Breast cancer remains the most commonly diagnosed cancer among women in the United States, other than skin cancer. According to the National Cancer Institute, there were an estimated 232,000 new cases in 2015, and 40,000 deaths from the disease. The number of survivors has risen dramatically over the years, and now stands at nearly three million. Despite tens of millions of dollars invested into research each year, little progress has been made in the fight against breast cancer. Not only are mainstream treatments like chemotherapy, radiation, and surgery generally not very effective, they also come with a host of dangerous, and sometimes deadly, side effects. Life-saving solutions don’t start with toxic drugs and risky treatments but prevention. It’s critical to note that prevention involves more than just exercising or purchasing a supplement. Like any inflammatory condition, a whole-body approach is needed in overcoming breast cancer.
There are a number of risk factors in the development of the disease. While some of these are out of our control, others clearly are not.
Dr. Susan Silberstein, health educator and author of Hungry for Health, shares some of the well-established facts regarding diet and cancer. “We know from the National Academy of Sciences and the World Health Organization that 70 to 80 percent of all cancers are diet related. We know from the National Cancer Institute that 70 percent of all breast cancer deaths are avoidable through dietary change. Much of the information we have comes from studies of Asian women, who have much lower rates of breast cancer when they are in their native countries and they are consuming their native diets. But as soon as they move to the United States and they adopt our Western diet high in meat and fat and dairy, their breast cancer rates go up 400 percent and meet the breast cancer rates of women in this country, and that happens in only one or two generations.”
Dr. Charles Simone, director of the Protective Cancer Institute in Lawrenceville, New Jersey, explains the association between fats and disease: “We know that fatty foods actually convert normal cells into problematic cells. Consuming high-fat foods, particularly unsaturated fats, increases free radical production, damaging the cell membrane. At this point the damaged cell has two choices. It can die. That’s fine, because if it dies, you make another one. Or it can repair itself. In the repair process, a cell can go awry and metamorphose into a cancer cell. So fats cause free radicals, which damage cells, which in turn try to repair themselves and transform themselves into cancer cells.”
Robin Keuneke, a natural food counselor and the author of Total Breast Health, points to another diet-related factor: essential fatty acid deficiencies. These fatty acids are found, for example, in extra-virgin olive oil. Many studies have linked Italian diets, which contain lots of extra-virgin olive oil, to lower rates of breast cancer. Other diet choices that seem connected to higher rates of cancer are cooked meat and fried foods. Keuneke notes, “One of the theses of my book is that burned meat and fried foods are linked to breast cancer. I found four studies linking burned meat, such as bacon, to cancer. Yet the so-called experts said there was not enough information to recommend changes in cooking.”
This is not true. The first study was published more than forty years ago. It was a population study looking at Seventh-Day Adventist women, who have a relatively clean diet. It found that women who ate the greatest amount of fried potatoes had the highest rate of breast cancer.
Hot, spicy foods, oily foods, and stimulants, such as coffee, black tea, and drugs, should also be avoided. Water should be pure, free from fluoride, chlorine, pesticides, and other synthetic chemicals.
Tobacco and alcohol are leading contributors to cancer. “We know that tobacco is the number-two cause of cancer in our country and the number-two cause of breast cancer as well,” Dr. Simone says. “Regarding alcohol, we know that two to three drinks per week is enough to confer a twofold to threefold risk of getting cancer of the breast independently of everything else. So the number one, two, and three causes of breast cancer—a high-fat diet, smoking, and alcohol consumption—are totally within our control.”
Dr. Lise Alschuler, author of The Definitive Guide to Cancer, a manual on alternative and integrative approaches to preventing, treating, and healing cancer, tells us that there is a linear relationship between the amount of alcohol that a woman consumes and her risk of breast cancer. With every drink added on a daily basis, a woman’s risk of breast cancer will increase proportional to that added alcohol. However, there is a way to mitigate the increased risk.
“There have been some interesting studies to show that if a woman drinks, let’s say, more than one and a half drinks a day, her risk of breast cancer goes up by about 30 percent,” Dr. Alschuler says. “If, however, she consumes folic acid in the form of a multivitamin or as some sort of supplement, her risk of breast cancer with that one and a half drinks only goes up 5 percent. So the folic acid clearly has a way to reduce some of the damage from alcohol. This is good news for the women out there who enjoy a glass of wine in the evening, because it’s possible to drink some alcohol as long as you’re consuming some folic acid as a supplement in the same day as well. Without the folic acid, alcohol is a clear and very strong risk factor for breast cancer, and most likely cervical and ovarian cancer as well.”
About 5 to 10 percent of breast cancers are believed to be hereditary. Certain inherited gene mutations can cause normal cells to become cancerous. Specific mutations in the tumor-suppressor genes BRCA1 and BRCA2 are known to be associated with increased risk of breast and ovarian cancers. According to the National Cancer Institute, BRCA mutations account for 20 to 25 percent of all hereditary breast cancers.
Although certain genes carry high risks for cancer and other diseases, caution is urged in how we respond. The actress Angelina Jolie had a double mastectomy and removal of her ovaries after learning that a mutation in the BRCA1 gene gave her an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. She determined that this was the right course of action in her particular situation and correctly implores other women to get advice and consider all of their options before making any of their own decisions. In a New York Times commentary in March 2015, she stated, “A positive BRCA test does not mean a leap to surgery. . . . There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.”
This case raises an urgent question regarding invasive surgery as a preventive medical procedure due to certain genes associated with disease. This risk model used is a mathematical model that does not take into account what if we changed the circumstances of our lives.
Dr. Christiane Northrup, a board-certified OB-GYN physician and author of several bestselling books including Women’s Bodies, Women’s Wisdom and Women and Menopause, offers her comments. “I agree that everyone has a right to whatever they choose to do with their bodies, and if your conventional doctor tells you that you have an 87 percent risk of breast cancer and you don’t know anything about [alternatives], which I’ve spent my whole life teaching, then her decision makes absolute sense.
“The whole flap around the Angelina Jolie decision is, unfortunately, going to get women in this huge state of anxiety. Ms. Jolie has the right to do what she did, and I completely understand it. The problem is that when you are a celebrity of that fame–she is a world citizen–your decisions influence unduly other people, and you have to take some responsibility for that. Her decision is fine. The article that she wrote, the op-ed piece was beautifully written and everyone can understand it.”
