‘More is better’ need not apply to hormone therapy
It only takes a pill. It just needs to be cut out. It is all about estrogen. It is all about testosterone. Disease is the typical outcome of life built into our genetic code without the means for change. Simple, isn’t it? When it comes to conventional medicine, when it comes to the traditional medicine marketing mantra, simple is the modus operandi. Simple would be nice. Simple would be … well, simple. If only simple existed. No matter how much we may want, the body does not work on simple. The perfect example of this simple modus operandi is in the relationship between hormones and cancer.
Simple would have you believe men are nothing more than testosterone-fueled erections and women are merely estrogen-fueled hot flashes. Just look at the popular medical marketing mantra: testosterone causes prostate cancer; estrogen causes breast cancer. If a man is diagnosed with prostate cancer or a woman with breast cancer, testosterone or estrogen is the culprit, and these hormones must be eliminated. It is almost modern-day Wizard of Oz fear-mongering: lions and tigers and bears, oh my!
Though our bodies may seem simple enough, they are a beautiful, complex biochemical machine maintaining an intricate, delicate, balance designed for healing potential. Thank goodness for that complexity! Though advocated as simple, the body is anything but simple.
If it is not simple, then the opposite is true: complexity rules the day. Hormones, especially about cancer, are a perfect example of this complexity. Hormones are just one piece of a very complex puzzle when it comes to hormones and cancer. For scientific, safe, and effective hormone knowledge and therapy in patients with cancer, it takes all the following:
- Re-evaluate definition of normal
- proper hormone evaluation
- knowledge of hormone levels
- hormone balance
- hormone metabolites
- hormone receptors
- outside influences
- physiologic hormone therapy
The first question that often comes up in the discussion of hormones is are they normal. But, what is normal after all? Who is normal? That discussion could go on for days. Normal is defined as what falls within the statistical reference range of normal. Normal is then determined as a percentage of the population as a whole. The definition of normal can change based on a shift in the population as a whole. As the population becomes more abnormal, then a shift occurs as normal is re-defined. What was once abnormal is now normal, and what is now normal is abnormal.
Statistically speaking, the top 2.5% and the bottom 2.5% are determined to be statistically abnormal, and the other 95% are deemed normal. If I used that logic with my kids, a 65 on a test at school would be considered statistically normal right? From my perspective and my child’s, 65 would not be normal. A 65 falls far closer to failing than succeeding, yet it is statistically normal. This highlights the limitations of this simple definition of normal when discussing anything, but especially hormone levels in people with cancer.
This approach may work for disease medicine (though I highly doubt it), but it is not the best for the pursuit of healing from cancer.
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Proper hormone evaluation
In the past, hormone evaluation was limited to blood. Today, hormone evaluations can come in all shapes and sizes: from blood to saliva to urine. Even blood spot and urine spot hormone evaluation are available today. People like my good friend Dr. David Zava have pioneered these hormone evaluation techniques. When it comes to different methods to evaluate hormones, no method is better than another, but it is all about perspective. Each hormone evaluation is a different perspective or separate window into the room of hormone physiology. No one window is better than the other, but each provides a different window with a different perspective.
The various windows provide different clinical aspects that are helping to provide a complete evaluation of hormone physiology of the individual and to provide a complete hormone treatment regimen for the specific environment of the individual with cancer. The question becomes what perspective or what window offers the most useful information for the clinical issue at hand. Is a single image good enough, or is a panoramic view better? For me, I like the complete hormone panoramic view. In the treatment and healing of cancer, no questions should be left unanswered; or in this perspective, is viewed.
What is your number? The conventional medicine marketing mantra is full of this. Just look at the Testosterone marketing for men. “What is your number?” is a standard marketing cry for low Testosterone clinics around the country. For this reason, I call testosterone clinics the 21st-century version of the methadone clinic.
Contrary to most thought today, hormones are not just about the specific numbers. Hormones are a means of communication throughout the body; a language if you will. I am always amazed at the answers I get when I ask post-menopausal women if they still make hormones. Or men older than 65, if they make testosterone. Most will say no. Because of what they are exposed to in marketing, I am not surprised by their responses. Of course, the answer to both questions is yes. The body must have these hormones to communicate, to live, and to survive. Even after menopause, women need some estrogen.
It can be about the numbers if the numbers are exceedingly low or exceedingly high. However, that is a rare finding and usually occurs as a result of hormone therapy. Hormone impacts on individuals with cancer are rarely about the levels, but more about the balance.
Hormones must exist in balance. Balance is the source of health and wellness. Just look at the body for the importance of balance. The human body is created in balance: two eyes, two ears, two legs. Try losing a limb and see how the rest of your body is affected by the imbalance. Bumps, bruises, and even worse are definitely in the future. The loss of balance is often the precipitating cause of symptoms short term and contribution to disease risk in the long-term. The most well-publicized hormone imbalance is that of the estrogens and progesterone in women, but the irregularities of hormones are widespread in the body and have a significant impact on cancer risk and cancer healing. Imbalances are not just isolated to hormones, but also apply to neurotransmitters and the immune system. The body must exist in balance.
