How Hormones are Disrupting the Oncology Industry

How Hormones are Disrupting the Oncology Industry

QUESTION:

I need assistance.

I have a new patient 49 who came to me with history of 7-year survival of breast cancer, estrogen positive, and she was on tamoxifen for 3 years but told her oncologist that she would commit suicide if she was not taken off.

She has not taken tamoxifen for 2 years now. She had radiation only for her cancer.  She approached me and is begging for some hormones.  She said she is cannot live this way and no-one will help her.  I explained her oncologist would never go for it, however she said she will not even tell her oncologist. The patient is desperate.

Any thoughts, who to send to or how to treat? How do we help these women?

Thanks for your thoughts.

– Dee

ANSWER AND DISCUSSION:

Neal Rouzier, MD

I will review many references illustrating the safety of ERT in breast cancer survivors in Part II: Expand Treatment Options with Advanced Concepts, which includes topics like:

Estradiol & Progesterone | Hormones and cancer – especially breast cancer

Testosterone | Does testosterone replacement increase the risk for blood clots?

Cardiology | Can hormone optimization decrease the risk for cardiovascular disease?

PCOS | What is the role of testosterone, progesterone, and insulin in PCOS?

Estrogen in MenIs the use of aromatase inhibitors to decrease estradiol levels evidence based?

Osteoporosis and Estrogen Metabolites | Which is more effective in treatment – bisphosphonates or estradiol?

But for now, Dee, let me answer your questions by bringing up additional relevant questions.

Why do I show all the studies that demonstrate the decrease in breast CA recurrence, decrease in CVD, and improvement overall in morbidity and mortality with ERT (Estradiol Replacement Therapy)?

Why is there increased morbidity and mortality in those that don’t take ERT?

This is simply because there is an increase in breast cancer recurrence in prior cancer survivors, around 350/10,000 women (that don’t take HRT). This does not mean, though, that taking estrogen increases the risk. However, those that do take BHRT do benefit from HRT despite the resistance from oncologists. The increase in breast cancer recurrence at baseline should not be extrapolated to what happens with treatment. In every study, treatment with estrogen decreases breast cancer risk. Observation at baseline does not prove causation. The most recent issue of JAMA proved that the only drug to decrease breast cancer mortality was estrogen! It was not a SERM or AI.

Why do researchers do research and publish studies on the safety and efficacy of ERT, or of ERT with P4?

Why do research centers use P4 as an adjunctive treatment for breast CA?

In outcome studies, P4 is apoptotic to breast cancer cells, protects against cancer, and should be utilized to treat breast cancer patients despite the oncologists’ general belief that it causes cancer–they think progesterone is Provera.

Why is it that the oncologists ignore this data, even though it is in their own literature?

If the oncologist says that it is OK to take hormones, and the patient gets the predicted breast cancer recurrence (average rate of recurrence in the general population is 350/10,000), then the oncologist (and PMD that prescribed BHRT) gets blamed and sued.  However, there is no EBM (evidence based medicine) that shows estrogen increases recurrence rate in breast cancer survivors. There is EBM that shows an overall decrease in morbidity and mortality for all causes, including breast cancer with estrogen.

Odd that the scientific literature proves improved survival and quality of life, yet the oncologic world completely ignores that data.

Well, we should not.

In Part II: Expand Treatment Options with Advanced Concepts, I present the studies that very convincingly show and prove no increased risk of cancer recurrence with ERT alone, or E2 (estradiol) with P4 in all the studies. I also show the ERT did not increase risk (as does HRT with CEE/MPA), and P4 decreases risk and is apoptotic to cancer cells. Testosterone has been used successfully for 30 years as a treatment for breast cancer, and it prevents the side effects of the cancer meds.

Can you treat these poor, miserable, suffering women?

Yes, you can! (And you know what that means).

They will be so grateful. They will no longer be miserable and you can absolutely restore their quality of life and give them their life back.

I recommend that you read the book “Estrogen Matters” by Bluming to understand the benefits of estrogen in breast cancer survivors.

However, I don’t recommend treating anyone without prior consent from their oncologist. Oncologists may resist treating breast cancer survivors with any hormones.

It is the system and the system is inadequate.

The system does not protect doctors despite our clear intention in trying to help our patients.

I am also one of the few physicians that provide all the EBM studies demonstrating the safety and efficacy of BHRT in breast cancer survivors, as well as the lack of harm.

So, I have convinced you not to prescribe BHRT and at the same time told you that you are the patient’s last hope.

I have tried to script this into you believing that:

1) you absolutely must prescribe BHRT as you know it better than their doctors and you are their last hope and saving grace

2) you should absolutely not prescribe BHRT to a breast cancer survivor unless you have prior clearance from their oncologist

Again, I have not given you an answer to your question. However, I hope that I have clearly outlined both sides of the predicament as there is no easy answer. If the patient was you or yours, I would absolutely treat you and provide you with all of the supporting literature that I present in Part II: Expand Treatment Options with Advanced Concepts.

However, for others, I would refer to Dr. Bluming who is an oncologist that understands estrogen.

I hope in many ways this is helpful, and I hope to see you in Part II.

– Neal Rouzier