Friday, 4 February 2011

Breast cancer is a disease not a punishment

There has been blanket coverage of the publication of new statistics on breast cancer in the UK. There are statistics, interpretation of statistics and news stories and sometimes the latter wins out over the former.

I am always nervous of certainty without evidence. They were certain that the earth was flat, that smoking was harmless and that a radical mastectomy was the only way to treat breast cancer. None of those is true and we have the evidence to prove it.

The facts in this case are that there are more cases of breast cancer being diagnosed now than before – around 48,000; age is still the biggest risk factor for breast cancer – 81 per cent of women diagnosed were 50 and older and more women are surviving longer after treatment.

Increase in the numbers diagnosed is part of a trend and we have some ideas why this might be happening: there has been a partial extension of the screening programme from 50 to 47 and from 70 to 73; the number of women going for screening is going up and we are living longer.

Apart from a genetic predisposition to breast cancer which is between 5 – 10 per cent of all cases there is no identified cause. I use the word cause advisedly because a risk factor is not a cause. There are various risk factors which probably contribute to this and these have been well aired in the media – women are having fewer children and having them later and not all are breastfeeding; increasing levels of obesity and less physical activity and links with regular consumption of alcohol be it binge drinking or a couple of glasses of wine every night.

These are risk factors and while turning into some sort of breeding machine and breast-feeding until pregnant again is not an option - reducing alcohol consumption, increasing exercise and controlling your weight are lifestyle changes you can make (and your overall health will be much better!). None of these in themselves will cause breast cancer but neither are you “protected” if you are teetotal, run marathons and are as slim as a reed.

There are many reasons why survival is improving – screening leading to earlier diagnosis and better treatments (thanks to research done in the past – so keep supporting research!).

I am all in favour of taking responsibility for one’s own actions, one’s own health and one’s own life. But in the end this is a disease not a punishment and we need to understand better why breast cancer happens in the first place (and therefore whether we could prevent it), why it spreads to other parts of the body and why some people respond well to treatment and others don’t. Of course I would say this but research has led to longer survival and less damaging treatments but the need is no less pressing.

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