As we move from 2019 to 2020, we see that more women are surviving cancer. With this great news also comes an increased incidence of menopausal symptoms in survivors, whether from normal, age-related causes or those exacerbated by the cancer treatments themselves, or a combination of both. Although menopausal symptoms are often treated with exogenous hormones such as bioidentical hormone replacement therapy, the majority of women with gynecological cancers are not able to use such HRT, because of the nature of their cancer.
Many gynecological cancers are related to hormones, meaning that hormones, almost exclusively estrogen, are considered “fuel” for the cancer cell. Hence, administration of hormones for menopausal symptoms is contraindicated for fear that giving women hormones could either enhance the growth of an existing cancer or cause recurrence should there be residual or hidden cancer cells after “successful” treatment. Since conventional medicine relies almost exclusively on drug therapy for such symptoms, and since such therapy is often insufficient, naturopathic medicine has and continues to be a comprehensive and effective source for amelioration of symptoms.
Although most naturopathic physicians are educated about menopause and related physiology, naturopathic oncologists, those NDs who are specialists in oncology, are more attuned to the intricacies of managing menopausal symptoms for women with or surviving from cancer. Typical symptoms may include:
Hot flashes or night sweats
Insomnia or difficulty sleeping
Cognitive issues, brain fog or “chemo brain”
Bone health, decreased bone density
Joint pain or arthritis
Weight gain or difficulty losing weight
Lifestyle treatment is one of the central tenets of the naturopathic approach to symptoms. For instance, a low estrogen environment may promote weight gain since we know that a decrease in estrogen levels may lower the metabolic rate, increase appetite and reduce desire for physical activity! This can also lead to poor management of starches and sugars, which hence become stored in the body as fat, especially as the level of calorie burn (exercise) deceases. Furthermore, and to compound the issue, obesity can increase menopausal symptoms. Why? In general, obese women suffer more severe consequences of hot flashes, which may cause them to stop certain activities and also decrease their work efficiency; there is also the thermoregulatory theory, which proposes that a women’s basal metabolic index, or BMI, is positively associated with certain menopausal symptoms because body-fat tissue acts as a strong heat insulator. Such insulation makes the distribution of heat more problematic, which then causes obese women to suffer more hot flashes. Thus, it is important to find a diet and exercise program that works well for you. Even if a woman is inclined toward exercise or understands the basics of healthy eating, sometimes motivation is a limiting factor. And motivation may be limited by a medical cause. It is important for a patient to have her doctor test other endocrine (hormone) functions such as the adrenal or thyroid glands. These glands are associated with well-being, energy and cognition, but often their functions are impaired from conventional cancer treatments such as surgery, radiation or chemotherapy.
If someone has low thyroid or adrenal function or they have fatigue or joint pain or a multitude of such symptoms, it may be quite difficult for them to find the motivation to make a needed lifestyle change in order to help them reduce their symptoms. For instance, we know that, in general, fruit-and-vegetable-based diets are inversely associated with menopausal symptoms. Furthermore, diets that contain mayonnaise, liquid oils, sweets, desserts, red meat, organ meat, fish, poultry, egg, coffee, refined grains are associated with higher (1) general menopausal symptom scores; and (2) genitourinary-based symptoms. In the clinic, we often find that women with fatigue or endocrine dysfunction are less likely to engage dietary changes until we can help manage their non-estrogen hormones and/or help them reduce their fatigue.
The naturopathic physician or naturopathic oncologist has many tools available to help manage symptoms of menopause and lifestyle changes, although difficult and effective, are not the only tools. We utilize herbs, nutrients, physical therapies, homeopathics and more, and sometimes a combination of therapies is most appropriate. In general, because of the complexities of symptoms and cancer-related-physiology, self-treatment is ill-advised. A naturopathic oncologist is well-prepared to answer your questions and place you on a safe and effective treatment plan. Two of the most common questions we are asked are regarding estrogens in the environment (xenoestrogens, often referred to as toxins or toxic estrogens) as well as soy-based foods. Stay tuned for the next oncology-related article when we discuss both subjects. FBN
By Dan Rubin, ND, FABNO
Dan Rubin, ND, FABNO, is founding president of the Oncology Association of Naturopathic Physicians. He is the co-founder of Aspen Integrative Medical Center in Flagstaff and medical director of Naturopathic Specialists, LLC, in Scottsdale. For additional information or to schedule an appointment with a member of the oncology team at Aspen Integrative Medical Center, LLC, visit our website at aspenmedcenter.com or call 928-213-5828. Aspen Integrative Medical Center, LLC, is located at 323 N Leroux St Suite B, Flagstaff, AZ 86001.