocious puberty, breast, uterine, and prostate cancer, not to mention ambiguous genitalia in animals and humans.  Your Standard American Diet (SAD), is full of convenience and fast foods that are highly processed, perservative and chemical laden, and full of fake fats, artificial sweeteners, flavor enhancers and the heart-toxic trans-fats that the FDA still lets the food industry get away with.  So everyone needs to detoxify, especially someone who is trying to treat/prevent cancer.   Since this is just an overview, I am not going to get into specific detoxing regimens but some natural detoxing elements besides trying to eliminate the chemical cascade as best you can:  iodine, Vitamin C, glutathione, alpha lipoic acid, your trace minerals like magnesium/zinc/selenium, detoxifying foods like citrus fruits especially lemon, flaxseed, cranberry, and your anti-oxidants mentioned above.   Some people need deeper levels of detoxing with chelation.  Point is, even if you feel healthy, but especially if you don’t, you need to detoxify.  For more information, see Dr. Sherry Rogers’ excellent book Detoxify or Die.

The Mind-Body-Spirit Connection

Dealing with toxic emotions is important in any healing process, not just cancer.  It is hard for the body to heal if the mind is loaded down with fear, anger, bitterness, resentment and unforgiveness.  While it is normal to experience some conflicting emotions when hearing a diagnosis, I strongly encourage you to use those feelings to turn you in a new productive direction:  a desire to fight.  Attitude plays a big role in people’s response even to traditional medical treatments.  So do whatever you can to tap into a support system that will help you fight whether that be your family, a support group, your faith community or just good friends.  Controlling stress is easier said than done but is also essential for healing.  It is necessary to deal with the toxic emotions listed above, through prayer, counseling, and active stress management.  Keeping your mind on positive feelings and thoughts will enable your body to respond in amazing ways.  For those of faith, the power of prayer is one of the main things we rely on, and even the literature has shown it can have real therapeutic effects.  Walking in forgiveness for those who have hurt you, actually frees you from the burden of carrying that hurt around so that it can’t interfere with your healing process.

Options for testing

Complete screening blood work, saliva hormone testing, 24 hour urine-iodine excretion test, glucose tolerance testing with insulin levels, urine testing for good and bad estrogen metabolites (2-OH-estrone/16-OH-estrone ratio), erythrocyte nutrient and toxin testing, heavy metal urine excretion in response to chelator, COMT testing, BRCA testing for those with extensive family history of  cancer.  There are more tests available but this is more of a list for those who do not currently have breast cancer.

Well, I hope this helps someone and I know that when people begin to truly think about disease prevention and what they can do NOW, we will be able to fight the scourge of breast cancer and make a real difference.