We’re busy reviewing the evidence on soy and genistein. While we’re working, we share the original summary from our predecessor website, Beyond Conventional Cancer Therapies.

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Genistein / Soy

Key Points

  • Before using this therapy, consult your oncology team about interactions with other treatments and therapies. Also make sure this therapy is safe for use with any other medical conditions you may have.
  • Soy contains large amounts of isoflavones, including genistein.
  • In laboratory studies, isoflavones have slowed the growth of several types of cancer.
  • BCCT is interested in soy because it may reduce risk of breast, prostate and lung cancers, plus colorectal cancer in women. It may also prolong survival and reduce recurrence in some cancer patients.
  • Soy can increase risk of bladder cancer.
  • Cell and animal studies have shown that adding soy food nutrients to tamoxifen inhibits the growth of estrogen receptor positive (ER+) breast cancer cells.
  • Not enough information about soy supplements, such as concentrated isoflavones, has been assessed to determine if they are safe.
  • Soy or genistein can interfere or interact with a few other prescription medications.

The beans of the soy plant contain isoflavones, a type of phytoestrogens which are chemical structures similar to the estrogen made in our bodies. However, phytoestrogens are not the same as female estrogens. Soy foods do not contain estrogen,1 and is not likely to have estrogen-like effects on hormonally responsive tissues.2

Soy consumption has been associated with lower risks of breast cancer, prostate cancer, lung cancer and colorectal cancer in women, as well as better survival in breast cancer and lung cancer and lower prostate cancer markers. Soy consumption may be associated with increased risk of bladder cancer

While in the past patients on tamoxifen were advised to avoid soy and genistein, more recent data suggest that soy does not reduce effects of tamoxifen and may even protect against estrogen-related endometrial cancers.3

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Clinical Evidence

Breast Cancer
  • Improved breast cancer survival with intake of soy foods (but not supplements), but only among women with tumors that were negative for hormone receptors and those who did not receive hormone therapy for their breast cancer4  but see the Cautions section below regarding HER2 positive breast cancer.
  • Population studies do not show any harmful interactions between soy foods and anti-estrogen medications, and protective effects have been seen for women who take tamoxifen or the aromatase inhibitor anastrozole.5
Lung Cancer
  • Among women with lung cancer, prediagnosis intake of soy food is associated with better overall survival.6
Ovarian Cancer
  • Genistein has showed mixed results in ovarian cancer, but in a case study of a woman with ovarian cancer resistant to platinum-based chemotherapy, the cancer stabilized and then improved following treatment with a concentrated fermented soy extract.7
Prostate Cancer
  • Supplementation with genistein and other soy isoflavones lowers8 or stabilizes9 PSA levels in men with prostate cancer.
  • Anticancer effects with genistein supplementation include changes in expression of genes involved in developmental processes, stem cell markers, proliferation and transcriptional regulation.10
  • Soy supplements decreased serum sex hormone levels but not androgen receptor expression in a small pilot study.11
  • A combination of soy isoflavones and curcumin decreased PSA levels in patients with PSA of 10 or higher.12

Lab and Animal Evidence

Click or tap to open.

Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Soy isoflavones protected normal tissues and organs against radiation damage in prostate cancer patients23 and reduced urinary, bowel, and sexual adverse symptoms induced by radiation therapy for prostate cancer in a small pilot study.24

Soy isoflavones show slight and slow effects in attenuating menopausal hot flashes compared with estradiol25 but greater effects than placebo in some studies.26 but not all.27 The 2015 update of the North American Menopause Society’s evidence-based position on nonhormonal management of menopause-associated vasomotor symptoms found that S-equol derivatives of soy isoflavones may be beneficial for alleviating hot flashes.Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015;22:1155–1172.

Soy products have protected mucosal cells against methotrexate toxicity in animals, potentially reducing mucositis, stomatitis, diarrhea, decreased nutrient absorption, translocation of gastrointestinal bacteria, and anorexia.28 Consistent with this, a pilot study in children showed less myelosuppression, mucositis, and infection when genistein was taken with chemotherapy, and patients who received abdominal radiation reported less pain and diarrhea when they took the genistein supplement.29

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Clinical Evidence

Soy consumption is associated with reduced risk of some cancers but increased risk of others.

  • A 2018 review and meta-analysis found soy foods and their isoflavones (genistein and daidzein) are associated with a lower risk of prostate cancer.30
  • Soy consumption may protect against breast cancer.31 Women consuming moderate amounts of soy throughout their lives have lower breast cancer risk than women who do not consume soy. This protective effect may originate from soy intake early in life.32  Soy consumption is also associated with lower recurrence of breast cancer, even among postmenopausal women treated with tamoxifen.33
  • High intake of isoflavones may also reduce risk of lung cancer,34 (in nonsmokers), colorectal cancer (in women)35 and endometrial cancers.36

Lab and Animal Evidence

Click or tap to open.

