By Dr. Mercola
Some days I wonder if this is all a bad dream. How on earth have we come to this craziness? The latest and greatest “preventative” strategy for women genetically predisposed to breast cancer is amputation, which puts the wheels in motion for this type of “preventive surgery” to be covered by health insurance.
I’m referring, of course, to Angelina Jolie’s recent and very public decision to undergo a double mastectomy as a prophylactic measure. While she admits this is a very personal decision, the impacts to the public could be quite significant based on her celebrity influence.
Her mother died from ovarian cancer at the age of 56, and Jolie carries a hereditary gene mutation associated with both breast- and ovarian cancer. According to Jolie, who revealed her decision in an op-ed in the New York Times:1
“My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.
Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. … I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made.
My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”
It is nearly incomprehensible to me how any researcher can give such precise predictions of future cancer risk based on genetics. The only explanation is near complete ignorance of the science of epigenetics and the power we all have to change the expression of our genes.
Why Does US Recommendations Place Women with Gene Defects at Even Greater Risk?
The genetic test to check for mutations in the BRCA1 and BRCA2 genes (the BRCA stands for ‘breast cancer susceptibility genes’) costs about $4,000 in the US, when not covered by insurance.2
Ironically, if you discover that you carry the mutated BRCA gene, the standard recommendation in the US is to get a mammogram and an MRI scan at least once a year thereafter, even if you’re under the age of 40. This is unconscionable, in my opinion. If anything, should you have genetic susceptibility for breast cancer, it would be wise to avoid ionizing radiation as much as possible, not the other way around!
Several European countries including Britain, the Netherlands and Spain, have already altered their screening recommendations for women with BRCA mutations, advising them to get MRIs (which do not emit ionizing radiation) instead of mammograms before the age of 30.
Research has demonstrated that women with these genetic mutations are more sensitive to radiation, and because the genes in question are involved in repairing DNA, radiation damage to these genes will subsequently raise your cancer risk. For example, a study3 published just last year in the British Medical Journal (BMJ), found that women with faulty BRCA genes are more likely to develop breast cancer if they’re exposed to chest X-rays before the age of 30. According to Cancer Research UK:4
“[W]omen with a history of chest radiation in their 20s had a 43 percent increased relative risk of breast cancer compared to women who had no chest radiation at that age. Any exposure before age 20 seemed to raise the risk by 62 percent.”
In response to these findings, Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society was quoted as saying:5
“This will raise questions and caution flags about how we treat women with (gene) mutations.”
And Anouk Pijpe of the Netherlands Cancer Institute, one of the authors in the above-mentioned study, told CBS News:6
“We believe countries who use mammograms in women under 30 should reconsider their guidelines. It may be possible to reduce the risk of breast cancer in (high-risk) women by using MRIs, so we believe physicians and patients should consider that.”
Genetic Defects Are Not a Major Contributor to Breast Cancer
A key point for women to remember is that while women with BRCA defects have a 45-65 percent increased risk of breast cancer, only about TWO PERCENT of diagnosed breast cancers are caused by BRCA faults. So this genetic defect is nowhere close to being a primary cause of breast cancer. Clearly, other non-genetic factors play a far more significant role.
As pointed out by H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and a co-author of “Overdiagnosed: Making People Sick in the Pursuit of Health,” Angelina Jolies personal story is completely irrelevant to 99 percent of all women because they simply do not have the BRCA1 or BRCA2 mutations. In a recent CNN article, he writes:7
“Let’s be clear, the BRCA1 mutation is a bad thing… It is a powerful risk factor for these cancers…When people are at very high risk for something bad to happen, preventive interventions are more likely to be a good deal… When people are at average risk, the deal changes… It is a fundamental precept of medicine… Patients with severe abnormalities stand to gain more from intervention than patients with mild ones. Patients with mild abnormalities are more likely to experience net harm from intervention, simply because they have less opportunity to benefit.
The vast majority of women don’t have the BRCA1 mutation. They are at average risk for breast cancer… They should not have a preventive mastectomy.
