This Page will continually be updated, with new information, on a weekly basis

06/19/2022

Myasthenia Gravis – Autoimmune disorder, as with many autoimmune disorders, they are more common in women. It remains important for women to keep their level of chronic inflammation low, especially starting in their 30’s, to lessen the impact and prevelance of sporadic onset of auto-immune disorders.

Ashley G. was diagnosed with generalized Myasthenia Gravis 12 months ago on the basis of ocular symptoms (diplopia, ptosis that increases throughout the day), bulbar muscle weakness, generalized muscle weakness, and presence of anti–acetylcholine receptor (AChR) binding antibodies. Shortly after diagnosis, Ashley had an intrauterine device (IUD) placed for long-term birth control. She was initially started on treatment with pyridostigmine for myasthenia gravis symptom control. That proved inadequate, prompting trials of concomitant corticosteroids (prednisone) and other immunosuppressive medications (azathioprine, methotrexate). Ashley is currently being treated with pyridostigmine in combination with methotrexate. Four weeks ago, she experienced a respiratory exacerbation (myasthenic crisis) requiring hospitalization. She had an uneventful recovery and was discharged after 6 days. She is now presenting for a follow-up visit to assess her disease status and reevaluate her treatment plan.



What Does It Mean to Have HER2-Negative Breast Cancer?

Human epidermal growth factor receptor 2 (HER2) is a protein that’s found on the surface of breast cells. Its normal function is to promote cellular growth and division.

Some breast cancers have higher-than-normal levels of HER2. These are called HER2-positive breast cancers. However, only a low percentage of breast cancers are HER2-positive.

Most breast cancers are HER2-negative. According to the National Cancer Institute (NCI), an estimated 78 percentTrusted Source of breast cancers are HER2-negative and don’t produce too much HER2.

HER2-negative, hormone receptor-positive

In addition to having a HER2 status, breast cancer cells also have a hormone receptor (HR) status. Estrogen and progesterone hormone receptors can be found on breast cancer cells. It’s worth noting that these receptors can also be found on healthy breast cellsTrusted Source.

A breast cancer is HR-positive when it has receptors for estrogen, progesterone, or both. Estrogen receptor-positive cancers are more common and are estimated to occur in about 75 percent of all breast cancers.

In HR-positive cancers, estrogen or progesterone can bind to the hormone receptors on breast cancer cells, helping to promote their growth and spread. As such, treatments for HR-positive breast cancers often targets hormone receptors.

Overall, HER2-negative, HR-positive breast cancers are the most common subtype of breast cancer. The NCI estimates that between 2014 and 2018, 68 percentTrusted Source of breast cancers in the United States were this subtype.

HER2-negative, hormone receptor-negative

It’s also possible for a breast cancer to be negative for both HER2 and for hormone receptors. A breast cancer that’s HER2-negative, HR-negative is called triple-negative breast cancer.

This subtype of breast cancer is less common. The NCI estimates that between the years of 2014 and 2018, only 10 percentTrusted Source of breast cancers were this subtype.

Because triple-negative breast cancer lacks both HER2 and hormone receptors, it doesn’t respond to treatments that target these factors. Additionally, it tends to recur more often than other subtypes of breast cancer.——- Immuno-therapy is very important in this subtype.

Testing types and diagnosis

If you’ve been newly diagnosed with breast cancer, the HER2 status of your tumor will be determined. This is performed on a tissue sample collected from a biopsy or surgery.

HER2 status can be tested in two ways:

  1. Immunohistochemistry (IHC): An IHC test uses a dye to stain HER2 protein on the surface of the tissue sample.
  2. Fluorescence in situ hybridization (FISH): A FISH test uses special labeling molecules that bind to HER2 proteins. When they attach to HER2 proteins in a tissue sample, they glow in the dark.

Generally speaking, testing HER2 status with FISH can take longer and be more expensive. Because of this, IHC is often used initially. The results of this test are reported as a number value from 0 to 3+:

  • 0 or 1+: Low or normal levels of HER2 are detected. The cancer is considered to be HER2-negative.
  • 2+: The HER2 status of the cancer can’t be determined. It’s likely that your doctor will recommend retesting with FISH to determine the cancer’s HER2 status.
  • 3+: High levels of HER2 are found. The cancer is considered to be HER2-positive.

