Learning Lessons from Breast Cancer
Janet Maendel DO(EUR), DNM
“You have breast cancer.”
Few statements carry more emotional weight. Those three words often ignite a cascade of appointments, procedures, and decisions that can leave a woman feeling overwhelmed, frightened, and as though she has lost control of her health and her life.
Many women are led to believe that they have no options in what comes next. Treatment plans may be presented quickly, sometimes before all relevant diagnostic information has been gathered, and rarely with a full explanation of why particular therapies are recommended over others. It can feel as though everything is happening to them rather than with them.
Yet every cancer cell is still a part of the person in whom it resides. These are our very own cells, no longer functioning as they were designed to. This raises an important question: is it possible that the body, in its own way, is trying to communicate something? And if so, what lessons might breast cancer be offering us about the terrain in which it arose?
Understanding Breast Cancer
Breast cancer is the second most common cancer in women in North America. Most cases begin in the cells lining the ducts of the breast. As these cells become cancerous, they can move beyond the duct, infiltrate surrounding tissue, and spread to lymph nodes or distant organs. Although breast cancer is predominantly a disease of women, it can occur in men as well.
Since the early 1990s, mammography has been widely used as a screening tool. Earlier detection initially increased the number of diagnosed cases, which was partly attributed to improved detection methods. However, breast cancer incidence has continued to rise by approximately 0.5% per year for many years, prompting deeper questions about risk factors, prevention, and the biological environment in which cancer develops.
Standard treatment options include surgery, chemotherapy, radiation, hormone therapy, immunotherapy, and targeted therapies. The specific combination depends on tumor type, grade and stage, receptor status, and the extent of spread. While these tools are often necessary and life-saving, they represent only one part of the picture.
The Terrain: The Internal Environment of the Body
The concept of terrain refers to the biological environment within and around our cells—the sum of factors that influence how those cells function. When the terrain is healthy and resilient, cells are more likely to behave normally. When the terrain is imbalanced, inflamed, toxic, or stressed, the risk of cellular dysfunction and cancer increases.
The terrain can be evaluated through comprehensive laboratory testing. In breast cancer, some of the most common patterns of imbalance include low vitamin D, poor metabolic health, hormone dysregulation, genetic and epigenetic vulnerabilities, unresolved emotional stress, and elevated toxic burden.
Metabolism
Metabolism is the collection of biochemical processes through which the body generates and uses energy. Cancer cells, including breast cancer cells, are highly glycolytic—they preferentially use glucose as fuel. They also tend to have an increased number of insulin receptors. Breast cancer cells have been shown to carry several times more insulin receptors than healthy cells, meaning that high blood glucose and high insulin levels create a very favorable environment for their growth.
Blood glucose may rise not only from sugar and refined carbohydrates but also from chronic stress, certain medications, inflammation, and emotional distress. Insulin rises in response, and this metabolic pattern—high glucose, high insulin, high inflammation—is one of the most consistent terrain patterns seen across cancer types.
Hormones
Breast cancer cells may express receptors for estrogen and progesterone. When these receptors are present, hormones can act as growth signals, driving proliferation. Approximately 80% of breast cancers are influenced by estrogen. The longer a woman is exposed to estrogen over her lifetime, the higher her risk of hormonally driven cancers.
This reality raises important questions about the use of exogenous hormones, including hormone replacement therapy (HRT) and hormone-based birth control. In 2002, the Women’s Health Initiative published data linking certain hormone replacement regimens with increased breast cancer risk. Following this, HRT use dropped significantly, and breast cancer incidence decreased by about 7% from 2002 to 2003. While hormone therapy can be very helpful for some women, it underscores the need to consider individualized risk, timing, and alternatives.
Genetics and Epigenetics
A family history of breast cancer—especially in a mother or sister—does increase risk. The genetic component of breast cancer has received substantial research attention. BRCA1 and BRCA2 are well-known genes that significantly raise risk, but they account for only a small percentage of total cases. Other genes, including PIK3CA, HER2/neu, TP53, MTHFR, and many more, can influence susceptibility and treatment response.
Genetic testing can be useful, but genes alone do not determine destiny. Epigenetics—the study of how gene expression is turned on or off—offers a more hopeful perspective. Genes can have small variations called SNPs (single nucleotide polymorphisms) that alter how they function. Lifestyle, nutrition, herbs, and supplements can modulate whether these genes are expressed in ways that promote or inhibit cancer.
For example, research suggests that expression of the PIK3CA pathway can be influenced by a low-carbohydrate or ketogenic diet. Beyond genetics, other terrain elements—such as inflammation, circadian rhythms, the microbiome, immune function, and angiogenesis—play crucial roles in cancer development and progression. These elements are central to the metabolic approach to cancer, as described in The Metabolic Approach to Cancer by Dr. Nasha Winters and Jess Higgins Kelley.
Toxins
It is widely accepted that certain toxins are carcinogenic. Hundreds of chemicals are known to cause cancer, and many more are suspected but not yet fully studied. Toxicity is seldom addressed in conventional oncology, yet it is a major piece of the terrain. For breast cancer specifically, toxins such as cadmium, heavy metals like mercury, pesticides, DDT, glyphosate, certain plastics and BPA, radiation, radon, and some medications have been implicated.
