Solving the Breast Cancer Puzzle
by Lara Grinevitch

It can't just be coincidence that rates of breast cancer skyrocketed along with the number of chemicals in our environment. However, there are many simple opotions to minimise your risk, writes naturopath Lara Grinevitch.

Ten years ago, we were still being told that breast cancer was genetic. After decades of research and billions of dollars spent, researchers have finally had to admit that only 10 per cent of breast cancer cases have any genetic factor, and less than half of cases can be linked with other risk factors such as reproductive history and diet. The research has quietly shifted direction, with new attention being focused on the effect of pollution. In 2003 alone, there were 26 studies linking breast cancer with dioxins and PCBs. According to many authorities now, including the American Cancer Society, the majority of breast cancer may actually be the result of exposure to environmental toxins like these.

Late last year, the American Breast Cancer Fund released a report called State of the Evidence 2004: What Is the Connection between the Environment and Breast Cancer? According to the report, the rapid increase in breast cancer in recent decades has occurred at the same time as a staggering increase the number of chemicals. Nancy Evans, the editor of the report says that 'compelling scientific evidence' links breast cancer with some of the 85,000 synthetic chemicals in use. The worst chemicals are plastics, pesticides, petroleum combustion, manufacturing solvents, and also personal use products such as nail polish, sunscreen, and other cosmetics.

The chemical age

Chlorinated hydrocarbons, or organochlorines, form the basis for plastic and pesticides. These products are so pervasive now that it is easy to forget that their effect on our health is actually brand new. Prior to the 1930s, when chlorine was combined with organic molecules, it was known only as highly toxic chlorine gas. (Chlorine itself is virtually nonexistent in nature, and is not the same as the harmless chloride ion.) The invention of chlorinated hydrocarbons heralded the beginning of the chemical age. We are involved in a health experiment that is only two generations old.

The most famous chlorinated hydrocarbons are DDT, Agent Orange, DES, PCBs, and dioxins. You probably know that DDT has been banned, but don't get too comfortable just yet. There are thousands of other cousins to DDT that are pumped into our environment every day, many as industrial by-products, but over 11,000 are used intentionally as pesticides, bleaching agents, plastics and solvents.

But aren't they in a very low concentration? Chemical manufacturers argue that our bodies should be able to detoxify trace amounts of chlorinated compounds. It's true that we are designed to eliminate the thousands of natural toxins in our food supply, but we are not successful in detoxifying organochlorines. According to the American Center for Disease Control and Prevention, the average American tests positive for at least 116 chemicals, many of which were banned over two decades ago. Over 250 toxic substances have been identified in human breast milk, including perfumes, suntan oil, pesticides and heavy metals. It is estimated that infants ingest 42 times above what is regarded as the safe limit for dioxins, a chemical that in does not even have a safe limit, because according to the US Environmental Protection Agency, dioxin is 300,000 times more carcinogenic than DDT.

These toxins are different. They are fat-soluble, and are therefore difficult to eliminate from the body. Furthermore, they are hormone disruptors (also called endocrine disruptors), and this means that miniscule amounts are all that is necessary affect health.

Hormone disruption

Endocrine disruptors are toxic chemicals that interfere with hormone receptors. Any hormonal system can be affected, including the thyroid, but the biggest worry are oestrogenic chemicals, also called xenoestrogens (meaning foreign oestrogens). Oestrogen is a very powerful molecule to begin with, and some xenoestrogens, such as dioxins, stimulate oestrogen-sensitive breast tissue up to 1000 times more strongly than oestrogen. This means that abnormal proliferation of breast tissue can occur when the toxins are only a few parts per billion(1).

Xenoestrogens are a serious problem for the environment and human health. They are blamed for declining frog populations, sex changes in fish, early puberty in girls, decreasing sperm counts, lack of male births, infertility, endometriosis, prostate cancer and breast cancer. There is no immunity to these chemicals. We cannot adapt to them. Adaptation occurs over millions of years, and our bodies have had only 50 years to cope with these very potent biological agents. For some delicate species, such as frogs, extinction is a real possibility.

Endocrine disruptors are dangerous to males and females of all ages, but breast cancer is more likely to develop after exposure during specific times in a woman's life. The most vulnerable time for exposure to occur is when females are still in utero. Research has found that exposure to insecticides as a foetus leads to abnormal breast tissue proliferation later in life(2). Early puberty is another particularly vulnerable time(3). This means that pregnant women and pubescent girls must take particular care to minimise their exposure. It also means that studies that look only at the general population are of little use.

