Breast+Cancer

//Western Diagnosis// Most common CA in women

2010 Statistics ~207,000 invasive cases 54, 000 non-invasion cases 40,000 deaths

Risk factors
1. family hx in 1st degree relative (parent, sibling, child) 2. early menarche, late menopause 3. late or no pregnancies [1st after age 35] 4. Fibrocystic Breast Disease 5. high fat diet [controversial at the moment]

Signs & Symptoms
1. >80% present as a lump found by woman 2. dominant mass: distinctly different from rest of breast tissue 3. usually painless, unilateral mass 4. hard, non-moveable mass 5. any mass must be carefully considered 6. instruct woman in BSE if not done: monthly at same time in cycle 7. may metastasize to any organ: Lu, Lv, bone, lymph nodes, skin

Diagnosis
1. mammography ---controversy as to when to begin ---controversy as to how often to perform them 2. biopsy ---E receptor analysis ---2/3 are ER+ - better prognosis 3. genetic testing [mutations of BRCA 1 &2 raises risk to 80%, more common in Jewish women of eastern European descent]

Treatment
1. lumpectomy - modified radical mastectomy [results seem to be better in conjuction with radiation] 2. radiation - chemotherapy 3. endocrine therapy: tamoxifen 4. Diet: ---fatty acid manipulation ---aspirin use can reduce risk ---vitamin reduces risk & recurrence ---

Studies and risk reduction
Exercise is one of the most influential components to reducing risk 1.25-2 hours/week reduced risk by 18%. 4 hours/week of stenuous exercise doubled that

Breast feeding reduces one's risk, moreso if feeding for 2 years or longer

Aluminum in antiperspirants may play a factor in risk, also paraben in them that has a small estrogeinc effect

Tight underwire bras where there is significant local restriction may increase risk

employees working night shifts increased their breast cancer risk 60%

having had 25 prescriptions or 105 days of antibiotics showed to increase risk by 50%

Mammograms: study in Denmark showed it was not useful, the standard is controversial ACS: suggests every woman over 40 should have one every year; women in 20-30s should have breast exam every 3 years

removal of the axillary lymph nodes does not seem to increase survival rates [

=
========================================================================= ==**Definition:** == Malignancy of the breast.
 * IBIS:**

==**Etiology:** == The risk of an American woman developing breast cancer during her lifetime is approximately 11%, or 1 in 8 women, with approximately 3-4% dying of the disease. Breast cancer accounts for 27% of all cancers in women. It is rare in women under 30, and greatly increases in incidence after menopause.

Factors known to increase the risk of breast cancer include a diet high in fats, alcohol consumption, radiation of the breast, and unopposed estrogen stimulus. Several factors appear to increase the risk of developing breast cancer, including family history, reproductive history, diet high in fats, alcohol consumption, radiation exposure, and hormone usage, especially unopposed estrogen stimulus. Despite the recognition of these risk factors, approximately 70% of the women who develop breast carcinomas do not have any of these identifable risk factors.

A study published in the New England Journal of Medicine tracked 1,300 women for 25 years, they found those who had the densest bones were 3.5 times more likely to develop breast cancer than those with the least dense bones. It is important to note that the researchers acknowledge that it may be a woman's lifetime exposure to estrogen that could increase her chances of developing breast cancer -- not necessarily estrogen taken during and after menopause. (Zhang Y, et al. N Engl J Med 1997 Feb 27;336(9):611-617. ) == ==


==**Nutrition:** == » eating principles: • several 7-10 day alkaline fasts interspersed with eating for 3 weeks (see Fasting in materia medica)

» therapeutic foods: • foods rich in Vitamin A • liver-cleansing foods: beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root • Rats with chemically-induced breast cancer that received a series of injections of tomato extract rich in the carotenoid lycopene developed significantly fewer tumors and the tumor size was smaller compared to placebo. Rats injected with beta-carotene did not experience the benefits against breast cancer. (Sharoni Y, et al. Cancer Detect Prev 1997,21(2): 118-123.)

» fresh juices: • carrot (Walker, 129.) • carrot and spinach (Walker, 129.) • apple (Shefi) Note: Carrots and apples are considered estrogenic foods to be avoided by some sources, but recommended in concentrated in juice therapy by other sources.

» recommendations for all cancers: • seaweeds, mushrooms - Chinese black, Maitake and Shiitake, figs, beets, beet tops, papaya, mung beans, licorice, sea cucumbers, carrot, garlic, walnut, lychee fruit, mulberries, asparagus, pumpkin, burdock, dandelion greens, white fungus, taro roots, pearl barley, grains, fresh fruits and vegetables (Ni, 108-109.)

