Archive for Breast Cancer

Breast Cancer Rates Have Declined

by Berris Burgoyne – Naturopath –
Suite 8/1177 Logan Road, Holland Park, Brisbane 4121

Breast cancer rates have declined significantly
Research presented at the 29th Annual San Antonio Breast Cancer Symposium showed a significant drop in the incidence of breast cancer in 2003 – a dramatic fall that never before has been observed in a single year. In women aged 50-69 years of age there was a 12% decline in oestrogen dependent cancers and a 4% decrease in non-oestrogen dependent cancers. It appears that the decreased use of hormone replacement therapy (HRT) may be responsible, at least in the case of oestrogen dependent breast cancers.

Another research team reporting in a recent issue of the Journal of Clinical Oncology came to similar conclusions, “Hormone therapy use dropped by 68% between 2001 and 2003, and shortly thereafter we saw breast cancer rates drop by 10% to 11% and this drop was sustained in 2004, which tells us that the decline wasn’t just a fluke”.

Why did the use of HRT decline?
The use of HRT declined significantly after the results of two long-term studies were published in 1998 and 2002. The most significant of these was the Women’s Health Initiative (WHI) study which involved almost 162,000 women between the ages of 50 and 79 years. The role of the WHI is to focus on defining the risks and benefits of treatments that could potentially reduce the incidence of heart disease, breast and colorectal cancer, and fractures in postmenopausal women.

The duration of the study was planned for 8.5 years and included assessing the benefits and risks of women using either combined HRT (oestrogen/progestin) or oestrogen alone. However, after just 5.2 years, in mid 2002 an independent monitoring board recommended stopping the combined HRT trial because they considered the risks to health of taking combined HRT outweighed any benefits.

There were a number of negative outcomes resulting from this trial and although some of the risks are relatively small, they do exist.

The bad news –
• Increased risk of breast cancer
• Increased risk of ovarian cancer
• Increased risk of heart disease
• Increased risk of stroke

• Increased risk of blood clots/deep vain thrombosis (DVT)
• Increased risk of pulmonary (lungs) embolism
• Increased risk of dementia
• Possible increased risk of cognitive decline
• Increased risk of urinary incontinence

In relation to breast cancer the WHI trial found that relatively short-term combined oestrogen/progestin use increased breast cancers, which were diagnosed at a more advanced stage compared with placebo use.

The good news –
• Decreased risk of fracture (osteoporosis)
• Decreased risk of bowel cancer

Despite the early termination of the WHI oestrogen plus progestin trial, the oestrogen-alone trial was continued with ongoing careful scrutiny by the monitoring board. However, in February 2004 the National Institutes of Health (NIH) decided to terminate the oestrogen-alone trial after 6.8 years, rather than allowing it to run the full 8.5 years. They determined that oestrogen therapy did not offer significant benefits compared with the possible risks.

As with combined HRT, oestrogen alone therapy also reduced the risk of fracture although it did not have the same protective effect against bowel cancer that combined HRT appeared to offer.

So, what does this mean for you?
There are a number of different reasons why women either choose to take HRT or are prescribed HRT by their doctor. Each individual woman has to decide, with the help of a health care professional, how important the use of HRT is for her.

HRT has been traditionally prescribed not only to alleviate the symptoms of menopause but also to protect against conditions such as heart disease, dementia and osteoporosis. We now understand from extensive clinical trials that HRT does not carry the protective effect previously assumed for heart disease and dementia. In fact, the use of HRT (particularly combined HRT) increased the risk of these conditions.

For some women however, HRT may be important to help prevent or reduce the occurrence of osteoporosis. This is particularly the case where there is a strong family history of the disease and the woman has a significant number of risk factors. For example, slight build, therefore less bone mass; little weight bearing exercise; sedentary life style; diet high in salt and caffeine, (which leach calcium from the body); history of eating disorders such as anorexia or bulimia; and drugs such as corticosteroids.

Are there effective alternative treatments for menopausal symptoms?
The answer is a very big YES. In most cases menopausal symptoms are extremely easy to treat with natural therapies and women have a significant improvement in a relatively short period of time. The type of treatment used depends on the individual woman, her lifestyle and the symptoms experienced.

Is it possible to stop HRT?
Yes it is definitely possible to stop taking HRT, however it is not a good idea to do so suddenly. We have had a lot of experience at helping women wean off HRT and the best way is to do so gradually. However, before making the decision to stop HRT, it is important to consider the reason that HRT was initially prescribed and how relevant it is to your long-term health and wellbeing.

It is important to understand that the uncomfortable symptoms of menopause are caused by the reducing levels of female hormones, particularly oestrogen. By taking HRT it is really only delaying the inevitable. If HRT is stopped suddenly, particularly without any other support being offered, the body once again has to go through the withdrawal process, producing the original symptoms.

