What’s Up With Being Negative? ER – Breast Cancer Patients Need to Know!
I was speaking in Milwaukee a few weeks ago to a large Komen group and a young lady, just 26 years old, came up to me and said, “I have estrogen receptor negative breast cancer…I don’t fit into the same mold as other women. So, what kinds of foods should I be eating?”
Eight years ago, when I was writing Challenge Cancer and Win!, that same question sent me to the National Library of Medicine to find an answer. I couldn’t find one. While we have thousands of studies specific to breast cancer, it is only recently that researchers are focusing on the dietary link to breast cancer based on estrogen receptor status.
As you probably know, breast cancer is one of the most common cancers in the United States. Most women will be diagnosed with estrogen receptor positive breast cancer-which means that their cancers are spurred on by excess estrogen in the body. Many studies have helped us formulate certain dietary recommendations specific to this kind of cancer. But what about the individuals who are diagnosed with estrogen receptor negative breast cancer-a type of cancer that accounts for nearly 25% of all breast cancer diagnoses?
Recent studies have surfaced in the last five years and now we have a game plan for estrogen receptor negative breast cancer survivors too! In a study published in the February 2006 issue of the Journal of Nutrition, researchers found that women who scored high on Harvard University’s Alternate Healthy Eating Index had a lower risk of estrogen receptor negative breast cancer. This index provides guidelines describing the “gold standard” for cancer risk reduction and includes recommendations to consume a daily intake of the following: 9 servings of fruits and veggies, 7+ grams of dietary fiber, eating three times more chicken and fish than beef, lamb and pork, consuming 30-40% less saturated fat than polyunsaturated fats, eating less than 3 grams of trans fats and consuming 1 ounce of nuts or soy. So, basically, the researchers recommend a diet that is rich in plants. That’s no surprise. And those recommendations apply to any woman concerned with breast cancer, or any cancer or disease for that matter.
In August 2005, a study published in the journal Cancer Epidemiology Biomarkers and Prevention revealed that researchers looked at folate intake and risk of breast cancer characterized by hormone receptor status. Remember that folate is a B vitamin given to pregnant women to help prevent birth defects. B vitamins play a crucial role in many body functions, including accurate cell division. For optimal health, we want accurate cell division-we want those healthy cells to keep duplicating themselves so we have even more healthy cells! The researchers found that women whose diets were deficient in folate had an increased estrogen receptor negative breast cancer risk. Higher folate intake was not associated with a lower risk of developing estrogen receptor breast cancer. So, while it makes sense for everyone to strive for accurate cell division and consume foods rich in folate, those individuals with estrogen receptor negative breast cancer may want to add these folate-rich foods to their daily checklist: fruits like cherries, oranges and strawberries, beans and peas, and dark, green leafy veggies. Alcohol, by the way, robs the body of folate and other B vitamins, so it’s prudent to enjoy alcohol only occasionally, if at all.
The University of Texas MD Anderson Cancer Center researchers found that high intakes of linoleic acid were associated with more than a 300% greater risk of estrogen receptor negative disease than estrogen receptor positive disease. Linoleic acids are found in polyunsaturated fats like cottonseed, soybean, and corn oil as well as vegetable-based margarines. We have certainly seen a link to all breast cancers with the intake of excessive polyunsaturated fats (sources for linoleic acid) but this study offers significant insight for those individuals with estrogen receptor negative status. I would recommend exclusive use of extra virgin olive oil and butter, rather than margarine. And don’t forget the hidden fats found in crackers and other bakery products. It’s time to choose non-hydrogenated food products if you haven’t paid attention to this suggestion already.
In a final study, Roswell Park Cancer Institute researchers published their findings in Breast Cancer Research Treatment journal in October 2006. They found that among premenopausal women, there was a reduced risk of estrogen receptor negative breast cancer for those women who consumed the highest lignan intake. We see benefits of lignans in estrogen receptor positive breast cancer studies as well. Lignans, a fibrous compound, are found in flaxseed, and to a lesser degree in sesame seeds, and kale. Ground flax seed can be added into soups, stews, cereals, waffle and pancake batter, tossed into a salad, mixed into a smoothie or stirred into a glass of orange juice.
The take home message is simple: dietary recommendations for estrogen receptor negative breast cancer survivors are similar to those recommended to estrogen receptor positive breast cancer survivors. It’s time to eat more fruits, veggies and fiber containing foods like grains and beans, limit alcohol and fats, use olive oil and butter and include flax in your diet. I believe that impact of these studies is more profound: For those of you with estrogen receptor negative breast cancer, when you read nutrition information specific to breast cancer, you can rest assured that the majority of those recommendations will apply to you too. You are not alone! Isn’t that positively wonderful?