[Photo: rue McGill College, Montréal]
October is Breast Cancer Awareness Month here in North America, and this year the pink ribbon is a little tattered.
First, the Susan G. Komen Foundation controversy in the United States brought the issues of breast cancer and charity operations to the forefront. Soon after other contentious charitable breast cancer initiatives came to light, including the recent revelations that the NFL’s pink ribbon efforts only net 5% of proceeds to charity. I have closely followed these particular news items with interest, partially in terms of the debate on the politics of these embroilments, but also in terms of the topics as women’s health issues. I know the public debates on the controversies have been quite lively in the Internet sphere, and many young women joined in the discussion on women’s sites like Jezebel. However, I wondered how these efforts of breast cancer education affect these young women’s knowledge of the disease despite their Internet outrage and opining in the pink ribbon controversies.
Breast cancer affects 1 in 9 Canadian women in their lifetime, meaning that many of us have known someone with breast cancer or have otherwise been personally affected by the disease. Since my family member’s first diagnosis when I was a child, I became interested in learning more about breast cancer and decreasing my risks in developing the disease. However, it seems that many young women are not aware about the risks and symptoms of breast cancer despite the massive efforts at education and involvement. I feel that this is akin to the behaviours of many young people regarding their risks of sexually transmitted infections (STI) — despite massive efforts at public education, many are kind of aware, many are kind of taking steps to prevents transmission, and many are kind of getting tested. STI’s are a much more of an immediate threat for most young people than breast cancer, but breast cancer is a specific risk to women with a very high risk of occurrence during their lifetime. Therefore, I wanted to write this post as, from talking to my friends, it is clear that many young women are not well informed about breast cancer and how certain lifestyle factors can impact the risks in developing the disease.
One reason why I infer that young women are not educated about breast cancer is because cancer and, in general, serious illnesses, mainly afflict the older rather than the younger population. Consequently, the young falsely feel that they are immune to such health concerns. However, research has indicated that the risk of breast cancer increases with the presence of several environmental factors and that some of these antecedents are controllable. This means that it is especially pertinent for younger women to be mindful of how certain lifestyle decisions that are currently being practised can increase one’s risk of a serious disease as breast cancer. Some of these risk factors are related to the modern Western lifestyle including:
- Body weight with a body mass index (BMI) over 25;
- Postponing pregnancy until after the age of 30 or not having one full-term pregnancy until after the age of 30;
- Absence of breastfeeding;
- Drinking alcohol;
- Receiving Hormone Replacement Therapy;
- Exposure to chemicals in lawns and gardens, cosmetics, plastics, and sunscreen;
- Exposure to chemical in foods from grilled meats;
- High levels of light during evening periods; and
- Low levels of Vitamin D (which is influenced by exposure to sunlight).
Sunlight and light exposure are correlated with the risk of breast cancer in at least two ways. Several studies have pointed to the increased risk in women who work night shifts and thus are exposed to light during normal periods of sleep. This is troubling for many individuals who prefer the schedules of a night owl, or whom simply do not have the choice but to work during the evenings.
Another factor that has been picked up by news agencies in the recent years is that low levels of Vitamin D have been found to increase the risk of certain illnesses. One way the body produces Vitamin D is through sunlight exposure, and many of us inhabiting this northern country of Canada do not receive enough sunlight. It is recommended that 15 minute exposures to direct sunlight, three times a week, fulfills the recommended intake of Vitamin D for most individuals, though the ability to produce Vitamin D differs depending on one’s skin colour, one’s geography, and the number of daylight hours at the individual’s current location. The takeaway from these points is that careful and mindful exposure to light recommended, while understanding that consistent skin damage from too much tanning can also increase your risk of another cancer, the skin cancer kind.
While some individuals will apply sunscreen in hopes of decreasing their risk of developing skin cancer, the type of sunscreen used may in turn increase your risk of breast cancer. Research suggests that exposure to certain chemicals found in every day items such as personal care products and packaged food, including the chemicals found in sunscreen, can contribute to breast cancer development. These chemicals, including oxybenzone, avobenzone, and octisalate, are common sunscreen ingredients. Thankfully, chemical-free sunscreens do exist which are correctly labelled as sunblocks (not sunscreens) as they act as physical barriers in protecting the skin from UV rays, rather than being absorbed by the skin. A bonus is that these non-chemical sunblocks contain zinc oxide and/or titanium dioxide, which are broad-spectrum meaning they protect the skin from both UVA (aging) and UVB (burning) rays. The Environmental Working Group (EWG) has an excellent website about the facts and myths of sunscreen, and includes a list of recommended non-chemical sunblocks.
Other chemicals that increase the risk of breast cancer include bisphenol A (BPA), found in many plastic food products. BPA has also been a new item of interest as the chemical is ubiquitous in every day items such as can linings and water bottles. The most effective way of avoiding BPA is to limit the consumption of water bottles and canned goods, including canned baby formulas and plastic baby bottles. This may mean you will need to roll up your sleeves and boil your own dried beans and cook your own soup. However, more and more companies are coming out with non-BPA products though some of these alternatives tend to be a pricier option.
