Breast Cancer

From Health Facts

Breast cancer describes tumors of the breast and chest wall. The most common type arises from the milk ducts and is called invasive ductal carcinoma. Less common types include lobular carcinoma and inflammatory breast cancer. Breast cancer can spread to the surrounding breast and chest wall tissue, liver, lungs, brain, and bone, amongst other locations.

Breast cancers develop in 124 out of every 100,000 women, and the incidence of the disease is increasing. ^[1] While most breast cancer patients are women, it is possible for men to develop breast cancer.

Signs and symptoms that may lead a doctor to rule out breast cancer include a breast lump, rash, skin thickening, nipple inversion, or abnormal nipple discharge. A lump that persists through the menstrual cycle is more concerning than one that grows and shrinks throughout the cycle.

Contents 1 Naturopathic Assessment 1.1 Causal Factors 1.1.1 Lifestyle 1.1.2 Social 1.1.3 Environmental 1.1.4 External 1.1.5 Genetics 1.1.6 Medical Interventions 1.1.7 Physiology 1.2 Diagnostic Testing 1.3 Related Symptoms and Conditions 2 Characteristics 3 Naturopathic Treatment Strategy 3.1 Prevention 3.2 Cancer Specific Treatments 3.3 Supportive Care 3.4 Integrative Care 3.5 Prevent Recurrence 4 Resources 5 Recommended Reading

Naturopathic Assessment

Check out this book	The Alchemy of Modern Medicine: A Naturopath's memoirs during breast cancer and reconstruction (Volume 1)

Check out this book	The Complete Natural Medicine Guide to Breast Cancer, a practical manual for understanding, prevention & care

Check out this book	A Call to Women: The Healthy Breast Program & Workbook: Naturopathic Prevention of Breast Cancer

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With breast cancer, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to the development and growth of breast cancer.

Lifestyle

• Dietary Factors

• Dietary imbalances such as a diet high in animal fat, processed food, and alcohol, are linked to breast cancer.^[2]

• Activity Level

• Physical activity decreases breast cancer risk and improves survival in people with breast cancer. For women with breast cancer, walking 1-3 hours a week decreases the risk of dying from breast cancer by 20-50%.^[3]
• Another study regarding the impact of exercise on life span overall found that even 15 minutes of daily activity lengthens life expectancy by 3 years, within an increase of life for each additional amount of exercise. ^[4]

• Obesity

• Obesity increases the risk of breast cancer. Fat cells make estrogen and inflammatory cell signals (cytokines), both of which stimulate the growth and development of breast cancers. Fat also stores and concentrates environmental chemicals. Chemicals made from petroleum or plastics are fat soluble, easily stored in fat, and are poorly excreted by the body.^[5]

Social

• Stress

• Chronic stress is associated with increased risk of breast cancer.

Environmental

• Environmental Toxins

• 216 common environmental chemicals are linked to breast cancer.^[6]
• Environmental contaminants that acts as estrogen in the body include PCBs, Phthalates (DEHP DINP, DIDP, DBP, DnOP, DnHP) from plastics, and bisphenol A.
• Fat also stores and concentrates environmental chemicals. Chemicals made from petroleum or plastics are fat soluble, easily stored in fat, and are poorly excreted by the body.^[7]
• Exposure to estrogen in the environment increases the risk of developing breast cancer.^[8]

• Some breast cancer activists are concerned about "pink washing" by companies that both manufacture carcinogenic products and support breast cancer research.^{[9] [10]}

External

• Household Products

• Non-stick coatings on cookware and flame retardants in carpet and upholstery cause breast cancer in animals. These chemicals build up in body fat, leading to cumulative doses from multiple low level exposures.^[11]

Genetics

• Family History

• There tends to be a familial link to breast cancer risk. This is due to both inheritable genetics and to lifestyle and environmental traits that are shared among families.

• Genetic syndromes associated with familial breast cancer include BRCA mutation, hereditary breast and ovarian cancer syndrome, and possibly Lynch syndrome .^[12]
• Some breast cancers have the Her-2-Neu receptor and gene activated. Her-2-Neu drives tumor growth and is a potential target for therapy. ^[13]

Medical Interventions

• Prescription Medications

• The use of hormone therapy is linked to an increased risk of breast cancer.^[8]

Physiology

• Age

• Breast cancer risk increases with age.
• Lifetime estrogen exposure increases the risk of breast cancer. Relevant factors include early first menses, late menopause, pregnancy and breastfeeding.^[8]

Diagnostic Testing

• Breast cancer self-examination and clinical breast exams are valuable tools for early breast cancer detection.

• Blood tests that are often requested included tumor markers Liver function tests and CBC. Tumor markers are not routinely ordered for early stage breast cancer. Tumor markers such as CEA, CA15-3, and CA 27.29 are used in advanced breast cancer to track response to treatment.

• Specialized tumor markers such as estrogen receptor status, progesterone receptor status, Her-2-neu amplification, TNF, VEGF, IL-6, and estrogen metabolism studies may be ordered to identify targets for therapy. Oncotype DX may be ordered to determine the relative benefit of adjuvant chemotherapy.

• Imaging Studies may include mammography, MRI, ultrasound, thermography, or PET.

• Mammography or MRI are the primary whole breast imaging tools.
• Ultrasound can be used to differentiate between a breast cyst vs a solid mass.
• Thermography and PET are adjunct imaging tools used to clarify findings from mammography or MRI, and are not advised for use as stand alone breast cancer screening.^[14]

• Detection of breast cancer is usually confirmed histologically by biopsy after a physical exam and breast imaging.

