Breast cancer

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.

Conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. Unfortunately statistics show this is rarely the case.

Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy.

Evidence based medicine suggests that the only reliable evidence for efficacy comes from properly run randomised controlled trials (RCTs).

As mentioned below, none of the RCTs evaluating conventional intervention for breast cancer have shown any clear benefit. Therefore the conventional cancer paradigm needs to be questioned.

The following is based on the conventional cancer paradigm.

The breast is made up of glands called lobules that can make milk, and thin tubes called ducts that carry the milk from the lobules to the nipple. Breast tissue also contains fat and connective tissue, lymph nodes, and blood vessels.

The most common type of breast cancer is ductal carcinoma, that begins in the cells of the ducts. Breast cancer can also begin in the cells of the lobules and in other tissues in the breast. Invasive breast cancer is breast cancer that has spread from where it began in the ducts or lobules to surrounding tissue. (NCI)

A common condition is Ductal Carcinoma In Situ or DCIS. “In situ” means that it has not spread or invaded surrounding tissue so it is not cancer. It is wrongly described as cancer and as mentioned below it is usually treated as if it were cancer. (CISS)

Signs and Symptoms: Most breast cancer is detected as a lump in the breast, either by the woman, by her doctor during a regular check-up or during mammography screening.

Breast cancer usually grows very slowly and sometimes disappears. For this reason there is often overdiagnosis and overtreatment as outlined below. (CISS)

Breast cancer accounts for 12% of all cancers and 7% of cancer deaths in Australia. Among women it accounts for 28% of all cancers making it the most common type of cancer and 16% of deaths making it the second highest cause of cancer, just behind lung cancer.

Studies have identified numerous risk factors for breast cancer in women, including increasing age, personal history of certain benign breast diseases or breast cancer, early menstruation, late menopause, never having been pregnant or having a first pregnancy after age 30, use of oral contraceptives, family history of breast cancer, presence of certain inherited genetic changes, history of radiation therapy to the chest, long-term use of combined hormone therapy, use of diethylstilbestrol (DES), increased breast density, alcohol use, and obesity after menopause.

For women at high genetic risk due to a harmful mutation in BRCA1 or BRCA2, it is claimed that bilateral prophylactic mastectomy can reduce the risk of breast cancer by at least 95 percent (NCI), placing them after surgery almost on par with the average risk run by women without the harmful mutation.

These risks factors have been identified mainly from correlation studies so few can be considered as contributory factors for breast cancer. In fact most women who get breast cancer have none of these risk factors except for age and those related to the time of having children, such as never having been pregnant or having a first pregnancy after age 30.

There is no strong evidence that genetic mutations are causes of breast cancer. The normal measure of causation from genetic abnormality is that the ‘penetrance’ must be close to 100% i.e. all people with the abnormal gene get clinical symptoms of the disease. Yet with breast cancer the penetrance is only about 70%.

There is no evidence from RCTs for the claim that bilateral prophylactic mastectomy can reduce the risk of incidence of and death from breast cancer by at least 95 percent. It is based on observational studies with comparisons with a risk calculated from other population studies. Also none of the studies that make this claim measured deaths from all causes. See also Prevention below. (CISS)

There are no dietary factors that are known to increase the risk of breast cancer although it is claimed that increased hormones present in food might contribute. (CISS)

Treatment: There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is.

Apart from the different types of breast cancer above, breast cancers are also classified as node positive or negative and receptor positive or negative.

Node positive means that lymph nodes (sometimes called “glands”) in the armpit area also contain cancer cells.

Receptor positive means that particular hormones are presence at a higher level. For example ER-positive means that the breast cancer cells have an increased level of the Endocrine Receptors (estrogen or progesterone receptors).

HER-2 positive means that the breast cancer cells have more of the protein HER2 (ie Human Epidermal growth factor Receptor 2. (1 out of every 4 of breast cancers are HER2-positive.)

