Sweet poison and the rest of the army; Reducing the risk of breast cancer
Some degree of chaos and confusion is still lurking in the air following the recent media attention on Angelina Jolie’s “preventative” double mastectomy, a decision reached after acknowledging that she was a carrier for the BRCA 1 (breast cancer susceptibility gene) gene together with her family history of both breast and ovarian cancer.
This is not another debate about her decision. With all due respect, that is her personal decision.
However, it is worth noting that less than 10% of breast cancers have anything to do with the BRCA genes. And in the case of having a particular gene defect, it does not necessarily mean that the gene will be expressed to cause the cancer .Genes are a bit like default settings on a computer. Everybody’s risk profile will be unique. It is clear therefore, that there are certainly many other factors at play, determining whether someone will develop breast cancer or not. Gene expression is influenced by the environment around it- factors such as toxins, nutrients, as well as “fluffy stuff” like thoughts and emotions.
It is imperative to mimimise risk in ways that are in our control. We can’t do anything about our genetics but there is still much that can be done to reduce overall risk of cancer as well as other lifestyle illnesses. As you will see, there is much commonality amongst cancer prevention as there is for diabetes and heart disease prevention. This topic could easily turn into several books! But the aim here is to give an overview of some important recommendations to reduce the risk of cancer. These are discussed under the broad categories of
- Environment and
“Summarised in a few words, the prime cause of cancer is the replacement of respiration of oxygen in normal body cells by a fermentation of sugar”. It was two- time Nobel Peace Prize Winner, Dr Otto Warburg who in 1924 linked the fermentation of sugar as the prime cause of cancer.
Basically, cancer cells need sugar to survive. More so, fructose (sugar is sucrose which is made of the two simple sugars glucose and fructose). In a study published in Cancer Research, it was shown that “cancer cells can readily metabolise fructose to increase proliferation” Sugar also reduces the efficiency of neutrophils (white blood cell) to do their job in destroying pathogens including cancer cells.
Further, it is important to keep glucose and hence insulin levels steady, so the concept of the glycaemic index is important. Insulin promotes tumour growth if the levels remain elevated.
So, yet another very justifiable reason to cut down on refined sugars and processed carbohydrates.
The association between vitamin D and cancer is now widely accepted. It also is linked to several other conditions including multiple sclerosis, inflammatory bowel disease, weight management, blood pressure, Alzheimers disease and diabetes. There are vitamin D receptors in every single cell of the body. So it is no surprise that a deficiency would impact on so many conditions. Studies have been done demonstrating that the higher the vitamin D, the less risk of breast cancer.1
“Epidemiological studies suggest optimal vitamin D levels can reduce cancer incidence by at least 50%” 1
“Epidemiological studies show that in the US, for every one patient that gets a melanoma, 40-50 people get preventable cancer due to suboptimal vitamin d levels” 2
More recently. a study published in the American Journal of Clinical Nutrition yet again confirmed this association. The study involved a group of Saudi Arabian women- average levels of vitamin D were lower in the breast cancer group compared with the control group. Their age ranges were 18-74; In Saudi Arabia, breast cancer is more common in women under 40 than in the US.
Maintaining an adequate vitamin D intake is largely from sun exposure and supplements. There is relatively little in foods. It has been estimated that our daily requirement of vitamin D is 4000-8000IU daily. Note that standard vitamin D capsules are 1000IU each. Ensure that you check your vitamin D levels; the optimal level is between 100-150nmol/l.
Meat– esp charred meats. The chemicals produced (heterocyclic amines,polycyclic aromatic hydrocarbons) are known to be carcinogenic
The UK Womens Cohort Study also showed a link between breast cancer and meat consumption. This was a study where 35,372 women aged 35-69 years were assessed using a 217 item food frequency questionnaire. The conclusion was that women, both pre and post menopausal, who consumed the most meat had the highest risk of breast cancer. 4
Brassica vegetables– esp Broccoli. The chemicals are involved in oestrogen metabolism and they reduce tumour proliferating oestrogen metabolites ( 2 and 16 oestrogen metabolites).
