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by Janice Stensrude
published in Uptown Express
August/September 1995

This article was based on an unpublished academic paper that offers a more in-depth treatment of the topic.

* * *

Vested interests, economic gain, and resistance to change haunt the fight against breast cancer as the death rate climbs.

"Breast cancer is the number one killer of women between the ages of 35 and 50" declares the California-based Women's Cancer Resource Center (WCRC). WCRC distributes a postcard with an impactful message: A photo of a mastectomized woman, with scar and remaining breast exposed, carrying a placard that reads "INVISIBILITY EQUALS DEATH." Large white letters beside the photograph declare, "Since 1971, more than 1 trillion dollars have been spent on cancer research and treatment. Where has it gone?"

Singer-songwriter and former Gap Band member Dorian lost his mother to breast cancer. Still the new kid on the block in the music business at the time, he thought that the only thing that stood between his mother's recovery and death was enough money to hire a good enough doctor to implement a cure. July 31, 1995, the eleventh anniversary of his mother's death, is the publication date for For Mother's Sake, Dorian's autobiographical account of his and his family's struggle to cope with his mother's illness and eventual death from a disease that strikes an increasing number of American women each year.

In the years since the death of Dorian's mother, despite diagnostic improvements and earlier detection, life expectancy rates for women with breast cancer have not changed. Dorian is using the profits from his book and his soon-to-be released record to launch his BOYS FOR MOM Campaign Against Breast Cancer. As one of nine children, he is dismayed at the lack of progress since his mother's death and what this could mean to the lives of his sisters and his daughter.

Understanding the Statistics

"1 in 8" is the statistic emblazoned in the American memory by cancer organizations seeking attention for this growing health concern for American women. Based on a life expectancy of 95 years, this figure is somewhat of a public relations artifact. The women's health reference, Ourselves, Growing Older, stated that, based on a life expectancy of 70 years, 1 in 14 women will get breast cancer in the course of their lifetimes.

Ruth Spear, founder of National Alliance of Breast Cancer Organizations, quoted in Betty Friedan's The Fountain of Age, had her own way of extrapolating meaning from published statistics. Since breast cancer affects 145,000 American women annually, and since breast cancers detected by mammogram have been growing for an average of eight years, Spear extrapolates that 1,160,000 women (8 x 145,000) are walking around with undetected breast cancer at any given time. Since, according to Friedan, only 30 percent of women submit to mammography, and since breast cancers detected by examination have been growing much longer than those detected by mammography, one could argue that Spear's figure is quite conservative.

While estimates such as these may leave some doubt as to how serious the breast cancer issue really is, the frightening reality of the actual figures for death from breast cancer leave no doubt whatsoever. According to American Cancer Society statistics, while the population grew 38 percent between 1960 and 1990, the number of deaths from breast cancer grew by more than 82 percent during that time period. In terms of absolute numbers of deaths caused by cancer, only lung cancer increased more than breast cancer.

Dr. Christiane Northrup in the June 1995 issue of her newsletter, Health Wisdom for Women, pointed out that, since use of mammography began in 1965, there has been "no substantial decrease in overall breast cancer mortality." This is a surprising statement when the widespread use of mammography has been justified on the basis of a better chance of survival with early detection.

The effectiveness of treatment is measured by a figure called the five-year survival rate. The assumption is that, if a larger proportion of women are living more than five years after treatment than was the case at an earlier point in time, then the treatments are successfully improving chances for survival. As Northrup observes, there are factors that may make the five-year survival rate less reliable than it appears. The statistics show an increase in the five-year survival rate over the past 10 years, but an increase in mortality over the past 20 years.

Cancers are being detected at earlier stages than was previously the case. Thus, 20 years ago a woman may have survived only a year after being diagnosed with a breast cancer that had been growing for 15 years. Today a woman may be diagnosed when her cancer has been growing for eight years. Her survival for six years past detection would improve the five-year survival statistic, when in truth she died one year sooner than her sister of 20 years ago.

