What Your Dr May Not Tell You About Breast Cancer: Chapter 1

WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT BREAST CANCER


How Hormone Balance Can Help Save Your Life

By John R. Lee, M.D., David Zava Ph.D., and Virginia Hopkins

CHAPTER ONE


THE HISTORY AND POLITICS OF THE BREAST CANCER INDUSTRY


Why We Can't Seem to Prevent or Cure Breast
Cancer


Why is modern medicine going nowhere in its attempts to treat
breast cancer? Our research has found that the answer to this question lies
primarily with the politics of medicine, the cancer industry, and the
industries that create the pollutants that contribute to breast cancer. We
believe that the only way to truly prevent and treat breast cancer is to go
outside the current way of doing things in medicine and stop the wholesale
pollution of our planet with petrochemicals, but the forces that would keep
things the same are very powerful and entrenched. That's why, just as they did
with hormone replacement therapy (HRT), women need to educate themselves about
pollutants, about breast cancer, and about alternative treatments. They need to
rebel against ineffective and harmful treatments, and do what they can to teach
their doctors.


Over the past few decades, conventional medicine has done very
little to make any meaningful difference in what will happen to you if you get
breast cancer, and virtually nothing it has done has reduced the incidence of
the disease. The harsh reality is, if you get breast cancer, you'll get more
treatment than you did 50 years ago, you and your insurance company will spend
a lot more money, and if it's fatal you may gain a few more months of life
(usually of very poor quality), but statistics clearly tell us that
conventional medicines for treating breast cancer such as tamoxifen, radiation,
and chemotherapy just aren't working in the long run. The way breast cancer is
currently treated is a way of doing something in the face of not knowing what
else to do. If you have an invasive or nonlocal breast cancer, your chances of
dying from it are still about one in three, the same as they have been for
decades.


The incidence of breast cancer (how many women are getting it) is
steadily rising, and the numbers are appalling: According to the National
Cancer Institute, breast cancer incidence rates have increased by more than 40
percent from 1973 to 1998. In the year 2000 approximately 182,800 women were
diagnosed with breast cancer. Since 1950 breast cancer incidence has risen by
60 percent. Some will argue that this is due to better and earlier detection.
But even for women over 80 years of age, where this early detection issue is
doubtful, the incidence of breast cancer has risen the past 30 years from 1 in
30 women to 1 in 8 women. The American Cancer Society estimated that in the
year 2000, 552,200 people in the United States would die of cancer, and 40,800,
or just over 7 percent, of those would be women dying of breast cancer. This
means that about 15 percent of women who die of cancer are dying of breast
cancer. These are the annual statistics for the United States, but it's even
more sobering to realize that worldwide about 1,670,000 women have breast
cancer.


The mortality (death rate) from breast cancer is also staggering.
If you combine mortality rates from the United States and Canada (which have
the highest rates of breast cancer in the world), in North America a woman dies
of breast cancer every twelve minutes.


Do Radiation, Tamoxifen, Mammograms, and Chemotherapy Help or
Hurt?


How can we be so bold as to state that conventional medical
treatments for breast cancer aren't working? It's very well documented. It
seems as if every time we open a medical journal lately, there's an article
showing that conventional breast cancer treatments are ineffective, harmful, or
both. Just in the past few years, major studies published in prestigious
peer-reviewed journals meeting all the conventional medical criteria for
so-called evidence-based medicine have shown that:



  • Mammograms don't really save lives (G. Sjonell, et al.,
    Lakartidningen 96 (1999): 904-913.

  • Radiation doesn't really save lives (Lancet, 22 May 2000).
  • Tamoxifen doesn't really save lives (Mitchell, et al., Journal
    of the National Cancer Institute, November 1999).

  • Chemotherapy doesn't save lives (which isn't news; we've known
    this for a long time).


So what's left for the conventional medical doctor to treat breast
cancer patients with? Nothing but the same surgical removal of the cancer that
they were doing 50 years ago. More American physicians need to face the hard,
cold facts that current therapies just aren't working and open their eyes to
alternatives for prevention and treatment of breast cancer. Let's take a broad
look at the current treatments.


Radiation


Radiation is the most common treatment for breast cancer following
surgery, and yet a recent article in the prestigious British medical journal
Lancet showed that this treatment is not working. In fact, while using
local radiation to treat breast cancer reduces deaths from this disease by 13.2
percent, it increases death from other causes, mostly heart disease, by 21.2
percent. The obvious conclusion of this study: “The treatment was a success but
the patient died.”


