On June 25, 2004, the US government proudly announced that 64% of cancer victims are living longer than five years, compared to a 50% five-year survival rate three decades ago.1
The grim fact, however, is that 1,368,030 among us will be diagnosed with cancer in 2004. This translates into 3,748 Americans being told each day that their lives may never be the same.2
While the government brags about statistical improvements, it ignores the horrific lifelong debilities suffered by those fortunate enough to survive cancer. The dreadful reality is that those successfully treated with conventional cancer therapies often suffer from chronic pain, depression, fatigue, immune suppression, mental impairment, disfigurement, and other side effects.3-5 On top of that, cancer survivors usually have higher risks of developing heart disease, stroke, and new cancers.6-7 Many of these lethal side effects, plus recurrence of the original tumor, can happen after the “five-year survival” milestone has been achieved.8-12
So what does all this have to do with my interview with actress and author Suzanne Somers? Suzanne is a breast cancer survivor who is doing something highly unusual. Although she had estrogen-receptor-positive breast cancer, she made a personal decision to forgo chemotherapy and estrogen-blocking drugs. Instead, Suzanne did the opposite of what conventional medicine advocates and is continuing to take her natural estrogen replacement drug. Her reason for taking the estrogen drug, despite the fact that estrogen is supposed to increase the odds of cancer recurrence, is that she does not want to suffer the agony and debility of hormone deprivation.
Suzanne Somers has authored a book on natural hormone replacement that has sold over 2 million copies. Her book eloquently extols the virtues of natural female hormone replacement in a way that will appeal to the lay reader. Suzanne’s celebrity status, her grasp of anti-aging medical concepts, and her willingness to discuss her intimate personal affairs will motivate many women to follow in her footsteps.
In this issue, we take a critical look at natural hormone drugs that make us look and feel better today but may increase our risk of cancer tomorrow. We also discuss how Suzanne Somers’ book will influence the decisions aging women make to stay biologically younger using natural hormone replacement, and the possible long-term effects of those decisions.
The most important revelation in this month’s issue is our in-depth investigation of what estrogen actually does in an aging women’s body. A lot of experts think they understand estrogen, but there are serious misconceptions as to how this hormone reacts at the cellular level. The new scientific findings we report, as they relate to how estrogen is prescribed to aging women, may turn the medical community upside down. The encouraging news is that there may be ways for women to enjoy their youth hormones without increasing their risk of cancer.
Head and neck cancer is the fifth most common form of cancer, yet most people are not familiar with this type of cancer. The mortality rate for those diagnosed with head and neck cancer (which does not include brain tumors) is high.
Radiation therapy is an important part of treating many different head and neck tumors, and is often used after surgery. Lethal radiation necrosis to the brain is one potential side effect.
Another danger of radiation therapy to the head is increased risk of stroke. A study of head and neck cancer patients who received radiation therapy found that stroke rates were five times greater than expected.13 This elevated stroke risk was found many years after administration of radiation. The average time between radiation treatment and stroke was 10.9 years, but the increased risk of stroke persisted for 15 years after radiation therapy.
For cancer patients treated with radiation therapy who later die of a stroke, the official cause of death is stroke, even though the cancer radiation therapy most probably caused the stroke. This is an example of how cancer cure statistics are misleading. The government brags that radiation therapy is curing cancer patients, yet long-term radiation side effects cause many deaths that are not attributed to cancer.
The government boasts that more cancer victims are living beyond five years, but conveniently ignores the fact that the toxic therapies often used to eradicate cancer can themselves cause premature death.
(The authors of this study do not recommend that head and neck cancer patients refuse radiation therapy, as it often buys years of extra life. Patients who have received radiation therapy to the head or neck should take extra precautions to reduce their stroke risk.)
The Estrogen Dilemma
As women enter the menopausal years, they face a difficult decision. The body’s natural production of estrogen, progesterone, DHEA, and other critical hormones needed to maintain health and vigor rapidly declines. While individual effects of menopause vary widely, most women suffer because their glands no longer produce the hormones needed to regulate critical physiological processes. Depression, irritability, and short-term memory lapses are common menopausal complaints, along with hot flashes, night sweats, and insomnia.
Scientific studies show that commonly prescribed estrogen drugs (Premarin® and Prempro™) increase the incidence of heart attack,14-19 stroke,19-21 breast and ovarian cancers,22-35 and possibly other diseases. More and more women are switching to “natural” estrogen drugs in the hope of deriving estrogen’s anti-aging benefits without the lethal side effects associated with Premarin® and Prempro™.
Recognizing that even natural estrogen drugs stimulate breast cell proliferation, proponents of natural estrogen replacement advocate consumption of fruits and vegetables, along with supplements such as indole-3-carbinol (I3C),36-50 resveratrol,51-61 gamma tocopherol,62-67 melatonin,68-75 genistein,76-91 and green tea.92-97 The cancer-preventive effects of these dietary modifications are well substantiated in the scientific literature. A concern remains, however, that we do not know for certain whether dietary modification confers absolute protection against estrogen drug-induced cancers. Life Extension addresses these controversial topics in the estrogen articles featured in this month’s issue.
If you read Suzanne Somers’ book, you will learn of the multiple wonderful benefits attributed to proper natural hormone replacement therapy. You will read expert physicians touting the benefits of so-called “bioidentical” estradiol (a natural form of estrogen), as opposed to drugs like Premarin® that are extracted from horse urine.
Our obligation is to convey factual information so that women can make a rational choice as to what they should be doing now to maintain healthy hormone balance while guarding against potential carcinogenic effects. We have in the past recommended the lowest effective dose of natural estrogen drugs, but we are concerned about the relatively high levels of estradiol (a potent form of estrogen) that some women are now taking for anti-aging effects.