With epigenetics, people have been led to believe that if you have the gene you inevitably get the disease, Dr. Northrup says, adding that research proves otherwise. (See chapter 15 for a discussion of epigenetics.) She cites several recent studies as examples. One found a 50 percent reduction of all cancer risks, including breast cancer, once vitamin D levels were in the optimal range. A 2013 article in the New England Journal of Medicine reported that since 1980, 1.3 million women “were overdiagnosed and overtreated for cancers they would possibly die with but never die from.”
Another study, published in the Archives of Internal Medicine, followed 200,000 Norwegian women between the ages of fifty and sixty-four over two consecutive six-year periods. Half received regular periodic breast exams or regular mammograms. The others had no regular breast screenings. “The study reported that those women receiving regular screenings had a 22 percent increase in breast cancer just because the screenings showed things that then were treated in the conventional way,” Dr. Northrup explains. “The authors said chances are good that what happened in the others is they might have had exactly the same incidence of things we pick up on screening, but that the body healed those early cancers.
“What you and I want women to know is there are so many other choices fully backed by science. Just the vitamin D thing alone or the New England Journal thing alone makes so much sense to me, and having been on the frontlines of women’s health for so many years, I can tell you that women are tortured. They’re tortured by this conventional approach.”
Dr. Siberstein adds her thoughts on this issue. “In my experience, and I’ve worked with about 12,000 breast cancer patients, we also find that only 20 percent of the women have conventional risk factors. We tried to figure out where the rest of this breast cancer came from. And what we found is lifestyle factors. Now this is empowerment. This is empowering because you can’t do anything about the conventional classical risk factors. You can’t change your sex or what family you were born to or your menstrual history or the history of having given birth or not. You have no control over that, but we have tons of control over our lifestyle factors. And research shows that changing our lifestyle choices can be the difference between just having a loaded gun and pulling the trigger. In other words, we can be dealt a crappy set of a hand of cards, but it’s the lifestyle factors that influence how that deck of cards plays out. As I say, genes impel but they don’t compel.”
Exposure to estrogen plays a critical role in breast cancer. Dr. Michael Schachter, a complementary physician from New York, explains. “Women whose menstrual periods start when they are relatively young have an increased risk for developing breast cancer, as do women who have a late menopause,” explains Dr. Schachter. “This suggests that a woman who has a longer exposure to female sex hormones during her lifetime is at greater risk for developing breast cancer and that estrogen, the female sex hormone that stimulates cell growth, may play a role in its formation. Women who have no children and women who have children but do not breast-feed also have an increased risk. This suggests that the other female sex hormone, progesterone, may have a protective effect.”
Estrogen and progesterone tend to balance each other in the body. “Excessive estrogen or reduced progesterone may lead to a condition known as estrogen dominance,” Dr. Schachter says. “The symptoms of estrogen dominance include water retention, breast swelling, fibrocystic breasts, premenstrual mood swings and depression, loss of sex drive, heavy or irregular periods, uterine fibroids, craving for sweets, and fat deposition in the hips and thighs.
“Estrogen tends to be transformed into two major metabolites in the body. They can be called the good and the bad estrogen, just as there are the so-called good and bad cholesterol. The bad estrogen, known as 16-alphahydroxyestrone, favors the development of breast cancer, whereas 2-hydroxyestrone seems to protect against it. Certain chemicals stimulate the formation of one or the other.”
Xenoestrogens are chemical substances that are foreign to the body but behave like estrogens. “These substances mimic estrogen’s actions,” Dr. Schachter says. “Some xenoestrogens can reduce estrogen’s effects. These varieties, which are rapidly degraded in the body, usually occur in plant foods such as soy, cauliflower, and broccoli. They protect against the development of breast cancer. Other xenoestrogens, typically synthetic ones, appear to stimulate cancer growth.
The amount of synthetic chemicals produced annually has jumped into the billions. “We are living in the petrochemical era,” Dr. Schachter says. “Many of these compounds are toxic, mutagenic, and carcinogenic,” he warns, adding, “the majority have not been adequately tested for toxicity, let alone for their environmental and ecological effects.
“Many synthetic chemicals behave as bad xenoestrogens, particularly pesticides, fuels, and plastics. They do so in various ways. Some enhance the production of the so-called bad estrogens, and others bind to estrogen receptors, inducing them to issue unneeded signals to increase cellular growth. Xenoestrogens may enter the body through animal fat, since they tend to accumulate in fatty tissue and tend to concentrate as you go up in the food chain.
“Xenoestrogens tend to be synergistic so that a mixture of tiny amounts of many chemicals may have dire effects.”
Another possible cause of breast cancer is poor lymphatic drainage. Dr. Sidney Ross Singer, a medical anthropoplogist who did graduate work at Duke University, specializing in biochemistry, has championed this point in his book Dressed to Kill: The Link between Bras and Breast Cancer. Dr. Singer explains: “The lymphatic system is so underemphasized by modern medicine. When I was in medical school, there was not even ten minutes’ discussion of it. Yet it is a critical part of the body.”
The lymphatic system is the circulatory part of the immune system. It consists of tiny vessels, like capillaries, microscopic in size and originating in all the tissues of the body. They drain the tissue of fluid, toxins, debris, cancer cells, bacteria, and so forth. The blood flowing through the blood vessels delivers oxygen and nutrition through capillaries under pressure. The fluid in the blood oozes out to bathe the tissues. This fluid is called lymph fluid. It is the medium of exchange through which nutrients are delivered to the cells.
As the cells take in oxygen and food and give off their waste, some of the cell debris is flushed out through this other channel, the lymphatic system. For the breast, most of the lymph nodes are located in the armpits. These nodes are tiny factories for white blood cell production in response to infection. They filter out the lymph fluid, which then goes back to the bloodstream and through the heart.
This pattern of flow is how the body works normally, Dr. Singer says. However, “when you wear a constrictive garment, the pressure of the garment, such as the elastic of a bra, presses on these tiny vessels, shutting them off and preventing them from draining. They have no internal pressure; they are passive drains. They are not like the blood capillaries, which are under pressure from the heart. As soon as they are constricted because the bra lifts the breasts and gives them a different shape—which requires pressure—there is a backup of fluid in the breast, which is a condition called lymphedema, or edema for short.” This pressure and backup can cause pain and tenderness in the breasts.
Before a woman has her period, her estrogen level is very high, and this causes generalized body fluid retention. The condition goes away after the hormones drop and the woman starts having her period. But during that time of elevated fluids she has typically been wearing the same size bra she wore all month, even though her breasts have been a little bigger. As a result of the constriction from the bra, which has become like a tourniquet, the breast cannot drain the fluid, and it backs up, causing congestion in the breast tissue.
