How Being Sour May Just Save Your Breasts…And Your Life

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I knew there was a benefit to my attitude! Instinct wins again.

Many people reading my blog have either had breast cancer, are in the middle of treatment, or are trying desperately to figure out how to keep it from coming back.  At the very least, you probably love someone you don’t want to lose.

That’s where my passion lies. I decided after my own bout with advanced breast cancer two years ago that it was my calling and my mission to educate myself and other women about natural prevention, nutrition, and treatment support.

When something easy yet powerful comes along, I listen…

I scour tons of literature looking for ways to protect myself in my quest to stay healthy and to be there for my kids. For cancer survivors, nothing is taken for granted and each day is a gift.  Although the fear dims with the passing of time, the possibility of recurrence lurks in the background like a constant companion.

So What’s The Latest Scoop?

The simply elegant, unceremonious little LEMON. More specifically, a recent study at the Arizona Cancer Center showed that the peel of the lemon is the hero in our story. The peel contains a natural substance called d-limonene, which has shown promise against a wide variety of cancers. In this study, a small group of women were given 2 grams of limonene each day for 6 weeks before lumpectomy surgery.

In these women, d-limonene supplementation reduced expression of the breast tumor marker cyclin D1 by 22%!

Cyclin D1 rears its ugly head in over half of invasive breast cancers and can cause Tamoxifen treatment failure.

D-limonene is known as a terpene. Other sources include:

  • citrus fruits
  • berries
  • cherries
  • peppermint
  • basi
  • thyme
  • rosemary

So How Are You Gonna Get Your Terpenes?

my juice glass

A delicious and easy way to get several in one shot would be to make a daily green juice. I just bought a Breville juicer and have tried out the following recipe:

4 lactinato kale leaves rolled into a bundle

3 carrots

half a lemon with peel on

half a grapefruit

1 inch of ginger

With juicing, it is very important not to overload with sweet fruits. Remember, sugar feeds cancer, and whenever you juice it’s like mainlining produce.

You can also whip up a smoothie in a Vitamix or a Ninja. This will retain the fiber of the veggies, and you’ll get more yield from your greens.

Whichever way you go, please use organic produce. We don’t want to flood you with a pesticide cocktail!

Be creative in your cooking. Find some recipes that use lemon zest. Click here for an easy one that I use often. (I substitute pesto for the mustard).

I’ll be writing a series of posts about how to use natural substances in your health toolkit. Until someone can improve on nature, that’s where my focus will be.

For now, pucker Up And Get Your Lemon On!

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And We Close The Chapter on Tamoxifen…Farewell

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I know I’ve devoted a great deal of time and space these past few weeks to the agonizing decision of whether or not to take the hormone blocker Tamoxifen as the final piece of my breast cancer treatment. Frankly, I’m as tired of thinking about it as you are of reading it, so you’ll be glad to know that something happened yesterday that allowed me to put the subject to rest.

I was sitting at my kitchen table, browsing through some blog posts and dreading my afternoon oncology appointment with every bone in my body. I had already postponed the appointment for 2 weeks because I was not looking forward to being scolded about the Tamoxifen…again. Now, scold is a harsh word when it comes to my doctor. He is about as threatening as a teddy bear wrapped in velvet sitting on clouds.

No, I think I was really dreading….the look. You know the one. Like your favorite grandparent who catches you doing something wrong and doesn’t spank you. That would be too easy. Instead, they sit you down, their head hanging with the weight of their disappointment, and tell you that they never would have expected this of you…and it hurts them that you would do such a thing. By the end of the lecture, you feel like the lowest of the low, and you’ll do anything to get back in their good graces.

That’s how I felt after our last appointment. I came in ready to fight, ready to bring in research and statistics to back my argument. And I left in a haze of confusion and shame. I even went to the drugstore and filled the prescription. I couldn’t bear to let Dr. A down. He cares so much; it’s palpable.