Research must be targeted to the vulnerable periods in breast development. In addition, research must look beyond the effects of single chemicals. We are exposed to a cocktail of hundreds of similar molecules, and their effect is cumulative. When the body's detoxification pathways become occupied with one toxin, they cannot take care of the others properly. Research into Gulf War Syndrome has shown that when people are exposed to more than one pesticide, the blood concentrations of the individual pesticides are up to 100 times greater than during exposure to a single toxin(4).

Research into endocrine disruption is still in its infancy. If you are reassured by the fact that the Australian government seems unconcerned, think again. The government simply has not kept pace with science that is only 10 years old, but the emerging immensity of the problem is hard to ignore. The American Environmental Protection Agency, for example, now considers endocrine disruption to be such a problem that in 1996, it identified it as one of its top six research priorities. Some endocrine disruptors, such as growth-enhancers for livestock, have been banned in Europe for 20 years, but they remain in common use in Australia. The Australian governments attitude has been conservative, but with breast cancer rates on the constant rise, they cannot afford to waste much more time.

The worldwide trend is moving towards stricter regulation for thousands of chemicals. At the moment, only a fraction of household and industrial chemicals have actually been tested. Manufacturers have not needed to prove that they are safe, but rather, the onus has been on government and NGOs to prove that the chemicals are dangerous. This is a daunting task in a world with over 70,000 chemicals. This may be about to change. In 2003, the European Commission announced their REACH program (Registration, Evaluation and Authorisation of Chemicals). If it becomes law, it will mean that the chemical manufacturers will need to prove that chemicals already in use are actually safe. It will mean safety testing for the first time of close to 30,000 chemicals. There is no initiative like this in Australia.

Mammogram Alternatives In 2000, a Canadian study found that adding mammograms to a skilled breast exam does not improve breast cancer survival rates over the exam alone(29). Women should receive a physical exam once per year, and should also conduct a self-exam once per month. Monthly exams should be done at the same time in the menstrual cycle, preferably right after the period, when the breasts are less lumpy. Start by looking at your breasts in the mirror, and then you must carefully feel the whole breast and up under the armpit. Ask your doctor for more information. DUCTAL LAVAGE is a technique of collecting cells from the breast duct, kind of like a PAP smear for the breast. It is not yet available in Australia, but is under research30. COMPUTED TOMOGRAPHY LASER MAMMOGRAPHY (CTLM) is a breast imaging system that uses laser light and thermal heat (but no radiation) to produce a three-dimensional image. It is still under development. THERMOGRAPHY uses a heat-sensing infrared camera to detect the surface heat over cancerous tissue. Thermography is available in Australia, but, at this point, the National Advisory Committee to the BreastScreen Australia Program does not recommend it for early detection.

The Dirty Dozen              The most dangerous plastics are:                      1 Chewable baby toys                              2 Plastic liners in cans                                    3 Plastic coating in long-life milk containers              4 Plastic wrap and containers (especially if heated)      5 Plastic water bottles (single-use bottles are not designed to be reused)   6 PVC medical devices like bags and tubing           7 Coatings on time-released medicines                8 Dishwasher detergents                            9 Cosmetics                                       10 Moisturising cream                                 11 Sunscreens                                        12 Styrofoam cups

Hidden toxins

1. Xenoestrogens Where are the xenoestrogens in your daily life? Air pollution contains a cocktail of dioxins, PCBs, benzene, naphthalene, solvents, and incinerated plastics. Most air and water toxins are from vehicle exhaust and industry. Industry contributes emissions from the manufacture of chemicals, as well as paper bleaching and waste incinerators.

Solution If possible, avoid living in industrial and agricultural areas. Consider an air filter. Do not forget about indoor air quality. Much of our chemical exposure may actually come from our own carpets, cleaning products and air fresheners.

2. Drinking water Drinking water contains pesticides and -- volatile organic compounds, but the biggest concern is the chlorine that we add to it. Chlorine has been linked with cancer, and when it reacts with organic matter in water supplies, it forms toxic byproducts such as trihalomethanes and chlorinated hydrocarbons, which are proven xenoestrogens.

Solution Use an activated carbon water filter, and don't forget your shower. According to the New Scientist, the air from showers, baths and dishwashers delivers 6 to 100 times more chloroform and THMs than drinking water(5).