All this information may seem overwhelming and just a plain drag, and it is easy to dismiss that “everything causes cancer” so to discount the value of proactivity and education. However, there are small lifestyle changes that can be made that can help decrease a woman’s risk of breast cancer that can be incorporated into one’s every day routine. Some of the changes that I have made to my daily habits are listed below:
- Chemicals in Sunscreen: Practising safe sun is not only to prevent skin damage but panic-induced application of anti-wrinkle creams later in your life. However, to truly practise safe sun, the sunblock product should be carefully chosen for those containing zinc oxide or titanium oxide. Two of my favourite sunblocks are Clinique City Block Sheer Oil-Free Daily Face Protector SPF 25 ($25.00 CDN) and Maybelline New York Dream Fresh BB Cream SPF 30 ($9.99 CDN approximate retail value). [Note: The Clinique sunblock in the SPF 40 version contain the chemical ingredients Octinoxate and Octisalate.] The Clinique City Block has a skin-coloured tint because it is a physical barrier on the skin; these physical blocks do leave a visible trace when applied. However, the Clinique sunblock’s texture is not tacky like some sunblocks and becomes invisible on the skin. For my face, I like the Maybelline BB cream, which is pretty similar to that of tinted moisturizers by evening out my skin tone with a sheer dollop of colour (it comes in 5 shades). I use the BB cream as a light base instead of foundation, and the Clinique sunblock on my neck and hands. Both products have the minimum SPF levels recommended by dermatologists, are paraben-free, decently priced, and can be easily purchased at drugstores nation wide.
- Chemicals in Personal Care Products: Two groups of chemicals found in personal care products have received the most attention from researchers for their hormone disrupting properties: parabens and phthalates. Parabens are commonly found in cosmetics and hair care products, and phthalates (including DBP) are common in nail polish products. However, it should be noted that recent research has found that the penetration of product chemicals is especially critical in the scalp where hair fibres can augment the absorption of toxins. This is why I have switched to using paraben-free products such as shampoos and facial moisturizers from Yes To Carrots, which are decently priced, widely available at Pharmaprix/Shopper’s Drug Mart outlets in Canada, and are also free of phthalates and other harmful chemicals. These products also smell incredibly delicious, and do the job in the skin and hair departments. To be safe while maintaining colourful tips, choose DBP-free nail polish companies such as OPI and Essie, and other brands listed in the EWG’s Skin Deep website.
- Chemicals in Plastics: BPA is another hormone disruptor as it is a weak synthetic estrogen affecting the body’s hormones. It is found in rigid plastics including water bottles and the lining of canned food products. In the past few years, many products labelled BPA-free have emerged due to these health concerns, and companies such as SIGG produce BPA-free reusable water bottles with fun designs. Some companies that produce canned food products also followed suit, with Amy’s canned products guaranteed to be free of BPA. While Amy’s products are generally more expensive than other canned goods, they are a widely-available alternative found in many grocery stores in case the need arises. However, if plastic food products must be used, look out for the recycling symbol at the bottom of these products. Those with the number 7 often contain BPA, while those with the numbers 2, 4, and 5 are generally considered safe. More information about the safe use of plastics can be found in the Breastcancer.org website.
- Lifetime Exposure to Certain Hormones: Research indicates that the higher a women’s lifetime exposure to the hormones estrogen and progesterone, the higher her risk to developing breast cancer. Exposure to these hormones are affected by both non-controllable factors and controllable factors. Non-controllable factors include being a woman and early onset of menstruation. Controllable, environmental factors include receiving Hormone Replacement Therapy, which was once popular amongst post-menopausal women to ease hot flashes and other symptoms, and exposure to hormone disruptors such as parabens (see above). These chemical hormone disruptors interact with the hormones in the sensitive breast tissue area, increasing risk of cancer in the breasts. Another possible risk elevating factor is the use of birth control pills, according to Dr. Marisa Weiss, a breast oncologist and founder of Breastcancer.org. It was after reading an interview with Dr. Weiss in an article in Elle Magazine last year that I decided to switch from the Pill to the copper and hormone-free intrauterine device (IUD). [Note: Not all IUD's are hormone-free.] Switching to the IUD was a very economical choice as, depending on the type of IUD, the device does not need to be replaced for about five years from date of insertion and the only cost (in Canada) is for the purchase of the device. My provincial health coverage paid for the fitting appointment with my doctor, but not the actual IUD which set me back about $90 CDN, meaning the investment costs $18 per year for 5 years. However, the IUD must be fitted by a trained physician, the fitting procedure can be uncomfortable or painful, and once fitted the IUD often results in symptoms of varying type and intensity, though for most women subsides within the year. I experienced new menstrual symptoms that I had never experienced prior to the IUD including intense cramping and heavy flow, which in the months after insertion subsided to become minor annoyances. In addition, the IUD has a higher effectiveness rate than the Pill, I do not need daily reminders to take my dosage, and I no longer run into instances of forgetting to renew my prescription. Therefore, switching to the IUD made sense to me in many fronts with the added benefit of easing my health care expenditures.
- Grilled Meat Consumption: The consumption of meat cooked at high temperatures, particularly so that they are blackened from grilling, may increase the risk of breast cancer. This is because certain chemicals are formed from the change in the meat from raw to well done, and also due to the chemicals released from coal smoke. While consuming less meat in general and increasing intake of fresh produce is recommended for general health, some people may find it preposterous to ban the traditional
summeryear-round barbecue. Hence, when I cook meat at home I marinade the meat in herb mixtures before grilling (this reduces the formation of the harmful chemicals) and cut off the blackened parts of the meat before serving. Here is a winning chimichurri marinated steak sandwich recipe to absolve for the bad news.
To find out more about breast health and cancer risk reduction, go to the websites for the Canadian Breast Cancer Foundation and Breastcancer.org. Also, talk to your doctor to discuss any concerns or questions you may have about breast cancer, and to inquire about the commencement of breast cancer screening such a self-exams and mammograms. I hope that from reading this blog post you are not just more well informed about the disease but have thoughts on reducing your risk through small (and large) lifestyle changes. Have a happy, healthy, and proactive October.
Note: This blog post does not substitute medical advice. Go see your doctor!