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February 1, 2010
IF YOU WANT CHANGE, SET AN EXAMPLE
We think we want change, and many of us do, as has been clear from the behavior of voters in recent elections. But, too often what we want to change is other people or other things, not ourselves. If only “it” or “they” would change... everything would be so much better. If only that were true.
Gandhi had some words of advice for those who want change, Be the change you want to see in the world. Hard advice that, but it turns out that it’s easier than trying to change others! (I refer you to President Obama, Speaker of the House, Nancy Pelosi, and Governor Schwarzenegger for the details.)
If you want change, set an example. I want to change the whole pattern of breast cancer awareness, from the treatment-oriented principle to the prevention-oriented principle. I advise women to make significant changes to their lifestyles so that they can reduce their risk for breast cancer. I advise organizations, government and non-profits, to educate and emphasize the benefit of lifestyle changes for the prevention of breast cancer. But what have I, as a breast cancer surgeon and President of the Breast Health & Healing Foundation, done to be the change I want to see in the world?
DIET: A plant-based diet appears to lower the risk for breast cancer. I have been following such a diet, the one outlined by Dr. Caldwell Esselstyn in his excellent book, Prevent And Reverse Heart Disease. I lost weight - getting down to my “age 21” body habitus – and my serum cholesterol fell fifty points within three weeks of starting this diet. And I feel better. Really. I have more energy on this diet and I know that my heart and blood vessels are healthier, too.
ALCOHOL: There is convergence of data showing that regular alcohol intake, even ½ glass of wine per day, increases a woman’s risk for breast cancer. Unfortunately, there is no “safe” level of regular alcohol consumption for women. Alas, this was a blow to my own preference for fine red Burgundies and old Bordeaux, and my occasional indulgence in a well-aged single malt Scotch, Glenmorangie to be specific. I now only drink rarely, only on special occasions, and only the best, as a kind of consolation prize for abstinence.
SYNTHETIC HORMONES: In 2005 the World Health Organization declared, for good and substantial reasons, that oral contraceptives and combined hormone replacement therapy were Group I Carcinogens – known to cause cancer in humans. Unfortunately, millions of women, including myself, used birth control pills long before the news of their carcinogenic effects was made clear by scientific studies. Fortunately, those years of needing, or wanting, sexual freedom unencumbered by the threat of pregnancy are behind me, but they are well in front of millions of women who have to make the hard choice among a dismal menu of alternative contraceptive devices. As for HRT: I would not consider using HRT drugs under any circumstances and urge my patients to avoid them altogether. The role of bioidentical hormones for the postmenopausal patient is still under investigation, and therefore I must wait for firm evidence that they are safe before I can recommend them.
CIGARETTES: Please, don’t even go there. Smoking increases the risk of breast cancer and will try its best to kill you in lots of other ways besides. If you smoke, see your doctor immediately, as if you were being poisoned, which you are. Don’t even allow yourself to be around anyone who smokes. They will contaminate you with their second-hand smoke and even particles that cling to their clothing. Just don’t do it. Ever. Needless to say, I don’t smoke, thank God.
EXERCISE: Regular exercise, such as walking briskly for 30 minutes four times per week, reduces the risk of breast cancer 30-40% on average. And for women who have breast cancer, such exercise can lower the risk of death by 50%. As for me, I work out with a personal trainer for one hour, four times per week. I walk for 45-90 minutes 3-4 times per week, depending on available time and weather conditions. I urge all of my patients, especially my breast cancer patients, to do the same – and most of them do!
If I, weak and flawed and often uninspired, can exercise and eat well and stay away from foods and beverages that are likely to harm me, then I am sure you can, too. And to help with the process of eating better, I have just finished writing, with the help of one of my wonderful patients, a short cookbook of quick recipes that feature those ingredients that seem to reduce the risk for breast cancer. The cookbook will be available online shortly, and the proceeds from the sale of the cookbook will go entirely to the foundation.
February’s Message, one of love, for self and others: first, set the example for change. Then lead the way.
I'm doing my best, and will continue to do so. And I hope that my example will inspire others to at least give it a try.
Regards,
Kathleen T. Ruddy, MD
Reference: Sprague B, Trentham-Dietz, A, Egan K, et al. Proportion of invasive breast cancer attributable to risk factors modifiable after menopause. American Journal of Epidemiology. 2008;168:404-411.
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