The Merits, or Otherwise, of Ten Years of Aromatase Inhibitors

 

If you have been diagnosed with hormone receptor positive breast cancer, meaning that the cancer cells were shown to be fueled by estrogen, and sometimes progesterone, no doubt as part of your post-surgery treatment plan, your doctor recommended that you take hormone inhibiting drugs. You would have been recommended to take either Tamoxifen, which blocks the action of estrogen and is normally offered to premenopausal women, or an aromatase inhibitor like Femara, Arimidex, Aromasin or Evista, which block the production of estrogen, and are normally offered to postmenopausal women.

You probably then went to the Internet, had a look at the side effects of these drugs, and got worried. It seems that taking them for five years was hard enough – so what are the merits or pitfalls of taking them for ten years?

For Tamoxifen, a study released In 2012 [1] found that extending treatment with Tamoxifen from five years to ten years reduced both recurrence of and death from breast cancer. Because of this study, many women have been recommended to continue on with Tamoxifen for ten years rather than five.

For those taking aromatase inhibitors, however, many wondered if the findings about Tamoxifen could be extrapolated to aromatase inhibitors. A study published in 2016 [2] in the New England Journal of Medicine investigated whether or not extending the taking of the aromatase inhibitor letrozole (Femara) from five to ten years for women with hormone receptor positive breast cancer would be beneficial.

1,918 postmenopausal women were enrolled in the trial and half of them were assigned to either take letrozole for five additional years (after already taking it for five years), the other half were given a placebo. 959 women were treated with letrozole for ten years and compared with 959 women who took letrozole for five years and a placebo for five years. On average, the participants were followed for just over six years so that researchers could examine their recurrence rates in the same breast, or a new breast cancer diagnosis in the opposite breast. They also looked at overall survival and quality of life.

Researchers found that although there was a “statistically significant” improvement in disease-free survival (women experiencing neither a recurrence in the same breast nor a new diagnosis in the other breast), for women taking the letrozole there was no difference in actual survival at the five year mark. So in effect this means that 91% of women who did not take the letrozole for the additional five years were disease-free five years later and 94% of women who did take letrozole for an additional five years were disease-free five years later. That’s a difference of 3% between the two groups, with no difference in overall survival. The study was partly funded by Novartis, the maker of letrozole.

Those Pesky Side Effects

The problem is that there are significant side effects from hormone blocking medications. The side effects and toxicity of Tamoxifen and the aromatase inhibitors are rather different, but each definitely has a significant impact on health and quality of life for a large percentage of the women who take these drugs.

In my experience as a health coach, a small percentage of women tolerate these treatments fairly well, but for most, these drugs come with fairly severe side effects. Many women stop the medication before completing the recommended course due to life-altering side effects. What are some of the most common side effects? Here’s a partial list:

• joint pain and stiffness, feelings of being far older than you actually are
• muscle pain and weakness, leg cramps
• bone pain, bone fractures, higher risk for osteoporosis
• hot flashes and night sweats
• headaches
• dizziness
• vaginal dryness and loss of libido
• uterine lining abnormalities, and a higher risk for needing hysterectomy
• tiredness, fatigue, lethargy
• anxiety, depression (sometimes severe)
• vision changes, dry eyes, damage to cornea and retina
• insomnia
• weight gain
• loss of mental acuity and brain fog
• hair thinning
• blood clots and pulmonary embolisms
• fatty liver

I believe that any treatment which fails to significantly improve overall survival while at the same time exposing women to that many serious side effects should be considered very carefully. It’s also important to know that the World Health Organization considers Tamoxifen to be a human carcinogen.

I believe we need our estrogen, keeping it in balance is the key. Many women are not even checked to see what their estrogen levels are after surgery, chemotherapy and radiation have taken their toll – they are just told that blocking the action of estrogen is imperative and they “need” to take these drugs to improve their chance of survival.

The Many Functions of Estrogen

Besides its functions in reproductive health, which can be found in any book on the subject, here’s what our body’s own estrogen also does for us [3]:

• helps maintain body temperature
• involved in energy production in the body including muscles
• enhances the effects of certain neurotransmitters, the brain’s “feel-good” chemicals, so intimately involved in mood regulation
• improves the thickness and quality of skin, as well as collagen content
• alters disposition of fat cells around abdomen
• helps to preserve bone strength
• prevents bone loss
• promotes pancreatic health and regulates insulin secretion
• regulates cholesterol production in the liver, so has cardioprotective properties
• maintains vaginal health
• affects vascular tone and blood flow in organs and tissues, including the eyes
• protective to brain and nervous system

The Role of Xenoestrogens in Hormone Receptor Positive Breast Cancer

I believe that xenoestrogens (environmental estrogens, known hormone disrupters) are much more dangerous to our health than our body’s own estrogen, and I’m not alone. In the book “Molecules of Emotion“, author and scientist Candace Pert stated “… accumulated environmental pollutants within our bodies are mimicking and disrupting the action of our sex hormones — estrogen, progesterone, and testosterone — which run the male and female reproductive systems.” She continues with this line of thought, stating “A recent report on receptor binding in Science, for example, has shown that environmental toxins have estrogenlike effects and bind to estrogen receptors, where they can stimulate breast cancer tumor growth. Similarly, various toxins can act like testosterone in the male body and stimulate prostate cancer, which is embryologically similar to breast cancer. Although this has been suspected for a long time, only recently have we gotten the hard proof that accumulation of these toxins in our bodies chronically stimulates our estrogen and testosterone receptors, putting them into a state of overdrive and leading to cancer.”

