Reduce the Risk of Breast Cancer Recurrence

  • 6 Jan 2009
  • Reading time 13 mins
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What to do if you’ve been diagnosed with breast cancer, or want to decrease your chances of developing this disease.

Tamoxifen, Raloxifene, and Arimidex: The Anti-Oestrogens

Tamoxifen, the market leader, is potentially effective only for patients with oestrogen-positive breast cancer. It also does not appear to be effective when the cancer has spread to the lymph nodes. Trials have shown that, with oestrogen-positive breast cancer, the longer a woman takes tamoxifen, the more she reduces her risk of a recurrence. Reviews typically report that 10% more women survive longer than ten years when they take tamoxifen for five years. However, these reviews also indicate that tamoxifen significantly increases the incidence of endometrial cancer – quadrupling it after those same five years of use. This is because tamoxifen causes the uterus to quickly thicken in virtually all test subjects, doubling their risk of endometrial cancer in the first year or two of use. Because the drug has anti-oestrogenic properties in some parts of the body and potent oestrogenic effects on others, it is known, along with raloxifene, as a selective oestrogen receptor modulator.

Other side effects of tamoxifen include a tripling of the risk for potentially fatal blood clots in the lungs, increased risk of stroke, blindness and liver dysfunction. In consideration of these potential problems, tamoxifen’s overall reduction in risk of mortality is considerably less than 10%.

The National Cancer Institute (NCI) admits that tamoxifen is indicated for preventive use only in women with increased risk of breast cancer, as determined primarily by family history. NCI estimates that only about 0.3% of women age 39 or younger would be candidates for tamoxifen treatment, yet it used to be common practice to put most women with breast cancer on the medication.

Raloxifene is the major rival for tamoxifen. It hasn’t been so extensively studied in long-term trials, but the general consensus is that it reduces recurrence in oestrogen-positive breast cancer only slightly better than tamoxifen, but with less risk for endometrial cancer and no real difference in risk for stroke or cardiovascular problems. Some have claimed that raloxifene might reduce cardiovascular risk because, like tamoxifen, it appears to lower LDL (bad) cholesterol and raise HDL (good) cholesterol. But a recent trial, which studied the effects of raloxifene in women who had a history of heart disease or who were at high risk for heart disease, showed that after more than five years of follow-up, participants experienced no real improvement in heart problems. [1] This trial also found that taking raloxifene put some women at greater risk for dangerous blood clots, though the risk of stroke was found to be the same in women taking raloxifene as those taking the placebo. However, among women who had strokes during the time of the study, more women in the raloxifene group had fatal strokes than in the placebo group.

A second rival to tamoxifen is Arimidex. Although the survival rates of patients taking Arimidex don’t appear to be any different from the survival rates of patients taking tamoxifen, there are quite a few studies that focus on symptoms affecting ‘quality of life’. For example, one study says that women who took Arimidex reported less vaginal bleeding and thromboembolic events than women taking tamoxifen, but more hot flushes and vaginal dryness. [2] Another reports more loss of libido with Arimidex, but less dizziness. [3]

Over-Hyped Herceptin

Herceptin works by targeting the human epidermal growth factor receptor 2 (HER2) protein, which can fuel the growth of breast cancer tumours in women with HER2-positive breast cancer. However, this accounts for only 25% of breast cancer cases. Herceptin proponents tout clinical trials which show a 46% decrease in recurring breast cancer when the drug is prescribed to late-stage breast cancer patients. But one of the main studies cited in support of Herceptin, called the Hera trial [4], saw 34 deaths in the control group (2% of the participants) and 23 deaths (1.4%) in the group treated with Herceptin. This is a 0.6% absolute reduction in deaths. But there are problems. A study carried out by the University of Texas and published in the Journal of Clinical Oncology, found that a significant number of patients using Herceptin for at least a year suffered cardiac problems. [5] In this study of 173 patients, 28% of those treated with Herceptin experienced a cardiac event after taking the drug for an average of 21 months – and this included one cardiac-related death. At £30,000 a year, Herceptin hardly seems worth it when you think what you could do with that money by way of reducing your risk naturally.

Natural Ways To Reduce Your Risk

To put natural solutions in perspective, a survey of more than 44,000 twins determined that no more than 15% of breast cancer cases are the result of genetic predisposition. [6] Therefore, 85% of cases are likely a consequence of environmental factors, including diet and lifestyle. It makes sense to look at what these factors might be. One logical place to start is in China. According to research quoted by Dr Jane Plant, cancer survivor and author of The Plant Diet, a woman living in rural China has a 1 in 9,000 chance of developing breast cancer, compared to a 1 in 9 chance for a woman living in the United States. Because Chinese women living in the United States have a risk comparable to other women in the United States, the difference must lie in a quality or practice in China that doesn’t exist in the United States (or vice versa). Two things come immediately to mind: the Chinese don’t consume dairy products, and they eat phytoestrogen-rich beans every day.

Natural Anti-Growth Foods

The drugs I’ve discussed work by blocking growth signals to breast cancer cells. Two key growth hormones for cancer cells are oestrogen and IGF-1 (insulin-like growth factor). IGF-1 is made in the body, but it is also found in milk. A woman who drinks one pint of milk a day has substantially higher IGF-1 levels and a three times greater risk of breast cancer than ......

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