The recent news about Angelina Jolie getting a prophylactic double mastectomy is both sad and encouraging. Women, and their physicians, are becoming more aware of individual breast cancer risk. They are willing to use any available treatments to reduce that risk, and promote health.
Tamoxifen is a breast cancer drug success story. It works by competing with estradiol for estrogen receptor protein. Thereby inhibiting the Erα (estrogen receptor). See http://www.drugs.com/pro/tamoxifen.html Tamoxifen 1st significantly improves survival. 2nd reduces recurrence. 3rd reduces the incidence of breast cancer in high risk women. The drawback is that the tumors need to be overexpressing estrogen receptor, or ER+. Cancer that is “estrogen receptor negative”, or ER- now has a comparably worse prognosis. This is because hormone therapy using Tamoxifen or other selective estrogen receptor modulators (SERMs) doesn’t work for ER- cells.
An intriguing idea for treatment for ER- breast cancer was explored in the PloS ONE paper, Bioactive Dietary Supplements Reactivate ER Expression in ER-Negative Breast Cancer Cells by Active Chromatin Modifications. There are many DNMT and HDAC inhibitor synthetic drugs actively being researched. The challenge has been their low specificity and high cytotoxicity. The natural compounds green tea polyphenols (GTPs) and sulforaphane (SFN) target both DNA methyltransferases (DNMTs) and histone deacetylases (HDACs). As per the title, the authors showed how GTPs and SFN work synergystically to reactivate the estrogen receptor in ER- cancer cell lines. The right dosage combination made the cancer cells susceptible to Tamoxifen treatment. They examined the underlying molecular mechanism.
Investigating natural anti-epigenetic compounds is cutting edge cancer research. Ideally, combinational treatment of hormone therapy with diet supplements will prevent cancer, or halt its progression. The right treatment will reliably reduce an individual patient’s risk. And an ounce of prevention is worth a pound of cure!