| Breast cancer risk is very much associated with our lifetime exposure to estrogen. It is important to have a basic understanding of this concept before we move on. In a nutshell, the greater our exposure to estrogen during our lifetime, the greater our risk for breast cancer. This is because estrogen is a remarkable growth enhancer. When it locks onto the receptor site in a cell it is delivering a powerful message to that cell to “GROW”. This is what helps build up the uterine lining every month in preparation for a new baby. It is what makes our breasts swollen and tender each month before our periods. But if we have a small cancer growing and it is continually bombarded with high levels of estrogen, it is also getting the message to GROW, and grow it does.But even though estrogen frequently gets a bad rap, it is a marvelous substance with many beneficial properties and is actually the essence of femininity.Actually, estrogen is not even a singular substance, but a group of hormones that we collectively refer to as “estrogen”. Each substance is similar, yet unique, and it is important to know the difference.Estrogen is primarily formed in the ovaries (although it is also produced by the adrenals and fat cells). It is a combination of three compounds: Estrone (E1), Estradiol (E2), and Estriol (E3). The strongest and most influential of the three estrogen hormones is Estradiol. (E2), next in strength is Estrone (E1). These are the so-called aggressive estrogens. At high levels, they are thought to be associated with increased risk of breast and uterine cancers.
The two substances tend to convert back and forth into one another, so for that reason, standard blood tests tend to measure estradiol only. Generally speaking, estrone and estradiol are the most influential estrogens in creating the qualities of femininity, the qualities that turn a girl into a woman and affect and protect the mind, the bones and the cardiovascular system. Estradiol prevents the loss of old bone tissue. Estrone is thought to perhaps promote the growth of new bone tissue. Estriol (E3), the third major type of estrogen, is the more “benign” compound. It contributes to healthy and youthful skin, keeps the vagina moist and lubricated, prevents hot flashes and night sweats, and probably has a major anticancer role. It exerts a protective and counterbalancing effect against estrone and estradiol, its more powerful sister compounds. In some women increased estriol levels improve mental clarity. But estriol does not appear to benefit the bones or cardiovascular system the way estradiol and estrone do. You may have heard that the more pregnancies a woman has, the lower her risk for breast cancer. The reason has to do with estriol. With each menstrual period, the body produces estradiol (E2), the “Strong Estrogen”, which is thought to increase our risk for breast cancer. This risk exists because estradiol is giving a powerful message for the breast tissue, and any abnormal cells tucked within it, to grow. So the more menstrual periods and elevated estradiol (E2) levels we have, the more fuel is available for a tumor to grow. Now, estriol (E3), the weak estrogen, is only 1/1000, the strength of estradiol. That means that for every 1000 cells that divide and grow in response to the stronger message of estradiol, only 1 cell will divide in response to estriol’s weaker message. When a woman becomes pregnant and nurses a child, she is missing anywhere from 10 to 36 periods, on average. Not only is she avoiding excessive exposure to the strong estradiol, but also, during pregnancy her body is flooded with high levels of estriol, the weaker and more protective estrogen. Not only that, but pregnancy and lactation also confer another benefit. They accomplish what is called maturation or differentiation of the breast cells. If you read the chapter on the Physiology of Breast Cancer, you will remember that differentiation is a good thing. It defines healthy cells. And, the younger you were when this occurred, the greater your lifetime benefits in the form of increased immunity against breast cancer. So, Back to estrogen! Now that you have a handle on endogenous estrogen, in other words, that which is produced by our own bodies, lets go over some other kinds of estrogens. Phytoestrogens are plant-based estrogens. The 2 most prominent sources are soy and flax, although there are some herbs that act as SERMs (Selective Estrogen Receptor Modulators) these include Red Clover, Black Cohosh and European Rosemary. Phytoestrogens have a weak estrogenic effect. They are thought to benefit breast health by locking onto estrogen receptors in breast tissue and thus preventing the stronger and more dangerous estrogen compounds from entering. A word about soy. Although I am a fan of soy, in very limited quantities, I advise most women to eat only fermented soy products, such as tofu, miso, tempeh, and natto. This is because unfermented soy products (soy milk, edamame, soy protein powder) can have a suppressive effect on the production of thyroid hormones. Since many women have diagnosed or undiagnosed thyroid deficiency, as well as related hormonal imbalances, I think it is generally wiser to avoid unfermented soy. Plus, there are wonderful added benefits to fermented