Several reports have consistently discussed the association with high fruit and vegetable intake and lower rates of cancer (AICR, World Cancer Research Fund to name but a few). This is known to be due to the powerful phytochemicals as well as the vitamins and minerals (selenium, copper,chromium,zinc). Certain phytonutrients like resveratrol (red grapes) and ellagic acid (strawberries) are known to prevent angiogenesis– the growth of new blood vessels needed for cancer cell survival.
It is important to ensure an adequate and varied fruit and vegetable intake generally (2-3 fruit and 5-7 veggie serves daily recommended). This can be in salads or vegetable juices. Eat from all the colours of the rainbow! All the berries are powerhouses for antioxidants. The fibre from foods (fruits, veg, healthy grains) may also help to promote the growth of bacteria that can metabolise oestrogen as well as binding to oestrogen and promoting its excretion.
Omega 3 oils – This is evidence based nutritional therapy at its best. And it doesn’t stop with heart disease prevention. There is also substantial evidence of fish oil and cancer prevention.
“Dietary supplementation of fish oils rich in omega 3 PUFAs should be considered for members of high breast cancer risk families” 5
Adequate intake of oily fish (e.g salmon, mackerel) three times weekly is advisable. In any case, it’s a great idea to take 1g of omega 3 oils daily (EPA and DHA combined- not total marine oil). Vegetarian options are flax seeds, walnuts and pumpkin seeds.
Vitamin A – There is again much evidence for vitamin A’s role in breast cancer prevention. Good sources are eggs and milk or supplementation may be necessary depending upon dietary restrictions.
Green tea– An all round winner! So many beneficial properties with regards to cancer, diabetes and heart disease. enjoy 1-4 cups daily.
Iodine – There is evidence that iodine deficiency states are linked to breast cancer. Iodine itself has been shown to cause death of breast and thyroid cancer cells.
Iodine is present in seaweed, kelp and iodized salt. As Australian soil is so low in iodine, it is not surprising that many people would be iodine deficient. To check iodine levels requires doing a urine iodine test and supplementation is easy if the levels are found to be low.
Curcumin – A real gem- this is the active ingredient in turmeric. Several studies have been done which prove it to be an antioxidant and have immune modulating properties. In cancer, it is beneficial in prevention and in reducing progression. 6
Soy– Soy in general is a very topical matter, often confusing. Generally speaking, one should in this case avoid unfermented soy. Fermented soy (fermented tofu, tempeh, miso, natto) is beneficial though.. There are phytoestrogens known to be protective in breast as well as ovarian, cervical, endometrial and prostate cancers. They occupy the oestrogen receptors over xenobiotics. 7
Isoflavones can be both oestrogenic and anti-oestrogenic. The strongest evidence is in pre menopausal women where the soy isoflavones have an anti-oestrogenic effect (in a high oestrogen environment) and a weak oestrogenic effect in post menopausal women (a low oestrogen environment)
Other nutrients and foods – All the vitamins and some minerals, in particular- calcium, magnesium, iodine, zinc, selenium, chromium and copper.
Foods- algae, chlorophyll, CoQ10, fibre, flax seed, berries and cherries, citrus fruits, lycopene, garlic, kale,parsley…
Many of these prevent angiogenesis- substances in these foods stop the growth of new blood vessels that are needed for the cancer cells to survive. Resveratrol(red grapes) and ellagic acid (berries) are potent angiogenesis inhibitors.
Alcohol– As in, avoid! Yes, the resveratrol found in the skin of red grapes is a powerful anti-oxidant. But if you don’t drink- please don’t start! And if you do, then do so in moderation.
In breast cancer, it is known that alcohol increases the activity of aromatase enzyme (converts steroids to oestrogen)- there is a “dose-response” effect. An AICR report in 2007 concluded that a woman who consumes 5 drinks weekly has an increased risk of breast cancer by 5%. A woman consuming 2 drinks daily has increased her risk to 40%.
Smoking– this goes without saying.