3. Bleached products Industrial bleaching of paper products produces dioxins. Some products, such as tampons and paper cups, come into direct contact with our bodies, and should be avoided, but do not forget that bleaching of any product emits dioxins into our air, water and food supply. Until industry changes the bleaching process, we are going to simply have to do without sparkling white paper.

Solution Buy unbleached.

4. Bleached tampons There has been a lot of controversy .--(and Internet rumour) about these, but suffice it to say that tampons used to be bleached with chlorine gas, leaving significant residues of dioxin. Most companies now bleach with chlorine dioxide, and the residues are only a few parts per billion, less than you get in our standard polluted air(6). The problem is that vaginal tissue is highly porous, and these are chemicals that really do not have a safe level anyway. Furthermore, many synthetic material tampons are made from wood pulp that was originally bleached.

Solution Buy unbleached cotton tampons.

5. Plastics contain bisphenol A, PVC and phthalates. Bisphenol A and phthalates are softening agents used in vinyl flooring, plastic bags, food packaging, cosmetics, and -of most concern - plastic baby bottles and chewable baby toys. In the late 90s, Denmark banned the use of phthalates in baby toys, and the cosmetic industry followed suit by voluntarily reducing the amount in personal care products. Phthalates are still legal in Australia and are not currently reportable to the Australian National Pollutant Inventory.

Solution Don't microwave in plastic. Lobby your government for safer baby toys and food packaging.

6.Styrofoam cups These contain bisphenol A and .-polystyrene, both endocrine disruptors. Bisphenol A has been shown to produce genetic abnormalities after only a few days' exposure to 20 parts per billion(7). Bleached cardboard is probably not much better.

Solution Get your takeaway coffee in your own mug.

7. Cosmetics Can contain parabens, phthalates, and solvents, which are all proven xenoestrogens. The effect is measurable. Nail polish fumes have recently been shown to prevent the conception of baby boys, as well as to increase the risk of breast cancer. According to an American Environmental Working Group report Skin Deep, over 10,500 ingredients are approved for cosmetic use, and 89 per cent of those have never been safety-tested by any publicly accountable institution(8). Cosmetic manufacturers used to claim that the chemicals applied to skin are not absorbed, but new studies show that they are, in fact, absorbed very well, especially with the 'penetration enhancers' that are often added. Some of the worst ingredients, eg parabens, have been detected at high concentration in breast cancer tissue itself.

Solution Phthalate-free cosmetics are available in natural food markets. Unfortunately, there is no natural nail polish. Pregnant women, at least, should avoid it for now.

Understanding the Lingo A XENOESTROGEN is an industrial chemical that interacts with oestrogen receptors 1000 times more strongly than human oestrogen. Xenoestrogens are also called: • Environmental oestrogens • Oestrogen mimics • Endocrine-disruptors • Endocrine-disrupting chemicals (EDCs) A PHYTOESTROGEN is a plant molecule that buffers oestrogen receptors. It is many times weaker than human oestrogen, but will gently act when oestrogen is deficient, such as menopause. At the same time, if oestrogen and xenoestrogens are high, a phytoestrogen will protect against them. We are adapted to have them in our daily diet. Foods rich in phytoestrogens include soy, yams, lentils, carrot, flaxseeds, sesame seeds, beetroot, red clover, apples, garlic, broccoli, mung sprouts, pumpkin, rye, parsley, liquorice root, millet, and sunflower seeds.

8. Sunscreen ingredients These are of particular concern because they are applied liberally to porous childhood skin. The ingredients to avoid are benzophenone-3, octyl-methoxycinnamate (OMC) and octyl-dimethyl-PABA(10).

Solution Read the label. Sunscreens are available that contain active ingredients of only zinc oxide or titanium oxide. Common brands are UV Natural or Sunsense Low Irritant.

9. Cleaning products These create internal air quality that is two to five times more polluted than outside air(11). Volatile organic compounds, including many xenoestrogens, are emitted from cleaning products, disinfectants, aerosols and dry-cleaned clothing. One cleaning product surfactant called nonylphenol, is one of the xenoestrogens accused of causing sex changes in fish.

Solution Use natural cleaning products.

10. Air fresheners emit volatile organic compounds.

Solution Use essential oil burners instead.

11. Dry-cleaned clothes and carpets Perchlorethylene vapour is a known carcinogen, and will gas off for weeks from clothes and carpets. Dry cleaner workers and those that live near a dry cleaner are at even higher risk.

