Dialogue: Better to prevent breast cancer than to cure it

By ROBYN YOUSEF*

While the main thrust of international research into breast cancer seems to be the search for the elusive cure, another aspect demands more attention.

The Breast Cancer Network of New Zealand believes we should be concentrating more on prevention of the disease, a subject which appears to have taken a back pew.

We all know the "Slip, Slop, Slap" slogan regarding the prevention of skin cancer, and we are well aware of the dangers of smoking. But what message do we pass on to our daughters and granddaughters so they can avoid breast cancer?

Breast Cancer Awareness Month is a positive indication of how the disease has emerged out of the closet over the past 10 to 15 years - women can talk about their breast cancer in a much more open environment.

However, the incidence of the disease is increasing and death rates from it in this country are slow to decline although a small improvement in mortality rates is now being reported from overseas studies.

And there is more good news. Free mammography screening for women aged 50 to 64 is now available, enabling more early diagnoses, while quality treatment is available throughout New Zealand.

Along with specialist breast clinics, specialist surgeons and trained breast-care nurses, we have many support groups and networks of women to help those women living with breast cancer.

Information on the disease is also readily available in books, films, television documentaries, magazines, on the internet, in libraries and through cancer-information services.

Breast cancer starts when one maverick cell begins growing out of control. It is thought that several changes to the cell DNA occur before it becomes a cancer cell. While the cellular changes can be studied and a huge emphasis is placed on this research internationally, the causes of the changes are much harder to define. Because it appears many factors may be involved, it is commonly heard that we don't know what causes breast cancer so we don't know how to prevent it.

However, thousands of research projects have studied links between increased incidences of breast cancer and diet, alcohol consumption, taking the contraceptive pill, hormone replacement therapy, exposure to hormones, chemicals and radiation, being overweight, lack of exercise or having a certain type of benign breast disease. Our Western lifestyle seems conducive to developing breast cancer and so we should look seriously at possible changes, especially if there is family history of the disease.

Although a single cause of breast cancer has never been effectively pinpointed, the Breast Cancer Network believes that we can take firm control of many aspects of our lifestyle to reduce the incidence of the disease.

We can ensure that our diet is as natural and unprocessed as possible, with lots of fresh fruit and vegetables. Eat less fat, less meat and dairy products, cut down on alcohol intake and step up wholegrains, pulses, cereals and soya products.

We can try to avoid unnecessary chemicals in everyday life.

We can choose to exercise more and look at short-term use only of the Pill and HRT, or explore alternatives.

The network points out that it seems particularly important for teenage girls to exercise, avoid alcohol, the Pill and radiation. The upper body should be protected by a lead apron when x-rays are necessary. Most radiology units and dentists have these, but you may have to request one.

With an abundance of worldwide information now available, a very straightforward means of prevention - plenty of fruit and veges - seems to be our front line of defence.

Increased intake of fruit and vegetables seems to be one of the simplest means of decreasing the risk for cancer, according to a report in British Medical Bulletin 1999; 55 (No 3) by Harri Vainio, of the Karolinska Institutet, in Stockholm, Sweden. Cancer-preventative effects of fruit and vegetables have been observed in epidemiological studies, he explains.

That old adage that an apple a day keeps the doctor away still applies. Eating an unpeeled apple every day is far more effective in combating the breakdown of cells and boosting your protection against cancer than swallowing a Vitamin C pill. Researchers from the Department of Food Science at New York's Cornell University say that 100g of fresh apple provides as much antioxidant activity as 1500mg of Vitamin C.

That pyramid of healthy eating we are all used to seeing shows the dietary approach to preventing breast cancer. The Breast Cancer Network recommends the use of organic food when possible.

British geochemist Professor Jane Plant also believes that we should be eating lots of fresh fruit and vegetables (preferably organic). She was in New Zealand recently to promote her new book Your Life In Your Hands, Virgin) in which she advises we should be cutting out all dairy produce from our diet for both prevention and cure.

Her book presents the Plant Programme, which gives guidelines for food and lifestyle factors to prevent breast and prostate cancer. She claims to have cured herself and 63 other women when her unique dietary programme was combined with standard cancer therapy.

Professor Plant examines her own breasts, lymph nodes and liver on a regular basis and advocates this for all women, suggesting they should get their doctors to teach them or, better still, it should be taught in school biology classes.

The Breast Cancer Network believes females from primary-school age should be thinking how they could protect themselves from breast cancer. We want to them to be aware of their breast health well before the self-examination or mammography stage. Let's beat that ambulance to the bottom of the cliff and think of a way to promote prevention of breast cancer that would appeal to the dotcom generation.

The Breast Cancer Network is an organisation for survivors of breast cancer and their supporters. It aims to promote increased efforts to prevent and cure breast cancer by advocacy, education, information and networking.

* Robyn Yousef is an Auckland-based freelance writer and she edits the Breast Cancer Network's bi-monthly newsletter UPFRONT.