The story on Soy for Her 2

[hutchibk]

http://lifeovercancerblog.typepad.co...nds-again.html

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What kinds of soy should I eat?
Definitely choose organically grown soy, which by definition means that it will also be what is called “non-GMO” (non-genetically modified organism). Genetically modified (GM) soy is scary! Over 90 percent of soy grown in the United States is modified genetically to be resistant to herbicides sprayed on fields to kill off weeds. As a result, GM soy is now contained in up to 70 percent of all food products including cereals, pasta, breads and even meat since animals are fed GM soy as part of their feed to help them grow faster. GM soy has been linked to allergies, birth defects, infertility and cell mutations in the liver and pancreas. Yikes!

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Hey, Soy – Let’s Be Breast Friends Again!

Written by Jacki Glew, MS, RD, LDN - Clinical Nutrition Manager for the Block Center for Integrative Cancer Treatment

Soy. That little three-letter word that strikes fear into the stomachs of so many. Why are we so afraid of soy? Well, I bet you’re asking...

What’s so great about soy?
The soybean is the only bean that is a complete protein on its own. It has lots of good stuff like phytic acid that can bind dangerous heavy metals, alpha-linolenic acid that helps control inflammation and isoflavones like genistein and daidzein that help protect your heart and bones.

Soy also contains phytoestrogens (aka plant estrogens), which are pretty similar to the estrogen formed naturally in your body. Soy has a high level of phytoestrogens, but still only has a teeny-weeny bit of the power of human estrogen – just two percent! Phytoestrogens will bind to your cells’ estrogen receptors, but oddly enough, at the same time phytoestrogens can bind up estrogen to stop it from working.

And most people don’t realize that soy is not the only plant to contain phytoestrogens. Believe it or not, over 300 plants contain them, including flax, sesame, wheat, oats, barley, beans, yams, apples, carrots and pomegranates.

Can I eat soy if I have breast cancer?
Soy can seem kinda scary if you have breast cancer that is estrogen-receptor positive (ER+). But scientists are starting to unlock this mystery of how soy works in the body with breast cancer. What they have found is that many cells in the body have estrogen receptors. Think of these receptors like little locks that need estrogen to act as the key to open them. So estrogen unlocks these doors and lets breast cancer cells grow and multiply. But phytoestrogens fit into these same locks but cannot open the doors so they wind up competing with your natural estrogen and blocking it from working!

On top of that, phytoestrogens help to prevent cancer cells from talking to each other and ganging up on you. Phytoestrogens also stop the growth of blood vessels to tumors to cut off cancer cells’ nutrition and fiddle with processes involved in DNA that mess up how cancer cells grow and multiply. Cool!

Now, if you have what is called human epidermal growth factor receptor 2 (HER-2) positive breast cancer and are on a drug called trastuzumab (Herceptin), soy may actually help trastuzumab work better. Late breaking news: Breast cancer cells treated with genistein along with trastuzumab significantly slowed breast cancer cell growth more than using just the drug alone![1] On top of that, genistein has been shown to suppress HER-2 activity!

If you are on the drug tamoxifen, then soy may help you, too. Many people on tamoxifen are told by their docs to avoid soy because tamoxifen’s job is to block those estrogen receptors, and the thinking is that tamoxifen might bind to the phytoestrogen in soy instead. But back in 2007, researchers in Israel found that genistein may actually sensitize ER+ and HER-2+- breast cancer cells to tamoxifen and help it work better. Genistein and tamoxifen together caused breast cancer cells to self-destruct by targeting receptors on the cell surface and telling them to stop making something called “survivin,” which, you guessed it, helps cancer cells survive and ignore signals to self-destruct.[2]

What if I’m a breast cancer survivor?
First of all, congratulations for making it through a long and difficult journey! And to reward you, you can add soy to your diet, too! In 2009, results from a study of over 5,000 Chinese breast cancer survivors stated that women who consumed three cups of soy milk per day were less likely to have a recurrence or to die of breast cancer than women who only drank ½ cup a day![3] And last month, researchers found that the risk of recurrence for postmenopausal breast cancer survivors was 33 percent lower for Chinese women who ate more than 42 mg/day of isoflavones – that’s only ¼ cup tofu a day! And they found this was especially true for women with ER+ breast cancer and who were taking anastrozole (Arimidex).[4] Okay, yes, these were all Chinese women who grew up eating soy. But we could learn a lesson from them. What makes a big difference is the type of soy that’s eaten, and that we actually eat it! Read on...