Solution Choose a 'non-perc' drycleaner if possible. Better cleaning methods are being researched, but over 50 per cent of cleaners in Australia still use perchlorethylene.

12. Computers, furniture and carpets All are manufactured with brominated flame retardants, which have been proven to be stored in breast tissue. According to the Lancaster University, these chemicals have increased exponentially increase in breast milk in the last 25 years(12). Fresh paint and varnishes also emit volatile organic compounds, and vinyl floor covering emits phthalates.

Solution Lobby your government to ban these chemicals.

13. Pesticides Belgian researchers found that women with breast cancer have higher levels of the pesticides DDT or hexachlorbenzene in their blood stream than women without breast cancer(13). These particular pesticides were banned in Australia decades ago, but they are persistent and they were not banned everywhere. One pesticide of particular concern is still in use. Banned in some European countries as a cancer-causing agent, Atrazine is still legal in Australia. Atrazine is a proven endocrine disruptor, and increases the risk of breast and other cancers(14). Atrazine, and other pesticides such as diuron, fluometuron, metolachlor, simazine and trifluralin were found in Australian groundwater in 1997(15) Pesticide residues are in our water and food. Grains, coffee and tobacco are particularly heavily sprayed. Animal fat concentrates the pesticides that are found in the animal's feed.

Solution Buy organic.

14. Fly sprays contain synthetic pyrethroids, which are not the same as the natural pyrethrin from chrysanthemums. The modifications make the molecule fat-soluble, and new research shows that it is a xenoestrogen(16).

Solution Don't use insecticides inside your house.

15. Beef growth hormones Hormone growth promotants like Zeranol were banned in Europe in 1988, but they are still used in Australia as an implant in the ear of beef cattle(17). Zeranol has been shown to stimulate abnormal growth in breast cells, even at concentrations 30 times lower than what safety regulations allow(18). Similar hormonal growth promotants are used for lamb, and Australian chickens are regularly fed antibiotics. Antibiotics are also linked to an increased risk of cancer(19). Growth hormone and pesticide residues are almost certainly the reason why red meat is associated with a greater risk of breast cancer.

Solution Buy organic meat.

Bras and Breast Cancer The role of bra-wearing and cancer is still under debate. We know that bras worsen symptoms of fibrocystic breast disease (lumpy, painful breasts), and we also know that fibrocystic breasts increase the risk for breast cancer(31). The problem comes from the fact that bras inhibit lymphatic drainage from the breast tissue, and this means that the immune system cannot do its job. As many as 20 per cent of women wear bras to bed, and there is simply no reason for this. Research shows that bras actually promote sagging, rather than prevent it(32).

Do Something   LOBBYYOUR GOVERNMENT: Breast cancer is a political issue. Increased funding by the Clinton administration in 2000 and the European Commission in 2002 is what has brought information about hormone-disrupting chemicals into the mainstream. The new research will directly influence European Union legislation on chemical emissions, and this will result in regulation of industry. In many cases, industry already possesses the technology it needs to reduce emissions, but they choose not to use it because it will decrease their profit margin. An example is paper bleaching, which can be done with hydrogen peroxide or ozone rather than chlorine, but is costly and so industry has lobbied against a dioxin ban. Send a message to your MP that human health is more important than industrial profit.

16. HRT The strong oestrogen-like drugs in conventional HRT and the pill are xenoestrogens. They are more strong-acting and less predictable than human oestrogen, and, in 2002, the Women's Health Initiative study proved that conventional HRT increased the risk of breast cancer(20). Many Australian women discontinued the drugs at that time, but are now forced to return to them in order to control hot flushes and mood disturbances. The good news is that there is an alternative. Rather than taking conjugated oestrogens, ethinylestradiol or medroxy-progesterone acetate, women have the option of using hormone supplements that are exactly identical to human hormones, called bio-identical hormones. Bio-identical oestrogens and progesterone do not have the cancer risk of conventional HRT. Bio-identical oestriol (a mild oestrogen) and progesterone, in particular, have actually been shown to prevent breast cancer(21)(22).

Solution Use only bio-identical hormone replacement.

17. Birth control pill There is no bio-identical alternative to the birth control pill. In order to be strong enough to interfere with fertility, the pill has to be a xenoestrogen. The link between the pill and breast cancer remains ambiguous at this point, with conflicting research. The general consensus is that higher dose pills of the past almost certainly had a risk, but that today's pills carry a risk only during the period of use. Ten years after stopping the pill, the risk drops off.

