By Dr. David Tener
Associate Doctor, The Goldberg Clinic
In recent news, Oscar winning actress Angelina Jolie announced that she had both of her breasts surgically removed even though she had no breast cancer. The story quickly became national news and much of the mainstream media is now praising Mrs. Jolie, referring to her decision as both “heroic” and “empowering.“ Jolie opted for the procedure after having been told that she carries the BRCA1 gene, a mutation associated with an increased risk of breast cancer.
Angelina Jolie, like many other women who carry the BRCA1 gene, decided the best way to prevent breast cancer was to remove her breasts, both of which were cancer free. Mrs. Jolie's modus operandi is disturbing as is the idea that she may inspire other women to have their healthy breasts cut off as well. This line of thinking may ultimately lead to people removing their colons for fear of colon cancer, removing their stomachs for fear of stomach cancer, removing their testicles for fear of testicular cancer, etc.
13% of women, or 1 in 8, will develop breast cancer during their lifetime.(1) Breast cancer is the most common cancer in women and the 2nd leading cause of death exceeded only by lung cancer.(1) The numbers certainly are enough to inspire fear in all women, and trends indicate that the incidence of breast cancer is likely to continue to rise in the coming years.
Are our genetics to blame?
BRCA1 and BRCA2 belong to a class of genes known as tumor suppressors. Mutation of these genes has been linked to hereditary breast and ovarian cancer. According to the National Cancer Institute, a women who has inherited a harmful mutation of BRCA1 or BRCA2 is about 5 times more likely to develop breast cancer than a woman who does not have such a mutation.(2)
It is important to note that not every women who has a BRCA1 or BRCA2 gene mutation will develop breast or ovarian cancer, yet women who are told they carry these genetic mutations commonly believe that their genetic code is an absolute indication of impending cancer expression. The question then remains, how much control do we really have over our health? Do our genes really seal our fate?
From a biological perspective, human disease evolves from two major sources:
1) Inherited Genetic Predisposition
2) Environmental Factors: e.g. diet, toxins in the water, air and soil, radiation exposure, destructive habits such as overeating, alcohol, drug and tobacco consumption, stressful emotional influences, etc.
The genes we are born with represent our genotype. The way those genes are expressed represent our phenotype. In other words, genes can be turned on and they can be turned off through environmental factors including diet, sunlight, emotional stress, and toxins such as drugs, alcohol and environmental pollutants.(3)
The emerging scientific field of Epigenetics proposes that the true secret of life does not lie within the genes themselves but rather within the interactions that occur between the cell and its environment. Inherited genetic mutations are not in fact a death sentence as was once commonly believed. As it turns out, we have a tremendous amount of control over how our genetic traits are expressed--from how we think to what we eat and the environment in which we live.
"Our genetics determines who we are and what potential we have to an extent, but environmental factors have a significant influence on how our genes express themselves and how we can develop the potential that lies within us."
Paul Goldberg, MPH, DC, DACBN, DCBCN, Hygienic Heights page 9
A few years ago I attended a lecture by cellular biologist Bruce Lipton PhD, an internationally recognized leader in the field of Epigenetics. Years worth of research conducted by Lipton and others revealed that the environment, operating through the cell membrane, controls the behavior and physiology of the cell, turning genes on and off. According to Lipton, when you change your behavior, you are also re-programming your genetics.
"Your cells can choose to read or not read the genetic blueprint depending on the signals being received from the environment. So having a "cancer program" in your DNA does not automatically mean you are destined to have cancer. Far from it. This genetic information does not have to be expressed..."
Cellular Biologist Bruce Lipton PhD
Know Your Risk and Optimize Your Health
Most physicians recommend yearly mammograms as the go to method of breast cancer screening, yet the benefits of mammography are controversial. The health hazards associated with routine mammography are well established:
The routine practice of taking 4 films of each breast annually results in approximately 1 rad (radiation absorbed does) exposure, which is about 1,000 times greater than what you would get from a chest x-ray. Radiation from routine mammography poses significant cumulative risk of initiating and promoting breast cancer.(4-6)
Mammography entails tight and often painful compression of the breast, particularly in premenopausal women. This may lead to distant and lethal spread of malignant cells by rupturing small blood vessels in or around small, as yet undetected breast cancers.(7)
False positive diagnoses are very common, leading many women to be treated unnecessarily with mastectomy, chemotherapy, and yes, more radiation! For women with multiple risk factors including a strong family history, prolonged use of birth control, early menarche etc., the cumulative risk of false positive increases to as high as 100% over a decade's worth of screening.(8)
Contrary to popular belief and assurances by the National Cancer Institute and the American Cancer Society, mammography is not a reliable technique for early diagnosis. In fact, breast cancer has usually been present for 8 years before it can finally be detected.(9)
For women who are concerned about the hazards associated with routine mammography, safe alternatives for measuring breast cancer risk do exist and should be considered.