In other words, the radiation obliterates the breast cancer tumor
in a small percentage of women, but in the process it causes many of them to
die from other diseases. Proponents of newer and more localized radiation
procedures are claiming that it doesn't cause the damage the older radiation
techniques do, but at present this is only a claim and not backed up by
long-term follow-up. This means that there's no long-term benefit from using
radiation to treat breast cancers, because even though the cancer may not recur
at the site of the radiation, the overall chances of survival stay the same or
are slightly worse. And yet despite the fact that radiation helps so few
women—and eventually kills many of those whom it helped in the short
term—it remains the standard of care in medicine for women who have breast
cancer. How can this be? It's because conventional medicine has little else to
offer that reduces death even by 13.2 percent. If you were starving and someone
handed you a bowl of moldy old rice, you'd gratefully eat it up because it's
better than nothing.


Despite this study, published in one of the most prestigious
medical journals in the world, if you have breast cancer your doctor will most
likely insist that you undergo radiation treatments rather than
exploring possibly safer alternatives not popular among conventional
doctors.


Treating women with radiation who later die of heart disease
caused by radiation damage also affects breast cancer statistics. It means that
the diagnosed cause of death was shifted from breast cancer to cardiovascular
disease. As more and more breast cancer patients are subjected to radiotherapy,
fewer will be said to die from breast cancer, but more will be said to die of
radiation-induced heart disease. These deaths aren't counted in breast cancer
statistics, but they should be if we are to have a truthful picture of what's
happening to women who get this disease.


Tamoxifen


In the same issue of The Lancet as the above study on
radiation was a curious letter from Oxford professor Sir Richard Peto, with a
graph showing that breast cancer deaths rose about 20 percent from 1960 to
1985. From 1985 to 1997 breast cancer deaths were said to have decreased about
20 percent. Without speculating on the cause of the 1985 rise in breast cancer
mortality, or citing the sources of his information, Sir Peto instead addressed
only the matter of the recent decline.


An aside: The probable cause of the rise in breast cancer
deaths was the prescription of unopposed estrogen (not balanced with
progesterone) to menopausal women, a common practice from the early 1950s to
the mid-1970s. While the medical community acknowledged that this practice
caused endometrial (uterine) cancer, it never admitted that it also caused
breast cancer. From the mid-1970s, doctors were instructed to prescribe
synthetic progestins along with the estrogen to prevent the endometrial cancer.
This is also when the incidence of hysterectomy skyrocketed: Women felt so
terrible on progestins that they refused to take them, so doctors offered them
a hysterectomy so they would no longer have to take the progestins, and could
take estrogen only. To add insult to injury (literally), it was common practice
(and still is in some places) to remove a woman's ovaries along with her uterus
as a preventive for ovarian cancer. This misguided practice leads to many other
health problems, including osteoporosis, heart disease, fatigue, and a
diminished quality of life due to low libido, hot flashes, and other symptoms
of “instant menopause.”


Back to the supposed decline in breast cancer deaths: Because of
the “suddenness” of the decline, Sir Richard felt it was not due to fewer
breast cancers but more likely to “changes in the way breast cancer is
diagnosed and treated.” He speculated that it was “not from a single research
breakthrough” but from “the adoption of many interventions,” whatever that
means. He was later quoted in other news articles as giving credit for the fall
in breast cancer deaths to the antiestrogen drug tamoxifen.


We hope that those promoting Tamoxifen remember to mention how
many women taking it suffer from blood clots, deterioration of vision, and
diminished quality of life (hot flashes, night sweats). Also, how many women
have been forced to have a hysterectomy due to a particularly aggressive form
of tamoxifen-caused uterine cancer? It's rarely mentioned that women actually
die of tamoxifeninduced uterine cancer. When these women die of uterine cancer
instead of breast cancer, it improves the breast cancer statistics. This makes
tamoxifen look good, but it's a moot issue to the women in question.


