The recent news about a study regarding women who get mastectomies to prevent breast cancer is stunning.
This study finds most women who get double mastectomies don’t need it. They react out of fear. And this has many doctors puzzled.
Breast Cancer & Biochemistry
Can we prevent breast cancer occurrence through primary care means? The short answer is yes, we can.
We can identify breast cancer risks. We can do functional lab testing to assess nutritional and endocrine balance and test for products of hormone metabolism. We can treat the imbalances we find and monitor progress through lab work and imaging. We can achieve this by understanding some pretty basic biology and biochemistry, and applying it to our patients to help them overturn early cancerous processes in the body and improve overall health.
Expendable Body Parts?
This idea that certain body parts are expendable is not a new one. Modern medicine has been guilty of prophylactically removing the appendix, unfortunately before we knew it was the hot house of probiotic inoculation for the entire gut (oops).
The gallbladder is routinely removed when its dysfunction could be treated by non-surgical means. Who needs one of those (aside from the countless numbers of cholecystectomy patients who now live with chronic diarrhea, who have figured it out the hard way)?
We routinely see hysterectomies performed prophylactically in women beyond their childbearing years, because you can’t get cancer in it if it’s not there to begin with. But that involves major abdominal surgery and impairs blood flow to the ovaries, which reduces ovarian function resulting in hormonal deficiencies they didn't bargain for..
It’s really not that difficult to apply the same logic to the breasts. It’s no wonder we are seeing women push for elective bilateral mastectomies in an effort to prevent breast cancer, and I’m trying to figure out why this trend is surprising.
Patients Seeking Peace of Mind
It would seem that these patients are acting from the standpoint of proactive resolve when no other agreeable options are presented. It is nightmarishly expensive and emotionally horrifying to undergo cancer treatment, and our patients are hip to that. Not to mention better informed on breast cancer prevention research and updates than some of their own primary care doctors.
Really, what are the options doctors present to their patients wanting to prevent cancer but who are not in the high risk category? Watch and wait? Paradoxically more relaxed practice guidelines on clinical breast exams? That doesn’t exactly lend peace of mind to an educated patient who wants to prevent cancer down the road with or without surgery.
Providers Can Take Positive Steps
There are solid preventive strategies for breast cancer that doctors can implement with their patients right now, and it starts by asking these 5 questions:
- Is this patient getting adequate/optimal nutrition every day? Especially fiber from green vegetables in the cruciferous family? Are there adequate sources of B vitamins, magnesium, iodine and selenium?
- How balanced is this patient’s endocrine system? Are the sex hormones in balance? Are there symptoms of estrogen dominance? In women, what are the cycles like? Is the circadian rhythm in balance? Is blood sugar in balance? Is the thyroid functioning optimally?
- How well does the liver metabolize the sex hormones into safe metabolic products? Is this patient making excessive known breast cancer-promoting metabolites? Is proper methylation happening?
- How well is this patient eliminating hormonal metabolites? Is there a (healthy) bowel movement 1-2 times a day? Or is there potential for excreted estrogen metabolite re-absorption in a sluggish, toxic digestive tract? Is the creatinine clearance and kidney function normal? Is this person exercising and sweating regularly?
- How does this patient handle stress? What are their stress-reducing strategies and are they effective? Stress is well-correlated with tumor induction and may play a much larger role in its development than we know.
Addressing the 5 Questions
Nutrition going into the body, and how the body uses that nutrition to circulate nutrients and build hormones, and their elimination coming out should be big indicators of what’s going on at the cellular level. So, how do we address these 5 questions? Much of this can be evaluated in the subjective portion of any medical encounter. The rest can be assessed using existing lab tests.
- Saliva or blood spot testing for estriol, estradiol, estrone, progesterone, testosterone, DHEA-S, and diurnal cortisol levels are a good start for assessing the sex hormones and the circadian rhythm.
- Functional laboratory analyses on the market for assessing intracellular vitamin/mineral status and looking at traditional CBC/CMP with a “functional eye” can also tell you something about metabolic imbalances.
- Serum or blood spot HgbA1c, fasting insulin and fasting blood glucose will assess blood sugar balance.
- Thyroid function can be assessed by looking at serum or blood spot TSH, free T3 and free T4.
- ZRT Dried Urine Elements Profile that tests iodine and selenium status as well as bromine, arsenic and mercury excretion can show deficiencies in vital elements for cancer protection (iodine and selenium) and excesses in toxic elements.
- Healthy vs. cancer-promoting metabolites and proper methylation can be assessed using the ZRT Estrogen Metabolites Plus Profile, which is geared toward identifying breast and prostate cancer risks. There are also tests on the market that check for specific genetic SNPs if there is concern about a wider genetic methylation issue.
Learning More About Breast Cancer
If it’s hard to imagine how all of this fits together into one giant breast cancer prevention picture, don’t worry. Some researchers have made it their life’s work to comb through countless studies, conduct their own research, develop cutting-edge laboratory tests, and educate the provider community about ALL of it. Dr. David Zava’s 6-part Metabolites series of webinars are specific to the content here and are available to view. I think all medical providers on the front lines should be aware of the preventive care they could be providing their patients beyond the bare minimum screening guidelines currently set forth. Patients simply are demanding more.
That said, this approach may not be for everyone. There will always be a number of women who will opt for the prophylactic double mastectomy despite having no genetic or family history basis to justify it. For the rest of the women out there searching for real preventive strategies who may be researching the highly publicized prophylactic double mastectomy but reaching out for other solid options first, a real cooperative effort with their primary care physician may be the game changer. With this approach, doctors and patients can assess risk, make nutritional, lifestyle, supplement and hormonal adjustments based on the risk assessments, monitor the changes through lab work and feel confident breast cancer risk is decreasing.
- Blog: Breast Cancer - Awareness to Action
- Blog: Natural Progesterone as a Preventative for Breast Cancer
- Blog: Breast Cancer - What Exactly Are We Talking About?