LifeCare Chiropractic

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soy

MORE RATIONING OF BREAST CANCER TREATMENT

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You may have heard the news hoopla recently when the FDA withdrew the approval of Avastin for the treatment of breast cancer.  The world was floored.  The news screamed rationing.  The comments following all the news stories spoke of lives saved and how dare we put a cost on human lives.

As often happens, emotions trump science and common sense.  Here’s how the story went…

Avastin was initially approved not on survival, but on progression free survival.  This means that the drug was initially improved based on the data NOT that it saved lives, but that it lengthened the time before the breast cancer progressed.  This is the infamous “surrogate end marker” I’ve described often enough.  It does not check the actual outcome we want, but instead checks for some reflection of the actual outcome that someone decided might be a good idea to check for.  Unfortunately, using surrogate end markers, in the vast majority of cases (if not all), allows drugs that would not otherwise have been approved to make it past the FDA and make drug companies billions upon billions of dollars.  It is not until years later (and more billions) that we look at the actual end point and shrug our shoulders meakly, saying that maybe it didn’t work as well as we thought it was going to.

Back to Avastin.  It was approved based on the progression free survival.  Only later did the real picture emerge.  Actual average survival was not increased.  The cost for this “miracle” drug?  A whopping $92K.

The critics were quick to look at this as a money thing.  “Why can’t we spend $92K on a breast cancer patient–does this mean that we can place a value on a life of $92K??”  This argument, unfortunately, only works if it actually lengthened survival.  Further we need to look at the increased risk of side effects and lower quality of life scores.  Again at a cost of $92K.

Looking at the second round of data several years after Avastin was approved, the FDA voted unanimously to withdraw approval of Avastin.  The drug’s manufacturer, Genetech was not happy and have contested the ruling.  On what grounds, I’m not exactly sure.

Compare this to higher levels of isoflavanoids from soy in the bloodstream of breast cancer patients, where in one study the patients with the higher levels had DOUBLE the chance of survival.  All for less than $92,000….

http://healthpolicyandreform.nejm.org/?p=14796&query=OF

SOY AND PROSTATE CANCER

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Many of the headlines spread across the Internet on soy would have you believe that soy contributes to cancer, contains “anti-nutrients,” and is growing C cup breasts on every male out there.  Some of these, if you read past the title, do agree that soy has many potential benefits when consumed in the unprocessed forms.

This means avoiding GMO soy (this is getting more and more difficult–best best is to go organic as much as possible) and avoiding processed soy such as TVP.  That means that the veggie burger or veggie dog that’s been reheated in the microwave is probably not going to do the wonderful things for you that you think it is.  It means using forms of soy such as edamame, tofu, miso, tempeh and soy milk.

This also means that, to get the full advantage of soy, we may need to avoid antibiotics (there it is again–yet another damaging effect of indiscriminate antibiotic use).  The isoflavones in soy can get converted in the gut to their aglycone form by the right types of bacteria.  The aglycone form is believed to be the most potent and protective version of the compounds.  This is likely why Asain populations who were raised on soy and have more of the correct blend of bacteria in their gut, get more protection from soy.

While soy does have some potential to affect the thyroid in some sensitive individuals (although there is some question that this is only in those with lowered iodine status), the health benefits in the published medical litarature are quite vast.  Specifically, the outcomes and risk of certain hormone dependent cancers such as breast and prostate have some pretty massive protective effects.

This particular study looks at the potential of soy to protect against the radiation damage seen with treatment of prostate cancer.  This may occur by preventing cancer cells from protecting themselves, leaving them more susceptible to the radiation damage, while at the same time protecting innocent bystander cells.  Not a bad combination.

http://www.sciencedirect.com/science/article/pii/S0891584911002802

DOES SOY REALLY INCREASE RISK FOR BREAST CANCER?

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I’m unsure how soy has managed to get such a bad reputation.  But there is no doubt that the internet has contributed to the idea that soy is bad for our health and increases the risk of cancer, thyroid problems, breasts on men and maybe even hangnails.  It is a topic that I frequently have to address both in the community and in my office.

First, let me make a few things clear.  We are talking about unprocessed soy, so NOT veggie burgers, TFP (textured vegetable protein) or soy hot dogs (do people seriously buy these?).  Given the concern over the genetic modification of foods (GMO), organic or at least non-GMO soy is the only way to go.  So soy milk, tofu, edemame, tempeh.

I can tell you that the overwhelming majority of research studies on soy are very positive, especially as it relates to breast cancer.  Lowering the risk and improving outcomes have been shown consistently in the medical literature.  This particular study found a whopping 54% lower risk of dying after a breast cancer diagnosis.  Wow!  Too bad they don’t post this type of info all over the Komen 3-day sites.

The compounds believed to provide the most benefits in soy are the isoflavones.  We also know that isoflavones are converted by specific bacteria in the gut to the aglycone form, which is the most protective form.  This is likely why some populations get greater benefits from soy (like Asian women raised in Asia) because they have consumed soy over a lifetime and the bacteria in their gut have adapted.  It is also likely that antibiotics will destroy these beneficial bacteria–yet another downside to society’s heavy dependence on antibiotics for every little sniffle.

http://cebp.aacrjournals.org/content/20/5/854.abstract