A progressive medical evaluation coupled with lifestyle modification can be very powerful in the prevention of breast cancer, as genetics play a minor role in this modern day epidemic. Dietary modification and scientifically applied nutritional supplementation are important not only in preventing breast cancer but also in managing the disease once it has started. More precisely, nutrition can help slow or reverse tumor growth, reduce metastasis (spread of the cancer to other parts of the body), reduce toxicity from radiation and chemotherapy cancer treatments, and help prevent recurrence of breast cancer once it is in remission. 

Much of what follows is somewhat controversial because little of it has been "proven" by double blind, placebo-controlled experiments. However, does it not make sense to take action now based upon the best available evidence, rather than wait for studies to "prove" the best approach to prevention? If you wait, you may wind up regretting it. 

There is much to consider in the prevention of breast cancer. First of all, why is there so much more breast cancer today than there was 100 years ago? Three possible explanations are: 1) Dietary changes, 2) Increased exposure to environmental toxins, and 3) Increased exposure to estrogen. 

To better understand this subject, let's examine how cancers form. Cancer cells are "immortal." They are cells that have lost their growth restraining mechanisms and so multiply out of control. This results from alteration of cellular DNA or genetic material, which can be an inherited defect. Much more commonly, however, free radical damage is the cause of these genetic mutations. Free radicals are molecules that have an unpaired electron. All physical matter is held together by pairs of electrons called chemical bonds. When one electron becomes displaced for any reason, a free radical is formed. Free radicals "steal" electrons from other molecules in order to restore their own balance. In the process, they create another free radical that can participate in a chain reaction with resultant damage to the involved body tissue. When DNA or genetic material is involved in free radical reactions, mutations or genetic alteration can result. Free radical chain reactions are stopped by antioxidants. This is one of the reasons that antioxidants are important in cancer prevention. 

Some of the sources of free radicals are: normal metabolism (free radicals are produced in normal cellular energy production), environmental toxins, cigarette smoke, alcohol, impaired oxygen delivery to tissue, high blood sugar levels, consuming overcooked meats, and various disease processes. Under normal conditions every cell in our bodies encounters about 10,000 free radical "hits" on a daily basis! When our antioxidant defenses are adequate, this free radical damage is repaired without much consequence. However, if our antioxidant reserves are overwhelmed, and DNA damage is not repaired within a few hours, cancerous cell changes may be initiated. Obviously, our antioxidant status is critical. It is important to note that antioxidants function as a team - when one becomes oxidized by a free radical it can be regenerated to an active antioxidant form again by another antioxidant. This is the relationship shared by vitamins C and E. Also of importance is the fact that different antioxidants are active against different free radicals and active in different parts of the cell. For optimal health, a broad array of antioxidants is important to provide protection against free radicals. If we have a great excess of any one antioxidant, an increase in free radical activity may actually be stimulated. Antioxidant balance is the key. Some of the important antioxidants are: vitamin C, natural vitamin E, tocotrienols, selenium, mixed carotenoids, reduced glutathione, flavonoids, coenzyme Q10, and melatonin. Breast cancer patients have been found to have reduced levels of antioxidants in the blood. Let's look at a few of these antioxidants in more detail: 

Melatonin is a hormone produced by the pineal gland in the brain, gastrointestinal tract, and retina of the eye. Melatonin release from the pineal gland occurs in response to darkness and is a powerful orchestrator of various body cycles. Besides being one of the most powerful antioxidants yet discovered, melatonin boosts immune function, demonstrating partial reversal of chemotherapy-induced immune suppression in laboratory animals. Melatonin reduces nocturnal production of estrogen and may inhibit growth of estrogen responsive breast cancer. The theory that electromagnetic fields (produced by modern machinery of all types) may contribute to breast cancer is supported by the facts that strong electromagnetic fields suppress melatonin production (especially in women) and produce free radicals, and many women with breast cancer have no circadian (pineal gland produced) melatonin output. Beta-blockers (drugs used to lower blood pressure) suppress melatonin production. Melatonin is extremely powerful in preventing DNA damage and, in cell culture studies, when it is given in physiologic (natural) doses before Tamoxifen therapy, it increases the drug's breast cancer growth inhibiting activity 100 fold! Cell culture studies have also found melatonin to be 50 percent more effective in suppressing breast cancer cell growth than 5-fluorouracil, a chemotherapeutic drug. Taking oral supplements of melatonin deserves consideration in the prevention of breast cancer, especially given the fact that the body produces less of this hormone with age. Women who are trying to get pregnant and individuals with blood cell cancers or Seasonal Affective Disorder should not take melatonin. In order to make supplementation of melatonin as safe and effective as possible, we recommend measuring the body's circadian output of the hormone to determine proper potency and timing of dosage. This is done with saliva samples. 

