The Other War: Getting Pre-Emptive About Breast Cancer
By Simon Chaitowitz
This commentary ran Sept. 28, 2006, in The Salt Lake Tribune.
Like many breast cancer survivors who have suffered through chemotherapy, radiation and multiple surgeries, I wake up most mornings happy to be alive. With approximately 40,000 women dying of breast cancer each year in this country, I know I'm lucky. Although I still face a daunting medical challenge - I'm currently recovering from a stem-cell transplant to cure a blood disorder caused by my cancer treatment - my diseases are both in remission.
I can't help but wonder, though, if I could have avoided breast cancer in the first place if I had grown up knowing how important good nutrition is in preventing this horrendous disease. Instead, like most of the 200,000 women diagnosed with invasive breast cancer each year, I was raised on hefty amounts of meats, chicken, fish, milk and other high-fat animal products. Our family particularly loved salami and eggs, lox and cream cheese, and barbecued ribs. In fact, I don't think I met a Brussels sprout or a beet green until I was in my 30s. I certainly had no idea that our high-fat, low-fiber American diet was increasing my risk of developing breast cancer.
Although society pays more attention to good nutrition these days than it did in the 1950s when I was growing up, most Americans still don't realize that the right foods can help them prevent breast cancer and its recurrences. They certainly don't know that dietary choices have more influence over lifetime cancer risk than air or water pollution (35 percent to 50 percent compared with 5 percent, according to the National Cancer Institute) or even genetics (5 percent).
Unfortunately, diet seems to take a back seat to other concerns. Less than 10 of the nearly 700 breast cancer studies seeking participants on the Web site clinicaltrials.gov focus on nutrition. Teens are more likely to get their dietary cues from McDonald's CEO than a dietitian. And during Breast Cancer Awareness Month, we're more likely to hear about the latest Shop for the Cure promotion than the many cancer-fighting benefits of a low-fat vegetarian diet.
What do we know about how diet affects breast cancer risk and survival? Numerous research studies - some dating back to the early 1960s - show that cancer is much more common in populations consuming diets rich in fatty foods, particularly meat, and much less common among those eating lots of grains, vegetables and fruit. Diet, it seems, works in two main ways - some foods encourage cancer; others protect against it.
One primary reason is that meat and other fatty foods can increase the amount of estrogen in a woman's blood. Estrogen is the female hormone that, while essential, can sometimes cause cells to multiply and fuel tumor growth. Fiber, on the other hand, which is found in fruits, veggies, grains, and beans, but never in meat, helps remove excess hormones from the body.
Of course, high-fat, meat-heavy diets also contribute to obesity, another primary risk factor for breast cancer. And they contain high levels of saturated fat and cholesterol, which can impair immune function. A group of researchers at the Ontario Cancer Institute analyzed data from 45 studies involving more than half a million women and found that those who ate the highest amounts of saturated fat (found mostly in meat) were on average 20 percent more likely to get breast cancer than those who ate the lowest amounts.
Wholesome low-fat, meat-free diets - with their wide array of vitamins, minerals, antioxidants and phytochemicals - work instead to boost the immune system and protect against cancer. Several recent studies have added to the mountain of existing literature. One published in the Journal of Clinical Oncology showed that women with the highest consumption of carotenoids (a biomarker for overall fruit and vegetable consumption) experienced a 43 percent lower risk of breast cancer recurrence compared with women with the lowest levels.
Given all the good news about a low-fat vegetarian diet, why do scientists and government officials still focus more resources on drug treatments than lifestyle choices? Money plays a part, of course. There's more to be made in producing new drugs than selling healthy foods. And there's still a lot to learn about what diet can and cannot accomplish. But we certainly know enough to begin making important dietary and public health changes now. We owe it to those thousands of American women who die each year of breast cancer.
Simon Chaitowitz is a communications specialist with the Physicians Committee for Responsible Medicine.