18. Cigarette smoke contains multiple xenoestrogens, including insecticide residues. Tobacco is one of the most heavily sprayed crops in the world. Furthermore, cigarettes contain between 2 and 4ug of cadmium per pack. Cadmium is a toxic metal, known to cause kidney damage and lung cancer. According to a 2003 study, cadmium is also a xenoestrogen, and induces measurable changes in breast tissue(23). Like other xenoestrogen exposures, the most vulnerable time is in utero. Pregnant women who smoke are increasing their daughter's risk.

Solution If you have been a smoker, and want to measure your cadmium exposure, you can consider a hair mineral analysis. This test measures toxic metal residues stored in the body. Metals can be removed by detoxification and chelation therapy.

WHAT CAUSES BREAST CANCER?

STEP1
DNA damage Damage to the DNA by a xenoestrogen is the first step. Some DNA is more susceptible than others, and this is where the small genetic component of breast cancer risk comes in. We now also know that there are times in a woman's life when breast tissue is much more susceptible to DNA damage. One time is during foetal development, and the other is during early puberty. A combination of carcinogens, such as being exposed to solvents while on the Pill, will also increase susceptibility. Most breast cancer occurs decades after the initial damage is done. It is difficult to prevent DNA damage entirely, but we can prevent those cells from surviving and growing.

STEP 2
Growth Most cells in the body have a natural life span, after which time they are replaced with new cells. This natural cell death (also called apoptosis) is promoted by hormones such as progesterone and melatonin, and by a healthy immune system. Cancer cells, on the other hand, do not die off. Instead, they begin rapid cell growth, which is promoted by oestrogen, prolactin, and insulin-like growth factors. After breast cells have been exposed to xenoestrogens, they are vulnerable to other factors:

• Poor liver clearance of oestrogen Oestrogen promotes the unchecked growth of abnormal breast cells. The liver is normally supposed to remove oestrogens through the stool, but if there is constipation, or problems with the liver, this removal will not occur. An example is the finding that some over-the-counter painkillers inhibit liver clearance and therefore increase the risk of breast cancer(24).

• Partially detoxified oestrogens There is also a problem with partially detoxified oestrogens. These molecules are called oestrogen metabolites, and they stimulate abnormal breast tissue more strongly than ordinary oestrogen. Toxic oestrogen metabohtes can be detected with a urine test called 2 & 16 Urinary Oestrogen Metabolites, available through a naturopath or GP. If they are present, toxic oestrogen metabolites can be cleared from the body with broccoli, or with supplements of broccoli's active ingredients: indole-3-carbinol (I-3-C) and diindolylmethane (DIM).

• Oestrogen dominance (progesterone deficiency) is the result of too much oestrogen (and xenoestrogens) compared to progesterone. Symptoms of oestrogen dominance include PMS, fibroids, endometriosis, endometriosis, irritable, fluid retention and sugar cravings. Oestrogen dominance also increases the risk for breast cancer because abnormal breast cells are stimulated under these conditions. It can be detected with a saliva hormone test. Insulin stimulates breast cancer to grow, and may also contribute to oestrogen dominance. According to researchers at the Harvard School of Public Health in Boston, women who consume more carbohydrates, particularly sugar, are at a greater risk of dying from breast cancer(25). The majority of breast tumours are positive for insulin-receptors.

• Trans fat Contrary to previous belief, there is no , direct link between dietary fat and breast cancer(25). The association of breast cancer with fat is probably due to the pesticide and hormonal residues concentrated in animal fat, as well as to trans fat. Trans fat is damaged polyunsaturated fat that is found in partially hydrogenated vegetables oil such as margarines and commercially prepared food. In a recent study, European women who ate higher levels of trans fat were 40 per cent more likely to develop breast cancer(26). Trans fat also increases insulin levels and is a risk for PCOS.

• Alcohol Because alcohol inhibits liver detoxification enzymes and increases oestrogen, women who drink more than one standard drink per day have a higher risk of breast cancer(27).

• Chronic stress increases the risk of developing breast cancer, and also decreases the chance surviving it. The stress hormone cortisol appears to be the culprit. It increases oestrogen and melatonin, and when it's high at night (a common feature in stressed women), it suppresses the immune system and melatonin. Night-time can be detected by saliva hormone test. Traumatic events such as divorce, abuse, and death of a loved one are associated with breast cancer.

