Estrogen and NSCLC

[Nana Jane]

I've just begun to read and hear about a possible link between estrogen and non small cell lung CA. I don't know what it's about and wonder if anyone has citations in any journals. Specifically I'm wondering about the link between hormone replacement therapy (long term, >20 years)and the ERPR status on lung cancer tumor cell surfaces.

Does anyone know anything about this?

Jane

[Donna G]

There are many links , here is one.

http://my.webmd.com/content/article/85/98631.htm

Women are different from men in many respects. Donna G

[Hebbie]

Just came across this article:

Certain Foods May Protect Against Lung Cancer

Contributed by Tom Harrison| 28 September, 2005

Phytoestrogens may help protect against lung cancer development because they latch on to estrogen receptors that are present in both normal and malignant lung tissue, and this binding could exert a role in the regulation or deregulation of cancer growth. Consuming a diet rich in phytoestrogens -- which produce a weak estrogen-like activity in the body -- may lower the risk of lung cancer both in smokers and nonsmokers, according to a study published in today's issue of the Journal of the American Medical Association.

Researchers at the University of Texas MD Anderson Cancer Center report that study participants who ate the highest amount of foods with dietary phytoestrogens had a 46 percent reduced risk of developing lung cancer, compared to those who ate the lowest quantity.

More than 3,500 people participated in the research, making it the largest case-controlled study to examine dietary phytoestrogens and lung cancer risk in a US population, say the researchers.

Not a License to Keep Smoking

The researchers also found gender specific benefits for different classes of phytoestrogens.

Men who ate the highest amount of soy-isoflavins lowered their risk of developing lung cancer by 72 percent, and women who ate the most fruits and vegetables by 41 percent. For women who also used hormone replacement therapy, the protective effect was enhanced further.

"What we have found is intriguing and supports a small but growing body of evidence that suggests estrogenic-like compounds in food may help protect against development of lung and other cancers," says the study’s lead author, Matthew Schabath, PhD, a postdoctoral researcher in the Department of Epidemiology.

"But these kinds of studies, which rely on a person’s recall of the food they have eaten months before, have known limitations and require more investigation," he notes.

As promising as they are, the study results should not be seen as a license to continue smoking while increasing consumption of vegetables, says the study’s principal investigator, Margaret Spitz, MD, chair of the Department of Epidemiology.

"The best cancer prevention advice continues to be to stop smoking, and it is clear that all of us can benefit from healthy eating and exercising," Spitz says. "Still, our results generally show that higher intake of these foods resulted in lower lung cancer risk, and that is certainly a tantalizing preliminary finding."

Lung Cancer in Lifetime Nonsmokers

One of the most intriguing findings, says Schabath, is that people who had never smoked had a reduced chance of developing the disease if they ate large quantities of phytoestrogen-rich food.

"About 15 percent of lung cancers occur in lifetime never-smokers, and besides exposures to second-hand smoke, other risk factors for these cancers are yet to be determined," he says.

The study builds on the group’s 2004 finding that women who used hormone replacement therapy -- which restores estrogen to postmenopausal women -- had a lower risk of developing lung cancer than women who did not use these agents, given a similar history of cigarette use.

If estrogen drugs could protect against lung cancer, the researchers wondered if the same might be true of foods that have naturally occurring low levels of estrogens. Several epidemiological studies of phytoestrogenic foods had suggested that might be the case for breast, endometrial and prostate cancers.

The researchers further noted that lung cancer rates are substantially lower in Asian populations that typically eat larger amounts of phytoestrogens than is consumed in America.

Soybeans, Spinach, Sprouts

Between 1995 and 2003, the research team enrolled 1,674 patients treated for lung cancer at MD Anderson, and 1,735 healthy volunteers from private clinics in the Houston area to serve as controls. The participants were asked detailed questions about their diet for the year prior to their enrollment or to their cancer diagnosis, with the assumption that what they ate that year reflected their general eating pattern over a number of years, Schabath says.