It would appear that only one statistic is reliable and without mystery, a larger proportion of the female population in the United States is dying from breast cancer than at any other time since statistics have been kept.

Solving the Mystery of Why

"For some 70 percent of breast cancer," wrote Friedan, "causal factors remain unknown. A number of researchers feel that the link for all the known risk factors for breast cancer involves the metabolism of estrogen." There is a known increase in breast cancer among women using estrogen replacement therapy (ERT). Recently published research results have shown so many benefits for ERT that most health-care practitioners consider the breast cancer risk small in comparison to the benefits. These proponents of ERT point to the fact that many more women die of heart disease than of breast cancer, tipping the balance in favor of risking breast cancer in order to avoid the more lethal heart disease.

There is an interesting statistic, though, that makes the ERT choice not quite so clear-cut: A woman dying of heart disease loses, on an average, 8 years of life; a woman dying of breast cancer loses 19 years. Clearly this statistic needs to be converted to woman years lost in order to really understand the risk. Are we adding eight years of low-quality lifestyle for some women at the cost of subtracting 19 years of high-quality lifestyle for others? These are hard questions that need honest answers.

Current genetic research promises to identify the gene responsible for the breast cancer that runs in some families. The women's health resource, Ourselves, Growing Older (OGO), warns, "it may actually be harmful to think that our fate is in our genes and that there is nothing we can do to improve our health, because, though many factors are beyond our control, we can sometimes make beneficial changes in our lives." Proponents, of course, maintain that knowing of the risk in advance will encourage women to make positive changes at an early age.

Toxic Breast Syndrome

While it has long been accepted that lung cancer is largely an environmentally induced disease, there appears to be considerable resistance to classifying breast cancer in the same category. OGO declares, "Less than 25 percent of women with breast cancer fall into the currently defined high-risk categories. Therefore, there must be other ignored or unknown reasons for the increased number of women with breast cancer, especially in those areas with continued high incidence."

OGO points to the use of a class of industrial chemicals made from chlorine called organochlorines. These include DDT, PCBs, and dioxin, and thousands of other lesser known chemicals. These chemicals gather in the environment and accumulate in living organisms, passing up the food chains and into the bodies of wildlife and people, concentrating in the fat tissue of the body. One would presume that this includes the female breast, which is largely fatty tissue.

As a group, women with breast cancer have higher levels of organochlorines in their tissues than women without breast cancer. Additionally, since the phasing out of organochlorine pesticides in Israel, which began in 1978, breast cancer rates and mortality among young Israeli women have dropped. In 1962, the publication of Rachel Carson's Silent Spring led to the ban of DDT. The use of other organochlorines, however, has increased. And though the use of DDT has been banned in this country, U.S. chemical companies continue to produce it and ship it out of the country, where it is used on crops that find their way back across the border and onto our supermarket produce counters.

Geographic patterns suggest environmental factors are the culprit in some breast cancers. Breast cancer mortality in the New York metropolitan area has been shown to correlate with cumulative airborne releases from nuclear plants in the area. According to OGO, "This radiation appears to act synergistically with other carcinogens, such as ordinary air pollution, cigarette smoke, diesel fumes, asbestos, exogenous hormones, and organochlorines; that is, the effects of each are greater in the presence of the other."

Early Detection: Just Another BFD?

Despite the continued push for educating women in breast self-examination, a federal panel determined that breast self-examination has not proved effective enough to be classified as a method of breast cancer detection. The most touted method of early detection, mammogram screening, is also under fire.

To the extent that mammography contributes to a woman's lifetime exposure to X-rays, mammography may actually cause some breast cancers. Statistically, there is no benefit shown for younger women with mammogram screening. However, studies in the U.S. and Sweden showed a 30 percent lower breast-cancer death rate from regular mammogram screening in women over 50. Even such a dramatic statistic could benefit from scrutiny. What are the characteristics of women receiving regular screening? Are they more affluent (with access to supplements and a better diet) than women not submitting to screening? Do they generally take more care with their health? What makes these women different from women not availing themselves of screening?

