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| Acknowledgments | xi | ||||
| Welcome | xiii | ||||
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1 | (51) | |||
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52 | (11) | |||
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63 | (21) | |||
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84 | (30) | |||
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114 | (84) | |||
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198 | (34) | |||
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232 | (13) | |||
| Notes | 245 | (18) | |||
| Further Reading | 263 | (2) | |||
| Index | 265 |
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Excerpt
The Hat,
The Boa Constrictor,
and The Scientist
In this chapter I explain to you why, as a natural scientist, I approach the problem of breast cancer differently than doctors and orthodox medical researchers. I then go on to explain how I used my training and experience to cope with all the orthodox types of treatment a breast cancer patient is likely to undergo, including surgery, radiation therapy, and chemotherapy. I explain the treatments clearly and simply and give lots of practical tips to help you cope: for example, how to avoid or minimize hair loss during chemotherapy. In this chapter I have tried to make you feel as if you have a good and caring friend guiding you toward the light at the end of the tunnel.
Scientists can often seem to be rather strange people.
The truth is, scientists are different--we're trained to be. Let me explain what I mean by using the story I tell when I first lecture to new students at one of the universities I visit. It comes from a wonderful children's story you may already be familiar with: The Little Prince by Antoine de Saint-Exupéry. In this magical book the little prince draws a picture of a boa constrictor digesting an elephant. But when he shows his masterpiece to grown-ups and asks them whether they are frightened by the picture, they ask why they should be frightened by a picture of a hat. It is the ability to see that the hat is a boa constrictor digesting an elephant that distinguishes the best scientists.
Let me give you a well-known example to show you what I mean. What sort of person sees an apple fall from a tree, wonders what force is drawing it down toward the earth--and then goes on to develop the whole concept of gravity?
Here's another example. What sort of person leaves a plate of glass coated with photographic emulsion next to a piece of granite in a drawer and, when he notices that the emulsion appears to have been damaged by "emanations" coming from the granite, does not simply curse and throw it away but instead deduces that previously unknown particles and rays have been emitted from the rock--and discovers radioactivity?
And one more. What sort of person attempts to culture bacteria in a petri dish, finds the experiment has gone "moldy," yet does not simply throw it away but instead looks carefully, observes that something in the fungus has killed the bacteria, and discovers penicillin--thereby establishing the basis for the development of modern antibiotics?
All three people--Sir Isaac Newton, Henri Bequerel, and Sir Alexander Fleming--saw things a little bit differently. It is this ability to see a familiar situation from a different viewpoint or angle that probably makes scientists seem rather odd to other people. But sometimes it results in a major leap forward in our understanding of the natural world.
Thinking like a creative scientist is more a state of mind than anything to do with training or education (although increasingly, we need to know and understand more and more facts before `we can contribute new ideas).
This book sees things a little bit differently. For many decades, women have lived in the shadow of a devastating disease that continues to kill a high proportion of sufferers and that is associated in many women's minds with treatments involving invasive surgery, irradiation, or chemicals with frightening side effects. The disease is, of course, breast cancer. The only hope we are given is that with enough expenditure on research, we might one day find a truly effective treatment. Sadly, that day has been a very long time coming.
In these pages I want to take you on a journey. Partly it is the story of my own learning experiences with breast cancer, which I have suffered from five times and eventually conquered. But mainly it is the story of a new and rather different way of seeing, understanding, and treating this disease.
It is my hope that this book will serve two purposes. First, I want it to be directly useful to you, the reader. The straightforward advice and simple lifestyle suggestions it contains will be of practical benefit to every woman in significantly reducing the risk of developing breast cancer. If you happen to be that one woman in ten who has developed breast cancer, then you will also find much additional information here, which will give you a better chance of survival overall and help you to cope with rigorous treatment methods.