» specific remedies: • soup of black or ling zhi mushrooms and white fungus, three times daily (Ni, 108-109.) • boil together mung beans, pearl barley, adzuki beans, and figs (Ni, 108-109.) • dandelion, burdock, and chrysanthemum flower tea (Ni, 108-109.) • tea from asparagus and dandelion, apply externally as compress to breast • charcoal the pumpkin cap into powder, take l tsp. of powder in l shot of rice wine twice daily (Ni, 108-109.)

» avoid: • meat, alcohol, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, caffeine, coffee • estrogenic foods: animal products, apples, cherries, olives, plums, carrots, yams, nightshade family, peanuts, soy products, coconut, brown rice, barley, oats, wheat • Foods that contain estrogen-like sterols (see materia medica)

==**Botanicals** == • Alaria esculenta: inhibits breast cancer (Mowrey, pp. 20, 208) • Echinacea spp.: for pustular afflictions and carcinomatous ulcerations; for tendency to malignancy and sepsis (Felter, p. 347) • Phytolacca decandra (toxic): marked action on the mammary glands, hard painful glandular enlargements; a poultice of fresh grated or boiled dried root is very caustic and causes ulceration and suppuration of skin and underlying cancerous tissue (Felter, pp. 535-538; Anderson Geller) • Trifolium pratense: traditional anti-cancer herb used by Thomsonians (Mitchell, p. 42)

nutritive herbs: support the immune system and the woman's defenses to better withstand chemotherapy, surgery and radiation if these are chosen. Avoid alcohol, drugs, smoking, stress, etc. • Avena sativa • Medicago sativa • Trifolium pratense • Urtica dioica

==**Chinese Formulae** == • Ping Xiao Dan: Primary preventive and anticancer formula: given alone if the patient complains only of a mass (Jia Kun, p. 4, 13, 101) • Gua Lou Yin Feng Wan: administered with Ping Xiao Dan when heaviness of the mass and mild pain appear (Jia Kun, p. 101) • Lou Ju Ci Gu Tang: administered with Ping Xiao Dan when the lump grows bigger and is mobile with bloody nipple discharge, fever and pain (Jia Kun, p. 101) • Fan Su Wan: administered with Ping Xiao Dan if further disease progression, ulceration and rupture with bloody and purulent discharge and pain, and the overlying skin becomes hard and purplish (Jia Kun, p. 101) • Xiong Shen Gao: for external application (Jia Kun, p. 101) • Fen Bei San: for external application if the lesion does not heal with Xiong Shen Gao (Jia Kun, p. 101) • Qi Xiang San: for external application if the lesion aches (Jia Kun, p. 101) • Gua Lou Xiao Yao Tang: administered with Ping Xiao Dan if no appetite and weight loss (Jia Kun, p. 101) • Jing Xiao Wan: for metastasis with enlarged lymph nodes (Jia Kun, p. 102) • Lithospermum and Oyster Shell C.: lymphadenoma; anemia, weakness (Hsu, 1980, p. 632; Dharmananda, 1986, p. 478) • Dandelion and Vacarria C. (Dharmananda, 1986, p. 477) • Chih-ko and Curcuma C. (patent) plus Blue Citrus (patent): Breast lumps (Dharmananda, 1990; Chih-ko and Curcuma, p. 41: Blue Citrus, p. 38) • Xi Huang Wan (patent) (Zhu, p. 199) • Tang Kuei Sixteen C.: Dissolves masses and abscesses; cervical lymphadenopathy (Hsu, 1980, p. 402) • Xi Huang Wan (patent): with abscess (Zhu, p. 199) • W.T.T.C. plus Six Major Herb C. (Liu Jun Zi Tang): to prevent post-surgical metastasis (W.T.T.C.: Hsu, 1980, p. 617; Six Major Herb: Hsu, 1980, p. 242; Yeung, p. 150; Dharmananda, 1986, p. 131; Bensky and Barolet, p. 238) • Zeng Ye Tang plus chrysanthemum flower (ju hua), trichosanthes root (tian hua fen), glehnia (sha shen), dioscorea (shan yao) and moutan bark (mu dan pi): Large Intestine Dryness: oral side-effects of radiation therapy: dryness that is worse at night, irritability, dry tongue, rapid thin pulse (Bensky and Barolet, p. 166) • Dang Gui Ji Xue Teng Tang: Qi Xu (Deficiency) with Xue Xu (Blood Deficiency): leukopenia or thrombocytopenia during radiation therapy or chemotherapy (Bensky and Barolet, p. 251) • Hoelen Five Herb F. (Wu Ling San): side-effects from radiation. (Hsu, 1980, p. 516; Yeung, p. 244; Dharmananda, 1986, p. 173; Bensky and Barolet, p. 174) • Ji Xue Teng Qin Gao Pian (patent): increases white blood count. (Zhu, p. 103) • Ci Wu Jia Pian (patent): Qi Xu (Deficiency) with Kidney Jing Xu (Essence Deficiency): enhances immune system, helps protect body from radiation; inhibits metastasis (Zhu, p. 284) • He Che Da Zao Wan (patent): Kidney Yin Xu (Deficiency) (Zhu, p. 286) • Ling Zhi Feng Wang Jiang (patent): Qi Xu (Deficiency) with Xue Xu (Blood Deficiency) (Zhu, p. 262)