The end result, Dr. Singer explains, is that “the cells are sitting in their own waste and debris. The pressure builds, there’s tenderness, and cysts form. That’s why women get cysts in their breasts. These cysts, which are filled with lymph fluid, eventually become hard. This condition is called fibrocystic breast disease. Eighty percent of American women have it, and it’s because of the bra.”
The late Dr. John Gofman, professor emeritus of molecular and cell biology at the University of California, Berkeley, sounded the alarm on the harmful effects of X-rays in his book Preventing Breast Cancer.
The effects of X-rays take years, even decades, to manifest, which is why orthodox medicine does not pay attention to this danger. Indeed, X-rays are standard practice for medical diagnosis and treatment. “The incubation time is what has led organized medicine exactly in the wrong direction,” he said.
“In the first half of the twentieth century, medicine looked at treatments in this way: If you gave someone poison, the effects would be seen in weeks or months. They did not think in terms of years or decades. What we have learned about X-ray–induced cancer is that a very small proportion occurs in the first few years after the X-rays are administered. But most of them take ten, twenty, even fifty years. Women with breast cancer who are forty-five, fifty, or sixty are thinking, ‘Why me? I haven’t done anything wrong.’ What these women are not thinking about is what they were exposed to early in life.”
It is not the radiation itself that persists but chromosomal damage, Dr. Gofman said. “Inside the nucleus of every one of our cells is a string of DNA organized into forty-six chromosomes. That’s a treasure. Damage to your chromosomes is going to be there for the rest of your life.
“A couple of years ago, I tried to answer this question—not whether X-rays cause breast cancer but what part of all breast cancers are being caused by Xrays? My estimate was about 75 percent. Everybody said, ‘Oh, that’s too high. It must be much lower.’ Since that time I’ve done much more extensive work, and I have changed my numbers from 75 percent to more than 90 percent. Moreover, I now have enough data on a variety of other cancers to say that most cancers, not just breast cancer, are caused by medical X-rays.”
Whether Dr. Gofman was 100 percent right or just partly right—whether medical X-rays are a primary cause of breast cancer and other types of cancer or merely an important secondary factor that until now has been ignored by our government and the medical establishment—women need to recognize the seriousness of the problem and insist that radiation exposures be as minimal as possible.
The initial symptoms of breast cancer include thickening, a lump in the breast, and dimpled skin. Later on there may be nipple discharge, pain, ulcers, and swollen lymph glands under the arms.
Once breast cancer is diagnosed, the prognosis depends on the course of the disease. The staging of breast cancer involves the size of the cancer in the breast, whether it has spread or metastasized to regional lymph nodes, and whether it has metastasized to distant organs. The more lymph nodes involved and the greater the size of the tumor, the worse the prognosis. Stage zero is limited to the topmost layer, and the five-year survival rate is about 100 percent. In stage four, in which cancer has metastasized to lymph nodes above the collarbone or has distant metastases to organs such as the liver, lungs, and brain, the five-year survival rate drops to 22 percent.
The use of tamoxifen is highly touted by conventional medicine. It has been used for nearly forty years as a treatment to prevent a recurrence of breast cancer. While it may benefit some women, it is also a highly toxic drug with serious side effects. We saw earlier that excessive estrogen production is held responsible by some for breast cancer. This is the rationale for prescribing tamoxifen. However, this treatment is far from the panacea it is claimed to be.
Tamoxifen is in a class of drugs collectively known as SERMs, serum estrogen receptor modulators. Although the way these drugs work is not totally understood, it is believed that SERMs block the action of estrogen on the breast tissue, which in turn inhibits the growth of tumors. Many but not all breast cancers require estrogen to grow. These types of tumors have a site on the cell called an estrogen receptor. Tamoxifen competes with estrogen to reach these receptors, where it creates a barrier that prevents estrogen from binding to the cell.
In theory, then, tamoxifen acts like a phytoestrogen, although it has contradictory effects. In the breast it seems to reduce the effects of estrogen on tumor growth, yet in other parts of the body it acts like one of these estrogens, stimulating growth, for example in the uterus, where it can cause endometrial cancer. According to Dr. Sherrill Sellman, naturopath, psychotherapist, and author of the best-selling book Hormone Heresy, “It’s unpredictable in the sense that we don’t really know what are going to be the consequences in a woman’s body.”
In the early 1980s American researchers began to speculate about whether tamoxifen might actually prevent breast cancer in women who had never had the disease. So in 1992 the National Cancer Institute initiated a $60 million clinical trial to test tamoxifen as a cancer preventive. Thirteen thousand healthy women who were at higher than average risk for breast cancer were enrolled in the trial. Half the women took tamoxifen (20 milligrams a day); the other half received a placebo.
From the beginning, the Breast Cancer Prevention Trial was controversial. Critics of the trial were outraged that healthy women would be exposed to the health risks associated with tamoxifen.
Results of the trial were made public in April 1998. At first glance, the trial results seem impressive. Women in the trial who took tamoxifen had a 44 percent reduction in breast cancers compared with the placebo group. But these results are misleading; tamoxifen also caused uterine cancer, blood clots, and cataracts. In fact, women who got tamoxifen had almost three times the rate of endometrial cancers and blood clots. Two prominent health groups, the National Women’s Health Network and Public Citizen, have calculated that for every thousand women who take tamoxifen, there will be 2.9 fewer cases of breast cancer, but 2.8 more cases of extremely serious health problems. Even more important, results of the trial show there is no difference in overall survival rates or in the number of women who died of breast cancer.
In addition to cancers, blood clots, and cataracts, tamoxifen also caused strokes, hot flashes, vaginal discharge, mood changes, menstrual irregularities, and skin rashes.
In October 1998, the Food and Drug Administration (FDA) approved the use of tamoxifen to reduce the risk of breast cancer in healthy women. But even members of the FDA’s own advisory committee voiced concerns about giving tamoxifen to healthy women. One committee member noted that every woman who took tamoxifen was exposed to the health risks, but only a few women would benefit from the drug.
Critics of the FDA say that approval of tamoxifen as an anticancer drug is premature. Two European studies found tamoxifen provided no benefit as a preventive measure. Still other criticism focuses on the statistical model (known as the Gail model) used to assess breast cancer risk for women considering taking tamoxifen as a cancer preventative. Opponents say this model greatly overstates risk, putting large numbers of women into a high-risk category and therefore eligible to take the drug.
