Question about DIM

Ozgirl

Question about DIM

Ozgirl

Hi Everyone

I have not had breast cancer, but my mum has (diagnosed at 61 and going very well). My naturopath has said that I should take DIM. I had never heard of this supplement before, so did a little research on the internet.

From what I can find, it seems safe, but I was a little concerned about one report that said that DIM (or IC3) they caused cancer in trout (the fish). This has got me worried - but I have not been able to find any further information.

Can any of you ladies shed any light on this topic or do you know of any further studies on this subject?

Thanks in advance.

R

dlb823

Ozgirl ~  Many of us on the "Natural Girls" thread use DIM or I3C.  There is also a thread here entitled "DIM."  I believe you'll find research papers cited within both of those threads.  Both I3C and DIM are estrogen modulators.  DIM may be better for women who are pre-menopausal. 

I hadn't heard about the study you mentioned re. either one causing cancer in trout, so I just looked it up and will post a link here to aid this discussion.  (I actually thought you might be kidding until I read it myself.)  http://lpi.oregonstate.edu/infocenter/phytochemicals/i3c/but 

What I didn't quite understand about the study was this -- "However, a number of studies have found that I3C actually promoted or enhanced the development of cancer when administered chronically after the carcinogen (post-initiation)."  Does this mean it was administered while there was still cancer in the animal, or after it's hopefully been removed via surgery/chemo/rads, as we do with breast cancer?  Assuming fish studies apply to us, I think that's a point that needs clarification.

Did your naturopath suggest a blood test to see where your estrogen levels are?  That might be a good idea before doing anything to tweek them, so that you will know if it's actually needed.  Future monitoring would then tell you and our naturopath if you're getting the response you're after.

Glad to know your Mum is doing well ~  Deanna  

Ozgirl

Hi Deanna

Thanks for your well wishes re my mum - she is a trouper!

I have to say that I also found the article confusing....I hoped it was just me, but obviously not.

I can't find anything more recent either.

I have had my estrogen levels checked. My naturopath said that they are a little high (the "bad" one) - so I should take the DIM.

Very confused about what I should do.

Take care - thanks so much for your reply.

Rachel

Anonymous

HI Ozgirl, 

Here is a link to a summary regarding the confusion between I3C and Dim which I found  very interesting. I read about the Trout and this addresses that issue along with others. I was going to add DIM to my regimen but for now I am taking I3C as it is converted to DIM. 

Maybe someone here can explain the benefit of using DIM vs I3C. My NatDoc is out of the country so no one to ask.

Fantastic news about your Mom.

Hope this is helpful,

Carole

http://pointinstitute.org/resources/Point+Inst.+I3C-DIM+April+06.pdf.  

"And when I am ill, it is He who cures me" Ash-Shu'arâ' 26:80

Ozgirl

Hi Carole

Thanks for the link.

I am not very scientific savvy - can you explain the effect of this study in plain English? Is it that DIM and I3C caused cancer in trout already susceptible to cancer?

Thanks

Rachel

Anonymous

Hi Rachel, 

I missed that totally. I thought the researcher was trying to show that some of the claims made by critics of IC3 were unfounded or at least further research was needed to determine if the claims were valid. He pointed out that Dr Zelig,  who is a strong opponent of IC3, holds the patent for a form of bioavailable DIM. Could be a conflict of interest.

I am by no means scientific savvy myself. When it comes to these types of research papers my approach is slow and steady often re-reading the papers over and over and making comparisons to other research until they make sense. In this case it is still a work in progress. My focus at this point is to research the other compounds that are converted from IC3 and their effect of BC. There is a summary on page 9 that might help in grasping the results of the research in it's totality.

