Breast Cancer & Constipation

Breast Cancer & Constipation
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The reason why women who have more frequent bowel movements appear to be at lower risk for breast cancer may be because bile acids absorbed from our intestines concentrate in the breast and have a estrogen-like tumor promoting effect.

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Why do constipated women appear to be at higher risk for breast cancer? Results suggest a slight increased risk of breast cancer for both decreased frequency of bowel movements and firm stool consistency, whereas women who have three or more bowel movements a day—super poopers—appeared to cut their risk of breast cancer in half. This could be because constipation means a greater contact time between our waste and our intestinal wall, which may increase the formation and absorption of fecal mutagens—substances that cause DNA mutations and cancer—into the circulation, and they could end up in breast tissue.

This concept dates back more than a century where severe constipation, so-called chronic intestinal stasis, was sometimes dealt with surgically. Figuring the colon was an inessential part of the human anatomy, why not cure constipation by just cutting it out? What they noted, though, was that potentially precancerous changes in the breasts of constipated women seemed to disappear after the surgery.

It would take another 70 years, though, before researchers followed up on the clues by those distinguished surgeons who claimed breast pathology cleared when constipation was corrected. So they investigated the relation between potentially precancerous changes in the breast and the frequency of bowl movements in nearly 1500 women. They found four times the risk in women reporting two or fewer bowel movements a week compared to more than once daily, who had the lowest risk.

We know that even the non-lactating breast actively takes up chemical substances from the blood, so maybe substances originating in the colon might enter the bloodstream and reach the breast. We know there are mutagens in feces, so it is not unreasonable to suggest that potentially toxic substances derived from the colon have damaging or even carcinogenic effects upon the lining of the breast. And those toxic substances may be bile acids.

First shown to promote tumors in mice in 1940, subsequent experiments on rats led to the mistaken belief that bile acids just promoted existing cancers but couldn’t actually initiate tumors themselves. However, there is a fundamental difference between the rodent models and human cancer. Rats only live a few years, and so the opportunity for cancer causing mutations may be at least 30 times greater in humans. Now we have at least 15 studies that show that bile acids can damage DNA, strongly suggesting they can initiate new cancers as well.

Bile acids are formed as a way of getting rid of excess cholesterol. Our liver dumps bile acids into the intestine for disposal, assuming our intestines will be packed with fiber to trap it and flush it out of the body, but if we haven’t been eating enough whole plant foods, bile acids can be reabsorbed back into the body, and build up in the breast.

Carcinogenic bile acids are found concentrated in the fluid of breast cysts at up to a hundred times the level found in the bloodstream. By radioactively tagging bile acids they were able to show that intestinal bile acids rapidly gain access to the breast, where they can exert an estrogen-like cancer-promoting effect on breast tumor cells. This would explain why we see 50% higher bile acid levels in the bloodstream of newly diagnosed breast cancer victims. These findings support the concept of a relationship between intestinally derived bile acids and risk of breast cancer. So how can we facilitate the removal of bile acids from our body?

Well we can speed up the so-called oroanal transit time, the speed at which food goes from mouth to toilet, because slowed colonic transit can increase bile acid levels. We can do that be eating lots of fiber. A diet packed with plants greatly increases bile acid losses.

Fiber can bind up and remove toxic elements like lead and mercury, as well as cholesterol and bile acids. But plants can bind bile acids even independent of fiber. Vegan diets bind significantly more bile acid than lacto-ovo or non-vegetarian diets even at the same fiber intake, which could explain why it appears that individuals eating vegetarian might excrete less mutagenic feces in the first place.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Why do constipated women appear to be at higher risk for breast cancer? Results suggest a slight increased risk of breast cancer for both decreased frequency of bowel movements and firm stool consistency, whereas women who have three or more bowel movements a day—super poopers—appeared to cut their risk of breast cancer in half. This could be because constipation means a greater contact time between our waste and our intestinal wall, which may increase the formation and absorption of fecal mutagens—substances that cause DNA mutations and cancer—into the circulation, and they could end up in breast tissue.

This concept dates back more than a century where severe constipation, so-called chronic intestinal stasis, was sometimes dealt with surgically. Figuring the colon was an inessential part of the human anatomy, why not cure constipation by just cutting it out? What they noted, though, was that potentially precancerous changes in the breasts of constipated women seemed to disappear after the surgery.