There are yet other drawbacks to mammography; it cannot distinguish between benign and cancerous lumps. Skillful interpretation by an experienced physician is essential, and overtreatment is one byproduct of poorly interpreted mammogram results. OGO reports, "A mammogram can find lumps so small they are difficult to diagnose correctly under a microscope. Some of these lumps are cancers that may not spread, called in situ cancers. Women with such cancers may be misdiagnosed and treated as though they have rapidly spreading disease." In addition to the unnecessary trauma to the woman, overtreatment distorts statistics supporting the benefits of mammography. Women who never needed treatment in the first place are declared "cured," and the statistician marks up one more for mammography.

Northrup reported the development of a new method of early detection, one that could detect cancer earlier than mammography and with less risk. The new method, based on heat-detecting technologies developed for the military, is sensitive enough to detect, in the very early stages, the heat increases characteristic to tumor growth. The Food and Drug Administration (FDA) and the National Institutes of Health (NIH) showed no interest, "mostly because the mammography establishment is firmly entrenched and run by radiologists not open to new ideas," writes Northrup.

The Japanese are now funding the research, and the new technology should be available in about three years. Whether or not it will be available in this country is difficult to say. The FDA and NIH have increasingly become the Fu Lion guardians at the gates of profit for drug companies and the medical establishment, more carefully guarding the interests of these economically powerful giants than the health interests of the populations they were created to protect.

With very early detection, the five-year survival rate will improve dramatically, whether or not there is any actual improvement in mortality rates. Let's assume for the sake of argument that the average number of life years remaining from the beginning of cancer growth is 9 years. If all women submitted to mammography and therefore all cancers were detected at the tumors' eighth birthdays, every woman with detected breast cancer would have one year left following detection; the five-year survival rate would be 0%. Now let's suppose that the cancer's life remains at nine years, but the cancer is now detected on its first birthday. Every woman with detected breast cancer would now have eight years left following detection, and the five-year survival rate goes from 0% to 100%--a vast improvement in the statistic, but the woman who begins growing breast cancer at age 25 will still die when she's 40, whether her cancer is detected when she's 26 or when she's 39.

There is thus a significant question as to whether or not early detection is meaningful. There has been no research that convincingly illustrated that women submitting to invasive surgery, radiation, and chemotherapies actually survive longer than women who do not submit to these procedures. Given the importance of belief in the efficacy of a procedure, these methods should work just as well as any other if the woman believes in them. The bad track record would seem to indicate that most women who submit to such invasive procedures don't hold much hope for their own survival. People who believe in miracles are more likely to survive than people who don't.

Northrup cautions, "Diagnosing breast cancer earlier, even with a safe, accurate technique, won't help much in the long run without a significant change in how we think about and treat breast cancer. Earlier diagnosis alone will just lead to more women than ever recovering from ineffective surgery and chemotherapy."


For 100 years, mastectomy was the treatment of choice for breast cancer. During the period 1970-1985, more than 1.5 million women underwent mastectomy. Said OGO, "In the belief that time was essential, surgeons often performed the operation while the patient was under general anesthesia given for the biopsy. A woman awoke to find that she had cancer and had lost one or both breasts." Though some surgeons continue to perform radical mastectomy (removal of the breast, underlying muscle of the chest wall, and lymph nodes), OGO declares it is "never necessary."

Radiation treatment has shown some ability to prevent a cancerous lump from growing back again in the same breast, but, over time, it has shown no life-prolonging benefit. Chemotherapy and hormone therapy (using the drug tamoxifen) each have some success among certain categories of breast-cancer sufferers. All these treatments have severe side effects. Lumpectomy, the surgical procedure which removes only the cancerous tissue, has been found to be as effective as lumpectomy accompanied by chemotherapy (the use of drugs to prevent recurrence of the cancer) or mastectomy.