• Radiation increases cancer risk. For example, women who had diagnostic x-rays for scoliosis have a 70 per cent higher risk of developing breast cancer. Other sources of radiation include long-haul flights and being within a few feet of microwaves, computers, fuse boxes and TVs.

Mammograms are another source of radiation, and may increase your risk of breast and other cancers. Mammography provides 1000 times greater radiation exposure than that from a chest X-ray, and may do more harm than good. Another problem with mammograms is that the tissue compression used during the procedure could cause cancer to spread.

According to a 2001 Lancet study '[mammography] screening is unjustified because there is no reliable evidence that it reduces mortality(28). The authors of the Danish study argued that previous studies showing reduced mortality had used a faulty definition of breast cancer survival.

Areas of calcification that represent ductal carcinoma in situ (DCIS) are easily detected by mammogram. In fact, since the use of mammograms became widespread in the early 1980s, DCIS represents 43 per cent of breast cancers detected in women 40 to 49 years. DCIS is technically not a cancer, and treated or not (most are treated unnecessarily) survival rate is 99 per cent. And yet, its 'cure* is statistically attributed to mammograms. When DCIS is eliminated from the statistics, breast cancer mortality rates have actually increased by 10 per cent in the last two decades. Fortunately, there are alternatives to mammograms (see box 'Mammogram Alternatives').

For more information
• What your doctor may not tell you about breast cancer, by Dr. John Lee
• State of the Evidence 2004: What Is the Connection between the Environment and Breast Cancer? by the Breast Cancer Fund 2004. Available online www.breastcancerfund.org
• Skin Deep: A safety assessment of ingredients in personal care products by the
Environmental Working Group 2004. Available online:
www.ewg.org/reports/skindeep ' Sensible-Alternative Hormone Clinic: www.sensible-alternative.com.au
• Analytical Reference Laboratories: www.arlaus.com.au

Everyday Protection
 
PHYTOESTROGENS A recent Finish study confirms the theory that plant oestrogens protect against breast cancer. Women with the highest blood levels of the plant oestrogen, enterolactone, were found to have the lowest incidence of breast cancer(33).

Unlike xenoestrogens, which stimulate lOOOx more strongly than human oestrogen, plant oestrogens in soy, linseed, and red clover stimulate many times less strongly. In this way, they buffer oestrogen receptors, protecting hormone sensitive tissue from oestrogen and xenoestrogens. Phytoestrogens have always been in our food supply, and our bodies are adapted to a steady supply of them. At a moderate dose, they are part of our normal hormone balance. In their function, phytoestrogens are actually more similar to the breast cancer drug tamoxifen than to oestrogen. Some caution is advised, however. Red clover or soy should not be supplemented in a concentrated form, because in a high dose, phytoestrogens can interfere with hormone balance and fertility. High doses may also be inappropriate for the vulnerable foetal stages of breast tissue development. One study showed that female foetuses exposed to soy in utero were more likely to develop breast cancer later on(34).

GREEN TEA contains epigallocatechin gallate (EGCG), a phytochemical that inhibits tumour growth. BGCG has a similar structure to methotrexate, a common chemotherapy agent, but unlike chemotherapy, it does not have harsh side effects. Recent research suggests that 2 to 3 cups per day is enough EGCG to inhibit cancer. Pregnant women, and those at risk for heart disease, need to be careful because excessive EGCG can reduce folate levels.

VEGETABLES generally are recommended as prevention for breast cancer. Dark green vegetables, in particular, are rich in phytochemicals and antioxidants which support liver clearance and immune system. Raw vegetables in juice form provide natural enzymes that help the immune system to destroy cancer cells. Broccoli contains indole-3-carbinol (I-3-C) and diindolylmethane (DIM) which help to clear toxic oestrogen metabolites through the liver.

DETOXIFY The liver can only remove xenoestrogens if it has nutrients that it needs: B-vitamins, essential fatty acids, vitamin C and selenium. Raw vegetables, particularly beetroot, are beneficial to the liver.

Breast Cancer Preventative Juice

2 carrots
'/a lemon, with some peel
2 stalk celery, with leaves removed
1 clove garlic
3 florets broccoli
2 cm slice beetroot

Dilute with '/a cup of green tea. Lemons provide concentrated flavonoids and limonene to help the body fight cancer, and to prevent metastases. Carrots and celery are rich in phthalides, a proven anti-cancer phytochemical Garlic, especially when raw, provides
important allyl sulphur compounds for the immune system and liver. Broccoli and other cruciferous vegetables provide indole-3-carbinol, a phytochemical that protects against
oestrogen-sensitive cancers.

