Mind-Body Approaches to Preventing Breast Cancer

Mind-Body Approaches to
Preventing Breast Cancer
by Sheila Patel, M.D. and Valencia Porter, M.D., M.P.H.
October is National Breast Cancer Awareness Month in the United States, giving us an opportunity to bring awareness to
the most common cancer in women throughout the world. The World Health Organization estimates that there were 1.6
million new cases of breast cancer worldwide in 2011. According to the American Cancer Society, in 2012 approximately
230,000 new cases of breast cancer will be diagnosed in the U.S. Chances are, you or someone you know has been or
will be affected by this health challenge.
What Is Cancer?
The American Cancer Society defines cancer as a group of diseases that cause cells in the body to change and grow out
of control. Cancer isnt just one disease, but describes any number of situations where cell growth has gone unchecked.
That is why there can be many different reasons why cancer develops.
Cancer begins when one of our own cells undergoes a change and becomes abnormal. This can happen through exposure
to cancer-causing agents, or by a natural mutation in the DNA during cell division. Chronic inflammation in the body
can also contribute to the formation of abnormal cells, as can imbalances in our metabolic functioning. When we have
inflammation in the body, the excess of inflammatory chemicals can cause abnormal cells to form. With a healthy immune
system, our body can recognize and rid itself of abnormal cells that may develop. If, on the other hand, our immune
system is not healthy, our body is unable to recognize and eliminate abnormal cells. These cells may then continue to
reproduce uncontrollably and cancer can develop.
Making choices that strengthen our overall immunity are therefore protective against a host of disease processes,
including cancer.
What Causes Breast Cancer?
Although scientific research into breast cancer has been ongoing for many years, no one knows exactly what causes the
disease to occur in each individual. We do know that there are several factors that can increase our risk of developing
breast cancer, as well as many factors that can reduce our risk.
In this article, we will look at breast cancer and how we can reduce our risk of developing it, using a holistic approach that
encompasses the body (physical), mind (emotional), and spirit (our connection to Self).
Our Body and the Environment
In considering our physical nature, we need to include our environment, which is truly an extension of our body. With
every breath we take, every bite of food, everything we bring in through our senses, and through all the processes of
elimination, we are in constant contact and exchange with the molecules around us. Whatever is in our environment
eventually is incorporated into our physical structure.
One of the main physical factors in developing breast cancer is an increased overall lifetime exposure to estrogen.
Our lifetime exposure can be increased by early age of first menstruation, having no or few children, choosing not to
breastfeed, having a later onset of menopause, and taking hormone replacement therapy (HRT).
The choices we make in terms of lifestyle and diet affect our risk of developing breast cancer. For example, we know that
alcohol consumption and carrying excessive fat tissue can affect the metabolism of estrogen and thus increase circulating
levels in the body, contributing to an increased exposure to estrogen over a lifetime.

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Mind-Body Approaches to Preventing Breast Cancer

