Southpoint Medicine & Women's Health Associates
6216 Fayetteville Road, Suite 105 Durham, NC 27713
Phone: (919) 405-7000
Fax: (919) 405-7006

Can the Growing Tide of Breast Cancer Be Turned?

Breast cancer is the second most common cancer affecting women in the United States second to lung cancer. We know that the majority of lung cancer is caused by cigarette smoke but what about breast cancer? We have more research, more studies, greater access to mammograms and more patient education than ever before and we don’t seem to be making a dent in this disease. What’s more, women are diagnosed at younger ages with more aggressive types of cancer than was true forty to fifty years ago. In addition, with all our technology, the United States has the highest rates on the planet with a mortality rate of 89.2 per 100,000! This is much higher than third world and less industrialized countries.

We know that our breasts have hormone receptors and are under their influence just like our uteruses, brains and bones. We make three types of estrogen of different strengths. They compete for space on the receptors. Estrogen is a growth promoting hormone. After binding to the receptor, the hormone is responsible for instructing the cells to replicate or manufacture progesterone receptors or produce more cell components. The higher the estrogen level, the more cells that are recruited for this process. The body has biochemical mechanisms for the destruction and excretion of excessive estrogens and estrogen that have already done their job. These estrogen metabolites or by-products are usually safely excreted in urine, feces or sweat. If however the estrogen is exposed to a free radical (a molecule with an unstable oxygen that can remove electrons from other molecules and make them unstable), it becomes a quinone estrogen that has the potential to strip electrons from other cells and consequently damage DNA.

Usually the quinone estrogens are circumvented by protective enzyme systems in the body. The systems may fail however, if your body doesn’t have enough of the enzymes due to a genetic defect, you are nutritionally deficient in the building blocks necessary to maintain these enzymes or if your system has been assaulted by pollutants, stress, excess estrogens or viruses.

There are a couple of other major points to consider. The first is the fact that progesterone is the hormone that balances estrogen. Estrogen promotes growth and proliferation of cells in the uterus and breast and progesterone stops this growth. Estrogen inhibits bone resorption and progesterone stimulates bone growth. Progesterone cannot be effective without priming of the receptors by estrogen and progesterone influences the sensitivity of cells to estrogen receptors. It is an amazing and very complex relationship.

The second point is the fact that during the period of organogenesis (that time in utero when our organs are being formed) we are exposed to very high levels of two hormones, estriol and progesterone. This is the most vulnerable time of development and we are bathed in these hormones with no deleterious affects! We also know that women who have several full-term pregnancies before the age of 30 decrease their rate of breast cancer.

What is my point? First of all, we have chosen to disrupt this relationship in the way we give hormonal replacement therapy to menopausal women in this country. If the patient does not have a uterus, typically no progesterone is given with the prescribed estrogen. As mentioned earlier, we know there are progesterone receptors located other places in the body, like breast tissue. What happens when the breasts are stimulated by estrogen but not checked by progesterone? Not to mention the progesterone receptors in the brain and bones!

The other consideration is the type of estrogen used to treat menopause symptoms and menopause related problems. We predominately make estriol, the weakest estrogen among the three produced in women. This weaker estrogen is also the estrogen, as mentioned earlier, produced in greater amounts by pregnant women. Many studies have shown that women with higher estriol levels have decreased risks of breast cancer AND estriol is used universally for estrogen replacement in Europe . YET, the predominant estrogen used in the United States, conjugated equine estrogen not only contains no estriol but has as it’s primary metabolite estrone, the estrogen associated with increased risks of breast cancer!

What about younger women diagnosed with breast cancer who have never been on hormonal replacement therapy of any kind? We have pervasive estrogens in this country known as xenoestrogens and we are all affected by them.

Xenoestrogens are chemicals that can act like estrogens in the body. The source is primarily petrochemicals which can take many forms. Our primary exposure is from pesticides, herbicides, plastics, solvents, cosmetics, gasoline (including exhaust) and industrial chemicals (PCB and dioxins). In other words, they’re everywhere in our society. They are dangerous because they can compete with our naturally occurring hormones for receptors on our cells BUT they won’t necessarily affect our cells in the same way. They are known to suppress our immune system and can activate an enzyme known to convert our own estrogens to a more dangerous type that damages our DNA. We know that people who consume large amounts of beef and pork are probably exposing themselves to greater levels because of xenoestrogens because of estrogens give to these animals to speed the growth process. Animals also concentrate herbicides in their tissue from treated grains and grasses they eat.

SO WHAT’S A WOMAN TO DO? A multilevel approach is necessary!

First investigate the hormones you are taking and whether they are being properly balanced. Are you on the least amount necessary? As a proponent and prescriber of bio-identical hormones I know exactly what the pharmacist is compounding for my patients and what the balance is.

Is your diet properly balanced? This would include not only limiting the amount and type of meat you eat (and consideration for eating organic) but adding adequate fiber and vegetables to help assist in the metabolism and elimination of these hormones. Most of our diets need to be supplemented with vitamins and minerals to give support to the very important enzyme systems mentioned above.

And lastly, exercise which also not only aids in regular elimination but helps boost our immune system so that it may effectively confront and irradicate these insults.

Obviously avoidance of chemicals is also desirable though is easier said than done. In addition to considering eating organic produce and meats, try to read labels and be more conscious of what is not only in the food you eat but also the products you bring into your home. One cleaner for every job may sound good but may not be the best thing if it will potentially expose you and your loved ones to harmful chemicals.