By Dr Stephanie Ogura, ND
October is Breast-Cancer Awareness Month, a moment to highlight current statistics and emphasize the integration of lifestyle modifications with natural medicine approaches.
Current Statistics
It is estimated that 30,500 Canadian women will be diagnosed with breast cancer in 2024.[i] This corresponds to 25% of all new cancer cases in women. On average, 84 Canadian women will be diagnosed and 15 will die from breast cancer every day. It is estimated that 290 Canadian men will be diagnosed and 60 will die from breast cancer in 2024. The 5-year net survival (estimates from 2015 to 2017) is 89% in women and 76% in men.
Notably, there is a growing concern about the increasing incidence of breast cancer in women under 50. A 2024 study reported a 45.5% and 12.5% increase in incidence rate among Canadian women in their 20s and 30s, respectively, since 1984.[ii] While this increase does not justify routine breast-cancer screening for women under 40, it highlights a need for awareness and preventive strategies—an area where naturopathic medicine can play an important role in enhancing patient care and overall wellbeing.
Naturopathic Approach
The integrative natural-medicine approach to breast health emphasizes individualized treatment plans that consider factors such as age, personal and family history, social factors, and lifestyle.
Central to this approach is the modification of risk factors[iii],[iv] that are linked to breast health. Key strategies include:
- Reducing body mass index (BMI) through physical activity and healthy dietary habits
- Eliminating or minimizing alcohol and tobacco use
- Reassessing the use of oral contraceptives in premenopausal women
Several phytochemicals such as epigallocatechin gallate (EGCG), curcumin, and resveratro have demonstrated potential benefits for breast-cancer survivors. Proposed mechanism of action include (see Table 1 below for detailed proposed MOA)[v]:
- Modulation of epigenetic events
- Reducing cell proliferation and the induction of apoptosis
- Targeting arachidonic acid (AA) pathway, including metabolic enzymes cyclooxygenases (COXs), phospholipase A2s (PLA2s), and lipoxygenases (LOXs)
Additionally, growing evidence points to the relationship between the gastrointestinal tract microbiome, estrogen metabolism, and breast cancer.[vi] Dysbiosis may result in an increase in beta-glucuronidase-producing bacteria, and consequently, an increase in estrogen levels in circulation. Modulation of the microbiome with pre- and probiotics, and beta-glucuronidase inhibitors such as calcium d-glucarate may improve estrogen excess.[vii], [viii]
More specifically, beta-glucuronidase inhibits the breakdown and excretion of toxins and other chemicals from the body. By inhibiting this enzyme, calcium d-glucarate helps promote the elimination of toxins and potentially harmful compounds that would otherwise be reabsorbed into the body. This mechanism is of interest in cancer-prevention and detoxification contexts. A typical dose, although not studied in humans, is 500 mg two or three times per day.
Conclusion
As breast-Cancer incidence rises among younger women, there is an increasing need for integrative, patient-centered care that considers broader preventive and supportive strategies. The incorporation of phytochemicals, microbiome modulation, and lifestyle adjustments offers a proactive framework for both patients after conventional treatments and those focused on prevention.
Mark Your Calendar for The Vitazan-NFH Breast-Cancer Survivorship Webinar
Breast-Cancer Awareness Month underscores the importance of ongoing education. Join Dr. Baljit Khamba, ND, MPH, EdD, on February 12, 2025, at 1 p.m. EST for a webinar on Integrative Approaches to Women’s Health in Post-Breast Cancer Care.