Eating a diet high in saturated fat from animals contributes to obesity and inflammation, as well as to the accumulation
of many of the toxins that are stored in fat, thus leading to an increased risk of breast cancer. Research also shows that
eating a diet that is low in the healing phytochemicals found in plants can predispose us to a variety of illnesses, including
breast cancer.
On the other hand, a diet that contains many cruciferous vegetables (such as broccoli, cabbage, cauliflower, kale, and
Brussels sprouts) can help reduce the risk of breast cancer. These vegetables contain a phytochemical known as indole3-carbinol, which shifts estrogen metabolism away from the carcinogenic metabolites and toward a healthier estrogen
metabolism, thus lowering the risk of breast cancer.
Having a sedentary lifestyle can also contribute to increased risk, while staying active and maintaining a healthy weight can
help reduce the risk. A 2012 study published in The Journal of Clinical Endocrinology and Metabolism found that women
with higher levels of daily exercise had lower levels of harmful estrogen metabolites in their body.
The Threat Posed by Environmental Toxins
There are many studies that confirm the effects of environmental toxicity on the development of cancer, and specifically
breast cancer. These toxins can directly damage the DNA in our cells as well as altering estrogen metabolism. Toxins
known as Endocrine Disrupting Chemicals (EDCs) favor the formation of estrogen metabolites that can negatively
stimulate breast tissue and promote cancer-cell growth. As estrogen is metabolized in our body, we can form several
different estrogen metabolites. One of those metabolites (16-alpha-hydroxyestrone) can promote breast cancer, while
another form (2-hydroxyestrone) can be protective against breast cancer.
Environmental toxins are found in many everyday products, from cosmetics and canned foods to cleaning agents and
pesticides (see below for specific guidance on how to reduce your exposure). Not only do these chemicals act like
estrogen in the body, they can also disrupt the bodys ability to detoxify substances, thus creating carcinogenic substances
from natural substances already present in our body.
What about Genes?
Genetic factors also play a role in our susceptibility to breast cancer and there are several genes that have been
identified that increase the risk of developing breast cancer in a small proportion of individuals. However, despite these
predispositions, there is a growing appreciation for the fact that genes can be turned on or turned off and that our
lifestyle choices are often the most important factor in gene regulation. By limiting toxicity in our lives and making healthy
choices, we can keep certain genes from expressing themselves and increase the expression of health-promoting genes,
thereby preventing cancer.
The Role of Emotions
From a mind-body perspective, both physical and emotional factors play a role in the development of disease. Unresolved
emotions or stored emotional toxicity can interfere with the normal communication between the cells in our body,
leading to abnormal cellular behavior. Unmanaged stress in our lives can send biochemical signals that put our body in
fight or flight mode. The signals can suppress our immune system and interfere with our innate healing ability. When we
are under chronic stress, our mind and body become inflamed, and there is a release of harmful inflammatory chemicals
that can increase our risk of cancer by decreasing our ability to respond to abnormal cells.
We now have a sophisticated understanding of the mind-body connection that wasnt appreciated years ago. Many cells
in our body respond to the chemical signals sent from our brain. We are constantly communicating our current emotional
state to the rest of our body via neurotransmitters. Therefore, a persistent negative emotional state can impair the
proper functioning of our physical body. When we understand and accept this connection, we can begin to change the
conversation that our mind is having with our body and move ourselves towards health, rather than away from it.

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Mind-Body Approaches to Preventing Breast Cancer

The Spiritual Dimensions of Health and Wellbeing

In addition to the appreciation of the mind-body connection, a consciousness-based approach to cancer incorporates
the added level of our spiritual intelligence. This is the natural intelligence inherent in our mind-body that orchestrates
the thousands of processes that occur every second without our conscious effort. It is the part of our being where we
experience meaning and purpose and a connection to something greater than our individual selves.
From this perspective, in the purest, uninhibited expression of this divine consciousness, each cell in our body functions
in its unique way, while also supporting the wholeness of our physiology. Ideally, this process continues effortlessly and
infinitely. However, when there is some interference in this effortless communication between our cells, be it physical
and emotional toxicity, or a loss of the sense of connectedness, individual cells begin to take on a life of their own without
regard to the whole.
When we consider this perspective, it opens us up to an increasing number of modalities that can help us return to our
natural state of oneness and connectedness, such as meditation, yoga, and other mind-body-spirit practices.
Spiritual practices connect us to our unbounded selves, and in so doing, elicit a deep relaxation response in our mindbody. When we are in a state of deep relaxation and connection, our entire physiology has the potential to change. A
study published in 2008 by researchers at Massachusetts General Hospital and Harvard Medical School was the first to
document the fact that practices of meditation and yoga can affect gene expression. The researchers were able to show
that by engaging in spiritual practices, we can turn on (express) healthy genes and turn off (not express) harmful genes.
The study found that the practice of meditation, yoga, deep breathing, and prayer can change the expression of thousands
of genes. The genes that are affected are those that control inflammation and cell death, as well as those involved in how
the body deals with abnormal cells.
In addition to affecting our genes, when we engage in mind-body-spirit practices, we learn to calm the emotional turmoil
in our minds. We also begin to access our innate healing abilities that keep us in balance and health.
Lifestyle Choices that Reduce the Risks of Breast Cancer
From a physical perspective, breast cancer prevention begins with lifestyle choices that reduce modifiable risks that affect
the bodys overall estrogen burden, including decreasing the exposure to and production of harmful estrogens, enhancing
metabolism and elimination of estrogens through detoxification, reducing inflammation, and enhancing immune function.
The following are some areas where lifestyle choices can make a difference:
Eat an anti-inflammatory diet rich in fruits and vegetables, high in fiber, and with adequate omega-3 fatty acids.
Dietary fiber helps with elimination of excess estrogen, and fruits and vegetables provide phytonutrients and antioxidants.
Include indole-3-carbinol and di-indolylmethane found in cruciferous vegetables like broccoli, cauliflower, Brussels
sprouts, kale, and bok choy; quercitin found in apples, cabbage, onions and garlic; and resveretrol (found in the skin of
red grapes) to help in the healthy metabolism of estrogen.
Eat foods that enhance detoxification, including those in the allium family (such as onions, leeks, garlic, and chives);
methionine-rich foods like eggs, sesame seeds, Brazil nuts, fish, meats, and some other plant seeds; and foods that boost
glutathione levels, such as avocado, asparagus, broccoli, garlic, spinach, tomatoes, and turmeric.
Omega-3 fatty acids found in cold-water fish, walnuts, soy, flaxseeds, and other seeds improve the good (2-hydroxy)/
bad (16-hydroxy) estrogen ratio and are anti-inflammatory. In addition, consumption of phytoestrogens (plant-based
estrogens) such as non-GMO soy foods (edamame, tofu, tempeh), legumes, and seeds, has been associated with a lower
breast cancer risk. However, do not overdo it with soy supplements and processed soy products as we dont know the
effects of high levels of these substances.