So, back to yesterday. I hopped over to one of my absolute favorite blogs, chrisbeatcancer.com. He was diagnosed at 26 with Stage 3 colon cancer and refused chemo and radiation, choosing to heal himself through nutrition. He is now an eleven year survivor who lectures around the country and offers much of his wisdom for free on his site. I’ve visited many times before, but this video struck a chord in me for some reason.

I’ve been somewhat beaten down by the medical establishment over the past year, and I’ve started to compromise my core beliefs. Namely, The belief that our bodies are designed to express health, not sickness. Yes, there are genetic aberrations, environmental insults, etc. that challenge us, but this is not destiny. We can radically transform the terrain inside the body by the way we treat ourselves. Proper nutrition, sleep, stress management, and healthy relationships are essential to disease prevention.

Chris is a very articulate, warm person who expresses these ideals perfectly. I am in no way against doctors or medicine when it is necessary, but the whole “fear culture” surrounding cancer puts so much pressure on patients to “go with the flow” or face dire consequences. Take Tamoxifen, for example. In my case, the statistics show that I have a 12% reduction in recurrence over the next 10 years if I take the drug. The mortality reduction is about half that.

For these slight statistical improvements, I will endure hot flashes, night sweats, depression, fatigue, joint pains, weight gain, and the possibility of aggressive uterine cancer, blood clots, and cataracts, or worse. There are very, very few people who have pleasant tales to share about this drug. And the kicker is.. the research will show that Tamoxifen is not curing cancer, but rather putting it to sleep. And it almost always finds a way to get around this “trance” eventually.

So..yesterday I had what could almost be described as a revelation. I found my convictions once again and decided that my body is not suffering from a Tamoxifen deficiency. I plan to do a hard core re-examination of my life and change the things that need changing. I went in to the doctor’s office, ready to defend my decision once again. Dr. A must have seen the look of determination in my eyes. He asked if I was taking the Tamoxifen. When I explained why I wasn’t, he simply looked at me and said, “Ok.”

I think that in a way he knows he is asking a lot of women, but he feels that it is his duty to try. I wouldn’t be surprised if he even has a sliver of doubt about the standard treatment in his most private moments. As for me, the Tamoxifen train has left the station, and I’m at peace as I wave goodbye.

 

The Doctor Said “Eek!”

shouting doctor

I had my 3 month check-up with the oncologist this week. I’ve been dreading this appointment like a case of shingles for weeks. Why? Let’s see. Not only did I not start my Tamoxifen like a good girl in January, but I have been doing the polar opposite of what was recommended. I moved the appointment back 3 weeks to stall, in the guise of waiting for my BRCA genetic testing results (negative) to come back, but the truth is I would have told him anything to delay the inevitable. “I can’t come in right now because I’m recovering from ebola”, etc.

So, my oncologist has been in sweet denial for the past 3 months, thinking that I’m a compliant patient, resting comfortably at night with the knowledge that he is in charge. Let’s just say I burst that bubble with a pitchfork on Wednesday.

He walked in the room after knocking gently. He greeted me warmly and asked how I’d been. “Fine, really well”, I offered, almost sheepishly. I thought that maybe my fears had been unfounded, maybe he was just going to check in and leave it at that, assuming everything was going as planned. It wasn’t to be.

“Are you on Tamoxifen?” he asked as he sat down and flipped open my chart.

“Oh, crap, here we go!” I thought, the red heat of shame traveling steadily up my chest to my neck.

“No…I…decided not to take it.” There, it was out.

He looked at me for a minute, not quite sure how to respond. “What happened?”

“Well, I’ve done a ton of research and reading about it, and I don’t see anything good. I know four people who’ve had to quit taking it because they felt that they would rather live 2 years happy than live with the side effects.” I was scanning his face for a reaction.

“I see. So, did you even try it?”

I felt at this point that I had to offer up something to make my case seem stronger and more logical, so I began to spill the beans.