The mineral selenium is the coenzyme for the antioxidant enzyme glutathione peroxidase and, as such, plays a role in protecting the body's fatty structures from free radical damage. Selenium also stimulates the immune system and detoxifies heavy metals, which can serve as carcinogens. Women with higher blood levels of selenium have been linked with lower incidence of breast cancer. Animal studies with this mineral have been very impressive. Adding selenium to the diet of a strain of mice prone to breast cancer resulted in a 72 percent reduction in cancer development! Selenium is one of the most powerful anti-cancer substances ever discovered and has a role to play in treatment as well as prevention. Unfortunately, most Americans are deficient in selenium. Hair and blood analyses are two ways to measure the body's selenium status. Supplements of 200 micrograms daily should be sufficient. 

Another antioxidant of special importance in the prevention of breast cancer is reduced glutathione. Not only is reduced glutathione the most important antioxidant inside cells, it is also a very important compound in removing toxins, including carcinogens, from the body. Several studies have found reduced glutathione to be the single biological compound most closely correlated with good health in older age. Reduced glutathione is both obtained from the diet and manufactured in the body. Reduced glutathione binds heavy metals and protects DNA from free radical damage. Its most interesting role in cancer prevention, however, involves its regulation of p53 tumor suppressor protein. This protein malfunctions in more than 50 percent of all cancers. Normally, when DNA becomes damaged, p53 tumor suppressor protein slows down cellular division to allow more time for the damage to be repaired by other specialized proteins. By allowing for DNA repair, p53 tumor suppressor protein prevents the cell from becoming malignant. Inside cancer cells, p53 tumor suppressor protein has a different function. It induces apoptosis, which is programmed cell death. It literally causes the cancer cell to self-destruct! Adequate intracellular levels of reduced glutathione are required for p53 tumor suppressor protein to function as described above. However, when reduced glutathione levels are depleted, the actual shape of p53 tumor suppressor protein changes and so does its personality - it may instead act as a tumor promoter! Reduced glutathione status is the result of dietary factors including protein quality, overall free radical and antioxidant balance, and toxin exposure. Reduced glutathione levels can be measured in the blood. From what we have seen, reduced glutathione deficiency appears to be very common. Reduced glutathione is a very unstable compound and most available supplements are of limited value. "Recancostat" by Tyler Encapsulations is a patented, stabilized form of reduced glutathione that has been used with success in high doses in the treatment of breast and other cancers. "Recancostat" should be high on the list of supplements to take in the prevention of breast cancer. 

Coenzyme Q10 is another antioxidant with immune stimulating abilities. It is a necessary component of cellular energy production and its manufacture by the body falls with age. Certain medications, such as beta-blockers and cholesterol lowering agents, also reduce coenzyme Q10 levels. Coenzyme Q10 deserves special mention because of two anecdotal reports of women with breast cancer (that had spread to other organs) going into complete remission with use of very high doses of this compound. The lack of oxygen at the interior of quickly growing tumors causes these cells to become even more cancerous. Coenzyme Q10 may work by increasing oxidative metabolism and free radical damage within these cancer cells. Coenzyme Q10 levels can be measured from blood samples. Emulsified forms are best to use for supplementation. 

In addition to laboratory tests for evaluating the status of specific antioxidants, there are other related tests to consider. Equally important are the tests that can be performed on blood and urine samples to measure overall free radical stress and damage within the body. When free radical activity is high, steps must be taken to improve antioxidant status. 