…But there is a second question for women raised by Ms. Jolie’s piece: Should I be tested for BRCA1?
She seems to believe the answer is yes, pointing to the half-million women who die from breast cancer worldwide each year. But she neglects to point out that 90 percent of these deaths have nothing to do with the BRCA1 mutation. That’s because most women don’t have the mutation and because most breast cancer is sporadic.”
Furthermore, it’s also important to understand that even if you do carry a defective gene, that in and of itself does not mean that the gene in question is destined to be expressed. In other words, having the BRCA defect is by no means an automatic death sentence. As you will see below, there are many things you can do to dramatically decrease your cancer risk through the lifestyle choices you make, which have a profound impact on your genetic expression.
What Do Gene Patents Have to Do with It?
Since the mid-1940’s, genomics and the patenting of genes has grown exponentially. At present, nearly 20 percent of the entire human genome, or some 4,000 genes, are covered by at least one US patent. These include genes linked with Alzheimer’s disease, colon cancer and asthma. Myriad Genetics8 owns the exclusive patent for the BRCA1 and BRCA2 genes. As explained by The New Yorker:9
“Anyone conducting an experiment on them without a license can be sued for infringement of patent rights. This means that Myriad can decide what research is carried out on those genes, who can do that research, and how much any resulting therapy or diagnostic test will cost.”
Needless to say, this has profound implications for medicine. As stated by the American Civil Liberties Union (ACLU):10
“Through its patents, Myriad has the right to stop anyone from using these genes for clinical or research purposes. It has therefore locked up a building block of human life.”
In her op-ed Jolie states that is “has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment,” pointing out that the cost of genetic testing is an obstacle for many. The root of that problem lies with our current patent laws, which allow for the patenting of human genes and other life forms. According to the ACLU, which is the plaintiff in another gene patent lawsuit heard by the Supreme Court in April,11 Myriad recently raised the price of their genetic test from $3,000 to over $4,000, even though gene testing technologies have advanced to the point where you can sequence ALL of your genes, about 23,000 or so, for as little as $1,000.
The Supreme Court will decide in a matter of weeks whether human gene patents will continue to be allowed or not, and if they are, you can expect prices for gene-related medicine to continue to skyrocket and become increasingly monopolized.
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It’s Starting to Look Like a Coordinated Yet Cleverly Designed PR Campaign…
When looking at a number of different yet related events, this whole thing is starting to look like a well-coordinated PR push where a number of companies and industries stand to gain. The only real loser in this game appears to be women in general… First, as we predicted would happen months ago, the Supreme Court ruled in favor of Monsanto in the Monsanto vs. Bowman case12 on May 13, thereby affirming that a patent holder can control the use of its patent through multiple generations of seed. Alas, the implications of this ruling go far beyond agriculture. It will also have implications for other businesses such as vaccines, cell lines, and human genes.
What this ruling does is grant ownership of genetic material in perpetuity. A silly but simple analogy would be that if you own the patent to a dog trait, and your dog with that trait impregnates all the neighbors’ dogs, all the pups would be yours, as would the pups of those pups, and so on. As we predicted, the Supreme Court only took this case to protect the biotech industry by setting precedent. There is very little morality left in our fascist federal government, and that includes most of its agencies, including the IRS, FDA, and FTC. They’re all operating for political and industrial gains.
In Monsanto vs. Bowman, Justice Kagan justified the unanimous decision to allow living, self-replicating organisms and their offspring to be licensed property of the patent owner due to financial interests. “A patent would plummet in value after the first sale of the item containing the invention,” she said. And just seconds into Bowman’s attorney’s opening arguments, Chief Justice Roberts interrupted him by asking “why anyone would ever patent anything if Bowman were to prevail?”
That and more indicated that it was a closed case right from the start… Justice Breyer went so far as referencing the infamous law13 Buck vs Bell14 (that still stands in the US to this day, which legitimizes government forced sterilization and vaccination) when he said: “There are three generations of seeds. Maybe three generations of seeds is enough.” This was a spin on Supreme Court Justice Oliver Wendell Holmes’s statement:
“It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Three generations of imbeciles are enough.”