Second, it is vitally important that this book ignite a debate within the scientific and medical communities. Science is, at heart, an adversarial process. Progress is made by vigorous cross-questioning of your own and others' work. This book puts forward a new perspective on breast and prostate cancer and backs it up with compelling evidence from the scientific literature. The inescapable conclusion is that relatively small augmentations to the orthodox medical therapies currently being used in clinics and hospitals would result in major improvements in patient survival. For example, providing breast cancer patients with sound dietary advice, as is common in the case of heart disease or diabetes, could greatly increase survival rates. So much suffering could be prevented, and so many lives could be saved, that the evidence must be heard--and acted upon--with the very greatest urgency.
HOW MY STORY BEGAN
I didn't choose to study breast cancer--it chose me.
I first stumbled into science because I was an instinctive feminist. The boys at my local grammar school could choose among Latin, art, and physics as options, while at the girls' school we could choose from only Latin, art, and cookery. Although Latin was my best subject, I did not like it and resented the time spent on something that, as a teenager, I could see little point in. So I led a campaign for the girls to be offered the same choices as the boys and, for my efforts, became hoist with my own petard when I was obliged to study physics just as the boys did. Without quite realizing it, I had started on the road to becoming a scientist.
At school I occasionally regretted what I had done, but at university I literally fell in love with the scientific subject I had chosen to do--geochemistry. I was the only woman to pursue the subject in the final year; however, I was so dedicated and such a perfectionist that I had some problems. For example, after my final year examinations I ran away because I believed I had failed my exams. In fact, when my professor finally tracked me down it was to tell me that I had gained a first class honors degree.
After leaving university I married a young doctor who subsequently trained as an army psychiatrist, and had a son, named Mark. Our marriage failed and, in a protracted and painful custody battle, I lost my son to my ex-husband and his new wife, a psychologist. This has been a source of intense and chronic stress for the last thirty years of my life. Four years after we separated, I married my present husband, Peter, who, like me, is an earth scientist. We have two children, Emma, now twenty-five, and Tom, now eighteen. You will read about them later.
I was lucky to be employed by the British Geological Survey (BGS) as only the second woman scientist in its history. (Women had previously been employed only in a technical capacity.) I am now the Chief Scientist of the organization, and I hope my position is helping to encourage other women to progress in what in the past has been a very male-dominated subject.
Geochemistry is about the chemistry of the earth. My specialty is in understanding the chemistry of the surface of the earth, especially concentrations of chemicals where these occur either as natural concentrations in ore deposits or as a result of man's activity; for example, where there are landfill sites or contaminated land. I have frequently worked with biochemists, veterinarians, epidemiologists, and medical geographers looking at the impact of chemicals in the environment on the health of humans, animals, and crops. Early in my career, between 1975 and 1977, I served on a Royal Society committee concerned with geochemistry and health. Since that time, my team of scientists at the British Geological Survey has been concerned with a wide range of human health problems related to the environment. Some of the methods we have developed allow us to make highly reproducible high-resolution maps showing the distribution of chemicals over the surface of the earth. We are able to look on our computer screens at the distribution of, say, arsenic and uranium (as potentially toxic elements) or zinc or iron (trace elements essential to animal and human health) in the same way people can look at Earth's physiography--using remotely sensed photographs from space. Almost from the beginning, these images, although intended for geologists, created a lot of interest among veterinarians, who found them helpful in diagnosing environmental and nutritional animal diseases in Britain. It was by working with them that I first began to learn of some of the amazing connections between geochemistry and biochemistry. I also learned, when I was ill, that veterinary rather than medical literature provided the most fundamental answers based on biochemistry. Eventually I established a team that is regarded as the best in the world in tackling health problems related to anomalous levels of trace elements in the environment--for example, diseases caused by high levels of arsenic or fluoride or by deficiencies in iodine, selenium, cobalt, or zinc in soils and/ or water supplies. This is a particular problem in many developing countries.
Very recent work that the BGS team has conducted, which has received wide publicity, deals with the problem of arsenic contamination in water from wells in Bangladesh. There the levels of arsenic in water can be so high that many people develop skin lesions--their skin becomes black and thickened--that in a significant proportion of sufferers become cancerous.
What I had learned as a result of this type of environmental detective work time and time again was that until you identified the fundamental cause of such problems, there was little or nothing that could be done to help the affected individuals. And until you've found the cause (whether it's of breast cancer or any other disease) and effectively neutralized it, you can never, ever claim to have "solved" the problem.
