80’S CANCER JAM OF THE DAY:
For women with estrogen positive breast cancers, or any breast cancer for that matter, it’s a given that hormone replacement therapy is off the table forever. Or is it….? Surely if the cancer is driven by estrogen and/or progesterone, it would be a suicide mission to even contemplate this possibility. Yet I’ve often wondered if the link is really this simple.
I actually asked my oncologist about the link between hormones and breast cancer at our last visit. Intuitively, it makes sense to me that if cancers are hormonally driven, then the greatest incidence of cancers should appear at the time in a woman’s life when her estrogen and progesterone levels peak, namely pregnancy. Yet, it is extremely rare to hear of a pregnant woman diagnosed with breast cancer. Instead, the odds seem to increase as we age, with the great majority of women being diagnosed after menopause, when hormones should be in decline.
According to the latest “Cancer Statistics Review” or “SEER” report put out by the National Cancer Institute, you have the following odds of being diagnosed with breast cancer per decade of life:
- Age 30 . . . . . . 0.44 percent (or 1 in 227)
- Age 40 . . . . . . 1.47 percent (or 1 in 68)
- Age 50 . . . . . . 2.38 percent (or 1 in 42)
- Age 60 . . . . . . 3.56 percent (or 1 in 28)
- Age 70 . . . . . . 3.82 percent (or 1 in 26)
Although I love my new doctor, I didn’t feel like he adequately answered my question. He said something about a woman still being able to produce a little bit of estrogen via her adrenals and her fat cells (particularly if she is overweight) after menopause. True. But this amount would still pale in comparison to the amount produced by a woman in the height of her reproductive years. In light of the above statistics, it would almost make more sense that a lack of adequate hormones increases the risk of breast cancer.
As some of you know, I’ve been reading a really fascinating book by Suzanne Somers about alternative doctors who are curing cancer with mostly non-toxic methods. Some of them do use low-dose chemo, but the low doses are made possible by the combination with the natural treatments. Even if you choose not to step off the mainstream path, I highly recommend reading this just to increase your awareness of what’s out there.
One of the doctors interviewed for Somers’ book is Jonathan Wright, who is one of the pioneers of hormone replacement in the U.S. His interview captivated me so much that I just bought his book, which is pictured here. He talks about using Estriol, which is the estrogen most abundant in pregnancy, as a kind of “natural Tamoxifen”.
The role of Tamoxifen in breast cancer therapy is to act as an estrogen receptor blocker to prevent the more potent and agressive estradiol from taking this spot and potentially causing cell proliferation. Tamoxifen is the “goalie”, so to speak. This works well in breast tissue; the problem comes in other parts of the body, where Tamoxifen acts more like estrogen. We see this mainly in the uterine lining, where a dangerous proliferation of tissue can occur, leading to uterine cancer.
Dr. Wright describes three types of estrogen: Estradiol (E2), Estriol (E3), and Estrone (E1). E2 and E1 are the more agressive forms, while Estriol or E3 has been shown to be cancer-protective. According to Wright, Estriol will block the estogen receptors in our cells like Tamoxifen, without the other side effects that we see so often. But, it will also help ease quality of life issues caused by menopause, which is a subject currently only addressed with anti-depressants or blank stares.
In addition to reading these books, I have been doing random PubMed searches entering “hormone replacement therapy breast cancer” . Surprisingly, most of the studies that I looked at found no increase in breast cancer recurrence or mortality in women using hormones following a breast cancer diagnosis. Granted, many of the studies did not specify whether the women were estrogen receptor positive or not, but this is the most common diagnosis.
Why do we care about all this? I can tell you from a personal standpoint that Tamoxifen scares the hell out of me. I’m not even talking about the prospect of getting uterine cancer here. I have serious concerns about my mental health if my hormones decline any further. Just the beating that they have taken during chemotherapy has reduced my quality of life. Estrogen stimulates serotonin receptors in the brain, and serotonin is responsible for feelings of happiness and self-esteem. I like those feelings.
This is a very controversial debate, but one that is deserving of attention. It’s just a shame that women who don’t fall obediently into the “medical model” have to search so hard to find alternatives. And it’s unethical that there is no funding to do the kinds of studies that would truly ease our minds about taking a different path. It’s not easy being a rebel!