Promoting Breast Health
By Stephen Holt, MD, MRCP (UK), FRCP (C), FACP, FACG, FACN, FACAM
HRT and Breast Cancer
Recent statistics on the occurrence of breast cancer in the nation are
depressing. Added to this situation is the shocking recent report in the UK
medical journal "The Lancet" published on August 9, 2003. This report
indicates that conventional hormone-replacement therapy (HRT) increases the
occurrence of breast cancer. This recent finding comes from the research
collaborators who are running the "Million Women Study" which is
designed to provide information about HRT use, disease occurrence and
lifestyle. The researchers report that the use of HRT by women aged 50 to 64
years in the United Kingdom over the past 10 years has resulted in 20,000 extra
cases of breast cancer. The terrible news is that the current use of HRT is
clearly associated with an increased occurrence of fatal breast cancer and that
this risk is particularly high for HRT which combines estrogens and
progestagens (synthetic progesterone).
Breast Cancer Prevention
While the current bad news focuses on breast cancer occurrence in mature women
taking HRT, the increasing occurrence of breast cancer in young women is
alarming. Therefore, many women and their health care practitioners are seeking
effective disease prevention programs. Certainly, adverse lifestyle and poor
diet are involved in the breast cancer epidemic. While some authorities have
suggested that poor diet could account for about one-half of all breast
cancers, there are few large-scale studies to define dietary components that
will protect against breast cancer. In contrast, much investment has been made
in studying breast cancer prevention using drugs, such as tamoxifen. Tamoxifen
has potentially serious side effects, including the development of cancer
itself. Clearly, there is an urgent need to place new order in the priorities
of research for breast cancer prevention.
The Role of Estrogen
The biggest focus of research in breast cancer attempts to characterize the
effects of the female hormone estrogen on breast cancer development and
outcomes. Although estrogen can be a woman's best friend, it can act sometimes
like a woman's enemy. Mature females can be quite desperate in their attempts
to escape the unpleasant symptoms of the period around the menopause. Such
symptoms include hot flashes, lack of psychological well-being, mood change,
sleeplessness, vaginal dryness, etc. While quite distressing, these symptoms
are time-limited and the greatest significance of the menopause is the
onslaught of cardiovascular disease, osteoporosis and age-related cancer. The
occurrence of these diseases increases following the cessation of periods in a
mature woman.
HRT: More Risks Than Rewards
There was a time when HRT was seen as not only a way of melting unpleasant
symptoms of the menopause, but it was also viewed as a healthy way to prevent
age-related diseases. However, HRT seems to come with more risks than rewards.
Added to the alarming increased risk of breast cancer with HRT are the reports
of the association of HRT with risks of coronary heart disease, stroke,
increased tendency to blood clotting and cancer of the womb. There appear to be
no options to avoid these demonstrated risks of HRT. To add to the bad news is
a study published in the New England Journal of Medicine on August 7, 2003 that
shows that HRT is not preventive against coronary heart disease. In fact, the
New England Journal of Medicine study implies that the risk of heart attack
increases 81 percent during the first year of use of conventional
hormone-replacement therapy.
Breast Cancer Prevention
While most breast cancer occurs in women following the menopause, prevention
should begin early in life. It is never too late or too early to engage in a
lifestyle and nutritional program to prevent breast cancer. These natural ways
to prevent breast cancer may be effective even in preventing recurrence of
breast cancer. My recommendations are listed below in Table 1.
INTERVENTION
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COMMENT
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Improve lifestyle
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Exercise, avoidance of substance abuse and
stress-reduction techniques.
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Weight control
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Weight gain in early adulthood can cause an increased risk
of breast cancer which is only apparent later in life. Weight loss and weight
control must occur with a global health initiative.
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Reduce refined sugar intake
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Simple sugars in the diet cause high blood glucose which
is linked to the development of insulin resistance, obesity and other factors
that cause the metabolic syndrome (Syndrome X). Syndrome X causes menstrual
irregularity and polycystic ovaries and high blood insulin levels are
associated with cancer.
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Specific dietary interventions
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Increase omega 3 fatty acid intake (fish oil) and keep a
balance between omega 6 and omega 3 fatty acid intake. Add liberal amounts of
dietary fiber, especially soluble fiber which helps with weight control and
general health. Eat fruits and vegetables which are a good source of
antioxidants.
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Consider dietary supplements
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Powerful antioxidants e.g. ellagic acid, green tea,
turmeric, Vitamin C, etc. Consider nutritional factors that may combat
Syndrome X. Add fish oil and fiber supplements. Antioxidants that are found
in berry powders and cruciferous vegetables are very valuable.
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Think carefully about avoiding chemical estrogens
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Discuss the risks and benefits of HRT with your physician.
Consider viable, simple, gentle and natural ways of dealing with menopause
e.g. soy isoflavones, black cohosh, etc.
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Natural Ways to a Healthy Menopause
There are several pathways to approach menopause in a natural way. It has been
shown in scientific studies that women with a positive attitude and good
lifestyle have less symptoms and adverse events while going through the early
postmenopause. Several researchers have suggested that certain herbs and
botanicals may be viable alternatives to conventional HRT for helping with
troublesome symptoms associated with the menopause.
Soy isoflavones have been shown in certain studies to reduce hot flashes and
they help build bones. In addition, soy isoflavones have been described as
having certain anti-cancer benefits by virtue of their ability to block
estrogen receptors (an adaptogenic role) and exert antiangiogenic and
antioxidant effects. Soy isoflavones are sometimes referred to as
"phytoestrogens", but their actions have more to do with other
benefits, in addition to any effect they have on estrogen. Standardized
extracts of black cohosh have been shown to have value in reducing symptoms due
to the menopause and other herbals or botanicals have been shown to exert
benefits in the support of healthy menstrual function and the postmenopause.
These natural substances include black cohosh (Cimicifuga racemosa,
standardized for triterpene glycosides 2mg), soy isoflavones (40% extract), red
clover (8% extract), L-Theanin, evening primrose oil (60%), Dong Quai (Angelica
sinensis, 1% extract) chasteberry (Vitex agnus castus, 0.5% extract) and Gingko
Biloba extract (24% gingkoflavonglycosides and 6% terpene lactones).
New, evidence-based, dietary supplements have been developed for menopause and
healthy menstrual function and the benefits of the ingredients within these
supplements have been quite well defined in recent scientific publications in
major medical journals (Kronenberg F and Fugh-Berman A, Annals of Internal
Medicine, Vol 137 No 10, November 2002) For further information on herbs and
botanicals.
About the author:
Dr. Stephen Holt, MD is a practicing physician, best-selling author and dietary
supplement industry expert.
Resources
- Holt S, The Menoplan, in
press, 2003,
- Arnot B, The Breast Cancer
Prevention Diet, Little Brown and Company, New York, 1998
- Read C, Preventing Breast
Cancer, HarperCollins, London, 1995
- Kronenberg F and Fugh-Berman
A, Complementary and Alternative Medicine for Menopausal Symptoms: A
Review of Randomized, Controlled Trials, Annals of Internal Medicine, Vol
137 No 10, November 2002
By Stephen Holt, MD, MRCP (UK), FRCP (C), FACP, FACG, FACN, FACAM
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