This is the last article in the series on Lifestyle Medicine and breast cancer, basically using the book by Dr Kristi Funk as our main resource.  As a breast surgeon who is an expert in breast cancer, she deals with much more than just the lifestyle aspects of the disease, and it is beyond the scope of these blogs to go into the medical, surgical and oncological treatments.  They all have a definite place. Let me remind you that Lifestyle Medicine is not against proven medical/surgical/oncological therapies.  But it does provide a base for the preventative/health promoting environment of your body to enhance health and often prevent a large part of these diseases that affect our bodies in the first place.  However if this fails, and we live in a hostile cancer promoting environment, then by all means utilise the resources available to manage these diseases appropriately.

ALSO READ : Turning the Tide – Lifestyle Medicine and Breast Cancer (Part 6)

What we will cover in this article is a brief overview of some of the medications that have been shown to protect the body from either developing breast cancer – some which were only discovered long after to benefit in this way; or medications that interfere in the progression of breast cancer.

Specific medications for breast cancer inhibition/prevention:

• Aromatase Inhibitors – these are medications that prevent the conversion of “male” hormones into oestrogen. Aromatase is an enzyme found in adrenal glands, ovaries, fat and brain tissue, and even in fat cells in breasts which local cancer cells recruit to create their own supply of oestrogen.  Thus aromatase inhibitors reduce the amount of oestrogen which can enhance the development of oestrogen-sensitive breast cancers.  Examples of these medications are Aromasin, Arimidex and Femara.  Unfortunately these are all fairly expensive medications, but can be beneficial in preventing breast cancer in those with high risk, or preventing recurrences – in post-menopausal women.
• Selective Estrogen Receptor Modulators (SERMS). These block the oestrogen receptors on cell walls in breast tissue, and especially in oestrogen positive breast cancer cells.  The best known one is Tamoxifen which is widely used in S Africa.  Most patients who are on this use it for 5 years.  It has been shown to reduce recurrence of breast cancer by half.  Other benefits include improved bone density, lower cholesterol and less density of breasts – making mammograms more effective.  However side effects include increased risk of blood clots, stroke and uterine cancer through paradoxical stimulation of oestrogen receptors in the uterine lining.  Another SERM that has less effect on blood clots but is used mostly for osteoporosis is Raloxifene (Evista).  It also reduces risk of breast cancer.

Non-specific medications for breast cancer inhibition:

• Bisphosphonates for osteoporosis – e.g Alendronate (Fosamax was the original, now a wide range of generics) has been found to reduce the risk of invasive breast cancer by 32%. It works by reducing growth of blood vessels in cancer cells, suppressing cancer cell growth and promoting cancer cell death.
• Metformin most commonly used for insulin resistance and type 2 diabetes has been shown to reduce the risk of breast cancer by more than 50% if used for 5 years or more. Of course that is not a reason to take it, as insulin resistance can also be reversed by a whole-food, plant based diet, (which also reduces your risk of breast cancer by more than 50%, and provides so many other benefits to reverse, or protect against, lifestyle diseases).
• Non-steroidal anti-inflammatories such as Ibuprofen, Diclofenac and even Aspirin taken 2 or more times per week, have been shown to reduce the incidence of breast cancer by 20-30% depending upon how long they are used.

Hopefully this series on breast cancer has empowered you to study how you can adopt lifestyle changes to prevent this most common cancer amongst women. 

There is so much you can do to avoid this disease that has affected so many women you know.

Next week we will begin a short series on one of the most common cancers of men – prostate cancer, and explore how lifestyle medicine can prevent, or even in the early stages reverse prostate cancer.

Until then, don’t tire of keeping safe in the face of the Covid-19 threat by social distancing, washing hands frequently, using alcohol-containing hand cleanser, avoiding touching your face, eyes or nose unless you have just washed your hands, and now the latest – wearing a cloth face mask when in public.

Kind regards,

Dave Glass

Dr David Glass graduated from UCT in 1975.  He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital. 

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world.  He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work.  He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing.  He is active in community health outreach and deeply involved in church activities.  He enjoys teaching and sharing information.