In addition to tamoxifen, raloxifene has also been approved by the FDA to reduce the chances of breast cancer in high-risk postmenopausal women. According to a 2012 National Cancer Institute fact sheet, the common side effects of tamoxifen and raloxifene include hot flashes, night sweats, vaginal dryness, and disruptions in menstrual cycle. Less common but serious side effects of tamoxifen are blood clots, strokes, bone loss, mood swings, endometrial and uterine cancers, and cataracts. Side effects of raloxifene include blood clots and stroke. Animal studies found a link between tamoxifen and liver cancer in rats, but the results of human studies have been less conclusive. A Swedish study looked at 1,327 breast cancer patients who took 40 milligrams of tamoxifen a day for two to five years. Comparing this group to one of the same size that didn’t take the drug, it was found the tamoxifen users upped their chances for getting uterine cancer sixfold.
Strangely enough, many women’s groups are supporting and advocating this treatment. Most of the time, however, these are groups that take money from the pharmaceutical industry. But other women’s groups have been the primary activists opposing tamoxifen, the lead group being the National Women’s Health Network. And there have been so many false reports and so much misinformation that unless you really investigate the issue thoroughly, you will very seldom get access to truthful data. As Dr. Sellman says, “It’s very easy to play with results, stats, and studies to make it look like something wonderful is occurring when in fact it is a scam. This drug has the potential to be such a big money spinner. It is already the number-one drug given to women with breast cancer. The industry will stop at nothing to get its drug out there. Health is not their primary concern.”
We have a health care system in the US that emphasizes early diagnosis and treatment. On face value this sounds like a logical and prudent approach. But coercing healthy individuals to subject themselves to tests searching for microscopic signs of illness is far from merely an overzealous waste of time and money because these tests are frequently not benign—they can be invasive, harmful, and even fatal. There is perhaps no better example of this than the $5 billion American women spend annually on mammograms. Lauded as a tool that saves lives, mammograms are starting to come under attack by a host of critics and consumers and for good reason.
A mammogram is an expensive test that requires a slew of health care professionals: a skilled technician to do the procedure, one or two board-certified radiologists to interpret the results, and more time by the primary care physician to discuss the results. If there is a suspicious finding, then usually there is a repeat mammogram, possibly a surgeon, a surgery suite, a nurse, and an anesthesiologist to do a biopsy, then a pathologist to interpret those results, then back to the primary care physician. How many thousands of dollars does this add up to so far? And how much stress and anxiety does it create for the woman who worries about the outcome? Studies show that women experience severe psychological distress for up to a year or more as a result of a breast cancer scare.
Nowhere in this scenario are women warned that there is a dark side to mammograms. They actually are a crude and inaccurate diagnostic test for breast cancer. There are large numbers of both false positives and false negatives, meaning that women will be told they have cancer when they don’t, and told they don’t have cancer when they do. A large Swedish study concluded that an incredible 70 to 80 percent of all women with a positive mammographic diagnosis of cancer were found not to have cancer on biopsy. A 2015 editorial in JAMA Internal Medicine warned of the dangers of overdiagnosis: “Overdiagnosis is the diagnosis of a tumor that would not have become clinically apparent in the absence of screening. Treatment of an overdiagnosed tumor cannot provide benefit, but it can lead to harm.” This editorial referenced a recent study that found that more mammograms did not equal reduced detection of larger cancers or lower death rates. Over the course of the next decade, American women are expected to spend as much as $70 billion on unnecessary surgeries stemming from false positive mammogram results.
It is estimated that for 2,000 women who receive mammograms regularly over a ten-year period, one life will be saved but ten more will undergo needless and harmful treatment for cancer that they don’t have—including chemotherapy, radiation, and even breast removal. Conversely, a supposed clean bill of health from a normal mammogram result is not something that should cause any woman to breathe a sigh of relief. Many women have a negative mammogram only to discover a suspicious lump on their own a few weeks or months later, and it is estimated that a full 40 percent of women between age 40 and 49 will have breast cancer that goes undetected by mammography.
Far worse than the fact that mammograms do not provide reliable results is the fact that they are dangerous, due to the extreme amount of ionizing radiation emitted from the machine directly to vulnerable breast tissue. According to Dr. Samuel Epstein, the amount of radiation from a mammogram is 200 times that from a chest X-ray. Research presented at the Radiological Society of North America’s Scientific Assembly incriminated low dose radiation as a key factor in the development of breast cancer. The research demonstrated that women were 2.5 times more likely to develop breast cancer if they had received either a mammogram or chest X-ray before the age of 20.
Mainstream medicine tells us that more women have breast cancer than ever before but the survival rate has increased because of mammograms and early treatment. They don’t tell us that a significant percentage of the increase in breast cancer is due to the fact that mammograms are finding cancer that isn’t there, which would possibly explain the improved cure rate. They likewise don’t tell us that the definition of breast cancer has changed significantly since the advent of mammograms. A frequently overlooked statistic shows that the rate of one type of breast cancer, ductal carcinoma in situ (DCIS), has skyrocketed by 328 percent since mammograms were first introduced in the 1970s. DCIS is a condition that can only be found by mammography because these lesions are too small to be picked up by physical examination. DCIS is currently the most common diagnosis resulting from breast tissue biopsy, but is DCIS even breast cancer at all? Ductal carcinoma in situ is actually a precursor lesion for breast cancer. Rather than cancer itself, a precursor lesion is a collection of cells that could grow into breast cancer, but also might not; we simply cannot know and have no way to predict the outcome. DCIS has been called the poster child for uncertainty because we really can’t say whether it is even a serious threat to women’s health: studies of DCIS that were missed at biopsy suggest that the lifetime risk of progression to cancer if untreated is very low.
The mammography industry is very lucrative and powerful, and has worked effectively to prevent other means of breast cancer identification from being developed. In fact, studies show that MRI would likely be more effective at identifying breast cancer, and thermography also shows promise as a technology that is non-invasive and does not emit radiation. While a mammogram begins to detect cancer clumps of about 4 billion cells, thermographic imaging may be even more sensitive, picking up abnormal growth as small as 256 cells. However, we must keep in mind that so-called early detection is a dangerously misleading term because finding cells that are a variation from normal is not the same thing as identifying cancer. There are many abnormal cells that never progress to malignancy and we truly cannot tell the difference in most cases. Thermograms, like mammograms, hold the potential for disease mongering by finding abnormal cells that will not develop into cancer, thus bringing women into a destructive treatment regimen they have no need for.