The main types of cancer treatment include:

Surgery: A procedure in which a doctor with special training, called a surgeon, removes cancer from your body. (NCI)

This is based on the unproven assumption that the tumour is the disease so removing the tumour removes the cancer. There is no evidence from trials to support this assumption.

Several randomised controlled trials have been held to evaluate the optimum amount of breast tissue to be removed to increase breast cancer survival or reduce breast cancer mortality.

Trials (RCTs) comparing radical mastectomy (removing the whole breast plus lymph nodes) with simple mastectomy (removing just the whole breast), quadrantectomy (removing the part of the breast containing the tumour) and lumpectomy (removing just the tumour plus surrounding tissue) have shown that there is no difference in survival between the different degrees of surgery.

This suggests that breast cancer is not a disease that starts locally but a systemic disease, with tumours only late stage symptoms.

Reference: (see Benjamin DJ. The efficacy of surgical treatment of cancer – 20 years later. Med Hypotheses (April) 2014; 82 (4): 412–420. ).

For this reason the only rationale for breast cancer surgery is cosmetic (eg to remove a fungating or ulcerating tumour) or to remove the tumour burden prior to immunotherapy (see Alternative Cancer Therapies below). (CISS)

Radiation Therapy: This uses high doses of radiation to kill cancer cells and shrink tumour (NCI). Although radiotherapy can result in a significant reduction of breast cancer recurrence, this is rarely accompanied by any increase in survival.

For example three randomised trials have reported a statistically significant decrease in the risk of recurrence with radiation therapy in combination with lumpectomy compared with lumpectomy alone, but there was no survival advantage with the addition of radiotherapy.

This shows that the presence or absence of a recurrent tumour is not a measure of the presence of cancer – again raising questions about the validity of the conventional cancer paradigm.

Radiotherapy also has side effects, including the suppression of the immune system and other cancers. In fact there is some evidence that a contributory cause of breast cancer is repeated X-rays of the lung during early childhood.

References: Leonard GD, Swain SM. Ductal Carcinoma In Situ, Complexities and Challenges. JNCI (June 16) 2004; 96(12): 906-920.

Goffman, John W. M.D., Ph.D. Preventing Breast-Cancer: The Story of a Major, Proven, Preventable Cause of this Disease. 1996. (CISS)

Chemotherapy: This uses drugs to kill cancer cells. (NCI) The absolute survival benefit at 5 years for chemotherapy in women less than 50 years is 6.8% for node-positive and 3% for node-negative women. For women aged between 50 and 69 years, the absolute survival benefit at 5 years is 2.1% for node-positive and 3.9% for node-negative women.

A more recent RCT has shown that a benefit from adjuvant chemotherapy in node-negative women aged 50-69 years is limited to women with receptor-negative disease; only 30% of node-negative women are in this group.

Reference: (Morgan G et al The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies. Clinical Oncology (2004); 16: 549-560.)

Hormone Therapy: This is designed to slow or stop the growth of cancer that uses hormones to stimulate its growth. (NCI) Two randomised trials have suggested a benefit in terms of reduced recurrence from the addition of adjuvant Tamoxifen therapy, although in one trial the benefit was not statistically significant. Neither trial demonstrated a survival benefit with adjuvant Tamoxifen. Current data suggest that Tamoxifen use should be restricted to patients with estrogen receptor-positive DCIS.

Reference: Leonard GD, Swain SM. Ductal Carcinoma In Situ, Complexities and Challenges. JNCI (June 16) 2004; 96(12): 906-920.

However long-term hormone therapy also has serious side effects. One study showed that when Tamoxifen is taken long-term not only did it increase the risk of uterine cancer 6.9 fold in women who took it for at least 5 years, but also these cancers are significantly more likely to be deadly. (CISS)

Reference: van Leeuwen FE et al. Risk of endometrial cancer after tamoxifen treatment of breast cancer. Lancet 1994; 343: 448–52.

