ER+/PR+ /ADRENAL EXHAUSTION/ CORTISOL

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Ikari
Ikari Member Posts: 40
edited July 2014 in Stage III Breast Cancer

During the last eight years prior to diagnosis I have been under extreme and contant stress from multiple sources and knew that my body was responding adversely - mild depression, slow recovery from exercise, memory problems, extreme PMS, cramping, irregular periods etc.  During that time I had looked into adrenal exhaustion and cortisol levels and basically came to "some sort"" of conclusion that my cortisol levels were out of whack. I had repeatedly raised my concerns with several doctors and these concerns were basically brushed off.

Differing internet articles state adrenal exhaustion is estrogen promoting (therefore higher risk of breast cancer) but I do not understand the interplay between estrogen and progesterone. Ive read up on the levels during the menstrual cycle and understand that process.

If I have been estrogen dominant and this has been the precursor to getting breast cancer, how does progesterone + come into this?

Can anyone simply explain the PR+ component.

Thanks 

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  • Myleftboob
    Myleftboob Member Posts: 1,469
    edited December 2012

    You raise excellent question and I'm looking forward to hearing more. I too for at least 3 years prior to DX was under tremendous stress from various sources. Financial, relationship, family and wondered about cortisol. I'm adding this to my fav's to follow.

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  • Momine
    Momine Member Posts: 7,859
    edited December 2012

    I don't know the answer, but had been wondering about that too.

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  • Ikari
    Ikari Member Posts: 40
    edited December 2012

    Anyone?

    Im struggling to get my head around this. 

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  • hopefour
    hopefour Member Posts: 459
    edited December 2012

    I had hoped by now someone with understand of this topic would have responded...still hoping as I was ER+ 95% as well as PR+ 95%. Seems so many address the ER, but not the PR. I also was in exteremely stressful situations for 7 years prior to BC ( my daughter was in a car accident caused by a 80 year old man running a stop sign...years of medical care and brain surgery, as well as other stresses)! Thanks for posting this question.

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  • TectonicShift
    TectonicShift Member Posts: 752
    edited July 2020

    .

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2012

    Hi Shikari,

    I  am aware that huge amounts of coritsol corsing tru your system for an extended period of time does cause chemistry changes in your brain which result in major depressive disorder and PTSD.  Cortisol is the fight or flight hormone triggered by the raised adrenaline from what I understand.  I went thru a terribly stressful few years that extended from 1989 thru 2000 of constantly having this body reaction which resulted in hospitalization in a center for PTSD.  Many years of therapies resulted after my hospitalization.  After going thru all of this stress I had a sudden brain Hemorrhagic stroke in 2005, more hospitaliztion and more new stresses, then 2009 I was diagnosed with breast cancer.  I do believe large amounts of unnatual stress causes much inflamation and weakening of our bodiy and it's immunity to disease.

    I'm sorry you had to go thru what you went thru. I do believe that just as a person can become diabetic, or have cancer, or other diseases and must be treated by a doctor to treat with appropriate medication, we also need to be treated by a doctor who is knowledgable about mental diseases that result from chemical changes in brain.  I was treated with medications prescribed by a pharmachological Psychiatrist, to treat the chemical reactions by cortisol in my brain that caused the depression and PTSD.  I also had cognitive therapy to help me learn how to manage the stressors that triggered the stress cortisol reaction.  It was a process in my journey in life and I survived it all, just as I survived the coma from the brain hemorrage and the breast cancer.  I haven't been here on this forum in awhile, but was just stopping in to say hi and saw your post. Stay well and God Bless You.

    image

    Barb
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  • cmdczc
    cmdczc Member Posts: 75
    edited December 2012

    Hi, just caught this thread...

    Progesterone is, like estrogen, a steroid hormone (all produced from cholesterol) in a pathway that includes the production of other steroid hormones, including cortisol.  Progesterone is produced in the pathway before (as a precursor) to estrogen, therefore, if you are estrogen +, you should be also progesterone +.  This also explains the correlation with stress and cortisol production with breast cancer.  Progesterone is also stored in adipose tissue, so obesity promotes both estrogen and progesterone production and release, thereby feeding our ER+/PR+ receptor tumors. A vicious cycle...

    Hope that helps!

    Cindy (stage IIIa)

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  • Myleftboob
    Myleftboob Member Posts: 1,469
    edited December 2012

    Cindy

    Thank you for that explanation!   Makes a ton of sense to me.

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  • pebee
    pebee Member Posts: 317
    edited December 2012

    Except.... I was diagnosed with adrenal failure (stress) and took cortisol for a year.  I am ER+ PR-.  And, that is not a typo - they double checked.....

