Hi everyone long time no see! I hope you are enjoying the sunnier and longer days at last.
I recently attended a seminar on Integrative Strategies for supporting patients with Breast Cancer (BrCa) by Dr Lise Alschuler an expert from the USA . It was fascinating and I wanted to share a little of what I learned with you. It will be in two parts so keep a look out for part 2 next week.
I hope it will create a dialogue between mothers, daughters, grandmothers and even fathers, brothers and uncles. I also hope you can use or pass on some information to friends. All the recommendations in this article are general and for specific health advice please call to make an appointment with me.
Breast Cancer is the most common cancer in Australian women (excluding non melanoma skin cancer) and in 2010 there were 15,000 new cases diagnosed. Right now there are over 160,000 women alive who have been diagnosed with breast cancer in the last 30 years.
First of all, most of you will know that mammograms are free after the age of 40 and I would urge all the over 40 ladies to have one every year alongside regular breast exams. There are 3 main types of breast cancers. Estrogen receptor rich (60% post menopausal women diagnosed have this and it has the best prognosis), Her2-neu found in approximately 12% of premenopausal women diagnosed, and triple negative or basal subgroup found in 39% of premenopausal women diagnosed with breast cancer.
Did you know that prognosis is not just dependant on how big the tumour is but also more importantly whether there are lymph nodes involved? The other thing researchers have found which influences prognosis are Vitamin D levels. Low Vitamin D levels have been linked with larger tumour size, while high vitamin D levels correlate with a higher survival rate with less chance of relapse and risk of metastasis (cancer spread to other organs). A Meta-analysis (a study of lots of different clinical trials) found a 38% reduction in mortality in those with the highest levels of Vitamin D compared to lowest levels at the time of diagnosis.
Factors which may increase your risk
Stress has a huge effect on decreasing immunity and on breast cancer progression which can be measured by the stress hormone cortisol in the blood. Mammary fat has a heightened sensitivity to stress hormones. In addition, low Thyroid function is associated with decreased cell repair and increased breast cancer risk. If you have a thyroid condition (which I see more and more of in clinic) make sure it is being properly managed by your doctor/endocrinologist and you have regular blood tests.
Systemic Inflammation is also associated with an increased risk of breast cancer. Regular blood tests can tell you whether you are inflamed by looking at increased CRP, ESR, Homocysteine, Ferritin, Interleukin 6 & 8 or fibrinogen levels most of which are part of a full blood count or you can request from your Naturopath. Conditions like arthritis, obesity and gout are a good indication there is some level of inflammation.
High insulin levels in the blood can also contribute to your risk of BrCa particularly something called Insulin like growth factor (IGF-1) which is produced mainly in fat cells and promotes the growth of cancer cells. BRCA-1 gene mutation carriers (BRCA gene is found in 10% of cases and is associated with a 40-85% lifetime risk) have a higher incidence of IGF-1 receptors, are more sensitive to the effects of IGF-1 and therefore insulin. So anything to reduce insulin levels can be helpful eg: Physical activity, weight loss, blood sugar lowering strategies (diet, supplements, herbs) and insulin lowering medication (diabetes medication like metformin).
Conventional treatment can involve surgery, chemotherapy, radiation, & hormonal therapy. Early stage treatment usually involves a lumpectomy and radiation followed by tamoxifen or an aromatase inhibitor in post menopausal women. It can become more invasive in premenopausal women and can involve chemotherapy prior to radiotherapy and hormone treatment. The rationale for chemotherapy in those younger than 50 is a 30% reduction in the annual risk of death and a 10% absolute improvement in a 15 year survival (42% of women survive with chemo compared to 32% without chemo). In women over 50 there is a 12% reduction in the risk of death per year and a 3% absolute improvement in the 15 year survival rate (50% vs 47%).
Over half of all women diagnosed with BrCa receive radiation therapy typically provided over 6 weeks post surgery, side effects often include dermatitis, fatigue and lymphedema. To prevent radiation induced dermatitis on the breast area, topical Calendula or Manuka honey dressings have proved effective along with oral Turmeric and Vitamin E 400 IU daily for 6 months after radiation. L-Carnitine an amino acid has been found to reduce radiation induced fatigue. Selenium has also been found to be effective at reducing lymphedema which can lead to swelling in the arms common after radiation therapy.
Risk Factors for developing Breast Cancer
|• BRCA gene mutation|
|• Early menarche (first period)|
|• Higher Body Mass Index (menopausal women)|
|• Oral Contraceptive Pill and HRT|
|• Alcohol use|
|• Diet: Obesity, High starch intake, Low fiber, Low vegetables|
|• Pesticide exposure, PCB, DDT, dioxins, benzenes|
|• Cigarette smoke|
|• Melanocyte nevi: Premenopausal women with 15+”nevi” (a type of mole) greater than 3mm on one arm are 35% more likely to be diagnosed with breast cancer than women who have no nevi – This is not a causal relationship, but likely reflects a shared origin.|
Next week we will be discussing Natural Support for Breast Cancer including what diet you should be following so keep a look out for Part 2!
Naturopath & Director
Green Door Health