Immunotherapy : This is designed to helps your immune system fight cancer.(NCI) Most conventional immunotherapy has limited benefits and serious side effects. (CISS)

Targeted Therapy: This is designed to target the changes in cancer cells that help them grow, divide, and spread. (NCI) There is limited evidence for benefit from using this approach to treatment except that it can reduce the harm from using treatments such as chemotherapy unnecessarily. (CISS)

Precision Medicine: This is based on the assumption that by identifying genetic changes in the cancer cells, treatments can be chosen that are more likely to be effective. (NCI) This is similar in effect to Targeted Therapy and, by being based on an unproven assumption, is unlikely to have any benefits. (CISS)

Stem Cell Transplant: These are procedures that restore blood-forming stem cells in people who have had theirs destroyed by high doses of cancer treatments, such as chemotherapy and radiation therapy.

Some women with breast cancer will have only one treatment. But most will have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. (NCI)

The above therapies all come with risks and side effects that should be discussed in detail with your treating physician.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If you feel your doctor or other health practitioner is not able to answer these questions, or shows that he or she is not comfortable with you asking these questions, it raises the question as to whether they are practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

Early detection/Screening: Many doctors believe that one of the tests for the presence of breast cancer, the mammogram, should also be used to screen women for early breast cancer. This has resulted in the increasing promotion of mammography screening before it was proven to be beneficial.

Despite the plausible idea that finding breast cancer early would provide significant benefits, seven subsequent randomised controlled clinical trials to evaluate the benefits of mammography screening found that there is little or no benefit from early detection, with the possible exception of allowing less mutilating surgery.

Unfortunately such screening has increased rather than reduced the number of mastectomies, including among women with DCIS, the non-malignant condition.

Reference: Gøtzsche PC, Jørgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013 Jun 4; 6:CD001877.

Despite the fact that leading experts in the USA and Canada have argued against the continued use of mammography screening, most cancer authorities in Australia do not accept their arguments and continue to promote mammography screening.

The lack of benefit from an increased degree of surgery and the lack of benefit from earlier surgery made possible by early detection through screening shows that the conventional mantra of “Get it all” and “Get it early” is not supported by any evidence. This again suggests that breast cancer must be a systemic disease, not one that starts locally. (CISS)

Overdiagnosis: Another problem relating to mammography screening is overdiagnosis resulting in overtreatment. There is evidence that up to a half of all breast tumours found through mammography screening are not life-threatening.

About 25% of all so-called cancers diagnosed are ductal carcinomas in situ (DCISs). Most of these are not cancer and are therefore not life-threatening. Only about 3% of women diagnosed with DCISs die from breast cancer after their DCIS becomes malignant.

Reference: (Narod SA et al. Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ . JAMA Oncol. (August 20) 2015. doi:10.1001/jamaoncol.2015.2510 ).

In addition to these about 26% of invasive breast tumours actually disappear on their own without treatment.

Reference: (Morrell S, Barratt A, Irwig L, Howard K, Biesheuvel C, Armstrong B. Estimates of overdiagnosis of invasive breast cancer associated with screening mammography. Cancer Causes Control (Feb) 2010; 21(2):275-82.)

For these reason there are strong arguments against surgery for breast cancer.

Gilbert Welch has estimated that “for every one breast cancer death avoided, somewhere between two to ten women are overdiagnosed”. The Cochrane Group has estimated that “for every 2000 women invited to screening for 10 years one death from breast cancer will be avoided but that 10 healthy women will be overdiagnosed with cancer.

This overdiagnosis is estimated to result in six extra tumorectomies and four extra mastectomies and in 200 women risking significant psychological harm relating to the anxiety triggered by the further investigation of mammographic abnormalities.”

Reference: (H Gilbert Welch et al “Over- diagnosed: Making people sick in the pursuit of health” Beacon Press, Boston, 2011.)