Until 1987 I had no interest in cancer became, like most people, I never imagined that it could happen to me. I had never smoked or sunbathed, rarely drank alcohol, and ate what most experts would consider to be a healthy diet. I even checked to make sure that the cosmetics I used contained no harmful chemicals. My lifestyle was hectic, certainly (it still is!), but no more stressful than many other women's.
Then, one Friday evening in September of that year, my life changed forever.
I was in northern Canada examining gold deposits before attending a major scientific conference in Toronto. I was working on a project aimed at understanding how gold, which is the rarest element on earth, could become concentrated by factors of up to about 10,000 times by natural geologic processes to form minable gold deposits. I was feeling pleased because I had begun to see clues that would lead to new theories and models, which subsequently I punished in peer-reviewed papers (see p. 15) and in a textbook I wrote over the next few years. It had been a grueling day working down in the gold mine. It was hot, sweaty, dirty work, not to mention noisy and dusty, and I couldn't wait to get back to my hotel and the luxury of soap, hot water, and fresh towels.
Finally back in my room, I dried myself and returned to my bedroom to search for a bra. As I was walking around topless hunting for my underwear, I suddenly saw in the low-angle, late-afternoon sunlight a lump about the size of a large pea just under the skin of my left breast. I felt it and was immediately overwhelmed with fear and panic; my mouth went dry and I felt sick. I knew without a doubt that I had breast cancer. Over the next week or so, I was to become very familiar with the feel of the cancer. I was surprised by how hard it felt--like a compressed rubber ball surrounding one of the ducts in my left breast. I was angry with myself for not having examined my breasts before, but somehow I had never thought the advice applied to me. I was only 42--surely too young to get cancer? My family and loved ones, my developing career, the many happy and productive years I had always imagined to be ahead of me ... In one heart-stopping moment, everything came crashing to a very full stop.
After the initial shock had subsided somewhat, I tried to think what to do. My husband was working in Jamaica and I had no contact telephone number (this is common among geologists), and my children were both staying with their grandmother. In any case, I saw no point in upsetting them. The first thing I did was to telephone one of my oldest and dearest friends. Dr. John Camac had been my doctor throughout my childhood and was still my mother's doctor. Despite the fact that it must have been about midnight in Britain, he was wonderful to me. He guided me through a careful self-examination. He knew me well enough not to give me false reassurances and we agreed that the lump that I had found probably was cancer but that it appeared to be very localized and could probably be treated by lumpectomy on my return to Britain. With his advice and the help of a friend in Canada, I decided to stay for the conference until I had honored my commitments, but also to go to the famous Princess Margaret Hospital in Toronto for an examination and diagnosis.
I thus spent the next week alternately being a professional scientist chairing sessions or giving lectures in front of an audience of about 800 people; attending a specialist breast clinic for examinations and biopsies, finally to be given the diagnosis of cancer; and sitting alone or with friends feeling like a terrified 5-year-old worrying about what the future held. Most people have some attractive feature--for example, long legs, beautiful hair or eyes, and so on. In my case, it had been my boobs. I had a small waist and shapely breasts. Before I was married, my surname was Lunn and this led to two of my teenage nicknames--busty Lunn or lusty bun! The thought of losing one of my breasts terrified me. Would it mean that people would treat me as an object of pity? Would my colleagues joke about me?
By the time I returned to London, my local doctor had already managed to get me an appointment with the breast cancer clinic in a leading London teaching hospital, the Charing Cross Hospital. I shall never forget the scene that greeted me on my first visit. The waiting room was full to bursting with strained-looking women and their supporters; the atmosphere was thick with fear and anxiety; there was no conversation, and mostly we avoided even making eye contact with each other. Even then, I noted that most of the women appeared well groomed but were of different ages, different shapes and builds, and with different breast sizes. There were two black women, one woman of Indian appearance, one woman of Middle Eastern appearance, but no Eastern women. Looking back I realize that I was already searching for clues about the cause of breast cancer by looking for common factors among the women affected. Of course, if it were that easy someone would have identified the factors long ago, but it was impossible for me to suppress my instincts as a scientist. Seeing those scared faces--and knowing how scared I felt, too--was the first time I fully understood what a common disease breast cancer is, and how dreadful and widespread is the damage it causes to women and their families and friends.