It’s a chilling thought when you consider the potential implications this case can have on the trend of patenting of human genes and other life forms. Over 20% of the human genome is already patented, and the old eugenics movement has a lot in common with the burgeoning anti-choice movement when it comes to vaccinations and other medical treatments, including cancer treatment for minors. Children have been taken from their parents for refusing to follow the conventional cut-poison-burn cancer treatment plan for their ailing children, even though statistics and research clearly shows that chemotherapy is typically what ends up killing the patient, even when the cancer itself is conquered!
GMO Opponents Are ‘Elitist’ and Insensitive to World’s Needs, Monsanto CEO Says
If the idea of a new eugenics movement is not enough, Monsanto CEO Hugh Grant was recently quoted15 stating that opponents who want to block genetically modified foods are guilty of “elitism” and fail to consider the needs of the rest of the world. Thank goodness the CEO of a $58 billion multinational corporation, which last year paid him over $14 million, is ready to stand up to the selfish elitists opposing his plan to save the world…
But I digress… On May 14, one day after Big Biotech was granted patent rights to genetic material in perpetuity, Angelina Jolie’s op-ed comes out, and the very next day, biotech stocks took a jump.16 Then on the 16th, Arthur Caplan, director of the Division of Bioethics at New York University’s Langone Medical Center, pens a CNN op-ed17 applauding Jolie’s “brave message.” Chillingly, he ends his article with:
“As the U.S. pushes forward into health reform, Jolie’s story reminds us that we need to adjust our health care system from one that pays for treatment to one that also covers prevention.”
“Prevention” here meaning a $4000 test that if positive results in amputation of a non-diseased organ… According to reports,18 Jolie is also planning to remove her ovaries to limit her risk of ovarian cancer—a decision that leads to ‘surgical menopause,’ which requires careful hormone replacement and monitoring.
Truly, we need to drive home the message that testing is NOT prevention. Testing is a diagnostic tool that has nothing to do with actually preventing disease. True prevention requires taking a close hard look at lifestyle choices, as well as making some radical changes to a wide range of industries that don’t want to change the way they do business. Toxic chemicals are oftentimes far cheaper to use than all-natural ones. And toxins drive cancer processes in your body…
The Angelina Effect—Don’t Be Swayed…
Deception by the agricultural, food, biotech, chemical, and personal care product industries are primary drivers of most of the chronic and deadly diseases plaguing our modern society They’re poisoning you from all angles, and then pretend to have the solutions… Parallel with this mockery of a “science-based” health care system, federal agencies have been cleverly manipulated by highly leveraged lobbying to force you to pay for most of this by tax subsides, and federal regulatory agencies limiting your choices.
Within days of her “coming out,” Jolie again graced the cover of TIME magazine with the words: “The Angelina Effect—Angelina Jolie’s double mastectomy puts genetic testing in the spotlight. What her choice reveals about calculating risk, cost, and peace of mind.”
I have no special insights about what this woman has been thinking but I certainly don’t blame her. To me she is merely a victim of sophisticated and clever techniques that have successfully twisted common sense on its head. She has learned to trust and believe in the system that has created this insanity. The PR campaign that catalyzed her decision is clearly aimed at deceiving naïve and preoccupied people into an utterly flawed system motivated primarily by corporate greed not by any compassion or desire to decrease human suffering.
I don’t fault Jolie for any of it. She, like everyone else, made the best decision she could based on the information she was given or sought out. Few people have enough time to study and understand the complexity of system that has evolved for over a century..