If the side effects of tamoxifen are this bad, why is it being
used at all, and why is it being trumpeted so loudly as the great cure-all, to
the extent that the Food and Drug Administration (FDA) even approved its use as
a preventive? It's the moldy rice problem again. It's the lesser of many evils;
it's better than nothing. Very few other FDA-approved pharmaceuticals have been
made available to oncologists treating breast cancer. Theoretically—on
paper, in test tubes, and in laboratory animals used as models for human breast
cancer—tamoxifen looks promising, and the rationale for using it is based
on a solid scientific foundation: Estrogens increase the rate that breast
cancer cells proliferate, and tamoxifen slows the rate of cell proliferation by
acting as an antiestrogen.


Unfortunately, breast cancer cells in a test tube and laboratory
animals can't really explain to us how they feel, and don't live long enough to
give us a genuine appreciation for long-term health risks. Research
investigating the effects of tamoxifen on hormone-dependent cancers looks good
in the short term. However, in reality, tamoxifen is unnatural to the human
body, and these side effects are the body's warning signals that something is
terribly wrong.


Tamoxifen has been available for 25 years and its effect on breast
cancer prevention is still being debated: This in and of itself should tell us
something. Two studies, a five-year placebo-controlled one from England in
1992, and a nine-year placebo-controlled one from Italy in 1998, showed no
difference in cancer incidence between tamoxifen- treated women and controls.
The only large study in the United States was cut short, supposedly because the
incidence of breast cancer dropped so much in the tamoxifen group that they
couldn't justify withholding this treatment from the placebo group. It's worth
noting, however, that the trial was stopped at around the same time that breast
cancer began to reappear, despite the tamoxifen, in the two European
studies.


The lessons we learned from those studies are that in some women
tamoxifen may put a breast cancer to sleep for a few years, and in women who
have breast cancer it may slow the rate of recurrence for a few years. But in
the long term it tends to do more harm than good. Again, the only reason this
is such a popular treatment right now is that it seems to oncologists to be
better than doing nothing, which many of them believe is the only other viable
option open to them. But as you'll discover, it's definitely not the only
option available.


For the most part, it's only in the United States that doctors
still believe tamoxifen significantly prevents or reverses breast cancer. In
fact, now even the National Cancer Institute (NCI) has come out with a
statement that in all but a very narrow group of women under the age of sixty,
tamoxifen may do more harm than good in terms of preventing cancer. Despite
this, the FDA just approved the use of tamoxifen to treat a form of breast
cancer known as ductal carcinoma in situ (DCIS). You'll understand later in the
book why we believe this is an outrageous move.


Mammography


Like tamoxifen, radiation, and chemotherapy, mammography is big
business these days. Mammography is also conventional medicine's only real
answer to breast cancer “prevention,” although it isn't preventing cancer at
all, it's simply detecting it.


Countless advertisements and physicians are telling women to have
mammograms. But the value of this procedure is far from clear. We all know
women diagnosed with breast cancer that wasn't detected by mammography, and we
all know that mammograms present a real risk of false positive and false
negative findings. The test procedure is unpleasant and the radiation is
potentially harmful. Both tissue damage and radiation are known risk factors
for breast cancer, so it may even be logical to assume that mammography can
contribute to breast cancer.


A summer 2000 study published in the journal Spine, and looking at
data collected over 40 years, showed that women with scoliosis who received
many diagnostic X rays during childhood and adolescence have a 70 percent
higher risk of breast cancer than women in the general population. The more X
rays a woman was exposed to, and the higher the dose of radiation, the greater
her risk of breast cancer. Although the dose of radiation in a typical X ray is
now much lower than it was when these women were being X rayed, the point is
still valid: Radiation is a potent risk factor for breast cancer, its effect is
cumulative, and mammography involves forcefully squashing the breast and then
shooting radiation through it.


It has been claimed that mammography lowers the risk of dying from
breast cancer. Proponents argue that mammography can detect breast tumors a
year or so earlier than simple palpation such as breast self-exams. This early
detection, so the argument goes, leads to earlier treatment and a lower risk of
breast cancer mortality. Statistics, it is claimed, have validated this
argument.


Many statisticians, however, disagree. Statistics are not immune
from biases, which include mechanical factors (use of different measuring
instruments in different subjects), study methodology, conscious or unconscious
assumptions, age of subjects, socioeconomic factors, faulty randomization of
subjects and controls, duration of observation, and other confounding
factors.


