What is the link between estrogen and cancer?
In a new video, An Oasis of Healing senior medical staff Dr. Nathan Goodyear talks about estrogen and cancer, estrogen receptors, hormones, and a plethora of other topics related to treatment for cancer.
The video is part of the center’s weekly in-house staff education program wherein Dr. Goodyear leads the discussion on pertinent cancer-related topics and how it relates to An Oasis of Healing’s comprehensive care program and their patients’ healing journeys.
According to Dr. Goodyear, when doctors and patients talk about hormones and cancer, most people will relate it to breast cancer. “They’re thinking triple positive which is ER-positive. They are also thinking triple negative which would be ER-negative. What doctors talk about and what patients think about is true, but it is often oversimplifying a very complex process,” he said.
ER refers to estrogen receptors. Estrogen receptors are a group of protein inside cells of the female reproductive tissue. They are activated by the hormone estrogen.
Dr. Goodyear explained, “When a woman produces estrogen, it has to bind to its receptor and then sends the signal inside to the nucleus. It’s important to understand that there are receptors of estrogen on the cell membrane surface and nuclear receptors. So, it’s not just something that is on the surface, they can also be inside the cell.”
He further noted that estrogen does stimulate a lot of different types of cancer but the majority of cases center around breast cancer.
Breast cancer is most common in postmenopausal women and most of these cancers are hormone receptor positive. This can happen because as women age, fat cells in the breast produce greater amounts of aromatase, which then promotes estrogen production. This locally produced estrogen can trigger the development and growth of breast cancer. The tumor acts to increase estrogen levels, thus helping it grow.
Some studies have also established a link between obesity and estrogen production because obese women have more fat cells that produce estrogens.
Dr. Goodyear noted that some patients in the center have had receptor positive triple positive cancer even though they are not obese.
“Thin women don’t produce a ton of estrogen,” he said. “Now, how can we say that? Because of the predominance of estrogen produced menopausally and perimenopausally is from abdominal fat. Even at younger ages, a lot of estrogen is produced from abdominal fat. This is where metabolites come in to play.”
Metabolites are the “intermediate products of metabolic reactions catalyzed by various enzymes that naturally occur within cells.
He added, “When you look at the metabolites of the estrogens, you will actually see a very different picture. Everyone knows the word detoxification. Detoxification is the process by which one chemical is converted to another to be either eliminated or used differently. Detoxification does not just happen in the liver; it happens in every cell in the body. It has to happen. In looking at the estrogen metabolites, they are not inactive and, on their way, out the door. They are very active.”
These active metabolites can either contribute or protect against cancer. A thin person can have low estrogen but metabolites, and how they are detoxifying the estrogen, can contribute to the cancer.
As a final note, Dr. Goodyear reminded cancer care specialists and patients alike that estrogen receptor positive is not just about estrogen. It is always crucial to look at the bigger picture and ask yourself: What is the body doing with the estrogen?
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