Dr Pert is not alone in these thoughts. Countless others have seen the problems associated with xenoestrogens on hormonal health. It is my belief that we need to start there – by detoxifying our food, our body products, our household cleaning supplies, etc. See my article for more information.

Bottom Line: Please evaluate the potential benefits and harms of hormone blocking medications, and talk to your health care provider about your concerns. Please be aware that estrogen is not the only factor involved in breast cancer. For a tumor to begin growing, and to be allowed to continue to grow, a good many things have to go wrong first. A good overall anti-cancer strategy would be to eat a healthy diet full of fresh organic fruits and vegetables, include particular superfoods, take supplements that have research backing them showing their anti-breast cancer activity, detox your household from toxic skin care, hair care and household cleaning products, get at least 30 minutes of exercise every day, and keep your stress levels down. If you’d like my help putting together a personalized program of health, I’d be happy to assist you. You might like to consider my coaching services. I also have a comprehensive online course called Toxic Free Me which will teach you exactly what you need to do to stay healthy.

References:

[1] Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61963-1/fulltext

[2] Extending Aromatase-Inhibitor Adjuvant Therapy to 10 Years – https://www.nejm.org/doi/full/10.1056/NEJMoa1604700

[3] The Role of Estrogens in Control of Energy Balance and Glucose Homeostasis – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660717/

GET MY BEST TIPS on healthy ways to beat breast cancer and prevent recurrences by signing up for my free e-newsletters and e-books on the right. You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.

Searching for Tamoxifen Alternatives?

Image source: freedigitalphotos.net / stockimages

Image source: freedigitalphotos.net / stockimages

Searching for Tamoxifen Alternatives?

One of the most searched phrases on the Internet for women fighting breast cancer is “tamoxifen alternatives”.

For those of you who have been prescribed the estrogen blocking drug Tamoxifen because your breast tumor had estrogen receptors on it, one of the first things you undoubtedly did was Google something like “Tamoxifen side effects”. And what you read scared you, with good reason. The list of side effects, as well as women complaining about those side effects, is pretty darned long.

When I was going through breast cancer in 2004, I was prescribed Tamoxifen as well, even though I didn’t have an estrogen-receptor-positive tumor – mine was progesterone-receptor positive (which in itself is odd, nobody knew quite what to do with me). I couldn’t see how blocking my body’s estrogen was going to help that situation and all my doctors could say in response was to mumble something about “well, it may have some therapeutic benefit anyway.” I found that hard to believe, especially after I learned a few things about it – and back in 2004 there was nowhere NEAR the amount of research available, or chat rooms, or online support groups, that we have available to us now. What I did find was pretty distressing, so I refused Tamoxifen. Then I went in search of other, better things I could do to support my health, well-being and ability to stay healthy. I will share some of those things later in this article.

Those Pesky Side Effects

As a breast cancer coach I am in regular contact with women who took Tamoxifen and some of the other inhibitors like Femara, Arimidex, Aromasin and Evista. With the rare exception, everyone complains about the side effects. Apparently only a small percentage of women taking the drug do NOT have any side effects.

What are some of the most common side effects? Here’s a partial list (and inside the parentheses are comments made to me by others taking these drugs): joint pain, muscle pain, bone pain, joint stiffness, feelings of arthritis (“I felt like I was 85 years old on this drug!”), hot flashes (“You could fry an egg on my head!”), leg cramps, vaginal dryness (“It’s a desert down there!”), tiredness, anxiety, depression (“I felt like killing myself”), vision changes, uterine lining abnormalities (“I had to have a hysterectomy.”), insomnia, weight gain, loss of mental acuity (“I couldn’t think straight while taking it.”), hair thinning and, most worryingly, unexplained blood clots.

And we MIGHT be prepared to put up with some of those side effects if the drug actually worked well. I don’t know what the statistics are, but what I am discovering with my clients is that many of the women who took this drug still had recurrences of breast cancer, despite putting up with the side effects and toxicity. I hear this all the time! Now we also are finding out that some women don’t metabolize them well.

What Does the Research Tell Us?