soy, in particular miso, which has been shown in studies to reduce a woman’s risk for cancer when consumed regularly. Now about Xeno-Hormones. These are toxins. They are pesticides and herbicides sprayed on our food (always go organic!), they are solvents in paints, nail polish and remover, fumes at the gas station, off gasses from many carpets and foam products, they are in the sprays we use around the house and the beauty products we use. They are everywhere! They are chemicals, which are so close in their molecular structure to estrogen that they are able to lock on to estrogen receptors in breast tissue. They then enter the cell and begin to damage the structure and function of the cell, often damaging delicate DNA, which can lead to cell mutations and cancerous tumors. Fat tissue stores toxins at much higher levels than other tissues in the body (up to 700 times the levels found in the bloodstream!), and sadly, the breast is mainly composed of fatty tissue, so toxins accumulate at a much higher concentration in the breasts than other places. In the toxic world we live in, it is no wonder breast cancer has become an epidemic! Much of the protocol is focused on these dangerous xeno-toxins and clearing them from the body. The last kind of estrogens I want to discuss are synthetic estrogens and other hormones used in Hormone Replacement Therapy, or HRT. These are sometimes called conjugated estrogens and are represented by such brands as Premarin, which is made from the urine of pregnant mares. There have been many books written on the dangers of synthetic estrogens and if you need convincing, I suggest you read some of them. In our Interesting Links section you will find titles that may interest you. In essence, these synthetic estrogens, although touted as a cure-all for menopausal and post-menopausal women, have the potential to be very dangerous and harmful to health. These synthetic estrogens and synthetic progesterones, called progestins (Provera) are also the main ingredients in Birth Control Pills. HRT has been linked to an increase in the risk for breast cancer, blood clots, heart attacks, strokes and death. Premarin is a cash cow (or cash horse), in America, with the pharmaceutical industry enjoying the financial benefits of its being the number 1 prescription drug in the nation for many years. Since the release of the Women’s Health Initiative Study, which concluded that Premarin caused increased risk for heart attack, stroke blood clots and breast cancer, those profits have dwindled by 40%. There are safer, more natural ways for women to enjoy the supposed benefits of heart protection (that has already been proven a false claim by the Health Initiative Study, in which so many women suffered cardiac problems, the study was cut short), prevention of bone loss and prevention of Alzheimer’s disease. The risks are too great for women to continue to take these drugs. If a woman does choose to take synthetic hormones, it should be for the briefest possible time, not as a lifetime program. Bio-Identical hormones, for women who chose to take supplemental hormones, are a much safer alternative. Okay, with this understanding of all the different kinds of estrogen, lets look at how estrogen is processed within the body. Understanding how estrogen is produced, used, broken down and eliminated by your body – the estrogen pathway – is important. It will help you to understand the protocol better and make choices that support your optimum level of wellness. I am going to quote Christine Horner, M.D. directly, from her book, Waking the Warrior Goddess, (which I highly recommend.) She has an analogy that is very simple and easy to understand. “To understand the estrogen pathway better, lets use the analogy of a car ride. Your trip begins in the ovaries where estrogen is made and then is released into the blood. The blood vessels are like highways and estrogen flows through these blood vessel highways to get to its target destinations. When estrogen travels in the blood, it either travels alone or is attached to a substance called a “protein binder” (HSBG, Human Sex Binding Globulin), -the difference between driving alone and carpooling. When you carpool in certain cities, you can use a special high-speed lane, usually on the far left. In this lane, you can’t exit from the highway. If you’re driving alone, you can’t use these high-speed lanes. You must travel in lanes that have access to exit lanes. Like the person driving alone, only the estrogen that travels alone – without a protein binder, SHBG – can exit from the blood-vessel highway. In this case, we are concerned about the off-ramp for only one destination: the breast tissue. When estrogen reaches the breast, it looks for a place to “park”. Parking spaces represent the “estrogen receptors”, which estrogen binds to on the breast cell membranes. There are estrogen receptors all over your body, but the highest concentrations are found in the uterus and breast. Because of the relatively large number of estrogen receptors in these tissues, they respond more to estrogen than the other tissues in the body do. When estrogen binds to an estrogen receptor, it “turns it on”. A turned-on receptor causes cells to start dividing. Estrogen receptors don’t turn on like a