You may have noticed from previous posts that I am somewhat conflicted about taking Tamoxifen. As I have made a decision to hold off for now, mum thinks that I should get some input from somebody she trusts. We drive down the Tasman peninsula to see a naturopath, Ree van Galen.
Ree is a very open and welcoming person who speaks in no-nonsense terms. She does not offer advice on whether of not I should take Tamoxifen. That decision is for me alone. She does, however, give me some very useful information to aid me with my decision.
Here is my somewhat simplistic interpretation of what I learned. This post is a touch on the long side but you may find it helpful if you are in a similar quandary. It will certainly help me to refer back to it in the future.
First she builds up a picture of how my body has produced and handled oestrogen in the past. She asks all about my history. Was I ever on the pill? What were my periods like? Did I ever have PMT? Pregnancies? Based on my answers she ascertains that I have not been over-producing oestrogen.
She explains that there are different types of oestrogens, those that we manufacture in our body and those that we ingest from other sources. Tamoxifen blocks the uptake of all oestrogen. Unfortunately it inhibits uptake throughout the body, not just in the breast tumour. I have never been able to quite get past the idea that the rest of my body must need that oestrogen for some important purpose.
If I am not taking Tamoxifen, Ree explains, then I must do two things: reduce any oestrogen from outside sources and also ensure that my liver converts enough ‘good’ oestrogen to occupy the receptor sites, thereby blocking the uptake of the ‘bad’ oestrogen.
So she asks questions about my liver. Have I had hepatitis? Do I drink alcohol? Take drugs? Were my liver function tests at the hospital ok?
Having established that my liver is up to the job Ree tells me the most common sources of ‘bad’ oestrogens: plastics and pesticides. The substances released by plastics and pesticides are not real oestrogen but the human body does not have receptors for plastics and pesticides, yet, so it treats them as strange oestrogen and sends them to the same places.
“Avoid all soft plastic and non-food grade plastic,” says Ree, “especially if the plastic is heated in any way.” What I understand this to mean is: don’t wrap food in cling-film or plastic bags, don’t drink water out of plastic bottles and never eat food that has been microwaved in plastic. “And don’t eat food out of tins that have that white lining. It is plastic and they heat the tins to seal them. That stuff has already been banned in many European countries.” “Not in the UK,” I tell her. She suggests that I contact the manufacturers of my plastic water filter jug to ask them if the plastic that they use is food grade, which means that it does not leach PVC molecules. I have already replaced my plastic water bottle with a glass lemonade bottle that I refill from the tap. “Tupperware is food grade,” says Ree, “but don’t put it in the microwave.” I visualise the shelves of my local Sainsbury’s. Every single edible item is enveloped in a sheath of soft plastic. Avoiding plastic is going to be difficult.
Next, pesticide. That is more straightforward. Eat organic food wherever possible. I have already done so ever since I was diagnosed. The shame of it is that it has precluded shopping for lovely fresh veggies on Portobello market and forced me into the supermarkets where all the produce is sheathed in plastic. If organic is not available, she advises me to reduce my intake of meat, chicken and dairy. “I have already cut out dairy,” I tell her about Jane Plant’s book. “That sounds good,” says Ree, “but you must get your protein. Eat fish and organic meats along with lots of vegetables and whole grains. The most important vegetables for you are brassicas. Make sure that you eat either cabbage, broccoli, pak choy, brussels sprouts or cauliflower every day of your life.” Apparently brassicas contain a substance that is sold as a very expensive supplement called IC3. It helps one’s to liver convert human and animal oestrogen into a quasi-phyto-oestrogen.
Ree tells me to include some soy products in my diet each week, such as tofu. “But don’t go overboard on the tofu and soy milk.” Also to make a mixture called LSA. This involves milling equal amounts of linseed, raw almonds and sunflower seeds in a coffee grinder and adding a teaspoon each morning to my muesli or porridge. “Make it fresh once a week and keep it in the fridge, otherwise it will turn rancid.” I am also advised to add a teaspoon of lecithin granules daily to my cereal. For B vitamins I should eat oats, brown rice, eggs and nuts.
I have lugged my extensive array of supplements along with me. “Which of these can I live without?” I ask with a pleading eye. I find it tedious to force all those pills down my throat each morning. The supplements that she recommends for me are: selenium (200 ug daily) and omega 3 fish oils. I have been taking an expensive high dose co-enzyme Q10 capsule. “That was important to protect your heart whilst you were having chemo,” she says, “but you could reduce it now. Resveratrol is a powerful anti-oxidant. You should definitely continue that as long as you are smoking.” She gives me an oral test to check my levels of zinc. “Medium to low,” she pronounces. “Keep taking the zinc but do one month on and one month off. Have you had your vitamin D levels measured? You will get plenty of sunshine in Australia but you’ll need to top it up if your levels are low.” I recall that Dr Coulter did request a blood test for vitamin D3 before I left but in amongst all the activity I don’t remember if we ever discussed the results.” I promise to call the hospital and check up on that. “Magnesium is important too,” Ree continues, "but there are two good sources for that: Brazil nuts and a twenty-minute soak in a bath with half a cup of Epsom Salts." How hard can that be?
