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Life Extension Magazine

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January 1996


How To Prevent Breast Cancer Estrogen Replacement Therapy: What's A Woman To Do?


One of the likely reasons for the increased incidence of breast cancer in the U.S. in recent years has been the increasing number of women who have been taking supplemental estrogen to replace the estrogen lost during and after menopause. Although estrogen replacement therapy (ERT) can eliminate the negative effects of the menopause (including hot flashes, sweats, headaches, and nervousness), and is effective in preventing osteoporosis (bone loss), heart attacks, and (perhaps) colon cancer, it also increases the risk of endometrial (uterine) cancer, ovarian cancer, and breast cancer.

Scientists have found that the risk of endometrial cancer can be eliminated by giving women supplemental progestin (a synthetic version of progesterone-another hormone depleted after menopause) in addition to estrogen. However, it appears as if the combination of these two hormones does not reduce the estrogen induced risk of breast cancer and ovarian cancer. A recent story in TIME magazine dealt with a study in The New England Journal of Medicine showing that women taking estrogen and a synthetic progestin had a 32%-to-46% increase in their risk of breast cancer. This increase translates into large numbers of women when you consider the degree of risk (1 in 8) that all women face when it comes to breast cancer.

What Is The True Risk Of Breast Cancer?

At the Life Extension Foundation, we've taken the position that ERT causes breast cancer for years because of the laboratory studies showing that estrogen is a growth hormone that induces cellular growth, which, under certain circumstances, can lead to the uncontrolled cell proliferation that occurs in malignant tumors.

As a result, we've introduced our members to the anti-cancer benefits of Melatonin and natural progesterone cream to counter the potential cancer effects of estrogen. We'll discuss the role of these therapies in preventing breast cancer ater in this article, as well as an alternative form of estrogen that does not increase the risk of breast cancer, but first let's take a look at recent studies regarding the risk of estrogen for breast cancer.

Short-Term Vs. Long-Term Studies

Some short-term studies have shown that estrogen does not cause cancer. However, in those studies in which women taking estrogen and/or a synthetic progestin were followed for more than ten years, there appears to be a significantly elevated risk of breast and ovarian cancer (and uterine cancer in women taking estrogen alone). The Life Extension Foundation bases its warning about the carcinogenic risk of estrogen and estrogen/progestin replacement therapies on these longer term studies.

The New England Journal's report that women using estrogen alone, or estrogen combined with a synthetic progestin, had an increased risk of breast cancer of 32%to-46% was based upon data from the famous Nurses' Health Study conducted at Harvard Medical School. The nurses participating in this study represented 725,550 person-years of follow-up. Because of the sheer size of this study, its findings are persuasive. It is also persuasive because it is a prospective study, in which every woman was healthy when the study started, with differences in disease incidence delineated with the march of time.

Strikingly, the New England Journal study showed that women who took estrogen plus a synthetic progestin actually had a higher rate of breast cancer than women who took estrogen alone!

The authors concluded that: "The addition of progestins to estrogen therapy does not reduce the risk of breast cancer among postmenopausal women. The substantial increase in the risk of breast cancer among older women who take hormones suggests that the trade-offs between risks and benefits should be carefully assessed."

Elevated Risk Of Ovarian Cancer

All the hoopla over The New England Journal's report about the elevated risk of breast cancer from estrogen replacement therapy obscured another report in the American Journal of Epidemiology, showing that long-term estrogen therapy increased the risk of fatal ovarian cancer. This 7-year study included 240,073 peri- and postmenopausal women. After adjusting for other risk factors, women who used estrogen for 6-8 years had a 40"% higher risk of fatal ovarian cancer, and women who used estrogen for 11 or more years had a 70% higher risk of fatal ovarian cancer!

Cancers of the breast, uterus, and ovary account for 41% of cancer incidence in U.S. women, with breast cancer running at epidemic levels. Clearly, an alternative is needed to provide women with the anti-aging benefits of estrogen, while protecting them against its potential cancer-causing effect.

In addition to increased cancer risks, some of the risks of estrogen/progestin therapy include:

  1. Weight gain.
  2. Abnormal blood clot formation.
  3. Breakthrough uterine bleeding.
  4. Increased risk of gallstones, fibroid tumors, headache.
  5. Premenstrual type symptoms (irritability, bloating from fluid retention, etc.)
Some of these side effects are probably attributable to the synthetic progestins prescribed with estrogen, and not necessarily to estrogen itself.

The Estrogen Dilemma

Estrogens are steroid hormones that promote youthful cellular division, and regrowth of cellular components in target organs of the body, including the brain. Too much estrogen increases the risk of cancer, yet estrogen is an important antiaging hormone that provides us with many health benefits. This creates a dilemma that conventional medicine has yet to resolve.

The benefits of maintaining youthful cellular division with estrogen replacement therapy includes:

  1. Enhanced skin smoothness, firmness, and elasticity.
  2. Enhanced moistness in skin and mucous membranes.
  3. Enhanced muscle tone.
  4. Reduced genital atrophy and enhanced sex drive.
  5. Reduced menopausal miseries.
  6. Reduced risk of heart disease and osteoporosis.
  7. Reduced risk of colon cancer.
  8. Improved memory and overall neurologic function,
  9. protection against Alzheimer's disease.
  10. Enhanced immune function.
  11. A greater sense of well-being.