Self Breast Exam
Annual clinical breast exams together with at home monthly self breast exams is safe, effective and low cost. Most breast cancers are discovered by women themselves and proper training in self-breast examination has been shown to increase the frequency and number of small tumors found.(10)
Thermography looks at vascular changes in the beast. Thermal imaging detects the subtle physiological changes that accompany breast pathology, whether it is cancer, fibrocystic disease or a vascular condition. Unlike mammography, thermal imaging is not painful and emits no radiation. Studies suggest that thermography is a safe, practical and effective means of detecting breast abnormalities.(11,12)
At the Goldberg Clinic, we recommend Estronex Testing for women over 35 and for those at an elevated risk of breast, ovarian and cervical cancer. The Estronex Profile measures six important estrogen metabolites and their ratios to help women (and men as well) assess whether they are at risk for the development of an estrogen sensitive cancer. Approximately 90% of breast cancers are estrogen dependent, making the Estronex Test an important screening tool to assess relative risk. Based on the data collected, patients can be guided into the proper health promoting behaviors to balance their ratios and thereby reduce their risk. All that's required is a urine sample.
Optimize Your Health
Our genes can be accentuated or depressed (turned on and off to some degree) through specific environmental influences. At the Goldberg Clinic, a concerted effort is made to understand the patient's genetic predispositions/weaknesses (cancer or otherwise) and determine how to best improve upon them by changing nutritional and other environmental factors on an individualized basis. Criteria reviewed and considered include but are not limited to:
Individualized Dietary Reform
Sleep and Rest Patterns
Sunlight Exposure/Vitamin D Production
Pure Water Intake
Allergens (Dietary and Environmental)
Toxic Exposures e.g. Past and Present Pharmaceutical Usage
Digestive Function and Gut Microflora Involvement
It is by working to create the best conditions for health to occur that the function of all the body's systems are optimized and genetic weaknesses are minimized. This is in contrast to the "preventive" surgical removal of otherwise healthy organs and tissues as is commonly done medically, which neither addresses the cause(s) of disease nor prevents its development.
1. Breast cancer risk in american women. [cited 2013 May 17]. Available from: National Cancer Institute, National Institute of Health Web site: http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer
2. BRCA1 and BRCA2: Cancer risk and genetic testing. [cited 2013 May 17]. Available from: National Cancer Institute, National Institute of Health Web site: http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA
3. Goldberg PA Hygienic heights: Health and disease from a vital-natural hygienic perspective. 2012.
4. Bertell, R. Breast cancer and mammography. Mothering, Summer 1992, pp. 49- 52.
5. National Academy of Sciences- National Research Council, Advisory Committee. Biological Effects of Ionizing Radiation (BEIR). Washington, D. C., 1972.
6. Swift, M. Ionizing radiation, breast cancer, and ataxia-telangiectasia. J. Natl. Cancer Inst. 86( 21): 1571- 1572, 1994.
7. Watmough, D. J., and Quan, K. M. X-ray mammography and breast compression. Lancet 340: 122, 1992.
8. Christiansen, C. L., et al. Predicting the cumulative risk of false-positive mammograms. J. Natl. Cancer Inst. 92(20):1657-1666, 2000.
9. Epstein S, Bertell R, Seamen B. Dangers and unreliability of mammography: Breast examination is a safe, effective, and practical alternative, International Journal of Health Services 2001; 31(3):605-615.
10. Hall, D. C., et al. Improved detection of human breast lesions following experimental training. Cancer 46 (2): 408- 414, 1980.
11. Arora N, Martins D, Ruggerio D. Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer. Am J Surg 2008; 196(4):523-6.
12. Keyserlingk JR, Ahlgren PD, Yu E. Infrared Imaging of the Breast: Initial Reappraisal Using High-Resolution Digital Technology in 100 Succesive Cases of Stage I and II Breast Cancer, The Breast Journal 1998; 4(4)