Unfortunately, many oncologists are under the misbelief that estrogen is the enemy, and often misrepresent estrogen as the root cause of one’s cancer. Perhaps your doctor recommended an aromatase inhibitor to get rid of this ‘dangerous’ estrogen. And most likely if you are reading this post it is because you are concerned about the side effects or the resulting effects of these drugs. Or maybe you started on one, feel terrible and are seeking alternatives.
The Role of Aromatase Inhibitors
Aromatase inhibitors drugs (AIs) such as Fermara, Aromasin and Arimidex, stop the production of estrogen in postmenopausal women. More specifically, they block the enzyme aromatase, the enzyme responsible for the biosynthesis and balance of estrogens.
However, while AIs have been found to prevent some breast cancer recurrences, they have not been found to actually prolong life (meaning you don’t die of the breast cancer, but rather from aromatase inhibitor use). This is due to the resulting effects—as I like to call them—particularly heart damage. They also reduce quality of life due to side effects such as the never ending flu symptoms, hair thinning and loss, vaginal bleeding, skin rashes, joint pain, stiffness and swelling (severe enough to require pain medication), hot flashes and night sweats, vaginal dryness, nausea, and headaches. Women may also feel tired and lethargic while on the drug, experience breathing difficulties, depression, and mood swings, tightness in the chest, and because of the loss of the estrogen, bone thinning (think broken bones). Not to mention that breast cancers eventually develop resistance to drug therapies.
Just because your doctor prescribed an AI, doesn’t mean that it is right for you. Making the right decision for you, for your body, is bigger than just accepting doctor’s orders. Masking a problem with an aromatase inhibitor is not the same thing as correcting the problem. And even if reducing aromatase might be helpful for you, yes, there is a better way.
Your doctor just might need to better understand the role of hormones in breast cancer. While oncologists know how estrogen receptors fuel the growth of cancer cells, they seem to know a lot less about what progesterone receptors do in those same cells.
The Scoop on Estrogen
It is time to set things straight. We need estrogen for aiding in the prevention of heart disease and for strong, healthy bones–estrogen is essential to the health of all parts of your body, from your eyes to your heart to your brain to everywhere else. We can we live with our estrogen, we need it; in fact, we can’t live without it. However, estrogen must be balanced by progesterone, which will be discussed below.
Hormonal imbalances have reached epidemic proportions in most developed countries over the last several decades. Due to poor diets, lack of exercise, a rise in obesity levels, the widespread use of hormone-altering chemicals, and other factors, many women suffer from chronically higher than normal estrogen levels and much lower than normal progesterone levels. Age plays a role as well, as after the age of 45 or so, estrogen levels decline, but progesterone plummet even more so. In other words, many women are in chronic states of estrogen dominance. This is one of the key reasons why breast cancer rates are as high as they are.
You see, while certain estrogens can stimulate cancer cell proliferation, progesterone inhibits this from happening. Progesterone acts as an antagonist to estrogen. When there is unopposed estrogen because of a deficiency in progesterone, there is an increased risk of developing cancer. When progesterone is raised to healthy levels relative to estrogen, it turns on genes that can prevent breast cancer from occurring and reduces the size of existing tumors.
So here is what your doctor needs to know. When adequate progesterone is present, the progesterone receptors attach themselves to the estrogen receptors. Once this happens, the estrogen receptors stop turning on genes that promote the growth of the cancer cells. Instead, they turn on genes that promote the death of cancer cells (known as apoptosis) and the growth of healthy, normal cells. In other words, the progesterone receptors activate genes such as p53 that promote apoptosis. Apoptosis enables the body to “kill off” many cancer cells before they develop into tumors. On the other hand, the estrogen receptors directly bind and inactivate p53, which otherwise would restrain the replication of damaged cells. The P53 gene is the primary gene that protects men from prostate cancer and women from breast cancer. So naturally we want to support the p53 gene (which is really the P53 protein). You can read more about how to support the P53 gene in my Estrogen Handout.
It is important to note that progesterone also helps to offset xenoestrogens (chemical estrogens which are foreign to the body) which are difficult for the body to detoxify.
However, it is very important to understand that estrogen, in general DOES NOT CAUSE BREAST CANCER. Cancer is a multifactorial disease– genetics, lifestyle factors, infection, and especially environmental and emotional toxins all play a role. But since we cannot efficiently metabolize xenoestrogens and because of the overall estrogen dominance, inhibiting aromatase is often a good idea. It may not be that you have too much estrogen or that you need to block the estrogen receptors, it could just that you don’t have enough progesterone.
For a more in-depth discussion on how estrogen and progesterone affect the expression of tumor suppressor genes and what you can do to make the expression favorable, please request my Estrogen and Detoxification Handouts.
Is There a Natural Alternative to Aromatase Inhibitors?
Progesterone’s opposition to the effects of estrogen is so basic, that I fail to see how oncologists do not see progesterone as being the ultimate antiestrogen. Given that progesterone stops cell division by opposing the effects of estrogen, and given that it is not in our best interest to completely block estrogen, the real goal of the oncologist should be to reduce estrogen while increasing progesterone.