There is an enormous conflict of interest between our cancer authorities and promoters of mammography; no fewer than five American Cancer Society presidents have been radiologists specializing in mammography. In light of such industry influence, it should come as no surprise that the ACS has consistently adopted policies favorable to the companies that make mammogram machines, such as DuPont, Siemens, and General Electric. DuPont, in fact, was a major sponsor for the group’s ACS Breast Health Awareness Program, an initiative that encouraged women to receive a mammography screening while failing to publicize the scientifically established methods of prevention that would help them avoid the disease altogether. Another disturbing conflict of interest lies in the fact that the ACS actually contracts with the mammography industry to conduct cancer research, calling the results of such research into question.
A well-funded campaign of fear prompts women to undergo regular mammograms believing that they are being responsible and taking the best possible action for their health based on science. But as the Cochrane Review has concluded in their meta-analyses from both 2001 and 2011, the currently available reliable evidence does not show a survival benefit of mass screening for breast cancer. A Canadian study published in The Lancet went farther, stating that “since the benefit achieved is marginal, the harm caused is substantial, and the costs incurred are enormous, we suggest that public funding for breast cancer screening in any age group is not justifiable.”
The National Cancer Institute nevertheless continues to recommend that all women should submit to mammograms every two years beginning at age 40. Our current promotion of “breast cancer awareness” leading to widespread mammography is simply drawing more healthy women into the patient pool rather than saving lives. Women would be better served by learning what they can do to improve their chances of never developing breast cancer: eating a healthy plantbased diet free from processed foods and animal products, exercising, losing weight, and avoiding the toxic materials in our surroundings that are known to cause breast cancer.
Dr. Tori Hudson, a naturopathic physician in Portland, Oregon, is among the many practitioners who claim that breast cancer is a preventable disease. “Just look around the world,” she says. “Women in our culture have one of the highest—if not the highest—incidences of breast cancer, while women in Asia have the lowest. The reason is diet. To make a big story simple to understand, cultures that have a vegetarian diet or are closest to a vegetarian diet have the least breast cancer. That’s how it all pans out no matter how you look at it. This implies that cultures that eat less fat, especially less animal fat, have the least breast cancer. So the big picture is really clear. Eat a lot of vegetables, fruits, and whole grains and beans. Those foods provide protection.”
Quite a few large epidemiological studies have looked at the relationship between a person’s lifelong eating pattern and the development of cancer. Those studies have shown that the more vegetables and fruits a person eats, the less likely they are to develop cancer. People who eat five to six servings of vegetables a day plus another couple of servings of fruit have the lowest risk.
“A serving usually refers to a cup of raw vegetables or a half cup of cooked vegetables,” says Dr. Alschuler. “So getting six servings, while that may sound a little intimidating, is actually quite doable. If you eat a big salad at lunch you’ve probably got almost five servings right there. Add another vegetable to your dinner plate and you’re done for the day.”
Letha Hadady, an herbalist and educator in New York City, visited China to learn why Chinese women have such a low incidence of breast cancer compared with American women and those in other Western nations. She found that Asians build immunity through diet and cleansing herbs, as well as the avoidance of pollution, stress, negative emotions, smoking, alcohol, and radiation.
In addition, Hadady made this important discovery. “I found it quite interesting that breast cancer is considered a disease of melancholy in China. That feeling of heaviness in the chest leads to poor circulation and excess phlegm. This leads to two conclusions: Increase circulation and you have a better chance of prevention, and reduce phlegm. The easiest way to reduce phlegm is to stay away from foods such as cheese, chocolate, fried foods, and milk. You will not find dairy in the diet in China. Their diet tends to consist of grains and greens.”
Certain foods are medicinal in their ability to protect against breast cancer. They include soybeans, soy products, and lima beans. Isoflavones and phytoestrogens found in soybeans, soy products, and lima beans protect against cancer. The low incidence of breast cancer among Japanese women is largely attributed to the widespread eating of soybeans. Other cancer-fighting foods include flax, fish that is high in omega-3 fatty acids (salmon, tuna, sardines, mackerel, and herring), cruciferous vegetables (broccoli, cauliflower, and brussels sprouts), mushrooms (reishi, shiitake, and maitake), and onions.
Vitamins and minerals are important in breast cancer prevention as well as after diagnosis and treatment. Among the vitamins recommended are vitamin A, betacarotene, vitamin B1,vitamin B6, vitamin C, and folic acid. Dr. Schachter states that trace minerals play a vital role in the prevention of free radical damage that can contribute to breast cancer. “The body contains certain antioxidant proteins, such as SOD (superoxide dismutase), which help neutralize oxidatively induced free radicals. SOD requires three minerals—zinc, copper, and manganese—to function properly. Deficiencies of any one of these minerals may predispose to oxidation damage, with a resulting increase of susceptibility to breast cancer. Adequate amounts of calcium, magnesium, selenium, chromium, and molybdenum also are important.”
Dr. Schachter says he uses the whole range of trace minerals in colloidal form as a supplement. “That’s a liquid form where the minerals are bound to organic chemicals. We use about seventy different minerals. Many of these minerals are in trace amounts, have already been shown to be essential, and are probably lacking in our synthetically fertilized soil. I believe these colloidal trace minerals will play an important role in bolstering the immune system.”
Natural herbal substances are a veritable gold mine for treating as well as preventing breast cancer. Some herbs to know about are listed below:
CARNIVORA (VENUS FLYTRAP)—This powerful herb is popular in Europe but less known in the United States. In Germany it is even used to wipe out cancer that already exists.
ESSIAC—Essiac is a Native American herbal combination that has a synergistic effect in putting an end to cancer and aiding in its prevention.
CAT’S CLAW—A cat’s claw formula is used by the Peruvian Indians for the prevention and treatment of cancer.
EVENING PRIMROSE, BORAGE, AND BLACK CURRANT SEED OILS— All these herbs supply gamma-linoleic acid, which is known for its strong anticancer activity.
XIAO YAO WAN—This combination of digestive herbs increases circulation, builds blood, and breaks apart fibroids. The Chinese say it prevents breast cancer caused by phlegm and feelings of melancholy, which impede circulation to the chest. Xiao yao wan is available in Chinatowns throughout America.
DANDELION—Dandelion helps prevent cancer by breaking up phlegm and eliminating it from the system. Excess phlegm can turn into tumors.
