By Dr. Robert Zieve, MD
The risk for breast cancer increases with age, because as we age, we accumulate the type of toxins that cause gene mutations that lead to cancer. These toxins include environmental xenoestrogens, including chemicals like BPA in many plastic containers that mimic estrogen and can stimulate estrogen receptors on breast cancer cells.
Cancer Is Not Just Cancer
There are many different types of cancers. Each cancer, after diagnosis by biopsy, is given a
grade, stage, and classification based upon the expression of proteins and genes. The purpose of classification is to select the best treatment. The effectiveness of a specific oncology treatment is demonstrated for a specific breast cancer, (usually by clinical trials), but that treatment may not be effective in a different breast cancer. Some breast cancers are aggressive and life-threatening and must be treated with aggressive treatments that can have major adverse effects; other breast cancers are less aggressive and can be treated with less aggressive treatments, such as lumpectomy followed by radiation.
Keep in mind that modern oncology is really only addressing the cancer, not you as a person--your sleep, emotions, bowel function, and other aspects of your health and well-being; nor is modern oncology addressing or looking for many imbalances in your biochemistry, like inflammation, immune system imbalances, heavy metal toxicity, Vitamin D deficiency, metabolic blood sugar imbalances, acid/alkaline balance, and so forth. Without doing these two important things, it is difficult to help many people with cancer improve and heal. It is this more integrative approach that defines what we do here at our clinic.
Three-quarters of breast cancers fall into these categories on biopsy:
Invasive ductal carcinoma - 55% of breast cancers.
Ductal carcinoma in situ - 13%. DCIS is not cancer, and ought not to be treated like a cancer.
DCIS is more like an abnormal PAP smear. You have time to make some changes in lifestyle, do some further testing, and be reevaluated some time down the line. That being said, if left
untreated, approximately 60% of low-grade DCIS lesions will become invasive over the course of 40 years in follow-up. This is according to the medical literature. But remember, if you make needed changes in your lifestyle, start to detoxify, and start on a well-thought-out oral supplement and food program, these statistics likely do not apply to you. For that matter, if you follow these lifestyle and detoxification guidelines, most of the statistics as to 5-year survival rates in breast cancer likely do not apply to you, because the medical models behind these statistics do not take into account the changes you are making in your life.
Invasive lobular carcinoma - 5%
Types of Breast Cancer
There are many different types of breast cancer, and these vary depending on pathology. This can get somewhat complicated to discuss an article like this and is really should be discussed with your oncologist or integrative cancer doctor. There are cancers in the breast ducts, invasive breast cancer (most women have this on biopsy), cancer in the small lobes of the breast, inflammatory breast cancer, Her2 neu positive cancer, triple negative breast cancer, BRCA 1 and 2 cancers, and many, many others.
You can see that all cancer is not the same. It is not just about having breast cancer; it's about identifying the particular mutations in the cancer you have to learn the weakness or
vulnerability of the cancer to whatever treatment you decide to do, whether that be surgery,
chemotherapy, herbs, IV alternative/complementary naturopathic therapies, or others.
Permit me to add here that this month you're likely going to hear a lot about how mammograms prevent breast cancer. This is not true. Mammogram is one diagnostic procedure used to detect breast cancer, but it is not a prevention for breast cancer. And there are many drawbacks to mammograms, which I will address in the next article. Many women ask their physician to order an ultrasound, or breast MRI, to identify if they have a breast cancer.
Also, having tests for BRCA 1 and 2 genes does not prevent breast cancer, but can be used to guide treatment decisions if the results are positive. While inherited genes can play a role in some women who develop breast cancer, this is way overplayed as a cause of the cancer. However, if a close relative has or has had breast cancer, the risk for you is higher. However, even if this is true in your family history, there is much you can do in your lifestyle to help prevent this.
Is Breast Cancer Preventable?
Yes, if you improve your lifestyle, and have an ongoing process of detoxification in place. Here are some steps you can take:
Lower your alcohol consumption: alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer, which is by far the most common form of breast cancer especially in postmenopausal women. Alcohol also may increase breast cancer risk by damaging DNA in cells. Compared to women who don't drink at all, women who have three alcoholic drinks per week have a 15% higher risk of breast cancer.
Focus on a healthy diet
Limit toxin exposures and do good detoxification often
Work on your stressors and sleep.
What To Do After Your Diagnosis?