simple on/off switch. Instead, they turn on like a rheostat, a light switch with a dimmer. The rate at which cells divide in response to estrogen is affected by many factors. First, the rate depends on the strength of the estrogen. There are strong estrogens (ESTRADIOL, ESTRONE, XENOHORMONES) and weak estrogens (ESTRIOL, PHYTOESTROGENS). Strong estrogens speed up cell division and therefore, increase the risk of cancer. Weak estrogens slow down cell division, therefore reducing the risk for cancer. Parking at an estrogen receptor causes a lot of wear and tear on the estrogen. After awhile, it needs to go in for service. So, the estrogen leaves the estrogen receptor and heads for the liver (service station). The liver is the great detoxifier of the body. It breaks down toxins and other natural substances to prepare them for elimination. Estrogen is broken down in the liver, and is influenced by the presence of certain chemicals. It is either broken down into a “good” kind of estrogen (Technically known as 2-hydroxyestrone) or a “bad” kind of estrogen (16-alpha hydroxyestrone). For instance substances in cruciferous vegetables and flax create more of the good kind, while environmental toxins (xenohormones) create more of the bad kind. The difference between good and bad estrogen is that good estrogen causes the cells to divide very slowly, whereas bad estrogen causes them to divide rapidly. Bad estrogen can also cause mutations or mistakes in how the cells grow that increase your risk of cancer even more. The good estrogen causes no damage and drives immediately to the colon or to the bladder where it leaves the body. The bad estrogen backfires, gets stuck in reverse, and speeds back to the breast where it wreaks havoc. If this bad estrogen finds a parking spot on a breast cell, it will rapidly speed up cell division. If you have a lot of bad estrogen in your body, your risk of breast cancer goes up significantly. In the colon, estrogen is either eliminated or absorbed back into the blood. If it is absorbed back into the blood, it adds to the total amount of estrogen in your body, and therefore, adds to your risk. There is a simple solution: eat more fiber. Fiber binds to the estrogen in your colon and eliminates it.” I would like to add a little bit here to Dr. Horner’s reference to the “protein binder” sex hormone-binding globulin- SHBG. Understanding this protein can make a big difference in your understanding of the “big picture” of hormone health and balance. It is a critical player with a big impact on all our hormones. As Dr. Horner mentioned, estrogen (and other hormones) that are bound to SHBG are in the “carpool lane” and cannot make random exits from the bloodstream. Only “free” (unbound) estrogen can roam through various tissues of the body searching for estrogen receptor sites to lock on to. In terms of our risk for breast cancer, it is only the free estrogen that concerns us. However, there is more to the story. The inner intelligence of the body doesn’t want hormones running wild or falling below a certain level. It wants normalcy, hormonal law and order. To achieve this, your body utilizes these sex hormone-binding globulins, which are produced by the liver. These proteins chaperone individual hormone molecules though the blood. Should the hormones reach too high a level, the protein binds and inactivates them – sort of like a handcuffing effect. The protein not only transports but also regulates and assists in the access process at target cell sites. If the estrogen level goes too high, an alarm goes off in the liver, the body’s master chemical factory. It pumps out extra SHBG. In reaction to a high tide of estrogen, your liver can produce up to three times the normal amount of SHBG. The problem is that this special protein doesn’t just bind up some of the excess estrogen. It binds up – and inactivates – some of the other important hormones, such as thyroid hormone, growth hormone and testosterone (which is more important for women than you might think!) You may have heard of a condition referred to as “Estrogen Dominance”. This is where the body is flooded with higher than necessary levels of estrogens, which might be produced by your own body, or come from a toxic source, xenoestrogens. Usually it is a combination of both. In addition to the deleterious effects we have already discussed in regards to excess estrogen in the body, there is now a complicating factor. High levels of estrogen in the body trigger the release of sex hormone-binding globulin, as the body tries to maintain balance by inactivating some of the excess estrogen. But, at the same time the estrogen is being inactivated, the release of high amounts of SHBG causes other important hormones to become bound and inactive as well. In this way estrogen dominance not only raises our risk for breast cancer, but can cause a cascade effect on other important hormones as well. The effect on you is not immediate. It takes about six weeks before you usually start to experience the fallout from the lowered hormonal activity. Quantities of your important anti-aging hormones have now been taken out of commission. In essence, the available amount of these hormones falls to levels you might have when you are years older. The body becomes less “alive”. Perhaps the skin becomes less radiant, the vagina drier. Lowered thyroid, for instance, can cause weight gain, fatigue, coldness and dry skin. These are all signs of a thyroid deficiency. Elevated SHBG can cause such multiple effects. Obviously the goal is to achieve balance. We want enough estrogen in our systems to enjoy its protective and feminizing influence, but not so much that we raise our risk for breast cancer or activate the release of too much SHBG. There are a number of ways in which we can attempt to achieve this balance. One is through the use of phytoestrogens, such as flax, and SERMs that I mentioned earlier. Another is the “fiber factor”. We simply must make sure we have adequate (at least 30 grams per day) of fiber in our diets to bind the excess estrogen that is ready for elimination from the colon. The use of select nutrients and supplements can have a big impact as well. Two very powerful such supplements are indol-3-carbinol and Calcium-D-Glucarate. These both influence the breakdown of estrogen in the liver and favor the conversion to the protective form of 2 hydroxyestrone, which protects breast tissues and activates tumor-suppressor genes within the cell. Avoiding the use of or exposure to xenoestrogens, is another way to reduce the estrogen burden in the body. Eat organic food, use “green” household products, avoid breathing fumes of any kind and use chemical-free body care products. Careful use of progesterone cream can have enormous benefits for women suffering from estrogen dominance. In estrogen dominance, the estrogen in our body is “unopposed”, it remains dominant and out of balance, because there is not enough of our own progesterone to knock it back into a normal range. As we age, our bodies produce less and less progesterone and many women eventually suffer from an estrogen dominant condition, which triggers not only physical imbalances, but many emotional imbalances as well. What I am referring to is all-natural, bio-identical progesterone, which is identical to that which is made by a woman’s body, NOT synthetic (and dangerous) progestins, found in many artificial hormone replacement therapies (which I do NOT recommend) such as prempro and provera. Please AVOID THE USE OF ARTIFICIAL, SYNTHETIC HORMONES, such as birth control pills, premarin, etc. These have been shown to INCREASE a woman’s risk for breast cancer. Bio-identical hormones are hormones, which are identical both in their quantity (strength) and quality (molecular structure) to our own naturally produced hormones. Natural progesterone cream is safe, easy to use, and can have many comforting and protective benefits for women, particularly those older than 35, when many symptoms of estrogen dominance really get extreme, PMS can drive you nuts, and the peri-menopause, menopause symptoms kick in, big-time. Progesterone is the great harmonizer. It has an amazing ability to balance our moods and symptoms along with our estrogen. Progesterone calms, relaxes, and protects your nervous system. It helps you sleep. It decreases anxiety, depression, and mood swings. It promotes the build-up of new bone tissue. It is a natural diuretic, preventing water retention and fluid build up. (With only a few exceptions, such as sodium intake or congestive heart failure, water retention is caused by too much estrogen or too little progesterone.) Plus, progesterone is incredibly protective of the breast tissue. Here are some examples: It enhances a protective gene system (known as P53) this system slows down another gene system (BCL2) that promotes cancer. It down-regulates (decreases) survivin, a gene that acts similar to cancer promoting NCL12. It prevents cells from proliferating excessively (dividing faster) in breast and uterine tissue. In one study, researchers found that aggressive estrogen could promote breast proliferation by 230%, while progesterone, applied as a topical cream to the breasts, decreased the activity by 400%. It enhances natural killer cells and interluken-2, two important components of the body’s defense system. It increases apoptosis, also known as “cell suicide”. This process deters cells from mutating into harmful forms due to oxidative and chemical reactions in the body. Estradiol (the strongest estrogen) slow down apoptosis. It reduces the ability of cancer cells to metastasize. That is an impressive list of attributes! This is why progesterone cream is part of the Pro-Active Protocol for Breast Cancer Prevention. In fact, everything in the protocol has been selected because there is piles of solid research and evidence that it protective of the breast and supportive of the body’s ability to fight cancer. I hope that after reading this material, you feel more empowered and enlightened in your daily choices and recognize how much you really can do to beat breast cancer! The first step is always self-awareness. We need to become intimately acquainted with our own anatomy and biology if we are going to be able to influence it consciously and deliberately. See our Interesting Links section for a recommended reading list, which can get you started on a deeper path of learning. Thanks to the authors whose work I referred to in this article: John Lee, M.D. Uzzi Reiss, M.D/O.B.-GYN. Christine Horner, M.D. |