Is Soy Healthy for Breast Cancer Survivors?

Soyfoods have become controversial in recent years,…even among health professionals,…exacerbated by misinformation found on the Internet.” Chief among the misconceptions is that soy foods promote breast cancer, because they contain a class of  phytoestrogen compounds called isoflavones. Since estrogens can promote breast cancer growth, it’s natural to assume phytoestrogens might too.

But, people don’t realize there are two types of estrogen receptors in the body—alpha and beta. And, unlike actual estrogen, soy phytoestrogens “preferentially bind to and activate [estrogen receptor beta]. This distinction is important, because the 2 [types of receptors] have different tissue distributions…and often function differently, and sometimes in opposite ways.” And, this appears to be the case in the breast, where beta activation has an anti-estrogenic effect, inhibiting the growth-promoting effects of actual estrogen—something we’ve known for more than ten years. There’s no excuse anymore.

The effects of estradiol, the primary human estrogen, on breast cells are completely opposite to those of soy phytoestrogens, which have antiproliferative effects on breast cancer cells, even at the low concentrations one gets in one’s bloodstream eating just a few servings of soy—which makes sense, given that after eating a cup of soybeans, the levels in our blood cause significant beta receptor activation.

So, where did this outdated notion that soy could increase breast cancer risk come from? The concern was “based largely on research that showed that [the main soy phytoestrogen] genistein stimulates the growth of mammary tumors in [a type of] mouse.” But, it turns out, we’re not actually mice. We metabolize soy isoflavones very differently from rodents. The same soy leads to 20 to 150 times higher levels in the bloodstream of rodents. The breast cancer mouse in question was 58 times higher. So, if you ate 58 cups of soybeans a day, you could get some significant alpha activation, too. But, thankfully, we’re not hairless athymic ovariectomized mice, and we don’t tend to eat 58 cups of soybeans a day.

At just a few servings of soy a day, with the excess beta activation, we would assume soy would actively help prevent breast cancer. And, indeed, “[s]oy intake during childhood, adolescence, and adult life were each associated with a decreased risk of breast cancer.” Those women who ate the most soy in their youth appear to grow up to have less than half the risk.

This may help explain why breast cancer rates are so much higher here than in Asia—yet, when Asians come over to the U.S. to start eating and living like Americans, their risk shoots right up.  For example, women in Connecticut—way at the top of the breast cancer risk heap—in their fifties have, like, ten times more breast cancer than women in their fifties living in Japan. But, it’s not just genetic, since when they move here, their breast cancer rates go up generation after generation, as they assimilate into our culture.

Are the anti-estrogenic effects of soy foods enough to actually change the course of the disease? We didn’t know, until the first human study on soy food intake and breast cancer survival was published in 2009 in the Journal of the American Medical Association, suggesting that “[a]mong women with breast cancer, soy food consumption was significantly associated with decreased risk of death and [breast cancer] recurrence.” Followed by another study, and then another, all with similar findings.

That was enough for the American Cancer Society, who brought together a wide range of cancer experts to offer nutrition guidelines for cancer survivors, to conclude that, if anything, soy foods should be beneficial. Since then, two additional studies have been published, for a total of five, and they all point in the same direction. Five out of five, tracking more than 10,000 breast cancer patients.

Pooling all the results, soy food intake after breast cancer diagnosis was associated with reduced mortality (meaning a longer lifespan) and reduced recurrence—so, less likely the cancer comes back. Anyone who says otherwise hasn’t cracked a journal open in seven years.

And, this improved survival was for both women with estrogen receptor negative tumors and estrogen receptor positive tumors, and for both younger women, and for older women. Pass the edamame.

Doctor’s Note

This is probably the same reason flax seeds are so protective. See Flax Seeds & Breast Cancer Survival: Epidemiological Evidence and Flax Seeds & Breast Cancer Survival: Clinical Evidence.

What about women who carry breast cancer genes? I touched on that in BRCA Breast Cancer Genes & Soy, and it’s the topic of my next video, Should Women at High Risk for Breast Cancer Avoid Soy?

What about genetically modified soy? I made a video abut that too; see GMO Soy & Breast Cancer.

Who Shouldn’t Eat Soy? Glad you asked. Watch that video too! 🙂

Not all phytoestrogens may be protective, though. See The Most Potent Phytoestrogen is in Beer and What are the Effects of the Hops Phytoestrogen in Beer?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

In health,
Michael Greger, M.D.

