Breast Cancer

BREAST CANCER OVERVIEW

Cancer occurs when cells multiply (proliferate) faster than normal, lose their ability to differentiate (remain immature), and have diminished apoptosis (cell death) rates. When cells grow too fast it causes mutation ie cancer.

HOW CANCER STARTS

The first stage of cancer is known as initiation. This is when the initial damage, or modification of the genetic material of a normal cell, occurs. This damage is caused by a carcinogen, which could be a hormone, a chemical, a virus, radiation, trauma or a combination of these factors. Scientists now believe that it usually takes more than one "insult" by carcinogens to DNA before a normal cell is transformed into a cancerous cell.

For example, as a teenager you might have been exposed to pesticides or birth control pills during the time when your breasts were developing. In your early twenties you might paint the inside of your house without adequate ventilation and be exposed to xenoestgrogens in the form of solvents. Xeno-oestrogens are substances which contain oestrogenic properties which do not occur in nature. These include: pesticides, fertilisers, petro-chemicals, food colourings and preservatives. Given our more industrialised world we eat drink and breathe these toxic substances daily. Throughout your life you get chest x-rays that expose your breast cells to radiation. In your thirties you fall and hit your breast hard. In your forties you get a mammogram, both squashing the tissue and exposing it to radiation, and then you follow it up every few years with another one. In your fifties you are given an excessive does of estrogen along with synthetic progestins in synthetic HRT.

This is quite an accumulation of insults, but it's very typical of most women, and most could add a dozen or more incidents to this list.

The final insult to the breast cell that transforms it into a full-blown cancer cell probably occurs at least 10 to 20 years (depending upon the individual) before the tumour can be recognised by palpation or by mammography.

Meanwhile, the body has many protective factors in place for stopping DNA damage before it begins, including sophisticated detoxification and excretion mechanisms, specialised cells that remove dead and damaged cells from the breasts; antioxidants and other nutrients that help the cell protect and repair DNA; and hormones such as Progesterone, which encourages cells to differentiate and to die when they're supposed to.

Cancer arises when the DNA in a cell is permanently damaged and this escapes the body's normal detection systems. The damage is passed on from one generation of cells to the next, resulting in an accumulation of DNA damaged cells without proper controls needed to keep them normal.

THE GROWTH PROCESS

The second stage of cancer, called promotion, involves the expansion of the tumour cell population to the point where it begins to interfere with the normal workings of the body. This state occurs over an extended period of time, as long as 10 to 20 years, and varies depending on many factors. For example, tumour growth rate will depend on whether there's a good blood supply around it for delivering nutrients to its cells, and on growth factors such as oestrogens, the hormone prolactin, and the substances called insulin-like growth factors that trigger breast cell division. Tumour growth will also depend on substances that inhibit growth such as Progesterone, Thyroid hormone Melatonin, DHEA and phytochemicals from fruits and vegetables.

Assuming 100 days is the doubling rate for the average breast cancer cell, there would only be about 4 to 5 tumour cells the first year, 30 to 50 tumour cells in the second year, and so on. Finding a tumour this small would be more challenging than finding a needle in a haystack. Not until the seventh year would there be about a million tumour cells. This may seem like a lot of tumour cells, but if you packaged them into a perfect ball it would measure only about a millimetre across - not much bigger than an average pencil dot. Tumours these sizes are not detectable by mammography. Only after the tumour grows for another three to four more years, or for a total of 10 to 12 years, and contains 1 billion to 10 billion cells is it large enough (about 1 centimetre in diameter; 1 inch equals just about 2.5centimetres) to be detected by mammography. (Mammography is the most reliable form of early detection of breast cancer at present. Another form of monitoring is Thermography, it is less invasive than Mammography but is not as recognised by conventional medicine.)

Of course tumour growth patterns are never this simple. The in situ tumours, or those tumours whose growth is confined to the breast ducts from which they originated, tend to grow more as spheres or tubes because their growth is confined to the inside of the ducts. Invasive tumours, in contrast, don't generally grow as perfect spheres but radiate out in a claw like pattern - hence the term crab, or cancer - as they invade normal tissue and seek nutrients for growth. This type of spread can make them even more difficult to detect within the confines of the normal breast tissue.

If we are to minimise the scourge of breast cancer, we must learn to identify and limit the causative or cancer-promoting factors and maximise the protective or cancer-preventive factors.

