The Most Popular Questions A Naturopath Gets, Answered Here
Recently, Rethink hosted an Ask An Expert live segment with Dr. Jill Shainhouse, owner and director of Insight Naturopathic Clinic in Toronto, and fellow of the American Board of Naturopathic Oncology, for her evidence-based advice on everything from exercise to diet to the supplements you might want to try and why. Her goal? To help provide safe and effective support during or after conventional therapies to cancer patients.
It’s no secret that unsolicited advice in the breast cancer community is rampant with lots of “you shoulds”—especially when it comes to food and supplements. Just think, how many times have you been told (enter trendy superfood) will cure you?
Here’s what Dr. Shainhouse, one of the few naturopathic doctors in Ontario to obtain the highest standard of training in naturopathic oncology, has to say about the most common questions she’s asked.
How important is exercise after a breast cancer diagnosis?
Exercise is probably the most important thing you can do. It improves everything from body composition, sleep, fatigue, depression, anxiety, maintenance of bone mineral density and insulin sensitization. And not only is there the major impact that exercise has on recurrence prevention, data supports that physical activity can reduce the risk of deaths caused by breast cancer by approximately 40 percent. Aim for at least 30 minutes of exercise daily, such as a mixture of aerobic and resistance training, five days a week.
Is there a special diet that works best for someone who has received a breast cancer diagnosis?
Sorry Keto fans, unfortunately there is little evidence that suggests following a specific diet will prevent the recurrence of breast cancer. What we do know is that there are some cruciferous vegetables, like broccoli, kale, cabbage, Brussels sprouts, bok choy and collard greens, that might help improve outcomes in terms of recurrence and mortality risk. Bottom line: Maintaining a healthy body mass is crucial in the prevention of recurrence. If you feel good on a certain diet, I’m inclined to encourage you to stay on that diet, with a few tweaks here and there.
There is a lot of speculation around soy – is it good or bad for breast cancer patients?
I often get a lot of comments like, soy is bad, right? That’s not actually the case. In general, if we look at the best evidence available, consuming soy (think edamame, raw soybeans, tofu, tempeh) may help to prevent ER positive breast cancer recurrence in both pre and post-menopausal patients. With triple negative breast cancer, there is generally more of a preventative or neutral effect on TNBC recurrence, although different studies show different outcomes. The only breast cancer biomarker that I’m cautious about recommending a lot of soy consumption is the HER2 positive subset because there is one small study that suggested a potential increase in recurrence in HER2 positive women when soy was consumed in large amounts (study found this trend in 8 Korean women with HER2 positive disease).
We know that soy is a good source of calcium and studies have shown that younger patients who consumed more soy had a 77 percent reduced risk of osteoporotic fracture. Other important facts to consider about soy: it doesn’t appear interfere with the efficacy of Tamoxifen or aromatase inhibitors.
Recently there have been some scary news stories about dairy causing breast cancer – is there any truth here?
A recent publication (International Journal of Epidemiology, February 2020) raised some concern regarding the primary risk of breast cancer and consumption of drinking milk. The study was scrutinized, reported risks were relative and not absolute and there have been prior conflicting study results from prior publications so my advice? Take this with a grain of salt.
What I tell patients about dairy, and we’re talking everything that comes from a cow (not eggs like some might think), is people who consume a lot of milk and/or milk products tend to have higher levels of circulating levels of Insulin-Like Growth Factor (IGF-1), which may contribute to the abnormal growth of cells. Anyone can get a serum test to determine what their level looks like.
What supplements do you recommend taking?
Always check with your healthcare provider first, but here are the top supplements that are evidence-based for their use to help with recurrence prevention.
- Vitamin D (best dosing is determined with a blood level)
- Selenium (200 mcg/day). *NOT DURING ACTIVE TREATMENT*
- Vitamin C (at least 100 mg of vitamin C to reduce all cause and breast cancer-related mortality). *NOT DURING ACTIVE TREATMENT*
- Melatonin (dose according to tolerance: 3- 20 mg)
- Probiotics (and probiotic foods) are often recommended to hold on chemotherapy
*As always, before introducing any type of new treatment or supplements into your medical plan, check with your primary care physician first.
