Hormones Increase Breast Cancer Risk

Did you read recently in the Arizona Republic that women who take estrogen and progestin after menopause not only increase their risk for breast cancer, but also face even a somewhat increased chance of dying from the disease? How does this differ from what we already knew? How great is the risk? It can be confusing to sort it all out, so here are the facts:

• Eight years ago a federally funded study called the Women’s Health Initiative revealed that the risks of heart disease and breast cancer outweighed the benefits of taking estrogen and progestin for relief from menopause symptoms.

• Although at the time researchers thought the risk of death from breast cancer was not any greater, the use of the hormones dropped almost 65% from 2002 to 2009. Still, some 40 million women were taking the hormone combination.

• As a result of the diminished hormone use, breast-cancer diagnoses started to drop.

• Last year researchers concluded that women who took the hormones were 70% more likely to die of lung cancer. Lung cancer and breast cancer are the two leading causes of cancer death in women.

• Now that researchers have 11 years of data from the study, they have determined that the tumors that result from the hormone combination are just as likely to be the more difficult to treat type of tumors, not the smaller, less-threatening ones they had thought eight years ago. This means the risk of dying from breast cancer is slightly higher.

• Still, this newly identified risk of death from breast cancer as a result of hormone use is low.

• Researchers recommend that women who take the hormone combination do so at the lowest effective dose for the shortest period of time. There continues to be debate about whether five years is too long to be on the hormones.

• The use of estrogen alone, which women who have had hysterectomies take, does not carry the risks reported here.

There are many other risk factors for breast cancer, such as smoking, a sedentary lifestyle, a diet high in saturated fat, and genetics. Be sure to discuss your risks carefully with your physician so you can make the most informed choice about your health.

You Can Significantly Modify Your Cancer Risk

So says the Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Report published by the American Institute for Cancer Research and the World Cancer Research Fund. The report took five years to compile and contains the analysis of over 7,000 large-scale studies by 21 international experts. Key findings include:

• Some 30-35% of cancers are caused by diet.
• Other than not smoking, the single most important thing you can do to prevent cancer is to keep your weight under control.
• Cancers linked to obesity include endometrial cancer, colon, kidney, pancreatic, postmenopausal breast cancers, and some lymphomas and leukemias.
• Even a 5-10% weight loss can be significant.
• Inactivity increases the risk of breast and colon cancer.
• Even one drink a day can significantly increase breast cancer risk. (But one or two drinks/day “very substantially reduces heart disease risk.”)
• Dietary supplements are not recommended to prevent cancer.
• Plant foods are recommended to protect against digestive tract, lung and prostate cancers.

Factors with convincing evidence they increase cancer risk include obesity, abdominal fatness, consuming red or processed meat, and drinking alcohol. On a more positive note, things with convincing or probable evidence they decrease cancer risk are physical activity; lactation; and consuming milk, non-starchy vegetables, onions, garlic, fruits, and foods that contain fiber, folate, beta-carotene, lycopene, vitamin C, selenium.

I find this very encouraging. Certainly progress is being made in finding a cure for cancer, and that’s great. Why not take steps to reduce the risk of even getting it to start with?