More than 15 years ago Dr. John C. Bailar III observed that
counting survival time after treatment creates a bias in most mammography
studies because mammography detects breast tumors a year before they would have
been found by palpation. He pointed out that subjects with breast tumors found
by palpation have lived at least a year prior to the time when they would have
been found by mammography. When this year is added to the survival time of the
control women (those who did not use mammography), their survival results match
those of subject women whose tumors were found by mammography.


This means that the apparent difference in survival after
treatment was due not to earlier treatment, as a result of mammography, but
merely to starting the counting of survival time one year earlier among
mammography subjects. When this factor is included in the statistical analysis,
the so-called benefit of mammography and earlier treatment disappears. Dr.
Bailar, now professor of epidemiology and biostatistics at McGill University
and senior scientist in the Office of Disease Prevention and Health Promotion,
U.S. Department of Health and Human Services, called this the lead-time
bias.


This should not be surprising. For a breast cancer cell to become
large enough to detect by palpation, the cancer has usually been growing for
about ten years. If found one year earlier by mammography, the cancer has been
growing for about nine years, which is plenty of time to spawn metastases if
the cancer is prone to do that. The one-year difference between palpation and
mammography detection is ultimately of little importance.


Does mammography truly save lives? If you read the numerous ads
for it, you might think the case is closed—of course it does. If you read
the studies themselves, the answer isn't so clear. For example, a 1999
epidemiological study found no decrease in breast cancer mortality in Sweden,
where mammography screening has been recommended since 1985.


As a result, two Swedish scientists reviewed all published
mammography trials to evaluate their methodological quality. Their purpose was
to ascertain whether or not mammography truly saved lives. Their findings are
worth a close look.


In their analysis of eight different clinical studies on
mammography, the authors found six of them seriously flawed by baseline
imbalances and/or inconsistencies of randomization. The flaws were sufficient
to nullify the studies' claims of a benefit from mammography. The two
adequately randomized trials found no effect of mammography screening on breast
cancer mortality.


The meta-analysis conclusion is clear. Since there is no reliable
evidence that mammography screening decreases breast cancer mortality,
mammography screening for breast cancer is unjustified. This means that
physicians should not order routine mammography screening.


However, mammograms have become a substitute for breast selfexams.
If you stop having mammograms, it becomes essential that you examine your own
breasts thoroughly at least once a month. If you're premenopausal, you should
examine them shortly after your period, when hormone levels are low, so that
premenopausal lumps aren't confused with a cancerous lump. You should also
examine your breasts in the mirror and look for any unusual skin abnormalities
or dimpling. After a few months you'll become very familiar with how your
breasts feel, and you'll be able to detect very small abnormalities.


Chemotherapy


It's difficult to make generalizations about chemotherapy these
days, because there are so many different kinds, most of them extremely poorly
studied: The women who agree to try new chemotherapies are guinea pigs for a
type of treatment with a notoriously poor track record. Like most other aspects
of the breast cancer industry, there's little agreement about what constitutes
chemotherapy. We'll make the generalization that chemotherapy is an attempt to
poison the body just short of death in the hope of killing the cancer before
the entire body is killed. Most of the time it doesn't work. There are new
chemotherapies that target specific parts of the cancer process, but none have
proven themselves truly effective in stopping the entire process.


Some chemotherapy does prolong life for a few months, but
generally at the high price of devastating side effects, and if a woman does
happen to get lucky and survive that bout of cancer, her body is permanently
damaged; recurrence rates are high. The use of chemotherapy is purely a gamble,
and we don't think it's worth taking. Sometimes it works, and sometimes it
doesn't, and sometimes it makes things worse. Precious little is known about
why it works or doesn't, and it seems much smarter to find an alternative
therapy with a good track record that will both support your body in fighting
off the cancer and promote health.


There are some chemotherapylike approaches to fighting metastatic
cancer, including inducing a high fever for a number of days and insulin
potentiation therapy (see the Resources section at the end of the book), that
hold much promise with less potential damage done to the body. They are much
more widely used in Europe than the United States. They may never be widely
available in the United States, because there's no patent medicine to sell.
Europe is decades ahead of the us in its approach to treating cancer.


The Breast Cancer Numbers


It's important that women understand how much breast cancer
numbers are misused and abused, juggled, twiddled, and tweaked, depending upon
who wants you to believe what. So let's keep it simple:


Breast cancer is the most common cause of death from cancer among
women between the ages of 18 and 54, and it's the most common cause of death
period among women aged 45 to 50.


