What We Really Know About Breast Cancer

Scott: Doctor, let's just talk about breast cancer for a little bit. I think it's one of the top two or three conditions that we hear about all the time, when it comes to health. Can you talk about what may be behind the rise in incidence of that and what we might be able to do to take care of that.

Dr. Stephen Holt: Yeah, I think breast cancer is a really horrifying um, circumstance for many women. We've had problems in really looking at early prevention programs. We've had arguments about what the correct age for mammography should be. We've looked at self examination. We've had reports on the one hand that all of these early intervention attempts have not really given us the benefits we may have anticipated, but on the other hand, we feel really strongly that they're an important part of public health screening for breast cancer.

You're asking me a question about breast cancer and why do I believe it's on the up. Well, I've got to implicate environmental toxicity from what are population studies. Because there are certain areas you know, that we can see geographically where we can associate environmental toxicity. For example, the very high prevalence of breast cancer on Staton Island or Long Island where there's been a tradition of many years of dumping of waste that could be toxic.

We've seen circumstances of the increasing use of what are called xenoestrogens. Meaning kinds of chemicals that have estrogenic activity that you find in the food chain. We obviously have really sad outcome from the women's health initiative studies where we see Premarin and Prempro, conventional hormone replacement therapy, was associated with a higher incidence and prevalence of breast cancer. And of course this angered, I think, a lot of women appropriately. Because, arguably, the Boston Health Initiative, they actually described this long protracted experience with conventional hormone replacement therapy as some kind of uncontrolled experiment on women. I don't necessarily want to get into that. It has it's own political ramifications. But now we have a move towards using bioidentical hormone therapy. But we don't have sufficient data to really state emphatically it's safer or better. So, the reason I'm going in this direction is because I have a preference for simple, gentle, natural approach, with lifestyle modification and herbal and nutritional supplements rather than hormones. But I would use and do use bioidentical hormones under the correct circumstances.

Now, obviously if I knew exactly what was going on in the breast cancer epidemic, I'd be a very privileged person. But we've got genetic tendencies, we're understanding more about hormonal sensitivities of these cancers, obviously there's the issue of estrogen dependent cancer versus non-estrogen dependent. And there's work going on know where how, maybe stem cell cancers are what it's all about. Where you have this population of cancer stem cells, where the real important aspect of tumor promotion. We're seeing evidence in that area. So we're seeing it from a variety of circumstances.

And I think what we do have, we have certain knowledge that things like exercise is preventive somewhat against breast cancer as is perhaps reduction of saturated fat intake. Arguable. Breast and womb, or uterine cancer are associated with obesity. There's a clear association developing between insulin resistance perhaps and breast cancer.

So, I'm not answering your question because there's such a multifactorial circumstance. But we have some very exciting substances out there that I think, could make a difference. I'll give you one example. There's an extract of raspberries, or pomegranates, it's called elegiac acid, which has a very interesting effect, tending to turn malignant breast cancer into a lesser form of malignancy. So it's actually a sort of changer of the degree of malignancy. Perhaps not consistently, but there's an example of a natural compound. We know about antioxidants, we know about hormonal manipulation. And we know, for example, I wrote a best selling book called the Soy Revolution, published by Dell, almost a decade ago. And in the book I pointed out the protective nature of soy food diets on breast cancer. Which is also something that revered researchers like T. Colin Campbell, the author of the China Project, got out of many years of study of soy food consumption in oriental populations. And the data supports that if soy food is taken early in life, it creates protection in adulthood. And that's probably because the soy is altering or modulating the effect of lifetime exposure to estrogen. So see how complex these matters are? I'm very supportive of aggressive screening, secondary prevention, which is really all about diagnosis at a time where the intervention makes a difference. And we're still beleaguered by the problem that breast cancer can present often at an advanced stage which has a poorer prognosis than a cancer detected early, in general terms.

So again, a mixture of factors and I'm optimistic, I'm always optimistic about our ability to one day beat, you know, breast cancer in general. But we've got a long way to go before we fully understand prevention and it's a focus I think of anti-aging medicine. But we've got to look more at prevention. And I think innovations in surgery have helped, I'm not denying that, but maybe we've got some other alternative pathways. I'm very, very much into advanced preventive medicine.