Day 034 - 11 Oct 94 - Page 26


     
     1
     2        The next paragraph says:  "To the extent that endogeneous
     3        oestrogens" -- by "endogeneous" we are referring to
     4        oestrogens produced within the body as opposed to
     5        oestrogens that are taken as pills or as birth control
     6        pills or as hormonal supplements:  "To the extent that
     7        endogeneous oestrogens influence the onset of breast
     8        cancer, sustained elevation of oestrogen levels likewise
     9        could predispose women with the disease to experience more
    10        virulent illness, i.e. high oestrogen levels may
    11        facilitate the spread of tumours, once initiated, by
    12        providing an environment favourable to their growth."
    13
    14        So far in his discussion he has been laying out evidence,
    15        which is well accepted and was well accepted back in 1985,
    16        that higher levels of oestrogen, whose function in the
    17        body after all was to stimulate -- one of whose functions
    18        is to stimulate the multiplication of breast cells, that
    19        excessive levels or sustained elevations of oestrogens are
    20        a risk factor for breast cancer.  In the third paragraph
    21         -- I am just about finished with this paper -- the author
    22        states:
    23
    24        "High-fat diets have been hypothesized to contribute in
    25        several ways to sustained elevation of serum oestrogen
    26        levels".  So, here the author is not only saying that the
    27        oestrogen levels may encourage or do encourage cancer, but
    28        that high fat diets have been hypothesised to elevate
    29        oestrogen levels in several ways. "Conversion of
    30        androstenedione in peripheral adipose tissue to estrone,
    31        which is known to be carcinogenic in animals, is the
    32        principal source of endogenous oestrogen in postmenopausal
    33        women".
    34
    35        All he is saying in that sentence is that the fat tissue
    36        causes oestrogen to be produced, particularly
    37        estrone: "High-fat diets likely contribute to early onset
    38        of menarche, which adds to a woman's cumulative exposure
    39        to oestrogen".
    40
    41        He goes on to describe other contributors:  "It is also
    42        known that greater fecal and intestinal bacteria, which
    43        are characteristic of high fat diets, contribute to
    44        estrone and estradiol production".
    45
    46        I will not take any further time with this paper, unless
    47        there is a question about it.  I simply wanted to show
    48        that those connections, as described by Dr. Gregorio, were
    49        already known and already accepted back in 1985 and
    50        reported in the Journal of the National Cancer Institute, 
    51        which is the leading cancer research centre in the United 
    52        States.  Dr. Gregorio, by the way, is from the State 
    53        University of New York in Buffalo.
    54
    55   MR. JUSTICE BELL:  So what you are saying is that the level of
    56        oestrogen and the length of time over which it is a
    57        factor, which itself can be related to early menarche and
    58        late menopause, is cogent evidence for a causal effect on
    59        breast cancer?
    60        A.  That is right, my Lord.

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