Posts Tagged ‘Alternatives to Tamoxifen’

Natural Alternatives to Aromatase Inhibitors

In Alternative Cancer Therapies, Alternatives to Hormone Therapy for Breast Cancer, Alternatives to Tamoxifen, Natural Alternatives to Aromatase Inhibitors, Tamoxifen, Uncategorized on October 26, 2016 at 12:30 pm

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. Here is what you need to know before you get led down that ‘primrose path’.

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.

Found this article helpful?  Please let me know.


~~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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Is Tamoxifen Right for Me? Is There an Alternative?

In Uncategorized on January 23, 2014 at 2:50 pm

Tamoxifen has been successfully used in the management of breast cancer for over twenty years.  However, as with any drug, Tamoxifen has benefits and risks associated with its use. The general opinion seems to be that the benefits outweigh the risks. For many men and women, choosing Tamoxifen may be the right choice for them.

For others the side effects are very real, and the risk is too high– namely the risk of developing uterine cancer, blood clots, muscle pain, mental fogginess and cataracts.  This can be especially true for those with certain early stage breast cancers.  Such concerns have led many to seek alternatives to hormone therapy.

pills tamoxifenHow can you know which is the right choice for you?  Be informed; empower yourself to educate yourself with information and options.  You may want to take advantage of one the risk/benefit calculators such as www.lifemath.net  to help you gain a better understanding of your individual risk for declining Tamoxifen, and weigh those risks against your concerns and reservations of taking the drug.

To help you understand how these calculators can help you, Dr Gwen Stritter, MD, an expert in clinical advocacy, shared with me two different scenarios and how the use of Tamoxifen would play out in each:

● Let’s take the case of someone with a 1 cm, stage I ER-positive breast cancer.  The proportional reduction in breast cancer death from using Tamoxifen for 5 years in a woman < 50 years of age is about 32% (Early Breast Cancer Trialists Collaborative Group, Lancet 1998).  The typical stage I ER+, node-negative patient at 40 years of age has a 6.3% risk of cancer death in the next 15 years without treatment (www.lifemath.net).  Adding Tamoxifen would decrease the mortality rate by 32% which means it would decrease to 4.3%, an absolute gain of only 2 percentage points of survival.  In this situation, it could make a lot of sense for someone to decline Tamoxifen and use only alternative approaches if they were getting uncomfortable side effects.

● Now let’s take another hypothetical example:  someone with a stage II, ER-positive, node-negative breast cancer.  The same calculation shows that there is a 20% chance of death in the next 15 years without treatment.  Adding Tamoxifen would decrease the mortality rate to 13.6%, an absolute gain of almost 7 percentage points.  If that seems like only a small gain, remember that gain is more percentage points than the risk of actual death in the untreated stage I case.  And, that translates to, on average, an extra 3 years of survival because of the Tamoxifen therapy.  If it were a stage II node-positive case, Tamoxifen would add on average 4 years of life.  If it were a stage III cancer, the benefits of Tamoxifen would be even greater – almost 6 years of life gained, on average.  Many men and women would tolerate more side effects for such a gain of survival.

For the stage I BC example, the worst-case scenario is only a 2% increased risk of death – avoiding Tamoxifen and using only alternative approaches with a reasonable clinical track record does not seem to be such a risk.  In higher stage examples, the risk of death would more than triple causing an average loss of 3 – 6 years of life.  Dr Gwen Stritter, MD

We can gain valuable information on our risk/reward by using one of these calculators, as well as by gathering information from our medical team– every bit of information you can gather will help you to make the most informed choice possible. However, while statistics can be useful for treatment recommendations, they do not always predict the outcome of an individual.  Every person and every cancer is unique with its own set of circumstances based on genetic and physiological characteristics associated with them.  The calculated results and other statistics do not factor in quality of life or the lifestyle choices and factors of the patient, so use such information to help you make choices, not to put a timeline on your life.

We also do not have any side-by-side studies that compare the use of hormone therapy versus holistic approaches.  Part of the reason is lack of funding—drug companies have little to no reason to fund such studies and there is comparatively little profit from the alternative approach.  So until the day comes when this scenario changes (don’t hold your breath), we are left to weigh the pros and cons and make the best decision for us, our cancer, and our own individual needs.

I just tried this out on myself, giving the information at diagnosis (as it was not available to me then). At 45 year old, I would have a 1.8% risk of cancer death in the next 15 years without treatment, and it would be expected that this cancer would shorten my life expectancy by 0.8 years (from 37.3 year to 36.5 years.)  Therefore the therapy would give me an additional 96 days.  In my case Tamoxifen might not be worth the risk.  Remember too…these are just averages—my actual risk could be higher or lower depending on my own unique circumstances. ej

If you choose Tamoxifen, you may want to consult an integrative or alternative doctor or a qualified coach for advice on nutrients that can help boost the efficacy and reduce the side effects of the drug—as well as improve your survival.  I am happy to help you or assist you with a referral; please leave a request here.

If you choose not to take hormone therapy, please know that managing estrogen and your breast cancer requires a comprehensive approach encompassing diet, exercise, stress reduction and other mind-body-spirit therapies. For more information on an alternative approach to hormone therapy, please read Natural Alternatives to Tamoxifen and view my video with Dr Kelly Turner, PhD, author and founder of The Radical Remission Project. To discuss options or for a referral, please leave a request here.

Please remember that managing cancer is not just about managing estrogen.  If you do not change the environment in which your cancer was permitted to grow, you may increase your risk of recurrence.   Addressing stress issues, diet, sleep habits, exposure to toxins, adrenal fatigue, thyroid and iodine deficiencies and other cancer responsive imbalances may make your terrain less hospitable to cancer.


             ~~If you don’t know your options, you don’t have any~~


MEDICAL DISCLAIMER:  Reading the information in this post does not constitute a physician-patient relationship. The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult with your healthcare provider regarding a medical condition or any treatments.

 Gwen Stritter, MD is a physician and clinical advocate/navigator who has been practicing intensive, personalized research and advocacy for those with life-threatening health problems for the past 13 years.  Her area of special expertise is integrative breast oncology. 

She is coauthor of the chapter on clinical advocacy (chapter 19) in the textbook, Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient Centered Care (2007) and a frequent speaker at integrative oncology and breast cancer conferences.

While side effects of breast cancer therapy have recently caused Dr. Stritter to close her clinical practice, she has since committed herself to studying the effect of active integrative approaches on metastatic breast cancer survival and sharing this information with those whose lives have been touched by it.  With several other women living with breast cancer, she has started a non-profit, People-Powered Research, to do the clinical research that highly interests patients but is a not focus for the academic-pharma complex.

 Elyn Jacobs is a breast cancer survivor, professional cancer strategist, speaker, and the Executive Director for the Emerald Heart Cancer Foundation. Elyn empowers women to choose the path for treatment that best fits their own individual needs. She is passionate about helping others move forward into a life of health and well-being. Elyn has been featured on CNN Money, Talk About Health, and Breast Cancer Answers and has written for the Pink Paper, Breast Cancer Wellness, Integrative Oncology Essentials, Surviving Beautifully, Body Local and more, and writes the Options for Life column for the Natural Healing-Natural Wellness Newsletter.  Elyn hosts the Survive and Live Well Radio Show on the Cancer Support Network. Elyn lives in New York with her husband and two young boys. https://elynjacobs.wordpress.com/about/

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