Dr. John R. Lee, writing in Natural Progesterone, cited a study in which "premenopausal women with low progesterone levels were found to have 5.4 times the risk of developing premenopausal breast cancer and a 10-fold increase in deaths from all malignant neoplasms compared to those with normal progesterone levels." Lee further noted that "both progesterone and estriol, the two major hormones throughout pregnancy, are protective against breast cancer. . . . Both hormones are available and are relatively inexpensive."

No information seems to be available on the use of progesterone and estriol as treatments for breast cancer. One reason may be that naturally occurring hormones are not patentable, and therefore would not be major profit generators for drug companies. Whereas natural progesterone may offer protection against breast cancer, as shown in the study cited by Lee, the artificial form, available from drug companies as a patented product, appears to increase risk of breast cancer.

Finding Research Funds

In Cancer Facts and Figures--1994, the American Cancer Society reported that their 1993 research budget was nearly $100 million. "A number of investigations concentrate on breast cancer," said the report, "specifically on how women can be motivated to make use of mammography screening, and how to adjust to surgery, if such intervention becomes necessary." According to their own figures, more than 8.5% of all cancer deaths in 1990 were from breast cancer. A proportionate share of research funds would be more than $11.5 million. The idea that $11.5 million may be spent on motivating women to use a detection method that is subject to question and an invasive treatment that may be vastly overused is almost as scandalous as the likely reality that nowhere near $11.5 million is being spent on research in breast cancer. Federal research funds have historically been just as unavailable. Dr. Stanley West in his 1994 Hysterectomy Hoax reported that only 13 percent of the NIH research budget was earmarked for women's health, and in a $9 billion research budget, the National Cancer Institute granted only $18 million for breast cancer research, barely 2 percent of its rightful share of $765 million, based on number of deaths.

The Politics of Breast Cancer

Dorian is not alone in his concern over the lack of progress in pinpointing causes and finding effective treatments for breast cancer. Indeed private fund-raising efforts for organizations less influenced by established power structures may be a very effective way of shortening the time span on finding meaningful answers. The impetus, however, has been in forming groups that are big enough and loud enough to be heard in Washington.

The National Breast Cancer Coalition successfully lobbied for $400 million in federal funds for breast-cancer research in 1992, double the amount available in 1991. Massachusetts Breast Cancer Coalition, founded in 1991, influenced the state of Massachusetts to pass regulations on the quality of mammography equipment and the training of physicians who interpret mammograms. 1 in 9 Long Island Breast Cancer Action Coalition in New York is actively speaking out and conducting its own surveys on environmental causes for the high rates of breast cancer there. Women's Community Cancer Project, established in 1989, has marshalled support for A Women's Cancer Agenda: The Demands to the National Cancer Institute and U.S. Government. These are only a few of the groups that are coming forward to demand a rightful share of research dollars.

Healing Begins at Home

Northrup cited studies suggesting that breast cancer is created daily in women's bodies and daily, in most women's bodies, the immune system destroys it. She suggests that, by studying women whose cancers grow and women whose cancers perish, factors may be identified so that women can be taught how to reverse a growing cancer and how to prevent its growth in the first place.

Though she employs standard treatments as the occasion demands, Northrup has seen, in her own medical practice, breast cancer arrested or reversed using nutrition, mind/body interventions, and other noninvasive therapies. "What if we could all learn how to reverse the early heat changes in our breasts that signal trouble, and learn how to create healthy breast tissue daily?" she asks.

In reminding us that early detection is not the same as prevention, Northrup wrote, "Whether or not you've ever had breast cancer, or any disease, for that matter, you have the power within you to create and maintain a healthy body. Your body is made up of dynamic, ever-changing organs that are affected not only by your immune system, but also by your thoughts, emotions, beliefs, and lifestyle habits. No machine, drug, or surgical procedure will ever be able to create a healthy body for you. . . . You don't have to be a sitting duck just waiting for disease to strike. When you begin to think that your ability to heal comes from within, not only from without, you're well on your way to creating health daily."

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