This will help to maintain a healthy weight and increase insulin sensitivity. It is important to keep the insulin levels down with diet and exercise together. High insulin levels and obesity have been linked to increased cancer incidence; excess fatty tissue also produces oestrogen.
A study just published this month showed a beneficial association of exercise in women in relation to breast cancer. Essentially, oestrogen metabolites were measured in 2 groups of women- those exercising 5 times weekly for 4 months and the other group doing no exercise. They found that those women who were exercising had more of the “good” oestrogen metabolite and less of the “bad” one ; there was no change in those who didn’t exercise. Professor Kurzer, University of Minnesota concluded: “Exercise, known to favor fitness and improve heart health, is also likely to help prevent breast cancer by altering estrogen metabolism.” 8
Adequate sleep is necessary for overall health. Many hormones are implicated here- melatonin and growth hormone to name just a couple. If sleep is disrupted, less melatonin hormone is produced- this is a powerful antioxidant as well – which can help fight off free radicals.
Xenostrogens– These are enviornmental chemicals that have oestrogen-like activity and have been shown to increase breast cancer risk. Many are pesticides/herbicides/fungicides as well as Parabens and Phthalates used in many products including personal care products and plastics. So, minimizing risk would include getting organic fruits and vegetables (inc. apples, spinach, broccoli, strawberries), using natural personal care products (free of parabens, SLS etc) and minimising use of particular plastics (avoid the plastics numbered 1,3,6 and 7 in the triangular recycling symbol on plastic containers).
Electromagnetic radiation– There is compelling evidence on EMR and cancer. This is not easy to avoid in today’s world but it important when trying to minimise risk. For example, reducing- mobile phone use (use the speaker phone), wireless network exposure, electric blankets.
Breast radiation– Several studies, most recently a large UK study have shown no significant benefit of mammograms and breast cancer risk reduction. Indeed, repeated doses of radiation from mammography could cause changes that lead to breast cancer. Mammograms have a place sometimes but alternative safer methods like thermography should also be considered (this is available in the UK and Australia).
Aluminium– this can be found in vaccines (adjuvant), anti-perspirants and can also be ingested orally (food additive). Aluminium is being implicated in many conditions including breast cancer. A study published in the Journal of Inorganic Chemistry found increased levels of aluminium in nipple aspirates of breast cancer patients compared with healthy controls. 10
Indeed, the term “metalloestrogen” has been coined by Researchers, describing the role that various metals have as endocrine disruptors. e.g. arsenic, mercury, copper and lead.
Breast cancer is no exception when it comes to mind-body connection. Emotions do affect the physical state. Indeed, even the Centers for Disease Control (CDC) stated “ Up to 90 % of the doctor visits in the USA may be triggered by a stress-related condition”. As such, it is important to resolve negative emotions like anger, fear, sadness, resentment and guilt. Whatever works for you- meditation,exercise, emotional freedom technique, tai chi, time line therapy, counselling, yoga, prayer…and don’t forget GRATITUDE.
Let’s end with this…
“At least 70% of all cancer is directly attributable to poor lifestyle choices” – World Health Organisation
1.Abbas et al. Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer-results of a large case –control study. Carcinogenesis 2008. Vol 29 No1. P93
2. Garland et al. The role of vitamin D in cancer prevention. Am J Public Health. 2006. Feb:96(2):252-61. Epub 2005 Dec 27. Review
3.Grant et al. Benefits and requirements of vitamin d for optimal health;a review. Alter Med Rev. 2005 Jun;10(2):94-111.
4. British Journal of Cancer Apr 10;96(7):1139-46
5. Franceschi et al. Int J Cancer 1997;72
6.Nagabhushan et al. J Am Coll Nutrition. 1992. Vol 11. P192
7.Adelcreutz. J of Clinc Nut 1995 (125)
8.Alma J Smith, William R Phipps, William Thomas, Kathryn H Schmitz, and Mindy S Kurzer. The effects of aerobic exercise on estrogen metabolism in healthy premenopausal women. Cancer Epidemiol Biomarkers Prev. 2013;22:756-764.