If a FISH test is done, the results are reported as either positive or negative. A test that comes back FISH negative is considered to be HER2-negative.

HER2-negative cancer treatments

The treatment of HER2-negative breast cancer can also depend on HR status. Let’s examine some of the potential treatment options for each subtype of HER2-negative breast cancer.

Hormone receptor-positive treatments

HER2-negative breast cancer that’s HR-positive can be treated with hormone therapy. This blocks the actions of hormones, stopping the cancer from growing.

Most of the drugs that are used in hormone therapy target estrogen. Some examples include:

  • tamoxifen (Soltamox) or toremifene (Fareston): selective estrogen receptor modulators (SERMs) that block estrogen receptors on breast cancer cells
  • fulvestrant (Faslodex): a selective estrogen receptor degrader (SERD) that both blocks and decreases levels of estrogen receptors throughout the body
  • aromatase inhibitors: lower estrogen levels in the body, and include:

Another way to block the action of estrogen is to reduce or shut down the ovaries’ activity. This is called ovarian suppression and can be accomplished by:

  • luteinizing hormone-releasing hormone (LHRH) analogs, which shut down the ovaries (often called chemical or medical menopause)
  • surgical removal of the ovaries (oophorectomy or surgical menopause)
  • chemotherapy drugs, which may reduce or end ovarian production of estrogen

Some types of targeted therapy may also be used in HER2-negative, HR-positive breast cancer. Targeted therapy drugs bind to specific proteins on or in cancer cells. Some that may be used for this subtype of breast cancer are:

  • CDK4/6 inhibitors, which can be used along with hormone therapy and block the activity of growth-promoting proteins called cyclin-dependent kinases (CDKs). They include drugs like:
  • the PI3K inhibitor alpelisib (Piqray), which is used with fulvestrant to inhibit cancer cell growth in individuals with mutations in the PIK3CA gene
  • the mTOR inhibitor everolimus (Afinitor), which can help block cancer cell and blood vessel growth
  • PARP inhibitors, which block the DNA repair process in cancer cells with BRCA1 or BRCA2 mutations, causing them to die, and include the drugs olaparib (Lynparza) and talazoparib (Talzenna)

Other potential treatment options for HER2-negative, HR-positive breast cancers include:

  • Surgery. Many people that are diagnosed with breast cancer have some type of surgery, such as lumpectomy or mastectomy, to remove the cancer.
  • Immunotherapy. Immunotherapy helps your immune system to better respond to the cancer.
  • Chemotherapy. Chemotherapy uses strong drugs to kill cancer cells or stop them from dividing.
  • Radiation therapy. Radiation therapy uses high energy radiation to either kill cancer cells or slow their growth. It’s often used after surgery to help prevent the cancer from coming back.

Hormone receptor-negative treatments

Breast cancer that’s triple-negative won’t respond to some of the treatments used for HER2-negative, HR-positive breast cancer. This includes hormone therapy and many targeted therapies.

As with many breast cancers, the first potential treatment option for this subtype is surgery. This may or may not be followed by radiation therapy to help prevent the cancer from coming back.

If surgery isn’t possible or doesn’t remove all of the cancer, chemotherapy is the main systemic treatment option for triple-negative breast cancer. Chemotherapy may also be given along with the immunotherapy drug pembrolizumab (Keytruda).

Targeted therapy with PARP inhibitors (olaparib, talazoparib) may be used in people with triple-negative breast cancer and BRCA1 or BRCA2 mutations. This is typically given when cancer hasn’t responded to chemotherapy.

Another targeted therapy drug called sacituzumab govitecan (Trodelvy) may be used to treat triple-negative breast cancer that has metastasized, or spread, to other parts of the body.

What factors can affect treatments?

In addition to HER2 and HR status, there are also several other factors that can impact breast cancer treatment. These include:

  • the specific type of breast cancer
  • the stage of the cancer
  • how quickly the cancer is growing
  • whether or not this is a new diagnosis or a cancer recurrence
  • which types of treatments have already been used, if any
  • if certain genetic changes are present, such as those in BRCA1 or BRCA2
  • your age and overall health
  • whether or not you’ve reached menopause
  • your personal preference

Your doctor will take all of these different factors into account when determining what type of treatment to recommend for your individual situation.