While there is no one magic pill for this, a comprehensive strategy will help to support the tumor suppressor genes by supporting the production of progesterone and inhibiting the estrogen-fueled proliferation of cancer cells. What you eat, do, and think all play a significant role.
- Eat good food—a diet rich in whole, primarily plant-based foods will support the adrenals and pretty much every function of the body.
- Consume button mushrooms, rosemary, celery, parsley, pumpkin seeds, raw whole carrots, citrus and other essential oils, oregano, thyme, rosemary, sage, turmeric, onions, garlic, chives, and scallions which inhibit estrogen and boost progesterone levels.
- Consume phytoestrogens -phytoestrogens act more like estrogen blockers than like estrogen; they modulate the production, availability, and action of hormones and slow down cell division. Flaxseed is especially important. Flaxseed: Better Than Tamoxifen and Demystifying Flaxseed and Estrogen.
- Consume cruciferous vegetables as nutrients derived from them help with the detoxification of estrogen trough the liver. Note that DIM and raw crucifers can inhibit iodine and the thyroid. Estrogen also inhibits the absorption of iodine and impacts thyroid levels. Have your iodine and thyroid levels checked and supplement with iodine if necessary.
- Eat more vegetables. Aim for 15 servings a day (at least one pound daily). This will help excrete estrogen so it doesn’t keep circulating in the body.
- Anti-inflammatory foods that are rich in saturated and omega-3 fatty acids such as 100% organic, grass-fed beef & dairy, organic poultry, wild-caught Salmon and wild game are anti-estrogenic. Plant based fats such as avocados, coconut oil and olive oil are all powerful anti-estrogenic superfoods.
- Take supplements such as DIM, zinc, Vitex Fruit (Chaste Tree), grape seed extract, magnesium, zinc, ginko biloba,vitamin E, and iodine.
- Support liver function with milk thistle and other natural detoxifiers. Estrogen is metabolized in the liver. Fortifying the liver will help speed up estrogen clearance from the body. Estrogen that is not metabolized by the liver will continue to circulate, contributing to estrogen dominance.
- If you are overweight, lose weight. Fat cells increase estrogen production. Increased weight often means insulin resistance and this is a common cause of high estrogen levels.
- Exercise—it helps reduce stress and positively effects gene expression, and helps to balance hormones.
- Clean out the closets—replace health, home and beauty products with non-toxic alternatives. A quick visit to the Environmental Working Group website will enable you to evaluate the products you use.
- REDUCE STRESS—stress challenges adrenal function and makes direct physiological changes to DNA, not to mention that it significantly raises estrogen levels and depletes progesterone.
- Avoid alcohol, but if you do drink wine, make it organic–you wouldn’t eat conventional grapes, so don’t drink conventional wine.
- Get more sleep—lack of sleep disturbs hormone balance.
- Go with your gut, take a probiotic. Probiotics support gut bacteria and improve digestion, helping to prevent constipation. This is important because when the stool remains in the bowel for extended periods of time, excess estrogen is re-absorbed and re-circulated into the bloodstream.
Estrogen is metabolized in the liver. Fortifying the liver will help speed up estrogen clearance from the body. Estrogen that is not metabolized by the liver will continue to circulate, contributing to estrogen dominance and raising the risk of hormonal cancers. Studies show that women with genetically impaired estrogen metabolism function may have a higher risk of breast cancer and may benefit from increased detoxification.
For more detailed information on aromatase inhibitors, natural alternatives to Tamoxifen, and detoxification strategies please request my Estrogen and Detoxification Handouts.
Read also Natural Alternatives to Tamoxifen
Read 12 Things a Cancer Doctor Should Never Say, my most recent article on The Truth About Cancer website. Look for my upcoming article Emotional Trauma and Cancer: The Missing Link, in their October newsletter.
Read Mushrooms as well as the link in that post.
Note: This article is an updated version of my 2012 article.
This information is for educational purposes only. It is not intended to treat, cure, prevent or diagnose any diseases or conditions. The information in this post does not represent medical advice, and I encourage you to discuss this information with your integrative oncologist or naturopathic doctor. Always consult with a medical doctor before you consider any prescription or over the counter drug or herb.
~~If you don’t know your options, you don’t have any~~
Elyn Jacobs is a breast cancer survivor and holistic cancer strategist who helps people make better, healthier, non-toxic choices. She emphasizes the critical nature of addressing the root cause of cancer and not just its presenting symptoms (such as the tumor). Elyn specializes in understanding the role of estrogen in breast cancer and debunks the myths associated. She brings a plethora of knowledge to her practice and will help you think outside the box so you can incorporate every lifeline you may need for long term survival. Elyn is a Contributing Editor for The Truth About Cancer and was creator and host of the Survive and Live Well Radio Show on the Cancer Support Network. She is on the Medical Advisory Board for BeatCancer.Org and is on the Advisory Board to the Radical Remission Project. Elyn was the former Executive Director of the Emerald Heart Cancer Foundation. Contact Elyn via her website. Elyn offers consults via Skype, phone or in person.
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