Estrogen

jojo68

I noticed some posts here were saying women with low estrogen were still getting Mets! If this is the case, why even bother with hormone therapy and its side effects?

Momine

Joelle, none of the cancer treatments is foolproof. If they were it would be a cure and not a treatment. In my case, taking femara makes it far more likely, statistically, that I will still be around in 10 or 15 years, but it is no guarantee.

If someone has a very early stage cancer and the hormone therapy will only add a minor advantage, I can see skipping it. But for advanced cancers it seems more important than chemo almost, as far as I can judge.

In the end it depends on your risk tolerance and your personal balance of risk vs QOL.

jojo68

Such tough decisions...My onc said chemo and Tamoxifen only gives me a 3-5% benefit....My radiologist said the same benefit percentage for his treatment!

NattyOnFrostyLake

Joellee,

Specifically, how do they define "benefit"? Benefit for what?

Recurrence? Or survival from all things besides breast cancer?

Lots of treatments impact recurrence but the harsh side effects alter the survival statistics, like heart complications from the estrogen blockers...or the coranary artery damage from radiation.

jojo68

I had asked all of the Docs/oncologist what my risk/benefit ratio would be...they said risk of serious side effects for all of the standard treatment is 1-2% and the benefit of keeping recurrance away was (while using chemo/rads/tamoxifen etc) 3-5%....If you do reserch, this is what the American Cancer society says as well...

Anonymous

Joelle, because estrogen ALONE doesn't drive cancer.  Unfortunately it isn't that simple. It seems you are really working through your own plan of treatment and focusing on percentage of survival, which tells me you are really doing your homework.

For me, I wanted every percentage--even that 1% advantage.  Someone has to be in that 1%, and I wanted that chance.  My husband died 17 years ago from oral cancer--and he was told that he had a 90% chance of survival, so we felt very hopeful.  Unfortunately, we eventually understood that someone has to be in that 10% of those who didn't survive.

Percentages are both useful and dangerous, I feel.  But for me, knowing my strength and my body and my health, I knew I could handle anything my oncologist and I decided to throw at my cancer to capture those little single-digit percentages. In my case tx was lumpectomy, 5 months chemo, 6 weeks of rads, tamoxifen, and a bmx/recon.  No ill effects from any of them. Add to that 3-5 hours of exercise, a mostly vegan, all organic diet, positive spirituality, and meaning in my life--and I feel that I'm doing everything I can to live a long life. I hope.

Claire

Poke

^^^ Thanks for this. Numbers can be so frustrating.

jojo68

I can totally see your points!  I, personally, feel the risks are much more scarier than the cancer itself....cancer can be so well controlled and kept away through supplements, detox and diet...plus the positive attitude.  I really feel that what works best for each of us is what we truly believe in....for instance, if I believe wholeheartedly that chemo will kill me...then, it probably will.  I really feel much is out of our hands and just to live every moment to its fullest.

Husband11

For ER+ breast cancer, hormonal therapies reduce the risk of recurrance by almost 50%.  That is 50% of whatever the odds were of it recurring without adjuvent therapy.  So for women with a low initial risk of recurrance, say 4%, that reduces the risk in half, to 2%.  A small absolute benefit (2/100 women) for that subset of women.  For another group of women with a 40% risk of recurrance, that risk halved is saving 20% or 20 out of 100 women from recurrance.  A much larger absolute benefit.  Unfortunately in either group, there will be recurrances as the therapy is not a cure for all.

I would think it logical to weigh your risk and potential absolute benefit vs the risk of side effects.  As you move towards the group with the highest risk of recurrance, and therefor greatest absolute benefit for their group, the weight of benefit vs risk increases, and in my reasoning, so should the desirability of employing the therapy, despite the risks and side effects.

Most medical treatments, whether its antibiotics for an infection, removal of a suspicious mole or heart by-pass operations for clogged arteries have less than 100% success rates.  Yet many choose the medical intervention based on weighing their risk to benefit, and not writing off the entire procedure based on some rate of failure.

Momine

Timothy, agreed. My risk of recurrence was and remains high. The AI therefore gives me a relatively significant benefit. If I had a very early stage cancer, I could easily see skipping the blasted pill. With stage 3, not so much.

jojo68

Timothy...Do you have a study to support the 50% reduction of recurrance?

jojo68

The scary truth about Tamoxifen!...