Women less than 45 years old have a 26 percent higher risk of a
recurrence of breast cancer compared to older women. The types of cancer that
these middle-aged women are dying from are not the mostly benign, “99
percent curable” DCIS “cancers” that have been detected since the early 1980s
with mammograms (thus increasing the rate of detection); they're deadly
metastatic cancers that kill quickly once they start to spread.


According to the Centers for Disease Control, cancer ranks higher
than heart disease in terms of age-adjusted death rates among people under age
65 in the United States. While heart disease has declined, cancer has not.


Breast cancer is the second most common form of cancer in women
after lung cancer, which is almost always due to smoking cigarettes.


Statistical Shell Games


The breast cancer industry has been playing a statistical shell
game with the disease by including ductal carcinoma in situ as a breast cancer
diagnosis when in fact it's rarely fatal, with or without treatment. Many
oncologists like to say that DCIS is “99 percent curable.” (Since DCIS wasn't
detectable-and thus not diagnosed or treated-until the advent of mammograms, we
don't even really know the true nature or course of untreated DCIS, because it
has always been treated if diagnosed.) We'll go into this in more detail later
in the book, but for now, we want to focus on the fact that some 30 percent of
breast cancers are DCIS.


Given that DCIS is rarely fatal, let's make some gross
generalizations to illustrate a point. If we simply eliminate DCIS from breast
cancer statistics, and thus subtract 30 percent of those who have survived
breast cancer from the statistics, we would then not have a recent drop of 20
percent (as claimed by some) but rather a rise of 10 percent in breast cancer
mortality rates. This is a crude way of making the point, but it's important to
consider when a doctor is using these types of statistics to justify a
treatment. For example, let's say a doctor justifies putting you on tamoxifen
to prevent breast cancer based on the now much-quoted “fact” that breast cancer
deaths have dropped by 20 percent thanks to tamoxifen (see chapter 12 for
details). If you know going into the doctor's office that this is a highly
questionable statistic, you'll be more empowered to make the right decisions
for yourself. In fact, we suspect that if women with lowgrade DCIS weren't
subjected to tamoxifen, chemo, and radiation, their survival rate would stay
the same-but the women wouldn't be damaged for life by the treatments.


A Word about Prevention


Of course the key to reducing the incidence of breast cancer is
prevention, but prevention is a dirty word in the breast cancer
industry unless you're referring to tamoxifen or mammograms, neither of which
is really remotely like prevention. TV personality and author Bob Arnot, M.D.,
wrote a book called The Breast Cancer Prevention Diet, which contained
mostly good, solid, practical dietary advice associated with reducing the known
risk factors for breast cancer. Sadly, he was terribly trashed by the American
media for using the word prevention, as if he were suggesting that
diet was a cure-all (he wasn't), and as if he were somehow hurting women by
suggesting that a healthy diet could fend off breast cancer (it can only help).
Arnot was an unfortunate victim of the intense breast cancer political
establishment, which savagely attacks those who stray outside conventional
medical boundaries and dare to suggest that something besides surgery,
chemotherapy, radiation, and tamoxifen might be helpful.


It may shock you to know that despite breast cancer being the
leading cause of death among middle-aged women in the United States, only 5
percent of the National Cancer Institute's budget is allocated to research on
cancer prevention. And just in case you thought some other branch of
the U.S. government was going to pitch in with some unbiased, nondrug,
prevention-oriented research, the enormously expensive, taxpayer-financed
Women's Breast Cancer Initiative will be researching only pharmaceutical drugs
(Premarin plus various synthetic estrogens and progestins) in relationship to
breast cancer. We believe this is like subsidizing the drug
companies—which already make billions of dollars in profits after
spending billions on advertising, public relations, and lobbying money to
influence congressional decisions. Drug testing should be the responsibility of
the drug companies, not taxpayers. To add insult to injury, this is research
that should have been done by the drug companies decades ago, before the drugs
were approved.


The prevention picture is equally dreary in other big cancer
organizations. When you log onto the Web site for the American Cancer Society
(ACS) and access the area about cancer prevention, it says, “At this time,
there is no way to prevent breast cancer.” This is true only in that we can't
point to one cause and make it the culprit. The reality is that we know so much
about what causes breast cancer that of course we know what we can do to help
prevent it, in the same sense that we know how to help prevent heart disease or
diabetes.


