Breast Cancer – An Integrative Approach
0nly 10-15% of cancers can be attributed to an inherited genetic abnormality. Epigenetics is where we should be focusing our attention to prevent the rest of the cancers we diagnose.
So what is Epigenetics?
“The study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. Epigenetics has transformed the way we think about genomes.”
We have no control over the genes we are born with (yet!), but we can make choices that can modify “bad genes or SNP’s” (Single Nucleotide Polypeptides). In a patient with breast cancer, the following adjustments to her lifestyle could be beneficial.
There are some foods that I always advise my patients not to eat. They are sugar, milk, yoghurt, cheese and gluten. Glucose is the fuel that feeds all cells. Cancer cells have more glucose receptors on their cell surfaces than normal cells, and sugar is their primary food source. PET scans depend on radioactively marked glucose concentrating in cancer cells and thus helping us to exclude spread of cancer in our patients.
Breast milk from any mammal contains growth factors that grow babies as fast as possible so that they can survive. These proteins are present in milk, yoghurt and cheese, but the fat part of milk, the butter and cream, don’t contain them.
Gluten is what gives modern grains their pliability, but it contains a protein that many of us are unable to digest properly, unlike the older grain, millet. This leads to gut lining problems, which impairs absorption of nutrients and can lead to ongoing allergies and autoimmune diseases.
I advise my patients to eat 7-8 cups of vegetables and salad daily. I reduce sugar by limiting fruit to 1-2 portions daily. The breakdown should be: 5-6 cups of green, 1 cup of cruciferous (cauliflower, broccoli, kale, cabbage, brussel sprouts), 1 cup of colour and 1 cup of white (mushrooms, onions, garlic, ginger, turnips etc.).
I encourage my patients to source their meat from suppliers of pasture reared meat. Most meat in South Africa is sourced from animals that have been fattened in food lots. Here they are fed grains, so their fats contain omega 6 fat, not omega 3 as in pasture reared animals. In food lots, they are often fed antibiotics and are vaccinated as the animals are in close proximity to each other. Venison is safe at the moment in SA. one-two portions of red meat a week is acceptable, if it is pasture reared, if not exclude red meat. Pork is also red meat not white and should be pasture reared.
South Africans love to braai, so how can we do this safely? Marinate your meat in olive oil and lemon juice. When you serve your meat, serve it with the following as they antidote the carcinogen that is produced when charring protein; lemon juice, horseradish, country mustard, watercress and rocket. Chicken and eggs should be free range. Check your source. Greens make the egg yolks bright orange, which is a good indication that the eggs really are free range. Eat fish off the SASSI list freely.
If you are vegetarian, make sure you are getting enough protein, especially during chemotherapy, as you need protein to repair your body. I find my vegetarian patients are often deficient in essential amino acids, iron and vitamin B12. Make sure that you check these levels.
There are some great protein powders if you do not have an appetite for animal proteins. Hemp, pea and whey protein are all good sources. Check that they are not contaminated with herbs that stimulate growth of tissue.
Fats are essential for good health and you need to consume enough. I recommend the following: You can eat coconut oil, nut oils, avocado oil, ghee, butter, cream and of course be liberal with olive oil. NO SEED OILS!!! They often lead to an elevation in arachidonic acid, which is linked to high levels of inflammation.
Grains are highly processed foods and I advise my patients to refrain from eating them. In fact I advise them not to eat any food that has been processed, including processed or smoked meats. Rather eat cereals that you make yourself from nuts and seeds. Instead of having them with yoghurt you can eat them with cream, almond milk or sugar free rice milk. Other grains you can eat are millet, organic non-GMO mielie meal, sorghum, spelt, buckwheat and rice. Always wash rice 2-3 times, including organic brown rice as they all contain arsenic. (Arsenic is used to ward off rats in the silos, apparently).
Starches like potatoes and sweet potatoes are fine.
Snacks: Nuts, carrots, celery, snap peas, tiny tomatoes can all be dipped in humus or tzatziki made with cream instead of yoghurt.
I don’t need to go into detail about the quality of South Africa’s water as there has been a lot in the news lately about the poor state of our water purification. Recently SAMA sent us a memo stating that they expected the incidence of water borne diseases to soar. Chlorine kills all the bad bacteria in our water, but it is carcinogenic. We live in a third world country and can’t afford the alternatives to high doses of chlorine. Chlorine has saved more lives than it has killed, however if you are able to purify your water, this needs to be your number one priority. Make sure you get a good carbon filter, preferably with a UV light, to kill any organisms that make it through the filter. I recommend the Espring solid block carbon filter, as all the research on the filter is available, and has been done on a filter AFTER 5 000 l of water has gone through the filter. When buying one, make sure you ask the right questions and ask for the research that has been done on the filter. You need to drink at least 1.5 l daily. Wash all your vegetables and salad in your purified water.