ASTRAGALUS—Astragalus is a wonderful immune-system-strengthening herb that can be used in cancer prevention or as an adjunct to cancer treatments. Add a teaspoon of astragalus powder to some pure water and drink once or twice a day. Or try Astra-8, a combination of astragalus and other immune-system-strengthening remedies in capsule form that is found in health food stores.
ROSEMARY—Rosemary has been highly researched and is recommended even more than soy for its breast-protecting qualities. According to Keuneke, “Use rosemary in a vinaigrette or to marinate fish. Try to buy rosemary on a regular basis. Perhaps make a salad dressing with rosemary and garlic, fresh lemon, and extra virgin olive oil. All those ingredients are wonderful foods that are eaten throughout the Mediterranean.”
MINT—Include mint in your diet on a regular basis. Mint has a phytochemical in it called limonene, which is effective in fighting breast cancer. In one study, it was found to reduce mammary tumors in animals up to 80 percent. The foods containing limonene are mint, dill, sage, celery seed, caraway, and organic citrus peel. The last item is also found in the Thai diet, which frequently uses lime peel.
TURMERIC—Turmeric also contains a vital phytochemical that has been found to prevent mammary tumors in animals.
Enzymes are organic substances that help create reactions in the body, such as breaking down fats. They are linked to breathing and all the bodily functions we need to live and stay well. There are 3,000 enzymes in the body. A healthy person can produce enough enzymes to fight off cancer cells, but substances such as free radicals from smoke, pollutants, junk foods, and medications interfere with enzyme production.
“So, as you can imagine,” Robin Keuneke says, “there are many people who are low on enzymes. To combat this, people can increase the amount of raw foods in their diet and increase fresh juice—juice all kinds of fruits and vegetables.”
Numerous studies, she recounts, link enzymes and breast health. More than 90 were conducted by universities throughout the world regarding the beneficial effects of enzymes. Much of this work has been done in Germany.
Activities that detoxify the body can further reduce the chance of acquiring breast cancer. For instance, aerobic exercise assists in lymphatic drainage and induces sweating, which is a natural way for the body to eliminate waste products. And exercise has been shown by studies to be correlated with a lowered breast cancer risk.
Lymphatic detoxification is aided by manual lymphatic drainage (MLD), a simple method of massage that uses light, slow rhythmic movements to stimulate the flow of lymph in the body. Massage therapist James Kresse notes that this is especially important for women suffering from lymphedema, a condition that often occurs after a mastectomy: “When our lymph nodes are not functioning properly or have been irradiated or removed, an excessive accumulation of stagnant waste occurs. The lymph system becomes overloaded, thus forming lymphedema.
“MLD should be applied directly after surgery rather than when a massive edema has formed. This will guard against any possibility of a blockage in the system or alleviate any that exists. Studies in Europe show that severed lymph vessels regenerate with constant MLD therapy. The therapy makes the scars from the mastectomy more subtle, which increases the mobility of the arm. It also lessens pain from surgery and the uncomfortable sensitivity that occurs.”
Increasing melatonin may also help in the prevention of breast cancer. “Melatonin is a hormone that is produced at night,” Dr. Alschuler explains. “It helps us to fall asleep, and it helps us to stay asleep. It’s produced throughout our body, particularly in our brain and in our intestinal tract, and it’s been shown that women who have lower levels of melatonin have a higher rate of breast cancer.
“In addition to helping us fall asleep, melatonin has very strong immune regulating or stimulating properties. At the same time, it reduces the amount and the influence of estrogen on cancer cells. It actually blocks estrogen binding to estrogen receptors, and it blocks the production of estrogen. And then finally, melatonin literally helps to put the cells to sleep. It slows down cellular division. It slows down cellular growth enough so that some of the reparative mechanisms that our body innately has have time to work and repair the cells.”
To get more melatonin, Dr. Alschuler recommends sleeping at night in a dark room without alarm clocks with bright lights, night lights, or the glow of the television. “All of that light at night reduces our production of melatonin, so it’s really important to sleep in a very dark room.”
In the 1950s Dr. Lawrence Burton and a team of researchers discovered Immuno-Augmentative Therapy (IAT), a nontoxic, noninvasive method of controlling cancer by restoring the patient’s own immune system. Although the therapy was successful, Dr. Burton left the United States after medical politics prohibited him from practicing here. In 1977 he opened the Immunology Research Center in Freeport in the Grand Bahama Islands, where thousands received treatment for the disease.
Since Dr. Burton’s death, Dr. John Clement, an internationally respected cancer specialist who studied with Dr. Burton, heads the center, now called the Immuno-Technologies Cancer Clinic. Dr. Clement gives an overview of the treatment: “The intellectual basis of the treatment is that many cancers can be controlled by restoring the competence of the patient’s immune system, as the body’s complex immune-fighting system may well be the first, best, and last line of defense against many cancers.
“The method we use is similar in any type of cancer we treat, although each patient has her treatment tailored to the results of her own blood test. We do not deal with toxic chemicals in any way. We assay the blood for the factors we believe are aiding the patient’s cancer. By identifying these factors, we are able to control them, put them back into balance, and hopefully destroy the patient’s cancer.”
Regarding breast cancer, Dr. Clement says, “We have had patients with breast cancer who have had no other treatment but IAT for upward of twenty years who have no recurrence of disease. While we are still claiming only to control their cancer, you will see that to all intents and purposes, by any kind of medical description, they have been cured.”
Dr. Clement reports less success with patients who come to him after extremely arduous chemotherapy and those with advanced cancer where there is a loss of bone marrow and fluid collection in the abdomen or pleural effusions in the lungs.
The late Dr. O. Carl Simonton, medical director of the Simonton Cancer Center in California and coauthor of Getting Well Again and The Healing Journey, firmly believed that emotions drive healing systems and that the imagination and standard counseling can be used to increase a patient’s will to live. “I would like to give an example of a patient I have worked with for more than twenty years,” he said. “This thirty-six-year-old woman came to me with metastatic breast cancer that had spread to her ribs and spine. Her father was a physician, and her husband’s family had run a retail store for three generations. She was involved in helping her husband run the family business.
“Her religious and spiritual life was important to her. It was a great source of strength. She wanted more time to be involved in religious administration and spiritual counseling. As she began to pursue these areas, her beliefs about how she should be the good daughter, the good wife, and the good mother came into play. These beliefs were all quite rigid, allowing virtually no freedom for her own creativity. Over time we helped her make a shift in these beliefs and behaviors that was central to her recovery.