It is the adrenal glands that produce oestrogen after menopause therefore it is important to improve adrenal function prior to starting to reduce the dose of HRT. When we consider this function of the adrenals it is hardly surprising that so many women experience symptoms during the perimenopausal and postmenopausal time. The number one factor that depletes the adrenals is stress, particularly over a long period of time.

There is a very fundamental difference between HRT and herbal medicine for the treatment of menopausal symptoms. It needs to be remembered that menopause is not a disease process but a natural occurrence in the life of all women who reach a certain age. Herbal medicines provide the support for the body to do what it should naturally be doing. That is, produce hormones in the adrenal glands. HRT does just the opposite. By putting hormones into the body you actually shut down this natural process in the body.

There are a number of herbal medicines and nutritional factors that quickly improve adrenal function so that the body can increase the natural production of female sex hormones. Depending on the continued level of stress, we will often prescribe herbs that help the body deal with stress and generally tonify the nervous system, which further takes the load off the adrenals.

Once adrenal function has improved the dose of HRT can gradually be reduced until it is no longer required. What this means is that we have restored the body to a natural state of health.

During this process we also use herbal medicines that are specific for any symptoms that may arise during the weaning off period. Where necessary we support the nervous system because stress is a major cause of adrenal depletion.

So, you can see, it is easy to come off HRT if desired. All you need to do is take it slowly and use the appropriate herbs and nutrients for each stage of the process.

If you are using HRT and are not sure if you wish to continue, why not give us a call.

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Reduce Breast Cancer Risk with Simple Test

by Berris Burgoyne – Naturopath –
Suite 8/1177 Logan Road, Holland Park, Brisbane 4121

You can reduce your risk of oestrogen dependent cancers such as breast cancer by using a simple test to monitor oestrogen metabolites in the urine. You can read more about this test and the importance of oestrogen metabolites below but basically there is a ‘good’ metabolite and a ‘bad’ one. High levels of the ‘bad’ metabolite is a risk factor for breast cancer, however there are things you can do to change this. The right diet can be very beneficial. For example components in vegetables in the cabbage family, particularly broccoli, help to reduce the dangerous metabolite and increase the protective one. Sometimes food is not enough to correct the imbalance initially so supplementation with products containing high levels of these compounds may be needed. Once the correct balance is achieved diet alone is often enough to maintain it. There are other nutritional factors that also have a favourable effect on the metabolism of oestrogens. Many herbal medicines also improve the way that oestrogens are metabolised.

Breast cancer is the most common cancer in women. In many cases breast cancer is hormone dependent, meaning that the naturally occurring female hormones (usually oestrogens) cause it to grow. Although there are many factors involved in the development of cancer, in oestrogen dependent cancers excessive oestrogen and/or improper metabolism of oestrogen plays a role.

An excess of oestrogen can occur when the body produces too much or when it is not removed efficiently from the body once it has done its job. Taking hormone containing drugs such as the oral contraceptive pill or HRT can also upset the body’s natural balance.

Although oestrogens are extremely important female hormones they need to be at the correct levels and to be in balance with other hormones. The liver is the main organ that ensures excessive oestrogens are removed from the body, so it is very important that the detoxification pathways in the liver are working efficiently.

Oestrogens can be metabolised in two ways and these need to be in balance if oestrogen dependant conditions, including cancers, are to be prevented. One pathway produces a metabolite called 2-hydroxyoestrone (2-OHE1) and the other produces a metabolite called 16a-hydroxyoestrone (16a-OHE1). For the sake of simplicity I will call these 2 and 16 from now on. These metabolites can be measured in the urine or blood, however urine is the best method. In the blood these metabolites fluctuate throughout the menstrual cycle making it difficult to know the true levels. This is not the case in urine where the levels are consistent throughout the menstrual cycle.

So what does all this mean for you? Very simply type 2 is protective against breast cancer and other oestrogen dependent cancers whilst 16 is proliferative and increases breast cancer risk. We will always have both of these metabolites because that is the natural result of oestrogen metabolism. However, it is the level of each of these metabolites and the ratio between them that is very important and must be kept in balance.

The ideal ratio between 2:16 is 2.0. A low ratio, indicates low levels of the protective 2 and a state of oestrogen excess, increasing the risk of oestrogen dependent cancers. If the ratio is very high it can indicate low oestrogen levels and an increased risk of osteoporosis.

So, you can see it is worthwhile having this simple urine test so that any problems with oestrogen metabolism can be fixed. This not only applies to mature women but also to younger women. It seems that we are seeing an increase in the number of young women being diagnosed with breast cancer so perhaps all women should be tested from time to time. This is particularly true for women taking the oral contraceptive pill and for women taking HRT.

The test is very simple and easy to perform. Upon your request the test is sent to you directly from the laboratory and contains instructions and everything you need. All you need to do is collect a sample from your first wee of the day and send it off as per instructions. You do need to stop eating at 10 pm the night before and for women who have a regular menstrual cycle the sample should be collected between days 18-25 of the cycle. Do not collect urine during menstruation.

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