Why Cancer Prevents Us from Reversing Aging
Several promising anti-aging therapies are being denied to the very people who need them the most—older adults. Fear of cancer is the main reason that elderly people do not take youth hormones and other agents that might reverse the biological effects of aging. The problem is that older cells contain more mutated genes responsible for regulating cellular propagation. Older cells are therefore more prone to becoming cancerous. When a growth-stimulating agent like estradiol is added to an older person’s body, the risk of certain cancers appears to increase.157,158
I cannot tell you the frustration that we at the Life Extension Foundation encounter when we discover a potential age-reversing therapy, only to have to rule it out because it might increase the risk of cancer. This is why we have done such an in-depth report on Suzanne Somers’ new book. Suzanne looks and feels so much better by taking natural youth hormones (along with a plethora of cancer-preventive nutrients) that she is willing to risk a recurrence of her breast cancer rather than do without her hormones. After reading the details of Suzanne’s battle with breast cancer and the devastating effects she encountered when deprived of her hormones, you cannot help but see her personal point of view. That does not mean, however, that you should follow her exact footsteps.
What is abundantly clear from Suzanne’s book is that if we are to overcome the destructive impact of aging on our bodies, it is critical that a cure for cancer be found. Cancer is the roadblock that is denying aged people the full complement of anti-aging hormones, of drugs that increase cellular longevity by increasing telomere length, and of a novel method of rejuvenating the circulatory system that corrects the dysfunctional aged arterial wall.
For example, Life Extension has published numerous articles about the anti-aging benefits of testosterone replacement therapy in aged men.159-173 The sad fact is that so many older men already have prostate cancer that they are deprived of this youth-promoting hormone. Testosterone replacement does not appear to increase prostate cancer risk in men. Interestingly, studies show that it may be high levels of estradiol that increase prostate cancer risk in aged men.174-176 (Aging men often convert their testosterone into estradiol.) The problem is that once prostate cancer manifests, testosterone is contraindicated, and aging men have to endure the serious consequences of hormone deprivation, which include depression, impotence, vascular disease, osteoporosis, anemia, and a host of other degenerative ailments.177-198
What Is the Solution?
The Life Extension Foundation has long advocated that finding a cure for cancer should be a national priority. Not only will one of every two men, and one of every three women, develop cancer in their lifetimes,199 but the fear of cancer is denying aging people access to validated anti-aging therapies. So cancer not only directly kills 1,500 people every day, but it also causes the deaths of countless others by denying them youth hormones, telomere extenders, and therapies that could restore healthy arterial function.
Cure cancer and 563,000 Americans who would have otherwise perished from the disease will be alive 12 months from now. Cure cancer and the gates open up to potent anti-aging therapies that would significantly reverse many aspects of normal aging and possibly keep alive a million human beings who would otherwise die of an age-related disorder over the next year.
You do not see cancer discussed on the front page of the newspaper very often. In today’s surreal world, a mere threatened act of terrorism grabs the news media’s attention, while millions of Americans suffer and perish silently from cancer and other related diseases. For those diagnosed with cancer, their concern over international events is subordinated to the harsh reality that even if they beat the cancer, their bodies will suffer possible lifelong side effects from the curative therapy. Suzanne Somers’ book brings out the reality of cancer and the tough choices patients have to make. Suzanne advocates natural hormone replacement as an anti-aging therapy, yet the very hormones that make her feel better today might increase the risk that her cancer will recur. We address the dilemma faced by breast cancer patients in this month’s issue.
We at Life Extension think it is deplorable that cancer victims are still put in the terrible position of not being able to access cures for their disease that are free of side effects. For the past two decades, our nonprofit organization has exposed how cancer research is impeded by antiquated FDA policies. We have shown how the FDA delays or denies clinical studies for promising cancer therapies. We have revealed how the FDA manipulates clinical testing of cancer drugs in such a way that guarantees that the drug will fail to show efficacy. We have reported on the FDA’s police-state attacks against pioneering cancer researchers and the stifling effect this creates in the scientific community.200-211 Our unequivocal position remains that if a cure for cancer and age-related disease is to be discovered in our lifetime, the FDA’s totalitarian authority has to be abolished. Only in a scientific environment that is free of political bias will diseases as complicated as cancer be cured.
Many misconceptions exist concerning the role played by estrogens in women who have had their primary breast tumors removed and currently have no apparent sign of residual disease.