Both the National Cancer Institute (NCI) and the American Cancer Society (ACS) supported the drug company, AstraZeneca to profit from the drug Tamoxifen [Tamoxifen.doc]. AstraZeneca (formerly known as Zeneca before it merged with the Swedish pharmaceutical company Astra) was owned by Imperial Chemical Industries, a leading international manufacturer of industrial chemicals and carcinogenic pesticides. Teaming up with taxpayer-supported NCI and “charitable” ACS was a masterful public relations coup for AstraZeneca, providing the company with valuable, albeit undeserved, goodwill from millions of American women.

http://www.preventcancer.com/losing/nci/drug_ties.htm

The five-year clinical trial claimed that Tamoxifen reduced breast cancer risks
by 30 percent. The risks of this toxic drug, including potentially fatal uterine
cancer and blood clots, were noted but trivialized. As the trials progressed, it
became clear that the risk of serious complications outweighed professed
benefits. Women have still not been informed about delayed risks of liver
cancer.

Also...

After an extensive review of clinical oncology studies, for example, Dr. Ulrich
Abel of the Institute of Epidemiology and Biometry at the University of
Heidelberg, Germany, concluded that for most patients chemotherapy functions as
little more than a placebo, with an attendant decline in quality of life from
the toxic treatment.

SelenaWolf

It always concerns me when I see people state that cancer can be "controlled" by [insert treatment of choice here].  Cancer cannot be controlled.  Cancer cannot be prevented.  Cancer cannot be cured.  And cancer cannot be predicted.  The best we can hope for is full- or partial remission for as long as possible.  That's it.

There is a belief that cancer can be "managed" like a chronic disease and that someone can live a good, long time being "managed" and by having a positive attitude.  This is true up to a point.  But once that point is crossed, i.e., late-stage or advanced breast cancer, or metastatic breast cancer, the percentage of patients that can be "managed" long-term grows increasingly smaller.  Yes, there are some cases where someone with metastatic breast has survived 10, sometimes 15 years post-diagnosis, but these cases are - sadly - the exception not the norm.  I wish it were otherwise.

Unfortunately, as women, we'll never, ever be able to root out and destroy every last vestige of estrogen in our bodies.  It's impossible, largely because the ovaries (while the main producer of estrogen) are not the only organ in our bodies that creates estrogen.  So, as long as we are female, even if we are post-menopausal, we will, always, carry the risk of developing a recurrence of some sort.

The risks of tamoxifen are still far, far less than the benefit it provides.  For someone who has a 30-40% chance of recurrence, the less than 1% chance of developing uterine cancer is well worth it. 

And, for what it is worth, natural remedies are not without danger.  Vitamin D, also, has serious health risks involved, including kidney disease, atherosclerosis, and histoplasmosis.  It can increase blood calcium levels in people with parathryoidism, lymphoma and should never be taking in doses exceeding 4000iu if you are pregnant or breast-feeding because it can harm the fetus.  Curcumin is similar to aspirin in this respect; it is an anticoagulent and can lead to severe bleeding.  In addition, when taken in large doses over long periods of time, it is poisonous to the liver and gallbladder.

Tylenol can cause bleeding and irreversible liver damage.   Aspirin can cause potentially life-threatening GI bleeding and, in addition, the National Journal of Cancer Research claims that daily use of either aspirin or ibuprofen increases breast cancer risk up to 80%.  Taken in large doses, DIM also has problems: vomiting, headache and arthralgia.

Some cholesterol-controlling drugs have been linked with cancer development.  For than matter, so has Prozac (for ulcers), Elidel Cream and Protopic Ointment (for eczema), Humera (RA).  Aldactone (for blood pressure) causes tumors in rats.  In August 2012, Health Canada announced that it was investigating Calcitonin (for osteoporosis) to see if long-term use of the drug caused cancer.

Any drug, any supplement, any "natural" remedy has both beneficial and not-so-beneficial side effects.

"... good girls never made history ..."

jojo68

Selenawolf...with all due respect...it's also just a choice of words...

It also 'concerns me greatly' when people just blindly follow the standard of care (chemo/rads) that is recommended by a billion dollar a year industry!  I mean no disrespect!  Why talk about 'wording' when our lives are at stake....just research BOTH sides before making life threatening decisions!

Momine

Joelle, it is actually quite insulting when you assume that anyone having done conventional treatment is just some kind of bleating sheep believing everything the evil docs claim. 

The nice doctor you quote may believe that chemo is just a toxic placebo, but piles of studies contradict him. 

