Healthy Eating for Women

What would you think if you looked out your window and saw a traveling “lung cancer detection” trailer? In no time at all, a healthcare worker could screen you for early signs of lung cancer, quite possibly saving your life. Not a terrible idea, you might conclude, but not exactly hitting the mark. After all, we already know that smoking is the single most important risk factor for developing lung cancer. And we know that arming the public with this information has saved countless lives. Wouldn’t our resources be better spent bolstering programs that keep people from smoking, and prevent the disease in the first place? Of course they would. And in the case of lung cancer, we are doing just that.

If the same resources had been poured into aggressive breast cancer prevention programs—not just early detection—we might actually be winning the “war on cancer,” which was declared back in 1972 but has yet to make a real difference in the lives of most women. Instead, we’ve taken a turn for the worse. In the first two decades after the “war” was declared, breast cancer rates climbed inexorably and have only recently begun a modest decline. Breast cancer now strikes one in eight women, up from one in fourteen women just thirty years ago. For lack of better life-saving strategies, many women are resolved to do nothing more than having yearly mammograms after age forty, waiting for the one that reveals cancer, hoping to destroy it before it destroys them. Not exactly a decisive “war tactic,” nor a blueprint for good health any mother could confidently pass along to her daughters. Programs that focus solely on early detection strategies ignore all we know about prevention.

When it comes to lung cancer, everyone has gotten—if not heeded—the message: Give up cigarettes. With other types of cancer, we’ve been much slower to shun equally harmful culprits— poor diet, inactivity, environmental factors, and certain medications—that are strongly linked to causing the disease. We cannot pinpoint the exact cause of breast cancer in individual cases, nor can we prevent it 100 percent of the time. But we do know of risk factors so strongly associated with its development that taking steps to eliminate them can almost certainly lower your risk. One way that the government evaluates progress in its war on cancer is by looking at “five-year survival” rates, that is, the number of patients who are living five years after being diagnosed with cancer. When these rates improve, the news hits the media, and we feel as though we are approaching a cure. The unfortunate truth is, we are just finding it sooner.

A recent study in the Journal of the American Medical Association pointed out that five-year survival is more likely today because patients are often diagnosed when the tumor is small. This is not to say that better treatment methods are not prolonging the lives of those with cancer and many other diseases. But treatments still have a long way to go and, most important, chemotherapy and cancer drugs are not stopping the disease from occurring. Researchers examined data on twenty types of cancer diagnosed between 1950 and 1995, looking at incidence, five-year survival, and mortality.

Although five-year survival rates increased for all twenty cancers, occurrence decreased for just five. The study authors argue that policymakers should focus on mortality rates, the truest indicator of whether we are defeating cancer or any other life-threatening illnesses. With a more accurate measure of progress, perhaps more effective cancer prevention initiatives would be developed. As it stands, five-year survival shows little relationship to overall mortality rates, which is what really counts.

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