It would take another 70 years, though, before researchers followed up on the clues by those distinguished surgeons who claimed breast pathology cleared when constipation was corrected. So they investigated the relation between potentially precancerous changes in the breast and the frequency of bowl movements in nearly 1500 women. They found four times the risk in women reporting two or fewer bowel movements a week compared to more than once daily, who had the lowest risk.

We know that even the non-lactating breast actively takes up chemical substances from the blood, so maybe substances originating in the colon might enter the bloodstream and reach the breast. We know there are mutagens in feces, so it is not unreasonable to suggest that potentially toxic substances derived from the colon have damaging or even carcinogenic effects upon the lining of the breast. And those toxic substances may be bile acids.

First shown to promote tumors in mice in 1940, subsequent experiments on rats led to the mistaken belief that bile acids just promoted existing cancers but couldn’t actually initiate tumors themselves. However, there is a fundamental difference between the rodent models and human cancer. Rats only live a few years, and so the opportunity for cancer causing mutations may be at least 30 times greater in humans. Now we have at least 15 studies that show that bile acids can damage DNA, strongly suggesting they can initiate new cancers as well.

Bile acids are formed as a way of getting rid of excess cholesterol. Our liver dumps bile acids into the intestine for disposal, assuming our intestines will be packed with fiber to trap it and flush it out of the body, but if we haven’t been eating enough whole plant foods, bile acids can be reabsorbed back into the body, and build up in the breast.

Carcinogenic bile acids are found concentrated in the fluid of breast cysts at up to a hundred times the level found in the bloodstream. By radioactively tagging bile acids they were able to show that intestinal bile acids rapidly gain access to the breast, where they can exert an estrogen-like cancer-promoting effect on breast tumor cells. This would explain why we see 50% higher bile acid levels in the bloodstream of newly diagnosed breast cancer victims. These findings support the concept of a relationship between intestinally derived bile acids and risk of breast cancer. So how can we facilitate the removal of bile acids from our body?

Well we can speed up the so-called oroanal transit time, the speed at which food goes from mouth to toilet, because slowed colonic transit can increase bile acid levels. We can do that be eating lots of fiber. A diet packed with plants greatly increases bile acid losses.

Fiber can bind up and remove toxic elements like lead and mercury, as well as cholesterol and bile acids. But plants can bind bile acids even independent of fiber. Vegan diets bind significantly more bile acid than lacto-ovo or non-vegetarian diets even at the same fiber intake, which could explain why it appears that individuals eating vegetarian might excrete less mutagenic feces in the first place.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Doctor's Note

I touched on this in my new live presentation From Table to Able: Combating Disabling Diseases with Food that just came out, but what I didn’t get to discuss is the relative bile acid binding abilities of different foods. I’ll cover that in my next video Which Vegetable Binds Bile Best?

What intestinal transit time should we be shooting for? See Food Mass Transit. That may be why Stool Size Matters. We can improve speed and size by Bulking Up on Antioxidants and eating lots of whole plant foods (Prunes vs. Metamucil vs. Vegan Diet).

Fiber may also help women remove excess estrogen from their body. See my video Fiber vs. Breast Cancer. For more on the wonders of fiber, see Dr. Burkitt’s F-Word Diet.

For more of my latest videos on breast cancer prevention and survival, see:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

35 responses to “Breast Cancer & Constipation

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  1. Great video, I have a question, though. When it comes to constipation issues, food combining is often mentioned. Is there any science that supports food combining? And is it worth the effort? I mean things like eating fruit only on its own would accordingly speed up the digestion, but is that really advisable? Blood sugar wise it would be better to actually add some protein or fat to fruit, same for absorption of E, D, K and A, right? Please let me know if there are any good NutritionFacts about that, the internet is as always very confusing and does not help!

    Thanks in advance
    Matheo




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    1. i agree with doc Michael, i try to seek their evidence but found nothing… i get their logic but their logic is not the very truth to lead people to the basic understanding of “what is healthy food ?”. many people found the food combining as their way out… i found out that because previously they live a screw up (live to eat) diet. so those people just like people that previously live in chaos, now they live BETTER becoz of the “order of combining food” but that doesnt mean they found the very truth of healthy diet. matheo… becareful the internet is full of fraud diets. i suggest that always seek for the very truth,the evidence, the studies, like what doc. michael provides.




