Dr Fuhrman on Breast Cancer
By Joel Fuhrman, M.D. www.drfuhrman.com
- Cruciferous vegetables powerfully prevent breast cancer.
- Vitamin D powerfully protects against breast cancer.
- Mammograms cause some breast cancers, reduce deaths by almost the same number of deaths they cause and overall do very little to extend lives.
Breast cancer is the second leading cause of death in North American women (heart disease is number one). In spite of modern cancer detection and treatment methods, the percentage of women dying from this common cancer has not changed much in the last thirty years.1
The current consensus view of physicians and health authorities in America is that mammography for women under the age of 50 is appropriate if there is a certain degree of family history of breast cancer. Mammographic screening is recommended to begin as early as 25 to 30 years of age in carriers of the BRCA1 or BRCA2 mutation, which increase the risk of developing breast cancer. However, new data from more carefully designed studies contradicts this generally accepted view. A new study reported in the Journal of the National Cancer Institute reports that women who are at high risk of breast cancer who are advised to start getting mammograms as early as age 30, are at even higher risk for breast cancer from the additional radiation exposure. They reported that due to the risk of radiation-induced breast cancer, mammographic screening may have a net harmful effect.
Using data from 22 pedigree studies (studies done on the entire family, not just a person) of 8,139 subjects, the research team estimates that for BRCA1 or BRCA-2 mutation carriers, annual mammographic screening starting at 25 to 29 years of age would confer a lifetime risk of radiation-induced breast cancer mortality of 26 per 10,000 women. This means undergoing mammograms caused more harm than good. SOURCE: Journal of the National Cancer Institute, February 4, 2009 (http://jnci.oxfordjournals.org/cgi/content/abstract/101/3/205.)
Finally, we are receiving some real results about this confusing but traditionally biased and highly emotional subject. The problem is that instead of the focus being on the environmental, lifestyle and nutritional causes of cancer that really has the power to beat this disease, our nation and medical authorities are focused solely on mammograms, biopsies, radiation and chemotherapy. In general, mammograms’ benefits have been dramatically exaggerated to the general public.
Contrary to what we hear in America, researchers around the world are more cautious about jumping on the mammogram bandwagon, because the evidence that lives are saved is scant. Regular mammography carries a cumulative risk due to radiation. Dose and age at exposure are the two most important determinants of this risk, and hence the risk is theoretically greater for younger women. In addition, those who have an inherited predisposition to cancer may be more susceptible to environmental carcinogens such as radiation. Nobody who has carefully reviewed the studies can argue that our present method of detection and treating breast cancer is doing much to prolong lives and reduce breast cancer deaths.
US Breast Cancer Incidence and Mortality (per 100,000 population)
Source: Breast Cancer Facts & Figures 2001-2002 - American Cancer Society – www.cancer.org
The Nordic Cochrane Centre in Denmark is famous for their careful, comprehensive, and non-biased research. They analyze pooled data from all the studies on mammograms and breast cancer treatments.
These researchers examined the benefits and negative effects of seven breast cancer screening programs on 500,000 women in the United States, Canada, Scotland and Sweden. The study’s authors found that for every 2,000 women who received mammograms over a 10-year period, only one would have her life prolonged, but 10 would endure unnecessary and potentially harmful treatments. This new analysis attempted to update and revise the original Nordic Cochrane report that assessed the efficacy of screening mammograms in reducing breast cancer deaths because the initial report surprisingly found no benefit to mammograms at any age. The more recent version carefully reviewed all the published randomized trials and attempted to find reasons and flaws with the earlier report that found mammograms did not reduce mortality.2 The earlier studies that focused on breast cancer deaths missed tallying fatal cases that were misclassified or that were triggered by cancer treatment such as radiotherapy, they wrote in their article. For example, all the leukemia deaths and cardiac deaths occurring as a result of chemotherapy for breast cancer or increased cases of fatal lung cancer caused by radiation to the breast for breast cancer were never considered in prior studies. Lung cancer is a known late stage side effect to breast cancer radiation3and congestive heart failure is a known late side effect of the cardiac toxicity of chemotherapy.4 The Cochrane researchers concluded the studies and claims that mammograms reduce breast cancer deaths by 25 to 30 percent are invalid, since those investigators did not consider all other deaths related to breast cancer treatments.
