Genistein / Soy
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
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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.
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 Authors
Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Read more Ms. Pole is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation and education services for more than 30 years. View profile.  Nancy Hepp, MS, BCCT Project Manager
Read more Ms. Hepp is a science researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. View profile. Last updated April 29, 2021.
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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, and is not likely to have estrogen-like effects on hormonally responsive tissues.
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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.
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
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- 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 cancer 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.
Lung Cancer
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- Among women with lung cancer, prediagnosis intake of soy food is associated with better overall survival.
Ovarian Cancer
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- 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.
Prostate Cancer
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- Supplementation with genistein and other soy isoflavones lowers or stabilizes 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.
- Soy supplements decreased serum sex hormone levels but not androgen receptor expression in a small pilot study.
- A combination of soy isoflavones and curcumin decreased PSA levels in patients with PSA of 10 or higher.
Lab and Animal Evidence
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Evidence from studies is generally beneficial, but with some conflicting results.
- Soy isoflavones such as genistein sensitize cancer cells to radiation, causing increased cell death of tumor cells.
- Effects in breast cancer:
- In rats, genistein intake mimicking Asian consumption patterns improved response of mammary tumors to tamoxifen therapy, including increased antitumor immunity.
- In cell studies, genistein promoted cell death (apoptosis) when used in combination with adriamycin and docetaxel in one type of breast cancer cells and with tamoxifen on another cell line.
- Genestein inhibited cell growth, induced cell death (apoptosis) and showed other anticancer effects in colorectal cancer cells.
- Genistein has stimulated cell death (apoptosis) of osteosarcoma cells in animals.
- Results from in vitro and in vivo studies about soy and ovarian cancer are conflicting, but a cellular study demonstrated that genistein and daidzein from soy reduce ovarian cancer cell proliferation.
- Animal studies have yielded conflicting results regarding beneficial effects of genistein on prostate cancer:
- Benefits: isoflavones have slowed the growth of prostate cancers:
- Decreased tumor volume in animals with genistein combined with AG1024
- Reduced metastasis in animal studies with genistein use
- Reduced human prostate tumor cell proliferation, increased apoptosis, reduced microvessel density and increased the angiogenic protein insulin-like growth factor-I in mice
- Harms: in high concentrations, pure genistein induces metastasis in mouse xenograft prostate cancer models, although the addition of diadzein (in soybeans and various products) may prevent this response.
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 patients and reduced urinary, bowel, and sexual adverse symptoms induced by radiation therapy for prostate cancer in a small pilot study.
Soy isoflavones show slight and slow effects in attenuating menopausal hot flashes compared with estradiol but greater effects than placebo in some studies. but not all. 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.
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. 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.
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.
Expand list
- A 2018 review and meta-analysis found soy foods and their isoflavones (genistein and daidzein) are associated with a lower risk of prostate cancer.
- Soy consumption may protect against breast cancer. 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. Soy consumption is also associated with lower recurrence of breast cancer, even among postmenopausal women treated with tamoxifen.
- High intake of isoflavones may also reduce risk of lung cancer, (in nonsmokers), colorectal cancer (in women) and endometrial cancers.
Lab and Animal Evidence
Read more
- Genestein reduced tumor numbers in mice, dependent on the composition of the diet.
- An animal study using genistein and daidzein from soy demonstrated a protective effect against estrogen-related endometrial cancers."
- Different lines of research indicate that rodents metabolize soy differently than humans and other primates, and that a woman’s microbiome (gut bacteria) can influence how she metabolizes soy and therefore how soy may influence breast cancer. These and other factors may contribute to conflicting results from studies.
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 inflammation and improved hormone balance, although the specific interactions with hormones are still under investigation.
Genestein shows anti-inflammatory and antioxidant effects
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."
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.
In HER2 positive breast cancer patients, soy consumption has been associated with a greater risk of recurrence, and overexpression of genes that promote cell proliferation. 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. Soy consumption may be associated with increased risks of bladder cancer, although evidence is contradictory across studies.
Soy Supplements
Not enough information about soy supplements, such as concentrated isoflavones, has been assessed to determine if they are safe. 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.
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. This is consistent with animal studies showing increased metastasis with the use of soy supplements.
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.
Interactions with a few prescription medications are noted. These include tamoxifen and aromatase inhibitors.
Soy supplementation had been proposed as a cause of endometrial hyperplasia, but several studies have found no increased risk. Animal evidence (see above) shows a protective effect against endometrial cancer.
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
BCCT 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."
Further recommendations are available from these sources:
Integrative Programs, Protocols and Medical Systems
- Programs and protocols
- Alschuler & Gazella complementary approaches
- Traditional systems
Non-cancer Uses of Soy/Genistein
BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
- Prevent heart disease
- Reduce high cholesterol
- Treat menopause symptoms
- Prevent bone loss
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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.
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View All References
More Information
- Evidence-Based Monographs, The Centre for Health Innovation:
- American Institute for Cancer Research website. Soy and Cancer Survivorship
- National Cancer Institute: Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)–Health Professional Version: Soy
- Memorial Sloan Kettering Cancer Center About Herbs webpage: Soy
- Academy of Nutrition and Dietetics Oncology Nutrition Dietetic Practice Group: Soy and Breast Cancer
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- Dawn Lemanne and Victoria Maizes: Advising Women Undergoing Treatment for Breast Cancer
- LifeExtension Nutritional Support: Diet and Lifestyle Considerations for Breast Cancer
- Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition
- Keith Block and others: A Broad-Spectrum Integrative Design for Cancer Prevention and Therapy
- Dwight McKee, MD, editor: Clinical Pearls
- National Cancer Institute at the National Institutes of Health: PDQ® Cancer Information Summaries
- Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- National Cancer Institute: Complementary and Alternative Medicine for Health Professionals
- ConsumerLab.com
- American Botanical Council: HerbMed
- Lone Star Medical Group: Natural Alternative Treatments
- Therapeutic Research Center: Natural Medicines Database
- National Cancer Institute: Office of Cancer Complementary and Alternative Medicine
- The Tracey Birnhak Nutritional Counseling Services: Soy and Breast Cancer
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