Optimizing Your Terrain

Creating an environment within your body that does not support cancer development, growth or spread

Clinical Evidence

Evidence is generally favorable but sometimes inconclusive. Soy consumption is associated with reduced inflammation40 and improved hormone balance,41 although the specific interactions with hormones are still under investigation.

Genestein shows anti-inflammatory and antioxidant effects42

Access

Soybeans and foods derived from soybeans are widely available. Extracts are sold as dietary supplements.

Cautions

While in the past patients on tamoxifen were advised to avoid soy and genistein, more recent data suggest that soy does not reduce effects of tamoxifen and may even protect against estrogen-related endometrial cancers.

Soy Foods

Soy foods are generally well tolerated by patient. “Regular ingestion of moderate amounts of soy daily seems to be safe—especially with the traditional fermented soy foods such as miso, tempeh, and natto when made from organic non-GMO soybeans.”43

High intake of soy isoflavones or soy-based food during infancy and in adulthood is associated with an increased risk of uterine fibroids in premenopausal women.44

In HER2 positive breast cancer patients, soy consumption has been associated with a greater risk of recurrence,45 and overexpression of genes that promote cell proliferation.46 Naturopathic oncologist and BCCT advisor Lise Alschuler, ND, FABNO, recommends limiting consumption of soy products to one serving daily for women with a history or high risk of estrogen-dependent breast cancer.

A diet high in soy, when combined with iodine deficiency, can increase the risk of thyroid cancer. Therefore, a diet high in soy products may be contraindicated for those diagnosed with thyroid cancer or at high risk of thyroid cancer.47 Soy consumption may be associated with increased risks of bladder cancer, although evidence is contradictory across studies.48

Soy Supplements

Not enough information about soy supplements, such as concentrated isoflavones, has been assessed to determine if they are safe.49 Because phytoestrogens and their active metabolites can remain in food/meat, they may influence the hormonal balance of those consuming the food. Phytoestrogens may affect fertility, sexual development and behavior.50

A 2016 review found that estrogenic isoflavone-based food supplements are associate with both increased risk and decreased risk of breast cancer. The authors concluded that benefits do not outweigh the risks to postmenopausal women.51 This is consistent with animal studies showing increased metastasis with the use of soy supplements.52

Consumption of soy supplements may cause mild stomach and intestinal side effects such as constipation, bloating and nausea and may also cause allergic reactions involving rash, itching, and anaphylaxis in some people.53

Interactions with a few prescription medications are noted. These include tamoxifen and aromatase inhibitors.54

Soy supplementation had been proposed as a cause of endometrial hyperplasia, but several studies have found no increased risk.55 Animal evidence (see above) shows a protective effect against endometrial cancer.56

Further adverse effects and side effects are noted on the Memorial Sloan Kettering About Herbs webpage: Soy. However, the About Herbs site does not reflect recent results regarding finding of effects of soy consumption for women taking anti-estrogen hormone therapy for breast cancer.

Dosing

CancerChoices does not recommend therapies or doses but provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.

A 2018 review offers this guidance: “Women with breast cancer can be advised to enjoy a reasonable amount of whole soy foods, while avoiding supplemental soy protein and isoflavone isolates. A reasonable amount can be deduced from the average soy consumption in Asian populations, which provides 10–20 mg of soy isoflavones per person daily. This is the amount found in 30 g of whole soy products such as tofu.”57

Further recommendations are available from these sources:

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.

  • Programs and protocols
    • Alschuler & Gazella complementary approaches58
      • Ovarian cancer
      • Prostate cancer
      • Primary bone cancer (such as osteosarcoma)
      • Uterine cancer
  • Block program, with reference to prostate cancer59
  • Chang strategies, with reference to prostate cancer60
  • MacDonald breast cancer program61
  • McKinney protocols62
    • General cancer
    • Breast cancer
    • Ovarian cancer
    • Prostate cancer
  • Traditional systems
    • Traditional Chinese medicine

This summary draws from the Memorial Sloan Kettering Cancer Center’s About Herbs and National Cancer Institute’s PDQ® websites, the American Institute for Cancer Research website, and other sources as noted.