The real foundation for antioxidant nutrition is a diet rich in plant foods. There are many, many different compounds within fruits, vegetables, nuts, seeds, legumes, and grains that exert antioxidant activity. This is one of the reasons that plant based diets are associated with good health, including reduced risk to breast cancer. 

Plants also contain a myriad of compounds (called phytonutrients) that, when consumed, impact a large array of bodily functions. Upon studying phytonutrients, one quickly comes to the realization that our bodies are like a laboratory and everything we eat contributes to the outcome of the experiment, which is our state of health. With regard to cancer, there are many ways in which phytonutrients have an influence. 

One large group of plant chemicals is the flavonoids, which are found in all plants. Various flavonoids have been studied in cell culture and animal experiments. A number of flavonoids have been shown to have the ability to inhibit the carcinogenic process, thereby preventing cancer cells from forming. When cancer cells do form, they are dependent upon various compounds to grow and proliferate. One class of such compounds is the protein tyrosine kinases. These, and other cancer promoting compounds, are inhibited by the flavonoids quercetin and luteolin, and genistein, which is found in soy. Soybeans, whole grains, fruits and vegetables contain phytic acid, which has been shown to inhibit breast cancer in animals. Genistein inhibits tumors in a number of ways including the induction of apoptosis-programmed cell death. Genistein also has the extraordinary ability to convert cancer cells back to normal cells! Genistein also reduces the activity of the breast cancer-promoting hormone, estrogen. 

Once a tumor is well established it begins to spread to other tissues in the body, a process referred to as metastasis. A number of flavonoids have been shown in experimental animals to inhibit metastasis. One method tumors use to spread is the production of proteases, which are enzymes that break down neighboring healthy tissue. Protease inhibitors are found in soybeans, rice, and corn. Low calorie diets induce the body's production of its own protease inhibitors. Grape seed extract and shark cartilage are two supplements that have anti-protease activity. Another means by which a tumor spreads is by secreting compounds that stimulate the replacement and growth of its fragile blood vessel network - a process called angiogenesis. Genistein from soy and lignins from flaxseeds have both been demonstrated to have anti-angiogenic activity. This is also true of shark cartilage. 

A diet rich in plant foods supplies a variety of essential nutrients as well, including vitamins, minerals, amino acids and essential fatty acids. These are all important for the health of the immune system and all body functions and, as such, play a role in breast cancer prevention. Essential nutrient status can be measured from blood, hair and urine samples. 

Another aspect of diet with influence on breast cancer development and progression is fat consumption. There appears to be a direct relationship between the amount of dietary fat and the risk to breast cancer. 

Probably of more importance than the amount of fat in the diet are the types of fat eaten. Omega 3 fatty acids, which are found in high concentration in flaxseeds, cold water fish, and algae, offer protection from breast cancer and its spread throughout the body. Olive oil also appears to offer some protection from breast cancer. The omega 6 fatty acids, especially linoleic acid (found in most vegetable oils) and arachidonic acid (found in red meat, organ meats, dairy products, eggs, and shellfish), are converted in the body into inflammatory compounds called series 2 eicosanoids. These eicosanoids stimulate cell transformation and metastasis. The production of the series 2 eicosanoids is stimulated by eating excess refined carbohydrates and hydrogenated vegetable oils (both found in cookies, cakes, crackers, and most breads), and inadequate amounts of the omega 3 fatty acids. 