Over the months and years that followed my first visit to that clinic, I made it my business to learn as much as I could about this devastating disease. In times of great personal crisis, people usually fall back on the fundamental things they know best and trust most. For some, it may be their religious faith. For others, it could be close friends and loved ones, In my case, when disaster struck, I fell back on what I trusted most: my scientific training.
And that's what saved my life.
HOW SCIENCE SERVES US--
AND WHY IT SOMETIMES DOESN'T
A good scientist will see things a little bit differently from most people. As a science "insider," I'd like to tell you something about the way science works, which will help you make sense of the differing approaches that scientists have adopted toward breast cancer.
When I lecture to my students, I like to ask them to visualize science as a mighty oak tree--a tree of knowledge, if you like. Start deep down under the earth, at the very tips of the ever-probing roots. This is where lots of discoveries are constantly being made and new facts found. Then some of these are brought together to form larger roots, and finally, the whole knowledge can be assembled to give a total or holistic trunk to the tree. This last function--the assembling of disparate bits of information to give a new insight or theory or sometimes a major breakthrough--has often been achieved by one individual with a grasp of many or all of the different aspects of a problem, who has the good fortune to be in the right place at the right time to make all the necessary connections. Finally, this newly acquired knowledge flows to the branches and leaves, as the information is communicated to the world at large--where it may be used for good or ill.
This is, of course, a simplification of a complex and dynamic subject, but it is a useful way of understanding how science has always functioned to deliver the fruits of its labors to society. In recent years, however, things have changed significantly, and not for the better. Today, the overwhelming trend is to devote maximum attention and resources (money, people, equipment, and facilities) to scientists working at the root tips, often using very expensive, high-technology methods. Sometimes this approach is called "bottom-up" science (as opposed to "top-down"). The great natural scientist James E. Lovelock lucidly explains the problem in his book Gaia: The Practical Science of Planetary Medicine: "To understand the physiology of the earth requires a `top-down' view of the earth as a whole system. We need science, but it must grow from the top down as well as the bottom up!"
Science that exclusively and narrowly focuses on the extreme root tips at the expense of everything else can be bad science. My friend Professor John Dewey FRS, of Oxford University, made this point recently in a thoughtful and thought-provoking article in the science journal Geoscientist (John is a modern scientific hero, being one of the pioneers of plate tectonic theory, which explains how the earth's surface has evolved over time). He wrote:
In our ambitious scramble for funds and recognition, we have forgotten the traditional values of scholarship, the seamless integration of research and teaching to generate knowledge and science. Scholarship includes intense library research and reading literature more than five years old.
There is a word to describe what has happened to many branches of science in recent decades, which is increasingly used pejoratively: reductionism.
The current emphasis on high-technology reductionist science means, to put it candidly, that we are spending more and more to learn more and more about less and less. As far as cancer research is concerned, it means that we are studying ever smaller parts of the total process involved in the development of the disease, such as some aspect of cell biology or molecular chemistry--in some cases just one gene, or the protein it encodes for. But this increasing specialization and compartmentalization of cancer research, each subdivision with its own jargon (which other researchers may not understand), simply isn't producing the results that society is entitled to.
There's another problem caused by the emphasis on reductionist science, too. Its all-pervading influence has made any other type of scientific endeavor more difficult to pursue. In particular, I'm talking about the sort of science that takes place further up the tree trunk--the sort of science that involves analyzing, synthesizing, or reviewing the work of others. This is now highly unfashionable. It is thought not to be creative and not to provide the original cutting-edge ideas that "bottom-up" science produces. Hence there are few prizes or distinctions for scientists carrying out such tasks, and it is difficult to find sources of funding for this type of work.
The implied aim of reductionist science, in the case of cancer research, is to find the single "magic bullet," that one missing piece of the jigsaw, the ultimate answer, the Holy Grail.