What kinds of soy should I eat?
Definitely choose organically grown soy, which by definition means that it will also be what is called “non-GMO” (non-genetically modified organism). Genetically modified (GM) soy is scary! Over 90 percent of soy grown in the United States is modified genetically to be resistant to herbicides sprayed on fields to kill off weeds. As a result, GM soy is now contained in up to 70 percent of all food products including cereals, pasta, breads and even meat since animals are fed GM soy as part of their feed to help them grow faster. GM soy has been linked to allergies, birth defects, infertility and cell mutations in the liver and pancreas. Yikes!

Also be sure to get the least processed forms of soy in your diet: edamame, soy nuts, soy milk or tofu. And by all means, experiment with fermented soy options like tempeh, miso, tamari soy sauce or natto. If you’re still scared of soy, it’s good to know that fermenting soy lowers the phytoestrogen content found in soy. Since some of the carbohydrates in soy are broken down during fermentation that means less jet propulsion from gas. Bonus!

But that doesn’t mean all you eat is soy, soy, soy each day. Make sure you get a variety of beans, legumes, nuts and grains in your diet each day to round out your protein intake. Based on the studies out there right now, you should aim to get at least one serving of soy each day – that’s ¼ cup of tofu or tempeh, one cup of soy milk or a small handful of soy nuts. Get your soy on!

[1] Lattrich C, Lubig J, Springwald A, et al. Additive effects of trastuzumab and genistein on human breast cancer cells. Anticancer Drugs. 2010 Dec 14. [Epub ahead of print]
[2] Mai Z, Blackburn GL, Zhou JR. Genistein sensitizes inhibitory effect of tamoxifen on the growth of estrogen receptor-positive and HER2-overexpressing human breast cancer cells. Mol Carcinog. 2007;46(7):534-542.
[3] Shu XO, Zheng Y, Cai H, et al. Soy Food Intake and Breast Cancer Survival. JAMA. 2009;302(22):2437-2443.
[4] Kang X, Zhang Q, Wang S, et al. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. Can Med Assoc J. 2010;182(17):1857-1862.

Jacki Glew originally posted this blog on February 25th as a guest blogger on crazysexylife.com.

[hutchibk]

Be sure and read the top regarding "what types of Soy should I eat?" ~ probably the MOST important part. THIS type of Soy is reported to help Herceptin work too.

So, I don't don't don't do soy milk, I prefer Almond milk, and read read read labels, everything these days has soy oil (GMO) in it, so read labels and buy without if you can. It'll mean shopping a little differently possibly, but I just eat organic edamame and occasionally organic tofu.

[schoolteacher]

Brenda,

Thanks for the article. Glad to see you post on the board.

Amelia

[ElaineM]

I loved the article. Thanks. Great to see you aboard the her2 train today !!
Like you I eat good quality non GMO edamane and Tofu occassionally. I prefer almond milk too.
My estrogen levels have actually dropped alot since my diagnosis.
Asian women who eat pounds of tofu or edamane every month have less ER positive breast cancer than Western women do.

[Rich66]

For what it's worth, another cell line test of similar vintage that warrants consideration:

Carcinogenesis. 2010 Jan 12. [Epub ahead of print]
Genistein Induces Enhanced Growth Promotion in ER Positive/erbB-2 Overexpressing Breast Cancers by ER-erbB-2 crosstalk and p27/kip1 Downregulation.