Like all cancer, breast cancer cells are not foreign invaders like bacteria, viruses, and allergens, but, as british researcher A.b. Astrow aptly put it, "essentially normal cells in which proportionately small changes in their genes lead to large changes in behaviour".

One of the most important new findings in what causes breast cancer has to do with apoptosis, or programmed cell death. Appoptosis (ah-po-TOW-sis) literally means "falling away" - like leaves from a tree in autumn. It's often explained as "programmed cell suicide". It is now well understood by cancer specialists that delayed apoptosis of older cells increases their risk of becoming cancer cells.

THE DEADLY STAGE OF CANCER

The third stage of cancer, known as the progressive stage, is the final stage of the disease. In this stage a distinct tumour grows in size; invades surrounding tissues, blood vessels, and lymphatics; and migrates to (metastasises) and grows in other tissues of the body.

Once a cancer has invaded other parts of the body, stopping its growth becomes much more complicated, but it can be done. The good news is that breast cancer is a disease of long duration, and we have daily opportunities over a lifetime to make decisions that will encourage the body to get rid of a cancer. The interval between the initial transformation of a normal cell to a cancer cell and the full blown clinical detection of a tumour the size of a pea, containing as many as a billion cells, may take decades.

The incidence of breast cancer is increasing rapidly. Fifty years ago the risk of breast cancer was 1 in 50, now it is nearer to 1 in 8. These cancers are almost always oestrogen responsive and are rich in oestrogen receptors which cause proliferation (rapid cell growth) of breast tissue when exposed to oestrogen receptors which cause proliferation of breast tissue when exposed to oestrogen.

GETTING DOWN TO GENE LEVEL

This next section is a bit dense with information and technical terms, but if you have breast cancer and want to research it further, you'll run across these words and concepts. We feel it's important that you have a reference point for understanding them.

If genes are damaged - for example, by radiation, toxins, or viruses - normal cells can develop into cancer cells. Certain genes called proto-oncogenes are normal to cells but may mutate into oncogenes (cancer genes), which create products that allow excessive proliferation (cell growth) or delayed apoptosis (cell death), resulting in the change of the cell into a cancer cell. Other genes, known to be tumour suppressor genes, inhibit cell division or stimulate apoptosis, thus preventing cancer. A person's risk of cancer depends in large part on the relative activity of oncogenes versus tumour suppressor genes. Several groups of molecular biologists have been investigating the actions of two genes in these categories names bcl-2 and p53.

bcl-2 a proto-oncogene, and by now it's well known that it plays a pivotal role in the progression of cancer. bcl-2 production inhibits apoptosis and thereby promotes breast, ovary, endometrial and prostate cancer, as well as follicular b cell lymphoma.

Gene p53 is a tumour suppressor gene. Up-regulation of p53 will inhibit bcl-2 action; halts cell proliferation and induces apoptosis, thus helping prevent cancer.

In cancer cell cultures, researchers b. Formby and TS Wiley found that when the human oestrogen oestradiol (in concentrations similar to what the human body makes) is added to the culture, bcl-2 is activated and cancer growth promoted. but the addition of Progesterone (again in concentrations consistent with normal bodily levels) down regulates bcl-2 and up-regulates p53, thereby stopping cancer growth. This may sound simple, but it's actually a very profound and important piece of the cancer puzzle, because it involves a major anti-cancer substance, Progesterone, that's made naturally in the human body. Their work has now been duplicated in a number of laboratories worldwide.

Thus, we now know at least one gene-related mechanism of action that connects oestrogen to cancer promotion. Corroboration of these findings comes from research showing that one of the pathways some oestrogens take as they are processed by the body leads to a by-product called oestrogen-3,4quinone, which causes gene mutation and cancer. Evidence against the genetic theory and /or favouring the epigenetic (meaning "the action of the environment") theory includes the following:

• Under the same risk exposure, only some people develop cancer
• Under similar exposure to known carcinogens, different individuals develop cancer at different tissue sites.
• In humans and other animals exposed to known carcinogens, cancer can be prevented by agents such as beta-carotene, Vitamin C and CoQ10 all of which aid in the repair and maintenance of cells.
• In cell culture tests, cancer induced by known carcinogens can be reversed and eliminated by improving the nutrient quality of the cell culture.
• In humans with advanced cancer, survival time can often been increased by high dose vitamin C.
• Changes in patient attitude seem to extend survival time. We now know without a doubt that a negative state of mind can adversely affect the body down to the cellular level.
• In humans, spontaneous remissions and apparent cures can result from dietary changes or a combination of positive attitude and diet.

