Causes
Of Breast CancerThe usual answer doctors like to give to the question
"what causes breast cancer" is "we do not know what causes breast
cancer". But as I will explain further below, we do know now that unopposed
estradiol and xenoestrogens are the major cause for breast cancer, often in combination
with several breast cancer risk factors. For instance, it is known that the length
of ovarian estrogen activity between the first period (menarche) and the last
period (menopause) of a woman is directly related to breast cancer risk. The incidence
curve of breast cancer is highest just prior to menopause and flattens out after.
Another observation, which supports this, is the fact that removal of both ovaries
(oophorectomy) at a younger age reduces the risk for breast cancer later in life.
Ref. 8 explains that the reason for the peak about 5 years before menopause is
the dropping off of progesterone production (missing ovulations, corpus luteus
insufficiency). The longer a woman is under the influence of estrogen dominance
(unopposed by progesterone), the higher the risk for cancer initiation, promotion
and progression of breast cancer cells. Dr. Lee says that the "smoking gun"
is estradiol (one of the three estrogen molecules in humans). Here is a list and
some brief remarks about the risk factors for breast cancer. The
birth control pill (=oral contraceptives or BCP), which was originally
feared to possibly produce breast cancer, does not pose an increased
risk during the reproductive years as the ovarian function gets suppressed by
it making the BCP breast cancer risk neutral or even 20% less frequent. Other
authors point out that when taken more than 5 years there is a risk of 1.6 to
1.8-fold of causing breast cancer (likely because of estrogen dominance).However,
in the menopause postmenopausal estrogen replacement (HRT) carries
with it an estrogen side effect consisting of a 1.5 to 2-fold accumulative risk
for breast cancer over a 10 to 20 year time span. In the past it was thought that
a reduced rate of osteoporosis and reduction in heart attacks would increase life
expectancy overall with hormone replacement therapy following menopause. However,
this has been proven wrong in large trials that came out in 2004 and now the issue
of hormone replacement therapy (HRT) is in flux. Currently the thinking is that
one has to individualize therapy, use good nutrition and exercise to prevent osteoporosis
and in the case of control of hot flashes use the lowest possible estrogen hormone
replacement for less than a total of 5 years. However, discuss this with your
family doctor and/or gynecologist. Dr. Lee et al (Ref. 8) explains the effect
of the birth control pill (BCP) and HRT side-effects this way. Both of these synthetic
hormone-like mixtures of estrogenic and progesterone-like substances from the
drug companies block estrogen receptors in the woman's body. This leads to a lack
of ovulation in the case of the BCP with associated suppression of progesterone
production. The end result is an estrogen dominance as there is still enough estrogen
that is produced, but it is unopposed by progesterone that would have modified
the effect of estrogen (see table on "Important Properties of Bioidentical
Estrogen and Progesterone in Women and Men") under this
link. HRT on the other hand is using high doses of a number of estrogens
(Premarin) and when this is combined with progestins (as synthetic progesterone
like drugs are called) there is not the balancing effect of natural progesterone.
Again the "smoking gun" is pointing at estrogens as the cause of breast
cancer as these estrogens were unopposed (HRT had induced a state of estrogen
dominance). There is a peculiar linear relationship between total
fat intake per day and the death rate from breast
cancer. Epidemiological studies show that the daily fat intake in the Netherlands
is about 160 grams/day. In El Salvador it is only 40 grams/day. The adjusted death
rate from breast cancer in the Netherlands is 25-fold higher than in El Salvador.
Although we do not have all the answers why breast cancer deaths (and by the way
many other cancer rates as well) are lower with less fat intake, it is self explanatory
that a diet with less than 40 grams of fat per day is highly recommendable to
prevent breast cancer and also heart attacks. Dr. Lee et al. (Ref. 8) explains
that there are free radicals contained in bad fats (the trans-fats and in polyunsaturated
fatty acids such as in corn oil that turn rancid easily). Butter and olive oil
are more stable and will not cause these problems except that they need to be
limited in the total daily dose as indicated. When too many calories are consumed
the body will store the excess calories as fat in the body. This fat does not
sit there in isolation. It is metabolized, leads to hardening of arteries, and
causes insulin to get elevated (the syndrome of hyperinsulinism or metabolic syndrome).
As insulin has growth hormone-like attributes, any breast cancer cell will get
stimulated in growth and metastasize earlier than in a lean woman with normal
fasting insulin levels. Secondly, obese women convert androgenic hormones in fatty
tissue, particularly in the ductal cells of breast glands that border to the surrounding
fat tissue, into estradiol, which as you guessed right is the "smoking gun"
for breast cancer. Again, there is an estrogen dominant state with a lack of progesterone
production, which would have balanced the cell division effects of estrogen.