“Ok, Dr. A, I like you a lot and I respect you as a person, so I’m going to tell you something, but I’ll spare you all the details because I don’t want you to have a stroke.” His eyes widened and he sat back in his chair. “I’ve been seeing that integrative MD that I told you about.” He nodded. “We’ve been doing a little experimenting.” Deep breath. “He put me on some bioidentical testosterone and gave me Arimidex to keep it from turning to estrogen in my body. After 5 days on the Arimidex, I was in such a pit of depression that I stopped taking it. Now, that pretty much tells me how the lack of estrogen is going to affect me, no matter what drug we use.”

mouse

Dr. A sat up straighter and looked in my eyes. “Eek!” I thought that probably wasn’t because he saw a mouse out of the corner of his eye. “First of all, I had no intention of putting you on Arimidex because that is for post-menopausal women. There is no guarantee at this point that you’ll stay that way. I’ve seen women older than you resume their cycles after chemo. We just don’t know how the aromatase inhibitors effect pre-menopausal ovaries.”

He went on. “So I don’t know why he would put you on Arimidex; well, I understand it biochemically, but it’s not the path I think is best for you. Second, I would feel a lot better about your decision if you had tried the Tamoxifen and told me that you hate it and absolutely can’t take it. Try it for 10 days or 2 weeks. But don’t assume that you know how it will affect you. If you tell me you absolutely won’t take it, then we’ll figure it out and monitor you more closely, but give it a shot.”

Uggghhh! Dammit, why does he have to always pull out the logic? I tried another tactic. “The side effects aren’t my only worry here. I honestly don’t think long-term estrogen deprivation is healthy. I think everyone forgets that estrogen does some good things, like protect your bones and keep your brain functioning, not to mention allow you to have sex without pain.”

I could see that he understood my dilemma and really did sympathize. He almost teared up as he said something about his mom having osteoporosis and how he worried about her falling. But, no dice. “I agree. And if you didn’t have this”, he pointed to my chart, “we’d be in a totally different discussion. But we have to weigh the risks in your case.” He got really quiet for a minute and I could see him trying to find a way to frame his next sentence delicately. “I don’t want to sound crude”, he went on, “but the long-term side effects of estrogen deprivation will be kind of a moot point if this comes back, and I feel like the window of opportunity for the Tamoxifen to work is closing.”

Ouch! After an hour of gentle prodding, he finally wore me down. “Ok, Dr. A. I’ll try it just because I like you.”

“Don’t do it for me. Do it for you. I’m your advocate here, and I want you to live a long time.”

So, here I am again, doubting my choices and in turmoil. Now tell me how good that is for healing. I almost want to fill the prescription so I won’t disappoint the doctor, with his big pleading puppy dog eyes. I have an appointment, meanwhile, with the hormone doctor next week, and boy do we have a lot to discuss! I think my bottom line for him is “If this were your wife, would you feel comfortable making these same recommendations?” Waivers and consent forms aside.

heart couple3

But, I have made one decision. I am absolutely madly and deeply in love with my oncologist. I have never met a man with his combination of intelligence, honesty, and compassion. And I have never met a doctor who wears his heart on his sleeve. I’ve decided that we’ll leave our respective spouses and make a new life together once the boobs are complete. They’ll just have to understand that fate has stepped in. Phew! At least I’m sure about something:)

Playing Chicken With Cancer, Part 1

80’S CANCER JAM OF THE DAY:

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

I’ve been reminded of this, my favorite poem, several times over the past few days as I wrestle with the decision of whether or not to take bioidentical hormones. I know, you’re thinking at this point that I’ve finally lost my mind. After all, I just finished treatment in December for a cancer that was 95% positive for both estrogen and progesterone receptors. Do I have a death wish?

Quite the contrary. I have a life wish, a desire for a full, vibrant life. For those who have been down the path of being suddenly and completely thrown into a premature hormonal black hole from the effects of chemotherapy, you can attest to the fact that it takes away something of your essence. You may not be a raving lunatic, but the light in your soul is dimmed.

Of course, some will fare better than others, but it nevertheless leaves you forever changed from the person you were before. Last June, I was a young woman with a regular (albeit overzealous) menstrual cycle; fertility was a stretch, but still within sight. Boom! In July, I was menopausal, my ovaries poisoned and relegated to the role of dusty internal decorations.