Also known by these names

Soy foods may have several other labels:

  • Bean curd
  • Edamame
  • Kinoko flour
  • Kyodofu
  • Miso
  • Natto
  • Okara
  • Shoyu sauce
  • Soy milk
  • Soya
  • Supro
  • Tamari
  • Tempeh
  • Textured vegetable protein
  • Tofu
  • Yakidofu
  • Yuba

Resources

References

  1. Dyer D. Soy Foods, Diet, and Tamoxifen. Academy of Nutrition and Dietetics. January 2014. Viewed November 17, 2017.
  2. Evidence-Based Monographs: Soy and Soy Isoflavones. Ottawa Integrative Cancer Centre. Viewed May 14, 2019.
  3. Dyer D. Soy Foods, Diet, and Tamoxifen. Academy of Nutrition and Dietetics. January 2014. Viewed November 17, 2017; Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010. p. 374; Messina M. Soy and health update: evaluation of the clinical and epidemiologic literature. Nutrients. 2016 Nov 24;8(12). pii: E754.
  4. Zhang FF, Haslam DE et al. Dietary isoflavone intake and all-cause mortality in breast cancer survivors: the Breast Cancer Family Registry. Cancer. 2017 Jun 1;123(11):2070-2079; Chi F, Wu R, Zeng YC, Xing R, Liu Y, Xu ZG. Post-diagnosis soy food intake and breast cancer survival: a meta-analysis of cohort studies. Asian Pacific Journal of Cancer Prevention. 2013;14(4):2407-12; Caan BJ, Natarajan L et al. Soy food consumption and breast cancer prognosis. Cancer Epidemiology, Biomarkers & Prevention. 2011 May;20(5):854-8.
  5. Kang X, Zhang Q, Wang S, Huang X, Jin S. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. Canadian Medical Association Journal. 2010 Nov 23;182(17):1857-62; American Institute for Cancer Research. Soy and Cancer Survivorship. Viewed November 28, 2017.
  6. Yang G, Shu XO et al. Prediagnosis soy food consumption and lung cancer survival in women. Journal of Clinical Oncology. 2013 Apr 20;31(12):1548-53.
  7. Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010. p. 335.
  8. van Die MD, Bone KM et al. Phytotherapeutic interventions in the management of biochemically recurrent prostate cancer: a systematic review of randomised trials. BJU Int. 2016 Apr;117 Suppl 4:17-34; Lazarevic B, Boezelijn G et al. Efficacy and safety of short-term genistein intervention in patients with localized prostate cancer prior to radical prostatectomy: a randomized, placebo-controlled, double-blind Phase 2 clinical trial. Nutrition and Cancer. 2011;63(6):889-98.
  9. Hussain M, Banerjee M et al. Soy isoflavones in the treatment of prostate cancer. Nutrition and Cancer. 2003;47(2):111-7.
  10. Bilir B, Sharma NV et al. Effects of genistein supplementation on genome‑wide DNA methylation and gene expression in patients with localized prostate cancer. International Journal of Oncology. 2017 Jul;51(1):223-234.
  11. van Veldhuizen PJ, Thrasher JB et al. Dose effect of soy supplementation in prostate cancer: a pilot study. Oncology Reports. 2006 Dec;16(6):1221-4.
  12. Ide H, Tokiwa S et al. Combined inhibitory effects of soy isoflavones and curcumin on the production of prostate-specific antigen. Prostate. 2010 Jul 1;70(10):1127-33.
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  14. Zhang X, Cook KL et al. Lifetime genistein intake increases the response of mammary tumors to tamoxifen in rats. Clinical Cancer Research. 2017 Feb 1;23(3):814-824.
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  18. Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. New York: Crown Publishing Company. 2010. p. 335.
  19. Tang Q, Ma J et al. Genistein and AG1024 synergistically increase the radiosensitivity of prostate cancer cells. Oncology Reports. 2018 Aug;40(2):579-588.
  20. Pavese JM, Krishna SN, Bergan RC. Genistein inhibits human prostate cancer cell detachment, invasion, and metastasis. American Journal of Clinical Nutrition. 2014 Jul;100 Suppl 1:431S-6S.
  21. Zhou JR, Gugger ET et al. Soybean phytochemicals inhibit the growth of transplantable human prostate carcinoma and tumor angiogenesis in mice. Journal of Nutrition. 1999 Sep;129(9):1628-35.
  22. Raffoul JJ, Banerjee S et al. Soy isoflavones enhance radiotherapy in a metastatic prostate cancer model. International Journal of Cancer. 2007 Jun 1;120(11):2491-8.
  23. Hillman GG. Soy isoflavones protect normal tissues while enhancing radiation responses. Seminars in Radiation Oncology. 2019 Jan;29(1):62-71.
  24. Ahmad IU, Forman JD et al. Soy isoflavones in conjunction with radiation therapy in patients with prostate cancer. Nutrition and Cancer. 2010;62(7):996-1000.
  25. Li L, Lv Y, Xu L, Zheng Q. Quantitative efficacy of soy isoflavones on menopausal hot flashes. British Journal of Clinical Pharmacology. 2015 Apr;79(4):593-604.
  26. Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause. 2012 Jul;19(7):776-90.
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  29. Tacyildiz N, Ozyoruk D et al. Soy isoflavones ameliorate the adverse effects of chemotherapy in children. Nutrition and Cancer. 2010;62(7):1001-5.
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