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Breast Cancer Prevention Institute brochure
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If it's not OK for him to take steroids...
why is it OK for her?
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The dangerous performance
enhancing
steroids taken by athletes are
male steroid hormonal drugs
that build muscle.
One of their risks is liver cancer.
Similarly, female steroid hormonal drugs
build breast tissue.
They not only increase the risk
of liver cancer but breast and cervical
cancers as well.These powerful
steroid drugs are taken by millions
of teenage girls as BIRTH CONTROL PILLS.
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Why are teenage girls vulnerable to the cancer-causing
effects of birth control pills?
Teenagers are especially vulnerable to breast cancer
risk because their breasts are growing and most have not
yet developed cancer-resistant Type 3 lobules through
a full-term pregnancy. Therefore, the cancer-causing combination
contraceptive steroids (birth control pills) are especially
dangerous for them.
How do steroid hormones affect breast development?
Breast tissue is made of lobules. A lobule is a unit
of breast tissue that contains a milk duct and some milk
producing glands.
There are four types of lobules:
| Type 1 |
Develop during puberty when estrogen levels rise
and breasts develop |
|
Type 2 |
Some form during puberty |
|
Type 3 |
Form during pregnancy after 32 weeks |
|
Type 4 |
Actively produce milk |
Before a full-term pregnancy, most of the breast is composed
of Type 1 & 2 lobules, with Type 1 comprising 70%
of the breast tissue. Together Type 1 & 2 lobules
are where 95% of all breast cancers start.
Therefore, steroid hormones are most damaging to the
breast if taken before a full-term pregnancy.
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Photomicrographs
of Lobules |
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|
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| Type 1 Lobules |
Type 3 Lobules |
After a full-term pregnancy, most of the breast is composed
of Type 3 lobules which are fully mature and resistant
to cancer. This is why a full-term pregnancy lowers breast
cancer risk and why women who remain childless have a
higher risk of breast cancer.
How do steroid hormones and hormonal drugs increase breast
cancer risk?
Both alone and in combination, the powerful steroids
estrogen and progesterone and their synthetic equivalents
(estrogen derivatives and progestins) can cause breast
cancer through these two mechanisms:
1. They cause the breast tissue to grow which can result
in mutations and ultimately cancers.
2. Estrogens can act as direct carcinogens causing cancer
cells to form.
1. Breast tissue growth resulting
in mutations and cancers
Every cell contains a complete set of genes composed
of DNA in its nucleus. The combination of estrogen and
progesterone steroids cause breast cells to multiply by
first copying their DNA followed by cell division-this
is called mitosis. While copying DNA during mitosis, mistakes
can occur which are called mutations. Mitosis of mutated
cells multiplies these mutations. Cancer results from
accumulated mutations in a cell causing uncontrolled growth.
2. Direct carcinogenic effect of
estrogen steroids
There are breakdown products of estrogen (metabolites)
which can directly damage DNA, causing mutations and cancers
to form. One such metabolite is 4OH catechol estrogen
quinone, which is found in higher levels in women with
breast cancer than those without cancer.
| To be effective, high doses of contraceptive drugs
must be given to suppress ovulation (the release
of an egg) by mimicking pregnancy. They must also
resist biodegradation so that one pill a day is
effective. In a normal non-pregnant state, the levels
of natural steroids are lower and present for shorter
durations than experienced while using synthetic
steroidal oral contraceptives. These are potent
medications which should be used carefully and judiciously;
for example, short-term needs or serious medical
illnesses caused by hormonal imbalances. |
What is the medical
evidence for the link between birth control pills and
breast cancer?
In June of 2005, 21 scientists of the World Health Organization's
International Agency for Research on Cancer met in France.
This group thoroughly reviewed the entire world's medical
literature concerning estrogen-progestagen containing
drugs which are found in contraceptive steroids and hormone
replacement therapy (HRT). They concluded that these drugs
caused breast, cervical and liver cancer.1 On January 19, 2006, the New England Journal of Medicine
reported on the findings of two scientists from Johns
Hopkins University which concluded that oral contraceptives
increase breast cancer risk.2
In medical texts, birth control pills are acknowledged
to increase a woman's risk of breast cancer while in use
and for up to ten years after they are stopped.3
There is an approximate 20-30% increase in the risk of
breast cancer in women who use these drugs.
Through public media coverage in 2002, women of this
country were made aware of breast cancer risk from using
HRT. As a result, millions of women stopped taking these
drugs. Although the same type of drugs found in HRT are
also found in birth control pills in even higher doses,
their breast cancer risk remains widely unknown by the
public.
Through their widespread use over the last 30 years,
birth control pills and HRT are undoubtedly a significant
reason breast cancer rates have increased 40% over that
same period, especially in our young women.
But don't birth control pills lower the
risk of ovarian and endometrial cancer?
Yes, they do decrease risk by suppressing ovulation and
differentiating the uterine lining. However, according
to the American Cancer Society, out of 100 women with
cancer, 31 have breast cancer, 6 have endometrial cancer
and only 3 have ovarian cancer, so it is not a good "trade-off"
in risk.
What are some names of these synthetic steroids?
Some are ethinyl estradiol, conjugated estrogens,
norgestrel, medroxyprogesterone, levonorgestrel, norethindrone,
norethisterone, desogestrel, norgestinate, mestranol,
drostirenone, onorgestrel, drospirenone, and ethynodiol.
| Many thousands of cases of breast cancer a year
are attributable to these powerful steroid drugs.