Prevention: As mentioned above under Signs and Symptoms many surgeons have claimed that a woman with particular abnormal genes can reduce their risk of breast cancer by up to 95%. The Cochrane Breast Cancer Group carried out a review of 39 studies involving 7,348 women of whom 3,727 participants had had a bilateral prophylactic mastectomies on healthy breasts as a preventative measure of whom 3,025 had physical outcomes assessed.

Although the analysis confirmed significant reduction in deaths from breast cancer none of the trials were randomised studies and none of them measured deaths from all causes.

This study showed that up to 49 per cent of all the women opting for just-in-case double mastectomies suffered complications requiring repeat surgery.

Alternative Cancer Therapies

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. There is little evidence to support this paradigm.

Another paradigm states that cancer is a systemic disease and the tumour is only a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

  1. Treatment should cause no harm
  2. Treatment should be wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health. This latter paradigm is supported by CISS (See Introduction to CISS)

Alternative cancer therapies are generally consistent with the above principles. In fact those believed to be the most effective in controlling cancer – psychotherapy and immunotherapy – also have strong supporting evidence from randomised controlled trials.

There are approximately 200 alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. The following are those with the most scientific evidence for benefit. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

  • Psychotherapy

Two RCTs evaluating a particular type of psychotherapy called Creative Novation Behaviour

Therapy divided 100 women with metastasised breast cancer into four groups in two trials.

In one trial 50 women who were to receive chemotherapy were randomised into two groups: one group received psychotherapy in addition to chemotherapy; the control group just received chemotherapy. Those who received the additional psychotherapy had an average 22.4 months survival compared with 14.1 months for those who received just the chemotherapy, a 59% increased survival.

In the second trial 50 women who had refused chemotherapy were randomised into two groups: one group received just psychotherapy; the control group received no therapy.

Those who received the psychotherapy had an average 14.9 months survival compared with 11.3 months for those who received no therapy, a 32% increased survival.

Reference: (1. Eysenck, HJ & Grossarth-Maticek, R. Creative Novation Behaviour Therapy as a Prophylactic Treatment for Cancer and Coronary Heart Disease: Part II – Effects of Treatment. Behav Research and Therapy 1991; 29 (1): 17-31.)

Although RCTs with only 50 participants are rarely reliable because of the difficulty of ensuring properly matched groups after randomisation, those running this trial formed pairs of women matched according to age, smoking, cholesterol level, blood pressure and personality type from a larger group before randomising them into pairs, thus ensuring properly matched groups after randomisation.

Another RCT randomised 66 women with metastatic breast cancer into two groups: 30 women received group psychological therapy and the other 36 received no extra treatment.

There was a 24% reduction of deaths in the treated group although this did not reach significance.

Reference: (Cunningham A et al. A randomised controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology 1998; 7: 508-17.)

  • Immunotherapy

Several RCTs have shown benefits of Iscador therapy on women with different stages of breast cancer.

References: (Ziegler R and Grossarth-Maticek R. Individual Patient Data Meta-analysis of Survival and Psychosomatic Self-regulation from Published Prospective Controlled Cohort Studies for Long-term Therapy of Breast Cancer Patients with a Mistletoe Preparation (Iscador) Evid Based Complement Alternat Med. (Jun) 2010; 7(2): 157–166; 28; Salzer G: [30 years of experience with mistletoe therapy in public health facilities]. In: Leroi R, ed.: [Mistletoe Therapy: A Response to the Challenge of Cancer]. Stuttgart, Germany: Freies Geistesleben, 1987, pp. 173-215;Grossarth-Maticek R, Kiene H, Baumgartner SM, et al.: Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomised and randomised matched-pair studies nested within a cohort study. Altern Ther Health Med 7 (3): 57-66, 68-72, 74-6 passim, 2001 May-Jun; and Leroi R: [Postoperative Viscum album therapy after surgery of breast neoplasms] Helv Chir Acta 44 (3): 403-14, 1977.)