Yang X, Yang S, McKimmey C, Liu B, Edgerton S, Bales W, Archer L, Thor AD.
Department of Pathology, University of Oklahoma Health Sciences Center.
Genistein is a major isoflavone with known hormonal and tyrosine kinase modulating activities. Genistein has been shown to promote the growth of estrogen receptor (ER) positive MCF-7 cells. In ER negative/erbB-2 overexpressing cells, genistein has been shown to inhibit cell growth through its tyrosine kinase inhibitor activity. The effects of genistein on cell growth and tamoxifen response in ER positive/erbB-2 altered breast cancers (known as luminal type B and noted in approximately 10-20% of breast cancers) have not been well explored. Using erbB-2 transfected ER+ MCF-7 cells, we found that genistein induced enhanced cellular proliferation and tamoxifen resistance when compared to control MCF-7 cells. These responses were accompanied by increased phosphorylation of ERalpha and ER signaling, without increase in ER protein levels. Genistein treated MCF-7/erbB-2 cells also showed enhanced activation/phosphorylation of erbB-2, Akt and MAPK/Erk. Blockade of the PI3K and/or MAPK pathways abrogated genistein induced growth promotion, suggesting that genistein effects involve both critical signaling pathways. We also found that p27/kip1 was markedly downregulated in genistein treated MCF-7/erbB-2 cells. Overexpression of p27/kip1 attenuated genistein mediated growth promotion.

[Lani]

Have a different story.
Repost of one of threads I started:

Lani
Senior Member

Join Date: Mar 2006
Posts: 3,895
more in the "soy saga"

I had been under the impression that whether or not soy might increase or decrease the chance of recurrence of bc was related to ER/PR status but now two studies one out of Japan and one out of Korea (below) say soy's effect on recurrence more likely depends on tumor's her2 status. The article below is based on a small number of patients, but the full article refers to the Japanese study and is very interesting...

Nutr Cancer. 2012 Jan 2. [Epub ahead of print]
Differential Influence of Dietary Soy Intake on the Risk of Breast Cancer Recurrence Related to HER2 Status.
Woo HD, Park KS, Ro J, Kim J.
Source
a Cancer Epidemiology Branch, National Cancer Center , Korea.
Abstract
The effects of soy products and isoflavone on breast cancer recurrence were compared according to receptor status including epidermal growth factor receptor-2 (HER2) with 339 Korean women. Dietary intake of soy foods was assessed using a validated food frequency questionnaire with 103 food items. Twenty-five patients experienced breast cancer recurrence, 17 patients were HER2 negative, and 8 patients were HER2 positive. Legume intake (mostly from black soybeans) was inversely associated with the risk of breast cancer recurrence in HER2 negative cancer patients (HR: 0.27, 95% CI: 0.13-0.57, P for trend < 0.01), whereas legume intake was positively associated in HER2 positive cancer patients (P for trend = 0.02). In HER2 negative cancer patients, isoflavone was inversely associated with breast cancer recurrence (HR: 0.23, 95% CI: 0.06-0.89; P for trend = 0.01). Total soy intake was not associated with an increased risk of cancer recurrence. In conclusion, overall soy food intake might not affect the risk of cancer recurrence, but high intake of soy isoflavones increased the risk of cancer recurrence in HER2-positive breast cancer patients. However, further research is needed to confirm these results due to the small number of cancer recurrence events.
PMID: 22211813

[hutchibk]

I guess everything has differing research... that's why this is soooo hard.

[Jackie07]

Asian Pac J Cancer Prev. 2012;13(2):479-82.
Positive effects of soy isoflavone food on survival of breast cancer patients in china.

Zhang YF, Kang HB, Li BL, Zhang RM.
Source

Department of General Surgery, The Affiliated Hospital of Inner Mongolia Medical College, Hohhot, China E-mail zyming_2009@126.com.

Abstract

Aim: Soy foods are the major source of isoflavones, which are believed to play important roles in genesis of breast cancer and its progression. We here conducted a prospective study to evaluate the association of soy isoflavone food consumption with breast cancer prognosis.

