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October 25, 2004 |
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In This Issue...
LIVING WITH THE CURE Tamoxifen is one of the most successful drugs in cancer history, having succeeded in cutting breast cancer recurrences by half. Yet many women are troubled by side effects -- hot flashes, decreased fertility, vaginal changes, nausea, vomiting and weight gain -- and want to know about other drug options or ways to ease the side effects. There are currently no comparably effective alternatives for women with estrogen-sensitive breast cancer, says Barbara MacDonald, a naturopathic physician (ND) and breast cancer specialist at A Woman's Time clinic in Portland, Oregon. (Two-thirds of breast cancer cases are fueled by estrogen, which promotes the growth of breast cancer cells.) There's an overwhelming amount of evidence that tamoxifen works. However: There are steps you can take to ameliorate its side effects and make sure that tamoxifen is as effective as possible for you. THE ESTROGEN EFFECT Tamoxifen works by blocking the effects of estrogen in breast tissue. As a result, its side effects are similar to the symptoms of menopause, which occurs when your body naturally winds down estrogen production. This leads some women to think that tamoxifen brings on menopause. Dr. MacDonald does not agree. Irregular periods are a common side effect of using tamoxifen. However, if you were menstruating regularly before you started taking it, chances are that you'll return to your regular monthly pattern. On the other hand, the closer you are in age to starting menopause, the more likely it is that the change will be permanent. On the plus side, while tamoxifen acts as an estrogen inhibitor in breast tissue, it functions as a weak estrogen in other parts of the body, offering modest protection against bone-thinning osteoporosis. NATURAL TREATMENTS FOR SIDE EFFECTS Just as in menopause, the most disruptive side effects of treatment with tamoxifen are those nightgown-drenching, sleep-disturbing, meeting-interrupting, embarrassing, uncomfortable hot flashes. Also very common is excessive vaginal discharge or, ironically, vaginal dryness. Other possible side effects include irregular menstrual periods, headaches, fatigue, nausea, vomiting, skin rash, mood changes, anxiety and depression. As with menopause, not all women who take tamoxifen experience all side effects Note: There is a debate about the use of some of the recommended plant remedies (such as black cohosh, flaxseed and soy) by women with breast cancer. Critics contend that these remedies contain plant-based estrogens that may stimulate the growth of breast tumors, although consumption must be high. Dr. MacDonald believes that the whole category of these so-called phytoestrogens is misnamed because they don't contain estrogen. What they do is act like estrogen by affecting the same estrogen receptor sites in the body. Dr. MacDonald and her colleagues at A Woman's Time frequently recommend these treatments to breast cancer patients to counter the side effects of tamoxifen. However, she cautions that each woman should speak to her own ND about personal risk factors and medical history, and only then make the determination whether or not to use them. She adds that dosage is extremely important because large amounts of black cohosh, soy or flaxseed might block tamoxifen from important estrogen receptor sites. Treatments...
Also, identify and avoid triggers. Keep a record of when hot flashes occur and what you were doing or eating and how you were feeling at the time. Common triggers are stress, emotional upset, sugar, caffeine and alcohol. REGULAR MONITORING IS KEY Even more serious than transient side effects is the fact that tamoxifen increases the risk of two types of cancer that develop in the uterus: endometrial cancer and uterine sarcoma. If you experience symptoms, such as abnormal bleeding or pelvic pain, see your gynecologist at once. Dr. MacDonald stresses the importance of annual pelvic exams. A VALUE-ADDED OPTION Most women derive no further benefit from tamoxifen after using it five years, observes Dr. MacDonald. Around this time, risks begin to outweigh benefits. However, following tamoxifen treatment, studies indicate that a new class of drugs called aromatase inhibitors (Femara, Aromasin or Arimidex) can cut the risk of breast cancer recurrence by an additional 30% to 50%. These drugs work only in postmenopausal women and women who have had hysterectomies. To help you weigh the pros and cons of all the various approaches, it is best to add an ND to your treatment team. Dr. MacDonald recommends that you look for a licensed ND who attended a four-year accredited postgraduate naturopathic medical school. You can find an ND on the Web site of the American Association of Naturopathic Physicians (AANP) at www.naturopathic.org. In the long run, your best bet to beat breast cancer is to embrace a treatment plan that includes a range of complementary and conventional therapies. ULCERS GONE FOR GOOD Want to make your ulcer worse? Take antacids. Want to make it better in no time? Take the natural breakthrough called DGL that actually strengthens your stomach's natural lining while healing existing ulcers. You also can quickly halt a brutal cold... open clogged arteries... and ease the pain of arthritis. It's easy when you have the secrets from Mark Stengler, doctor to the stars. GROWING (COUCH) POTATOES It is a known fact that television watching is not the best activity for children The latest in a string of studies about kids and TV is from New Zealand's University of Otago. Published in The Lancet, the study connects children's early TV-watching habits with some major health risks. Researchers followed 1,000 children for two decades, from the time they were three until they were 26, and found that children who watched TV for more than two hours a day were more apt to have later problems with weight, cholesterol levels, smoking and poor fitness. Does this mean that parents should toss the TV? Not at all, says child psychologist John Murray, PhD, former director of School of Family Studies and Human Services, Kansas State University, and a specialist in the area of TV watching and children. TV itself isn't bad. Parents simply need to realize their role in being sure it is used wisely in their home, he says. SAFE TV STRATEGIES Although the American Academy of Pediatrics recommends that children watch no more than two hours of TV a day, Dr. Murray has additional advice. The first goal, he says, is to get kids (and maybe yourself) to be selective about what they watch. Children need to understand that watching TV is an activity, even though they're just sitting there, and it is taking time away from other things. To heighten awareness of TV watching as an activity, go through the listings with your kids each week and have them select their preferred shows. When it's time for a selected show, have the kids turn on the TV, watch it -- and then turn the TV off. Certainly you should set limits, but to prevent ongoing arguments and negotiations for more, make your rules simple and easy to follow. He suggests a school-year rule of no TV after dinner, a clear demarcation that defies manipulation. (However, he adds, flexibility is in order when big events, such as this past summer's Olympics or special holiday programming, come along.) Some parents find that creating activity goals with their kids also helps decrease TV watching while getting the children to exercise. The activity doesn't have to be "athletics" per se -- just something that doesn't include "the tube." To evaluate if your children are currently watching too much TV, Dr. Murray offers the following guidelines. Are your kids getting good grades? Do they have friends, hobbies and other interests? If the answer to these is yes, their TV watching isn't a problem. But TV watching should be limited if children are withdrawn, have few friends and do poorly in school. Parents should intervene by immediately steering children away from TV to explore new interests such as sports, activities with other children, books, etc. Finally, beware Be well,
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Sources... Living with the Cure
Growing (Couch) Potatoes
Required Disclaimer: The information provided herein should not be construed as a health-care diagnosis, treatment regimen or any other prescribed health-care advice or instruction. The information is provided with the understanding that the publisher is not engaged in the practice of medicine or any other health-care profession and does not enter into a health-care practitioner/patient relationship with its readers. The publisher does not advise or recommend to its readers treatment or action with regard to matters relating to their health or well-being other than to suggest that readers consult appropriate health-care professionals in such matters. No action should be taken based solely on the content of this publication. The information and opinions provided herein are believed to be accurate and sound at the time of publication, based on the best judgment available to the authors. However, readers who rely on information in this publication to replace the advice of health-care professionals, or who fail to consult with health-care professionals, assume all risks of such conduct. The publisher is not responsible for errors or omissions. |