But what if it doesn't exist?
In the meantime, we are left with surgery, radiation therapy, and chemotherapy--albeit improved and refined--as the main front-line treatments against breast cancer, as they have been since the 1950s, together with hormone-based methods such as the drug tamoxifen. True, there have been small, incremental improvements, but little that is having much impact on the incidence of breast cancer or affecting the long-term survival of many sufferers (see Fig. 1, p. 74).
A reductionist approach to breast cancer research also, sooner or later, runs into the law of diminishing returns, whereby we have to spend more and more economic resources in order to achieve less and less.
The high-technology approach to developing drugs for cancer is leading to many new drugs that are extremely expensive--which are then strongly marketed, often directly to patients via the World Wide Web--although they may prolong life for only a few weeks or months. Hence there are increasingly highly charged emotional debates between individual patients and their families, who understandably wish to have the latest treatment, and health authorities and organizations that find it difficult to justify the large aggregated bills for groups of patients receiving marginal benefit. Is this approach really helpful to breast cancer sufferers except in the very short term?
The modern era in cancer research really began in America when President Richard Nixon proclaimed "war" on cancer in his State of the Union address in 1971. And right from the beginning, it was dominated by reductionist scientific thinking, with its requirement for large-scale funding, extracted with the beguiling promise of a cure "just round the corner." "Many people anticipated swift victory," recounts the newsmagazine U.S. News & World Report , with the taming of the dread disease likened to a moon landing. Even as recently as 1984, the National Cancer Institute's director predicted that cancer deaths could be halved by the year 2000 in America.
Such optimism was, of course, unjustified. Despite massive expenditure--$2 billion in the United States in 1996 alone--by 1992 the cancer death rate had risen by more than 6 percent. Adopting the battlefield metaphor so beloved of cancer scientists, some critics have called Nixon's war on cancer a "medical Vietnam."
Certainly, there have been some significant medical success stories. For example, childhood cancers, particularly some leukemias, can now be treated and cured quite effectively: between 75 and 80 percent of children diagnosed with acute lymphocytic leukemia can now be cured. But these bright spots are too few and far between.
So what, you may be wondering, is the alternative to relying so heavily on reductionist science? And is it any more effective in delivering tangible benefits to ordinary people?
Most doctors would agree that the greatest contribution to all mankind in overcoming infectious diseases came not from the use of antibiotics but from improvements in public health: a clean water supply, improved sanitation, better nutrition, and proper housing. These improvements came about as we gradually increased our understanding of why and how infectious diseases were transmitted. An early example of this type of work was carried out by Dr. John Snow, who showed the value of studying the pattern of occurrence of disease. He made the famous dot map that showed the location of deaths from the epidemic of cholera that occurred in central London in September 1854. Deaths were marked by dots, and the area's eleven water pumps were located by crosses. Examining the scatter over the surface of the map, Snow observed that cholera occurred almost entirely among those who lived near (and drank from) the Broad Street water pump. He had the handle of the contaminated pump removed, ending the neighborhood epidemic, which had taken more than 500 lives. This "scientific detective work" is called epidemiology--literally the study of epidemics--and it has been used successfully many times to identify the cause of disease and, through public health medicine, to correct the things society was doing wrong.
In the case of cancer, Professor Sir Richard Doll's epidemiological study of lung cancer in the 1950s was one of the most significant advances in understanding cancer in this century. Sir Richard Doll demonstrated beyond any shadow of a doubt the relationship between lung cancer and smoking tobacco. Lung cancer was shown not to be a curse visited on us by a wrathful God, nor to occur because of bad or faulty genes, but rather to be caused by something human beings were doing to themselves. For the first time we had a modern rationale and scientific understanding of the cause of a common type of cancer. Following Doll's work, we can now choose whether to smoke or not in the knowledge that by doing so we shall significantly increase our risk of getting lung cancer. Moreover, identifying the cause of lung cancer has caused people in the United Kingdom to quit smoking, halving the death rate from lung cancer there. Since that time, rational explanations have been found for many other types of cancers. For example, mesothelioma--a type of chest wall cancer--is now known to be caused by exposure to asbestos dust, skin cancer to be caused by exposure to ultraviolet light or arsenic poisoning, and cervical cancer to be caused by infection with the sexually transmitted human papilloma (wart) virus, to give but a few examples.