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      1. Thanks Christo, thats actually pretty much what I’m doing. I tried food combining for a couple of weeks, but didn’t feel much of a difference and thought it was quite a boring way of eating. I mean, my diet consists of whole plants only anyway and I think I’m doing quite well health-wise and don’t have constipation issues… I just wanted to know if there actually is any science behind it, as I’m constantly seeking for ways to improve my diet a little bit further. Cheers, Matheo




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        1. Good to hear Matheo, if u are living in the plant based diet you already in the right track based on reliable evidence. and may be if you already in the the healthiest state of yourself, you cant go more coz u r on the edge of the sky Ahahhaahha, well am happy for you. if i am on your shoes… may be i will try to…. (this is something that i hardly do in my country bcoz of price tag) having berries as my breakfast and cook my veggies with “plant brooth” (the last one,i am too lazy to do it). cheers, Christo




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  2. I got a bit hooked on mixed nuts lately, wash them down with low sodium V8 juice. Great tasting combination. But wondering what are the limits on the nuts? Esselstyn says only moderate amt of walnuts and only if you don’t have heart disease. (I don’t).
    The v8 seems harmless with the low sodium. I also use paint brush and wire collander to brush off most salt from the mixed nuts, that works very well.




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    1. Greger, Esselstyn, McDougall, Fuhrman, Barnard, and Novick are all in agreement that 1 ounce per day is fine, though in slightly different contexts:

      Greger: advocates that 1-2 oz per day can have health benefits

      Esselstyn, Novick, & McDougall: their explicit recommendations state that 1-2 oz maximum per day is fine (barring advanced heart disease as you said), but since they don’t trust people to limit their own consumption, they often appear and are incorrectly interpreted to be against nut consumption completely

      Barnard: 1 oz per day is fine

      Fuhrman: 1 oz minimum per day is mandatory for good health

      I don’t believe any of them would recommend nuts with added oil. And salt, combined with the inherently high fat content even in dry-roasted nuts, can indeed make it easier to exceed the recommended serving sizes. But if overall sodium content in your diet is not an issue, and you are still able to control your servings then it may not be an issue.




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  3. So we know that breast cancer risk is increased by bile absorption from the intestine. Is high fat diet (that requires more bile to digest) actually the breast and prostate cancers culprit?

    I have a 2X normal length colon according to my GI doctor. Although I drink water, eat whole flaxseeds with my oatmeal each AM and follow a WFPBD, I tend toward constipation. McDougall has suggested I need to take Rx only stool softener; but I have resisted. Should I, or is my diet enough protection against both breast and colon cancer [my mother’s father, brother, and son (my brother) all had colon cancer]. I’ve thought maybe a SAD diet in all plus perhaps an inherited extra long colon were the culprits . . . but maybe bile? I have no gallbladder (removed before my lifestyle change 15 years ago). My intestine receives bile directly. Should I be taking the stool softener?




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      1. get some but not a lot. I ride a stationery bike and walk a fair amount. I’m a very active person and live in a neighborhood where I can walk to most services inc grocery stores.




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    1. Hi oceanfrontcabin,
      I hope by ‘whole flaxseeds’ you mean ground flaxseeds or flaxseed meal. Dr. Greger has several videos on flaxseeds to make this point. You may also think about adding some dried plums (aka prunes) to your oatmeal and maybe drinking some prune juice once in a while. Finally, I sometimes take flaxseed meal and add a teaspoon or two to a full glass of water and drink it down like metamucil, only much better (see flaxseed videos). I am not qualified to comment on Rx stool softeners. Good luck!




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      1. No, I do mean whole flaxseeds. They absorb water and swell in the colon increasing bulk and improving constipation. Dr McD told me to take them. I eat sometimes even more than 100Gm of fiber/day. I don’t think I need more fiber.




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        1. Chia seeds work really well for moving things along. A friend of mine had terrible problems, like impacted colon, requiring who-knows- what painful help from her doctor. She found chia worked wonders. Like flax, it becomes mucilagenous (sp) as it sits a few minutes in water or juice. Chia also provides complete protein and some of the elusive omega 3 fats. They sell it in bags at Trader Joe’s in the cereal section, but it’s cheaper at my food co-op.