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Mind-Body Approaches to Preventing Breast Cancer

Reduce environmental exposures from foods. Choose organic fruits and vegetables to avoid exposure to pesticides.
If you eat fish, choose smaller, less fatty, non-bottom-dwelling varieties that dont bioaccumulate toxins such as PCBs
and heavy metals. You can get more information on choosing fish with less contamination by consulting the Seafood
Watch list maintained by the Monterey Bay Aquarium.
If you eat beef, poultry or dairy, choose organic if possible and hormone-free to avoid consuming the residue of livestock
growth hormones.
Drink plenty of fresh water. Check your municipal water supply and utilize filtration such as reverse osmosis to remove
contaminants or drink pure spring water. A general recommendation is to drink half of your ideal body weight in ounces
per day (so if you weigh 150 pounds, you would want to drink 75 ounces of water). If you use a water bottle, choose one
that is BPA-free, glass or stainless steel.
Limit alcohol. Have no more than one drink a day (one glass of wine or beer, or one mixed drink) because alcohol
interferes with the proper metabolism of estrogen.
Control your weight. Being overweight or obese increases the risk of breast cancer. This is especially true if obesity
occurs later in life, particularly after menopause. In addition, people with insulin resistance or adult-onset diabetes
mellitus may have an increased level of circulating estrogen.
Get plenty of physical activity. Being physically active can help you maintain a healthy weight as well as reduce stress.
In addition, regular exercisers produce less of the toxic 16-hydroxyestrone.
Get a good nights rest. One chemical that has protective effects against breast cancer is melatonin, our natural sleep
hormone. There are many mechanisms that have been identified, including immune support, that explain this effect. Read
more about how to get more restful sleep in this article on the Chopra Centers Healing Wisdom blog.
Ensure regular elimination. Constipation can lead to recirculation of estrogen and thus increased levels of this
hormone. Eating a healthy diet and getting adequate hydration will help ensure elimination.
Reduce inflammation. The best ways to do this are by eating an anti-inflammatory diet (described above), maintaining
a healthy body weight, improving oral health, treating chronic infections, meditating, and managing chronic physical and/
or psychological stressors.
Check your vitamin D level and supplement if needed. Vitamin D is essential to many processes in the body,
including immune function, and studies have shown that optimal blood levels (25-hydroxy vitamin D of 50-60 ng/dl)
are associated with a decreased risk of breast cancer as well as many other health conditions. If your blood level is
suboptimal, check with your healthcare practitioner for proper dosing to safely increase your vitamin D level. In general,
2000 IU daily of cholecalciferol or vitamin D3 (the active form of vitamin D) is a good maintenance dose.
Maintain healthy detoxification. Certain individuals have genetic differences that impair the ability to detoxify. These
can be identified through testing and can often be addressed with diet and nutritional strategies.
Carefully consider hormone replacement therapy (HRT). Although a full discussion of the controversies of HRT
is too long to include here, studies have shown an increased risk of breast cancer with long-term use of estrogen with
synthetic progestin (medroxyprogesterone acetate, aka Provera), but not estrogen combined with other progesterones.
Risk of breast cancer was also associated with use of estrogen only in menopausal women who began HRT less than
five years after menopause and in women ages forty-five and older who had their ovaries removed. Testosterone use in
postmenopausal women may also lead to increased risk of breast cancer.