In this case, the goal is not to empower you to make proactive decisions about your health. It’s about herding you into the fold of the most profitable industries in the world. Myriad Genetics alone rakes in approximately half a billion dollars in revenue each year.19 Genetic testing for breast cancer accounts for 85 percent of their total revenue, and again, they have complete and total control of this niche since they own the patent for the BRCA genes. Salon magazine recently wrote an article titled: How One Company Controls Your Breast Cancer Choices.20
“Myriad’s monopoly over BRCA1 and BRCA2 not only means showing that it can charge whatever it wants for the test; it also means that further research on the genes is restricted, and that women who take the test and get an ambiguous result can’t get a second opinion, only take the test again. An ambiguous result can mean the difference between removing breasts or ovaries or leaving them intact.
The economic and racial implications of all this are major, both for how the research has been done and who gets access to it. In a video on the case, the ACLU points out, ‘Initial gene studies focused on white women. And now the patents make it more difficult to learn what some mutations mean in women of color, because Myriad has total control over researchers’ access to those mutations. … Myriad’s patent on the genes expires in two years, but the Supreme Court’s ruling21 will set the broader principle going forward. For now, Jolie’s Op-Ed has apparently made Myriad’s stock price rise 4 percent, its best level in years.’”
Nearly Every Part of the Human Genome Is Now Owned by Corporations
Ironically, just as we’re entering the age of individualized medicine, doctors’ ability to actually employ such advancements for the benefit of their patients is being profoundly undermined and restricted. As recently stated by Christopher E. Mason22 of Weill Cornell Medical College: “You have to ask, how is it possible that my doctor cannot look at my DNA without being concerned about patent infringement?”
Mason recently published a study in the journal Genome Medicine, in which he and his co-author, Jeffrey Rosenfeld, an assistant professor of medicine at the University of Medicine & Dentistry of New Jersey, show that when you include both genes and DNA sequences inside the genes, nearly the ENTIRE human genome is covered by patents! What this does is render medicine prohibitively expensive. Under the Affordable Care Act, BRCA genetic testing is classified as preventative care, which means no out-of-pocket cost for those deemed eligible. But as stated by Policymic:
“Affordable Care Act money should be used to provide medical care that is expensive for a reason, not to prop up an unfair and anti-competitive monopoly.”
Tissue Trauma and Surgery Can Actually Increase Your Risk of Cancer
There’s much yet to be learned about cancer development and progression. For example, research23, 24, 25 has shown that trauma to the breast itself can cause cancer. According to the authors:
“Models of epithelial cell generation indicate that a causal link between physical trauma and cancer is plausible. A latent interval between cancer onset and presentation of under 5 years is also plausible. The most likely explanation of the findings is that physical trauma can cause breast cancer.”
And, as reported by Science News in 2011: 26
“The slightest scratch can cause cancerous cells to crawl to the wound and form tumors in mice, a new study finds. The work may explain why certain kinds of cancers seem to cluster around burns, surgical scars and other injuries. ‘This work says that if you have a predisposition to getting cancer, wounding might enhance the chance that it will develop,’ says cell biologist Anthony Oro of Stanford University School of Medicine.”
This raises questions about the possibility of developing cancer in the remaining or surrounding chest tissue following a radical surgery as double mastectomy. Needle biopsies have also been fingered as sources of cancer that otherwise might not have occurred.27
Epigenetics—The Answer for Those Seeking Cancer Prevention
The paradigm-shattering research now referred to as epigenetics proves your genetic code is not nearly as predeterministic as previously thought. You actually have a tremendous amount of control over how your genetic traits are expressed. As it turns out, your genes will express or suppress genetic data depending on the environment in which it finds itself, meaning the presence or absence of appropriate nutrients, toxins, and even your thoughts and feelings, which unleash hormones and other chemicals in your body.
Dr. Susan Love, a breast cancer surgeon and president of the Dr. Susan Love Research Foundation commented on such research back in 2009, saying:28
“It’s exciting. What it means, if all this environmental stuff is right, is that we should be able to reverse cancer without having to kill cells. This could open up a whole new way of thinking about cancer that would be much less assaultive.”
