Posts Tagged ‘Gwen Stritter’

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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Integrative Oncology Works!!!

In Uncategorized on March 5, 2012 at 8:23 pm

This past weekend I attended the Annie Appleseed Project CAM conference; so many excellent speakers. Over the next few weeks I will be sharing some of what I learned. What resonated throughout the conference was that conventional medicine alone is not the answer.Today I will talk about Dr Gwen Stritter and her roadmap to beat cancer.

Dr Stritter provided a humorous and excellent plan for someone just diagnosed with early stage breast cancer who wants to increase her chances of a cure.  I just loved the positive tone; note she did not say to prevent recurrence, but rather spoke of that lovely word cure. She said that if she were diagnosed at 12pm, what she could do at 12:01pm that could take her on the path to wellness.

Exercise:  Fast walking 3hours a week improves breast cancer survival by 40%.  5-6 hours increased survival even more.  So, she will go for a walk. Social support: Increased contact with friends and family post diagnosis was associated with lower risk of death by 70%.  So, on the way home, she will stop in and visit some friends and family.  Alcohol:  having one alcoholic beverage a day increases death by 36%.  So, she’d give up that glass of wine with dinner…well maybe indulge only twice a week as she really loves wine.  D3: Vitamin D3 decreases metastasis and increases survival by 55%. So, she’ll pop in a 2000mg supplement as soon as she gets in the car.  Omega 3: high intake of omega 3 fatty acids from fatty fish increases survival by 25%, so she’ll call her husband and ask him to toss the fried chicken, and will stop at the fish market to buy some salmon for dinner. Controlling inflammation:  having a high CRP, (which indicates increased inflammation), results in a 100% increase of death.  So, she will take some anti-inflammatory natural products such as curcumin, omega 3 (yes, perhaps a supplement too), boswellia and a few others.  Low toxicity pharmaceuticals:  a daily baby aspirin reduced breast cancer death by 70% (alternatively, one regular aspirin taken three times a week can reduce recurrence by 50%, according to my integrative onc).  So, she will stop at the drugstore and buy some aspirin.  She might also take some other pharms that look promising, so she’ll call her primary physician. In trials, Propranolol, a cheap and non-toxic drug commonly prescribed for high blood pressure, increased  breast cancer  survival by 80% (in a retrospective study).  Metformin, which is derived from the French lilac plant, increased survival in diabetic patients by 60%, and non-diabetics with breast cancer who did not take Metformin had 3 times the risk of distant metastasis….the risk went up 300%!.  Metformin is cheap and has very few side effects.  (My doc recommends that almost everyone take it to avoid cancer, and certainly to prevent recurrence).  There is another study expected to be released by 2014, but likely you will not want to wait until then.

And of course, she will switch to a mostly plant based diet, be conservative on oil and fat intake, and if she were a smoker…she would stop asap! 

In summary, if she does all this, cancer does not stand a chance; she has provided an extremely hostile environment for her cancer to grow.    She also commented that Dr Keith Block did an excellent study on these combined steps and found a substantial increase in survival for those with advanced metastatic cancer.  Her overall deduction?  Integrative Oncology works!!! 

A few things to add:

You will likely need to ask your primary doc, not your oncologist for prescriptions for Propranolol and Metformin as they are not yet approved for cancer despite the fact that they can be quite effective.    At this conference as well as at the Integrative Healthcare Symposium, several doctors commented that Metformin was the only cancer drug that actually worked. My doc started me on this a while back, handing me piles of research to support his recommendation.

Also, remember to address stress….more on this later, but I offer this post until then: https://elynjacobs.wordpress.com/2011/12/09/changing-the-cancer-environment/

Lately there has been much in the news about red wine and breast cancer.  Research shows that a small amount of red wine may actually reduce breast cancer risk.  http://www.medicalnewstoday.com/articles/240065.php?utm_medium=twitter&utm_s

The trick is small.  Those who love wine (like me) might take this too far.  Your body converts alcohol into acetaldehyde, a carcinogen.  Acetaldehyde boosts cancer risk by inflicting oxidative stress that damages DNA, prevents DNA repair, and triggers a pro-inflammatory reaction.  You can help offset the damage by adding a few foods and plant-based compounds like silymarin, resveratrol, grape seed extract and barley grass, as well as adding some supps like selenium, NAC, vitamin B6, and folate, to prevent alcohol-related deficiencies of valuable cancer fighting nutrients and minerals.  The trick is to take the supps just before, with, or even immediately after accidental over- indulgence of wine. (Have a brazil nut with that wine!)So, I offer up this article, which effectively provides a good explanation of the dangers of alcohol as well as what we can do to offset the damage should we accidentally over-indulge.  http://www.lef.org/magazine/mag2011/dec2011_Link-Between-Alcohol-and-Cancer-Death_01.htm

Elyn Jacobs




Elyn Jacobs is President of Elyn Jacobs Consulting, Executive Director for the Emerald Heart Cancer Foundation, a certified cancer coach and a breast cancer survivor.  Elyn helps women diagnosed with cancer to navigate the process of treatment and care, and educates to prevent recurrence and new cancers.  She is passionate about helping others get past their cancer and into a cancer-free life. To learn more about Elyn’s coaching services, please visit:  https://elynjacobs.wordpress.com