This is because millions of women take these drugs
each year. |
What about the new patch and vaginal ring?
They contain the same drugs found in birth control pills
and increase breast cancer risk. The patch is especially
dangerous as it raises estrogen blood levels 60% higher
than the "the pill" and has resulted in strokes,
venous clots and deaths.4
What about injectable birth control like
Depo-provera and progestin-only pills?
The progestin only injection, Depo-provera, also increases
breast cancer risk like the pill. There are no long-term
safety studies available for the progestin-only "mini-pills"
which have recently become available.
Does the morning after pill (emergency
contraception) pose any breast cancer risk?
The morning after pill (MAP) contains a high dose of
progestin. Some websites recommend taking multiple doses
of birth control pills at once as a substitute for the
MAP where it is not available. These medications may increase
breast cancer risk if used regularly instead of infrequently
for emergency use as intended.
Are there safe, effective
alternative treatments for teenagers on birth control
pills for different medical problems?
Yes, there are, as below:
| Acne: |
Use safe topicals and antibiotics |
| Menstrual cramps: |
Use safe effective pain relieving drugs (e.g.,
Non-Steroidal Anti-Inflammatory Drugs) |
| Irregular periods: |
After a girl's first menstrual period, irregular
periods are not abnormal for a time and reduce breast
cancer risk later in life. 5 |
Are there safe, effective
alternatives to oral contraceptives for family planning?
Yes, there are several natural family planning (NFP)
methods. NFP methods teach women to reliably recognize
their few fertile days a month. Studies all over the world
have shown these methods to be at least as reliable as
the pill even when a woman has irregular cycles and low
education levels. It is cost free after initial instruction
of the method chosen. The ovulation methods include the
Ovulation Method of Natural Family Planning, the Creighton
Model FertilityCare System6 and the
Billings Ovulation Method. There is also the symptothermal
method of the Couple to Couple League. (NFP is not the
rhythm method.)
Why hasn't the National
Cancer Institute (NCI) warned the public of these documented
cancer risks?
There may be multiple ethical, socioeconomic, political
and cultural reasons why this information has not been
made readily available to the general public.
In February of 2005, Dr. Elias A. Zerhouni, the director
of the National Institutes of Health (NIH), which encompasses
the NCI, banned all staff scientists from taking drug-company
fees because he wanted "the NIH to be a source of
health information that could be trusted."7
Government scientists had moonlighting jobs and were receiving
large fees and stock options from pharmaceutical companies,
which is clearly an unethical conflict of interest.
More alarmingly, in 2005 the prestigious British journal
Nature published a study which showed 15.5% of scientists
with NIH grants anonymously admitted to "changing
the design, methodology, or results of a study in response
to pressure from a funding source," which is a form
of scientific misconduct.8
Former FDA director, David Kessler, wrote the book, "A
Question of Intent: A Great American Battle with a Deadly
Industry." In it he describes how the tobacco industry,
through its economic and political clout, successfully
suppressed for decades the link between cigarettes and
lung cancer using the NCI and medical groups such as the
American Medical Association.
Like tobacco, contraceptive steroids (birth control pills)
are very widely used, having been taken at some time by
at least 75% of American women, often for many years.
The belief in the use and the safety of "the pill"
is deeply engrained in American culture and the culture
of American health scientists, in both the government
and the pharmaceutical industry.
Despite decades of studies demonstrating the health risks
of birth control pills, the NCI has only very recently
revised an oral contraceptive fact sheet on its website
to reflect these studies.9
Why haven't cancer and medical organizations publicized
the link between breast cancer and the pill?
These organizations take their lead from the NCI and
other governmental agencies which at present have not
widely publicized this information.
Resources for effective hormone-free family planning
References
1 Cogliano V et al. Carcinogenicity
of combined oestrogen progestagen contraceptives and menopausal
treatment. Lancet Onc. 2005; 6:552-3.
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2 Yager JD et al. Estrogen Carcinogenesis
in Breast Cancer. N Engl J Med. 2006;354: 270-82.
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3 Bland KI, Copeland EM. The Breast:
Comprehensive management of benign and malignant diseases,
3rd ed. Saunders 2004;v1:499-535.
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4 Thacker, HL, et al. How should we advise
patients about the contraceptive patch, given the FDA
warning? Clev Clin J Med. 2006;73;1:45-47.
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5 Henderson BE, et al. Breast cancer
and the estrogen window hypothesis. Lancet, 1981;2:363-4.
back
6 Hilgers TW, Stanford JB. Creighton
Model NaProEducation Technology for avoiding pregnancy.
Use effectiveness. J Reprod Med 1998;43:495-502.
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7 William D. NIH Seeks 'Higher Standard.'
LA Times 2/2/05.
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8 Martinson BC, et al. Scientists behaving
badly. Nature; 2005;435;9:737-8.
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9 NCI. Fact Sheet 3.13, Oral contraceptives
and cancer risk: questions and answers. Reviewed 5/4/06. www.cancer.gov.
back
©2006 Breast Cancer Prevention Institute. All rights
reserved.
The Breast Cancer Prevention Institute is a research and
educational 501(c)(3) public charity
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Call toll-free: 1-86-NO CANCER (1-866-622-6237)
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