As for my quality of life, it has not been affected by chemo. There were a few unpleasant months in there, I grant you, but I have had no lasting side effects, other than being cancer free for the time being anyway.

dlb823

joellelee, regarding that comment by Dr. Abel... One thing to keep in mind is that chemo for early stage bc is considerably more effective than chemo for other types of cancer that involve internal organs.  I have always been extremely holistic in my beliefs, and it took me awhile to discern that a lot of holistic websites and critics of conventional cancer tx make no differentiation between chemo for lung or pancreatic cancer, for example, and early stage bc.  So, yes, while there is much truth in Dr. Abel's quote, I believe we can separate out early stage bc as being highly treatable, and chemo being an important tool to hopefully eradicate it before it can get into our organs.   JMO, although I totally respect you or anyone who doesn't feel chemo is for them.  I just think it's inaccurate to broadbrush all chemo as ineffective because some forms of cancer have much less of a likelihood of achieving remission or NED.     Deanna

jojo68

First of all...why are you being so defensive Momine?  I NEVER called anyone a sheeple...I have said over and over again that the best treatment for each one of us is the treatment we most believe in!!!!  I am never offended when people poke fun at my holistic beliefs!  Momine...have you done any research outside of the 'standard of care recommended by a billion dollar a year industry/'?...I am just trying to keep an open mind...I was thinking you would be open minded as well?  I honestly don't understand why people get soooo offended?  Is it out of fear?

Most of the time, chemo effects don't show up until years later.  Chemo forces the cancerous cells to go into hiding for fear of their life...AKA remission...then, they come back later as a secondary cancer etc which is MUCH harder to treat because now they have outsmarted ya!  Even the American Cancer Institute states chemo kills good cells and immune system....I will take a strong immune system anyday and y'all can have your chemo...I have no problemo with that....I am sorry if this sounds offensive, I really don't mean it to be an argument for or against chemo.  Why does any info from 'the other side' get so slammed on this forum?

Also, chemo has been shown to be much more effective on blood cancers such as Lymphoma, rather than tumor cancers...

jojo68

Also, Momine...'the piles of studies' you speak of that support your claim...who are they funded by?  I always check who is funding a study to see if there is any conflict of interest monetarily!

jojo68

I am shocked that some of you are not concerned that Tamoxifen is owned by a pesticide company with a conflict of interest???  They only admit a 30% benefit with LOTS of side effects (other reputable studies say benefit is MUCH less)...it is a carcinogen!  Am I the only one who is looking into this?

From Webmed...a very NONholistic site

"But when researchers considered the risk of side effects from tamoxifen in white women, they found 10% or fewer in all age groups were considered appropriate candidates for the drug based on their risk/benefit profile.

http://www.webmd.com/breast-cancer/news/20040927/study-few-women-benefit-from-tamoxifen

http://innerself.com/content/healthy/diseases-a-conditions/cancer/4799-dark-side-of-tamoxifen.html

SelenaWolf

Prilosec can cause cancer.  So can Humera.  Some topical eczema ointments have been linked with cancer.  Any drug will kill you.  Some cancer researchers are, now, claiming that daily use of Aspirin and ibuprofen over a five-year period will increase breast cancer risk by 80%.  Tylenol, supposedly, will increase your risk of developing blood cancer or Alzheimer's Disease.  If you have heart disease or high blood pressure, antacids can be dangerous. If you are hyperthyroid, decongestants can be dangerous.  Antihistamines can complicate glaucoma.  It's, now, becoming apparent that certain statin drugs could be lethal.  Cough syrop, if you take enough, can cause liver damage.  You can overdose and die on over-the-counter sleeping pills.

Natural supplements can be just as dangerous.  Curcumin is an anticoagulant and, taken in large doses over a long period of time, can increase your risk for a fatal GI bleed.  An overdose of St. John's Wort will kill you just as quickly as an overdose of Paxil.  In addition, natural supplements are not regulated: anybody can get into to the business.  Enchinacea is only effective is it processed from the root of the plant that has aged over three years; the flowers, the leaves are ineffective as a remedy, but the flowers and the leaves are the most common ingredient of many echinacea preparations.  Too much comfrey will kill you.  So will aconite.  Bitter orange will kill you as quickly as ephedra.  And yet these herbs are sold- and taken as supplements every day.

Many of us are willing to take tamoxifen because our risk of developing breast cancer again is much higher than the risk of developing the very rare (less than 1%) side effect of uterine cancer.  It's an acceptible risk.  And studies have proven that far more women survive breast cancer with tamoxifen than without, even with it's rare potential to cause another type of cancer.

Everything is dangerous in its own way.  Even walking down the street can kill you under the right circumstances, but none of us are going to stop walking down the street because of it.

dlb823

joellelee... just a suggestion... be sure to note the dates on the articles you're pulling up.  2004 is a pretty old reference when it comes to medicine.  

I personally refused an A/I or Tamox, so totally support you or anyone questioning if one of these drugs is right for you.  I just have a hard time giving a lot of credence to anything medical written in 2004, when so much has changed since it was written.     Deanna

SelenaWolf

Everyone should question whether or not a drug or a supplement is right for you.  But the world is not black-and-white.  There is alot of "grey" and many drugs fall into that "grey" area.  Humera can cause cancer, but - for those patients it's helped - it's a miracle drug.  Tamoxifen, also, has the potential to cause cancer, but - in the long run - it's potential to improve long-term survivability is far greater.  Everyone has to decide what is acceptible to them.