Plenty of studies have been done on Tamoxifen, far too numerous to list here. Several studies have established that there is an increased incidence of endometrial cancer among women taking Tamoxifen [1], [2]. In 1993, British researchers found that Tamoxifen administered to rats induced liver cancer and several subsequent studies confirmed those findings. [3] In other animal studies (again there have been many of them) Tamoxifen caused all sorts of reproductive organ cancers including testes, uterine, cervical, and vaginal cancers. In 2000, one researcher found that a key metabolite of Tamoxifen is mutagenic (DNA damaging) when particular conditions for its metabolism are met. Those conditions are discussed at length (if you can wade through the terminology) in the research paper listed at [4]. Notably, this researcher stated: “tamoxifen presents something of a problem in the arena of regulatory testing of pharmaceuticals for genetic toxicity: negative in the battery of short-term tests, but demonstrably genotoxic (and carcinogenic) in vivo.” (In vivo means inside a living body, either animal or human, not just a test tube.)

Of course, there do exist numerous studies which indicate Tamoxifen saves lives. Indeed one recent Lancet study [5] (funded in part by the pharmaceutial company making the drug) indicated that taking it for up to ten years substantially reduces breast cancer recurrence. We all heard about that not so long ago. However, all is not what it seems. I will point you to my learned friend, Sayer Ji, of GreenMedInfo.com, who has spent some time with the facts and figures on Tamoxifen, which culminated in his 2012 comment on this research: Tamoxifen: Praised As “Life Saving” But Still Causing Cancer.

It’s clear that the medical establishment believes that Lancet study because Tamoxifen continues to be one of the most-prescribed drugs for hormone-receptor-positive breast cancer. It irritates me that they remain stubbornly blind to the fact that natural medicine has many wonderful (and side-effect free) ways to stay well that can both help to prevent and also to treat cancer safely.

For those in the natural medicine arena, the bottom line is still what we see out there in the trenches – the terrible side effects from these drugs, the fact that so many women taking it are still having recurrences, and the fact that it is classed by the World Health Organization (WHO) and the State of California as a human carcinogen.

So What Should an Empowered Survivor Do?

I can share with you what I did and what I am teaching others to do.

First of all, I disagree that our body’s own estrogen (a hormone we both want and need in our bodies) is causing breast cancer. If that were truly the reason, it seems to me that breast cancer would have been a problem since ancient times and it has only really become the huge problem that it is in recent decades, with the advance of processed foods, chemically-laden body products and cosmetics, environmental toxins and rising stress levels. Breast cancer is a multi-factorial disease and must be addressed on many other levels, not just hormonal. The medical establishment seems to be totally focused on the presence of estrogen receptors on breast cancer tumors. Of course they are there, estrogen plays a huge part in breast health. But complicating the problem is that there are synthetic estrogens in our body products, our drinking water, our cosmetics, our environment — they are coming at us from all directions – and I believe these synthetic estrogens, termed xenoestrogens, are just part of what is making us sick. For more about xenoestrogens, see my articles Protect Yourself From Xenoestrogens and Estrogen Dominance and Unraveling the Mystery of Xenoestrogens and Estrogen Dominance.

So my plan involved, firstly, detoxing my household of chemicals. I got rid of all that crap and began using only natural, organic products. If I couldn’t find them, I made them myself.

I began using some very particular essential oils, massaging them, undiluted, into my breast tissue on a daily basis. See my page Essential Oils for Overall Health and Specific Health Problems for a list of the oils I use.

I had my husband fit a filtration system to the kitchen sink and filtered the drinking water. I also had him install a shower filter.

I began buying only organic produce and when I couldn’t get it organically grown, I either learned how to grow it myself or washed the hell out of it (for things I really wanted/needed) or avoided it completely (I mean who really needs a rutabaga?).

I began working on building up my immune system. Here’s my page on how to do that:  8 Ways To Build a Super Strong Immune System.

I found out which supplements really made a difference in breast cancer and I discovered which foods had real research on them indicating they had anti-cancer activity and began eating those foods. Lots of them! See my page Diet and Cancer.

I got my hormone levels checked periodically. Even though I don’t believe our body’s own estrogen causes breast cancer, it made sense to me to keep an eye on things. When necessary, I use a natural wild yam cream trans-dermally to boost progesterone levels and I take certain supplements that contain wild yam and other things for breast health.

I also got my vitamin D levels checked periodically. When low, I take supplements. See my article: Why Vitamin D is So Important for Breast Health.

I amped up my exercise after reading a study called The Women’s Healthy Eating and Living (WHEL) study [6]. It involved 1,500 women from 1991-2000 who had early stage breast cancer. It found that women who ate plenty of vegetables and fruit every day as well as got regular physical activity were nearly 50 percent less likely to die. So I began getting more regular exercise (in addition to all those lovely plant based foods)!