Differences between HER2-positive and HER2-negative

HER2-positive breast cancer cells have high levels of HER2 on their surface. This is in contrast to HER2-negative breast cancers, in which cells have low or normal levels of HER2.

The HER2 protein promotes cellular growth. Because of this, HER2-positive breast cancers tend to grow and spread more quickly than other types of breast cancers.

Breast cancers that are HER2-positive also have additional treatment options available. These are targeted therapies that specifically target the HER2 protein on cancer cells.

It’s also important to note that some researchTrusted Source has found that breast cancers may switch HER2 and HR status over time. This is why it’s important to reassess these markers if a cancer recurs.

Is HER2-negative better than HER2-positive?

You may be wondering if having HER2-negative breast cancer is better than having HER2-positive breast cancer. There’s no straightforward answer to this question, as both types of breast cancer have their own upsides and downsides.

For example, HER2-positive breast cancer is likely to grow and spread more rapidly. However, it also has many available treatment options, particularly if it’s also HR-positive.

Meanwhile, HER2-negative breast cancer grows and spreads more slowly than HER2-positive breast cancer. However, it also has less potential treatment options, especially if it’s HR-negative (triple-negative).

Further, other additional factors besides HER2 and HR status play into breast cancer outlook. Some of these include individual factors like your age and overall health. Other factors that are used in staging are also important, such as:

  • the size of the tumor
  • whether or not the cancer has spread to neighboring lymph nodes
  • whether or not the cancer has spread outside of the breast


Clinical Information – Fibroid Uterus

Pelvic Pain in woman can be caused by many factors such as Ovarian cysts, Endometriosis, Tubal Cyst / Abscess, Adenomyosis- which is essentially endometriosis within the wall of the uterus, Menstrual Cramping, Interstitial Cystitis (Bladder). Pelvic Pain can also be related to several GI (Gastrointestinal issues). Sometimes ultimately surgery is warranted to address the pain / condition. However, Inflammation remains the Root Cause in most cases. Taking 600–800 mg of Ibuprofen may be warranted at times, however that is not the most effective and healthiest way to treat. Starting with Turmeric / Curcumin, many Plant Based Compounds have Unique Anti-Inflammatory Properties, and impact inflammation on a cellular level through multiple mechanisms, and not just one pathway as with Ibuprofen. Taking Plant-Based Compounds consistently on a daily basis suppresses the inflammation most effectively and thus the pain, along with treating the Root cause of the condition. As I mentioned previously, with some conditions, surgery remains the answer. Depending on the Size and location of Fibroids within the uterus makes a large impact on the results. I will post info on surgical treatment options on this page in next several days, however, our core 3 Capsules shown below, which we recommend taking 1 of each capsule in AM hours with Food, then one of each capsule in PM hours with food, for a total of 6 capsules per day.

Top Lifestyle Tips to Balance Your Hormones Naturally

Hormones! Let’s face it, these chemical messengers have been messing with us women for years. From your first menstrual cycle to menopause and beyond, your hormones support incredible functions like reproduction, metabolism, mood, bone health, and more.

But when your hormones are out of balance—look out! Mood swings, weight gain, fatigue, brain fog, hot flashes, lack of sex drive, the list goes on. It can start to feel like you’ve lost control of your life.

I’m going to give you the same advice I give my patients on how to cope with hormone havoc. Our hormones are greatly influenced by the environment, and there are some simple changes you can make that can really help with hormonal health. Follow my top 10 recommendations on how to balance your hormones naturally, and I promise it will change how you feel.

1. Hormones and Sleep—Get Plenty of It!

Aim for at least 7–9 hours of sleep a night. Dimming the lights before bed, disengaging from technology, and sleeping in complete darkness helps support your melatonin production and circadian rhythm. And if you can get to sleep before 10:30 pm, you will be resting during the critical time that your body is undergoing physical and psychological repair.