Now, if you are diagnosed with cancer in your 60’s, as most women are, hopefully you have been allowed to gracefully cross over the threshold of menopause, and perhaps some of the hormonal side effects of chemo are less pronounced. But at 45, or God forbid 30, like some of my blogging sisters, you are asked to live like a woman 20 or 30 years your senior and just be grateful to be alive at all.

To add insult to injury, the final step in breast cancer treatment is often Tamoxifen, Femara, or one of their ugly step-sisters. These drugs eliminate whatever poor, lonely molecule of estrogen that might remain in your body, trying desperately to hang on. The side effects of these drugs can include: joint pain (post-menopausal arthritis), mood swings, weight gain, cognitive impairment, depression, uterine cancer, osteoporosis, heart problems, etc. If you complain to your doctor, you’re likely to get a pat on the shoulder and a prescription for pain meds and anti-depressants.

I understand the thinking in the medical community that IF estrogen drives breast cancer, the best course of treatment is to eliminate the offending substance, thereby creating a “cure”. What puzzles me is that there are a few chinks in this hypothesis. First, the times in a woman’s life where she has the highest level of hormones, i.e. pregnancy and in her late teens/early 20’s, also happen to be the times with the lowest incidence of breast cancer. You are much more likely to be diagnosed in your 60’s or 70’s, when estrogen levels have been low for some time.

Also, I see all around me women on these blogs who have towed the party line, done the chemo, radiation, and estrogen-blocking drugs, only to see the cancer recur in a more aggressive, or metastatic form. Sometimes it works, sometimes not, which would lead me to believe that cancer is a multi-factorial disease which can’t be watered down to a simple “kill the estrogen” approach.

I wrote about the work of Dr. Jonathan Wright, the doctor for Suzanne Somers, in this post. Dr. Wright is the pioneer of bioidentical hormones in this country, and he has had Suzanne on them since her breast cancer diagnosis over 10 years ago. He believes that estrogen (in it’s natural form and when properly balanced) does not cause breast cancer and may help prevent it.

He uses a formula made of a small fraction of estradiol (the aggressive estrogen), and a large fraction of estriol (a weaker protective estrogen). He believes that the estriol acts as a sort of Tamoxifen, attaching to beta receptors on the cell, which actually discourages cell growth and proliferation. He then balances the formula with progesterone and other hormones as needed.

I’ve read his book, and it makes a lot of sense. But, being me, I feel more comfortable consulting with someone who is knowledgeable and respected in his field, so I had an appointment this week with an integrative MD. Yes, I’ve been down this road before, but the previous guy I saw, while a lovely person, didn’t project the confidence that I need to see in such a serious matter. I don’t mean this to sound arrogant, but most of the time I leave a doctor’s office feeling like I know more than he does about nutrition, supplements, and the relevant research that’s out there. I want to be wowed.

I spent 3 hours at the new doctor’s office on Tuesday. Good start. For the first hour, I sat with the nurse as she took a detailed history and listened to my issues. She then gave the doc a synopsis while I had vitals taken. The next hour was spent with the doctor, going over his thoughts on my case and his recommendations. He told me right off the bat that he is not an oncologist and he wants me to be monitored by my own doctor. He also said that while he is an MD, he would be offering things that no mainstream doctor is willing to do, often at the risk of being attacked by the medical board.

I appreciated his honesty and his willingness to step “out of line” in spite of the repercussions. It was clear that he must have tangled with oncologists before, as he included in my packet a “Dear Medical Oncologist” letter that he had written in response to an angry doctor who challenged his use of hormones in a breast cancer patient.

He wasn’t the kind of warm and fuzzy that I prefer, and I actually put off going to him because I had heard that he is very arrogant. In truth, he is not so much arrogant as confident and efficient. He stared at me intently as he laid out his plans in a no-nonsense fashion. I scanned his eyes for signs of hesitation or self-doubt as he spoke. I saw none. I asked tough questions. He answered them, sometimes in a surprising way.