| Table 1 Proposed Mechanisms of Natural Compoundsv | ||
| Epigallocatechin gallate (EGCG) | Apoptosis pathway |
|
| Epigenetic regulation |
|
|
| Arachidonic acid pathway | • Decreases the COX-2 expression and kappaB (NF-kappaB) activations | |
| Curcumin | Apoptosis pathway | • Increase p53 level • Increase Bax expression • Downregulated NF-kappaB, cyclin D, and MMP-1 transcription in MDA-MB-231 and BT-483 cell line |
| Wnt signaling pathway | • Inhibits Wnt signaling at a dose of 5 μM in MCF-7 cell line | |
| Epigenetic regulation | • Inhibits the expression of class I HDACs • Upregulates the expression of some miRNAs to reduce the expression of Bcl-2 |
|
| Resveratrol | Epigenetic regulation | • Inhibits DNMT 3b expression and decreases RASSF-1α methylation • Activates SIRT1 and acetyl transferase p300 • Decreases the expressions of DNMT1, DNMT3a, and DNMT3b, HDAC1, and methyl CpG binding protein 2 (MeCP2) in MCF-7 cell line |
| Arachidonic acid pathway | • Inhibits ERβ, COX-2, NQO2, IKK, and GSTP1 | |
| Aromatase activity | • Reduces aromatase mRNA expression • Suppresses the transactivation of CYP19 promoters I.3 and II • Consumption of 1 g resveratrol per day had complimentary effects on estrogen metabolism as well as sex steroid hormone-binding globulin in postmenopausal women having high body mass index |
|
| Apoptosis pathway | • Stimulates p53-dependent pathway at a low dose in MCF-7 cells • Suppresses ER-dependent PI3K pathway • Src tyrosine kinase and signal transducer and activator of transcription 3 (STAT-3) phosphorylation pathways • Reduces Akt phosphorylation and activates procaspase-9 • Activates mitochondrial protein (Smac/DIABLO), caspase-9, and caspase-3 |
|
References:
[i] No author listed. “Breast cancer statistics.” Canadian Cancer Society. https://cancer.ca/en/cancer-information/cancer-types/breast/statistics. Reviewed May 2024.
[ii] Seely, J.M., L.F. Ellison, J.‑M. Billette, S.X. Zhang, and A.N. Wilkinson. “Incidence of breast cancer in younger women: A Canadian trend analysis.” Canadian Association of Radiologists Journal = Journal de l’Association Canadienne des Radiologistes, (2024): 8465371241246422. Online ahead of print. doi:10.1177/08465371241246422.
[iii] Yiallourou, A., K. Pantavou, G. Markozannes, A. Pilavas, A. Georgiou, A. Hadjikou, M. Economou, et al. “Non-genetic factors and breast cancer: An umbrella review of meta-analyses.” BMC Cancer, Vol. 24, No. 1 (2024): 903. doi:10.1186/s12885-024-12641-8.
[iv] Alsayer, R.M., E.B. De Vol, A. Almeharish, A. Alfattani, A.J. Alghamdi, L.B. AlBehlal, S. Alhaddab, and Y. Altwaijri. “Ranking of modifiable lifestyle risk factors for breast cancer in Saudi women: Population attributable risk and nomogram.” Breast Cancer, Vol. 16 (2024): 545–554. doi:10.2147/BCTT.S463193.
[v] Mitra, S., and R. Dash. “Natural products for the management and prevention of breast cancer.” Evidence-Based Complementary and Alternative Medicine, Vol. 2018 (2018): 8324696. doi:10.1155/2018/8324696.
[vi] Schettini, F., F. Gattazzo, S. Nucera, E. Rubio Garcia, R. López‑Aladid, L. Morelli, A. Fontana, et al. “Navigating the complex relationship between human gut microbiota and breast cancer: Physiopathological, prognostic and therapeutic implications.” Cancer Treatment Reviews, Vol. 130 (2024): 102816. doi:10.1016/j.ctrv.2024.102816.
[vii] Fernández‑Murga, M.L., F. Gil‑Ortiz, L. Serrano‑García, and A. Llombart‑Cussac. “A new paradigm in the relationship between gut microbiota and breast cancer: β‑glucuronidase enzyme identified as potential therapeutic target.” Pathogens, Vol. 12, No. 9 (2023): 1086. doi:10.3390/pathogens12091086.
[viii] [No author listed.] “Calcium-D‑glucarate.” Alternative Medicine Review, Vol. 7, No. 4 (2002): 336–339.