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Mind-Body Approaches to Preventing Breast Cancer

Several types of estrogens have been used for HRT, so its important to find out what type(s) are being administered.
Estriol selectively binds to the estrogen receptor-beta which inhibits breast cancer development and has thus far not
been associated with increased breast cancer. Estrone, on the other hand selectively activates estrogen receptor-alpha,
which promotes breast cell proliferation. Estradiol is a third type of estrogen that equally activates ER-alpha and ER-beta.
Synthetic or conjugated equine estrogens (such as those found in Premarin) selectively bind estrogen receptor-alpha and
downregulate estrogen receptor-beta.
If you are experiencing menopausal symptoms, you may be able to manage your symptoms with lifestyle modifications,
herbal remedies, or other non-hormonal therapies. If you decide with your doctor that the benefits of hormone therapy
outweigh the risks, consider using bio-identical hormones such as estriol and estradiol at as low a dose as possible for
your symptoms for as short a time period as possible. Using locally acting and topical estrogen instead of oral dosing for
symptoms such as vaginal dryness avoids systemic estrogen circulation and metabolism by the liver. Also make sure that
your doctor is treating your symptoms and not a lab result. Just because your hormonal levels are not in the normal
range for a woman of reproductive age does not mean that you require supplementation.
Avoid exposure to environmental endocrine disrupting chemicals (EDCs), heavy metals, and carcinogens. Here
are the main toxicants to avoid:
Polycyclic aromatic hydrocarbons (PAHs) in tobacco smoke, char-grilled foods, vehicle exhaust, and gasoline fumes
Flame retardants (such as PBDE in foam mattresses, furniture and childrens sleepwear)
Plasticizers (such as phthalates found in some childrens toys and PVC plastics)
Bisphenol A (BPA), found in the liner of most canned fruits and vegetables, many food containers, polycarbonate plastic
water bottles, and thermal cash register receipts
Some weed killers (herbicides such as atrazine and glyphosate)
Some pesticides. For other options for pest control, check out the U.C. Davis site for Integrated Pest Management.
Air fresheners, products to control mold and mildew, chemical cleaning supplies and detergents such as those containing
4-nonylphenol. Use nontoxic cleaning supplies that do not contain EDCs.
Heavy metals that can mimic estrogen, such as aluminum (in cookware and antiperspirants) and cadmium (in cigarette
smoke)
EDCs in personal care products such as sunscreens, lotions, cosmetics, shampoos, fragrances, etc. Our skin is our
largest organ and you should put nothing on your body that you would not also eat. Check out the safety of your personal
care product ingredients at EWGs Skin Deep Cosmetic Database website.
Breastfeed your infants if you are able. The longer you breastfeed, the greater the protective effect.
While these recommendations may seem daunting, many of them will not only decrease the risk of breast cancer but will
also reduce the risk of developing other cancers, cardiovascular disease, diabetes, and degenerative diseases.
Early Detection Is Key
Much of the increased survival for those diagnosed with breast cancer is attributed to early detection and treatment.
While regular self-exams are no longer advised, pay attention to your breasts and consult your healthcare provider if
you notice any changes, such as a new lump, skin changes, or discharge. Get regular health checkups that include a