“She has been free of disease for fifteen years. Currently, she is weller than well and runs marathons. The family store burned down about ten years ago. Now she works primarily in church administration, doing religious and spiritual counseling, which is what she always wanted to do.”
The following daily protocol of vitamins and minerals is recommended by Dr.
Steven Rachlin, an internist in Long Island, New York.
Emulsified vitamin A (up to 50,000 IU)
Beta-carotene (up to 100 mg)
Vitamin B1 (100 mg)
Vitamin B6 (100 mg)
Folic acid (3,200 mcg)
Vitamin C (up to 5 g)
Coenzyme Q10 (400 mg)
Flaxseed oil (1 tbsp)
Cat’s claw (300 mg)
Melatonin (up to 10 mg)
Pycnogenol (150 mg)
Pancreatic digestive enzymes (up to 40 g)
Aloe vera juice (9–12 oz)
Minerals
NK Cell Activator (500 mg)
Cytokine Supress with EGCG (300 mg)
Modified Citrus Pectin, as directed
Vitamin C to bowel tolerance (8x day)
medically supervised IV Vitamin C (35,000–150,000mg)
probiotics (5 billion, 3x day)
Fibrocystic breast disease is caused by overcongestion from foods that clog the system, such as wheat, dairy products, refined foods, and fats. Caffeinated products such as coffee, tea, chocolate, and soft drinks are hard on the body and add to the problem, as does a sluggish thyroid gland, which makes metabolism more difficult and leads to constipation, causing a buildup of toxins. Toxic accumulations worsen congestion and can manifest as breast lumps (cysts). Stress worsens the condition.
Fibrocystic breast disease shows up as single or multiple breast lumps. Cysts are usually harmless but are related to a higher than normal chance of contracting breast cancer later. Mammograms determine whether breast lumps are benign.
Drs. Ruth Bar-Shalom and John Soileau, naturopaths from Fairbanks, Alaska, add that the symptoms may also include tenderness and pain in the breast. In an article on the American Association of Naturopathic Physicians website (www.naturopathic.org) they stress the importance of learning breast self-examination and performing it every month, a week to ten days after the menstrual period starts. This enables you to recognize the cystic areas. If you are not sure whether a lump is a cyst or something else or if there is a discharge from the nipples, consult a physician.
A diet high in complex carbohydrates can make a difference; fruits, vegetables, grains, beans, and some fish are recommended. Red-hot peppers, cayenne pepper, and regular or daikon radishes cut through mucus and help eliminate breast lumps.
According to Drs. Bar-Shalom and Soileau, the most important dietary measure for reducing cysts is to eliminate from the diet all forms of caffeine, including coffee, tea, chocolate, and soda. Meat, especially the hormone-containing commercial type, should be avoided as much as possible. Finally, since constipation can aggravate fibrocystic breast disease, it is important to eat more vegetables, fruits, and whole grains and drink eight to ten glasses of water a day.
The following nutrients offer extra help when combined with a cleansing diet: selenium, vitamins A, C, and E, magnesium, and iodine drops. Iodine speeds the metabolism of the thyroid gland. As the metabolism perks up, breast lumps tend to disappear. Iodine drops from seaweed can be obtained in the drugstore in a saturated solution of potassium iodide or Lugol’s solution. There is also an Edgar Cayce remedy called Atomodine. In addition, health food stores sell iodine drops in the form of liquid kelp. Before you use iodine, a thyroid blood test should be done to check for thyroid antibodies. This ensures that there is no thyroiditis, an inflammation of the thyroid gland. Drs. Bar-Shalom and Soileau suggest the following supplements:
Herbalist Letha Hadady recommends the following plant remedies to break up congestion in the chest and release phlegm and mucus from the system before they lead to more serious problems:
XIAO YAO WAN—This formula is a combination of digestive herbs that increase circulation, build blood, and break apart fibroids. Xiao yao wan is available in Chinatowns throughout America.
DANDELION—Dandelion tea or capsules can be taken every day to break apart fibroids.
Drs. Bar-Shalom and Soileau recommend in addition poke root and iris versicolor taken as tinctures. Take 5 drops of each three times daily for up to three months. Do not take these herbs if you are pregnant.
CASTOR OIL PACKS—According to the medical psychic Edgar Cayce, stimulating liver circulation ends constipation. Substances that clog the body and form breast lumps are then eliminated. To do this, rub castor oil on the skin over the liver. Cover this area with a towel and place a heating pad over it. Do this for twenty minutes each day.
PEPPERMINT OIL—Rubbing peppermint oil on breast lumps diminishes them by stimulating the circulation.
PHYTOLACCA OIL AND HYDROTHERAPY—Dr. Joseph Pizzorno has found success with this combination treatment: “We have a woman put a hot compress on her breast so that it gets real warm. She then covers the area with phytolacca oil. After the application, she covers it with a cold pack. We combine herbal medicine with hydrotherapy to help the cysts drain out of the breasts. I use that treatment with a lot of women and have had quite a good response.”
Drs. Bar-Shalom and Soileau suggest the following homeopathic remedies. Choose one based on how well it matches your symptoms and then take it under the tongue three times a day, stopping when the symptoms are relieved.
PHYTOLACCA—Use 6c potency for hard, sensitive breasts or when you have multiple nodules.
CONIUM MACULATUM—Take 12c potency for sharp pain in the nipples and for breast swelling.
SEPIA—Take 6c potency when irritability accompanies breast swelling.
Dr. Gary Ross, a family physician and certified yoga instructor from San Francisco, recommends yoga poses, meditation, and breathing exercises to alleviate fibrocystic breast disease brought on by stress and a sluggish thyroid. These three postures increase blood flow to the thyroid and chest area:
SHOULDER STAND—On a mat or thick blanket, lie flat on your back. You may place a rolled towel under your neck. Raise your legs over your head so that your body is in a U formation. Rest the elbows firmly on the floor and support the back with both hands. Adjust your body so that it is completely vertical. Then press the chin against the chest. Hold still as you breathe slowly, concentrating on the thyroid gland. You may be able to do this for only several seconds at first, but then you will be able to work up to one minute. To come down, lower the legs slowly toward the head. Then lower the back to the floor one vertebra at a time. When the back is on the floor, continue to lower the legs gradually until you are once again flat on your back. Do this once in the morning and once in the evening. To get the full benefit, follow with the fish pose.