For example, there's no question that you can significantly reduce
your risk of these diseases by eating a wholesome diet, getting regular
moderate exercise, maintaining a healthy weight, and managing stress
effectively. This same approach will also help you lower your risk of breast
cancer by creating better overall health. The factors that dictate which women
get breast cancer and which don't include all of the practical
commonsense solutions listed above. Yes, we all know a health food nut who has
gotten breast cancer, but all the tofu and vegetables in the world may not make
up for a devastating insult to breast tissue such as years of estrogen
dominance or heavy exposure to pesticides or solvents. And then again they
might make a difference, depending on your genetics and a dozen other factors.
There is no one right formula for preventing breast cancer in every woman. The
key to prevention of breast cancer is being aware of the various factors that
cause the disease and avoiding them as much as possible, while at the same time
being aware of what discourages cancerous growth in breast tissue and promoting
that kind of lifestyle.


Preventive medicine is a multidimensional approach that takes the
entire human—the physical, emotional, mental, and spiritual
aspects—into account, and optimizes health for that particular individual.
Conventional medicine, which is narrowly focused on diagnosing disease and then
prescribing a drug to kill it, is a failure when it comes to treating cancer
and chronic diseases such as diabetes and arthritis because it ignores most of
the human it's purporting to heal. And this is also why, in the year 2000,
patient visits to alternative health care professionals exceeded visits to
conventional physicians—despite the fact that insurance doesn't cover most
alternative health care. Take a middle-aged woman with breast cancer who is
terribly depressed and emotionally devastated because of a major trauma or loss
in her life: All the drugs in the world aren't going to help her unless her
emotional and spiritual needs are also addressed.


Prevention is also a dirty word during the richly
endowed, muchhyped and -touted Breast Cancer Awareness Month that occurs every
October, because it's largely sponsored and funded by the drug company that
makes tamoxifen. Ironically, this firm also manufactures some of the toxic
chemicals that help cause breast cancer. Breast Cancer Awareness Month is about
being aware of cancer establishment treatments; there is little focus on
preventing breast cancer or raising funds for independent research. It really
should be called Breast Cancer Unawareness Month.


The Politics of the Breast Cancer Industry


To get to the bottom of why progress isn't being made in
preventing or treating breast cancer, it's important to consider the breast
cancer industry and what makes it tick. The detection and treatment of breast
cancer is hugely profitable in the United States, generating billions of
dollars a year. All those mammograms, biopsies, lumpectomies, and mastectomies,
and all that chemotherapy, radiation, and tamoxifen, create a substantial
income stream for hospitals, physicians, their support staff, those who make
all the equipment, and especially those who make the drugs. And that doesn't
even take into consideration all the research being done that's funded by the
hundreds of millions of dollars donated to nonprofit breast cancer
organizations. Where's the financial incentive to go outside this
framework?


If just a fraction of the research money now going into
perpetuating the above industries were honestly put into prevention and
effective treatment, the mortality rate from breast cancer would very likely
drop precipitously within a few years. But doctors keep squishing and radiating
women's breasts with mammograms, and possibly increasing their chances of
getting breast cancer in the process, perhaps because it's lucrative and it's
the standard of care. (Thanks to new technology using
the—hopefully—safer techniques of thermography and ultrasound,
mammograms are becoming obsolete anyway, but it will probably take decades to
phase out all those expensive machines.) Doctors keep doing unneeded biopsies
because they could get sued if they don't. They keep removing women's breasts
and giving them toxic drugs because they don't know what else to do, and they
feel they have to do something.


In its zeal to find a magic drug to stop breast cancer, the
industry has forgotten about healing. It doesn't have time. It has to run the
patients through the HMO mill, get them out of the hospital faster, cut costs,
avoid lawsuits, keep positions and funding, and make the drug companies happy
by promoting and prescribing their products so that they'll keep funding the
universities and hospitals.


Where does this leave the woman with breast cancer? She's terribly
afraid and confused, but she's also pretty much crushed by the cog wheels of
the medical machinery. Granted, she's what keeps the machinery going, but she
certainly isn't the center of attention; she's a supporting player in a much
larger drama. She'll be shuffled off to this operating table or that radiation
clinic not because it's necessarily best for her as an individual, and not
because that's what's going to truly help and heal her, but because she fits
into that slot, that's how the breast cancer industry machine works, and
there's no other choice. What conventional medicine presents her with is that
she's going to die if she doesn't do it. But if she sorts out the statistics
accurately, she's going to realize that if she has a nonlocal (non-DCIS)
cancer, even if she does everything the doctors tell her to do there's still a
one in three chance that she's going to die, from the cancer or as a result of
its treatment. These aren't great odds, and the path to possible recovery is
paved with treatments that can do permanent damage.