Warm regards,

Carole 

Anonymous

http://www.lef.org/
LE Magazine January 2002
I3C vs DIM
Indole-3-carbinol is a phytochemical found in cruciferous vegetables such as cabbage. It shows great potential in preventing cancer,
especially hormone-related cancers such as breast and prostate. Now available as a supplement, I3C is hugely popular both as an
antioxidant and as a cancer fighter. Research on I3C dates to the 1960s when it was investigated for its actions against chemical
carcinogens. Since that time, researchers have been able to show that I3C has powerful and diverse ways of stopping cancer.
Recently, it was brought to our attention that negative statements were being made about I3C. These were being generated by a
man who owns a patent on a product he wants people to buy instead of I3C. The product is DIM (3,3'-Diindolylmethane). DIM is
formed naturally when I3C is broken down in the gut. Unlike I3C, there are no published human studies on DIM. In fact, there are few
published studies at all. This is one of the reasons we do not recommend substituting DIM for I3C.
Who is Michael Zeligs, and why is he saying negative things about I3C?
Michael Zeligs is a doctor who has a patent for a DIM product that combines DIM with d-alpha-tocopheryl polyethylene glycol-1000
succinate to make it absorbable by the gut.
What is d-alpha-tocopheryl polyethylene glycol-1000 succinate?
Polyethylene glycol is a detergent-like chemical that breaks down fat (not to be confused with propylene glycol which is used in
anti-freeze). D-alpha-tocopheryl succinate is a synthetic, water-soluble form of vitamin E. According to Zeligs, this is the first time
this combination has been used for a supplement.
What is DIM, anyway?
DIM is a break-down product of I3C. DIM forms naturally in the stomach when I3C is ingested. I3C is the parent molecule of not only
DIM, but dozens of other phytochemicals that form in the gut. In addition to DIM, I3C also creates ICZ, NI3C and IAN. Although
these others haven't been studied very well, there is some evidence that they may each have their own unique actions against
cancer. For example, ICZ blocks the dioxin receptor better than DIM or I3C.1 This mechanism could potentially forestall some types
of chemically-induced cancers. And while IAN doesn't seem to do much for breast cancer, it looks promising for stomach cancer.[2]
When a person takes I3C, they get all of these products, not just DIM. It has been suggested that the phytochemicals in
cruciferous vegetables may work differently in combination than they do individually[3]-a good reason to keep the spectrum as
broad as possible.
Why has a chemical been added to DIM?
By itself, DIM is not absorbed adequately, so, an artificial system has to be created to make it bioavailable. This isn't nescessary
when DIM is converted naturally from I3C.
Zeligs claims that I3C "disappears" after it's ingested. What's the truth about this?
It "disappears" because it's converted to other products, including DIM. According to researchers, "At acid pH comparable to that
found in the stomach, I3C forms to wide variety of condensation products ranging from linear and cyclic dimers, trimer and tetramers
to extended heterocyclic compounds such as indolocarbazoles".[4] To put DIM's contribution into perspective, DIM represents
about 6% of the total condensation products of I3C.[5] I3C itself is one of hundreds of phytochemicals in cruciferous vegetables.
Zeligs claims that I3C creates "questionable reaction products" in the gut.
One of those "questionable" products is DIM. When DIM is administered by itself, it can actually provoke the growth of human
breast cancer cells and upregulate the estrogen receptor under certain laboratory conditions.[6] We want to stress that this does
not occur when the full product, I3C, is taken under ordinary conditions.
While the break-down products of I3C may act unpredictably by themselves, when taken as I3C in their natural form, they are
beneficial for preventing, and possibly treating, hormone-related cancers. The data is so compelling, it has provoked normally
reserved researchers into such praise as, "I3C has tremendous potential in the treatment and prevention of cancer, particularly
estrogen-enhanced cancer."[4] Although that comment was directed towards I3C's estrogen-blocking potential, I3C has equally
important actions against all types of cancer. The list includes powerful DNA protection, carcinogen detoxification, modulation of the
growth and invasion of cancer cells, induction of apoptosis selectively in cancer cells, bone marrow protection during chemotherapy,
neutralization of cancer-causing heterocyclic amines (i.e., from cooked meat), modulation of the estrogen receptor (which is also a
player in non-hormone related cancers), and possible upregulation of tumor suppressor genes.
Zeligs says that "no direct benefits can be attributed to absorbed I3C." The benefits of I3C have been proven in vitro, in rodents and
in humans. Whether they are direct or indirect-I3C works.
According to Zeligs, DIM has been "extensively tested" in humans.
One of the biggest problems with DIM is that it hasn't been extensively tested in humans. In fact, there are no published human