DIETARY RECOMMENDATIONS

Lots of fresh, organic vegetables, especially cruciferous vegetables: broccoli, brussel Sprouts, Cauliflower, and Cabbage. The most wonderful way to enjoy vegetables and to experience the benefits of good health is to get into daily juicing. It's a fiddly process, time consuming and it does cost money. However the rewards are well worth the hassles and the expense. Your body will love you for it. Consuming 500 mls of juice twice daily made fresh,30 minutes prior to breakfast and prior to dinner is an ideal amount. (Raw Juices can Save Your Life - Sandra Cabot)

• Organic meat wherever possible, Chicken would be first choice. This like fresh fish is good protein. First choice animal protein is anything that flies or swims.
• Fresh fish (preferably steamed or grilled)
• Whole fruits preferably organic limited to 3 pieces daily to reduce fructose intake.
• Drink at least 2 litres of filtered (non-chlorinated and non fluoridated) water every day (preferably room temperature). There are special filters available that remove fluoride.

HORMONES AND bREAST CANCER

Understanding the roles and functions of some sex hormones relationship to breast cancer will enable you to make a more informed choice of treatment option and plan for prevention and treatment of break cancer

THE MENSTRUAL CYCLE

• Oestrogen is dominant in the first 2 weeks of the menstrual cycle (Proliferative phase) and stimulates growth of breast and endometrial (lining of the womb) tissue.
• Progesterone should be dominant the second 2 weeks (luteal phase) and stimulates development and slows growth of breast and endometrial tissue.
• Unopposed oestrogen with out progesterone to mediate its aggressive growth can lead to cancer

OESTROGENS

The following is a brief outline of the Oestrogens we are exposed to through out life. Oestrogen arises in many forms and strengths, in nature and through the pollutants in our world. The following is a list of oestrogen starting with the most potent forms that are linked with cancers then cascading down to the weakest more protective oestrogens.

• xeno oestrogens,
• intrinsic (made in our bodies) oestrogens made in the human body,
• Oestrone E1
• Oestradiol E2
• Oestriol E3
• Phyto-oestrogens

Xeno oestrogens

Unlike any time before in history, we are exposed today to huge amounts of "Xenoestrogens"----foreign oestrogens originating outside the body. Pesticides and chemical compounds found in, petrochemicals (car fumes), plastic, detergents, personal care products (parabens), canned foods, and even contraceptive creams contain these xenoestrogsens. Dioxin is an example of one such chemical found throughout our environment and in alarming levels in our food supply. These chemicals behave like aggressive oestrogen and further throw hormonal levels off balance. They often begin creating problems in young girls hence early puberty. Also included in these aggressive oestrogen are the conjugated oestrogens developed from horses urine eg Premarin of HRT fame. Xeno-oestrogens have been linked to the huge increase in the occurrence of breast cancer over the last 30 years, to the increasing rate of infertility in females and the decreasing sperm count in males.

• Intrinsic Oestrogens Profile ( Oestrogens made in our bodies)
• Oestradiol (E2)
• Most potent human oestrogen.
• High levels are associated with increased risk of breast and endometrial cancer (which is negated by balancing with progesterone).
• Predominant oestrogen pre-menopausally.
• Primarily responsible for replenishment of uterine lining
• Surge of Oestradiol needed for ovulation
• Primary production in ovary.
• Oestrone (E1)
• Predominant oestrogen post-menopausally
• Primarily produced mostly in fat
• High levels associated with cancer especially in obese women and post menopausal)
• Oestriol (E3)
• Least potent human oestrogen
• Oestriol has both oestrogen agonist and antagonist properties (inhibitory and / or stimulatory properties)
• brief acting
• Primarily from metabolism of Oestrone and Oestradiol
• Most abundant estrogen in the urine
• Oestriol may be protective against breast and endometrial cancer.

Phyto-oestrogens 
Phyto-Oestrogens a plant based foods that have an oestrogen mimicking property. Phyto-oestrogens are weak in their oestrogenic action but very quick to the receptor sites around the body. Through this mechanism they are able to block xeno-oestrogens from entering the cells.