Based on this highly respected review the Lancet editorial concluded, "there is no reliable evidence from large randomized trials to support screening mammography at any age." These researchers believe that all the studies that show some benefit to mammograms to women in their 50’s and 60’s are biased in favor of screening and incorrect because they did not use all-cause mortality and only looked at breast cancer mortality.
The reassessment in the Cochrane analysis confirmed the earlier findings that breast cancer screening with mammograms also creates an overuse of aggressive treatments. Their reasoning was that the mammograms detect lots of slow-growing tumors that will never progress to cancer within the patient’s lifetime and classify them as cancer. These account for the “so-called” mammograms successes. There are cellular changes that may be histologically cancer but biologically benign. Carcinoma-in-situ may be treated by bilateral mastectomy even though they do not progress to invasive disease, ever. These are counted as mammograms’ successes, when they are not. Then the other cancers that are truly invasive are not really caught early enough to make a difference. The patient appears to live longer because the disease is diagnosed earlier, but actually does not.
Therefore, the inescapable conclusion is this – Data from the most carefully performed investigations support the position that mammograms do not provide a significant survival benefit in any age group. Those that benefit are balanced out almost equally by those that are hurt. Another reason for this is that chemotherapy for estrogen-positive, post-menopausal breast cancer is relatively ineffective. For example, a meta-analysis of chemotherapy for postmenopausal, estrogen-receptor-positive women (the largest group of women with breast cancer) pooled the six largest studies to get the most accurate date on survival and complications. They concluded for the group treated with standard chemotherapy, “No significant survival benefit was observed.” 5
None of these researchers or scientists are denying that there are some women who are helped and whose lives are extended when a cancerous lump is caught early and removed before it can spread, the problem they see is that this is a very rare occurrence and most often it is detected too late for medical care to effect the outcome. The point is that our society focuses on the big business of mammograms, but ignores the really effective things we should do to prevent women from getting breast cancer to begin with. Even if mammograms for the 50 – 65 age range have a very slight benefit, it is still promoted and viewed by women in America to be the most important thing they could do to protect themselves. Breast cancer month is all about promoting mammograms to the astonishing exclusion of what women really should do to protect themselves.
For example, last year an interesting study was published that gave about 1000 women 1100 IUs of Vitamin D and tracked them for four years. It showed a significant reduction in all types of cancer incidences as the study progressed (including breast cancer). This study was so important because it was the first randomized controlled trial to give a substantial dose of Vitamin D, sufficient to raise the blood level by a biological meaningful amount to 30 ng/ml (80 nml/l), and tract the outcome. Giving a higher dose (1110 IU), tracking the blood levels, maintaining a low dropout rate, the randomization of the subjects to placebo or the treatment arm, and the blinding of the recorded results made this the best study ever performed on Vitamin D supplements. The results were remarkable, the Vitamin D supplements had a very strong effect at preventing cancer development even in just a few years and the corrected blood value for Vitamin D correlated with the protective effects against cancer.6 This study was so impressive because cancer-causation is a process that takes decades, yet in this short time frame, the Vitamin D supplements decreased cancer occurrences by over 50 percent. If the study went longer it may have even shown a greater reduction in cancer outcomes. This illustrated that if Vitamin D supplements were a drug, and if a drug was ever shown to produce such an outcome, it would be worth zillions of dollars as the most impressive drug ever invented in medical history.
During the last twenty years, when mammograms were heavily promoted by the medical profession and health authorities, breast cancer rates rose, as more women got mammograms. Between 1970 and 1990 breast cancer incidence rose 24%. This is not because of in increased rate of cancer developing; rather it is the result of the increased use of mammograms and more cancers being detected. Now there are much more women living with the knowledge that they have cancer because of mammograms.