Is There a “Safe” Level of Estrogen?
In response to the negative studies about Premarin® and Prempro™, some doctors believe that natural estrogen drugs are safer alternatives. Many of these natural estrogen drugs consist of estradiol that is synthesized to be identical to this form of estrogen that is made in the human body.
There is controversy, however, as to how safe estrogen produced in the human body really is. Scientific studies show that aging women who naturally produce higher levels of estrogen have greater rates of estrogen-stimulated cancers (breast, ovarian, endometrial).98-101 The published literature is also consistent in showing that women with reduced levels of estradiol have lower rates of estrogen-stimulated cancers.102,103
Postmenopausal women are increasingly taking bioidentical estradiol drugs, with or without natural progesterone. The physicians who advocate this type of hormone replacement therapy claim that since it is natural and “identical” to a woman’s own ovarian-secreted estradiol, it will not pose the same risks associated with long-term use of Premarin®. These doctors also state that this type of estrogen replacement is safe as long as it is properly balanced with natural progesterone, and blood estradiol levels are monitored to maintain physiological (normal) levels.
Critics charge that no one knows whether natural estradiol drugs are less risky than previous regimens of synthetic hormone replacement therapy. They point out that it may take decades of higher-dose estradiol use before adequate data are produced. Those concerned about higher-dose estradiol drugs believe that without controlled long-term studies similar to those that revealed problems with Premarin® and Prempro™, safety cannot be assured.
From a cancer-risk standpoint, the use of higher-dose estradiol drugs is worrisome for two reasons:
1. Estradiol at physiological (normal) levels stimulates the growth and multiplication of breast cells. This is known as mammary hyperplasia. Hyperplasia is an increase in the number of cells in a body part—in this instance, the breast. Mammary hyperplasia is a precursor and a risk factor for the development of breast cancer.104,105
2. Older women whose breast cells are stimulated to grow and divide by estradiol have an increased risk in errors of DNA replication. This occurs because each time a cell divides into new cells, the DNA in the new cells is altered slightly. After numerous cell divisions, these alterations accumulate, which can eventually result in mutations to genes that regulate cell proliferation. The accumulation of mutations in genes that regulate cellular proliferation is the under-lying cause of all cancers. Consumption of antioxidants, antimutagenic plant extracts, and other nutrients reduces certain gene alterations that lead to cancer, but it is not known to what degree cancer risk will be lowered in women taking estrogen drugs.106,107
An examination of existing epidemiological studies shows an increased risk of breast cancer in response to longer exposure to estradiol. We have summarized 15 examples of this in the sidebar on page 12 titled “Troublesome Facts About Estradiol Therapy.”
It is obvious that placing postmenopausal women on estradiol drugs is increasing their lifetime exposure to this potent estrogen, something that epidemiological studies show increases breast cancer risk. As we discuss in this month’s issue, however, these epidemiological studies often fail to account for dietary factors that may significantly alter the effects that estradiol inflicts on breast cells. Eventually, it may be shown that the adjuvant use of natural progesterone with estradiol lowers the risk for breast cancer, but this has not yet been fully documented.
So when one asks whether a “safe” dose of estradiol has been established, the answer at this time, from a cancer-risk perspective, is no. That does not mean, however, that aging women should be deprived of the benefits of estrogen. The multiple anti-aging effects of proper hormone replacement therapy may still outweigh the cancer risks. We are in fact devoting most of this month’s magazine to the role of proper natural hormone restoration in preventing and reversing many of the negative aspects of aging.
The following 15 facts about estradiol suggest a justifiable concern about breast cancer for those contemplating estradiol drug therapy:
1. Women who start menstruating early in childhood have a higher risk for breast cancer (longer exposure to
2. Women who start menstruating later in childhood have a lower risk for breast cancer (shorter exposure to estradiol)111-113
3. Women who were born prematurely have a higher risk for breast cancer (higher exposure to estradiol)114
4. Women who had early menopause have a lower risk for breast cancer (shorter exposure to estradiol)115-118
5. Women who have surgical menopause early have a lower risk for breast cancer (shorter exposure to estradiol)119-122
6. Women who have late menopause have a higher risk for breast cancer (longer exposure to estradiol)123,124
7. Women who have osteoporosis have a lower risk for breast cancer (lower exposure to estradiol)125-127
8. Women who have strong bones have a higher risk for breast cancer (higher exposure to estradiol)128
9. Women who have anorexia have a lower risk for breast cancer (lower exposure to estradiol)129,130
10. Women who are overweight or obese have a higher risk for breast cancer (higher exposure to estradiol)131-136
11. Women who are taller have a higher risk for breast cancer (higher exposure to estradiol)137,138
12. Women who bear children at a younger age have a lower risk for breast cancer (probably less exposure to estradiol)139-141
13. Women who nurse have a lower risk for breast cancer (probably less exposure to estradiol)142-145
14. Women who consume more alcohol have a higher risk for breast cancer (higher exposure to estradiol)146-148
15. Women who exercise regularly, even those who are overweight, have a lower risk for breast cancer (lower exposure to estradiol)149-156
These 15 points indicate, based on epidemiological studies, that an increase in exposure to estradiol results in a correspondingly increased risk of breast cancer. These epidemiological studies, however, do not reveal the effects of dietary modification on breast cancer risk. An in-depth discussion of this critical topic appears in this month’s issue.
Note: Some of the facts above about estradiol also pertain to the peripheral conversion of estrogen precursors (such as androstenedione) into estrone, which is another potent estrogen.