==**Acupuncture** == after assessing the person and palpating, consider these patterns: Liver Qi Stagnation; Xue Yu (Blood Stasis); Phlegm-Dampness due to Spleen Xu (Deficiency); Xu (Deficiency) of Qi and Xue (Blood); Shi (Excess) of the Dai Mai (Girdle Vessel); Stagnant Toxins

» illustrative combinations: • SI-1 and St-18: treat most breast problems (Ambrose) • St-30, GB-22 <-> Sp-21 area and SI-11 are "essential" points for treating breast problems; St-15 <-> St-16 area along with PC-6 and Sp-4, to effect the Chong Mai (Penetrating Vessel), are secondary points; palpation, of course confirms the points' appropriateness (Matsumoto) • Kd-13, UB-67, Kd-7, GB-37, Sp-6, Kd-2, GV-4 and Lv-3: influence ovaries (Worsley, 1975, p. B-20; McWilliams, et al, Lesson 31, p. 258) • GB-41 and TW-5: open the Dai Mai (Girdle Vessel) for which unilateral problems of the breast are a symptom of Shi (Excess) • SI-1 and Lu-10: remove Obstruction of the breast (Flaws, 1989, p. 80) • St-36, GV-14 and LI-4: return the white blood cell count to normal (leukopenia after chemotherapy) (Finkelstein, p. 20)

==**Homeopathy** == • Asterias rubens: hard growth: nightly lancinating pains; often in left breast; sensation left breast drawn in • Carbo animalis: esp. right; burning, drawing pains through breast • Carcinosin: intercurrent • Conium maculatum: strong hard tumors, induration of tissue; swelling under axilla; painful or painless nodules • Condurango: hard tumor; either breast; lancinating pains radiating from tumor, whole breast tender to touch • Hydrastis canadensis: hard, painful nipple retracted; exhaustion from weakness; pain < night • Lac Humanum: history of difficult mother-daughter relationship; issues of nourishment • Phytolacca: hard, irregular with retracted nipples; sore, lame feeling extended to the arm; fissured nipple; pain radiates from the nodule • Plumbum iodatum: enlarged glands, chronic enlargement of spleen • Pulsatilla: irregular menses, pains move around; induration of tissue • Silicea: hard, painful nodule; < left side • Sulphur: tumor with internal itching and bleeding hemorrhoids; one dose 1M at each menses

==**Subtle Support** == notes: A, C, C#, G, G#

• chords: A Major, C Major (Gimbel, p. 116)

pain: • Mendelssohn's Spring Song • Meditation from Thais • Chopin's Preludes • On Wings of Song • Andante, Beethoven's Fifth Symphony • Adagio, Beethoven's Pathetique Symphony (Heline, p.18)


==**Mind/Body** == see also: cancer patients: personality characteristics cancer correlations: psychoneuroimmunology