I learned meditation, because I felt very strongly that a long period of badly managed stress was what undermined my immune system to such a degree that it let cancer in the door. I even created a downloadable how-to-meditate course to help others who don’t have access to meditation classes like I did. Here’s the link: Change Your Life Meditation Course

I learned how to improve my sleep because I found out that bad sleep also undermines the immune system, messes with your hormones and just generally makes you feel crappy. See my page about that: Want To Sleep Better?

I also learned how to do cleanses. A yearly or twice yearly bowel and liver cleanse is one of the best ways to get toxins and xenoestrogens out of your body and keep things running beautifully.

I am still well, healthy and here to tell the story.

References:

[1] Endometrial Cancer in Tamoxifen-Treated Breast Cancer Patients: Findings From the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14 – http://jnci.oxfordjournals.org/content/86/7/527.abstract?ijkey=f6e51d3ed6a435030236801eb63df2f1c9279a5d&keytype2=tf_ipsecsha

[2] Risk and Prognosis of Endometrial Cancer after Tamoxifen for Breast Cancer. Comprehensive Cancer Centres’ ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen – http://www.ncbi.nlm.nih.gov/pubmed/11036892

[3] Two-year Carcinogenicity Study of Tamoxifen in Alderley Park Wistar-derived Rats – http://www.ncbi.nlm.nih.gov/pubmed/8358718

[4] Understanding the Genotoxicity of Tamoxifen? http://carcin.oxfordjournals.org/content/22/6/839.full#content-block

[5] Long-term Effects of Continuing Adjuvant Tamoxifen to 10 Years Versus Stopping at 5 Years after Diagnosis of Oestrogen Receptor-positive Breast Cancer: ATLAS, a randomised trial – http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961963-1/abstract

GET MY BEST TIPS on getting through breast cancer and preventing recurrences by signing up for my free e-newsletters and e-books on the right. You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.

What Is Aromatase And Why Inhibit It?

https://marnieclark.com/What-Is-Aromatase-And-Why-Inhibit-It

What Is Aromatase And Why Inhibit It?

One of the pages of my website that is visited a lot is 18 Natural Aromatase Inhibitors and I suspect the reason for this is that people with hormone-driven breast cancer, known as estrogen-receptor-positive (or ER+) breast cancer, are being prescribed drugs known as aromatase inhibitors. There is a lot of interest in using natural medicine and nutrients to do this job. So what is aromatase and why would we want to inhibit it?

What Is Aromatase?

Aromatase, also known as estrogen synthetase, is an enzyme that is responsible for the synthesis of the hormone estrogen in the body.  Aromatase plays a key role in the conversion of testosterone and androstenedione to various forms of estrogen (see diagram above). You can see that aromatase is required for the conversion to take place.  Aromatase is located in special cells in the ovaries, adrenal glands, testicles, placenta, fat cells and the brain.

Why Inhibit Aromatase?

In the search for drugs that will offer people the best chance of living without breast cancer recurrence, science offers us aromatase inhibitors (AIs).

Two approaches have been developed to reduce the growth-stimulatory effects of estrogen in ER+ breast cancer:

1.  Interfering with the ability of estrogen to bind to its receptor
2.  Decreasing circulating levels of estrogen

AIs are unable to stop ovaries from creating estrogen, however, so AIs are generally only offered to postmenopausal women.

Three Aromatase Inhibiting Drugs

There are currently three main aromatase inhibiting drugs:

letrozole – Femara, made by Novartis
anastrozole – Arimidex, made by Astra-Zeneca
exemestane – Aromasin, made by Pfizer

Exemestane (Aromasin) was approved by the United States Food & Drug Administration for those who have already been treated with tamoxifen.  The other two drugs, letrozole (Femara) and anastrozole (Arimidex), have been approved as either first-line treatment without prior use of  tamoxifen or for use following tamoxifen treatment.

The Problem Is… Those Awful Side Effects

As with many pharmaceutical drugs, there are side effects associated with taking AIs. Estrogen plays a huge part in a woman’s wellness and depriving our bodies of its effects can have some fairly serious complications.

In 2008, Breast Cancer Action, an education and advocacy organization dedicated to supporting people living with breast cancer, released a report entitled Side Effects Revisited: Women’s Experiences With Aromatase Inhibitors 1. BCA sent out a survey to 1,199 women taking aromatase inhibitors to discover what some of the side effects were and how debilitating they might be. See the results of the study at reference 1 below.  In particular see Table 3 on page 7.

The most common side effects  were pain, particularly joint pain, stiffness, and arthritis but other common side effects included hot flashes, bone pain, muscle pain, tiredness, insomnia, weight gain, loss of mental acuity, anxiety, depression and hair thinning. Only 2.3% of women reported they experienced NO side effects. If you are considering taking AIs, you owe it to yourself to read this report.

Estrogen is Important

Estrogen is a hormone we need in our bodies. Outside of its huge role in reproduction, estrogen also exerts major effects on the health of our bones. It works closely together with vitamin D and minerals to build and maintain our bones. All aromatase inhibitors moderately enhance bone loss. 2

Estrogen is also necessary for maintaining healthy cholesterol levels and offers protective benefits by increasing triglyceride concentrations in the bloodstream, which helps to guard against atherosclerosis.