Finally, Ree wants to inspect the fluid build-up in my back. I take my top off. The way that other medical professionals universally celebrate Mr Hadjiminas’ handiwork is a source of continuing delight to me. “Oh my,” gasps Ree, “that is the most beautiful surgery I have ever seen.” She continues, “it takes time for your lymph vessels to re-establish after surgery. The white pith of citrus fruit helps in the strengthening process.” I am pleased to hear this. I regularly chuck half a lemon, with the skin on, into my juice extractor along with the carrots. She suggests lymphatic drainage massage. “They do it in all the breast clinics,” she remarks. “Not in the UK they don’t,” I reply. “Well in any case, apply some calendula cream but don’t rub hard. Too much pressure disrupts the healing lymph vessels. Just lightly stroke it on in a direction away from the scar.”
On the drive home mum and I stop at several roadside stalls. People in Tasmania just grow everything and then sell it from outside their house or the back of their ute. We buy cherries, sylvan berries, pink-eye potatoes, onions, snow peas and carrots. Every single thing is organic and plastic-bagless.
5 comments:
this is really helpful Jessica - thanks. I'd always thought plastics and pecticides were bad news but never linked them with uptake of 'bad' oestrogen. dairy products on the other hand are an entirely different matter; some time ago i wrote a comment about Plant's work on your blog, unfortunately the multitude of opinions about whether to be darey dairy or not is mind boggling...recently i read an article in the guardian by barbara ehrenreich about her experience of BC. I quote "What causes it and why is it so common, especially in industrialised societies? Why don't we have treatments that distinguish between different forms of breast cancer or between cancer cells and normal dividing cells? In the mainstream of breast cancer culture, there is very little anger, no mention of possible environmental causes, and few comments about the fact that, in all but the more advanced, metastasised cases, it is the 'treatments', not the disease, that cause the immediate illness and pain. In fact, the overall tone is almost universally upbeat." I don't believe that enough attention has been given to asking and investigating the BIG questions through random clinical trials. I do feel angry about this. But many of us just feel we are lumped with it on diagnosis and have to deal with it as best we can. This is not good enough given the prevalence of BC in industrialised societies. Who are the FAT CATS really? Bankers? Or more sinisterly the purveyors of commercialised products who work for their own economic gains? take care and keep up the good work. I hope you and your mum are doing good - my best wishes to you both. Lots of love indy x
thanks for the message Jess. I follow yr blog avidly because you sound just like me, and have the same doubts and fears. Its so very helpfull. I've just had my reconstruction reconstructed so am feeling weak and stiff and a bit sorry for myself. I had a dble mastectomy in April and the rt implant had turned around, they are shaped implants so that makes it look strange when it moves. So I had a new implant put in the rt side, and had the muscle adjusted on the left side...that was twitching more than it should. Also had the nipples constructed out of the scar tissue from my back...amazing. I don't know what they look like yet as still bandaged up. I hope all this is worth it and I have decent breasts by my birthday in April.
sending you love and support across the airwaves
X Mel
Jessica I think you need to wake up and smell the coffee here. Naturopathy and food are no match for a virulent cancer and even if they were (which they are NOT) you cannot be vigilant on all of the areas you outline on your post. Frankly, I think you are messing with your life. Tamoxifen dramatically reduces the risk of relapse and your genetic tests show that you are suitable for it. And yet you refuse.
Im not sure you realise the consequences of your decision...and I am certain that your doctors will be worried if you persist with what I think is an insane decision, in the circumstances. Be grateful that this option is available to it, follow the suggestions of your doctors, stop playing God, and start to take the bleedin thing...otherwise, you could die.
You know me. I say this with love and as a fellow cancer survivor. I have never agreed with this decision of yours and it worries me greatly.
When my doctor gave me my diagnosis, he said I had no choice but to have intensive chemotherapy. Then he corrected himself and said "Well, yes, you dohave a choice. You could choose not to do it, but then you would die."
You have had a very traumatic few months not only with the cancer, but emotionally too, and I seriously do not think you are thinking straight at the moment. Please give what I have to say some serious reflection.
Its up to you what you do in the end but this level of avoidance of materials (even if its merits are true) is impratical / impossible in the UK. Sadly cancers like yours tend to return if you take this approach there is a possibility that you will spend the last few years of your life trapped in a paranoid world of fear and control - like those poor women who dedicate themselves to punishing gyson therapy routines.
Dear Jamie and Iris,
I really appreciate your concern. This is not a decision that I take lightly by any means. It is my life that we are talking about, after all. I have been doing a lot of reading and finding out about different approaches to cancer treatment. There is no doubt that many of them are paranoid or just plain mental. I am, at the moment, impressed by Jane Plant’s book Your Life in Your Hands. Jane Plant had breast cancer that came back five times, despite chemotherapy, radiotherapy and a host of alternative regimes. The last time it reared its head she was given 3-6 months to live. Undaunted, she decided to do her own research and came up with what, in my opinion, is a relatively easy-to-follow regime. That was sixteen years ago and she is still alive!
It seems common sense to me to do everything that one reasonably can to minimise harmful substances in one’s diet, cancer or no.
At this time my mental health is my priority. I don’t want to add a drug-induced depression to the turmoil that I am already going through. I do feel, however, that I’m getting stronger day by day. I have discussed my decision with my oncologist and intend to do so again. The Tamoxifen issue is not closed. I intend to keep my decision under review.
Lots of love to you both and thank you for being such good friends,
Lily
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