Detoxification is the process by which the body transforms harmful substances into less harmful ones and eliminates them. This process involves multiple phases in the liver and other tissues. Genetic variations in detoxification pathways, high toxic load, nutrient deficiencies, and poor gut health can all impair detoxification. Assessing both toxic
exposure and detoxification capacity is an important part of terrain-based breast cancer care.
Mental Health and Stress
Mental and emotional health may be one of the most underestimated factors in cancer risk and recovery. It is common to hear cancer survivors say that their healing only truly began when they addressed long-standing emotional pain, trauma, or chronic stress.
From a physiological perspective, chronic stress leads to persistently elevated stress hormones and inflammatory mediators. Over time, this drives systemic inflammation, raises blood pressure and blood glucose, and contributes to immune dysregulation and hormonal imbalance. These are all terrain factors involved in cancer development and progression.
This reality cannot be fully addressed with anti-inflammatory drugs or supplements alone. Emotional healing, boundary setting, grief work, spiritual support, and stress reduction practices are often essential pieces of a comprehensive cancer care plan.
Breast Self-Exams and Screening
Monthly breast self-exams, performed about a week after menstruation, can help women become familiar with their own breast tissue and notice changes earlier. While self-exams are no longer heavily emphasized in some conventional guidelines, many integrative clinicians still see them as a valuable part of breast awareness.
Mammography has reduced breast cancer mortality in many populations, but it is not a perfect tool. False negatives and false positives can occur, and radiation exposure is a consideration over time. For some women, adjunctive or alternative imaging options such as ultrasound, MRI (preferably without gadolinium contrast where appropriate), or emerging technologies such as SonaCine may be suitable. The best approach is individualized and should be decided in collaboration with a trusted care team, weighing risks, benefits, and personal values.
Metabolism: Food and Fasting
Because glucose, insulin, and inflammation are involved in all cancers, nutrition is a powerful place to intervene. A whole-food diet based on low-sugar vegetables and fruits, high-quality animal protein, and healthy fats supports metabolic and immune health. Highly processed foods, sugars, and refined grains promote inflammation and dysregulated insulin signaling and are best minimized or avoided.
Fasting or time-restricted eating can be used strategically to improve metabolic flexibility, support autophagy, and lower insulin. Fasting also influences hormones, genetics, emotional resilience, and detoxification. Any fasting protocol, especially in people with cancer, should be guided by a trained practitioner.
Hormone Support
Supporting hormone balance begins with supporting detoxification and reducing exposure to synthetic hormones and hormone-like chemicals. This includes movement, sweating, hydration, and nutrient-dense foods that aid liver function and hormone metabolism—such as cruciferous vegetables, fiber, healthy fats, and magnesium-rich foods. Avoiding unnecessary exogenous hormones and endocrine-disrupting chemicals is an important preventive strategy.
Toxins and Detoxification
It is difficult to thrive in a toxic environment. The first step is to reduce exposure where possible: cleaner air and water, fewer chemicals in household and personal care products, mindful use of plastics, and choosing organic or low-spray foods when available. Detoxification protocols should be chosen with care. In those with active cancer, aggressive or rapid detox methods are generally not recommended, as they may place additional strain on an already burdened system.
Mental Health and Stress
Fear is a natural response to a cancer diagnosis—for the patient, the family, and even the medical team. Acknowledging fear is the first step toward moving through it. For those of Christian faith, there is an invitation to surrender fear to God and rest in the belief that He is sovereign and present in all circumstances, including illness.
Regardless of spiritual framework, tending to mental and emotional health is a critical terrain intervention. This may involve counseling, support groups, spiritual direction, trauma therapy, journaling, time in nature, creative expression, and practices such as prayer, meditation, breath work, and gratitude. Finding even small ways to experience joy and connection daily can shift physiology toward healing.
Specialty Guidelines and Ongoing Terrain Assessment
Women who have had breast cancer or who are at higher risk can benefit from periodic terrain assessments. Comprehensive labs that evaluate metabolic flexibility, inflammatory markers, immune function, vitamin D status, and other key variables can be done a few times per year. In addition to monthly breast self-exams, annual imaging with MRI (dye-free when appropriate) or SonaCine may be considered as part of a personalized surveillance plan.
For women currently diagnosed with breast cancer, having a metabolically trained practitioner on the care team can be invaluable. Regular check-ins and repeat terrain testing allow for ongoing adjustments in nutrition, lifestyle, supplementation, and supportive therapies alongside conventional treatment.
Lessons from Breast Cancer
In his book The Body Says No, Gabor Maté suggests that disease can be the body’s way of saying “no” when the mind cannot or will not. Cancer, in this sense, can be seen as a harsh and unrelenting teacher. Its lessons are not gentle, and its stakes are high. Yet within the experience of breast cancer, many women discover profound truths about themselves, their boundaries, their relationships, their beliefs, and the way they have been living.
Viewing cancer as a teacher does not minimize its seriousness or the suffering it causes. Rather, it acknowledges that alongside the loss and fear, there may also be insight, transformation, and a deeper call to live in alignment with one’s values. The lessons are intensely personal and different for each person. For some, it may be a call to rest. For others, a call to forgiveness, to courage, to changing long-standing patterns, or to finally placing their own health and wellbeing at the center of their lives.
Breast cancer is not a simple story of rogue cells. It is a story of terrain, of biology, of environment, of emotion, and of meaning. When we listen carefully—to the science, to the body, and to the heart—breast cancer can become not only a diagnosis to survive, but also an invitation to learn, to heal deeply, and to live differently.