The two groups were matched in terms of age, gender, ethnicity and smoking status. The researchers then divided consumption into three categories of foods that contain phytoestrogens:

Isoflavones -- soybeans and soy products, chickpeas and red clover;

Lignans -- rye grains, linseeds, carrots, spinach, broccoli and other vegetables; and

Coumesterol -- bean, peas, clover, spinach and sprouts.

They also looked at phytosterols, a fourth group of plant-derived steroidal compounds that are believed to have estrogenic properties. These include vegetable oils, margarines, spreads, grains, and certain fruits and vegetables.

The researchers divided consumption of these foods into quartiles, from highest use to lowest use, as measured against all participants. They then compared the two groups, and among their findings were the following:

Overall, consumption of phytoestrogens was statistically significantly higher in controls than in cases.

The overall reduction in lung cancer risk was 46 percent for the highest intake of all phytoestrogens from food.

For men, statistically significant trends were noted for each class of phytoestrogen, when they were consumed at the highest levels. For example, isoflavones reduced lung cancer risk by 44 percent, and lingans reduced the risk by 27 percent.

In women, only intake of total phytoestrogens from food sources was statistically significantly higher in controls than in cases. High consumption of these foods reduced risk by 34 percent, but no effect was seen when individual classes of phytoestrogens were evaluated.

No Benefit Seen in Former Smokers

Phytoestrogens may help protect against lung cancer development because they latch on to estrogen receptors that are present in both normal and malignant lung tissue, and this binding could exert a role in the regulation or deregulation of cancer growth, the researchers suggest.

However, they cannot say why women, in general, seemed to benefit less than men did from eating high quantities of specific classes of food with phytoestrogens or why former smokers seemed to benefit less.

Much more research is needed to prove a definitive chemoprevention effect, the investigators caution. For example, for reasons the researchers do not understand, even a high consumption of phytoestrogens did not reduce lung cancer risk in those people studied who had smoked and then quit.

"These findings need to be confirmed in prospective studies. We are just at the beginning of our work to explore the connection between these nutrients and lung cancer risk. The challenges and opportunities are enormous since lung cancer is the number one cause of cancer mortality in the United States," says Spitz.

[Connie B]

About 5+ years ago, I came across a few articles that talked about Estrogen & LC. Then about 3 years ago, I hear pretty much the same things, and then about a year ago, AGAIN I hear about estrogen and LC.

All that I have heard is in the article Donna G shared with you. When I asked my Onc Doc, my OBGYN about this, they both looked at me and said, "It's NEWS" and many things are published to reel us in because it's NEWS!

I'm not sure how much of WHAT you can believe, but it's always worth bringing up to your doc.

[Nushka]

I saw my gyn today. I asked the same question and he said that no major studies are proving that estrogen might be harmful for LC patients. He did reduce the amount I take 2 years ago. I tried to stop taking it for 3 months. All I can say about that is I was miserable. Hot flashes, feeling as though I was going to faint, and tired. I started back and all of my symptoms went away. My cardiologist says there may be a connection with adenocarcinoma (which is what I have) but that the risk is not worth feeling awful all the time. I have decided to continue to take my very low dose. I need it for my bones ( I has osteoporosis) and the way I feel.

Nina

[Hebbie]

My oncologist actually mentioned last week that they are starting to do some preliminary lung cancer clinical trials using the same breast cancer protocol (tamoxifine?) and also using some sort of shots that will temporarily shut off your ovaries, hence, reducing your levels of estrogen, due to the new studies, indicating that lung cancer may possibly fueled by estrogen, particularly in young, non-smoking women.

[chloesmom]

About the estrogen connection, here's something to add to the confusion...in June of 2001 I started taking tamoxifen to treat breast cancer. Tamoxifen is a drug that blocks estrogen from attaching to estrogen receptor breast cells. In May of 2003, I was diagnosed with adeno of the lung.

I had a clean x-ray prior to breast cancer surgery in 2001 and a 3cm tumor on my lung, found by x-ray, in May of 2003, so I don't think tamoxifen stopped the growth of that tumor.

I did send a message to Dr. Cunningham a while ago though, upon first hearing about this estrogen question. He said that continuing on tamoxifen after the 5 year protocol is past would not be the right thing to do.

I don't know. This is all confusing, but I'm just offering my experiences.

Cindy