Remember reading that some of the side effects of the AI drugs is loss of mental acuity? That’s because estrogen is very involved in brain health. It plays a role in memory retention, increasing serotonin levels, production of endorphins, and it even has a protective effect for nerves.

There are also estrogen receptors in the eyes, and vision changes are often one of the side effects people complain about after taking AIs.

Natural Medicine Approach

When we inhibit the biosynthesis of estrogen in every tissue of the body, no wonder the side effects are so life altering. Is it worth it? Are AIs really helping to keep recurrences at bay? Or are we suffering these side effects and still having recurrences?

Studies indicate that AIs are helping to keep recurrences at bay.  A 2005 study, Aromatase Inhibitors in the Treatment of Breast Cancer 3 indicates that the above three drugs are very effective, in vivo (meaning in the body) inhibition of whole-body aromatization ranged between 96.7% – 98.9%.  Most oncologists feel that AIs are the most effective hormonal therapy available for post-menopausal women.

But those side effects are very real and for many women, unendurable. These drugs are toxic to the body and could have repercussions down the line that we have no idea about because they have only been used since about 2000.

As a breast cancer coach, I can tell you that I am in contact with quite a few women who have taken these drugs and still suffered with recurrences and while I don’t possess statistical data, I can tell you that it does happen, all too frequently. No, it won’t happen for everyone, obviously, but I do believe there is a much better way to move forward.

Within the archives of this website you will no doubt read my words “it’s not all about estrogen” several times. What I mean by that is that having breast cancer, even ER+ breast cancer, is not all about having an overabundance of estrogen floating through our bodies. Cancer is a multi-factorial disease, with genetic, lifestyle and environmental factors interacting to create the havoc that cancer can be.

Natural medicine offers other ways of dealing with this problem, for instance:
1.  Looking into why estrogen levels are high in the first place and then managing that. Is it the body’s own estrogen, or is it an overabundance of xenoestrogens?
2. What is the patient’s diet like? What dietary factors might be influencing an overabundance of estrogen?
3.  What factors in the patient’s life may have contributed to the development of breast cancer?
4. What kind of stress was the patient under prior to diagnosis?
5.  What is the status of the patient’s immune system? What can we do to support it?
6.  What therapies has the patient already undergone to address the cancer? (Knowing this helps to establish the level of toxicity present.)
7.  What natural foods and supplements can assist the patient with blocking aromatase if that proves necessary?

These are just some of the questions a natural medicine practitioner will ask, looking at the patient as a whole and not just treating one small aspect of the disease.

References:
1. Side Effects Revisited: Women’s Experiences With Aromatase Inhibitors –http://bcaction.org/wp-content/uploads/2011/03/AI-Report-June-2008-Final-ONLINE.pdf

2. The potency and clinical efficacy of aromatase inhibitors across the breast cancer continuum – http://annonc.oxfordjournals.org/content/early/2010/07/08/annonc.mdq337.full

3. Aromatase Inhibitors in the Treatment of Breast Cancer – http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.327.1025&rep=rep1&type=pdf

GET MY BEST TIPS on getting through breast cancer and preventing recurrences by signing up for my free e-newsletters and e-books on the right. You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.


Disclaimer: The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional. You should not use the information on this site for diagnosis or treatment of any health problem and please be sure to consult your chosen health care professional when making decisions about your health.

Why I Chose Against Hormone Blocking Drugs

 

Photo courtesy of MorgueFile and Aidairi

Photo courtesy of MorgueFile and Aidairi

Why I Chose Against Hormone Blocking Drugs

Every single day I am contacted by women who are either going through breast cancer treatments or have finished their treatments and have been prescribed estrogen blocking drugs like tamoxifen (Nolvadex), anastrozole (Arimidex), exemestane (Aromasin), letrozole (Femara), raloxifene (Evista).

Many of these drugs are also known as aromatase inhibitors because they deactive a key enzyme (aromatase) that is responsible for a key step in the biosynthesis of estrogen.

Why Women Are Prescribed Hormone Blockers

A breast tumor is called “estrogen receptor positive” or “ER+” if it has receptors for estrogen – this suggests that the cancer cells, like normal breast cells, may receive signals from the hormone estrogen that could promote their growth.  The cancer is termed “progesterone receptor positive” or “PR+” if it has progesterone receptors.  Again, this means that the cancer cells may receive signals from progesterone that could promote their growth. According to BreastCancer.org, roughly two out of every three breast cancers test positive for hormone receptors.

The women who are contacting me are very concerned about the side effects of such medications, they are researching and wanting to know more and they are wondering if there are any natural products that will do the same job without the side effects.