So what did the doctor suggest as the next move in this high-stakes chess game? Stay tuned tomorrow for the results of my visit and my decision.

Would You Rather Be Shot Or Jump Off A Cliff?

80’S CANCER JAM OF THE DAY:

Go ahead. Take a couple weeks before you give us your decision. It can wait until after the holidays. Now keep in mind that 2 out of 10 women actually survive being shot, while the whole cliff thing is really sketchy…not much good going on there. But…and this is a big but…being shot can lead to all sorts of complications, depending on where you choose to take the bullet. So you may just wish you were dead.

This is something like the conversation I had last week with my oncologist, slightly paraphrased of course. Yes, I’ve finished radiation and been issued my platinum invitation to board the Tamoxifen train. Toot! Toot! He actually turned to me at one point and said “Have you done any research about Tamoxifen?” I just looked at him with wide eyes and replied “Really?”. He quickly realized what a foolish question that was and chuckled softly. “Oh yes, what was I thinking? Go ahead, tell me what you found.”

Of course I had been feverishly burning up the internet for days trying to tease out minute details about survival and recurrence statistics from mountains of muddled data. And let me tell you, they make it next to impossible to find “the bottom line”, which in my book is the absolute survival advantage in those who take this drug. I don’t care about relative risk or any other statistical shenanigans that pass for science. I was finally able to get a 10-year absolute survival difference of 10.9%, meaning that of 100 women, 11 more will be alive in 10 years if they take Tamoxifen than if they don’t.

I told the oncologist about this, and he agreed, saying that the odds might be slightly better for someone my age with my cancer, perhaps 12-15% greater survival. I’m not sure where he gets those numbers, as I was unable to find them. However, I also told him that I had serious concerns about the potential side effects of the drug versus the benefit. Common side effects include: hot flashes and night sweats, mood swings, depression, joint aches, cognitive difficulties (such as forgetting words), weight gain and headaches. Rarer side effects include blood clots, stroke, and uterine cancer.

Now, I don’t know about you, but I am just not dying to get on this train. First of all, I am deeply mistrustful of drug studies. I’ve taken enough research courses to know that data can be manipulated to say just about anything. I also know that the FDA does not require these companies to submit data showing adverse outcomes or data which doesn’t support the benefit of the drug. You only have to look at the long list of drugs which have been approved and later pulled from the market due to serious, often fatal events, or lack of efficacy to realize that you can’t always count on the “peer-reviewed research”.

Those concerns aside, I am feeling healthy for the first time in a year. I ran 8 miles last week. My color is good, and my hair now looks like a cute, short style instead of a chemo-ravaged patchwork quilt. I don’t want to be sad and have achy joints. I don’t want to be fat and wringing wet every morning. It feels very unnatural to take a body that is on the mend and feed it a drug that wreaks such havoc. The doctor said we will deal with whatever side effects come up, meaning he can give me different pills to add to the first pill.

I think the photo below shows a much better idea of what can be done with Tamoxifen bottles and a little creativity. I have to give credit to “The Sarcastic Boob” at http://thesarcasticboob.com/2012/08/16/ten-things-to-do-with-tamoxifen/ for this hilarious post.

tamoxifen boobs

All kidding aside, I truly believe in the ability of the body to heal if given the chance. I’m not against medical intervention when necessary, but I don’t think it’s natural to have zero estrogen, which will be the effect of the Tamoxifen. I understand that my tumor was fed by estrogen, but I’m not sure if it was that simple. Cancer is a very complicated, multifactorial disease. My fear is that the cancer will outsmart all of these outside interventions and come back more ruthless than ever. I expressed this to the oncologist, and he had to agree that if we use Tamoxifen and the cancer metastasizes anyway, it will likely be very aggressive and difficult to treat.

So…here I am again, at the edge of the cliff with a 9 millimeter in one hand. I think I may just lay the gun down and back away slowly. You’ll be the first to know.