In another paper the estimated increased median survival was 2.5 years.

Reference: (Grossarth-Maticek R, Ziegler R. Randomised and non-randomised prospective controlled cohort studies in matched-pair design for the long-term therapy of breast cancer patients with a mistletoe preparation (Iscador): a re-analysis. Eur J Med Res. 2006;11:485–495.)

The results for the non-randomised studies were also in favour of the Iscador therapy: Breast cancer with local recurrences and no metastases: estimate of hazard ratio and 95% confidence interval 0.52 (0.23, 1.17) – ie a 48% reduction in deaths; breast cancer with lymphatic metastases: 0.27 (0.15, 0.50) – ie a 73% reduction in deaths; breast cancer with distant metastases: 0.53 (0.32, 0.88) – ie a 47% reduction in deaths.

Reference: Grossarth-Maticek R, Ziegler R. Randomised and non-randomised prospective controlled cohort studies in matched-pair design for the long-term therapy of breast cancer patients with a mistletoe preparation (Iscador): a re-analysis. Eur J Med Res. 2006;11:485–495.

A Cochrane review of clinical trials evaluating Iscador concluded that “there is some evidence that mistletoe extracts may offer benefits on measures of QOL during chemotherapy for breast cancer, but these results need replication”.

Reference: Horneber MA et al. Mistletoe therapy in oncology. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003297. doi: 10.1002/14651858.CD003297.pub2.

Although not based on RCTs the most successful therapy for late stage cancers including breast cancer was Issels’ Whole Body Therapy that focussed on restoring the body’s immune systems.

It was estimated that a representative sample, 252 of Issels’ patients with late stage cancers of whom 56 (22%) had late stage breast cancer showed a 16.6% five year survival following his treatment and 15% 15 years survival. There were 10 women with breast cancer (23.6%) among the 42 who survived 15 years in good health.

References: Issels, J. Immunotherapy in Progressive Metastatic Cancer – A Fifteen-Year Follow-up. Clinical Trials Journal, August 1970: 357-365 – editorial by Phillips S. Dr Joseph Issels and the Ringberg Klinik. Clinical Trials Journal. August 1970: 355-56.

The above studies, that include RCTs, show that systemic therapies are much more successful than therapies based on the orthodox paradigm.

For breast cancer, Ralph Moss, Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention, reports the following alternative therapies have been shown to benefit women with breast cancer in addition to Iscador:

  1. Coley’s Toxins – These are mixed bacterial vaccines developed by William Coley MD after he observed that many people with cancer went into remission after having an acute infection that caused a fever. They are effective with a wide range of cancers. His results included 65% 5-year survival with late stage breast cancer. (This figure was well above that achieved with conventional treatments at the time. CISS)

Reference: (Nauts H. Bacteria and cancer – antagonisms and benefits. Cancer Surv. 1989; 8: 713-23.)

  1. Hyperthermia (Heat therapy) – Hyperthermia is increasingly used in conjunction with other conventional treatments because it has been found to enhance their effects. One effect of hyperthermia is that it simulates the effect of the fever induced by the Coley’s Toxins.

It is based on the principle that cancer cells are more susceptible to heat than healthy cells. (NOTE: In the last 25 years since Moss’ book was published there have been many developments in the hyperthermia area with more evidence of benefit of hyperthermia in the treatment of breast cancer – CISS)

  1. Indoles – Indole glycosinate is the scientific name for the protective chemical found in cabbage, broccoli, cauliflower and brussels sprouts. The presence of cabbage and related vegetable in the diet has been definitively shown to enhance a particular system of enzymes that detoxifies cancer-causing substances. It also has a protective effect against radiation.

Estrogen has been linked to an increase in the incidence of breast cancer. Because these substances are anti-estrogens they might find particular application in the treatment of hormone dependent tumours such as those of the breast. Eating raw or lightly cooked cabbage converts the hormone estrogen into its inactive form.