There are also genetic risks for some families
with a higher breast cancer incidence. In such families the risk is 1.5 to 3 times
higher than for the average population. This is due to an inherited mutation in
a BRCA1 or BRCA2 breast cancersusceptibility gene, which can now be determined
with special blood tests. As the lifetime incidence of breast cancer in mutation
carriers is above 50 percent, these women have to be screened much more vigorously
as the rest of the female population. These women come from families where close
female relatives had early onset breast cancers (at an age of the late twenties/early
to mid thirties). Pregnancy has always be known to have a
breast cancer diminishing effect. During pregnancy the progesterone level gets
raised as the placenta stimulates the corpus luteum to produce more progesterone.
This protects the pregnancy, but has a long-lasting effect of protecting the woman
from breast cancer. The earlier a woman gets pregnant and the more pregnancies
she has, the more breast cancer protection she gets. On the other hand the removal
of the ovaries (bilateral ovariectomy), which leads to a sudden lack of
estrogens, progesterone and testosterone, causes a reduction in breast cancer
also. However, the latter condition causes heart disease and osteoporosis and
physicians have long treated this with HRT. Unfortunately, many physicians treated
with estrogens only as this will take care of the hot flashes, but due to estrogen
dominance will also cause breast cancer. The proper biological hormone replacement
is to determine hormone levels and replace what is missing (with bioidentical
estrogen, progesterone and testosterone creams from a compounding pharmacist).
Radiation causes free radicals in the breast tissue that
can lead to mutations of the DNA with a simple lung X-ray and within the course
of 10 years this can cause a palpable breast cancer. Fortunately the body's immune
system gets rid of most of these mutations. Girls who here exposed to the ionizing
radiation during the bombing of Hiroshima during World War II had a two-fold risk
of developing breast cancer. Unfortunately, there is a risk of breast cancer as
a result of yearly mammograms, which are done with the best of intentions of early
detection of breast cancer. On page 11 to 14 of Ref. 8 Dr. Lee explains that mammography
will detect breast cancer about 1 year earlier than a woman can through breast
self examination. However, as breast cancer has a relatively good prognosis with
early detection he cites literature from Sweden that showed that most studies
were flawed with selection bias and that the two studies that were well designed
showed no effect of mammography screening on breast cancer mortality. In view
of newer technologies without the use of radiation, I would suggest that the occasional
MRI mammography study likely will show survival benefits when combined with self
breast examination, early surgical intervention and other life style changes.
Dietary factors: There is a host of food related factors
that translate into risks of breast cancer. Trans-fatty acids, also known as hydrogenated
oils or partially hydrogenated oils on food labels are a source of free radicals
that lead to breast cancer. Dr. Peter Ellison of Harvard University has noted
that higher calorie intake and lower exercise levels are risk factors for the
development of breast cancer (mentioned on page 43 of Ref.8). But intake of milk
produced in the US also is a risk factor for breast cancer due to the common practice
of giving cows the milk stimulant recombinant bovine growth hormone. Humans who
consume this type of contaminated milk produce the growth factor IGF-1 in their
livers, which is a known cause of breast cancer. If you want to drink milk, insist
on certified hormone free milk or organically certified milk. Goat milk does not
have this problem. Alcohol: Only about 4% of breast
cancer is caused by alcohol intake, but only if a woman drinks more than 1 alcoholic
drink per day. With more drinks there is competition in the liver between elimination
of alcohol and estrogen metabolites. As a result alcoholic women will develop
estrogen dominance (also because progesterone production decreases). Unopposed
estrogen (estradiol) causes breast cancer. Ref. 9 reports that the Nurses' Health
Study found that women consuming between 3-9 drinks per week were 30% more at
risk of developing breast cancer than women who were non-drinkers. Effect
of exercise: Dr. Lee (Ref. 8, p. 45) mentions that the Harvard
Nurses' Health Study compared a large cohort of nurses who exercised moderately
(seven or more hours per week) with those who exercised less than 1 hour per week.
The end result was a 20% less risk for developing breast cancer in the group who
exercised moderately. It was more important how frequent the exercise was rather
than how strenuous it was. Ref. 9 cites a National Cancer Institue study where
risk reduction for breast cancer was studied in young women. It showed that exercise
from 1 to 3 hours per week lowered the risk of breast cancer by 30%. However,
exercising 4 hours per week or more reduced the risk for breast cancer by 50%!
Pollution of the environment: Unfortunately not everybody
can live in the country where the air is cleaner and we are not exposed to as
many industrial chemicals. Many of these industrial pollutants of the city act
like artificial estrogens (xenoestrogens). However, exposure to other xenoestrogens
from nail polish, nail polish removers, pesticides in the house or garden, herbicides
or plastic that leaches into soft drinks of plastic bottles, will all also lead
to estrogen dominance and thus poses a breast cancer risk. Whenever possible,
drink fluids from glass bottles. Organochlorines (pesticides, insecticides) such
as DDT accumulate in breast tissue and function as xenoestrogens causing breast
cancer. The good news is that natural progesterone cream has been shown by Dr.
Lee to counter some of the cancer causing xenoestrogen effects (Ref.8). Smoking:
Cigarette smoking leads to an accumulation of toxic heavy metals and carcinogenic
substances in breast tissue. Overall the effect is that women who smoke developed
breast cancer about 8 years earlier than controls that were not smoking (Ref.9).