studies at all. This is a critical difference between DIM and I3C. One of the problems with DIM is that because human studies
haven't been done, no one knows the proper dose. Is this important? You bet. In separate studies, using different amounts,
researchers have gotten completely opposite results on DIM's effect on the estrogen receptor in vitro.[7,8]
Zeligs claims that DIM is more stable than I3C and therefore more desirable.
If I3C were stable, it would never form DIM or the myriad of other beneficial
phytochemicals. I3C is inherently unstable in stomach acid which converts it to its
multi-faceted products. As with all pro-active vitamins and supplements, I3C should
be protected from heat and light. The product has been tested for 12 months at room
temperature with no loss of potency.
According to Zeligs, the anti-cancer effects of I3C are due to DIM.
Far from it. DIM by itself has, in some cases, completely opposite effects of I3C on
human breast cancer cells. Research indicates that there is a difference between
the way I3C acts versus the way its
individual products act. For example, regarding a study on androgen metabolism and
I3C, researchers at Queen's University wrote that "the action of multiple inducers
present in cruciferous and other vegetables might produce androgen metabolic
profiles very different from those produced by individual components isolated from
them."[9] There is a prevailing view that the effects of I3C are due to the combination
of its condensation products together, not one single product. DIM may eventually
prove to enhance the effects of I3C, but the research has not been done.
What are some of DIM's "opposite effects" on breast cancer cells?
I3C studies show that I3C stops the growth of estrogen receptor-positive and
negative breast cancer cells in culture.[10] DIM reportedly either makes estrogen
receptor positive breast cancer cells grow[11] or inhibits them[9] in culture.
According to researchers at the University of California, DIM promotes the growth of
human breast cancer cells about as half as well as estrogen when no estrogen is
present in the culture. In addition, DIM's inhibition of cancer cell growth was "weak"
in the presence of estrogen. Remember, these are laboratory conditions only and
probably don't occur in real life. How DIM behaves, however, may depend on dose.
Researchers at Texas A&M report that DIM significantly counteracts estrogeninduced
growth of MCF-7 cells in culture at higher doses. However, unlike I3C which
retards the growth of estrogen receptor negative breast cancer cells, DIM has no
effect on estrogen receptor negative cells.[10] Another question about DIM is
whether it can increase aromatase in breast and other tissue. Aromatase is an
enzyme that helps create estrogen. DIM reportedly enhances the enzyme in
adrenocortical cancer cells.[11]
Not only is DIM not responsible for the anti-cancer effects of I3C, it has fewer anticancer
effects (due to fewer molecular mechanisms), when it's isolated from the
other phytochemicals that naturally occur with it.
ANTI-CANCER EFFECTS OF I3C
I3C DIM
Induces Apoptosis (Cell
Suicide) • •
Inhibits Breast Cancer in
Rodents • •
Inhibits Growth of
Estrogen Receptor
Positive Breast Cancer
Cells
• •
Inhibits Growth of
Estrogen Receptor
Negative Breast Cancer
Cells
•
Prevents DNA Damage •
Enhances 2-
Hydroxylation of Estrogen
(benefical) at the
Expense of 16 a-
Hydroxylation
• •
Antioxidant •
Blocks Dioxin • •
Blocks Estrogen • •
Enhances Effects of
Tamoxifen •
Blocks Chemically
Induced 16 a-
Hydroxylation of Estrogen
(including that induced by
pesticides and estrogen
mimickers)
•
Blocks Enzyme
(CYP1B1) that Promotes
4-Hydroxylation of •
Why does Zeligs say that DIM is the "active form" of I3C responsible for improved
estrogen metabolism?
Good question, because the study Zeligs uses to back that up doesn't say that. It
points to another product, ICZ, as potentially having greater estrogen metabolizing
potential than either DIM or I3C.[12] Not only is DIM not the active form of I3C, it
may not even be a desirable form of I3C. In the cited study, DIM had to be injected
to reach the level of estrogen modulation obtained with oral I3C.
Zeligs claims that DIM promotes cervical health.
The women in the study he refers to took I3C, not DIM.
According to Zeligs, DIM makes estrogen replacement therapy safer in women and
DHEA therapy safer in men.
It's a plausible theory, but DIM's ability to modulate hormone replacement therapy is unknown. The studies cited by Zeligs were
done with I3C, not DIM. Studies on I3C show that it modulates hormones in addition to estrogen, including androsterone,
androstenedione and testosterone.13, 14 This, along with the fact that I3C prevents uterine-related cancers, suggests that I3C will
be beneficial for people taking hormone replacement therapy. These kinds of studies have not been done with DIM.
According to Zeligs, "Supplemental use of DIM promotes higher levels of 2-hydroxy estrogens. This use in animals has been shown
to be associated with the prevention of spontaneous, estrogen related cancer of the breast and uterus."
It sounds good, but the problem is that, again, the research was done with I3C, not DIM.
Zeligs claims that DIM is unique in its ability to shift estrogen metabolism, and that DIM decreases the "activity" of the estrogen