Metabolism is presented as merely the means to gain or lose weight. Metabolism goes far beyond this simple definition. Metabolism is the mass production of day-to-day cellular processes that help the cell survive and thrive or not. In reality, metabolism is a measure of optimal cellular and thus body homeostasis. Thus metabolism can correctly be defined and applied to all cellular and body functions that result in day-to-day cellular homeostasis.
How the body processes hormones are called hormone metabolism. Hormone metabolites are just as important as the individual hormone levels and the hormone balance themselves. It may be more important as they reflect the flow, the trend of hormone movement, which is so essential in the assessment of function. We need to look at function, not static values — the body functions. The body is by no means static.
Hormone metabolites are just as they sound—the breakdown products that are the result of hormone metabolism. Whether the body endogenously makes hormones or whether they are exogenously administered through hormone therapy, hormone metabolism manages the breakdown of these hormones to help the body survive, thrive, or not.
The error is to think that hormone metabolites are merely waste products without any activity or physiologic significance. This has been the long-held thought. The truth is that hormone metabolites are very much active in hormone signaling. Hormone metabolites provide much of the risk and side effects equated to hormones and hormone therapy in cancer that is often overlooked. Not all hormone metabolites are harmful. Some of these hormone metabolites can also provide significant protection.
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The Cancer Survivor's Guide explains how foods influence the hormones that fuel cancer and how a dietary change to a low-fat, plant-based diet can be beneficial to anyone diagnosed with cancer. Each section describes specific nutrients and how they work in your body, which foods are the best sources, recommended recipes, and offers simple, practical steps you can take during the week to increase consumption of these foods.
Hormone receptors are just what the words imply. They are the receptors that the individual hormones bind too. Once the hormones bind to the respective receptors, the signal of the hormone is then internalized inside the cell through a series of secondary messengers. Hormone receptors are the doorway to the cell. Most of these signals then interact with DNA to turn genes off/on. There are, however, non-DNA and non-hormone receptor signaling that occurs as well. Again, straightforward need not apply. As crucial as hormone receptors are to the signal transmission of hormones to the cell, they are impossible to assess except in the case of physical tissue specimens in biopsies.
We are all products of our genetics (DNA) and our environment. The DNA that we have inherited from our parents is hard-wired. In contrast, the expression of DNA is not hard-wired but is quite fluid. The lifestyle choices we make and the environment we expose our DNA to influences the very expression of our DNA. Let this settle in for a moment. Though our DNA is fixed, we can determine whether genes are turned on or genes are turned off. These effects can be good, or they can be bad. This is called the study of epigenetics or the study of things “above genetics.” Above genetics includes items — i.e., diet, stress, sleep — that are above genetics, yet influence the expression of genetics. For example, studies have shown that our diet can affect our genetic expression to increase or decrease cancer risk.  Sorry, when your mom told you to eat your broccoli, she knew something that researchers are just now discovering. Broccoli anyone?
The same “environment” that can influence genetics can also affect the expression of hormones. One might call it the study of epihormones or “above hormones” if such a review existed. Based on the current dogma and outcomes of conventional medicine in hormones and cancer, it clearly should exist.
Physiologic hormone therapy
The classic approach to most things these days is that more is better: super-size that drink, super-size those fries. Unfortunately, the same super-size logic applies to medicine today. This is no more apparent than in hormones. Just look at how conventional medicine handles low hormones: More is good, and a lot is even better.
The conventional approach to hormones is the same approach to chemotherapy: more is better; when the ole testosterone levels in men or estrogen levels in women are running on empty, you stop off at your local doc station to filler up with more testosterone or estrogen. The overdosing of these hormones is evident in the testing of these patients as well as the complications of these dosing strategies. If testosterone therapy causes cancer or thickens the blood (polycythemia) or causes aggressiveness/rage/anger issues, then why doesn’t endogenous testosterone production cause the same at age 24 when peak testosterone production occurs in men? The point is that is doesn’t.
These symptoms are simply the result of overdosing. If testosterone doesn’t cause these symptoms at the peak age of production of 24, then it shouldn’t work with optimal physiologic dosing. It only does with overdosing. The same can be said of estrogen and breast cancer. If testosterone caused prostate cancer and if estrogen caused breast cancer, then every young man and young woman would have breast cancer. They don’t. The more is better philosophy — the super-size logic — need not apply to hormone therapy. That is if your goal is health and healing.
- Liu YC, Chen WL, Kung WH, Huang HD. Plant miRNAs found in human circulating system provide evidences of cross kingdom RNAi. BMC Genomics. 2017;18(Suppl 2):112. Published 2017 Mar 14. doi:10.1186/s12864-017-3502-3.