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Mind-Body Approaches to Preventing Breast Cancer

clinical breast exam by your provider, who may also recommend other screening tests such as mammograms, breast
thermography, or MRI.
Prevention Through Emotional Release
On an emotional level, decreasing negativity and reactive thought patterns will reduce the reactivity of the body. This
will reduce the risk of a host of diseases, including cancer.
There are many ways we can break the negative thought cycles and release accumulated emotional toxicity. Here are a
few suggestions:
Keep a journal. We can release toxic emotions by journaling. Identifying how we are feeling and writing it down has the
same effect as releasing the feeling by talking to someone. It settles down the amygdala, which is the part of the brain that
is activated when we are stressed, provoking the bodys fight-or-flight response. Especially focus on releasing any fear,
anger, guilt, and resentment that you may be storing. Write down your intention to release these emotions.
Practice conscious communication. Find ways of consciously communicating your feelings. Rather than stuffing
your emotions and not discussing them, you can release the negativity by working toward resolving emotional conflicts.
We recommend the techniques presented in the book Nonviolent Communication, by psychologist Marshall Rosenberg.
Train your brain. Focus on positive thoughts whenever you notice negative ones. Instead of activating the stress part of
our brain, when we have positive thoughts, we activate the cerebral cortex, which is where we feel joy, love, compassion,
and peace. Whenever you notice your mind wandering towards negative thoughts, think of three things you are grateful
for, or three things you like about yourself or someone else.
Exercise. Moving your body increases the feel good hormones in your brain and decreases stress, in addition to giving
you many other physical benefits.
Prevention Through Spiritual Practices
When we connect to our innate wholeness through spiritual practices, it allows us to access our inner healing abilities. We
strengthen our defenses against abnormal cells and activate the pathways that give us health and vitality.
Here are a few ways to bring spiritual practices into your daily life:
Meditate daily. There are many ways to meditate. All styles of meditation are designed to quiet the chatter of our minds
and settle the body so that we can experience calm, peace, and connection. At the Chopra Center, we practice a mantra
-based technique called Primordial Sound Meditation. By using the repetition of a mantra, we can transcend the mind and
body to experience deep levels of stillness and silence.
Practice yoga or other mind-body exercises. Yoga, tai chi, qi gong, and other practices are not only a form of physical
exercise, but at a deeper level, they keep us aligned with our natural rhythms and balance.
Connect to nature. Often people feel a deep spiritual connection by taking a walk in a beautiful natural setting, or
by gazing up at the stars. Find a way to connect to nature wherever you live and feel your inextricable connection to the
natural world.
Connect with family and friends. When we nurture our intimate relationships with others, we feel the divine energy
that connects us to all things. The love and support of people around us is a source of strength and healing, and can keep
us healthy.
Practice pranayama (yogic breathing techniques). Deep, rhythmic breathing induces the relaxation response and

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Mind-Body Approaches to Preventing Breast Cancer

calms the mind and body. By practicing these ancient breathing techniques, we can connect to and experience our deep
spiritual nature. They remove obstructions to the flow of spiritual energy through our bodies, which is controlled by the
breath. Learn the foundational pranayama technique known as ujjayi breathing here.
By understanding breast cancer from a mind-body-spirit perspective, we begin to see it as a phenomenon of the mindbody. We can then start to make choices that are most healthy for our physical and emotional layers while accessing our
deepest source of health and natural balance through spiritual practices.
About the authors
Sheila Patel, M.D., is the Medical Director of the Chopra Center for Wellbeing. She is a board-certified family physician
and a certified instructor of Primordial Sound Meditation and Perfect Health/Ayurvedic Lifestyle. She enjoys helping
patients find balance in their lives through the integration of modern medical therapies and ancient healing wisdom.
Valencia Porter, M.D., M.P.H. is the Chopra Centers Director of Integrative Medicine. Board-certified in both
General Preventive Medicine and Integrative Holistic Medicine, Dr. Porter has a caring, individualized approach that
encompasses all aspects of her patients lives. She is also a Chopra Center certified Vedic Master and has a Masters
Degree in Environmental Health.

Note: The information in this article is intended for your educational use only and is not a substitute for professional
medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider
with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health
program.

2012, The Chopra Center for Wellbeing | chopra.com | 888.736.6895 | 2013 Costa del Mar Rd., Carlsbad, CA 92009