Looking for Alternative to Tamoxifen

Member_of_the_Club

As I said, the test made a big stir a few years ago, the timeframe of these old studies you pulled up.  more recent studies have different results.  If anyone is truly interested there have been a bazillion threads on the topic.  Otherwise, its not worth our time.

Janeluvsdogs

Enough with the vague opinions and generalizations.

Facts please?

We'll be the judge of what's worth our time

Kathy044

"Facts please"

Try breastcancer.org if anyone mentions hearing about information on this site.  There's a searchbox on the home page, I found this from Dec 2010.

http://www.breastcancer.org/news_research/ask_expert/12_2010/q13.jsp

Janeluvsdogs

Thanks Kathy.

If Dr. Eric Winer is pooh-poohing the test, it must be unreliable. He held on to Arimidex with his fingernails for years until it was proven to be a dud.

hlth4513

ruth in singapore-

I am curious where you found info saying that flaxseed increases 16OH ?  I don't believe that I have ever seen this association mentioned. I happen to take both DIM and flaxseed and I do monitor my 2OH, 16OH  along with 4OH and other metabolites.

Beth

Edited to correct and add:

I went back and re-read your post, ruth and  - I guess I am confused. It is my understanding that flaxseed improves the 2OH:16OH ratio. What is your understanding?

I do realize that if the 2OH:16OH gets over 4.0 that can have some implications for osteoporosis - but for most of us - we are no where need that ratio.

Member_of_the_Club

I don't think there is anyone on this thread who is actually considering this test so I don't understand why you consider it an issue.  But, hey, go at it, have a metabolizing-test party.

Member_of_the_Club

Dr. Winer never said Arimidex was a dud and he still prescribes it.  He said it showed no survival benefit over tamoxifen.  Not the same thing.  This has been covered over and over again.

Janeluvsdogs

No survival benefit = dud.

He prescribes it only for recurrence. He's very disappointed that the three ongoing studies found it to be a dud. It's on his video. Heartbreaking.

Anonymous

Relation of flax seeds in balancing 2OH/16OH

Ideal 2OH/16OH is 2. If your ratio is above 2 = you should take flax seeds. But if it is lower than 2, you avoid it and take I3C/DIM instead.

Member_of_the_Club

We all saw the video and read the transcript.  No survival benefit over tamoxifen.  if he's only prescribing it for a recurrence (I don't buy that, actually) he obviously sees a benefit.  Not sure why you keep bringing this up  . . . over and over again.  

Janeluvsdogs

He said no survival benefit. I and others bring it up again because they're the facts. Sorry facts annoy you. Facts just won't go away.

Anonymous

regarding CYP2D6, here is my few cents worth

the first study that Ruth posted

- proves that there are certain women who can or cannot metabolize tamoxifen properly for the desired result to take effect

the 2nd study

- says that -- testing is currently under debate and maybe only for selected for women who are candidates for tamofixen alone but for whom alternative options are available. this is the reason why they did not approve it as a standard test.

my few cents worth: if you are not a candidate for Tamoxifen-- why do you need to be tested?

the reason to hold it as standard test is absurd-- "they do not have anything to offer other than Tamoxifen for women who cannot properly metabolize it"

however, even if is not a standard test, you can still order it from lab tests-

nikola

I am going to see my GP tomorrow and he is very good at ordering tests and BW. What is the name of test for 2OH/16OH ratio? Should I ask for any other tests?

Anonymous

nikola,

not all conventional doctors know about 2OH/16OH -- sometimes naturopath/endocrinologists/ob-gynae orders it.. seldom did I hear that an onc order it, but you can try

its called Urinary Estrogen Metabolite test

there are other versions of this-- which takes blood and saliva samples.

however, i think urine samples provide more accurate results

Anonymous

however the CYP2D6 testing altho non-standard can probably be ordered by your onc.

hlth4513

trasia-

It is interesting that flaxseed is responsible for raising SHBG - that is a good thing for someone with breast cancer.

I believe that looking at the entire estrogen metabolite picture is important - including the estriol ratio and 2-methoxyestrodial(sp?).  I have used the MEridian Valley 24 hr urine test and I believe that Genova has one as well.

Beth

Anonymous

Beth,

it also helps that if you have very poor metabolism and liver issues-- neither I3C/DIM or Tamoxifen will work effectively for you..

its quite important to know how your liver is metabolizing either of the 2.

the urine estrogen metabolic test-- is for I3C/DIM

while CYP2D6 test is for Tamoxifen

(bearing in mind that neither of these tests are standard tests so you cannot expect your doctors to offer it to you-- you have to ask for it yourself.)

NattyOnFrostyLake

Beth,

Why would a breast cancer patient want to raise SHBG?

