breast cancer

On Pink Washing: Dear Food Makers, Please Shut Up.

Pink washing health claims on food packaging are obnoxious. They are confusing, misleading, and (often) inaccurate. As a science journalist, I know that 99.9 percent of these health claims are hogwash, and I find it morally offensive that food marketers prey on people’s fear of disease to sell products. I actively avoid buying products with health claims or pink washing. So, imagine my surprise when I opened a new container of miso and found a giant health claim lurking beneath the lid. Sneak attack!

MisoSoup

Nothing kills my appetite more than a pink-ribbonly reminder of my mortality. Thanks Mr. Miso!

I will give them a tiny prop for including a study citation, even though its presence could be construed as manipulative because it adds superficial credence to the claim. So, I walked my anger right over to PubMed and looked up the study. A tiny part of me (the sucker part) hoped the health claim was true. But a much bigger part of me (the pompous part) wanted to feel “right” and, therefore, justified in my anger. Guess which part won?

Here’s the miso dish: In 1990, 21,000 Japanese women filled out diet questionnaires that included a question about miso soup. (BTW: Diet questionnaires are notoriously inaccurate because, really, who can remember what they ate for breakfast? Much less for breakfast six weeks ago?) Researchers followed the women for nine years and charted how many got breast cancer. In the end, fewer cases of BC popped up in those women who (reportedly) ate 3+ bowls of miso soup a day.

A few caveats: the study’s small sample size means its accuracy is suspect; miso’s magic only applied to postmenopausal women (bummer for me); I live in the West, not Japan, so my confounding factors are enormous; and, finally, who eats 3 bowls of miso soup a day for years on end? Not me.

When it comes to health claims, even those with citations, don’t be a sucker. Health claims on food packages are nothing but savvy marketing with a scientific sheen. I can only hope that, if we all vote with our dollars, food makers will get the message that we don’t want our fears manipulated at the grocery store.

Radiation=No bueno for breasts

Worried about getting breast cancer from your shower curtain? Don’t be. Instead, worry about getting it from your doctor’s willy-nilly use of radiation.

This month’s Archives of Internal Medicine includes a special report penned by the smart folks at the Institute of Medicine (IOM) and paid for by the deep, politically dubious pockets of Susan G. Komen for the Cure. In a nutshell, the experts said, stop sweating bullets over the noxious chemicals in everyday stuff (ie: bisphenol A in plastics and phthalates in perfumes). Instead, start sweating doctors writing scripts for radiation-based diagnostic tests like it’s a goddamn ticker-tape parade and cancer is the grand marshall.

The IMO starts by stating the obvious. Radiation causes cancer. Um…yeah. Tell it to Madame Curie. And then comes the forehead-smacking stuff. The IMO estimates that “2,800 future breast cancers would result from 1 year of medical radiation exposure among the entire US female population, with two-thirds of those cases resulting from CT (computed tomographic) radiation exposures.” Ironically, many doctors order CT scans to look for cancer. So, in layman’s terms, our fear of having cancer is giving us cancer.

This damned-if-you-do-damned-if-you-don’t news is magnified by the fact that CT use has skyrocketed nearly 5-fold in the past 20 years. In 2012, an estimated 75 million people (half of them women) will have a CT scan.

What doctors don’t tell you (because some of them don’t know) is that in the terms of radiation exposure 1 CT scan equals 500 X-rays. Yes, you read that right. 1 CT scan = 500 X-rays. The real kicker? Up to 30% of those CT scans are unnecessary.

Per my earlier posts, I suspect that radiation exposure in my early teens contributed to the breast cancer diagnosis I received in my late 30s. Of course, no one knows. But this new report adds to a growing pile of evidence that overuse of radiation has serious consequences. (And don’t get me started on CT scans and kids.)

Recap: respect radiation as a diagnostic tool. A CT scan may very well save your life if you have internal injuries from a car accident or a burst appendix. But, if you’re not in immediate danger, ask your doctor about other options. He/she might have to rely on more old-fashioned diagnostic tools, such as skill, knowledge, and intuition, instead of just irradiating you.

Truth, Certainty, and Dickinson

Since my breast cancer diagnosis, I wrestle with a lot of things. Two biggies are truth and certainty. My cancer diagnosis (x2) and the medical mishaps that followed violently severed every strand of trust that tethered me to my body and to the medical profession (both conventional and otherwise).

I am only beginning to acknowledge the depth and meaning of that loss. To feel deeply unmoored; to physically recoil from scientific evidence presented as “truth” or “fact” is made more difficult by the fact that I am a medical journalist.

Specifically, for the past 15 years I’ve reported on women’s health. I’ve written hundreds of articles on topics such as how to protect yourself from cancer; how to live strong after cancerhow bright light might cause breast cancer, and (my personal favorite) top cancer-fighting supplements.

So here’s my question: How can I continue to write about health in a way that meets my needs and my editors’ needs? How can I embody the voice of authority my editors demand? Expect? How can I continue to participate in and profit from the propagation of a “journalistic certainty” that is deeply disturbing to me?

If anyone has any answers, please let me know.

Until then, I will share an Emily Dickinson poem; if, for no other reason, than to know where I put it. I know nothing about poetry, but last month, when I stepped through the doorway of Dickinson’s home, a perky volunteer handed me the poem below. The poem was in easy-read type on a pale green sheet of paper.  The leaflet has floated around my desk every since, daring me to lose it, taunting me with the suggestion that it might contain the answer to my questions. Maybe it does.

Tell all the truth but tell it slant –

Success in Circuit lies

Too bright for our infirm Delight

The Truth’s superb surprise

As Lightning to the Children eased

With explanation kind

The Truth must dazzle gradually

Or every man be blind –

Emily Dickinson, 1872

Out of Luck

This time last year I felt pretty darn lucky. I’d tiptoed through my breast cancer treatment without awakening its two snarling monsters: chemotherapy and radiation. Now I find myself facing both head on. This coming Monday I’ll have surgery to install a port. Most likely, the following week, the first of 4 rounds of chemo. The decision to move forward with chemotherapy wasn’t easy. The genetic test was decisively vague. After much deliberation, the pros seemed to outweigh the cons (barely). Then again, as my oncologist freely admits, no one knows if chemo will help or not. Basically, it’s a crapshoot. The stakes couldn’t be higher. Maybe I’ll get lucky.

Hurry Up and Wait

Well, last Friday’s appointments with the surgeon and oncologist were anticlimactic (as usual). Basically, radiation and menopause-inducing hormone therapy are definitely in my near future. (Yanking out my ovaries is also an option. Yeah, thanks.) But the “other big C” (aka chemo) is still a tease. Not all breast cancers are sensitive to chemo. My oncologist says he’d be happy to send me to chemo, but it may not work. (Um…yeah, no.) The other option is to order a genetic profile of the new tumor and use that info to make a more evidence-based decision. (Hm…me thinks this sounds familiar.) My first tumor was not cut out for chemo, so we’ll see if this one’s personality is similar. And, since chemo must comes first in the breast cancer treatment buffet, all else must wait. In the meantime, I’m trying to live life as as if a giant meteor isn’t angling straight for me. Easier said than done I’m afraid.