FISH POSE—Lie on your back with the legs straight or folded. If the legs are straight, place the hands under the buttocks with the palms down. Otherwise, hold on to the crossed feet. Resting on the elbow, arch the chest and neck back. The head should be on the floor, but do not apply pressure there. Support should come from the elbows. Do not bend the neck too far back as that can impede circulation. Focusing on the thyroid, breathe deeply in this position, holding for thirty seconds.
COBRA—Lie facedown with the elbows and palms down on the floor or mat and the palms beneath the shoulders. With a smooth, gradual motion, raise the eyes upward, then the head, neck, and spine, one vertebra at a time. Allow the area below the hips to remain on the blanket. Hold the pose and then come out of it using reverse motions that are equally slow and gradual. Breathe in as you come into the posture, hold the breath while in the cobra, and breathe out when coming down.
In addition, Dr. Ross advocates deep-breathing exercises to bring more energy into the chest area. Visualization creates a mindset that helps make lumps disappear. Further, meditation creates spiritual and mental tranquility that is conducive to healing.
Lymphedema, a swelling of the limbs caused by an accumulation of lymph fluid, affects 1 percent of the US population. Health practitioner James Kresse explains: “There are two types of lymphedema. The first is primary lymphostatic lymphedema, a condition that predominantly affects women in their mid-thirties but can manifest at birth or during adolescence. The second is more common and frequently occurs in patients who have had mastectomies or the removal of malignant tumors. The large increase in the incidence of breast cancer and subsequent mastectomy operations is one of the major reasons for the rise in lymphedema today. Secondary lymphostatic lymphedema can occur from six months to three years after the initial surgery.”
Lymphedema appears as a swelling or skin thickening in a limb. It is important to detect the condition early, and this can be done in several ways. Kresse advises, “Notice any jewelry becoming tighter on the affected limb over a short period of time. Or squeeze the affected limb for ten seconds. If an indentation is noticed, notify your surgeon immediately or measure your arm with a cloth tape measure around your wrist and forearm. If you notice an increase in the circumference of your arm, call your surgeon right away.”
Lymphatic detoxification is aided by manual lymphatic drainage (MLD), a simple method of massage that uses light, slow rhythmic movements to stimulate the flow of lymph in the body. “This type of therapy is very, very light,” says Kresse. “It’s almost featherlike. We’re working on the parasympathetic nervous system. A regular massage stimulates the sympathetic nervous system. That is our fightor-flight nerve. The parasympathetic nervous system is our night nerve, our rest and relax nerve. This is the nerve that lymph drainage affects in order to calm the patient down.”
In addition to MLD, compression bandaging is used to apply pressure around the affected limb. Exercises performed with the bandage enhance muscular contractions that help with lymph flow.
Kresse has several lifestyle recommendations. “The person needs to practice meticulous skin care with the use of pH-balanced lotions and creams to protect the skin. Following a good nutritional program consisting of lots of fruits and vegetables is helpful. Salt and fatty foods should be eliminated, and protein intake should be limited. It is important to maintain an optimum weight, as obesity contributes to lymphedema. Exercise such as swimming, walking, and stretching is excellent. Incorporating deep diaphragmatic breathing techniques, along with specific exercises taught by an MLD therapist, is good. While sleeping, the patient can elevate the limb by tilting the mattress or by placing pillows under the arm. Antibiotic solutions should be carried at all times for incidental cuts, scratches, or bites. Infection should be treated at the first sign.”
Kresse also lists a variety of safety measures. “Precautions to take include not subjecting oneself to extreme temperature changes such as hot tubs, saunas, steam baths, and other thermal treatments. Care must be taken when using instruments on the affected limb, such as the instruments used in manicures and pedicures. Pets must be watched to see that they don’t scratch or bite. Blood pressure readings, injections, vaccinations, and acupuncture should be avoided on the infected arm. Constrictive clothing and jewelry should not be worn. Heavy prostheses can cause excess pressure on the affected limb. Care must be taken when cooking, gardening, and doing daily chores. Finally, heavy objects must not be lifted. This can cause a lymphedema right away or somewhere down the line.”
Other therapies that help lymphatic conditions include rebound exercise, ozone therapy, enzyme therapy, colon hydrotherapy, deep breathing exercises, and a good vitamin and herbal program.
An increasing body of evidence is showing the benefits of natural modalities to overall health and well-being. Following is a sample of recent peer-reviewed scientific studies in the area of cancer and more specifically, breast cancer.
A 2015 article in Life Extension Magazine cited many research studies showing the anticancer properties of the spice saffron. Saffron was shown to slow and reverse cancer growth in 2012 reports in Current Pharmaceutical Biotechnology and European Journal of Biological Science, and a 2014 report in Biochemistry and Cell Biology. Saffron was also found to help reduce the harmful effects produced by chemotherapy drugs. A 2011 article in Life Extension Magazine discussed evidence that citrus pectin can disrupt inter-cellular communication, slow metastasis, and improve quality of life in cancer patients. In 2015, the magazine reported on research showing that curcumin can be used against certain cancers by blocking the inflammatory master molecule nuclear factor-kappaB (or NF-kB).
A 2014 report in World Journal of Clinical Oncology summarized the epidemiological research indicating that diet plays an important role in breast cancer. Beneficial results were found with intake of probiotics in combination with a balance of fatty acids, fruits and vegetables, dietary fiber, and vitamin supplements. Consumption of probiotics with fermented products containing lactic acid bacteria was linked in some studies with decreased breast cancer risk.
Soy was found in a 2013 PLoS One literature review to be nonestrogenic and safe for women with breast cancer when consumed in amounts similar to that of a traditional Japanese diet (two to three 25–50 mg servings per day). Use of soy remains controversial, however, as reported in a 2012 Nutrition and Cancer study, which found that high intake of soy isoflavones increased the risk of cancer recurrence in HER2-positive breast cancer patients.
In a 2014 report in Townsend Letter, Dr. Barbara MacDonald summarized recent scientific evidence regarding the effects of exercise and diet on breast cancer prognosis. Although many studies have shown the benefits of moderately strenuous, regular physical activity, as noted in Cancer Epidemiology, Biomarkers & Prevention in 2013, most survivors fail to meet the recommended guidelines, with only 21 percent saying that they exercise the suggested three hours weekly. As reported in Cancer Diagnosis & Control in 2011, African American and Hispanic women with early-stage breast cancer who ate a diet consisting of fewer calories, added sugar, alcohol, and saturated fat, decreased their risks of mortality related to breast cancer by 88 percent. A 2010 meta-analysis in Breast Cancer Research and Treatment confirmed the positive effects of green tea.