receptor "system".
The study Zeligs says backs this up tested both I3C and DIM. DIM was less effective when taken orally. Only when it was injected,
did DIM reach I3C's level of estrogen modulation. Far from being "unique" in its ability, DIM was less effective than I3C when taken
orally. As for the claim that DIM decreases estrogen receptor "system activity", estrogen receptors were not evaluated in the study
at all.
However, another study has evaluated the effect of DIM on the estrogen receptor. According to the results, DIM activates, not
deactivates, the estrogen receptor.[15] Activating the estrogen receptor enhances, rather than prevents, the growth of estrogendependent
cancer cells. Again, this points up the problem of isolating DIM from its natural milieu. When DIM is taken in its natural
form, I3C, the estrogen receptor is
downregulated.[4]
Zeligs claims that people should buy DIM instead of I3C.
Only if they want to take something that's untested versus something that's proven. Part of I3C is naturally converted to DIM when
I3C is taken as a supplement or eaten in vegetables. I3C forms dozens of other phytochemicals in addition to DIM which have
proven anti-cancer effects. Anyone who metabolizes I3C will get DIM along with other naturally-occurring products.
The importance of co-factors in determining how these phytochemicals behave is illustrated by what vitamin C does to I3C. If vitamin
C is not present when cruciferous vegetables are eaten, more I3C will naturally form. If vitamin C is added, less I3C will form, but
more of a different product will result from digestion. It's called ascorbigen, and it can produce 20 times more ICZ than I3C.[16] No
one knows the significance of this yet, although it's been suggested that ICZ may be able to change estrogen metabolism better
than I3C or DIM.
The cancer fighting compounds in cruciferous vegitables clearly work synergistically. That's why a person wanting to gain an extra
edge over cancer should stick with I3C, which has valid scientific studies behind it.
Estrogen (cancerpromoting)
Inhibits DNA Damage in
Bone Marrow of Rodents
Treated with
Cyclophosphamide
•
Effective Against
Cervical Cancer in
Rodents
•
Stops the Growth of
Prostate Cancer Cells •
Upregulates BRCA1
Tumor Suppressor Gene •
References
1. Gillner M, et al. Interactions of indoles with specific binding sites for 2,3,7,8-tetrachlorodibenzo-p-dioxin in rat liver. Mol Pharm
28:357-63.
2. Wattenberg LW, et al. 1978. Inhibition of polycyclic aromatic hydrocarbon-induced neoplasia by naturally occurring indoles.
Cancer Res 38:1410-13.
3. Chang YC, et al. 1999. Cytostatic and antiestrogenic effects of 2-(indole-3-ylmethyl)-3,3'-diindolylmethane, a major in vivo product
of dietary indole-3-carbinol. Biochem Pharm 58:825-34.
4. Meng Q, et al. 2000. Indole-3-carbinol is a negative regulator of estrogen receptor- signaling in human tumor cells. J Nutr
130:2927-31.
5. Grose KR, et al. 1992. Oligomerization of indole-3-carbinol in aqueous acid. Chem Res Toxicol 5:188-93.
6. Chang YC, et al. 1999. Cytostatic and antiestrogenic effects of 2-(indole-3-ylmethyl)-3,3'-diindolylmethane, a major in vivo product
of dietary indole-3-carbinol. Biochem Pharmacol 58:825-34.
7. Riby JE, et al. 2000. Ligand-independent activation of estrogen receptor function by 3,3'-diindolylmethane in human breast cancer
cells. Biochem Pharm 60:167-77.
8. Chen I, et al. Aryl hydrocarbon receptor-mediated antiestrogenic and antitumorigenic activity of diindolylmethane. Carcinogenesis
19:1631-9.
9. Jellinck PH, et al. 1994. Distinct forms of hepatic androgen 6 beta-hydroxylase induced in the rat by indole-3-carbinol and
pregnenolone carbonitrile. J Steroid Biochem Mol Biol 51:219-25.
10. Cover CM, et al. 1998. Indole-3-carbinol inhibits the expression of cyclin-dependent kinase-6 and induces a G1 cell cycle arrest
of human breast cancer cells independent of estrogen receptor signaling. J Biol Chem 273:3838-47.
11. Sanderson JT, et al. 2001. 2,3,7,8-Tetrachlorodibenzo-p-dioxin and diindolylmethanes differentially induce cytochrome p450
1A1, 1B1, and a19 in H295R human adrenocortical carcinoma cells. Toxicol Sci 61:40-48.
12. Jellinck PH, et al. 1993. Ah receptor binding properties of indole carbinols and induction of hepatic estradiol hydroxylation.
Biochem Pharmacol 45:1129-36.
13. Jellinck PH, et al. 1994. Distinct forms of hepatic androgen 6 beta-hydroxylase induced in the rat by indole-3-carbinol and
pregnenolone carbonitrile. J Steroid Biochem Mol Biol 51:219-25.
14. Sonderfan AJ, et al. 1989. Identification of the cytochrome P-450 isozymes responsible for testosterone oxidation in rat lung,
kidney, and testis: evidence that cytochrome P-450a (P450IIA1) is the physiologically important testosterone 7 alpha-hydroxylase
in rat testis.
15. Riby JE, et al. 2000. Ligand-independent activation of estrogen receptor function by 3,3'-diindolylmethane in human breast
cancer cells. Biochem Pharm 60:167-77.
16. Preobrazhenskaya MN. 1993. (Meeting abstract). Ascorbigen as anticarcinogenic dietary constituent of cabbage. Non-serial;
CCPC-1993: Second International Cancer Chemo Prevention Conference. April 28-30, 1993, Berlin, Germany:109.
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Merilee