The importance of the type of fat in the diet was shown in an experiment using a strain of mice prone to breast cancer. Three hundred mice were divided into six groups of fifty each. The only variable in the experiment was the type (not quantity) of fat fed to the animals. Two groups were fed omega 3 fatty acids - flaxseed oil or fish oil. The types of fats fed to the other groups consisted of omega 6 fatty acids: oil of evening primrose, corn oil, or safflower oil. These five groups of mice were exposed to a carcinogen known as DMBA to initiate tumor growth. The sixth group of mice served as a control group. They were fed lard as a fat source and were not exposed to DMBA. At the end of the study, there were striking differences in the incidence of mammary tumors. Tumors developed in the following numbers of animals in each group: safflower oil group - 44, corn oil group - 42, evening primrose oil group - 32, fish oil group - 6, flaxseed oil group - 2, and lard group - 32. It is quite impressive that the animals fed flaxseed and fish oils developed far fewer tumors than the control group that had not been exposed to the carcinogen! It is important to realize that omega 6 fats are not evil. They are essential! The key here is balance. Both omega 3 and omega 6 fats are needed for good health. For breast cancer prevention they should be consumed in about a 2 or 3 to 1 ratio in favor of omega 6. Most Americans get more like a 20 to 1 ratio in favor of omega 6. When breast cancer has developed, a higher intake of omega 3 fats is desirable. The body's fatty acid balance can be determined by a red blood cell fatty acid analysis from blood samples. 

Another important subject related to the development of breast cancer is that of toxicity. The balance between toxin exposure and the body's detoxication ability is a very likely, although unproven, factor in breast cancer development. The types of toxins implicated are the 100,000 man-made compounds (known as xenobiotics) that now contaminate our food, water, and air. There are another three new xenobiotics being created every day. Many of these xenobiotics are carcinogenic and many also have estrogenic activity - a cancer causing quality in itself. 

When xenobiotics make their way into the body by ingestion, inhalation, or through the skin, an attempt is made to detoxify these compounds and eliminate them from the body. Our detoxication systems are not 100 percent efficient and so some toxins are left in circulation. The ones that are fat-soluble get stored in the fatty tissues and remain there indefinitely. The breast is a very fatty tissue and so is prone to concentrate many toxins. What's more, it is possible that wearing tight bras for extended periods of time may contribute to the build-up of toxins within the breast by impairing lymphatic (circulatory) drainage of the breast tissue. 

How exactly could environmental pollutants initiate breast cancer? One mechanism is through the production of free radicals, which damages DNA or genetic material, resulting in a mutation. Detoxification in the body is usually a two step process. The first step, referred to as phase 1, involves chemical alteration of the involved substance to make it easier for the body to deal with. The second step, or phase 2, involves binding the partially transformed toxin to one of several different compounds the body manufactures in order to make the toxin water-soluble. This allows for effective elimination from the body. There are actually six different phase 2 pathways. Phase 2 is also known as conjugation. An important fact about the body's detoxication system is that the partially transformed toxin resulting from phase 1 modification is often more carcinogenic than it was before the body acted on it! When phase 2 is functioning up to par, partially transformed toxins from phase 1 are eliminated from the body and all is well. In real life this is not always the case - often there is an imbalance between phase 1 and phase 2. We will explore this further in a moment. Another important fact about phase 1 is that its activity produces free radicals. When the body is exposed to a lot of toxins, there can be a great burst of free radical production that may overcome the body's antioxidant defense system. Under these conditions, genetic damage - and initiation of malignant cell changes - becomes more probable. 

Another way in which xenobiotics can contribute to breast cancer is through simulating the effects of the reproductive hormone, estrogen. Estrogen stimulates the growth of breast tissue and this includes breast cancer cells. Estrogen is often a major stimulus for the growth and spread of breast cancer. Some environ-mental toxins, including aromatic hydrocarbons and organochlorines found in pesticides, herbicides, plastics, refrigerants and industrial solvents, are structurally similar to estrogen. In this day and age, not only does a woman have her own natural estrogen to consider but also estrogen replacement therapy at menopause, and environmental or xenoestrogens as well. One study examined the concentration of three xenoestrogens - PCBs, DDT, and DDE - in healthy breasts versus breasts with cancer. These toxins were found at 50 to 60 percent higher levels in the cancerous breasts. Perhaps Long Island has such a high breast cancer rate because DDT was heavily sprayed there in the 1950's. 

There are two general considerations in regard to reducing breast cancer risk from toxicity: 1) Reduce your exposure to toxins, and 2) Enhance your body's detoxicating abilities. 

