Synthetic selective estrogen receptor modulators (SERMS) such as tamoxifen and pharmaceutical aromatase inhibitors are often recommended for ER+ breast and other hormone-driven cancers, but they have significant adverse effects. Is it possible that natural plant products can perform the same function without the risks and damage of pharmaceuticals? Research says they can.

While estrogen plays many important beneficial roles in humans, the proliferation of ER+ breast cancer cells can sometimes be enhanced by estrogen (especially in the absence of progesterone), which may induce multiple processes involved in cell survival and cell cycle progression. Beyond the estrogen dominance that comes from a lack of progesterone, it is not necessarily our own estrogen at fault, but more likely xenoestrogens — the chemical estrogens, environmental hazards such as BPA and BPS — Bisphenol A and S.

However, to add clarity to the estrogen equation that oncologists speak of, the body has two different estrogen receptors, ERα (alpha) and ERβ (beta). ERα has a proliferative effect, and ERβ acts as a negative regulator of ERα in breast cancer cells, counteracting the proliferative effect of estrogens. Importantly, plant estrogens (phytoestrogens) preferentially interact with ERβ and display high specificity toward ERβ transactivation. Phytoestrogens, also known as phytochemicals, are synthesized from plants and vegetables. They show low estrogenic activity or anti-estrogenic activity with anti-proliferative effects that studies show offer nutraceutical alternatives to pharmaceutical anti-hormone therapies for various cancers.[ii]

For the men reading this article (including those with breast cancer), androgens and estrogens also influence the development and progression of prostate cancer. Research shows that phytoestrogens such as soy could be used alone or in conjunction with anti-hormone therapies for prostate cancer to target metabolic pathways involved in androgen and estrogen syntheses and epigenetic modifications of DNA to promote tumor-suppressor genes.[iv]

In a nutshell, phytoestrogens may be useful as substitutes for breast cancer treatments such as tamoxifen or aromatase inhibitors, and could be extremely helpful for other hormone-related cancers.

The Role of Phytoestrogens as Replacements for SERMs and Aromatase Inhibitors

It is well-established that many foods and natural products have beneficial effects on ER+ breast cancer as well as other hormone-driven cancers.  Pytoestrogens are structurally similar to our own estrogen, but functionally are weakly estrogenic (weakly mimicking estrogen) or antiestrogenic (blocking estrogens’ effects). They have been researched extensively for their role in the interaction with estrogen receptors. The beauty is that they block the receptors from more volatile estrogens.  As such, they deserve consideration in preventive and therapeutic settings for the intervention of cancer initiation and progression.

Studies show that phytoestrogens may provide an alternative or complementary approach to anti-hormone treatments. For example, 2017 research published in the International Journal of Molecular Sciences cited many studies confirming that an important application of phytoestrogens is that they could be used as an alternative to the SERMs.[iii] In general, phytoestrogens act as aromatase inhibitors by decreasing aromatase gene expression and inhibiting the aromatase enzyme.   

Some of the more powerful phytoestrogens include flax and sesame seeds as well as whole soy. 

Flax and sesame seeds have anticancer, breast tumor-reducing effects. Both lignans are metabolized to estrogen-like enterodiol and enterolactone, and reduce cell proliferation and apoptosis.[xiv] While each works a bit differently, both may be useful as an effective adjuvant therapeutic agent against tumor development and progression, and therefore, could be used in the prevention and/or treatment of various types of cancer. Studies show that higher intakes of lignans such as flax and sesame seeds are associated with a reduced risk of breast cancer. Flax seed works with tamoxifen to inhibit breast cancer tumor growth, so if you choose to take tamoxifen, know that you can also benefit from flax.  

I have written extensively on the benefits of flax seed, but to recap, a few of the benefits of flax are the following:

• Decreases cell proliferation rates and inhibits tumor growth in ER+ cancers
• Decreases angiogenesis (blood supply for tumors) and increases apoptosis (cancer cell death)
• Influences ER-negative and ER-positive tumors by decreasing insulin-like growth factor-1 (IGF-1), epidermal growth factor receptor (EGFR), HER2 and the vascular endothelial growth factor (VEGF) which supports angiogenesis
• Reduces growth and metastasis of ER-negative and triple negative breast cancers
• Favorably influences tumor suppressor genes

For more on flax seed and breast cancer, please read some of my other posts, such as  Demystifying Flaxseed and Estrogen and Flaxseed, Better Than Tamoxifen for Breast Cancer.