An aside: In contrast, Dr. Zava recently had contact with a
woman who was given three to six months to live in 1993 because she had a very
large, node-positive breast cancer tumor. She opted against conventional
chemoradiation therapy and began juicing and progesterone therapy as an
alternative. She called Dr. Zava (in 2001) to update him on her progress and
get a saliva test! Granted, this is just one story, but we hear them on a
regular basis.


To make matters even more confusing for the average woman with
breast cancer who wants to do some research on whatever course of treatment her
doctor is suggesting, a great deal of medical research needs to be interpreted
in light of the context in which it was conceived and/or carried out.
Unfortunately, much of it is sponsored by drug companies, so it's no surprise
that thousands of small studies come out every year advocating some point that
the companies want to pay a scientist to support. You can come up with all
kinds of medical theories and support them, with perfectly reputable references
from peer-reviewed journals found on Medline, the National Library of
Medicine's huge research database.


The Politics of Medical Research and Media Information on
Breast Cancer


The politics of physician attitudes that don't support healing,
medical research, and media information on breast cancer are disheartening,
because they're largely controlled by large drug companies with one agenda:
Sell more drugs.


At the root of physician beliefs and attitudes about breast cancer
treatment is the fact that the pharmaceutical industry now powerfully
influences both medical education and research. A recent Journal of the
American Medical Association (JAMA)
reported that 31 percent of medical
school funding comes from governmental and pharmaceutical grants; we think this
is a gross underestimate. In addition, drug company money is the driving force
behind medical research, with a profound influence on the research that's
chosen. For example, if a drug that has the potential to be patented is
competing for funding with a drug that can't be patented because it's found in
nature, there's no contest. The patent drug wins, even if the drug found in
nature might be the biggest breakthrough since penicillin.


You don't hear much that's positive about non-drug alternative
health treatments in the national media, yet millions of people visit the
Internet daily looking for information on alternative health. Would they be
flocking to the Web in such large numbers if they were getting what they need
from their doctors, or from print media and TV? We think not. Drug company
money is a primary source of advertising revenue for the media, especially for
TV and magazines, so unless you're Bill Moyers you're unlikely to expose drug
company and medical politics or talk about alternative health in positive terms
and keep your job.


How about the FDA—aren't they looking out for the consumer?
On the contrary, endorsement of a drug or treatment by the FDA should not
necessarily give you confidence that it's a safe and effective treatment.
According to the prestigious Journal of the American Medical Association
and New England Journal of Medicine,
deaths from the side effects of
properly prescribed prescription drugs are the fourth-or fifth-leading cause of
death in the United States. This doesn't even include deaths from improperly
prescribed drugs, deaths from in-hospital errors, and unreported drug deaths;
if these were thrown into the statistics, drug treatments in general would
easily be in the top three causes of death in the nation. All the drugs that
are killing so many people are approved by the FDA and considered part of the
standard of medical care.


A recent scathing editorial in the Lancet took the FDA to
task for its inappropriately close association with pharmaceutical companies.
The title of the article was “Lotronex and the FDA: a Fatal Erosion of
Integrity,” and it described the process by which the drug Lotronex, developed
for irritable bowel syndrome (IBS), was approved by the FDA after inadequate
testing, killed five people, was withdrawn, and then as put back on the FDA
table for reinstatement. The Lancet editorial concluded that,
“…private communications appear to have subverted official procedures, while
suppressed scientific debate has superseded a full and open review process….
The Lotronex episode may show in microcosm a serious erosion of integrity
within the FDA, and in particular CDER [Center for Drug Evaluation and
Research], whose operating budget now depends on industry money.” Buyer
beware.


The original intent of the FDA was to protect consumers from
dangerous products, but the agency appears to have lost its way, and to be
heavily influenced in its decisions by the drug industry. A recent survey
conducted by the newspaper USA Today found that 54 percent of the
time, experts hired to advise the FDA on which medicines should be approved for
sale have a direct financial interest in the drug or topic they're asked to
evaluate. In turn, it's very common for FDA employees to retire to well-paid
positions on the advisory boards of large drug companies.