Me?  I'm staying with tamoxifen.  My life-time risk of developing a metastatic recurrence is 15-20%.  My risk of developing uterine cancer is less than 1%.  I'll take the tamoxifen, thank you.

Husband11

Here's a link to some excellent information summarizing the risks of various adverse advents caused by tamoxifen vs placebo:

http://www.adjuvantonline.com/breasthelp0306/TamoxifenRegimen.html

Note the references for the sources at the bottom of the information.

SelenaWolf

Thank you, Timothy for that.  I read so much sometimes, that - even though I remember what I've read - I can't remember exactly where I read it.  A number of women here have questioned my less-than-1% risk of uterine cancer statistic and I haven't been able to provide a source.  Thanks again.

jojo68

Just because a study may be slightly outdated, doesn't mean it's of no value!  Tamoxifen is VERY outdated, but ya'll still tout it!!!!

Chemotherapy treatment, in itself, is outdated and archaic ...so, instead of searching for 'recent' studies to make everyone happy, I will just attach the official FDA pamphlet insert for Tamoxifen...does anyone ever read these?  I do!

Look at their study for Tamoxifen effectiveness vs. control group...not much improvement in effectiveness to warrant the benefits for me...it's always a personal choice!

http://www.drugs.com/pro/tamoxifen.html

Among women with ER positive or unknown breast cancer and positive nodes who received about 5 years of treatment, overall survival at 10 years was 61.4% for Tamoxifen vs. 50.5% for control (logrank 2p < 0.00001). The recurrence-free rate at 10 years was 59.7% for Tamoxifen vs. 44.5% for control (logrank 2p < 0.00001). Among women with ER positive or unknown breast cancer and negative nodes who received about 5 years of treatment, overall survival at 10 years was 78.9% for Tamoxifen vs. 73.3% for control (logrank 2p < 0.00001). The recurrence-free rate at 10 years was 79.2% for Tamoxifen vs. 64.3% for control (logrank 2p < 0.00001).

YES!  We can all die in a car accident etc etc etc....But, we all are cautious and wear a seatbelt!  Was just trying to offer another point of view.

jojo68

Also, this is a complimentary/holistic thread...why are people being so offended by alternative views?  I thought I was in the right forum catagory...

SpecialK

I think many feel there is a difference between complementary and alternative.  I think the argument you are getting is because complementary medicine is generally viewed as medicines or techniques that are used with conventional medicine, as opposed to alternative medicine, which is used in place of conventional medicine.  If you are not receiving chemo, having rads, or taking anti-hormonals you are not complementing, you are either doing nothing going forward, or doing something else that would be viewed as alternative.

jojo68

Okay

I will leave....thanks!!!!!

Best wishes to the ladies here, I really was just trying to share info...I did think I was doing complimentary as I did do surgery...just because I am not doing chemo etc...I thought I would belong.

Husband11

Same source Joellelee, but a further paragraph down:

The effect of the scheduled duration of Tamoxifen may be described as follows. In women with ER positive or unknown breast cancer receiving 1 year or less, 2 years or about 5 years of Tamoxifen, the proportional reductions in mortality were 12%, 17% and 26%, respectively (trend significant at 2p < 0.003). The corresponding reductions in breast cancer recurrence were 21%, 29% and 47% (trend significant at 2p < 0.00001).

So it shows a 47% reduction in recurrance.

To further add to this, the same study has now gone to 15 years since initiation, instead of just the 10 years followed in this above data set, and they found the benefits continued for those women continuing taking tamoxifen for more than 5 years with added benefit between 10 and 15 years out. 

That's a pretty significant effect on recurrance, approximately halving the rate of recurrance. 

Husband11

No one is asking you to leave.  Please hang around. I believe we are simply replying to your (rhetorical?) question of "hormonal therapy, why even bother?"  47% reduction in rate of recurrance is a possible response, provided by your reference.

jojo68

So, nobody is concerned with the conflicting statements in the study?

My Onc told me, and my Radiologist that Tamoxifen, Rads and Chemo would only offer a 5% benefit tops....really...who cares...it's all a personal choice.  We could go round and round in circles...again, the FDA insert IS funded by those with only monetary interest to gain.

One has to also remember that many of these women on Tamoxifen are also changing their diets to all vegetarian and cutting out dairy which also stops estrogen!  How do we know if it is the Tamoxifen working or dietary changes?  Something to consider!  No studies for this...