Unfortunately, the exact same percentage of women still die of breast cancer at the same age as they did prior to mammograms. The primary difference between now and 20 years ago, before mammograms were widely used, is that more women know they have breast cancer earlier. It doesn’t appear from the statistics that many lives are being saved by so-called “early detection.” Five and ten year survival rates may look like they have improved, but naturally, if the cancers are detected earlier, it will look like women are living longer with their cancers, when in reality they are not.
Seven key weapons against breast cancer that work
Be proactive and adjust your diet and lifestyle to achieve a high level of health, so that any abnormal cells never can overcome your body’s powerful immune defenses. Early, pre-cancerous changes in the breast can be normalized by nutritional excellence. Women can prevent breast cancer and even if they have cancer they can significantly increase their survival with nutritional excellence. Read Eat For Health, understand nutritional excellence.
The best way a women can protect themselves from breast cancer is:
- Do not drink alcohol and of course do not smoke anything
- Do not take any type of estrogen, and avoid drugs (especially antibiotics).
- Have babies and nurse them as long as possible,
- Eat a high nutrient, vegetable-based diet, with loads of greens as described in my book, Eat For Health.
- Take sufficient Vitamin D supplementation to drive the blood level to 35 – 50 ng/ml.
- Use one tablespoon of ground flax seeds daily.
- Don’t grill or fry foods. Steaming vegetables or vegetable soups should be the primary modes of cooking.
- Exercise at least 3 hours a week, and maintain a lean body with little body fat.
Green vegetables are the most powerful anti-breast cancer food. Take note that a vegetarian diet does not show protection against breast cancer as much as a diet rich in green vegetables, berries and seeds. Many vegans eat a high glycemic, nutritionally poor diet, and do not take sufficient Vitamin D, leaving themselves at high risk of cancer. It is the phytochemical nutrient density and diversity of the diet that offers the most dramatic protection against cancer, not merely the avoidance of meat or fat. Close to 300 case-controlled studies show a protective effect of vegetable consumption against cancer and that cruciferous vegetables are the foods with the most powerful anti-cancer effects of all foods. While eating fresh fruits, beans, vegetables, seeds and nuts have been all been shown in scientific studies to reduce occurrence of cancer, cruciferous vegetables are different. Instead of a 1 to 1 relationship they have 1 to 2 relationship with a wide variety of human cancers. In other words, as plant food intake goes up 20% in a population, cancer rates typically drop 20%, but as cruciferous vegetables go up 20%, cancer rates drop 40%.7
Bottom line, eat lots of greens and don’t forget to take your Vitamin D every day.
1Greenlee RT, Murray T, Bolden S, Wingo PA.Cancer Statistics, 2000CA Cancer J Clin 2000Jan-Feb;50(1):7-33
2Olsen O; Gotzsche PC Cochrane review on screening for breast cancer with mammography. Lancet 2001 Oct 20;358(9290):1340-2.
3Rubino C, de Vathaire F, Diallo I, et al. Radiation dose, chemotherapy and risk of lung cancer after breast cancer treatment. Breast Cancer Res Treat 2002 Sep;75(1):15-24.
4Rock E, De Michele. A Nutritional approaches to late toxicities of adjuvant chemotherapy in breast cancer survivors. J Nutr 2003 Nov;133(11 Suppl 1):3785S-3793S.
5Hartman AR, Fleming GF, Dillon JJ. Meta-analysis of adjuvant cyclophosphamide/methotrexate/5-fluorouracil chemotherapy in postmenopausal women with estrogen receptor-positive, node-positive breast cancer. Clin Breast Cancer 2001;2(2):138-143.
6Lappe JM, Travers-Gustafson D, Davies KM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007; 85(6):1586-91.
7Michaud DS ; Spiegelman D ; Clinton SK. Fruit and vegetable intake and incidence of bladder cancer in a male prospective cohort. J Natl Cancer Inst. 1999; 91(7):605-13. Lee S, Fowke JH, Lu W, et al. Cruciferous vegetables, the GSTP1 Ile105Val genetic polymorphism, and breast cancer risk. Am J Clin Nutr 2008;87(3):753-760.