Soy: Numerous studies indicate that genistein, the most abundant isoflavone present in soybeans, has anti-proliferative effects on various cancer cells, including prostate, ovarian, and breast. Like other phytoestrogens, genistein interferes with the effects of estradiol by binding to estrogen receptors. This is good as soy may also inhibit inflammation and boost anticancer immune responses, while other estrogens do not. The following are a few key findings of soy[v]:

• Inhibits NF-kB activity in prostate, breast, lung, and pancreatic cancer cells. Nf-kB plays a crucial role in immune response, inflammation, cell growth and survival.
• Selective tyrosine kinase inhibitor impeding angiogenesis, a major factor in cancer growth and proliferation. Tyrosine kinases play important roles in cell proliferation, survival, migration and differentiation are often altered in cancer cells, leading to malignancy
• Induces cancer cell death (apoptosis) in several cancer cell lines, including prostate, ovarian, and breast cancer
• Modulates EGF (epidermal growth factor) which has been implicated in the development and growth of many types of cancer cells
• Long-term consumption seems to result in a decreased response to stimulation by estradiol[vi]

Please note that soy consumption is somewhat controversial. Please work with your coach or medical professional to see if soy consumption is right for you.

More Notable Phytoestrogens                                                                           

• Apigenin is a natural flavonoid commonly found in fruits and vegetables such as parsley, celery, thyme, chamomile tea, and oranges. The chemical structure of apigenin is similar to estrogen and as such it mimics estrogen. 2107 research indicates that phytoestrogens such as apigenin and resveratrol have the therapeutic potential act like SERMs and could be considered in the development of therapeutics for breast cancer and brain disease.[vii] Extensive studies show that apigenin has potent antioxidant and anticancer activities in ER-positive and ER-negative breast cancer. Apigenin also inhibits proteasome, which certain cancer cells need for survival. By inhibiting proteasome, phytoestrogens such as apigenin induce apoptosis in prostate, breast, and many other cancer cell lines.[viii]
• Pau d’ Arco exhibits selective anti-proliferative effects in carcinoma cell lines. A study performed at the Strang Cancer Prevention Center in New York found that the anti-proliferative effects of herbal medicines such as pau d’arco may correlate with down-regulated estrogen responsive genes and up-regulated apoptosis-specific genes. The researchers believe their data validates the need to prioritize efficacious herbal medicines and concluded that phytoestrogens such as pau d’arco may provide an alternative or complementary approach to endocrine therapy for breast cancer.[ix] Read more
• Broccoli: The sulforaphane in broccoli (particularly in broccoli seeds and sprouts) has been found to inhibit proliferation and down-regulates hormone receptor expression in MCF-7 cells. Sulforaphane also passes the blood brain barrier and targets cancer stem cells. If you cannot find sprouts locally, I recommend a supplement.

• Luteolin and Naringenin: Flavonoids, especially flavones such as luteolin and flavanones such as naringenin are potent aromatase inhibitors. [x] Luteolin has also been found to down-regulate aromatase gene expression. Luteolin is found in celery, thyme and chamomile tea. Some rich sources of naringenin include bergamot, grapefruit, tomatoes, and tart cherries.
• Quercetin, found in abundance in food sources such as apples, onions, tea, and red wine, has been reported to have strong antioxidant, anti-inflammatory, antiviral, and anticancer effects. It has the ability bind at high affinity to estrogen receptors, resulting in inhibition of estrogen-regulated cell growth and proliferation[xi]
• Hesperetin, found in citrus fruits and essentials oils, exerts it anticancer actions by inhibiting cell proliferation, inducing apoptosis, and by regulating aromatase activity and oxidative stress. Although hesperetin is unable to bind to ERs, it is effective in inhibiting cell proliferation of ER+ breast cancer and dramatically decreasing tumor size and other actions. Hesperetin has also been found to reduce serum estrogen levels and down-regulate estrogen target genes and estrogen metabolism-related genes.[xii]. Try putting a drop or two of lemon essential oil in your water, or grating the peel of an organic lemon.
• Black seed contains thymoquinone, a phytochemical compound found in plant Nigella sativa. It has been found to initiate apoptosis, improve estrogen metabolism, and regulate signally pathways in breast cancer.
• Vitamin E inhibits cell proliferation, down-regulates the expression of ERα, ERβ, COX-2, and serum estrogen levels (should always be mixed tocopherols, not just d-alpha.
• Red Clover binds to estrogen receptors, inhibits cell proliferation, and initiates apoptosis in ER+ breast cancer cells.
• Ellagic acid, a dietary flavonoid present in berries, grapes, pomegranates, and nuts, inhibits cell proliferation and promotes apoptosis in ER+ breast cancer cells.
• Eugenol, a compound found in clove oil, inhibits cell proliferation and initiates cancer cell death in both ER+ and ER- breast cancers. Excitingly, one study done in Indonesia found that eugenol  is a potent ERa antagonist. The researchers indicate that not only does it work just like tamoxifen, but it may actually work even better.
• This list is  not inclusive: There are many more powerful phytoestrogens. For more cancer-fighting alternatives to pharmaceuticals, please read my articles on Natural Alternatives to Aromatase Inhibitors and Natural Alternatives to Tamoxifen.