My Personal History

I went through breast cancer in 2004.  If you’d like to read my whole story, check out my Breast Cancer Diary page.  Briefly, however, I had a 2.5 cm tumor, about the size of an olive, and it was a rapidly growing tumor known as infiltrating ductal carcinoma.  I had a large lumpectomy and a latissimus-dorsi flap reconstruction.  I was recommended to have chemotherapy right away, but being a natural therapist I needed to be convinced of the necessity of that, so I went home to heal up and work on my immune system.  Eventually both my oncologist and my natural therapists convinced me that it would be beneficial for me to undergo chemotherapy and I did 6 months worth.  I chose not to have radiation for various reasons, and although both my oncologist and my regular doctor tried hard to get me to say yes to the hormone blocking drugs, I just could not be convinced that this was a good route for me to follow.  For one thing, I was progesterone receptor positive only, which is somewhat unusual.  I couldn’t see how tamoxifen, which is used as an estrogen-blocker, was going to help me since I was PR+.  My doctors argued it would “still have some therapeutic benefit.”  I wasn’t convinced, and especially when I read about the side effects of these drugs.  Instead I went home and went into deep research mode.  Here’s what I found.

1.  Some research indicated that tamoxifen was more useful in elderly and frail women and it removed the need for surgery in a high proportion of those women. (Akhtar SS, et al.  A 10-year experience of tamoxifen as primary treatment of breast cancer in 100 elderly and frail patients.  Eur J Surg Oncol. 1991; 17:30-5.)

2.  The Institute of Cancer Epidemiology in Copenhagen studied 3,500 post-menopausal women who received surgery for breast cancer. About half of these patients were considered to be low risk and received no further treatment.  The high risk patients received either radiotherapy or radiotherapy plus tamoxifen.  After about 8 years, the scientists looked at the incidence of cancer in these women.  All 3 groups had more cancer than the general population and for those who had received radiotherapy there was a higher incidence of leukemia.  There was no difference in cancer incidence in the high risk group that  received tamoxifen plus radiotherapy compared to those who just received radiotherapy, indicating that tamoxifen did not confer any special protective effects.  In fact, there was a tendency to an elevated risk of endometrial cancer. (Andersson M, et al. Incidence of new primary cancers after adjuvant tamoxifen therapy and radiotherapy for early breast cancer: J Natl Cancer Inst. 1991; 83:1013-7.)

3. The McArdle Laboratory for Cancer Research of the University of Wisconsin studied rats given tamoxifen.  At first, all appeared okay, but when the rats were also given a small dose of chemicals and then fed tamoxifen, the livers of these animals showed an increase in the size and number of altered liver lesions compared with the animals that had been fed the chemicals but not the tamoxifen.  The researchers felt that tamoxifen acts as a tumor promoter in the rat liver, that it was four times the strength of phenobarbital (a drug commonly used as a representative promoting agent in experimental carcinogenesis). (Dragan YP, et al. Tumor promotion as a target for estrogen/anti-estrogen effects in rat hepatocarcinogenesis. Prev Med. 1991; 20:15-26).

4.  There were too many disturbing reports of eye damage from the use of tamixofen.  In one article that appeared in the Annals of Ophthalmology, I read about toxicity to the cornea, retina and optic nerve.  And though it seemed that the damage did not progress once the drug was stopped, it could not be repaired. (Gerner EW. Ocular toxicity of tamoxifen. Annals of Ophthalmology 1989; 21:420-3).  I had enough problems with my vision, I certainly didn’t need any more.

I could go on and on here, citing all of the research that I did – and yes this research is a little older, I went through breast cancer in 2004, as I mentioned. 

Possible Side Effects of Hormone Blocking Drugs

The list of possible side effects of these drugs is lengthy:  hot flashes, vaginal dryness, headaches, muscle, joint and body aches, dry mouth, nausea and vomiting, changes in bowel habits, muscle weakness, fatigue, increased risk of liver cancer, precancerous changes in the uterus, blood clots which could travel to the lungs and cause pulmonary embolism or a stroke, cataracts and other vision changes. 

I just wasn’t willing to submit my body to any of that.

It’s Time To Wake Up

What I am seeing as a breast cancer coach is a large quantity of women (more than I ever thought possible) who have taken the hormone blockers for the prescribed length of time (usually 5 years) and are coming to me with a new breast cancer.

We need to wake up people!  These drugs are not working.  They are toxic to our bodies and there are better ways of regaining our health.  The thing is, you can’t just say no and do nothing else.  You really need to be very pro-active with your health.  If you don’t know what to do, feel free to sign up for my e-books and newsletters, I provide them as a free service to people going through breast cancer and I share all of my best tips and information in them (see the sign-up form on the right side of this page).

It’s Not All About Estrogen!

I have said this so many times lately, it’s starting to become my slogan.  Estrogen is a hormone we want and need in our bodies.  The doctors are so focused on the fact that there are estrogen receptors on our breast cancer cells but part of the problem is that there are synthetic estrogens in our body products, our drinking water, our cosmetics, our environment, and these are part of the problem with our health (see my article Protect Yourself From Xenoestrogens and Estrogen Dominance).