PROGESTERONE

• The mechanisms that Progesterone uses to keep oestrogen in check are: Progesterone reduces the oestrogen receptors stimulating effects upon cancer-promoting genes.
• Progesterone promotes the conversion of the stronger oestradiol to the weaker type oestrogen called oestriol.
• Progesterone reduces the number of oestrogen receptors on the cells, thus reducing the sensitivity of the cells to oestrogen. Properties of Progesterone:
• Has a calming effect.
• Regulates fluid balance.
• Reduction in mood disorders such as anxiety and depression
• Relieves Endometriosis and Polycystic Ovarian Syndrome
• Increases energy and libido.
• balances blood sugar, thyroid function and mineral balance.
• Necessary for fertility and maintaining pregnancy.
• Relieves menopausal symptoms.
• Reduction in hair loss
• Helps to overcome many of the PMS symptoms
• Decreases risk of Endometrial Cancer and may help protect against breast Cancer, Fibrocystic breast and Osteoporosis.
• Is effective in treating migraines

A study completed in 1993 at the John Hopkins University in the USA showed that women who were low in Progesterone had 5.4 more times more incidence of breast cancer and 10x more deaths from all kinds of cancer. It would therefore be a very sensible precaution to ensure you surgery is scheduled for the later part of your menstrual cycle when your progesterone level is normally at its highest. It would also be sensible to supplement with natural progesterone to ensure you have adequate level.

DHEA

DHEA, or dehydroepiandrosterone, is a steroid hormone like the Oestrogens and Progesterone. It is made in the adrenal gland, which make more than 150 hormones. Oestrogen and Testosterone are made from DHEA (or Progesterone) through out the body. The amount of DHEA is greater than any other steroid hormone.

between the age of 20 and 25 DHEA production peaks. Men produce more than women, but both sexes make about two per cent less every year after the age of 25. by the time a woman reaches her mid to late forties, DHEA levels can be quite low. Low levels of DHEA in women have been linked with metastatic breast cancer, DHEA helps prevent cancer. Several studies have shown how this hormone stimulates immunity, offering protection from several specific kinds of cancer, including breast, prostate, testicular, liver, thyroid and colon cancer.

In several studies, women with breast cancer and men with prostate cancer have lower than normal levels of DHEA in their blood. breast cancer patients have fewer than normal DHEA metabolites in their urine, (the metabolites being substances derived from DHEA after its use; their presence indicates the body has in fact been able to use DHEA).

Thus, if you DHEA levels are low, taking enough to restore mid normal levels may be beneficial, but keep in mind that an excess of DHEA could be harmful. If you decide to se DHEA keep a close watch on your overall hormone balance levels testing every 6 months.

MELATONIN

Pineal gland is a pea-sized organ located in the center of the brain. It is responsible for the production of Melatonin, a hormone that regulates sleep cycles. It also plays a role in regulating ovarian hormones and the immune system, and is an antioxidant. Melatonin levels are very high in adolescence but drop dramatically after puberty and then continue to fall steadily as we age.

Another interesting observation that Neurosurgeons have been making for many years is that the Pineal gland in breast cancer patients is most likely to be calcified, which means it is less likely to produce Melatonin. Other studies verify that women with early breast cancer have lower circulating levels of Melatonin. The more severe the cancer, the lower the Melatonin level usually is. A high level of Melatonin seems to provide some protection against cancer. Melatonin blocks the multiplication of certain fast-growing breast cancer cells (in lab cultures).

Melatonin is also a powerful antioxidant, helps neutralize potentially damaging molecules reducing free radical damage. Melatonin is particularly effective at clearing the damaged cells resulting from Radiotherapy.

THYROID

The Thyroid gland makes Thyroid hormones, which sets the metabolic rate (the rate at which energy is used) for all cells of the body. Early studies taken back in the 1950's show that low thyroid predisposes women to breast cancer. When thyroid hormone is low oestrogens are unable to activate proper amounts of oestrogen binding protein called Sen Hormone binding Globulin (SHbG) in the liver. SHbG in the blood stream binds tightly to Oestradiol, keeping too much from entering cells and stimulating the growth of tissues in areas such as breast and uterus. The result of low SHbG in hypothyroid women would be more 'free' or bio-available (available to the body for use) oestrogen in the bloodstream, which in effect causes higher oestrogen activity. Studies have shown in geographic areas of low iodine, which results in the development of Goitre (visibly enlarged thyroid gland) there is a 40% increase in the incidence of breast cancer.