All this background information suddenly becomes much more than an academic discussion when you've just had a diagnosis of breast cancer.
The first thing I did after my initial diagnosis was to fill out a questionnaire, which established that I was at low risk of contracting breast cancer! According to the Breast Cancer Society of Canada and Statistics Canada, some of the main risk factors are:
* Family history of breast cancer, especially in mothers, daughters, and sisters, as well as relatives such as aunts, cousins, and grandmothers. There is a six-times-greater risk if a mother or sister had breast cancer prior to menopause and up to ten-times-greater risk if the cancer was in both breasts for a mother or sister.
* A slightly higher risk for women who have never carried a full-term pregnancy or whose first pregnancy was after age 30.
* A higher risk with the early onset of menstruation or late onset of menopause.
Other suggested risk factors include prolonged use of the contraceptive pill before the first child, a history of benign breast lumps, the use of hormone replacement therapy (HRT), a high consumption of alcohol, obesity, and increased age.
In fact, most of these risk factors translate into indicators of a Western middle-class lifestyle and may not mean very much. Let me explain. Before Professor Doll's work, which showed that lung cancer was associated with tobacco smoking, a set of risk factors similar to those quoted for breast cancer could have been developed for lung cancer. In the 1950s, before Professor Doll reported his findings, these would probably have included being male (at the time few women smoked), being working class, consuming alcohol, increasing age, coming from a family where others had had lung cancer (smokers tend to have parents who smoke), and so on. None of the risk factors caused lung cancer--they were simply features of the population who smoked. I believe that the situation with breast cancer risk factors is the same: they are descriptions of the population that contracts breast cancer.
Many doctors tend to see noncommunicable diseases, especially breast and prostate cancer, as simply an inevitable result of aging. For example, a recent article in the British Medical Journal spoke of "the growing burden of non-communicable disease--in both developed and developing countries--as a consequence of population ageing. Cardiovascular disease, cancer, neuropsychiatric conditions, and injury are fast becoming the leading causes of disability and premature death in most regions." There is no mention in the article of the influence of Western diet and lifestyle or other possible underlying causes of noncommunicable diseases. According to this line of reasoning, age is a primary cause of cancer. I, for one, don't believe it.
In the period that followed my initial diagnosis, a grim sort of race ensued. As I suffered five times from progressively more advanced breast cancer, which eventually spread to my lymph system, I was simultaneously searching for greater scientific understanding of my disease, what might have caused it, and what might effectively make it disappear.
At the start I was very, very frightened. I kept questioning the basis of the therapy I was prescribed, investigating the data on outcomes myself, and as far as I could, evaluating all possible alternative therapies and theories. None of this made life easy for the cancer specialists treating me, but it made all the difference in the world to me. I felt less of a victim, and looking back I realize that this approach saved my life.
Sometimes I became very confused indeed. At the time there were seriously conflicting views among medical professionals on the value of mastectomy versus lumpectomy, just as recently there has been a major controversy about the value of expenditure on mammography versus improving chemotherapy. Then there is the undeclared state of war that seems to exist between orthodox and complementary (alternative) medicine about what to do for the best, so that you can quickly and easily become entirely bewildered.
What was I to do? The only course of action that made any sense to me and gave me any feeling of security was to fall back on my scientific training.
Customarily, scientists approach a new problem in five stages:
1. Gather existing information. Review previous facts and theories
as objectively and impartially but as critically as possible.
2. Produce new information. This is collected by experiment or observations, without emotional involvement. In some cases new ideas are produced by analysis and synthesis of information produced by other scientists. To be a good scientist you must be prepared to admit you are wrong: arriving at the truth is what is important, not personal prestige. If you raise a question, even if you arrive at the wrong answer, you will be respected if you work with honesty and openness. At the beginning of my science career, I learned a saying that has always stayed with me and guided my work. "The person who asks the questions solves the problem."