It is impossible to eliminate exposure to toxins but there are some important steps that can be taken. To reduce air pollution exposure: get plenty of fresh air, assure good ventilation when indoor, and use an air purifier. Minimize food-based toxin exposure by reducing consumption of animal products since these account for over 95 percent of food-borne xenobiotics. Choose "free range" animal products and "organic" produce whenever possible. Not only are organic fruits and vegetables raised without pesticides and herbicides, but also they contain about half the levels of heavy metals and twice the concentration of nutrients of their commercially raised counterparts. Water should be as pure as possible. The government allows much higher levels of toxins in our drinking water than in our foods for some reason. I recommend using a Doulton brand water filter to remove trihalomethanes and other carcinogens. If your water supply contains chlorine, a shower filter should be used as well. Not only do xenobiotics pass through the skin while bathing, but they are also inhaled in water vapor. Cigarette smoke has also been associated with breast cancer, and of course should be avoided. 

Understanding how to enhance the body's detoxication abilities is a bit more involved. Remember that the body processes and eliminates toxins in two phases. Ideally both phases are functioning normally. However, if phase 1 is slow, then toxins cannot be eliminated. Instead they circulate and deposit in body tissues, including the breast. If phase 1 is normal but phase 2 is slow, then toxins become partially transformed without being eliminated and we again have them stored in body tissues. Recall that many compounds become more carcinogenic after phase 1 processing. The worst case scenario is when phase 1 is overactive and phase 2 is slow. Again, the result is that carcinogens accumulate in the body. What’s more, the free radical "storm" that results from an overactive phase 1 is an additional source of carcinogenesis. 

The activity of the phase 1 and phase 2-detoxication pathways is genetically predetermined to some degree. There are, however, many environmental and lifestyle influences on these pathways as well. Without going into detail, the following all have an effect on the body's detoxication pathways: cigarette smoke, alcohol, caffeine, many medications, food antigens, heavy metals, xenobiotic exposure, toxic intestinal bacteria, dietary protein, fat and carbohydrate, vitamins, minerals, phytonutrients, and hormones. 

There is a laboratory test available which can measure the activity of the phase 1 and phase 2-detoxication pathways. The results of this test can be used to construct a tailored comprehensive detoxification support program consisting of specific foods and natural supplements, as well as other detoxification therapies. In this way, the body can be stimulated to safely rid itself of toxins. 

As was alluded to earlier, the hormone estrogen has been implicated in the initiation and promotion of breast cancer. Actually, there are three estrogen hormones with estriol being the weakest and non-carcinogenic. Estrone and especially estradiol are carcinogenic. The ovaries are responsible for about two-thirds of the estrogen produced in a premenopausal woman. The rest is produced by fat cells converting adrenal hormones into estrogen. In post-menopausal women, the adrenal source accounts for virtually all the estrogen (which is a small amount). 

The link between estrogen levels and breast cancer is supported by the finding that women with greater bone density also have a greater incidence of breast cancer. Long term elevations of estrogen increase bone mass - and may also increase breast cancer. Women have always produced estrogen, so why should we have such a dramatic increase in breast cancer in recent history if estrogen is involved? Not only may environmental estrogen-like toxins (xenoestrogens) and estrogen replacement therapy be factors, but also women are producing more natural estrogen throughout their lifetimes. With each menstrual cycle there is exposure to elevated estrogen levels. Modern females begin ovulating at a younger age and have fewer children, both of which result in greater lifetime exposure to estrogen and its breast cancer stimulating effects. One explanation for the earlier age of menarche (onset of menstruation) is exposure to xenoestrogens. In excess of 220 million pounds of estrogen-like pesticides are sprayed on U.S. crops each year. An additional source of estrogen exposure not mentioned previously is commercially raised beef and milk. Cattle are implanted with time-released estradiol pellets in order to fatten them up. Recall that estradiol is the most carcinogenic form of estrogen. To reduce exposure to food sources of xenoestrogens, again, choose "organic" and "free range" whenever possible. 

