Hormones & Cancer

We have long preached that one is not what one eats, but one is what one fails to detoxify. Toxins that can’t pass out of the body, for whatever reason, are stored in the fat cells. Breast tissue is particularly vulnerable to environmental toxins since breasts are made up of fat cells. Breast tissue is also influenced by hormonal activity, with a large body of research linking environmental pollutants to unhealthy hormonal signaling throughout the body. Many environmental toxins are not water-soluble making breast tissue even more susceptible.

In particular, many pesticides and heavy metals tend to gravitate toward fatty tissues. Numerous studies have found high levels of such toxins in breast tissue and breast milk. Many of these compounds, known as “POPs” (Persistent Organic Pollutants), remain in the environment for a long time and continue to bio accumulate up the food chain. There’s another group of chemicals that pose an issue for breast health and other hormone related areas, such as prostate, ovarian and uterine health.

Known as endocrine disruptors, environmental estrogens or xenoestrogens, these chemicals mimic estrogen and other hormones and trick the body into using them. Common examples include Bisphenol A (BPA) and phthalates found in certain plastics and food packaging. Xenoestrogens can trigger excessive stimulation of hormone-sensitive tissues, with widespread impacts on human and environmental health. Foods and supplements that help remove pollutants from the body provide a multitude of long-term benefits, not just for breast health but overall longevity. Sulphur-containing foods, such as: broccoli, kale, cabbage, cauliflower, onions, and garlic all contain compounds that aid in detoxification.

For comprehensive breast health support, we recommend several products below that givea unique integrative formula designed to promote optimal hormone health:

Aromatase Inhibitors

Both conventional wisdom and clinical trials have supported blocking aromatase for breast cancer (or any hormone positive cancer) patients but when Oncologists speak of an aromatase inhibitor they mean a drug.

hormones-and-cancer-what-to-avoid-conners-clinic

Aromatase inhibitors work by blocking the enzyme aromatase, which turns the both hormones stored in fat cells into “bad estrogens” and androgens into estrogens thereby increasing the risk of cancer promotion. The idea is to reduce estrogens, especially in hormone-receptor-positive cancer patients.

There are three main aromatase inhibitor drugs:

  • Arimidex (chemical name: anastrozole)
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)

Aromatase inhibitors don’t stop the ovaries from making estrogen, so clinically, they are mainly used to treat postmenopausal women. Tamoxifen, though not technically an aromatase inhibitor because its action is to shutdown estrogen production, is generally given to premenopausal women. Both classes of drugs do a good job in removing estrogen, but the cost is high.

Taking tamoxifen may increase your risk of uterine cancer, stroke, or a blood clot in the lung, which can be fatal.

The manufacturer warns to “tell your doctor” if you have:

  • A history of stroke or blood clot;
  • Liver disease;
  • High cholesterol or triglycerides (a type of fat in the blood);
  • A history of cataracts; or
  • If you are receiving chemotherapy or radiation.

It is not known whether tamoxifen passes into breast milk or if it could harm a nursing baby. This medicine may slow breast milk production. You should not breast-feed while taking tamoxifen.

In my experience, most women do NOT like the estrogen-draining effects of tamoxifen!

Aromatase inhibitor drugs tend to cause fewer serious side effects than tamoxifen, such as blood clots, stroke, and endometrial cancer. But aromatase inhibitors can cause more heart problems, more bone loss (osteoporosis), and more broken bones than tamoxifen, at least for the first few years of treatment.

Though it is standard practice to prescribe estrogen-blocking medications in ER+, PR+, and HER2+ cancer patients for at least 5 years post-diagnosis, a recent study revealed continued use may be beneficial: Women who had already completed 5 years of letrozole received either letrozole or placebo for 5 additional years. Five-year disease-free survival was slightly higher with letrozole than with placebo (95% vs. 91%), but overall 5-year survival was similar in the two groups. Because aromatase inhibitors do have adverse effects, discussions on whether to proceed with an additional 5 years of treatment (total, 10 years) should be informed by this trial (NEJM JW Gen Med Aug 1 2016 and N Engl J Med 2016; 375:209).

Is there a Natural Alternative?

When we attempt to support cancer patients naturally we typically aren’t trying to block estrogen production like the drugs do; we would rather support healthy, normal elimination of estrogens through proper metabolism. However, some women may over-express estrogen in a state of ‘hyper-aromatization’ and do well on nutrients such as Chrysin, Quercetin, Naringenin, Resveratrol, Apigenin, Genistein, Grape Seed Extract, and Oleuropein, all ‘natural slowers’ of aromatase.

Generally our desire is to support healthy metabolism by supporting the cytochrome P-450 pathways (also look at these genes). Compounds found in vegetables such as cabbage, Brussels sprouts, and broccoli, from the Brassica plant family are essential for this. I3C and DIM, are found in these foods. Glutathione S transferase is also upregulated by the sulfur constituents in cruciferous vegetables so make sure you look at and support genetic defects in the Transsulfuration genetic pathway.

Other nutrients that support healthy estrogen balance may include Norway spruce lignan extract AND Hops extract. Plant lignans are phytonutrients commonly found in small amounts in unrefined whole grains, seeds, nuts, vegetables, berries, and beverages, such as tea (green tea) and coffee. The friendly bacteria in our intestines convert plant lignans into the “human” lignans called enterodiol and enterolactone. Aromatic-PN is a concentrated, naturally occurring plant lignan called 7-hydroxymatairesinol, which is derived from the Norway spruce (Picea abies). In humans, 7-hydroxymatairesinol is a direct metabolic precursor of enterolactone.

Enterolactone is a phytoestrogen that binds to estrogen receptors and has both weak estrogenic and weak antiestrogenic effects. The latter accounts for much of its cell-protective capacity. Additionally, in vitro work has demonstrated that enterolactone affects aromatase and the biosynthesis of estrogen and has strong free radical scavenging and antioxidant properties.

The protective effect of lignans and enterolactone on tissues, including those of the prostate and breast, is encouraging. At the same time, the estrogenicity of HMR and enterolactone, although milder than estradiol, offers promising applications for women with menopausal concerns. For instance, in a randomized, single-blind, parallel group pilot study, 20 menopausal women taking 50 mg/d of hydroxymatairesinol for eight weeks experienced half as many hot flushes as compared to pretreatment. Furthermore, high serum enterolactone has repeatedly been associated with cardiovascular health.

Fermented soy may also be a great addition to help balance estrogens. Note: fermented soy acts opposite that of unfermented soy!

Summary:

Aromatase Inhibiting Medications

  • Block the conversion of other hormones to estrogens
  • Are widely prescribed in hormone positive cancer patients, especially those that are post-menopausal
  • Carry the risk for numerous dangerous side-effects

Tamoxifen Medications

  • Block the production of all estrogens
  • Are widely prescribed to pre-menopausal breast cancer patients
  • Carry the risk of numerous dangerous side-effects and unwanted changes and symptoms

 

Natural Alternatives that we use may include:

 Cruciferous vegetables such as broccoli, cauliflower Brussel sprouts and cabbage

DIM

Quercetin

Turmeric (Curcumin)

Astragalus 

Scutellaria barbata, adds to the effectiveness of DIM

Fermented Soy

More information may be found on the blog, Aromatase Inhibitors.

 

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