Related Symptoms and Conditions

The risk factors for breast cancer are the same risk factors for ovarian cancer, uterine cancer, endometriosis, or hormonal imbalance and include:^[15]

• Diabetes
• insulin resistance

• People with insulin resistance produce more insulin like growth factor (aka IGF), which stimulates the growth of breast cancer cells.

Characteristics

Breast cancers are characterized by their stage, tissue subtype, grade, lymph node involvement, and molecular markers.

Naturopathic Treatment Strategy

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body. A treatment strategy is the most effective when it addresses the underlying causal factors and when it follows the naturopathic therapeutic order. The treatment strategies include: cancer prevention, cancer specific therapies, supportive care and strategies to prevent re-occurrence.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Prevention

Prevention involves addressing any of the causal factors before they cause cancer.

Cancer Specific Treatments

Follow the general guidelines for cancer specific treatments. Additional treatments that are specific to breast cancer include:

• Dietary recommendations include increasing the intake of whole foods, and plant-based protein while decreasing the consumption of dairy products.
• Supplementation such as Vitamin D, Vitamin C, Melatonin, essential fatty acids
• Herbs such as Turmeric,Indole-3-Carbinol, Di-Indolyl Methane, Green Tea Extract, Resveratrol, Convolvulus, Sulforaphane, Modified Citrus Pectin
• Acupuncture focusing on decreasing dampness in the middle jiao and lower jiao while tonifying qi.
• Intravenous Vitamin C therapy has been beneficial in case reports and is being studied in a clinical trial. ^{[16] [17]}

Supportive Care

Follow the general guidelines for supportive care especially when conventional treatments such as surgery or radiation therapy are chosen. Specific considerations for breast cancer include:

• Dietary recommendations include increasing the intake of whole foods, flax, and green tea while decreasing the consumption of animal fat and alcohol.

• Supplementation

• Vitamins such as: Vitamin D, Vitamin C
• Minerals such as: Chromium, Calcium, and Magnesium
• Food Supplements such as: Melatonin, essential fatty acids, Resveratrol, Sulforaphane, Modified Citrus Pectin, D-Indolyl Methane, Indole-3-Carbinol,

• Botanical Medicine

• Turmeric (Curcuma longa), Green Tea Extract, Convolvulus, Incense tree (Boswellia serrata),

• Therapeutic targets for these botanical medicines include estrogen receptor, estrogen metabolism, Her-2-Neu, COX, LOX, IGF, p53, VEGF, IL-6, apoptosis and tumor stem cells.

• Acupuncture can improve side effects of conventional breast cancer treatments such as joint pain, muscle pain, fatigue, neuropathy, nausea, and dry mouth.

• Exercises

• Exercises are used to prevent or treat lymphedema after breast cancer surgery.
• If muscles from the back or abdomen are removed as part of breast reconstruction, exercises may be used for rehabilitation.

Integrative Care

If surgical removal of the tumor is indicated, your naturopathic doctor can also help you to prepare for and recover from surgery. This can include supporting wound healing, preventing or treating lymphedema, reducing development of post surgical adhesions,and supporting pain control. Surgery preparation also involves removing supplements, foods, or medications that can interfere with anesthesia or blood clotting. Adjuvant (after surgery) chemotherapy and radiation may be recommended.

Prevent Recurrence

After a diagnosis of breast cancer, it is important to pursue a lifelong anti-cancer lifestyle. Without these preventive strategies, hormone receptor positive tumors tend to recur 8 to 20 years after initial removal. Since cancer "cures" are defined in terms of 5-year-survival, this means that many people with breast cancer will have recurrence after being "cured" of their cancer. Recurrent breast cancer is treatable. However, recurrent tumors do become gradually more resistant to treatment. Natural therapies to increase chemotherapy sensitivity, target the tumor, and prevent recurrence are particularly indicated for patients with breast cancer.

Resources

1. ↑ http://seer.cancer.gov/statfacts/html/breast.html#incidence-mortality
2. ↑ http://www.sunarc.org/breastcan402.htm
3. ↑ http://jama.ama-assn.org/content/293/20/2479.abstract
4. ↑ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60749-6/abstract
5. ↑ http://www.chemicalbodyburden.org/whatisbb.htm
6. ↑ http://www.ewg.org/news/common-chemicals-are-linked-breast-cancer
7. ↑ http://www.chemicalbodyburden.org/whatisbb.htm
8. ↑ ^{8.0 8.1 8.2} http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
9. ↑ http://www.forbes.com/sites/amywestervelt/2011/11/04/the-pinkwashing-debate-empty-criticism-or-serious-liability/
10. ↑ http://thinkbeforeyoupink.org/?page_id=13
11. ↑ http://www.ewg.org/node/21726
12. ↑ http://ghr.nlm.nih.gov/condition/breast-cancer
13. ↑ “The Biology of Cancer” from: Clinical Oncology : A Multi- Disciplinary Approach, 8th edition by Rubin (ed.)
14. ↑ http://www.naturalmedicinejournal.com/article_content.asp?edition=1&section=3&article=257
15. ↑ http://care.diabetesjournals.org/content/26/6/1752.full
16. ↑ http://www.ncbi.nlm.nih.gov/pubmed/12672707
17. ↑ http://www.ncbi.nlm.nih.gov/pubmed/12648599

Recommended Reading

• The Breast Cancer Companion by Barbara McDonald and Kelly Fitzpatrick
• The China Study by T. Colin Campbell
• See also the Recommended Reading section in http://www.ndhealthfacts.org/wiki/index.php?title=Oncology_(Cancer)