UG! If find out I have been feednig my Cancer with DIM I am going to hurt someone

dlb823

Efflorescing/Carole ~ Thank you very much for posting that article!  I've used both 13C and DIM, and switched back to 13C because my (post menopausal) body just seems to like it better.  It's good to know that, as I suspected, some of the negative stuff written about I3C has been financially motivated.  Deanna 

Anonymous

Merilee, hopefully after more research we will find that both are beneficial but it does call for further investigation. But, if what this article and the one I posted previously are true Dr. Zelig has some explaining to do.

Deanna, you are very welcome. Notwithstanding the sarcasm, this article is quite interesting. Bodybuilding and I3C/DIM?

www.tmuscle.com/free_online_article/sports_body_training_performance_bodybuilding_supplements/i3c_and_dim_more_fools_gold

PS73

I read this too!  Unbelievable.  ..so now 13C is better than DIM?  From all of the papers, 13C has beent the one used in all of the studies however I remember reading that there were potential toxicological effects from 13C if you were exposed to carcinogens.  So is this still safe as long as you do a good liver cleanse?   "13C is much more sensitive to interaction with components of food, especially vitamin C, which limit its conversion into DIM and other condensation products".  - note that this quote was taken from a pro DIM article but just to keep it in mind w/ all of the supplementing times.

Here are some articles on the 13C

http://www.cbcrp.org/RESEARCH/PageGrant.asp?grant_id=2553

http://www.jbc.org/content/280/10/8756.full

luv_gardening

These articles are old.  LEF has more up to date information if you search for DIM in their search engine.  The muscle building article is undated but the references are all prior to 2000.  Since then DIM has been shown to inhibit angiogenesis, starving any tumours. See the LEF report dated 2006.  Sorry, I don't know how to post links yet.

Personally I prefer to take DIM along with raw food from the cruciferous family so I get the full benefit of all the phytochemicals working in harmony.

Brussel Sprouts are apparently in a class of their own, also water cress is exceptional.   I plan to use as many of these green foods as I can.

LE Magazine January 2006
I3C & DIM
Natural, Dual-Action Protection Against Deadly Cancers By Dale Kiefer

<SNIP>

How DIM Complements I3C

Many scientists believe that I3C's beneficial effects are partly driven by one of its principal byproducts, diindolylmethane, or DIM.34,35 For instance, DIM has recently been shown to promote production of beneficial interferon gamma by breast cancer cells. According to scientists at the University of California, Berkeley, "This novel effect may provide important clues to explain the anti-cancer effects of DIM because it is well known that [interferon gamma] plays an important role in preventing the development of primary and transplanted tumors."36 Recently, scientists working with cell cultures also showed that DIM activates cellular stress response pathways in breast, prostate, and cervical cancer cells. This response mimics the reaction of cells deprived of adequate nutrition, further enhancing the cells' susceptibility to destruction.37 In other studies, researchers have shown that both DIM and I3C induce cell death in prostate cancer cells.15,29

