Natural Alternatives for Aromatase Inhibitors and Chemoprevention

Aromatase inhibitors (AIs) are a class of drugs used to treat breast cancer by reducing the amount of estrogen available that can stimulate the growth of estrogen-driven cancer cells. This class of drugs doesn't halt ovaries from making estrogen, so AIs are only used in post-menopausal women. There are 2 types of aromatase inhibitors (AIs) approved to treat breast cancer:

• Irreversible steroidal inhibitors, such as exemestane (Aromasin), forms a permanent and deactivating bond with the aromatase enzyme.
• Non-steroidal inhibitors, such as anastrozole (Arimidex) and letrozole (Femara), inhibit the synthesis of estrogen via reversible competition for the aromatase enzyme.

How effective are AIs?

After researching the efficacy of AIs, I discovered that although they are associated with a reduction in breast cancer recurrence, they do not result in women with breast cancer living any longer. What's more, the drugs have been found to produce a host of adverse, sometimes toxic effects, which make the benefit somewhat questionable. Researchers in Medical Oncology and Hematology at Princess Margaret Hospital in Toronto suggests that the toxicity may explain the lack of overall survival benefit. See http://jnci.oxfordjournals.org/content/103/17/NP.6.full for details on this study.

Xenoestrogens 
Not only do we have estrogens naturally produced by our bodies, but we may also have external chemicals in our body, for example from certain pesticides, BPA, phthalates, toluene, perfumes, parabens etc which act like estrogens. They are called xenoestrogens and some of them can be just as harmful as the more aggressive natural estrogens.

Part of my protocol is replacing personal care products and home goods with natural ones that don't have the toxic chemicals listed above. I also eat organic and avoid pesticides wherever possible.

Are there safer alternatives?

The short answer is yes! There are many ways of cutting both natural and chemical estrogens. The first is to lose the fat. Being overweight is a counter-active factor as fat can provide the building blocks for estrogen, and is also an excellent solvent and so will store estrogens that you would be better to excrete. 

Having good blood levels of plant estrogens (phytoestrogens) has been shown to be protective, as has Indole3carbinol (from broccoli and greens).  Also important is the health and involvement of certain beneficial bacteria in the gut, and their ability to use whole foods like lignans to bind to estrogenic products and help excrete them.

Note: I highly recommend the website canceractive.com for more information on alternatives. Much of what you're reading here came from them. 

My Alternative AI Combo

Natural Phytoestrogen via greens and chickpeas - Phytoestrogens are herbs and foods that mimic the effects of estrogen in your body. Because they are weaker forms of estrogen, they provide a weaker stimulation of cell receptor sites. For those who have high amounts of estrogen, these foods competitively bind with receptor sites and decrease the overall effect of estrogen. Phytoestrogens are abundant in green vegetables, fruits and particularly pulses like chick peas and beans. I have a glass of juiced greens each day, green vegetables with every meal and I eat a lot of humus, which is made from chickpeas.

Soy is another phytoestrogen who's effects with breast cancer have mixed reviews. There are studies demonstrating both positive and negative effects. I eat edamame and tofu, but tend to limit my soy intake otherwise.

I3C - I3C contains indoles and other compounds found in cruciferous vegetables that have shown promise in supporting healthy levels of estrogens. I3C acts in a number of ways, from denaturing aggressive estrogen and its by products to rebalancing estrogen receptor sites. I3C is almost ‘the wonder compound’ it has so many beneficial effects – from being a natural Tamoxifen, without the side effects to an inhibitor of dangerous dioxins in the body. Natural supplements are available and synthetic drugs are in preparation. I take a I3C + DIM blend from Seeking Health.  http://www.seekinghealth.com/dim-supplement-indole-3-carbinol-dim.html

Rice Bran - Emerging evidence suggests that rice bran (from brown rice) may be beneficial against several types of cancer, including breast, lung, liver, and colorectal cancer. The chemopreventive potential is related to the bioactive phytochemicals in the bran portion of the rice such as ferulic acid, tricin, β-sitosterol, γ-oryzanol, tocotrienols/tocopherols, and phytic acid. Studies have shown that the anticancer effects of the rice bran-derived bioactive components are mediated through their ability to induce apoptosis (cancer cell death), inhibit cell proliferation, and alter cell cycle progression in malignant cells. Rice bran bioactive components protect against tissue damage through the scavenging of free radicals and the blocking of chronic inflammatory responses. Rice bran phytochemicals have also been shown to activate anticancer immune responses as well as affecting the colonic tumor microenvironment in favor of enhanced colorectal cancer chemoprevention. This is accomplished through the modulation of gut microflora communities and the regulation of carcinogen-metabolizing enzymes. From http://www.ncbi.nlm.nih.gov/pubmed/22983843 I eat brown rice regularly, and I also take Beta 1,3D Glucan. 

Resveratrol is a flavenoid that is the natural protective agent in the skins of red grapes and black and red berries. Research has shown that Resveratrol has a natural anti-aromatase effect. Unfortunately you can't get the needed amount of resveratrol from a daily glass or two of red wine, so you'll need to take supplements.  Check out this study - Anti-aromatase effect of resveratrol and melatonin on hormonal positive breast cancer cells co-cultured with breast adipose fibroblasts.

Melatonin - The hormone melatonin is a powerful antioxidant and free radical scavenger that helps combat inflammation. In addition to its immune system benefits and helping you fall asleep and bestowing a feeling of overall comfort and well being, melatonin has proven to have an impressive array of anti-cancer benefits. Melatonin inhibits the proliferation of a wide range of cancer cell types, as well as triggering cancer cell apoptosis (self destruction). The hormone also interferes with the new blood supply tumors require for their rapid growth (angiogenesis). Melatonin can also boost efficacy and decrease the toxicity of cancer chemotherapy.

Quercetin is an allstar anti-cancer nutrient that is widely available in onions and apples, however it denatures rapidly in the body and so it seems that the potency comes not so much from the quercetin itself but from its breakdown by-products. Science is playing catch-up tracking their effects, but apart from the usual antioxidant and anti-inflammatory benefits, and anti-bacterial/anti-viral factors, there is research indicating that they have AI benefits in breast cancer cells. Other sources include garlic, kale, brussel sprouts and cabbage. I eat a lot of garlic and I also take a quercetin supplement.