Lumpy and painful breasts: When a woman has painful
or lumpy breasts, it is more difficult for the woman or the physician to examine
the breasts in order to detect early breast cancer. It can also be more difficult
to get reliable mammography readings; with the introduction of MRI breast scans
these patients have now another tool available that is reliable. However, it is
important to note Dr. Lee's finding (Ref. 8, page 39 and 40) that these types
of patients have estrogen dominance due to a lack of progesterone leading to persistent
cysts and the gradual development of lumpy breasts. After transdermal application
of natural progesterone cream the lumpy breasts will normalize within 3 to 6 months.
A woman with estrogen dominance is significantly at risk to develop breast cancer
at a later date, but following hormone balancing with progesterone this risk disappears.
Other Factors Leading to Breast Cancer: Some other
hormones can be contributing factors in the causation of breast cancer as follows.
DHEA (dehydroepiandrosterone) is a steroid hormone that is
made by the adrenal glands. It is a precursor of estrogen and testosterone. We
need DHEA production to have normal sex hormones and to have a normally functioning
immune system. Men produce more of it than women and the peak production of it
is at age 20 to 25. After the age of 25 we produce 2% less every year and this
likely is the reason for immune weaknesses and autoimmune diseases as we age.
Dr. Lee (Ref.8) says that DHEA levels are a biomarker of aging as much as gray
hair or the need for bifocals is. Another hormone is insulin,
which is often elevated in the metabolic syndrome or insulin resistance,
as it used to be called. Fasting insulin levels when elevated will confirm this
syndrome. With the obesity wave in the US this syndrome has been well studied.
When people eat too much sugar and starch the pancreas gets over stimulated to
produce insulin. On the one hand the excess insulin functions as a growth factor
and early breast cancer cells will respond to this by multiplying faster. On the
other hand under the influence of high insulin the pituitary gland produces relatively
more LH (luteinizing hormone) in relation n to FSH (follicle stimulating hormone).
This in turn changes how ovaries function in that with the relative low FSH a
dominant follicle never develops for ovulation, but instead many follicles develop
in the ovaries that finally lead to polycystic ovary syndrome. With persistent
follicles there is a lack of progesterone production as there is no corpus luteum
(no ovulation). The more anovulatory cycles there are, the more estrogen dominant
the woman becomes (can be measured in blood or saliva tests) and this is a risk
for developing breast cancer. Metformin can be prescribed by your doctor to reduce
hyperinsulinism. Exercise and a sensible low fat, low refined (but high unprocessed)
carbohydrate diet will turn this condition around and help you to shed pounds
with ease. Other risk factors for breast cancer can be hypothyroidism
with high thyroid stimulating hormone (TSH) levels, which is known to be carcinogenic.
Dr. Lee mentions that fluoride in tooth paste or fluoridated water replaces
iodine in the body, which can lead to thyroid dysfunction and autoimmune thyroiditis
(Hashimoto thyroiditis). This will often lead to hypothyroidisms (with high TSH)
in the long run. Another important hormone is melatonin,
which helps us to fall asleep naturally when it is getting dark. It is produced
by the pineal gland at the base of the brain. It is a powerful antioxidant and
supports the immune system. When experiments were done with human breast cancer
cells in tissue culture, added melatonin was able to suppress breast cancer cell
growth by 75%. Clinical studies in women with breast cancer showed that they had
much less nighttime melatonin levels in urine than a control group of women with
no breast cancer ((Ref.8, p. 87 and 88). As melatonin is similar to DHEA in that
we produce it at much lower levels when we age, it is wise to take supplemental
melatonin of 1 mg at bedtime. It is freely available in drug stores in the US
(in Europe it is more difficult to get). Prolactin is another
hormone that can be a contributory factor to breast cancer development. It is
known that estradiol will stimulate prolactin production of the pituitary gland,
but not estriol. This can lead to milk production (discharge of milk from the
nipples), an annoying symptom to the woman affected by it. Natural progesterone
cream gets absorbed systemically and will reduce Prolactin levels and the symptoms
stop. According to Dr. Lee progesterone is inhibiting the actions of estrogen
and prolactin by down-regulating the receptors for these hormones (Ref. 8, p.90).
Summary about causes and prevention of breast cancer: Breast
cancer is caused by genetic damage to the DNA of breast cells by unopposed estradiol
due to poor diet habits, life style choices and environmental factors. Only the
minority of all breast cancers are due to inherited factors (BRCA1 gene etc.).
Eat organic meat to avoid growth factors from the food industry, lots of vegetables
and fresh fruit for protective nutrients and enzymes. Avoid sugar, alcohol (except
for the occasional glass of wine), cut down (or out) flour and pasta and engage
in regular exercise to complete your simple breast cancer prevention program.
Read Ref. 8 for more suggestions, if you want to be more aggressive about prevention.
Bio-identical hormone supplementation based on saliva hormone testing as described
undder Ref. 8 is also very effective on top of these other recommendations (melatonin,
DHEA, bio-identical progesterone cream).
|