In her book “Molecules of Emotion“, author and scientist Candace Pert shares with us “… accumulated environmental pollutants within our bodies are mimicking and disrupting the action of our sex hormones — estrogen, progesterone, and testosterone — which run the male and female reproductive systems.”  She goes on to state that “A recent report on receptor binding in Science, for example, has shown that environmental toxins have estrogenlike effects and bind to estrogen receptors, where they can stimulate breast cancer tumor growth.  Similarly, various toxins can act like testosterone in the male body and stimulate prostate cancer, which is embryologically similar to breast cancer.  Although this has been suspected for a long time, only recently have we gotten the hard proof that accumulation of these toxins in our bodies chronically stimulates our estrogen and testosterone receptors, putting them into a state of overdrive and leading to cancer.”

There are many other factors which put us at a higher risk for breast cancer, and right up there at the top of the list is STRESS.  You can do little to avoid it but you certainly can change the way that you react to it.  Try meditation to relieve that stress.  Get yourself into a meditation group, or if you live in a remote area download my meditation course.

I also believe that it’s vitally important to build up your immune system to be as strong and healthy as it can be, since our immune system is our first line of defense against cancer cells.  Why don’t the doctors tell you that?  Any natural therapist certainly will.  Have a look at my page 8 Ways To Build A Super Strong Immune System.  How important are these 8 items?  I believe they’re absolutely crucial.   Give proper attention to each of the 8 items on the list and you will be much happier and healthier than if you are taking toxic drug therapies.

References:

http://www.webmd.com/drugs/drug-1555-anastrozole+oral.aspx

http://www.webmd.com/breast-cancer/tc/breast-cancer-comparing-hormone-blocking-treatments-topic-overview

http://www.breastcancer.org/treatment/hormonal/serms/tamoxifen

Cancer Therapy, The Independent Consumer’s Guide To Non-Toxic Treatment and Prevention by Ralph W Moss, PhD.

Molecules of Emotion by Candace B Pert, PhD.

If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters and e-book on the right, and/or “like” me on Facebook (MarnieClark.com).  It is my honor and my goal to help you through this so that you emerge from breast cancer feeling better than before, thriving!

 PLEASE BE AWARE THAT THIS BLOG POST IS INFORMATION I HAVE DISCOVERED FOR MYSELF. IT FEELS TRUE FOR ME. THE INFORMATION PRESENTED HERE IS NOT MEANT TO DIVERT YOU ON YOUR HEALING PATH, IT IS ONLY INTENDED TO RAISE AWARENESS OF OTHER WAYS OF THINKING. YOU MUST DO WHAT IS RIGHT FOR YOU.

18 Natural Aromatase Inhibitors

Artwork courtesy of rgbstock.com and Idea Go

18 Natural Aromatase Inhibitors

The number one topic in breast cancer communities, and the thing I get asked about most often, is about natural aromatase inhibitors.  People are suffering from the effects of hormone inhibiting drugs – the list of side effects these drugs are capable of producing is seemingly endless. As a breast cancer coach, I hear all about them and have a great deal of sympathy for those taking these drugs.

It’s a subject near and dear to our hearts and we can spend plenty of time trying to dig up research on new natural alternatives – I know I do because I chose not to take Tamoxifen, much to my oncologist’s annoyance.  I just wasn’t willing to risk the side effects, such as cardiotoxicity and blood clots, etc. 

Update: I recently wrote an article sharing why I chose not to take Tamoxifen, in case you’re interested: Why I Chose Against Hormone Blocking Drugs

It worries me that the side effects of these drugs can be so debilitating and disruptive to quality of life.  More than that, I know quite a few who were on hormone blockers for the requisite period of time (usually 5 years) and suffered recurrences anyway.  That indicates to me these drugs aren’t working as well as they are meant to.

A Good Article

While doing some research recently, I came across a lengthy article, on the NIH website,  “Natural Products as Aromatase Inhibitors” [1]. Be warned, that article will do your head in, unless you are a doctor, researcher or medical professional! 

I will attempt to boil it all down into layman’s language for you – you can read for yourself all of the reasons why AIs are prescribed, how they work in breast cancer, and how scientists are actively researching many natural products to discover which ones can be utilized to help breast cancer patients.  I know what you are really after — the list of natural things that exhibit AI activity. 