Using a natural thyroid replacement, which includes T3 and T4, is as more balanced method of treating low thyroid. (60mg Whole thyroid is equivalent to 100mcg o0f Thyroxine)

SUPPLEMENTING HORMONES

The aim of natural hormone therapy is to achieve hormonal balance using bio-identical hormone in biological dosing. This means first establishing your individual level and supplementing to a level that would be appropriate given you age and health status. bio-identical hormones are derived from extracting Diosgenin from wild yam or soy bean which is converted in the laboratory to the exact same hormone molecule that your body would make if it was functioning at an optimal level.

Nb:

If available having IV Vit C up to 3 x weekly can be an effective, less invasive form of chemo therapy. Dosing is dependent upon you blood levels.

Suggested daily supplement regime for prevention of breast cancer would include:

• Good Anti-oxidant which includes
• Vit C, Vit E, Vit A, Selenium, Zinc and Omega's
• DIM 200mg
• Co Q10 100mg
• A good multivitamin and mineral supplement

It does not require the high dosing when using supplements for prevention that it does if you have full blown cancer.

COMMONLY ASKED QUESTIONS:

I HAVE BREAST CANCER AND AM DUE FOR SURGERY. COULD NATURAL PROGESTERONE HELP ME BEFORE I GO INTO HOSPITAL?
Work has been published that shows that most women being operated on for breast cancer who have hight levels of progesterone, both at the time of surgery and afterwards, show dramatically improved survival rates. From this point of view, wherever possible women should try to schedule any surgery in the second half of their menstrual cycle when the Progesterone level is highest.

A 30 year retrospective study done at John Hopkins University in the US found that women who were low in Progesterone had 5.4 more times more incidence of breast cancer and 10 times more deaths from cancer of all kinds.

Also a French study published in the peer journal Fertility and Sterility showed that the value of Progesterone lies in the fact that it actually slows down the rate at which cell division occurs in the breast ducts.

If would therefore be a very sensible precaution to ensure your surgery is scheduled for the latter part of your menstrual cycle when your Progesterone level is normally at its highest. It would also be sensible to supplement with natural Progesterone to ensure that you have adequate levels at the time of surgery and to maintain the Progesterone supplementation after it. Dr John Lee has said that all of his own patients treated in this way for breast cancer, non has subsequently died from the disease.

CAN TAKING PROGESTERONE CAUSE BREAST CANCER?
Progesterone never causes breast cancer. If a breast cancer is described as being progesterone-sensitive it does not mean that the Progesterone caused the cancer, or that the administration of Progesterone will make it return. What it means is that the breast cancer has receptors that are sensitive to Progesterone.

The effect of Progesterone on the breast is to reduce proliferation of the tissues, and it is this proliferation that makes cancer more likely. So by using Progesterone you are positively protecting your breasts against the risk of cancer.

If oestrogen is given on its own as a form of HRT, as it was in the 1960;s abd earkt 1970's, it can cause cancer of the lining of the uterus. This is the reason that oestrogen replacement therapy went out of favour and why women should not be prescribed unopposed oestrogen. Current forms of HRT for women who have not had a hysterectomy usually contain some form of artifical Progestins to protet the uterus, although natural Progesterone would be a better way to approach this problem. We have always known that unopposed oestrogen is a major factor in the acceleration of breast cancer. What is now becoming clear from research presented at an international cancer conference in 1998 is that unopposed oestrogen may actually be the cause of some types of cancer. For this reason alone, to give themselves maximum protection women need adequate levels of Progesterone to balance out any symptoms of oestrogen dominance.

Hertog, Theirry (2002) The hormone solution. New York, NY. Harmony
Lee J. R, Hopkins, V & Zava, D T. (2005) What your doctor may not tell you about breast cancer. NEW York, NY. Warner Books.
Jamison J. (2204) Clinical guide to nutrition and dietary supplements in disease management. London. Churchill Livingstone.
Link J. (2003) Breast cancer survival manual. New York, NY. Henry Holt & Company.
Northrup Christiane. (2010) Women’s bodies, women’s wisdom. New York, NY. Bantam Books
Anna Rushton & Dr Shirley A Bond (1999) Natural Progesterone, Hamersmith London Thorsons