Black cohosh, welcome back!?

Cancer Bitch was sorry to say goodbye to black cohosh pills, which she had been taking for hot flashes way back in pre-cancer days. She said goodbye to the substance because it was deemed an aider and abettor of estrogen-positive tumors.


But--(and now I change POV) I just was looking up something for a friend who has a 91-year-old mother with breast cancer (Google: older women, Susan Love) and found this on Dr. Susan Love's site:

Black Cohosh

Black cohosh is an herb that has long been used by Native Americans to treat menstrual and menopausal symptoms, but its mechanism is not understood. More recently it has become popular in the United States as a suggested treatment for hot flashes. A study of Remifemin Menopause, made from an extract of black cohosh, found that 70% of the 150 peri-and postmenopausal women in the study who took 40mg of Remifemin for 12 weeks reported a decrease in menopausal symptoms, including hot flashes. The group taking the higher dose did not do better than the lower standard-dose group. There was no placebo group in this study to compare the response with.
Black cohosh may be a good option for some women. The advantage of it over other alternatives is that it doesn't have side effects, like clonidine and antidepressants. But it's also clear that more is not better, and that women who do decide to try it should stick to the standard dose.
The question for breast cancer survivors is whether it is estrogenic. On this front we actually have some data. First of all there is no known phytoestrogen in black cohosh. Second, there is no evidence that black cohosh binds to the estrogen receptor. Finally, in a petri dish, breast cancer cells were exposed to black cohosh in the absence of estrogen, in the presence of estrogen, and in the presence of tamoxifen. They found that the black cohosh given alone inhibited cell growth. When estrogen was added it blunted the growth usually seen and it enhanced the effects of tamoxifen. This effect has been replicated in four other studies on cell lines. Studies in women have confirmed this lack of estrogenic effect.
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So--Good news and bad news. Good news is, of course, that I can get back on cohosh, which helped in the past. I am in the running for the hot flash world record. The flashes started at least a dozen years ago, and have been exacerbated by: menopause, Tamoxifen, polycythemia vera (You must have seen the commercials: "Polycythemia vera, the other other cancer," a direct copy of "the other white meat" ads. Nonetheless, it remains a rare blood cancer, and has not been taken up by the masses). Bad news, of course, is that women who are in menopause are "older." Older than what? Red dirt? I have news for Dr. Susan Love: Menopause Women are young, young. Who's older? Mothers. Mothers of Menopause Women. And don't you forget it.
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But wait! Sloan-Kettering begs to differ, telling us ER+ Menopause Women not to take black cohosh if: You currently have, or have been treated for, an estrogen receptor-positive (ER+) cancer (It is still unclear whether black cohosh acts in the same manner as estrogen, and might therefore stimulate growth of these tumors)
Ugh!! I am writing to S-K for clarification and will report its reply.

3 comments:

Cancer Bitch said...

Got a reply from Sloan-Kettering today:

"Whether black cohosh is safe for breast cancer survivors still remains unclear. Black cohosh does contain estrogenic constituents, like formononetin. An animal study showed that black cohosh increased lung metastases of mammary cancer. In our monograph, we included studies mentioned below that help explain how black cohosh may work. Given the conflicting information, we encourage breast cancer survivors to consult with a healthcare professional, and to weigh the risks and benefits, before using black cohosh for hot flashes."

Integrative Medicine Service
Memorial Sloan Kettering Cancer Center

admed said...

http://admed.co.uk - we can fight cancer together

Northwestern MA/MFA said...

how?