One of the things I admire most about women is the way you rush to support a friend (or a stranger, even) in distress. Take breast cancer. I’m moved when I see a picture of a woman who has lost her hair to chemotherapy surrounded by friends who have shaved their heads in support. I think you would do anything for your sisters. You walk, run, and ride bikes in the race for the cure.
But what if there isn’t a cure?
The portrait above was taken in the heroic style popular after World War II. It’s a most American picture. You see a young couple holding their children, framed against the sky in a way that makes them seem a little bigger than life, bravely striding into a promising future. The Quonset hut (a low-cost portable building left over from the war) is their home. Who are they? I remember them as Uncle Glen and Aunt Adele; they’ve been gone a long time.
Glen was a war hero in my mind, a Marine who fought in the terrible WWII battle for Okinawa. Adele was an unusually intelligent woman; her home was always extra nice. She likely planted and cared for the sweet peas in the corner of the picture. The children are my cousins Linda and Vicki; later there was a son, Rick.
And the future they were striding into? It was brief—each died in their early thirties. Glen in an accident; Adele of breast cancer, an unusual case, given her youth. Perhaps the sudden loss of her husband was a factor. As a young boy I was a spectator to the tragedy of their deaths. Their orphaned children, Linda, Vicki and Rick, were taken into our home, so I was also witness to how hard it is for young children to lose their parents.
This childhood memory is my only qualification to write about breast cancer; maybe it’s enough. So I repeat the question, “What if there isn’t a cure?” In a caring way, I sometimes ask women, “What should you do to prevent breast cancer?” The most frequent response is to get regular mammograms. Then I point out that a mammogram is for when you already have cancer and repeat the question. Most women are unsure; a few know a preventative measure or two. But that’s about it.
So in memory of my Aunt Adele, and with the hope of not adding to the burden of the breast cancer survivors in our audience, I offer ten steps to reduce a woman’s risk to breast cancer. This is not my work; it is based on a 2007 meta-study done by experts working for the American Institute for Cancer Research. I have added guidance from work by other scientists. With time this list should get better, but it’s the best I could find. (If you've been following our weekly Healthy Changes since January, you'll see that you are already doing many of these steps.)
1. Avoid alcohol. If you choose to drink, limit alcohol to one drink per day. (It’s presumed you are avoiding tobacco.)
2. Stay lean. As lean as possible within the healthy weight range. (Elevated body fat is a risk factor after the teen years.)
3. Be physically active. Every day, for at least 30 minutes.
4. Have children early (in your adult years) and as often as you choose. Breast-feed infants at least six months.
5. Limit sugar to the AHA daily guideline of 6 tsp. for women and 9 for men. Avoid sugary drinks and limit consumption of candy as well as sugary breakfast cereals and bread products. Less is better.
6. Limit intake of red meats and dairy; avoid all processed meats.
7. Eat a varied diet rich in fruits, vegetables, whole grains and legumes. (These foods are an excellent source of protective antioxidants including vitamins A and C.)
8. Eat food, not pills (unless prescribed by your doctor). Avoid the use of multivitamin pills, or supplements to reduce cancer risk. (See AJCN March 24, 2010, “Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women”.) Hormone replacement therapy is also a risk factor for breast cancer.
9. Maintain a healthy level of vitamin D with moderate sunshine where possible.
10. Eat healthy fats. Avoid all trans fats (noted by the word hydrogenated in the ingredient list). Eat natural fats like olive oil and butter in moderation and minimize vegetable oil products. (Limiting food with vegetable oils like chips, will improve the important ratio of omega-6 to omega-3 fats as well as reduce salt intake.)
The AICR recommends that cancer survivors—after receiving treatment—also follow their preventative steps. Readers are invited to share their experience or any other guidance on how to prevent breast cancer.