Michael Greger, M.D., is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous “meat defamation” trial. Currently Dr. Greger proudly serves as the Director of Public Health and Animal Agriculture at the Humane Society of the United

UNITY WITHIN: How To Build An Inner Safe Place

Dr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer and a licensed psychologist.

Unity is a word that is often associated with being together on the same page. However, as cancer survivors, the word “Unity” takes on a multitude of definitions. It is difficult to feel unified within when medical appointments steal precious hours from your days and emotions run the scale of numb to terrorized. Unity is something that must be worked on, developing it from within your being. It is important to discover tools that will help you with body, soul, and spirit. It is important to breath and connect to a quiet spot within.

As a psychologist, I often ask clients to build an inner safe place. This is a place that he/she imagines and creates with all of the necessary imagery, sounds, smells, colors, and ambiance for emotional safety. It is the first tool for developing unity within. Let me help you try it.

Allow yourself to take ten minutes away from the hustle and bustle of the day and sit quietly. You might want your journal and perhaps even crayons. Where is your favorite place to feel connected, happy, hopeful, and nurtured? This place does not have to really exist. You can imagine it.

For example, imagine that there is a place up in the sky that is surrounded by your favorite colors. There is a door with your name on it and you enter it to discover a room with a view of your favorite place (mountains, beach, meadow, park). The room is comfy with a big overstuffed chair, a cup of tea awaits you and the smell of sweet hibiscus fills the room. A candle is present if you choose to light it and as you look around, the room has everything that you can possibly need. As soon as you think of something that you need it appears. Take some time to write down what you see.

It is important to know that you do not have to re-create this same place each time you come here but this is a starter safe-place and it will change as you need it to change and as you change.

This room is very important because it is a safe and sacred place for you to come. It will allow you to get in touch with difficult emotions and explore the many choice points of your treatment. You can write anything in you journal in this room and will feel safe while you do it. Big cumbersome feelings will not overwhelm you in this room. It feels safe to cry here. It feels safe to be angry here. It feels safe to just sit and stare out of your window with a view. You do not have to do anything in this room. The room welcomes you just as you are. This room has enough mystery to it to help you re-connect to your body, soul and spirit.

Next ask yourself where you hurt or are uncomfortable. Send warm breath toward your uncomfortable body. Breath is your second most valuable tool for Unity within. Sit and breathe. Breathe gently in, as if you are going to fill yourself with nurturing oxygen, letting it swirl around in your nostrils and move into your lungs. Exhale slowly as if you are blowing out a candle. Or count as you breath in and out and continue to do so until you actually feel your body relax from inside out.

In your quiet safe place, relaxed by your breath you will be open to hear the wisdom within, that intuitive place that can help you make important decisions about what action steps you need to take. It is this place that you can be with your terror and not crawl out of your skin. It is in this place you can ask for wisdom and hear that quiet still small voice within. It is here that you can stretch your emotions as well as your body inviting the flexibility of life to help you stay open to change and options. As much as the body needs yoga, the mind and the spirit need emotional yoga. Emotional yoga is like learning to sit with your terror until it begins to transform into something different. Sitting is the key to Unity within.

Give it a try. Allow the possible frustration with learning to be with yourself to float away. Now more than ever you need to tools to be in touch with yourself. Enjoy your new safe place.

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Dr. Robin DilleyDr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer is a licensed psychologist in the State of Arizona. Her eclectic practice allows her to cross diagnostic barriers and meet clients in their need assisting them to respond to life in healthy and empowering ways rather than react to life’s circumstances.

Survivorship Gains Attention in the Medical World

Improving Cancer Standards for Breast Cancer PatientsDr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer and a licensed psychologist.

For those of you who have been treated traditionally by oncology and radiation therapy you may identify with the awkwardness felt when that day of discharge from the oncologist finally came. Now, that “discharge” is being re-examined and explored positive by the Commission on Cancer.

This morning I was listening to Dr. Andrew L. Sainer talk about cancer survivorship treatment. Dr. Sainer is the director of Helen and Harry Gray Cancer Center in Hartford Connecticut. In his short eight- minute audio he covered some very important facts and spoke of the Commission on Cancer. The Commission on Cancer is an important and clearly missing piece of this post treatment puzzle. There are current 14 million Americans living after a cancer diagnosis. 2/3 of that number will survive five years without a recurrence. This rapidly growing population has unique needs that have never been addressed by the treatment team because there has been no team.