18 Natural Aromatase Inhibitors

  1. Dioon Spinulosum – or gum palm, a cycad which grows in Veracruz and Oaxaca, Mexico
  2. Encephalartos ferox – also a cycad which grows mainly in Africa
  3. Riedelia – a genus of plants in the Zingiberaceae family, comprises approximately 75 species that are distributed among New Guinea and the Maluku and Solomon Islands
  4. Viscum album – a species of mistletoe, also known as European Mistletoe or Common Mistletoe to distinguish it from other related species. It is native to Europe and western and southern Asia
  5. Cycas rumphii – also a cycad, commonly known as queen sago or the queen sago palm, it grows in the Moluccan island group (New Guinea, Java, Indonesia)
  6. Cycas revoluta – also a cycad, native to southern Japan
  7. Alpinia purpurata – also known as Red Ginger, a native to Malaysia
  8. Coccothrinax Sarg – Coccothrinax is a genus of palms in the Arecaceae family, there are more than 50 species described in the genus, plus many synonyms and sub-species, and they grow in a variety of places
  9. Five red wine varieties, the most active being Cabernet Sauvignon from Tanglewood (France), the other mentioned was Pinot noir from Hacienda (Sonoma, CA)
  10. Brassaiopsis glomerulata – a deciduous tree found in North Vietnam
  11. Garcinia mangostana L. (Clusiaceae) – also known as mangosteen, has a long history of use as a medical plant, found mostly in Southeast Asia
  12. Euonymus alatus – also known as winged spindle, winged euonymus or burning bush, it’s a species of flowering plant in the family Celastraceae, native to central and northern China, Japan, and Korea
  13. Isodon excisus Kudo var. coreanus – a small herbaceous plant that grows in Western Asia (Japan, China, Korea)
  14. Scutellaria barbata – a plant used in traditional Chinese medicine, other names include ban zhi lian’, scullcap or skullcap, it grows in Korea and southern China
  15. Camellia sinensis – also known as green tea (easily obtainable every morning for breakfast!)
  16. Vitis L. sp – also known as grape seed extract, the report cited a study where a water extract of grape seed extract was utilized and it had AI activity
  17. Agaricus bisporus – also known as white button mushrooms
  18. Trifolium pratense L. – also known as red clover flowers.  There is a lot of misinformation out there about red clover, please read my article Red Clover Controversy – Safe For Breast Cancer Or Not?

Update: See two more discussed below – selenium and pomegranate.

The article also mentioned that coffee, cocoa, collards, stout beer, tomato leaves and even cigarette smoke (!) strongly inhibited aromatase using a microsomal assay.  I don’t know about you but I’m not eating tomato leaves or breathing in cigarette smoke intentionally!

Many of the above listed things are not currently being produced as natural supplements.  I would suggest you print out this list and take it to your naturopath to see which ones would be available and safe for you to use.  Some of the listed items will be easily available (like #9, #15, #16, #17 #18) and you could easily incorporate them into your diet. 

Something not listed is selenium, we do have research indicating that it acts as a natural aromatase inhibitor, see my article  Why Iodine and Selenium Are Useful For Breast Cancer.

2017 Update – I found an older study from 2010 [2] indicating that the ellagitannins (phytochemicals) in pomegranates also had anti-aromatase activity. So make that 20 natural aromatase inhibitors (including selenium, above).

2018 Update – We can add mangosteen to the list of natural aromatase inhibitors. [3]

The above list is not exhaustive – the report did also discuss 125 flavonoids, 36 terpenoids, 19 peptides, 18 lignans, 16 xanthones, 15 fatty acids, 10 alkaloids, and 43 miscellaneous compounds having been evaluated but there was not sufficient information for me to feel it was worth listing them all.

Unfortunately, there is no information on dosages for any of the above nutrients, more information is clearly needed.

Just Remember Estrogen Is Not The Only Factor Involved In Breast Cancer

The important thing I would like you to take away from all of this is that we can drive ourselves crazy looking for the tiniest things that will give us an edge over this disease.  I hope you don’t get bogged down in this. Please remember, estrogen is not the only factor involved in breast cancer.  An overall anti-cancer strategy is to eat a healthy diet full of  fresh organic fruits and vegetables and super foods,  take the supplements that have research backing them (see my page discussing that topic), limit your exposure to toxic skin care products, get plenty of exercise DAILY and keep your stress levels down through the use of meditation or prayer. 

You may want to read some of my other articles about aromatase inhibitors:

The Down & Dirty on Aromatase Inhibitors for Breast Cancer Treatment

Acupuncture: How It Helps With Cancer Treatments

Aromatase Inhbitors Natural vs Toxic

Researchers Discover Mushrooms Could Be Potent Natural Aromatase Inhibitors

Why Vitamin D is So Important for Breast Health

Is Chrysin a Good Natural Aromatase Inhibitor?

References:

[1] Natural Products as Aromatase Inhibitors — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074486/

[2] Pomegranate ellagitannin-derived compounds exhibit antiproliferative and antiaromatase activity in breast cancer cells in vitro – https://www.ncbi.nlm.nih.gov/pubmed/20051378

[3] Xanthones from the Botanical Dietary Supplement Mangosteen (Garcinia mangostana) with Aromatase Inhibitory Activity – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572570/

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