So what's a woman to believe? You need to find medical authorities
whose opinions you trust: people who have been successful in their practice and
proven right in their viewpoints over and over again for decades. People whose
opinions are not based on how large a grant they're getting from the drug
industry, or the soy industry, or the dairy industry, or a vitamin company, but
people who are objectively and intelligently looking at the facts, interpreting
experience, and evaluating studies. Put your trust in a physician who's willing
to take the time to talk with you; after all, this is a life-and death
matter.


How about doctors who would like to try treatments for cancer that
are outside the mainstream? They can't: They're forced to use medications (even
if they know they aren't working well), because there are no large-scale
studies to prove the effectiveness of alternatives and thus the FDA will not
approve them. (The evidence proving the effectiveness of conventional medical
treatments is scant, but that's politics.) If an alternative treatment doesn't
have FDA approval, a doctor can be fined, be reprimanded, or even lose his or
her medical license for using it. If you find the rare and courageous physician
willing to guide and support you through an alternative treatment, be
grateful!


The Implications of Being Honest


The political and financial implications of admitting that
conventional hormone replacement therapy, plastics, pesticides, and other
environmental toxins disrupt the body's ability to manufacture normal levels of
hormones and consequently contribute to causing breast cancer are enormous.
(We'll explain how and why these things can cause breast cancer later in the
book.) Just think what would happen to the drug company giants if they were
forced to admit that their products had contributed to the deaths of tens of
thousands of women? The tobacco companies would have to move over in the
litigation courts. However, the largest drug companies alone (never mind the
pesticide and plastics companies) spent $74.4 million in 1997-1998 to influence
congressional thinking via their lobbying efforts. That's one powerful
influence. The only potentially stronger influence is your vote.


Thanks to an undeniably steep rise in the incidence of prostate
and testicular cancer, Congress has taken some action to find out more about
how chemicals that mimic hormones affect humans. A 1996 mandate from Congress
charged the Environmental Protection Agency (EPA) with examining the hormonal
effects of the top 100 selling chemicals in the United States. As the first
studies trickle out, the evidence is clear: We are awash in a sea of chemicals,
many of them estrogenic in nature, that profoundly affect every aspect of our
health. Because estrogens oppose or negate the actions of testosterone, our
little boys—and eventually men—are as profoundly affected as women
are.


As it becomes clear to our political representatives that these
chemicals are affecting their own families, perhaps they'll be inspired to take
action to protect their constituents. It's also incumbent upon each individual
to maintain a lifestyle that's protective—this alone would dramatically
change the economics, because millions of people would stop spraying their
homes, lawns, and gardens with pesticides; start buying organic produce; and
stop eating hormone-laden meat. (Did you know that U.S. beef is banned in
Europe because of the hormones it contains?)


The Bottom Line


The bottom line is that a woman with breast cancer is left with
few viable options from the medical community. She can't completely trust
breast cancer research or recommendations about medical treatments, and she
lives in a culture that's averting its gaze from the real causes of her
disease. Thus, it takes enormous courage and fortitude to stand up and take
charge of your health, to question your physician and ask for clear answers,
and to carefully examine alternatives. We hope that through this book we can
inspire you to do just that.


Perhaps this excerpt from a letter to Dr. Lee will be
inspiring:


My deepest appreciation to you for being gutsy enough to tell me
your opinion concerning tamoxifen. You advised me against it, giving me the
courage to buck my very pushy oncologist who wanted me to take it. I have been
thriving without tamoxifen. I've had several follow-up mammograms and was told
the opposite breast looked “textbook perfect,” and the breast that had the
lumpectomy looked normal and benign.


I am 56, postmenopausal, and am using progesterone cream. You
reassured me it was safe even for a woman like me with high estrogen and
progesterone receptors, explaining this means progesterone can get in and do
its job of stopping the cancer when the receptors are present.


When I heard the flap about the “hazards of progesterone” I knew
before even checking further that it was probably a botched reporting job that
really referred to the synthetic progestins.


Thanks to you my life has been quite serene despite my diagnosis
of cancer. I think progesterone is a mood elevator, also. I have blessed you
silently many times since you replied to my letter asking about tamoxifen.


Blessings on you and your work,
MH

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