I recommend you walk at least 30 min 4 times weekly. Remember that over exercising leads to high levels of oxidation in your body. While you are receiving chemotherapy, you may only be able to exercise 5 to 10 min daily. This is okay, you need to rest at least 30 min daily while receiving chemo.
You need 7-8 hrs of sleep every night. The two hours from 10-12pm are especially important. Take 3 to 10 mg melatonin at night if you are not able to sleep properly. Melatonin also has the advantage of blocking oestrogen receptors.
You need to get your BMI down to 25. Fat stores excess oestrogen and this is detrimental to women with oestrogen positive tumours. Most of my patients lose their excess weight when they exclude dairy, sugar and gluten.
STRESS, RELATIONSHIP AND EMOTIONAL ISSUES
You need to address any excesses in your life. Stress is also one of these. If you need to get advice and help, please consult a therapist, life coach or see your GP/ Health Practitioner. When we are under a lot of stress – work, family, financial or otherwise, cortisol is increased and this affects hormones in our bodies and inflammatory cytokines. Relationship problems need to be addressed. You need to feel nurtured by your spouse, partner and family, as you nurture them. If you are not able to work out your emotional issues, see a therapist, pastoral counsellor or get advice from someone you trust.
In my opinion this is where we can make good choices. Take a look at your house starting at the perimeter. Are there any toxic areas around your house like vineyards or golf courses? They are sprayed regularly with pesticides, herbicides and fungicides. Often these are carcinogens and endocrine disruptors. Do you use poisons in your own garden? Change to safer organic options. Are you looking after your swimming pool? Chlorine is carcinogenic, reduce exposure to it to a minimum. Are there any toxic substances in your home? Insecticides are made to have no scent, enabling us to use more and thereby exposing ourselves to more toxins. You may be an avid rose gardener, using lots of poisons to kill bugs on your roses. Change to safer alternatives. There are fungicides available over the counter that are carcinogenic and endocrine disruptors.
Look at carpets, mattresses and other new furniture, they all have high levels of formaldehyde. Reduce your exposure to any and all toxins if you can. Remember this applies to your home, workplace and to the area you do your hobbies in. Take a close look at your hobbies; Are you working with glues, turpentine, paints, varnishes, wood shavings, lead, azo dyes (make – up artists and food scientists)?
Try to clean up your environment. Be careful of your personal environment too. Mercury fillings in your teeth, only remove them when you are in better health, not during chemotherapy. Products that you use on your body, check labels, be careful of azo dyes, formaldehyde and parabens.
So, now that you have sorted out your Epigenetics, let us take a look at the supplementation that can help a patient during chemotherapy and once they have finished treatment and want to prevent the tumour from returning.
During chemotherapy one has to take into account the chemo that has been prescribed. Discuss it with your oncologist. Only use supplements or nutritional therapies that are safe and compatible with the chemo you are using. Dr Lisa Alschuler and Karin Gazella have written a great book called “The definitive guide to cancer,” well worth the read. It is a 2011 edition and very well peer reviewed.
I advise my patients not to use any supplements the day before, day of and day after chemotherapy. They must only use nutritional vitamin supplements that are food based. Synthetic supplements are treated by the body like drugs and need to be metabolised by the liver and hereby affect the metabolism of chemo drugs. Food based vitamins are absorbed like food and mostly won’t affect chemotherapy drugs being administered.
Always discuss your supplement regime with your oncologist or health care practitioner so that they can make sure you are using the correct ones for your type of tumor. You may have an oestrogen or progesterone receptor positive tumor. There are supplements like Melatonin, DIM and I3C that can block these receptors, but your oncologist may have given you a medical receptor blocker. You may be undergoing radiotherapy and during this stage of your treatment, using a homeopathic remedy, melatonin and Biocurcumin will be beneficial. However, you should not use antioxidants during radiotherapy.
The scariest time for most breast cancer patients is when they are discharged by the oncologist or radiotherapist. Their question is always, “What do I do now?” Contact a practitioner who can help you with a plan to change your lifestyle. Remember, the lifestyle you followed before you were diagnosed was not serving you, you need to change. This is always difficult, but can help to prevent your cancer from returning and makes all the effort worthwhile.