Physician Discovers What It’s Like to Be ‘Sold’ Preventive Mastectomy
An article by Dr. Daniela Drake titled, Why I’m Not Having a Preventive Mastectomy29 presents the other side of the preventive mastectomy argument, and highlights the problems of our current paradigm:
“Lobular Carcinoma In Situ (LCIS)… increases my odds of developing cancer from 12 percent to 30 percent. But still, my options, my doctor explained, include immediate bilateral mastectomy… She tells me that my chances of developing cancer are 80 percent and that if she were in my shoes she would ‘just have them both removed.’ …Her offhand manner suggests something deeply unserious—like a manicure…
Although I used to be a vociferous advocate for aggressive medical interventions, my perspective changed radically when I began working as a house-call physician. My patients are too debilitated to go to the doctor’s office—and many were disabled by botched surgeries… I’m concerned about my surgeon’s flippancy and I suggest alternatives: ‘There’s growing data that this is a lifestyle disease. You know the Women’s Health Initiative shows exercise can greatly decrease risk.’
‘I don’t know. That may be true,’ she shrugs. ‘If we don’t do surgery, then we’ll just do mammograms every six months.’ When I object, saying that LCIS doesn’t show up on mammogram, she responds, ‘I know. It doesn’t make sense to me either.’ It becomes evident that we don’t know how to deal with my condition. The medical system does not tolerate ambiguity well, so breast amputation has become the answer…
Now I know why patients are so mad at us. This is supposed to be patient-centered care. But it feels more like system-centered care: the medical equivalent of a car wash. I’m told incomplete and inaccurate information to shuttle me toward surgery; and I’m not being listened to. I came to discuss nutrition, exercise and close follow-up. I’m told to get my breasts removed—the sooner the better.
Mastectomy may be appropriate in some cases, like in those where your risk of cancer is virtually 100 percent. But the risk of surgery—operative complications, infections, device and graft complications—remains significant. It’s callous and irresponsible to elide the risks to the public.”
The Case Against BRCA Testing
In the research paper titled, The Case Against BRCA1 and 2 Testing, published in the journal Surgery30 in June 2011, the four authors from the Department of Surgery, University of California explain what many oncologists don’t want to hear:
“It turns out that, like a book, a gene can be ‘read’ both backward and forward. Small sections (or chapters) within a big gene can be ‘read’ alone. The three-dimensional structure of DNA controlled by site-to-site methylation prevents many chapters from being “read” at all. In addition, short segments of RNA (22 base pair micro-RNA) can cycle back to control DNA transcription.
So, DNA is just the starting point, and like flour, you do not know whether the chef is going to cook a croissant or a tortilla with it… Are BRCA 1 and BRCA 2 unique? Or just like other genes, is their expression controlled by the inner cellular attitudes (both epigenetic and environmental) of the individual patient?
BRCA 1 and 2 code nuclear proteins, also known as tumor suppressor genes, capable of repairing damaged DNA… Both mutations increase the lifetime risk of breast cancer in a woman. Less than 5% of women diagnosed with either ductal carcinoma in situ or invasive ductal cancer are a result of inherited BRCA genes…
But BRCA 1 and 2 may speak with many voices. Polymorphisms are naturally occurring single nucleotide variations of a gene present in more than 1% of the population. Polymorphisms and other single-nucleotide variants have been identified within the BRCA 1 and BRCA 2 genes. Indeed, more than 500 mutations in BRCA 1 alone have been documented and most render their proteins inactive—so, some BRCA genes seem to be shooting blanks. And a single nucleotide polymorphism, albeit only a single nucleotide change, can have a formidable influence on protein expression.
Sequence variant S1613G, for instance, results in increased mutational risk of BRCA 1 neoplastic expression, whereas a variation in K1183R is related inversely to cancer risk. It seems that some polymorphisms may actually have a protective effect.”