Phytoestrogens can be our friends, but know that herbs are powerful. I have no concerns with food-based phytos, but do take care with extracts. They are best rotated so as to maximize benefits, reduce the chances of resistance, and avoid interactions. Drugs, of course, are often even more dangerous, yet are routinely prescribed.

                               Trust me, I’m a doctor” Peter Gøtsche

I interviewed Peter Gøtsche, author of Deadly Medicines and Organised Crime, on my radio show a few years back. Amazing man, whose controversial views have since gotten him tossed from the Cochrane Collaboration, which he co-founded. Sadly, there are many who wish to silence the voices who speak against Big Pharma.

Like me, Gøtsche worries that most people let their doctors make the decisions for them, but the evidence tells us that we should be cautious. He is a strong advocate for the avoidance of drugs and while not against medical interventions, believes one can not just blindly follow the orders of the medical community.

Notably, there is tremendous variability in the metabolic processing of phytoestrogens and pharmacological drugs, thus establishing the difficulty and complexity of this topic. The bottom line is that it extremely important that one understand that it may not make logical sense to attempt to poison one’s way back to health. Certainly drug therapies have worked for many. That said, NO ONE was every born tamoxifen or AI deficient, but over time we may become estrogen dominant, increasing our risk for cancer. It behooves us all to do our research and decide for ourselves whether drugs or holistic remedies are best, or even a combination of both.  

Estrogen plays many important roles in humans, so it may not make sense to arbitrarily take it away. If you are estrogen dominant (meaning out of balance with progesterone), you may want to consider a bio-identical progesterone cream (I like that one as it is paraben-free, soy-free, and Non GMO).

Read Part I of this article HERE.

Reminder: To get an additional $30 off on the online course for breast cancer,  Toxic Free Me, enroll now and use this LINK. This course will further delve into alternatives for anti-hormonal therapies.

An online course not right for you? Know that I am always there for individual consultations.  To inquire about a consult, please visit me HERE.

Life is a journey, just be sure that journey is on-course for a healthy life.

In your everlasting good health,

Elyn

~~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 healthier, less-toxic choices for their healing. She emphasizes the importance of not just surviving cancer, but surviving well and reducing the risk of recurrence. She is a Contributing Editor for The Truth About Cancer and is on the Medical Advisory Board for BeatCancer.Org and the Advisory Board to the Radical Remission Project. Elyn has written for numerous journals and publications. She was the former Executive Director of the Emerald Heart Cancer Foundation and the creator and host of the Survive and Live Well Radio Show. To contact Elyn, visit www.elynjacobs.com. Elyn offers consults via Skype, phone, or in-person. Elyn does not provide online advice.

DISCLAIMER:
Elyn Jacobs does not provide medical advice. The information provided is for general information only. No online site should be used as a substitute for personal medical attention.

This information is for educational purposes only and is not a recommendation to forgo medical advice and treatment.  This post is not intended to treat, cure, prevent, or diagnose any disease or condition. This post does not represent medical advice nor should it be considered to be medical advice or a replacement for medical advice.  I encourage you to discuss this information with your integrative oncologist, naturopathic doctor, or conventional oncologist. The information provided is from my research and not to be taken as scientific evidence.

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[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874/; Notably, there are numerous  crsos-references cited in this article that support the use of phytoestogens as nutraceutical anti-hormone therapies for various cancers.

[ii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874/

[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874/; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699002/

[iv] https://www.ncbi.nlm.nih.gov/pubmed/27194038; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874

[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874/#B61-ijms-18-01381; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874/

[vi] https://www.ncbi.nlm.nih.gov/pubmed/8625449

[vii] https://www.ncbi.nlm.nih.gov/pubmed/28396216; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5033666/

[viii] https://www.ncbi.nlm.nih.gov/pubmed/26771497; https://www.ncbi.nlm.nih.gov/pubmed/25408199

[ix] https://www.ncbi.nlm.nih.gov/pubmed/19578798

[x] https://www.ncbi.nlm.nih.gov/pubmed/21741436

[xi] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203161/#b9

[xii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535874

[xiii] https://www.ncbi.nlm.nih.gov/pubmed/26614455

[xiv] https://elynjacobs.com/2016/02/28/flaxseed-better-than-tamoxifen-for-breast-cancer/; https://www.ncbi.nlm.nih.gov/pubmed/29032105; https://www.ncbi.nlm.nih.gov/pubmed/22136581