Thursday, September 18, 2014

Genetics, Estrogen and the Promotion of Women’s Health

While breast cancer is of growing concern based on unfavorable trends, there is so much we now know regarding effective ways of reducing the risk of this diagnosis or its recurrence!

One challenge is the fact that the established risk factors for breast cancer account for only one-fourth of breast cancer cases! This is largely due to the fact that the research and medical profession in the United States has not focused primarily on the issue of causation but has revolved primarily around the best means of early detection and treatment.

The term ‘secondary prevention’ means early detection through mammography, clinical breast exams and self-exams. While vitally important, the ideal, of course, is true prevention (called ‘primary prevention’) which requires knowledge of the underlying causes of breast cancer which can be addressed prior to the detection of actual disease.

Genetic factors also have to be taken into consideration. Having a genetic marker for breast cancer, a BRCA gene mutation, is relatively uncommon, estimated to be between 1 in 300-800 in the general population, but do tend to increase the risk by about 60 percent.

While very important when present, these inherited BRCA gene mutations are estimated to be responsible for less than 5 to 10 percent of breast cancers and about 10 to 15 percent of ovarian cancers. Therefore, potentially 90-95 percent of breast cancers are associated with non-genetic risk factors which are much more under our direct control!

The new science of epigenetics reveals how the influence of diet, environment and belief, and the choices we make, can change our genetic inheritance and affect what genes will be turned on and off, so-called ‘gene expression.’

One of the most important epigenetic factors is the hormone estrogen. Estrogen can stimulate breast tissue and increase cellular division. Since cancerous cells can result from mutations occurring during the cellular division process and cancer involves uncontrolled cellular growth, prolonged exposure to excess estrogen and its breakdown metabolites is probably the most significant risk factor currently known for developing breast cancer.

Reducing the degree of exposure to estrogen is therefore extremely important.
How are we all exposed to excessive levels of estrogen?
  • Toxic pesticide residues and compounds found in plastics mimic estrogen and stimulate the estrogen receptors in an unhealthy way and are therefore referred to as ‘endocrine disrupters’.
  • Hazardous ingredients in skin care products such as paraben preservatives that mimic estrogen have been found in tissue taken from women with breast cancer. Journal of Applied Toxicology, Vol.24, Jan/Feb 2004
  • Estrogens have been used as additives to poultry and cattle feed resulting in excess estrogen in meat and milk.
  • Use of hormone replacement therapy (HRT) was widespread for many years and younger women are often prescribed birth control pills or other hormonal contraceptives, even for acne.
  • As body fat increases, so does an enzyme in fat called aromatase which turns hormones made in other organs in your body (such as adrenal glands) into estrogen.
  • Nutrient-depleted food, highly processed sugars and carbohydrates have created blood sugar problems and the pre-diabetic condition known as ‘metabolic syndrome.’ The increased level of insulin is associated with higher estrogen levels, increased breast cancer and its recurrence.
  • Disruption of the gastro-intestinal flora reduces the degree to which the good bacteria living in your gut can detoxify the estrogen made in your body after it’s been used to avoid re-absorption.
  • Increase of stress-associated hormones like cortisol (which is made from progesterone), causes a depletion of progesterone and a relative estrogen dominance.
Health coaching to help achieve a healthy lifestyle and to overcome psychological resistance to behavioral change becomes, therefore, an indispensable component in an effective approach to promoting breast health and reducing the risk of breast cancer.

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