Anonymous

Beth,

great analysis!! you are right-- estriol need to be factored in as well-- cause when DIM lowers your 16OH (the bad ones) -- it also lowers Estriol (the weak, but good and active estrogen-- which is good for us).

sometimes media coverage can make sensationalized news -- that skews the whole paradigm. its important to be skeptic sometimes.

print the diagram posted by ruth regarding correlation of 2OH/16OH and Estriol and DIM...it makes it easier to start a conversation with someone when you have a diagram in hand... its like a map (go and get your husband to help-- us women are naturally poor navigators )

hormones are very complicated-- and this is all that I can share with you-- a good starting point to discuss with your doctor (hormone specialist)

Anonymous

matty

we were talking about flaxseeds awhile ago.. it works the exact opposite way of DIM. it raises SHBG. so flaxseeds is a no - no for certain individuals-- but may be ok for a few.

so, its important not to self-medicate go to a doctor who supports hormone testing and I3C/DIM/Flaxseed supplementation.

NattyOnFrostyLake

Trasia,

Please lose the sexist crap about women being "poor navigators." It makes everything else you say sound suspect. Also, please cite some research sources for the benefit of raising SHBG.

Yeah, I can read the study without my husband. LOL.

Also, changing the estriol/estradiol ratio has never been shown to alter breast cancer outcome. It is a theory that has caught on.

Anonymous

hi matty,

ooops! sorry about that-- I just hope we can use some humuor.

am sorry I do not have time to dig in to numerous studies. this is only by experience and in discussion with the endocrinologist and reading books like Suzanne Somers' book and Dr. John Lee's book. we are in an alternative forum-- so most of it are not properly backed up by standard clinical studies. cannot help much on that one. a lot of women in this board seems to swear by the quality of living they gain out  of balancing 2OH/16OH.

hlth4513

trasia-

I am very well aware that hormones are complicated and these subjects have been discussed in detail in previous threads, so I will not re-visit all of that.

I have done a whole lot of research on hormonal balance and alternatives to Tamoxifen(which I do NOT take) and I had never heard that flaxseed works the "opposite" of DIM. I think there is value in both and take both every single day.

Matty-

SHBG(sex hormone binding globulin) binds the sex hormones such as testosterone and estrogen. It is believed that for that reason, SHBG can  help prevent breast cancer. There was some research done(Italy) that 25% of BC patients with ER+ BC have mutated/abnormal SHBG. They also found that breast cancer cells have a receptor for SHBG through which SHBG inhibits their proliferation and growth. SHBG also blocks estradiol from fueling these cancer cells.

Insulin decreases SHBG, regular exercise increases SHBG. Also, T3 increases SHBG.

(SOurce: Keeping a Breast, Khalid Mahmud)

Beth

sam52

MOTC.....it is pointless to argue with jane(luvsdogs)....She is determined to undermine aromatase inhibitors no matter what and she thinks HER facts are the only facts.(Even the so-called facts she quotes are a misreading of the outcomes).

But just backing you up so that others may look a little more closely at what some people purport to be facts.

Husband11

Respecting the issue of Dr. Eric Winer and his statement survival value of aromatase inhibitors, there is only one sensible thing to do, and that is ask him.  I will let you know if I get an answer.

 Tim

Husband11

I have heard back from Dr. Eric P. Winer MD.  He clarifies that his statement that there is little or no survival benefit to aromatase inhibitors is only relative to tamoxifen.  He says compared to no hormonal therapy, the survival benefit is similar to that of tamoxifen.

 That settles that.  No need to further spread a misunderstanding of his video.

Member_of_the_Club

Thanks, Timothy.  

Anonymous

Beth,

No offense meant-- I am just trying to say that 'it is a complicated subject' and matters that we should discuss with an expert. However, I do believe that what we have discussed is a good starting point for anyone- including laymen-- so we do not get confused by contradicting information in the media - be it conventional or alternative.

as for flaxseeds-- I believe if eaten occasionaly as part of your cereal should do no harm and probably even beneficial- but I would be wary of taking flaxseed supplementation.I guess I have to study more and discuss this at length with my endocrinologist.. I will get back to you if he says otherwise.

I am just afraid that people will forego Tamoxifen and self-medicate based on our discussion here. If anyone is considering I3C/DIM or Flaxseed Supplementation, I still want them to see a hormone specialist one who have a good understanding of bioidentical hormone therapy

Timothy made the right move of asking Dr. Weiner himself regarding another topic on AI versus Tamoxifen. Thanks Timothy!

mollyann

Thanks, Timothy,

What references did he give you? I'd like to take a look and post them here so we can look at the studies first hand and judge for ourselves.

Thanks again. A good beginning!

Kathy044

For mollyann, we've discussed these before, but as I happened to have them bookmarked...

The 100-month analysis of the ATAC trial (Lancet Oncology January 2008)

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2807%2970385-6/abstract

And a news article on same of the meeting on the results in San Antonio. Eric Winer commented from the audienc. Note this information is now getting a little dated, but keeps coming up on the forum.

http://findarticles.com/p/articles/mi_hb4365/is_2_41/ai_n29432767/

For more current information there is the 10 year followup of the ATAC Trial comparing Anastazole and Tamoxifen (The Lancet December 2010). By this time there was a very narrow sliver of an advantage of Anastrazole over Tamoxifen in overall mortality. The better news though was the advantage of Anastrozole over Tamoxifen for breast cancer disease free survival.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2810%2970270-9/fulltext