For instance, in my case, my oncologist acted as the hub of my treatment for the first five years and because I continued on the estrogen receptor blocker, Femara for an additional five years I continued to see my oncologist twice a year. Then I was discharged. Ten years is a long relationship. It was during a follow-up mammogram that my radiologist said to me that she did not relax until a patient was 15 years out. I remember thinking to myself. “Really? I have to still be on guard.” And sure enough 15 years to the month the ultrasound tech hung—out for a significant amount of time right over my nipple. When I asked her what she was finding, she said, “Something very small.” The radiologist came in and took over the ultra-sound equipment and told me “IT” is very small. Let’s look at “IT” again in three months. This was a different radiologist than the one I had seen previously. I sat up from the table and said, “Maybe you didn’t notice my right breast is missing. I am a cancer survivor. I am not waiting for three months to recheck.”

The good news about this story is that I did follow-up with my former surgeon and had a left mastectomy. The “IT” was DCIS and it was contained (meaning IT had not spread to my lymph nodes). No follow-up was recommended. Again, I initiated a follow-up with my former oncologist. So the fact that the Commission on Cancer is going to provide every cancer patient/survivor with education and comprehensive care by the end of 2015 is quite impressive. What will that include?

First it will include better education to the survivor. The education will include:

  • Knowledge about the disease and therapy
  • Possible late effects of therapy
  • Surveillance of recurrence
  • Screening for new cancer
  • Risk-reduction lifestyles

The Commission on Cancer believes the patient should be empowered with knowledge and not be lost in the transition from treatment to survivorship. I can attest to that feeling after discharge is a powerless one filled with a loud echo of “Now What?” Thus this important word, “survivorship” is now on the Cancer Control Continuum of Care.

Survivorship Care Issues will include a team approach that will include a psychologist or social worker, assessment of rehabilitation issues, late-effects intervention, wellness strategies, and proper transition to your primary care doctor. Each patient should receive a personalized plan of wellness guidelines that include the promotion of physical activity, diet, and body weight. This plan will be discussed with the patient and the family and with primary care physician.Cancer Treatment Standards

It is my opinion that each of us need to responsible for our medical treatment and follow-up and not leave these important decisions to an over-utilized, over-worked, and under-served medical machine. However, most of you know doing treatment of any sort is exhausting, mentally fatiguing, and so overwhelming that just getting through it is the only goal at the moment. But, as treatment draws to a close and energy begins to return it is important to turn your attention and energy to the “what-now?” Once you are in the survivor phase of treatment what is it that you need to do differently to enhance the quality of your life now?

Even though, there is some discussion over the use of the word “survivor” shall we put that aside for now and realize that as a person who has had cancer in the past, we are on a continuum of care and caring for the self, as a survivor is equally important. Unfortunately, cancer is never in the past tense for those of us who have been through-it, but the phase of survivorship treatment needs to be celebrated in life-enhancing choices. Live well today my friends and fellow survivors.

Dr. Robin DilleyDr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer is a licensed psychologist in the State of Arizona. Her eclectic practice allows her to cross diagnostic barriers and meet clients in their need assisting them to respond to life in healthy and empowering ways rather than react to life’s circumstances.

A Kindred Spirit So How Do I Help?

Kindred SpiritsJean Di Carlo-Wagner, Owner, Yoga Being Only Online Advanced Yoga Training For Cancer Survivors

“I been in a *German hospital for four days with a GI bleed,” said a rather pale man sitting next to me in the international airport to whoever was on the other end of his dying cell phone. “I thought I was better, but I’m still bleeding.”  My sandwich suspended midair, I contemplated what words to introduce myself. This is regular type of occurrence for me; since becoming a colorectal survivor and devoting my life to serving others. My prayer sent up, I began, “Excuse me, I didn’t mean to eavesdrop on your conversation, but I am an 11 year colon cancer survivor, on my way to Washington, D.C. to advocate for funding and prevention of gastrointestinal cancers. My name is Jean. “  *Dan told me that he lived abroad and had had a CT and colonoscopy in Germany; but nothing was found. A mysterious G.I. bleed can be fatal. We talked like old veterans comparing war wounds. He decided to get further testing in the States.