Methods: A prospective study was performed from January 2004 and January 2006 in China. Trained interviewers conducted face-to-face interviews using a structured questionnaire to collect information on dietary habits and potential confounding factors. The relative risk [hazard ratio (HR)] and 95% CI were calculated from the Cox regression model for all significant predictors from cancer diagnosis to the endpoint of the study (event).

Results: After a median follow up of 52.1 months (range, 9-60 months), a total of 79 breast cancer related deaths were recorded in our study, risk being inversely associated with a high intake of soy isoflavone. With an average intake of soy isoflavone above 17.3 mg/day, the mortality of breast cancer can be reduced by about 38-36%.

We also found the decreased breast cancer death with high soy protein intake, with a HR (95% CI) of 0.71 (0.52-0.98). Stratified analysis with reference to the ER status, further demonstrated a better prognosis of ER positive breast cancer with a high intake of soy isoflavone (HR 0.59, 0.40-0.93).

Conclusion: Our study shows the soy food intake is associated with longer survival and low recurrence among breast cancer patients. A cohort study with a larger sample size and long term follow-up is now needed.

[LuckyLinda]

Re: The story on HER2 and Soy


I can't take any credit for this information, though I can take credit for a lingering curiosity regarding the link between estrogen positive breast cancer and soy. Soy is a hot topic in the breast cancer arena. When I first met with the breast cancer educator, the day after getting my diagnosis, she told me that eating soy products was like “pouring gasoline on a fire.” She sounded so confident. Of course, I took her advice. When you’ve been told that you have invasive breast cancer, you would quite literally eat dirt if someone with medical expertise advised it. After all, we line up to have poison poured into out veins without protest, and then say “Thank you” and even give hugs of gratitude. But, and this is a big but, it continued to bother me that no physician ever recommended that I avoid soy, including my own daughter. And I really miss my dark chocolate-covered edamame. There is so much information that is regarded as “gospel” one day and turns out to be “garbage” the next, that I thought a little more sleuthing on my part was in order. What follows is information directly from the Dr. Susan Love Research Foundation. I joined the Army of Women at its inception, long before I was diagnosed with breast cancer. I like their emphasis on finding the cause of breast cancer. This, because of the source, is information I have confidence in. And it is easy to understand.

From Dr. Love:

The story of soy and breast cancer is an excellent example of the research process. Pieces of information come in slowly, some studies contradict others, and then, over time, as we learn more, we gain a clearer picture of the answer. But until that occurs, confusion and worry are common, as the subject in question—in this case soy—pops back and forth between the "good" category and the "bad."

Initially, soy was thought of as a wonder food. This happened because researchers looking for an explanation as to why women living in Asia had lower breast cancer rates than women living in the U.S. found that Asian women ate more soy products. Virtually overnight, soy became the best thing in breast cancer prevention. Tofu and soy milk were all the rage. All kinds of processed foods began to contain soy, and soy powders and supplements could be found everywhere. There was no question: Soy was GOOD!

But as scientists began to conduct laboratory studies to look for reasons why soy might decrease breast cancer risk, they found that when genistein, which is a type of isoflavone, was added to breast cancer cells they grew faster. Soon after, it was suggested that women who were taking tamoxifen and other anti-estrogens should avoid soy because soy acted like a weak estrogen, and could potentially counteract the tamoxifen or increase a woman's risk of recurrence. Suddenly, soy was now BAD!

That's why it was big news when a study conducted in Shanghai, China, published in December 2009 in the Journal of the American Medical Association, found that women with breast cancer who ate soy had a decreased risk of having a cancer recurrence or dying of the disease.

The study was based on data from the Shanghai Breast Cancer Survival Study, which includes 5024 female breast cancer survivors. After following the women for four years, the researchers found that the higher a woman's soy protein or soy isoflavone intake, the lower her risk of having a breast cancer recurrence or dying from the disease. This was true regardless of whether women had ER-positive or ER-negative tumors, whether or not they were taking tamoxifen, and whether they were pre- or postmenopausal. (Although the researchers didn't look at this question, the findings would be expected to be the same for women on aromatase inhibitors.)