Reference: Albert PM. Physiological effects of cabbage with reference to its potential as a dietary cancer–inhibitor and its use in ancient medicine. J Ethnopharmacol. 1983; 9: 261-72.

  1. Selenium – In addition to the above three alternative therapies there are several supplements believed to have anti-cancer properties that are not confined to specific types of cancer. Selenium is one of them. Selenium is believed to reduce the incidence of cancer by stopping carcinogens corrupting the genetic material of the cell; slowing the spread of cancer cells; and enhancing the body’s normal anticancer immunity.

Researchers believe this might explain why people who have a relatively abundant supply of selenium in their diets experience less cancer. This especially applies to breast cancer. For this reason selenium supplements are used.

The National Academy of Sciences (NAS) advises that no more than 150 micrograms of selenium be taken orally daily. However in the treatment of cancer the dosage is generally about 10,000 micrograms (or 10 milligrams), nearly 100 times the NAS’ recommended dose. Some surgeons familiar with the role of selenium use injections of selenomethianine for women with breast cancer

References: Schrauzer G. Selenium and cancer. A review. Bioinorganic Chemistry 1975; 5: 275-81. Schrauzer GN et al. Cancer mortality correlation studies.III. Statistical associations with dietary selenium intakes. Bioinorganic Chemistry 1977; 7: 23-24.Ladas HS. The potential of selenium in the treatment of cancer. Holistic Medicine 1989; 4: 145-156.

(NOTE: In many Western countries the soil is claimed to be depleted in selenium as a result of several factors. As a result less selenium is present in locally produced foods. This suggests supplementing the diet with selenium-rich foods or with selenium supplements in forms such as selenomethionine. CISS)

  1. Hydrazine Sulphate – Hydrazine Sulphate is a prohibited import in Australia. This is a common industrial chemical that was used as a component of rocket fuel during World War II. It was first proposed as a cancer treatment in the early 1970s by Joseph Gold MD, of the Syracuse Cancer research Institute, NY.

Gold drew on the work of Nobel laureate Otto Warburg, who theorised that cancer derived its energy from anaerobic glycolysis (fermenting sugar) rather than respiring in the normal way. Gold proposed using chemicals to control cancer’s growth by exploiting this process.

Gold suggested that by cutting off a tumour’s supply of new glucose, formed in the liver, the drug could starve the tumour, in turn stopping the cancer from depleting the body’s energy pools and putting an end to cachexia, the terrible wasting process that appears in the final stages of the disease. It is this wasting process that often kills the cancer patient.

A team of 11 scientists at the N.N Petrov research Institute of Oncology, Leningrad have been working on hydrazine sulphate since the 1970s. The Russians have had the greatest single experience with hydrazine sulphate having treated and evaluated over 740 patients. Thus, in the Russian studies, it was shown that hydrazine sulphate inhibited the wasting process. The best results were seen with desmosarcoma, neuroblastoma, laryngeal cancer, Hodgkins disease and breast cancer.

References: Filov, V, et al. Results of clinical evaluation of hydrazine sulfate. Vopr Onkol 1990; 36: 721-6. Filov, V, et al. Experience of the treatment with Sehydrin (Hydrazine Sulfate, HS) in the advanced cancer patients. Investigative New Drugs 1995; 13: 89-97. Chlebowski, RT. Hydrazine sulfate in cancer patients with weight loss. A placebo-controlled clinical experience. Cancer 1987; 59: 406-10.

Other therapies mentioned by Moss include benzaldehyde, caesium and rubidium and Essiac for which anecdotal reports suggest benefits.

If you or someone close to you has just been diagnosed with breast cancer it is important that you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical , mental, emotional / psychological and spiritual treatment.

If you don’t know where to begin in your journey to wellness then we suggest you read Where To StartThis provides an introduction to the alternative approach to treating cancer and also information about some evidenced based alternative cancer treatments.


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