• Breasts represent mothering and nurturing. (Hay, 1984, p. 157) • Associated with heart chakra; inability to nurture which results in guilt feelings and self-hate; fear and identity crises at closure of natural cycle of motherhood when children leave the home; giving continually to others but unable to love or nurture herself; resentment at not receiving love from others; emptiness of life of being alone, unloved and uncared for. (Shealy, p. 180) • Family History: adolescent experiences and shaping of sexual attitudes - Mothers who developed a strong grasp of their own identity provided their daughters with a vigorous and provocative role model. This was in contrast to daughters of resigned mothers, who exhibit ambivalence and avoidance of success. The effective modeling and identification with the same sex parent depends on the quality of the relationship with that parent. If mothers are unable to offer their daughters a positive acceptance of themselves and their own sexuality, for whatever reasons, those daughters are more susceptible to alienation from themselves - loneliness, separateness, betrayed intimacy - all of which plant the seeds of susceptibility to breast cancer. Many women with breast cancer perceive their mothers as unable or unprepared to assume the mothering role for them; further, their relationships with their fathers were stressful or lacking. (Boyd, p. 116, 164-166) • Comparison study of younger and older patients (those who developed the disease before or after age 48) in a sample of 49 women indicates that the psychic component plays a greater role with the younger patients. More often, these women lost an emotionally important figure in childhood, describe an emotionally cold family atmosphere, and were overstrained with responsibility at an early age. The ideals of these women are somewhat like those of the 'Amazons': they negate the typical female role, seem quite combative, and are achievers. Only 12% express a consistently positive attitude toward sexuality; and pregnancy, childbirth, and breast feeding are often accompanied by complications; but in the majority of cases, they have children. When regarding the multi-causal genesis of cancer, it may be that psychic factors have less influence on the immune system in older patients than the overall aging process with its weakening of the immunological defense system. The older patients in their life history and pre-morbid behavior are nearer to what passes for the psychic norm, and other carcinogenic factors may play a more significant role. (Locke, 1983, p. 122) • Psychosocial factors influencing delay and breast self-examination in women with symptoms of breast cancer, in a study of 90 women, revealed that one-fourth of the subjects had delayed more than 4 months in reporting their first symptoms, and half had never examined their own breasts. The report suggested that the delay was determined by unconscious psychological processes, including the use of ego defenses of denial and suppression. Conscious factors, including age, education, and knowledge about cancer were not related to the length of delay, nor to the practice of breast self-examination. (Locke, 1983, p. 125) • Long continued stress could lead to high circulating levels of prolactin, growth hormone, thyrotropin, estrogen, and corticosteroids; some of which might affect the growth of breast cancer. There have been reports suggesting that the prognosis may be worse in patients who are overanxious. It is possible that mental factors could activate the tumor, or that toxic effects of a more active tumor could cause specific mental effects. (Locke, 1983, p. 128) • Elevated serum prolactin levels caused by antipsychotic agents have been suspected of increasing the risk of breast cancer. The authors reviewed all the cases from 1969-1978 in a large psychiatric hospital. The rate of breast cancer among patients using antipsychotic drugs was not higher. (Locke, 1983, p. 167) • Recurrence-free survival of breast cancer was significantly more common among patients who had initially reacted to cancer by denial or who had a fighting spirit than it was among patients who had responded with stoic acceptance or feelings of helplessness and hopelessness, in a 5-year study of 69 patients. (Locke, 1983, p. 145) • Women who survived two years post breast surgery without any recurrence were less anxious initially and were possibly also less depressed. (Locke, 1983, p. 147)

personality profile: (from multiple studies): • unable to discharge or appropriately deal with anger, aggressiveness, and hostility • cover these feelings with pleasant facade - tend to be compliant, pleasantly cooperative, and continually avoid any form of open conflict, thus increasing sense of frustration and unworthiness • not even aware they are angry; more repressed existence of conflict • prone to be in masochistic relationships (cold, older man; passive, dependent man) • suffer from sexual inhibition (frigidity or restraint) and unacknowledged sexual frustration • inhibited motherhood - don't want children • strong tendency for unresolved hostility toward own mother, which is denied: in a majority of women, this appeared as an unusual and unrealistic degree of self-sacrificing devotion toward their mothers • parents who were cold, rejected the child, didn't allow them freedom to make mistakes or to express or show feelings • conflict over masculine-feminine interests (not so much what the activity was but on whether it was viewed as being properly feminine, concern over activity being seen as masculine and thus being disapproved of) • more fears, suspicions, and phobias; admit feeling isolated yet deny any fears or phobias; more depression • unawareness of bodily sensations or feelings • moralistic religious attitudes, dogmatic principles and ethics • diaries revealed all felt inadequate, generally felt alone and neglected (Boyd, p. 68-73)

• Stomach ~ Wei is the Sea of Nourishment and origin of all fluids; transforms and digests food so that the Spleen can separate the distilled food essences; with the Spleen, is the root of post-natal Qi; and as Earth, relates to the ability to assimilate, stabilize, and feel balanced and centered. » Mental signs of Stomach channel disorders include depression, death wishes, instability, suicidal tendencies, mentally overwrought, doubt, suspicions, tendency to mania, and slowness at assimilating ideas. (Seem, p. 27) The Stomach channel passes over the breast with St-17 at the nipple.
 * Chinese psychophysiology:**

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Tumors and other masses are considered a form of Xue Yu (Blood Stasis) and thus ultimately are derived from Qi Stagnation. Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216)