Believing that one’s dharma is supported by the Universe makes these encounters with people “normal” for me. Dan and I exchanged emails and I’ve been keeping up with his testing. Asking my network of “experts” what they would suggest and then writing detailed emails outlining the types of tests to request and how to be a ‘pain in the ass’ patient.  We must advocate for ourselves and educate others.  As I sat taking notes at the Digestive Diseases National Coalition advocates training the next day, I thought of Dan and the many others in his situation. It is part of what makes me keep fighting for prevention, awareness and funding.

Eleven experts in the field of digestive diseases spoke to us about the progress, problems, and the promises of research. New medication is making its way to market and networking. When you combine all the diseases of the digestive track, from mouth to anus, you have a total of cancers and diseases that outweighs any single part of the body’s cancers.  There is power in integrating the digestive track diseases into a coalition of advocates: the sum is greater than its parts. The main points that stick with me are 1) that it takes so long to become an expert in biomedical research, which effects all cancer advances. We have few young doctors choosing  to wait until 44 (the average age of the doctors getting  NIH grants) to get acknowledged in their field. This means the future is already compromised.  We should all be worried about this building gap in biomedical research. Of course in the meantime, 2) medical trials are expensive, labor intensive and burdened with government paperwork. This slow down means that new medicines are taking a very long to reach consumers. We all know how expensive new drugs are and there is legislation to expedite the process.  And, most critically, the reduction in the National Institute of Health’s budget for all medical research, in “real dollars” (those adjusted for inflation) means that the money  available is crucially important to increase this year, or we will fall further behind in all medical research.

After a full day of state-of-the-art training by the DDNC, the 50 patient advocates were pumped and primed for hitting the halls of the Senate and House of Representatives.  That’s when we heard that “due to snow” the government would be closed the following day. Our advocacy day was a bust.  Since when are snow days called the day before? Erika Hanson Brown, Mayor of COLONTOWN and I, and fifteen others, braved the snow and showed up, anyway.  I had flown across the country to speak my mind, and someone was going to hear me! I had Dan on my mind and five friends who have died from this scourge of a disease called cancer.  I was determined.

Stuffing gluten free brownies into my knapsack as rewards, I walked the Halls of Congress looking for an opened door. I found that South Dakota’s office was opened. I walked in and two of the nicest young woman listened to me rattle on about why I had come to D.C. and what we needed their Senator to support. Then I asked a question I always ask, ”Do you or anyone in your family have inflammatory bowel disease?”  I want to personalize the reason for the legislation, and in this case, one of the young ladies said she had Celiac disease.  “Yes,” I told her, “you have to have a colonoscopy at age 40.”   She looked stunned, but now she was informed. I had done one good thing.  It’s my minimum quota for the effort I put into advocating:  just help one person.

Ironically, California offices were opened, but they canceled all their meetings.  It was particularly disappointing to me that my own State would have its offices opened and still cancel all their meetings. Believe me, that’s another editorial that I will write.

I was able to advocate for integrative and alternative medical treatment.  While Dan and I were on the plane to D.C., he asked me about my work in the area of yoga and meditation for cancer patients.  I told him that he could change in his life in 20 minutes a day of a meditative practice, and gave him a magazine I had been reading encouraging all things meditative. While in New Jersey, I met with the founder of a nonprofit that offers yoga to cancer patients, at risk kids and soldiers with PTSD.  Kula for Yoga is a program in the Northeast, and serving underprivileged populations around my home town.  Their commitment to serving was just what I needed to get past the blow of not being able to advocate as I had planned in D.C.

Just today, *Dan texted me that he was on his way back to Germany with few answers. The possible answer for the bleed is that he had been using high doses of NSAID drugs for two years.  These have real risks and anyone taking them regularly should consider having blood and liver panel tests to see about their clotting time and their liver function.  For now, *Dan says that it is one BM at a time! Gotta have humor. Gotta have drive! Gotta have yoga and meditation to survive!

Jean Di Carlo-Wagner
Owner, Yoga Being
Only Online Advanced Yoga Training
For Cancer Survivors

Jean Di Carlo WagnerAbout Jean Di Carlo Wagner: Owner of
E-RYT200, E-RYT500 certified with Yoga Alliance
Yoga Therapist with International Alliance of Yoga Therapists
Atma Yoga Teacher Training, certified 500 hours Los Angeles
A Gentle Way Yoga, certified 200 hours
Silver Age Yoga, certified 200 hours

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