The love-hate
relationship between “I” and “Vitamin E” As a clinician of breast specialty, “outpatient service” is part of the work. Our breast specialist clinics seem to be communication-oriented, more “relaxed” than other surgical clinics, but to be honest, even after nearly ten years of work, when facing outpatients, they will still be “stumped” by some problems. At this time, I can only tell people frankly, “I’m sorry, I’m not very clear about this problem,” and then go back to desperately search for information and consult my superior doctor or master. However, sometimes, you will find that you are not as thorough as you imagined. You may give the answer, recall it carefully, regret that it is not so accurate, and then verify it repeatedly. But isn’t that the beauty of the clinic?
Some time ago just met with such a problem, a clinic physical examination lady, after finishing the breast examination, did not find abnormal, I consulted about the cause of breast cancer, of course, I have a well-thought-out plan to take out my standard answer “At present, the morbidity of breast cancer is not clear, therefore, we can not do the primary prevention of breast cancer now.”; But after so many years of research, some high-risk factors have been found, such as.. She listened to my explanation carefully, and when I was talking, she suddenly asked me, “Is it dangerous for me to take vitamin E every day?” I was stupefied at once, and then my brain quickly recalled the contents of the textbook, vitamin E is not a fat-soluble vitamin, has a powerful role in scavenging oxygen free radicals, and seems to say that it can enhance the metabolism of female hormones, increase the secretion of gonadotropins, increase the production of progesterone, enhance ovarian function, so now there are many women. Oral vitamin E to keep the skin young, since it can enhance ovarian function, then the occurrence of breast cancer is not a threat? Thinking of this, I blurted out, “This may increase the risk of breast cancer, because similar to hormone replacement therapy, it is best not to eat routinely.”. After asking some other questions, the woman left with satisfaction and said she would not take vitamin E in the future. There was a moment of silence in the consulting room, so I thought of checking whether taking vitamin E would increase the risk of breast cancer and see if there was any conclusion.
After searching the literature, I found that the original vitamin E, in addition to the instructions for the treatment of cardiovascular and cerebrovascular diseases and habitual abortion, there are many effects I do not know, such as peptic ulcer, gastritis, prevention and treatment of neonatal hemolytic anemia and enhance the detoxification function of liver cells, there is a special literature on vitamin E. Treat bedsores, infections, burns, etc., because it can promote the growth of granulation tissue and skin around the wound; it can help treat chronic renal failure, because vitamin E can reduce the oxidative stress in patients; it is also mentioned in the literature that vitamin E can inhibit nephrotoxicity during doxorubicin chemotherapy; Because vitamin E is an antioxidant, it can reduce the infarct area and reduce the damage of neurons when cerebral ischemia occurs, thus playing a role in brain protection; it can be combined with gentamicin to treat oral ulcers; prevent and treat proliferative vitreoretinopathy; treat skin reactions caused by tumor radiotherapy; soften skin scars; protect muscles and improve peripheral blood flow; treat hemorrhoids; Improve the immunity of the elderly, treat atrophic rhinitis and hearing loss, eliminate the withdrawal symptoms of morphine and other drugs, treat anemia and iron poisoning, and have anticoagulant effect, etc.
Having said so much, it seems that they are all benefits, and I want to eat a little. However, what I am really worried about is that I have told the lady that I can’t take them any more, but I am still a little careful in my heart. I hope I am not wrong, because the instructions clearly say that long-term use will lead to breast enlargement. There must be a reason for this, and I have said so many advantages. There was still no mention of the relationship with tumorigenesis, so I changed the search keywords, and at this time, I found another kind of literature, mainly about vitamin E and the role of tumors.
It has been observed in some reports that the content of vitamin E in the blood of cancer patients is very low; the risk of lung malignant tumors in patients with vitamin E deficiency is 2.5 times higher than that in normal people; in addition, some studies have shown that vitamin E can inhibit the growth of some tumor cells. Vitamin E, as a potential cellular regulator, has been shown to have anti-tumor effects in vitro and in vivo experiments and epidemiological surveys, which has attracted more and more attention.
Combined with the mechanism of action of vitamin E in the human body and the clinical phenomena observed, some articles have boldly speculated and described the anti-tumor mechanism of vitamin E, believing that vitamin E can treat tumors mainly in three aspects: 1. Inhibit the growth of tumor cells through antioxidant, immunomodulatory and interfering with the differentiation of tumor cells; 2. Reduce the side effects of antineoplastic drugs and increase their efficacy; 3. Reduce the risk of tumor occurrence and prevent the occurrence of tumors. And some in vitro tumor cell experiments have indeed concluded that vitamin E is also an immunomodulator and an inhibitor of tumor cell growth. However, despite many studies on cellular and molecular mechanisms, it is still impossible to determine the anti-tumor mechanism of vitamin E.
So far, I suspect that I will become a vitamin E admirer, what a good vitamin, how perfect! However, I still have a trace of calm, continue to check the relationship between vitamin E and breast cancer, continue to change keywords to search, this time, let me see the “reversal”!
There are few studies on the relationship between vitamins and breast cancer at home and abroad, so there is no article to answer whether taking vitamin E will increase the risk of breast cancer, and most of them are in vitro cell studies, including an article published in the European Review of Medicine and Pharmacology in 2016. It is entitled “Vitamin E promotes breast cancer cell growth by reducing ROS production and p53 expression.”. Breast cancer tumor cells were implanted in mice and fed with different concentrations of vitamin E every day. After a period of time, it was found that the volume and weight of tumor cells in all mice taking vitamin E were larger than those in mice without vitamin E. Therefore, the article concluded that vitamin E could promote the growth of breast cancer cells in patients.
In addition, a meta-analysis on the relationship between vitamin E and breast cancer was found, which collected 486 studies on the relationship between vitamin A, vitamin E, vitamin C and self-carotene and breast cancer published at home and abroad in the past 20 years (from January 1989 to December 2017). Animal experiments and in vitro cell experiments were excluded, and 54 articles were retained for full-text reading. After exclusion according to the inclusion criteria, only 5 articles were included, including 4 English articles and 1 Chinese article, 344 cases in the case group and 323 cases in the control group. The results of the study suggest that the content of vitamin E in the serum of breast cancer patients is indeed lower than that of healthy people, and there is a statistical difference! This suggests that the decrease of vitamin E may increase the risk of breast cancer, suggesting that we can reduce the risk of breast cancer by supplementing vitamin E clinically. However, the conclusions in the four literatures were contradictory, some suggested that the serum vitamin E content of breast cancer patients was increased, and some suggested that the serum vitamin E content of breast cancer patients was decreased. These controversial findings suggest that the relationship between vitamin E and breast cancer may vary among individuals and be related to vitamin concentration, which needs further study.
From the above, we can see that there are very few scientists conducting this kind of research, and in recent years, the research is limited to animal experiments and in vitro cell experiments, clinical studies are less, and the sample size is small, so we must look at its conclusions dialectically. That is to say, the relationship between vitamin E and breast cancer is still a “mystery”, we need to explore, to discover, I hope not in the future, scientists can give a satisfactory answer!
Breast cancer