Another problem with commercially raised cattle is the use of growth hormone. Giving this hormone to cattle (again for monetary reasons) results in increased production of Insulin-like Growth Factor-1 (IGF-1). IGF-1 passes into the cow’s milk. IGF-1 appears to be a very powerful stimulator of breast tumor growth- perhaps more so than estrogen. It should be noted that IGF-1 is found in cow’s milk ordinarily. To avoid additional exposure however, do not drink milk from cattle injected with BST (growth hormone). 

The issue of hormone replacement therapy at menopause needs consideration as well. Given the fact that osteoporosis and cardiovascular disease account for more death than breast cancer, should a woman use estrogen replacement or not? Although estrogen adequacy is a factor in osteoporosis and cardiovascular disease, it is not the only one. There are many other considerations and natural treatments that can be used to successfully deal with these conditions. And while estradiol (the main form of estrogen used in replacement therapy) and synthetic progesterone (progestins) may increase the risk to breast cancer, estriol and natural progesterone may reduce the risk to breast cancer. These latter hormones can be used as hormone replacement at menopause with much greater safety and fewer side effects. Women with breast cancer have been found to have decreased progesterone and estriol levels and increased estradiol levels. It should be pointed out, however, that a small percentage of breast cancers are stimulated by progesterone. An important dietary consideration related to menopausal symptoms is soy. Soybeans contain very weak estrogen-like compounds (called phytoestrogens), genistein and daidzein. Moderate consumption of soy can increase the overall estrogenic activity at menopause and thereby help to reduce menopausal symptoms, increase bone mass, and lower risk to cardiovascular disease. Women in Japan, where consumption of soy is high, not only have much lower rates of breast cancer, but they also do not experience the menopausal symptoms that Americans do. 

There is also much a woman can do to reduce estrogen-stimulated breast cancer growth throughout her lifetime. A special test, called the Female Hormone Panel, can be performed to give detailed information on the secretion of estradiol, estriol, progesterone, and testosterone throughout a menstrual cycle. The results of this test, which uses saliva samples, provide a glimpse into the body's reproductive hormone physiology, allowing for customized therapy to reduce breast cancer risk. This test also gives insight into other conditions: premenstrual syndrome (PMS), infertility, polycystic ovary disease, endometriosis, recurring headaches, miscarriage, and menopausal symptoms. 

There are many lifestyle factors that can influence the body's production of estrogen and estrogenic activity. Obesity increases the conversion of adrenal hormones into estrogen. Exercise lowers estrogen levels. Alcohol consumption increases estrogen levels. Dietary Fiber reduces estrogen levels by increasing elimination of it in the feces. Metabolism of estrogen within the body is a complex and important subject. Estrogen is detoxified or eliminated through phase 1 and two specific phase 2 pathways: sulfation and glucuronidation. Sulfation involves conjugation of estrogen with sulfate and glucuronidation refers to the binding of estrogen to glucuronide. Sulfation and glucuronidation also process other toxins. If phase 1 is under active, we will have more estrogen retained in circulation. If phase 1 is normal or overactive and phase 2 is slow, the result is partially transformed, more carcinogenic forms of estrogen remaining in circulation. 

Once estrogen is processed in phase 2, it is excreted in the bile and urine. The bile passes into the intestines for elimination in the feces. There is an enzyme in the body called beta-glucuronidase, which breaks the bond between glucuronide and the compound it is bound to for elimination. When beta-glucuronidase activity is high, it results in freeing up a lot of estrogen (and toxins) which can then recirculate throughout the body. Beta-glucuronidase also increases the carcinogenicity of some compounds. Beta-glucuronidase is stimulated by eating meat and animal fat and is suppressed by consuming fiber. There is also a supplement available called calcium D-glucarate, which not only inhibits beta-glucuronidase, but also increases the activity of the glucuronidation phase 2 pathway, with the net effect being that more estrogen and other toxins are eliminated from the body. Calcium D-glucarate has been found in animal models to lower estradiol levels and inhibit the initiation, promotion, and progression of cancer. Even after exposure to carcinogens, calcium D-glucarate was found to decrease breast cancer formation. It is important to understand that it is the glucarate, and not the calcium, responsible for these effects. Calcium D-glucarate is a supplement worthy of consideration in the prevention of breast cancer. 

