Dame Shirly Bond Answering Questions on Cancer
MY GYNAECOLOGIST HAS TOLD ME THAT IF I USE OESTROGEN WITH A PROGESTERONE CREAM FOR FIVE YEARS I WILL INCREASE MY RISK OF ENDOMETRIAL CANCER FOURFOLD, IS THIS TRUE?
This is a very sweeping and misleading statement because it does not take into account how much oestrogen you are taking, not how much progesterone cream you are using. Furthermore, it suggests that the combination of oestrogen and progesterone cream increases the risk of endometrial cancer, but even that is unlikely to increase it fourfold.
Originally HRT consisted of just oestrogen, and endometrial cancer did occur in a number of women. In order to protect the uterus from the oestrogen, a progestogen – an artificial chemical, which mimics some of the actions of progesterone – was added to the HRT. The use of the progestogen ensured a monthly bleed, which prevented the lining of
the uterus from building up and becoming cancerous. With traditional HRT, because of the high dosages of oestrogen used, this increase in the lining of the uterus can still occur even when progestogens are used. The result of this is the condition known as endometrial hyperplasia, and its existence is often used as a reason for performing a (probably unnecessary) hysterectomy. While it has been shown that natural progesterone can protect the endometrium against the stimulating effects of extra oestrogen, if you are using oestrogen in the high dosages normally associated with traditional HRT, then progesterone cream may not adequately protect the endometrium from hyperplasia. If a low dosage of oestrogen, which is often all that is needed to relieve symptoms, is being taken then progesterone cream can protect the endometrium and hyperplasia of the endometrium (which can lead to cancer) will not occur.
CAN TAKING PROGESTERONE CAUSE BREAST CANCER?
Progesterone never causes breast cancer. If a breast cancer is described as being progesterone-sensitive it does not mean that the progesterone caused the cancer or that the administration of progesterone will make it recur. What it means is that the breast cancer has receptors that are sensitive to progesterone. The effect of progesterone on the breast is to reduce proliferation of the tissues, and it is this proliferation that makes cancer more likely. So by using progesterone you are positively protecting your breasts against the risk of cancer. If oestrogen is given on its own as a form of HRT, as it was in the 1960’s and early 1970’s, it can cause cancer of the lining of the uterus. This is the reason that oestrogen replacement therapy went out of favour and why women should not be prescribed unopposed oestrogen. Current forms of HRT for women who have not had a hysterectomy usually contain some form of artificial progestogen to protect the uterus, although natural progesterone would be a better way to approach the problem. We have always known that unopposed oestrogen is a major factor in the acceleration of breast cancer. What is now becoming clear from research presented at an international cancer conference in 1998 is that unopposed oestrogen may actually be the cause of some types of cancer. For this reason alone, to give themselves maximum protection women need adequate levels of progesterone to balance out any symptoms of oestrogen dominance.
I HAVE BEEN TOLD THAT NATURAL PROGESTERONE INHIBITS OESTROGEN, SO CAN IT BE USED INSTEAD OF TAMOXIFEN FOLLOWING BREAST CANCER?
It is not true that natural progesterone inhibits oestrogen. Oestrogen and progesterone are female hormones that occur naturally in the body and should occur in quantities that balance each other out. The importance of progesterone is that it balances out the effects of oestrogen. Breast cancer is usually an effect of oestrogen dominance. If this dominance can be counteracted, then the activity of breast cancer cells should be inhibited. It is claimed that tamoxifen does this. However, tamoxifen is a very potent drug (actually a weak oestrogen) with unpleasant side effects of its’ own and, in the opinion of many people, is best avoided. On the bases that natural progesterone prevents oestrogen dominance and has no reported or know side effects, then it is preferable to use natural progesterone instead of tamoxifen for the suppression of oestrogen dominance following breast cancer.
I HAVE HAD A PROGESTERONE RESPONSIVE BREAST CANCER, SO IS NATURAL PROGESTERONE SAFE FOR ME TO USE?
The breast cells have both oestrogen and progesterone receptors. However, the effect of stimulating these receptors is different. If oestrogen receptors are stimulated they will encourage the breast tissue cells to develop, proliferate and become more active. This is how cancers, which are oestrogen receptor positive, can develop and spread. If progesterone receptors are stimulated they will have a different effect on the cells: to counteract the stimulating effects of oestrogen. This will prevent the proliferation and spread of cancer cells. There has been considerable research done which shows that high levels of progesterone in the body prevent the spread of breast cancer and also increase the likelihood of a good future prognosis for those women with a history of cancer. On this basis, and in discussion with your own doctor and consultant, it most certainly is safe to take natural progesterone.
WHAT IS THE DIFFERENCE BETWEEN USING NATURAL PROGESTERONE AND USING TAMOXIFEN IF YOU HAVE BREAST CANCER?