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    2. am sorry to hear your family cancer related-history. i dont have direct answert that could help you. but i were you, i will browse videos in this web that highly correlated with “colon cancer” and “anti cancer” those fruits or spices or beverages will protect u from colon cancer and other cancer. for your constipations… have you try to consume fruits like papaya or banana ?i hope its helps. Be Prime. Christo




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  4. Thank you Doctor Gregor. Isn’t the bile salt production in the liver regulated by a negative feedback mechanism, in which case the greater the reabsorption of bile salts in the small intestine, the lower their production in the liver? Doesn’t this mean that the fraction of reabsorbed bile acids have no effect on the concentration of bile acids in circulation, unless there’s is some problem with the regulatory process?




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      1. What do you think is happening to those consuming a fruit-based WFPBD? They aren’t getting any resistant starch. They will eat a lunch of, say, 10-15 very ripe bananas. What is their gut microbiota like? I used to be one of them, fruit-based Doug Graham follower, until I realized it was sub-optimal to a diet based in starch. Thank you Mr. McDougall.




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        1. Where are you bringing the focus on RS from? The transcript of the video doesn’t contain the term. Darryl’s comment explicitly mentions bananas as a valuable prebiotic food. Highly ripe bananas of the sweet variety contain no dietary starch per se, so it’s no surprise that they lack resistant starch, but they do have soluble fiber, and much of that fiber content is fermentable.




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  5. Seems to me that dairy is very constipating and certainly linked strongly to breast/prostate cancer so it may not be the constipation, just the one cancer promoting food that also constipates.




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    1. Dairy (even human milk) has growth factors that stimulate the growth of hormone-related cancers. Read Jane Plant’s work on the subject and you will want to avoid dairy after the age of weaning. Her breast cancer came back FIVE times before she discovered this connection. She was only eating a yogurt daily. Her newest cancer went away after getting off all dairy products. She took an oral chemo pill at the same time, but her doctor says he didn’t expect it to heal her. She already had a pretty clean diet before that. By the way, Jane Plant is a British scientist who was in a highly placed position and all her writings are backed by science she researched. She has written several books about female and prostate cancers and has helped many people heal themselves.




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    1. Holy cow it does say the opposite. Methinks maybe the problem is that the study starts with constipated individuals who have not responded to high-fiber diets, to the exclusion of the “normal” population that certainly does respond to high-fiber diets with easy regularity. Love to see a learned professional opinion on the matter. Thanks for posting it (confusing as it may be).




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  6. Do any of your videos talk about triple negative breast cancer? It is very aggressive and usually fatal, but is not involved with hormones or Her2nu. I’ve been amazing doctors for about three years, because with that diagnosis, had I been a good little cancer patient and followed doctors’ orders I’d have been expected to die about 18 months after diagnosis.




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  7. Dear Doc and NF teams. Kindly enlighten me. i read thishttp://ajcn.nutrition.org/cont… and found that table 2: total bile acids mg/day in Vegan is lowest which is in line with http://www.ncbi.nlm.nih.gov/pm…conclusion (below probiotic intervention) that “However, it appears that individuals on vegetarian diets might excrete less mutagenic feces and that probiotics might have a potential in decreasing fecal mutagenicity” but am confuse with this… http://ajcn.nutrition.org/cont… that this study show vegetarian GC bile binding is lower than others but the GCDC bile binding higher than others.. this result doesnt in line withthehttp://ajcn.nutrition.org/c… table 3 and 4 that shown cholic and chenodeoxycholic of vegetarian are both relatively higher than others diet. correct me if i am wrong, may be i miss some details . Last question.. why there are primary and secondary bile acids what differentiate them ?which part of bile acids responsible for mutagenicity ?primary ?secondary ?or both ?thx much for liberate me from confusion.




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  8. Women tend to become constipated as they approach menopause due to a drop in estrogen levels relative to progesterone. I think the breast cancer-constipation link needs to be studied in light of this; it could be that hormone balance is influencing both breast cancer and constipation.




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  9. Hello,
    I found a bottle of juice enriched with fibers. 4.5 grams per 100 mL. It has essentially inuline in it. What it is ? Is is as efficient as unrefined food ?
    Thank you,




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