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.
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Excerpted from What Your Doctor May Not Tell You about Breast Cancer by John R. Lee Copyright © 2003 by John R. Lee. Excerpted by permission.
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