In summary, the authors state that for screening and therapeutic purposes, BRCA 1 and BRCA 2 genetic testing is really little more than an expensive way of “determining what can be accomplished more expeditiously by speaking with your patient,” since:
The DNA base pair sequence in all humans is 99.6% identical
Epigenetic factors influence substantively the RNA processing and translational requisition of the initial DNA message
There are thousands of sequence variants of the BRCA1 and BRCA 2 genes
Family history trumps BRCA 1 and 2 status
Breast Cancer Prevention Strategies
So in summary, it’s important to realize that even though many well intentioned physicians and media will seek to convince you of the value of cancer screening, it does NOT in any way equate to cancer prevention. Although early detection is important, recently a number of very popular screening methods have been shown to cause more harm than good.
In terms of genetic testing, ask yourself what you would do with the information, should it turn out you’re a carrier of the breast cancer gene. Ideally, such a test result would spur you to take real prevention seriously. But even if you don’t have the mutation, lifestyle factors are still a much larger risk factor overall. Remember the percentage of diagnosed breast cancer cases that have the mutated gene is in the low single digits. Something else, primarily your lifestyle, accounts for the remainder.
In the largest review of research into lifestyle and breast cancer, the American Institute of Cancer Research estimated that about 40 percent of U.S. breast cancer cases could be prevented if people made wiser lifestyle choices.31, 32 I believe these estimates are far too low, and it is more likely that 75 percent to 90 percent of breast cancers could be avoided by strictly applying the recommendations below.
Avoid sugar, especially fructose. All forms of sugar are detrimental to health in general and promote cancer. Fructose, however, is clearly one of the most harmful and should be avoided as much as possible.
Optimize your vitamin D. Vitamin D influences virtually every cell in your body and is one of nature’s most potent cancer fighters. Vitamin D is actually able to enter cancer cells and trigger apoptosis (cell death). If you have cancer, your vitamin D level should be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I’m aware of, with no adverse effects. I suggest you try watching my one-hour free lecture on vitamin D to learn more.
Remember that if you take high doses of oral vitamin D3 supplements, you also need to increase your vitamin K2 intake, as vitamin D increases the need for K2 to function properly. See my previous article What You Need to Know About Vitamin K2, D and Calcium for more information.
Please consider joining one of GrassrootsHealth’s D*Action’s vitamin D studies to stay on top of your vitamin D performance. For more information, see my previous article How Vitamin D Performance Testing Can Help You Optimize Your Health.
Get plenty of natural vitamin A. There is evidence that vitamin A also plays a role in helping prevent breast cancer.33 It’s best to obtain it from vitamin A-rich foods, rather than a supplement. Your best sources are organic egg yolks,34 raw butter, raw whole milk, and beef or chicken liver.
Lymphatic breast massage can help enhance your body’s natural ability to eliminate cancerous toxins. This can be applied by a licensed therapists, or you can implement self-lymphatic massage. It is also promotes self-nurturance.
Avoid charring your meats. Charcoal or flame broiled meat is linked with increased breast cancer risk. Acrylamide—a carcinogen created when starchy foods are baked, roasted or fried—has been found to increase breast cancer risk as well.
Avoid unfermented soy products. Unfermented soy is high in plant estrogens, or phytoestrogens, also known as isoflavones. In some studies, soy appears to work in concert with human estrogen to increase breast cell proliferation, which increases the chances for mutations and cancerous cells.
Improve your insulin receptor sensitivity. The best way to do this is by avoiding sugar and grains and making sure you are exercising, especially with Peak Fitness.
Maintain a healthy body weight. This will come naturally when you begin eating right for your nutritional type and exercising. It’s important to lose excess body fat because fat produces estrogen.
Drink a half to whole quart of organic green vegetable juice daily. Please review my juicing instructions for more detailed information.
Get plenty of high quality animal-based omega-3 fats, such as krill oil. Omega-3 deficiency is a common underlying factor for cancer.
Curcumin. This is the active ingredient in turmeric and in high concentrations can be very useful adjunct in the treatment of breast cancer. It shows immense therapeutic potential in preventing breast cancer metastasis.35 It’s important to know that curcumin is generally not absorbed that well, so I’ve provided s