Many women I see right after the diagnosis of a breast cancer are being urged to do immediate surgery of some kind, assuming the cancer has not spread outside of the breast on MRI or PET scan. The surgery most often suggested is a lumpectomy, followed by radiation. This can be done with local anesthesia unless there is evidence that it has spread to your lymph nodes in the axilla. Many women and many people today fear doing any radiation therapy.
Let me add here that if you have been diagnosed by biopsy with a breast cancer, there is no
urgent reason to do surgery. It is best to spend a few weeks to a month changing your diet,
running blood tests to look for such things as inflammation and vitamin and mineral deficiencies, and begin a guided, robust oral supplement program. Don't get rushed into
surgery. Think it through and prepare if that is the therapy you chose to take, and think through your plan after surgery. If you need to, get a second opinion.
Also, begin a process of detoxification. This can be with herbs, nutritional supplements,
homeopathic remedies, far infrared sauna, colonic therapy, and/or coffee enemas. And work
with a nutritionist like our cancer nutritionist who has experience in advising people with cancer about individualized food programs.
If you have been diagnosed with the much more common estrogen positive breast cancer by
biopsy, you can always ask your doctor to order what is called an Oncotype DX recurrence
score. It is a 21-gene assay that was designed for use in estrogen receptor (ER) positive tumors. This can guide you and your physician in planning therapeutic strategies, and is often covered by insurance, Medicare, and AHCCCS if ordered by the appropriate physician.
Oncotype results are reported as a Recurrence Score (RS), where a higher RS is associated with a worse prognosis, referring to the likelihood of recurrence without treatment.
Lumpectomy and Radiation vs. Simple Mastectomy
Most deaths from cancer are caused by metastases to other organs. If you have been diagnosed with breast cancer, the goal is to do treatments that eliminate the localized cancer and prevent it from spreading and risking your life and well-being. There are enough studies that demonstrate that radiation done after a simple lumpectomy has better outcomes in terms of preventing spread or recurrence. If women don't want to have radiotherapy, the other option is a simple mastectomy the first time. If these are done right, and you prepare your biological terrain for these therapies, the risks of metastatic breast cancer are greatly reduced.
I find that out of fear of radiation, many women decline radiation therapy after a lumpectomy. This can be risky. I must describe here to you a woman I am working with who did this after her second lumpectomy (she had chemo but declined radiation after the first lumpectomy). She now has her fifth breast cancer recurrence, all in the same breast. I describe her to you so that you can better weigh the risks and benefits of doing radiation after a lumpectomy.
My conclusion is that it is best to do radiation after lumpectomy, or if you chose not to go this route, do a simple mastectomy. This can and often is an emotionally wrenching decision for most women with breast cancer, and understandably so. And you must feel good about the therapeutic choice you are making.
Remember, if you have been diagnosed with a breast cancer the goal is to prevent it from
spreading, or if it has spread, to limit its spread and help you to live a good quality of life. These goals are certainly attainable for most women with breast cancer, but it takes work and good planning.
Alternative/Complementary Cancer Therapies
Many women want to know if alternative cancer therapies like IV Vitamin C, Laetrile, Mistletoe, and ozone can heal cancer. The problem is that there have been no clinical trials to look at these treatments. There likely will never be such studies, in part because it costs millions of dollars to do them, and there are no vested interests that would spend such money to prove that a low-profit therapy is effective.
What we do know from clinical observations and studies done at major university centers, is
that in the treatment of metastatic cancers, combining and integrating CAM (complementary/alternative) therapies-- IV Vitamin C, ozone therapies, along with a
foundational oral program of herbs, nutrients, and homeopathic remedies--can help many
people with metastatic cancers live many years with a good quality of life. The IV therapies
mentioned here are most often not needed in women for whom there is no evidence of spread of cancer.
The mechanistic model of medical oncology wants to fit you into their statistical paradigm, one that is based upon drugs, surgery, and radiation, but what you do in your life and lifestyle can indeed make a difference. I have seen the truth of this in many women with breast cancer.
Don't ignore the studies, but make the needed changes, work with addressing your mental/emotional state so that you can feel comfortable after the due diligence you are doing that you are making the right decision, and stick with it, always being willing to re-address your strategies with a good integrative or naturopathic physician, and make therapy changes if you need to. And make sure not to alienate your surgeon or oncologist--they are part of your team.
It is no accident that you have been diagnosed with cancer. Look at this as a wake-up call to
change your life and take stock of who you are and how you got here. There is so much more to say, but I'll wait until the next blog to do so. If there are any specific areas about breast cancer that you would like me to address in any upcoming blogs, let me know.
~Robert Zieve, M.D.