3. Evaluate. Evaluate the new results in relation to existing theories, and identify new insights or ideas.
4. Propose a new hypothesis. Speculation must be identified as such and clearly separated from facts.
5. Test the hypothesis. If the hypothesis works, submit it for further testing and validation until you have a new theory. If it doesn't work, begin again.
In a recently published paper, Dr. D. E. Packham of the University of Bath listed the characteristic values to which scientists have traditionally aspired:
* Honest experimentation
* Meticulous respect for evidence
* Candid admission of mistakes or error
* Pursuit of truth
* Moral and intellectual independence of all political authority and economic power
* Openness to the public scrutiny of research by one's peers. (You will see that throughout the book I use the term peer reviewed to indicate science published after it has been critically reviewed by other scientists. This type of information is distinguished from newspaper reports and other sources of information.)
This logical and ethical framework has been successfully used by scientists (whether they realized it or not) for centuries. And it is precisely how I began to approach the challenge of my own breast cancer.
What I discovered in the months and years that followed the diagnosis of my breast cancer is the subject of the rest of this book. There is indeed a great wealth of accumulated research--some of which goes back many decades--on the factors involved in breast and prostate cancer. As you read the chapters that follow, I am sure you will be just as astonished as I was initially to learn precisely how much has been discovered already but has not filtered through to the public. While it is true that some of the risk factors for breast cancer--such as increasing age, early age of onset of menstruation, late age of onset of menopause, and family history of breast cancer--are completely outside our control, there are many other risk factors that we can control--easily. These controllable risk factors readily translate into simple changes that we can all make in our day-to-day lives to help prevent or treat breast cancer.
My message is: Even advanced breast cancer can be overcome.
I know, because I've done it.
HOW MY STORY CONTINUED
What follows is what happened to me after that first fateful diagnosis: what I did wrong, what I did right, and what I'd do differently if I knew then what I know today. I shall also explain the reasoning and rationale for current cancer therapy and describe exactly how it felt to be a cancer patient.
One of the first questions I asked, one that many women with experience of breast cancer will understand, is "Why me? Why has this awful thing happened to me?" Eventually I found the answer to this question, and it was very disquieting because it brought home to me the high risk I had been running, despite what I'd thought was a healthy lifestyle. However, as I was to learn, a Western woman's lifestyle increases her risk of developing breast cancer, the risk increasing more and more every year.
Throughout the West, breast cancer is the most commonly occurring cancer affecting women. In the United States, breast cancer is second only to lung cancer as a cause of cancer deaths among women. In the European Union, it is the commonest cancer affecting women, and three times more women will be affected by breast cancer than by the second-inline killer, bowel cancer. Breast cancer is relatively rare in women under age 25, and more than four out of five women affected are older than 50. Breast cancer remains the leading cause of cancer death in women between the ages of 40 and 55 in many Western countries. A small number of men--a few hundred a year--also develop breast cancer.
Looked at another way, in the West the risk of any woman developing breast cancer during her lifetime varies from about one in eight in parts of the United States, to about one in twenty in parts of southern Europe. For women in the United Kingdom, the risk is about one in twelve. Disturbingly, the risk has increased quite considerably in recent decades. For example, breast cancer attacked one woman in twenty in the United States in 1960, but by 1991 the rate was one in nine (and it is even higher there now). Between 1979 and 1987 the rates in the United Kingdom increased at approximately 2 percent per annum, but between 1988 and 1992 the annual rate of increase rose to nearly 4.5 percent.
So I should not have been so surprised to be one of those affected. The odds were high. However, what struck me very forcibly when I first became aware of these figures was the contrast between the comparatively high risk Western women run of contracting breast cancer and the much lower risk of women living in the East (see Chapter 3). This was my first suspicion that there might be a cause for breast cancer, just as there is a specific cause for the high risk of lung cancer that smokers run. In the following chapters, I will tell you what I think that is, but first, let us go along the orthodox path of treatment that most breast cancer sufferers will follow to a greater or lesser extent, depending on the type of cancer they are suffering from and the stage it has reached.
(Continues...)
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