Natural progesterone counteracts the stimulating effects of oestrogen on tissues such as those in the breast and endometrium, which have both oestrogen and progesterone receptors. Tamoxifen is an oestrogen block for breast tissue. That is to say, it attaches to oestrogen receptors and prevents the body’s own oestrogen from acting on them. However, it continues to have true oestrogenic action on other tissues of the body. Tamoxifen is in fact a weak oestrogen, but seems to have two conflicting characteristics. It can act as an anti-oestrogen to some tissues and as an oestrogen to others. Current option from the US, as reported by Dr John Lee, is that the manufacturers of tamoxifen cannot continue to claim that this drug blocks oestrogen in the breast tissue. Whatever the outcome of this debate, what is quite clear is that tamoxifen does have a considerable number of side effects, some of which can be fatal.
CAN I USE NATURAL PROGESTERONE AND TAMOXIFEN TOGETHER, AND ARE THERE ANY SIDE EFFECTS I SHOULD BE AWARE OF?
Yes, you can use natural progesterone and tamoxifen together. Obviously you would discuss any treatment with your doctor. However, given what we know of the beneficial effects of natural progesterone and its protective role against breast cancer, you may wish to give consideration to whether you do need to take tamoxifen as well. The problem with this drug is that it does have serious reported side effects.
Among these are:
- Blood clots in the lungs
- Menstrual irregularities
- Damage to the cornea and retina of the eye
- Depression
- Associated with increased risk of endometrial cancer
- May trigger asthma and liver disease
- Known carcinogen
It may seem strange that a drug, which is used after breast cancer treatment, should be a known carcinogen, but tamoxifen is listed as a cancer-causing drug by the World Health Organisation. Tamoxifen produces this carcinogenic effect by binding with DNA material in the body. There have been reported cases of both endometrial and liver cancer from its use. Until it becomes clear that tamoxifen really does prevent the occurrence and recurrence of breast cancer, it remains a drug that should only be taken with caution bearing in mind its possible side effects. Natural progesterone, however, does not have any reported side effects after more than 25 years of use throughout the world. It is known to have the effect of dampening down the stimulating effect of oestrogen on breast tissues – and this is exactly what you wish to achieve to give yourself maximum protection against the possibility of breast cancer.
I HAVE A BREAST CANCER AND AM DUE FOR SURGERY, COULD NATURAL PROGESTERONE HELP ME BEFORE I GO INTO HOSPITAL?
Work has been published that shows that women being operated on for breast cancer who have high levels of progesterone, both at the time of surgery and afterwards, show dramatically improved survival rates. From this point of view, wherever possible women should try to schedule any surgery in the second half of their menstrual cycle when the progesterone level is highest. The 30-year old retrospective study at John Hopkins University in the US found that women who were low in progesterone had 5.4 more times more incidence of breast cancer an d10 times more deaths from cancer of all kinds. Also, a French study published in the peer journal Fertility and Sterility showed that the value of progesterone lies in the fact that it actually slows down the rate at which cell division occurs in the breast ducts. It would therefore be a very sensible precaution to ensure your surgery is scheduled for the latter part of your menstrual cycle when your progesterone level is normally at its highest. It would also be sensible to supplement with natural progesterone to ensure you’ve got adequate levels at the time of surgery, and to maintain the progesterone supplementation after it. Dr John Lee has said that of all his own patients treated in this way for breast cancer, none has subsequently died from the disease.
I HAD BREAST CANCER 15 YEARS AGO AND NOW HAVE OSTEOPOROSIS. I BELIEVE I CAN’T HAVE HRT, SO WHAT ELSE CAN I DO?
No, you will not be prescribed HRT as you would be a prime risk for further cancer if you were to be given it. However, there is still a great deal that can be done to help your oesteoporosis. Taking Natural Progesterone will enable you to build up new bone and will further be protective against any further breast cancer risk.
I AM WORRIED ABOUT TAKING SUPPLEMENTS WHICH MIGHT STIMULATE MY BREAST CANCER TO START UP AGAIN.
Natural Progesterone will not increase the risk of a recurrence of your breast cancer as taking HRT can do. Women with high levels of progesterone have actually less risk of a recurrence of breast cancer than women with low levels do.
CAN USING NATURAL PROGESTERONE PREVENT OTHER CANCERS?
There has NOT been enough work done in this field to answer this question with any degree of authority. However, what is known is this: The body is constantly renewing its cells. All cells have a predetermined lifetime after which they should die, be removed and replaced by the body with new, young healthy cells. For some reason not understood, sometimes this does not happen and the old cells remain and begin to function and grow in an abnormal way which is known as cancerous. There is a gene (BCL2) which blocks the process that tells cells that it is time to die. This gene is actually stimulated by oestrogen. As a result it is more active when oestrogen is dominant. If the supplementation with natural progesterone is used thie will reduce the oestrogen dominance and as a result stop or slow down the activity of this gene. In addition to the gene (BCL2) there is another gene (P53) which encourages the cells to know it is time to die. This gene is actually stimulated by progesterone. As a result of supplementing with natural progesterone this gene will be made more active.