Let’s Focus!

Prevention of woman’s most feared cancer: Breast Cancer.

It has been estimated that Breast Cancer affects 70 million women today. One in 8 or more are being diagnosed yearly. The treatment can be disfiguring surgery, illness provoking chemotherapy, uncomfortable radiation and hormone inhibition. It is disappointing to me that there is so much focus on treatment and less on prevention these days. It seems to take so many years to change our thinking. Do we have to continue to wait for every double blind, placebo controlled study with 16,000 or more enrolled patients to be published before we can offer our patients a better alternative?

If you knew of a simple way to lower your risk of breast cancer, wouldn’t you want your daughter, mother, sister or best friend to do it? I know I would. Yes, we do not know enough about everything that causes breast cancer. But we do know that there are some simple ways to know your risk and then take steps to reduce it.

For instance, we have 3 different types of estrogens: Estriol (E3), Estradiol (E2)and Estrone (E1). Once you go through menopause, your adrenal glands make E1. Both estradiol (E2) and Estrone (E1) have cancer producing effects; Whereas, their breakdown product, Estriol (E3) has been shown to have some protective effects or no risk. E3 is mainly produced during pregnancy or is affected by your diet. You can test the balance between these estrogens, the Estrogen Quotient (EQ), thru a 24 hour urine study done on day 19 to 23 of your cycle if you are still menstruating. Getting this EQ higher than 1 can help you lower your risk.

In addition, making sure your cancer producing Estrone is broken down along the right pathway can also help with reduction in risk. Estrone is produced by your adrenal glands after your ovaries fail in menopause and from adipose/fat cells. It can be broken down to 2, 4 or 16 hydroxyestrogen. We want more of the 2 and less of the 16. Therefore, we can again do this 24 hour urine study and find the ratio of 2/16. Keeping it greater than 1 is the key to lower risk.

In addition, ensuring that the enzyme, catechol-O-methyltransferase (COMT) can detoxify these estrogens is essential. Making sure you have adequate B vitamins, B12, folic acid, certain amino acids and eating enough vegetable from the brassica plant family can all assist in the process of increasing your ratios and detoxification abilities. If these don’t do the trick after 3-4 months of therapy, you can take dindolylmethane (Noble DIM) or indole-3-carbinol (I3C). If still unresponsive, we can even test how well this enzyme is functioning thru genetic testing. So even though we do not know everything about why breast cancer occurs, Let’s change the focus to prevention!