Many other dietary compounds are involved in the proper detoxication and elimination of estrogen: many minerals, vitamins, fatty acids, amino acids, carbohydrates, and various phytonutrients, including those found in cruciferous vegetables. For this reason, consuming a lot of broccoli, cauliflower, cabbage, and Brussels sprouts, is important in the prevention of breast cancer. 

Phytoestrogens from various plant foods can reduce the activity of the body's own estrogens. Rye, flaxseeds, and especially soy are high in phytoestrogens. Recall that earlier, in connection with menopause, it was suggested that phytoestrogens can increase the overall estrogenic activity in the body. Actually, phytoestrogens have estrogen-normalizing effects. Phytoestrogens bind to estrogen receptors (including those on breast cells) and exert very weak estrogenic effects. If a woman is lacking in estrogen, the effect is an increase in estrogenic activity. If a woman has high levels of circulating estrogen, the phytoestrogen, by competing for attachment to estrogen receptors and exerting a much weaker effect will cause a net decrease in estrogen activity. This is obviously beneficial when estrogen is contributing to breast cancer initiation or promotion. 

Lignins, compounds found in highest concentration in flaxseeds, reduce the body's estrogenic activity in another way. Lignins stimulate the liver to produce sex hormone binding globulin. Sex hormone binding globulin binds estrogen and therefore reduces the levels of free estrogen in circulation. It is only the free estrogen that is biologically active and capable of contributing to breast cancer. Lignins also have antioxidant activity, decrease carcinogen formation in the body, and have been shown, in cell culture studies, to reduce estrogen-sensitive breast cancer cell growth and angiogenesis. Angiogenesis, you may recall, is the process whereby tumors stimulate formation of new blood vessels in order to foster more tumor growth. 

Another important area to consider in the prevention of breast cancer is the health and vitality of the immune system. There are numerous considerations in this regard. One component of the immune system that is particularly important is the natural killer (NK) cell. NK cells are a type of lymphocyte (white blood cell) directly involved in killing cancer cells. Healthy NK cell activity has been found to be associated with reduced risk of breast cancer metastasis and breast cancer recurrence. Interestingly, surgery and chemotherapy both suppress NK cell activity. So does smoking. 

Stress, or more appropriately, the body's response to stress, may also suppress NK cells. During the day, the body's immune cells concentrate in the spleen and bone marrow for "conditioning." During sleep the immune cells circulate throughout the body taking care of business, including the elimination of cancer cells. Elevated levels of the stress hormone cortisol cause an inhibition of this immune surveillance – more immune cells stay in the spleen and bone marrow. Reduced levels of the hormone DHEA also contribute to this problem. Increased cortisol to DHEA ratios result from chronic stress of any kind, with the most common causes probably being: 1) Mental-emotional stress, and 2) Biochemical stress from blood sugar dysregulation, which often results from eating excessive quantities of refined carbohydrates. Indeed, emotional stress and sugar consumption have been directly associated with risk to breast cancer. Cortisol and DHEA levels are best measured from saliva samples. When imbalances are found, comprehensive treatment to restore normal levels of these hormones is critical. 

Exercise, guided imagery, and many essential nutrients and phytochemicals can enhance NK cell activity. Consumption of vitamin C has been shown to produce a delayed increase in NK cell activity. For the first four hours after ingestion, however, vitamin C actually suppresses NK cell activity! A special form of vitamin C called "Ultra Potent C" has been shown to not cause this initial suppression of NK cell activity. "Ultra Potent C" has also demonstrated increased uptake and retention by the white blood cells. Many other vitamins, minerals, amino acids, fatty acids, and herbs, including several strains of mushrooms, have been found to also stimulate NK cell activity. Arabinogalactans, an active ingredient in Echinacea, astragalus, and shitake mushroom have been shown to enhance NK cell activity, reduce metastasis, and protect against radiation induced damage. Arabinogalactans are available in supplement form. 

In conclusion, there is much that a woman does (and can do) on a daily basis that influences the development of breast cancer. We offer comprehensive evaluation and individualized treatment and lifestyle modification strategies to reduce risk to breast cancer and other diseases.