AnnA Rushton’s View:
In many years of writing about health I often get a sense of déjà vu, where a ‘new’ story hits the headlines that serves to remind me that I am getting older, as I have seen it all before.
In the hormone debate there has been ferocious and dedicated PR by the companies making HRT to convince us of its many benefits. I have no quarrel with HRT if you want to take it and know the consequences, and stay on it for the shortest possible time at the lowest suitable dose then go ahead.
What I do take exception to is the wholesale blanking of the research done on the dangers of estrogen and wilfully ignoring the fact that the artificial progestins in HRT are the cause of many health problems.
This latest piece of research goes back to the data from the Women’s Health Initiative, when women taking these hormones were shown to have a higher risk of breast cancer, heart attack and stroke. The study was forced to end in 2004 because of these risks but a controversial new review of data suggests certain women who take estrogen alone, without progestin, to treat menopause symptoms may actually be protected from breast cancer.
Naturally, this view has not gone unchallenged, indeed it drew immediate criticism from researchers who said it was merely a rehash of old data. The oncologist behind the report, Dr. Joseph Ragaz, a clinical professor at the University of British Columbia, has focused his study on the 10,000 women who had undergone hysterectomies and took only estrogen or a placebo. He quotes that of 8,500 women with no family history of the disease, use of estrogen lowered breast cancer risk by 32 percent, compared with similar women taking a placebo. Among the 7,600 women with no history of benign breast disease, like lumps or cysts, those taking estrogen had a 43 percent lower risk of breast cancer.
This sounds to me like publicity for a new market for HRT – the post menopausal women who have had hysterectomies. It is being suggested that these analyses suggest a promising new area of research for breast cancer prevention – which we are all in favour of – but is this really the way forward?
I put this question to two of our contributing doctors for their opinion, which you will find below, and also that of Virginia Hopkins, who worked closely with the late Dr John Lee, so you can make up your own mind.
Dame Dr Shirley Bond’s View:
“So we go back to the early days when they just gave estrogen do we! I well remember what happened then:- a large number of women developed uterine cancer due to the over stimulation of the endometrium.
Does no one ever look at the history of medicine?!
This sounds potentially dangerous to me. We know that women who have had hysterectomies, and therefore can more safely take just estrogen, have a slightly lower risk of breast cancer than those taking combined HRT.
This decreased risk is due to the fact that they are not taking the addition of chemical progestins/progestogens which are believed to increase the risk of estrogen on the breast.
Dr Tony Coope’s View:
When I first read this report, the first thoughts that flashed through my mind were of fat brown envelopes, paying-in slips for offshore bank accounts, and application forms for huge grants for unnecessary research projects.
But while some or all of the above could be true, there may be a simpler explanation, albeit an even more scary one. It is to do with simple interpretation.
According to Dr Raguz, “The data show that for selected women it (estrogen alone) is not only safe, but potentially beneficial for breast cancer”. His ‘selected’ women were those with no family history of breast cancer, nor past history of benign breast disease. But these are precisely the women who are genetically less likely to develop breast cancer, and who are also least likely to have had the estrogen/progesterone imbalance (estrogen dominance) that can be a precursor to both these conditions.
If breast disease is a consequence, among other factors, of the cumulative effect of excess estrogen in relation to progesterone, then these women will have started the trial from a position of relative balance, and therefore of much lower risk. When they were then given estrogen with a progestin, or even estrogen alone, they would be much less likely to to reach the ‘tipping point’ at which cancer appears. Of course these women will have a ‘significantly reduced breast cancer incidence’!
But to interpret this as a result of receiving estrogen rather than from not having accumulated excess over a long-enough period of time is just extraordinary in the light of current knowledge.
Virginia Hopkins View:
The only good thing I have to say about the so-called news that estrogen reduces the risk of breast cancer is that Joseph Ragaz MD and the University of British Columbia’s School of Population & Public Health did a great job getting this misleading story into the media. In truth, however, they probably had little to do with the media blitz, which has all the earmarks of drug company money and influence.
The “research” cited by Dr. Ragaz was presented at the San Antonio Breast Cancer Symposium without peer review, and with no opportunity for the public to review his statistics or methods. I’ve often said that if you tweak the data enough you can prove that the moon is made of green cheese and that pigs can fly.
The data cited for this research was taken from the controlled group of the Women’s Health Initiative (WHI), which for starters carefully selected the women in the study to exclude those with prior health problems, and to include only women who had never used HRT. The women using estrogen-only all had hysterectomies and most of them likely had non-functional ovaries. Then the data Ragaz used was tweaked even more to exclude women with a family history of breast cancer and a history of benign breast disease. Furthermore, the “estrogen” used was Premarin, which is a hormone cocktail extracted from pregnant mares’ urine, which includes many other hormones besides estrogen, including progesterone.
In the WHI observational group, women using estrogen-only had a 28% increased risk of breast cancer.
The (real) scientific evidence that estrogen promotes breast cancer is overwhelming and inarguable, and exists in research from the cellular level right up to population studies. Estrogen-only HRT also increases the risk of thromboembolic events such as stroke and blood clots, and increases the risk of ovarian cancer. Here’s where you can read more about breast cancer and hormones.
What’s most troubling is not that the drug companies are putting profits before women’s health, which is business-as-usual, or that an individual knowingly or naively acts as a drug company shill, but that the media so willingly and unquestioningly regurgitated this press release and thoughtlessly spread misinformation with the potential to do harm.
Virginia Hopkins worked for many years with Dr John Lee on his books and articles. Since his death, she has set up Healthwatch whose mission is to educate women and men about the safe use of bioidentical (natural) hormones, and to share helpful, useful and commonsense information about health and nutrition based on solid scientific research. Virginia Hopkins Health Watch Newsletter can be found at her website www.virginiahopkinstestkits.com