The study's authors pointed out that there are differences in the types of soy eaten by women in Asia and women in the U.S. In Asia, women are more likely to eat whole soy foods, like cooked soybeans, edamame, tofu, miso, and soy milk, whereas in the U.S. women tend to eat more processed foods that contain soy—and at much lower levels.

This is additional evidence that women in the U.S. with breast cancer can feel even better about adding whole soy foods to their diet. To be sure, we need more studies in women to confirm this finding. But a study of this size that has been so well done and that shows no negative effects clearly suggests that eating soy will not increase your risk of a recurrence and that, in fact, it might even reduce it!

What about soy letcithin? It is extracted from soybeans, but it is not part of the soy protein. As a result, it does not contain any isoflavones, which are the part of the soybean that acts as an estrogen. It is primarily used as an emulsifier to hold ingredients together. So, there is also no reason to worry that you are getting lots of isoflavones in your diet each time you chew gum or take a supplement.

The soy story also shows us why we can't over simplify the science. Soy is not a phytoestrogen but rather a "phytoSERM," more like tamoxifen than estrogen. It also reinforces that we cannot automatically extrapolate from studies on cells and rats to women. We need to do studies on women so that we know what happens in women's bodies.

This post is courtesy of the Dr. Susan Love Research Foundation, dedicated to eradicating breast cancer and improving the quality of women's health through innovative research, education and advocacy. To support this important cause and donate, visit www.dslrf.org

So, the question remains............Can I go back to my Vanilla Soy Milk and chocolate-covered edamame? I think I’m going to have to trust Dr. Susan Love on this one. ♥♥♥

[hutchibk]

This stuff is sooo very difficult, and a lot of the problem is sugars in the soy, along with too much soy (read labels, it is the basis of oil in so many things, even if you shop healthy/organic, or conventional).

Different posts here illustrate again the controversy of differing research about how Americans eat soy, how much and how often, types, etc., vs. Asians. I may be wrong, but again, too much of something is too much. That's why I eat as I do. Everything in moderation and I shop the outer area of a grocery store more than the inner shelves. Just one girl's idea.

If you have never heard or spoken in person to Dr. Susan Love (as I have), you should.

But again, this initial article is about soy and Her2Neu from the Block Center. Please read it as such. If you have never heard of the Block Center, please do some internet research.

[LuckyLinda]

So much to learn........so little time. As if being diagnosed with and undergoing treatment for breast cancer is not complicated enough, the whole "which foods to eat" issue is stulifying! I will definitely be on the alert for GM soy products nd will choose, whenever possible, organic alternatives. Is there a chain supermarket that is more likely to carry these products? Can someone recommend brand names? Anyone know anything about Whole Foods? Grocery stores don't make it easy for us to find organic alternatives, do they?

[StephN]

Hi LL -

Great thread, as we revisit Soy.

Do you have any farmer's markets where you live? They are now open in my area and most of the vendors, if not certified organic, have pesticide free produce.

We have many Asian vendors and they do sell edemame at times.

Whole Foods just opened a new (huge - was an old Circuit City location) store 10 minutes up the road from my home. They tend to be more expensive than other choices I have for buying organic and non-GMO.

Most regular chain stores now have a "natural" foods section, or sections in various parts of the store. You have to do some more careful study of the choices, but I do find some items to buy in those sections.

There are meat and egg vendors at the farmer's markets as well. The items are more expensive, but really good. Once in a while I treat us.

[hutchibk]

Be sure to read labels if you buy anything that has a label (non veggie/fruit in it's skin). Make choices. Whole foods does a pretty great job at discerning organic from conventional. I do trust them, but I always read labels too. I probably spent more time in a grocery store than most people. Steph makes a wonderful point about Farm Stands and Farmers Markets! (but make sure that locally produced is not treated for pests other than an organic/non toxic compound.)

[harrie]

Great thread Brenda, thank you.
Maryanne