Two thirds of breast tumors are estrogen receptor positive, and only half of these patients respond to interventions that reduce the effects of estrogen. Until recently, tamoxifen was the drug of choice for the treatment of estrogen-responsive early and advanced breast cancer. Tamoxifen, however, is associated with increased incidence of endometrial cancer, uterine sarcoma, ocular disorders, and diseases caused by abnormal blood clotting.212 Many tumors eventually become resistant to treatment with tamoxifen.213 One third to one half of patients will not benefit from treatment that blocks the estrogen receptor (such as tamoxifen) or inhibits estrogen production, either because the tumor does not use hormones to grow (i.e., is not estrogen or progesterone receptor positive) or because tumors that were originally hormonally responsive develop other pathways to facilitate their growth.214
Doctors are increasingly looking at aromatase inhibitor drugs that suppress estrogen levels by inhibiting estrogen biosynthesis. The newer, third-generation aromatase inhibitors (such as Arimidex®, Femara®, and Aromasin®) are more effective in reducing estrogen levels than previous-generation drugs.213,215-19
The current theory is that women successfully treated for estrogen-receptor-positive breast cancer should aim to have reduced levels of estrogen in the body, because estrogen stimulates the growth of estrogen-sensitive tissues.220 One recent study showed that the aromatase inhibitor Aromasin® reduced recurrence of breast cancer by 32% compared with tamoxifen over a period of two to three years. The problem with this study is that while Aromasin® reduced the rate at which the breast cancer returned, the overall survival rates of the tamoxifen and Aromasin® groups were not significantly different 221 Could it be that denying a breast cancer patient adequate estrogens reduces cancer recurrence rates but also causes other health problems? We do not know the answer to this yet, but in men with prostate cancer who undergo testosterone ablation therapy, dangerous side effects are induced directly by the deprivation of testosterone.196
In another study, the aromatase inhibitor Femara® resulted in more than 40% fewer breast cancer recurrences compared to placebo after 2.4 years. This study showed a trend toward reduced overall mortality in the Femara® group, albeit not statistically significant. For patients taking Femara®, more toxicity with respect to hot flashes, joint pain, and muscle pain contributed to a statistically significant decline in quality of life. Also reported was a trend toward more new diagnoses of osteoporosis for patients who took Femara® than for those who took placebo (5.7% vs. 4.5%;).215
Several problems face hormonally responsive breast cancer patients (with no apparent remaining disease) who use a drug that artificially lowers estrogens. First of all, breast cancer cells have a high propensity to mutate into cancer cells that no longer have an estrogen receptor. These mutated cancer cells do not require estrogen and use other growth factors and pathways in the body to propagate. So for many women initially diagnosed with estrogen-dependent breast cancer, cells that may have metastasized to other organ systems will not necessarily respond to estrogen-deprivation therapy, especially in the long term and if they have lost their estrogen-receptor expression.222
Another problem is that a large fat mass (or obesity) can result in excess production of estrogens, despite aromatase-inhibition therapy in some cases.223,224 In postmenopausal women who have no ovarian estrogen production, fat cells often function like “glands,” secreting locally abundant amounts of estrogens that increase cell division and thus cancer growth.225,226 Breast tissue is largely composed of fat, especially in postmenopausal women. Indeed, tumor estradiol concentration is often higher than the concentration seen in surrounding normal tissue, consistent with local estrogen synthesis in the tumor.227 Studies show that obese women have higher rates and recurrences of breast cancer.131,228-230 This could be related to both higher insulin and leptin levels, and higher estrogen levels, seen in the obese. Insulin is a potent promoter of cancer cell growth.231-247 Leptin is a hormone that controls fat metabolism. It has been suggested that leptin can promote aggressive breast cancer characteristics that may be independent of estrogen. Leptin plasma levels correlate with total body fat, and particularly high concentrations occur in obese women.248 Furthermore, a recent meta-analysis revealed a strong correlation between body mass index and plasma estrogen levels in postmenopausal women, reinforcing the importance of lifestyle modification over currently available breast cancer treatments.217,249,250
Oncologists are increasingly prescribing aromatase-inhibiting drugs to estrogen-receptor-positive postmenopausal breast cancer patients. In the short term, this may be an appropriate therapy, especially if this estrogen-deprivation therapy can block enough cancer cell growth to induce a “cure.” Over the long term, however, there is a risk that residual breast cancer cells will mutate and become resistant to estrogen-deprivation therapy, which has long-term side effects that are not fully understood.
It is easy to criticize Susanne Somers for not taking an estrogen suppressor (aromatase inhibitor drug) and instead doing the opposite by taking an estrogen drug. Susanne’s arguments, so eloquently presented in her book, are that maintaining healthy hormone balance may be protective by virtue of maintaining better overall mental and physical health. There is evidence to back up what Suzanne states, as revealed in some of the articles in this month’s issue.
The frightening aspect to this debate is that many of us reading these words today may face these difficult choices in the future. One option is to endure the agonies of hormone deprivation; the other option is to increase the risk of cancer recurrence by taking drugs that restore youthful hormone balance. Neither option is a comforting choice for cancer patients.
Readers should note that long-term use of aromatase-inhibition therapy is currently a subject of fierce debate within the medical establishment. Even when a consensus is reached, it will not resolve how women who are apparently free of residual breast cancer should approach hormone restoration.
As Life Extension was going to press, a prestigious cancer journal published a critique of clinical trials of aromatase-inhibiting therapy, particularly as they relate to the long-term consequences of such therapy. The author of the critique, Dr. Michael Baum, states: “I consider it too early for a proper risk benefit analysis to be calculated until we have the overall survival result.”