NATURAL PROGESTERONE CREAM down-regulates oestrogen receptors in breast cells, prevents cell division, and has been shown to prevent breast cancer as well as the anti-cancer drug tamoxifen35. Progesterone is one of the reasons why pregnancy is protective against breast cancer. This natural human hormone is very high during pregnancy, and is also produced during the second half of every menstrual cycle. In women with oestrogen dominance, it is deficient, and a supplement may be required. Natural progesterone is available in Australia from compounding pharmacists by prescription.
 
MELATONIN is best known as a sleep hormone. It also is very important for immune function and hormone balance, and is being investigated for its activity against breast cancer. Melatonin deficiency can develop during a long course of night shifts, and by sleeping in a light room. New evidence suggests that tight clothing such as bras may also reduce melatonin secretion36. Always sleep in the dark, and if you work nights, you may want to consider a melatonin supplement, which is available from compounding pharmacists and may prevent breast cancer37.

EXERCISE AND SAUNA Perspiration removes fat-soluble xenoestrogens, such as dioxins, through the skin.

SELENIUM This trace mineral protects against breast cancer38. Supplementation is necessary because selenium is deficient in Australian soil. It will be absent even from organic produce.

VITAMIN D deficiency has been linked with an increased risk for breast and other cancers39''".Vitamin D is formed when the skin is exposed to UVB light, so the surprising fact is that moderate sunshine can actually prevent cancer. The amount of sunshine required will vary according to skin colour, age, season, time of day, and latitude, but the current recommendation is sunlight exposure for a period equal to 25 per cent of the time it would take to develop a light pinkness of the skin. This must be done without sunscreen, and not through a window.