Scientists at Wayne State University School of Medicine recently noted that "I3C and DIM affected the expression of a large number of genes that are related to the control of carcinogenesis, cell survival, and physiologic behaviors."15

Like I3C, DIM also stops the growth of new blood vessels that tumors require for their survival and metastasis. This newly discovered anti-cancer activity (anti-angiogenesis) is significant. In research at the University of California, Berkeley, in both cell culture assays and live animal models of cancer, small amounts of DIM dramatically reduced biochemical markers of angiogenesis and significantly impeded the rate of new vessel growth. "This is the first study," the scientists noted, "to show that DIM can strongly inhibit the development of human breast tumor in [an animal] model and to provide evidence for the antiangiogenic properties of this dietary indole."8

 

PS73

Sheila, just highlight the url you are on, hit ctrl and c at the same time and when you are ready to post the url, hit ctrl p in another window or wherever.

- the articles I posted are from 06.  LEF has a lot of information from a lot of sources but LEF is an online store that sells its own brands of nutritional supplements and although informative, I need harder evidence. 

13C breaks down upon digestion and DIM is fromed as a metabolite of 13C.  Ive read biased articles promoting both.  Clinical trials have been with 13C - I haven't seen any with DIM - although, if you can post that url, I would research the hell out of it down to the scientist to find something to support DIM vs 13C.  Now I think the article on the anti 13C was from a DIM supplier regarding the potential toxicity.  ..all along I thought the 13C scientist was being socially responsible by promoting DIM - silly me, silly me.

Another friend gave me a ND to call who is educated on the above.  I shall definitely report my findings as soon as soon as I can get there. xo

luv_gardening

Hi PS73,

Sorry, I couldn't have looked at your links and was referring to the other articles above. The LEF link is below, I didn't look up any of their references to see if I3C or DIM was used. I'm usually so particular about checking sources and original research but I think after 5 months of solid research since I got my diagnosis I'm getting brain freeze/overload/rusty cogs.  I think I need a relaxing trip away somewhere except of course there's nowhere to hide from this BC and the constant need for answers.

http://www.lef.org/magazine/mag2006/jan2006_report_i3c_01.htm

I'm very interested to hear what you discover.

fairy49

There are some clinical trials with DIM

http://www.dimfaq.com/site/abstracts3.htm

PS73

Thanks!!  Im going to print them all out and read them

Anonymous

Hi Sheila, 

The link I posted from 2002 was from LEF. The other link was for a research paper from 2006 and the bodybuilding article was not for research purposes. I found it interesting because I had no idea bodybuilders were using DIM. 

I believe that the article I posted "I3C vs DIM: addressed concerns over Dr. Zeligs' patented form of DIM not DIM  when metabolized naturally from I3C.

I decided to look into the I3C vs DIM controversy because it made sense to me that the other metabolites of I3C could be just as important as DIM if not more so why not benefit from them as well? Also, I wanted to investigate what was being "added" to the DIM and if it was necessary and beneficially.  Just my thinking. Since finding out about the Black Pepper and Curcumin I always wonder which supplements or foods combinations work the best. 

Still searching for answers.  

We could all use a vacation. BC has been a full time job.

Yazmin

You know, Efflorescing, I was just thinking what you wrote here: breast cancer IS a full-time job. Hope we can sustain the rythm, because there is no choice: we just have to fend for ourselves. Here we are, with a large number of oncologists unable to "think-outside-the-box," very little innovative research going on.......

Apart from this forum, I feel very much on my on, because I cannot count of any significant support from the non-breast-cancer-patients around me: despite their kindness and willingness to help, their understanding of the situation remains limited.

Anonymous

Yazmin, my sister actually calls to ask me if I am "On Duty" referring to my researching BC. I have a great support group, none have BC thankfully, but I still feel alone in this sometimes aside from this forum. There is an enormous amount of strength and resolve that comes with knowing others like you have adopted a similar approach. I am reminded by my support group when discussing certain protocols, that although they support my decision, they can't say for sure what they would do faced with the same circumstances. At those times it is great comfort to come here.

The oncologists, at least for me, have been a bust. My new approach is to try to share with them some of the things I've learned.  At the very least I can have a clear conscience and at most they will have more awareness.