Cancer and Bioidentical Hormones: A General Perspective

Heading up the BodyLogicMD’s Fort Lauderdale location, one of the common concerns and questions I get relates to cancer and bioidentical hormone therapy. I see many patients, women and men, suffering from symptoms that are often misdiagnosed by traditional physicians that end up being hormonal imbalances such as menopause, peri-menopause, PMS, andropause, adrenal fatigue (stress-related) and sexual dysfunctions.
Just about every person who considers hormone therapy will address the subject of cancer in one way or another. It’s a reasonable thing to do. I discuss it with my patients from various perspectives to help answer the questions at hand. Often the patient’s information about cancer risk and hormone therapy originates from a wide variety of media sources, some reliable, some not so reliable. But most of the time I find that their basic understanding how hormones and cancer may be related is the acknowledgment that it is a debated issue.
The medical community’s understanding of what causes cancer is not complete, despite impressive research and advances. As a medical doctor with a degree in occupational medicine, I agree we can say that cancer is associated with some type of an error in the DNA or genetic information in a cell. That alteration interferes with the healthy regulation of cell growth. When cell growth is no longer properly controlled, cells can multiply in an unlimited fashion. Sometimes these cells, growing without control, remain in the area in which they began and sometimes they become invasive or spread to other areas (metastasis).
Getting cancer and causing cancer – the difference
There are some things that physicians do believe causes cancer in humans. This includes certain levels of ionizing radiation, certain chemicals capable of causing DNA mutations, some viruses, and some inherited genetic mutations. But actually getting cancer is not as simple, of course, as just being exposed to “the bad virus”. For example, Hepatitis B virus has been connected to liver cancer, but certainly not everyone with Hepatitis B actually gets liver cancer.
Ultimately, the formation, survival, and growth of a cancer cell in the body is the process of multiple factors. Often the “seeds” of potential cancer risk are “planted” in our bodies many years before a cancer actually forms. These may include toxins in our air, water and food, chemicals or drugs we may have been exposed to, and stressors or demands on our bodies that have weakened our body’s protective mechanisms. But even if these factors are present allowing a cancer to begin developing, why would our normally protective immune system fail to destroy this aberrant cell (as usually happens), allowing this cancer cell to get a foothold and grow?
Where do hormones fit into the cancer puzzle?
Clearly, actually developing a cancer is a multi-factorial process. So, where do hormones fit in?
Succinctly stated:
The hormones that the human body normally produces do not cause cancer. If they did, I suspect the human body would not have survived to its present state.
In treatment regimens, bioidentical hormones refer to hormones that are exact chemical matches to the hormones our bodies produce: hence, my belief that bioidentical hormones do not cause cancer.
What about estrogen’s association with breast or uterine cancer?
Importantly, it does appear that in certain individuals, estrogen, particularly states of relative estrogen excess or estrogen dominance, can be a factor in cancer development, perhaps acting as a “promoter” of cancer. But certainly not every woman who has experienced a state of estrogen dominance ends up getting any form of cancer; in fact, the great majority do not.
This consideration of a certain hormonal state potentially acting as a cancer promoter, however, would not dictate that hormone replacement should never be embarked upon in those who might benefit from it. Would I stop filling up my gas tank because certain toxins in the gasoline fumes are potential promoters of leukemia? Should we all live underground permanently because ultraviolet radiation can promote skin cancer? I answer “no” to both questions, but add that I would use reasonable discretion with regard to such exposures.
Bioidentical hormone therapies should be used in a reasonable way. Most medications, prescription or not, may become harmful if used excessively or improperly. Bioidentical hormones should only be prescribed by a trained and experienced hormone therapy physician to patients who have symptoms of hormonal deficiency or imbalance and in whom laboratory testing reveals such abnormalities. Above all, patients undergoing bioidentical hormone therapy should be monitored to avoid significant states of excess or imbalance, including the recommended routine preventive health assessments.
Indeed, there is an “unknown” aspect to this area of medicine, but using both the available scientific information and clinical experience, and my intuitive assessment of “does this actually make sense”, I believe we are pursuing a reasonable and beneficial course.

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