References
1 Frederick S et aL 2005. Concerning Low-Dose Effects of Bisphenol A Shows the Need for a New Risk Assessment. Environ Health Perspect.
2 Greiner SN et al. 2000. EsCrogen-independent effects of atrazine (ATR) on mammary gland (MG) development in rats. Toxicological Science 54:332.
3 Markey CM et al. 2001. In utero exposure Co bisphenol A alters the development and tissue organization of the mouse mammary gland. Biology of Reproduction 65:1215-1223.
4 Abou-Donia MB. 1996. Neurotoxicity resulting from co-exposure to pyridoscigmine bromide, deet, and permethrin: implications of Gulf War chemical exposures. Toxicol Environ Health. 48:35-65.
5 Anderson, 1.1986. Showers pose a risk to health. New Scientist. Aug. 18
6 Tampons and Asbestos, Dioxin, & Toxic Shock Syndrome, PDA Report, www.fda.gov/cdrh/ consumer/tamponsabs.
I Hunt PA ct al. 2003. Bisphenol a exposure causes meiotic aneuploidy in the female mouse. CurrBiol.l3(7):546.53.
8 Cosmetics Ingredient Review (CIR). 2003 CIR Compendium, containing abstracts, discussions, and condusions of CIR cosmetic ingredient safety assessments. Washington DC
9 Darbre PD 2004. Concentrations ofparabens in human breast tumours. J AppI Toxicol. 24(1): 5-13.
10 Schlumpf M et al. 2001 In vitro and in vivo estrogenidty of UV screens. Environmental Health Perspectives. 109(3); 239-244.
11 The Inside Story: A Guide to Indoor Air Quality 1995. EPA publication 402-K-93-007.
12 Kalantzi Olga et al. 2004. Different Levels of Polybrominated Diphenyl Ethers (PBDBs) and Chlorinated Compounds in Breast Milk Environmental Health Perspectives 112(10).
13 Charlier C, et al. 2003. Breast cancer and serum organochlorine residues. Occup Environ Med. 60(5): 348-51.
14 Greiner SN et al. 2000. Estrogen-independent
effects of atrazine on mammary gland
development on rats. Toxicologica] Science 54:
332.
15 Timms. W. 1997. Liverpool Plains Water Quality Project 1996/97 Report on Groundwater Quality. Department of Land and Water Conservation, CNR97.108.
16 Go, V et al. 1999. Estrogenic Potential of Certain Pyrethroid Compounds in the MCP-7 Human Breast Carcinoma Cell Une. Environmental Health Perspectives 107:173-177.
II A review to update Australia's position on the human safety of residues of hormone growth promotants (HGPs) used in cattle. Chemical Review and International Harmonisation Section Office of Chemical Safety. TGA. July 2003.
18 Liu S et al. 2002. Involvement of breast
epithelial-stromal interactions in the regulation
of protein tyrosine phosphatase-gamma
(PTPgamma) mRNA expression by estrogenicaJly
active agents. Breast Cancer Research and
Treatment 71:21-53.
19 C. Velicer et al. 2004. Antibiotic Use Linked to Breast Cancer Risk? Journal of the American Medical Association.
20 Writing Group for the Women's Health Initiative Investigators. 2002. "WHI Study, the Risks and Benefits of Estrogen and Progestin in healthy post-menopausal women." JAMA 2002 288(3); 321-333.
21 Lemon, H.M. et al. 1989. Inhibition of Radiogenic Mammary Carcinoma in Rats by Estriol or Tamoxifen. Cancer 63(9):168S-1691.
22 Chang, KJ, et al. 1995. Influences of
Percutaneous Administration of Escradiol and
Progesterone on Human Breast Epithelial Cell Cyde in Vivo. Fertil Steril 63:785-791.
23 Johnson. M.D et al. 2003.Cadmium mimics the in vivo effects of estrogen intheuterus&nd mammary gland. Nature Medicine. Advance Online Publication.
24 Marshall. St et al. 2005. Nonsteroidal Anti-Inflammatory Drug Use and Breast Cancer Risk by Stage and Hormone Receptor Status. Journal of the National Cancer Institute 97(11);
805-812.
2S Borugian MJ, et al 2004. Insulin, macronulrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer? Cancer Epidemiol Biomarkers Prev 13(7): 1163-72.
20 Kohlmeier L et al-1997. Adipose tissue trans fatty acids and breast cancer in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Breast Cancer. Cancer Epidemiology and Biomarkers Prev. 6:705-10. 27 Collaborative Group on Hormonal Factors in Breast Cancer. 2002. Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95.067 women without the disease. Br.J Cancer;. 87:1234-1245. 21 Gotzshe PC and 0 Olsen. 2001. Cochrane review on screening for breast cancer with mammography. Lancet. 358:1340-1342.
29 Mandelson MT, et al. 2000. Breast density as a predictor of mammographic detection:
comparison of interval-and screen detected cancers. J Nad Cancer Inst. 92:1081-1087.
30 Dooley WC et al. 200. Ductal lavage for
detection of cellular atypia in women at high risk
for breast cancer. J Nad Cancer Inst. 93(21):
1624-1632.
31 Dixon JM et al 1999. Risk of breast cancer in women with palpable breast cysts. Edinburgh Breast Group. Lancet. 353(9166); 1742-5.
32 Ashizawa K. 1990. Breast Form Changes Resulting From A Certain Brassiere. Journal of Hum. Ergol 19(1):S3-62.
33 Pietinen, P et al. 2001.Serum enterrolactone and risk of breast cancer: A case-control study in eastern Finland. Cancer Epidemiology Biomarkers 81 Prevention. 10(4): 339-344.
34 Hilakivi-Clarke L et al. 1999. Maternal
exposure to genistein during pregnancy increases
cardnogen-induced mammary tumorigenesis in
female rat offspring. Oncology and Reproduction.
6:1089-1095.
35 Inch, A. et al. 1985. Protective Effects of
Progesterone and Tamoxifen in Estrogen-induced
Mammary Cardnogenesis in Overiectomized
W/Pu Rats. J Cancer Rts 76: 699-704.
30 Lee YA. 2000. The effects of skin pressure
by clothing on circadian rhythms of core
temperature and salivary melatonin. Chronobiol
hit (6):783-93.
37 Cos S et al. 2000. Melatomn. experimental basis for a possible application in breast cancer prevention and treatment. Histol Histopathol. 15(2); 637-47.
38 Hu YJ et al. 2003. Role of glutathione peroxidase 1 in breast cancer: loss of heterozygosity and allelic differences in the response to selenium. Cancer Res, 63(12);
3347-51.
39 Polar MK et al. 2003. Effect of the vitamin D3 analog ILX 23-7553 on apoptosis and sensitivity to fractionated radiation in breast tumor cells and normal human fibroblasts. Cancer Chemother PharmacoL 51(5):415-21.
40 Holick ME 2004. Vitamin D; importance in the prevention of cancers, type 1 diabetes. heart disease, and osteoporosis. Am J Clin Nutr 79:362-371.

Published in Nature & Health December 05/January 06