2. The Best Diet for Balanced Hormones

Choose organic produce whenever possible; especially avoid the dirty dozen and aim to eat the colors of the rainbow in the form of fresh fruits and veggies daily. Eat plenty of brassicaceae (cruciferous) veggies (brussels sprouts, broccoli, cauliflower, kale, collard greens, cabbage, and bok choy). They help your body produce more gentle-acting estrogen vs. stronger-acting estrogen that is associated with negative hormonal symptoms.

When eating meat and animal products, choose organic, grass-fed, and pasture-raised. Avoid GMO foods, high fructose corn syrup, and hydrogenated oils. Instead choose olive oil, avocado oil, coconut oil, and ghee.

To get plenty of the beneficial essential fatty acids in my diet, I eat lots of nuts, seeds, and small wild fish. I also recommend fiber from fresh veggies, complex carbohydrates, and ground seeds such as flax. It acts as a beneficial phytoestrogen, which helps support hormone levels when your estrogen is high or low. Plus, it helps bind any excess estrogen in your gut to help your body clear it out.

3. Move Your Body Daily

Moving your body daily in a way that you enjoy is incredibly beneficial, whether it’s walking, dancing, swimming, the list goes on. Resistance and/or weight training is wonderful for strength, balance, and bone health. You’ll even burn extra calories for a duration of time after your workout is over.

4. Go Outside

I love spending time in the great outdoors with my family. It’s a great opportunity to connect with nature—to breathe fresh air and soak in the sun for optimal vitamin D production. I highly recommend experimenting with earthing or forest bathing.

5. Breathe Clean Air

Our air is full of pollutants, especially if you live near highways, airports, industrial plants, or major cities. Our homes can also be a major source of toxic air. And mold and mycotoxins from water damage can infiltrate our bodies and negatively impact our endocrine system. To improve your indoor air quality:

  • Use an air purifier
  • Investigate all water leaks and musty odors and get them remediated by a professional
  • Remove artificially scented products
  • Use clean building supplies and formaldehyde-free furniture

6. Hydrate

Water should be your primary liquid. Choose filtered or reverse osmosis water to avoid impurities and contaminants.

7. Lower Your Stress Hormones

Deep breathing, yoga, meditation, relaxing with a good book, enjoying a bubble bath, doing something creative that you love—singing, dancing, painting, playing a musical instrument—are all fantastic ways to relax and minimize stress.

8. Minimize Plastic Exposure

Plastic acts like xenoestrogens, chemicals that mimic estrogen in your body and can wreak havoc on your endocrine system. Instead, use stainless steel or glass when serving food and avoid heating anything in plastic.

9. Use Natural Personal and Household Products

I recommend using the EWG Skin Deep database to check your products and choose the cleanest options.

10. Take Daily Supplements for Hormonal Balance

Supplements and herbs are extremely important to help balance your hormones. I recommend taking a multivitamin with methylated B vitamins and mineral support, fish oil, probiotics, vitamin D, and magnesium daily. I’ve also recommended maca and chaste tree to many of my patients to help support cycle regularity and healthy progesterone. Also consider DIM (diindolylmethane), I3C (indole-3-carbinol), calcium d-glucarate, and sulforaphane to support healthy estrogen metabolism.

This may seem like a lot, but you can start small. Add two or three of these tips to your daily routine to help balance your hormones naturally and notice how it changes how you feel. Then gradually add more.

Focus will be Breast Carcinoma, however, we will provide information on other Carcinomas

Keytruda is a form of Immunotherapy which activates your immune cells to destroy cancer cells in advanced cases of below Carcinomas

  • Biliary
  • Bladder
  • Breast
  • Endometrial
  • Esophageal
  • Gastric or gastroesophageal junction
  • Pancreatic
  • Prostate
  • Renal cell
  • Retroperitoneal adenocarcinoma
  • Sarcoma
  • Small cell lung
  • Small intestinal
  • Thyroid

Curcumin, the bio-active agent in Turmeric ROOT, at higher daily concentrations, 4-10 capsules, Curcu-Meric 900 mgTM , based upon lab and evidence based testing; shows a positive impact inhibiting Cancer initiation and progression, due to the unique cellular signaling it imposes on cells and Immune System Cells.