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  • weety
    weety Member Posts: 1,163
    edited December 2012

    If ER+ and PR- is impossible, than why do so many women on here have that diagnosis, including me?

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  • Sue2690
    Sue2690 Member Posts: 43
    edited December 2012

    I'm also Er+ Pr-.

    I thought it was Er- and Pr+ that was rarely seen and thought to be a mistake.

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  • TectonicShift
    TectonicShift Member Posts: 752
    edited July 2020

    .

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  • cmdczc
    cmdczc Member Posts: 75
    edited December 2012

    These ER/PR receptors are done by immunohistochemical stains.  Many times you will see that PR is generally weaker than ER, although still considered positive (anything over 1%), and some of those may essentially be interpreted as negative.  Yes, so there are cases that stain as ER+/PR-, however, what it means clinically, is controversial. The cases that stain ER-/PR+ are felt to be aberrant and might warrant repeating.

    Thanks for the discussion,

    Cindy  (stage IIIa)

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  • Myleftboob
    Myleftboob Member Posts: 1,469
    edited December 2012

    Actually in thinking back to my first discussion with MO about the path results.  He said that I was PR+ but it was such a small percentage that he considered it neutral.

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  • 1Athena1
    1Athena1 Member Posts: 6,696
    edited December 2012

    Interesting topic - I found this little abstract:

    http://www.psychosomaticmedicine.org/content/67/2/277.short

    Objective: Fatigue is one of the most common and distressing symptoms experienced by cancer patients and survivors. However, the etiology of cancer-related fatigue has not been determined. In previous studies, we have shown alterations in morning serum cortisol levels and diurnal cortisol rhythms in fatigued breast cancer survivors compared with nonfatigued control subjects. The purpose of the current study was to evaluate cortisol responses to an experimental psychologic stressor in fatigued and nonfatigued survivors.

    Methods: Participants included 27 breast cancer survivors (11 fatigued, 16 nonfatigued). All had completed cancer treatment at least 3 years previously and were currently healthy with no evidence of recurrence. A standardized laboratory stressor, the Trier Social Stress Test (TSST), was administered during a 90-minute afternoon session. Saliva samples and autonomic measures (heart rate, blood pressure) were collected at 15-minute intervals throughout the session.

    Results: Fatigued survivors showed a significantly blunted cortisol response to the stressor compared with nonfatigued survivors, controlling for depression and other potential confounds (p <.05). No differences in autonomic measures were observed.

    Conclusions: These results, together with our earlier findings, suggest a dysregulation in hypothalamic–pituitary–adrenal (HPA) axis responsiveness among breast cancer survivors with enduring fatigue. Although the sample size was small, results suggest that attention to the HPA axis may be important for understanding cancer-related fatigue.

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  • Momine
    Momine Member Posts: 7,859
    edited December 2012

    Athena, thanks for posting that. Interesting.

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  • Rdrunner
    Rdrunner Member Posts: 309
    edited December 2012

    interesting but it depends on what the inclusion and exclusion criteria were, there are lots of other disorders that one could have in addition to BC that can interfer with the HPA axis  such as ptsd which by the way is now being recognised amongst cancer survivors or cancer patients and their families even.

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  • ScubaGerl
    ScubaGerl Member Posts: 1
    edited July 2014

    Shikari

    Many factors contribute to breast cancer - there is no one determining precursor. As for Progesterone; it is the great balancer of estrogen, and if you are indeed estrogen dominant as many are, you are probably not making enough on your own, so your estrogen is raging around your body unopposed feeding your cancer! May I suggest a natural bio-identical progesterone cream, It has helped me be human again.

    I think what you are referring to is that when your adrenals are compromised your immune system also is not fighting disease with the force it would under normal circumstances, making you more vulnerable for cancer cells to proliferate and grow. Interestingly, when the adrenals are not working it means the body's immune cells are attacking the body, and if they are attacking the body they are NOT fighting the cancer cells! I hope this makes sense to you. This article may also help:

    http://www.project-aware.org/Resource/articlearchi...

    As for Adrenal Exhaustion; I think this is sadly overlooked in breast cancer treatment. Just 6 days ago I learned I was dangerously low in ALL steroid hormones including Cortisol via saliva testing. A study I just read states that low cortisol levels are correlative to a poorer outcome than women with healthier adrenals: 

    http://www.adrenalfatigue.co.nz/adrenal-fatigue/he…

    Do your own due diligence research and NEVER accept when a doctor brushes off your concerns or discounts what you are experiencing, clearly adrenal health is important to any women who is fighting or is a breast cancer survivor! 

    My Best,

    ScubaGerl 

    IDC 1a 

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