Breast health: a gynecologist's advice comes from her personal struggle with breast cancer - includes related article about herbs - Special Women's Health Issue

Vegetarian Times, July, 1997 by Barbara Joseph

I Had just finished breast-feeding. Oliver was eight weeks old. I knew my breasts were empty, yet a huge mass was still there and rock-hard. I could no longer pretend I was engorged with milk. I had to face the terrifying truth. As a gynecologist who had felt many similar masses, I recognized the likelihood that this was a malignancy.

At age 36, shortly after giving birth to my third child, I was diagnosed with an advanced form of breast cancer. Although most breast cancer cases occur in women over 50, one out of five occur in pre-menopausal women between the ages of 30 and 49. Many doctors believe that breast cancer in younger women is a more aggressive disease and so it was in my case. As a young woman, mother and physician, I began the journey to recover my health.

In my journey, I discovered many things about health that weren't taught in medical school: about taking care of myself, including how to eat; how to release stress; how to find joy in simple things and how to tune in to my intuitive wisdom as a woman. Many people helped me on this journey of recovery. Bernie Siegal, M.D., author of Love, Medicine and Miracles (Harper & Row, 1988), helped me to understand the role that emotions play in the development of and recovery from illness. Michio Kushi, who brought macrobiotic cuisine to this country, gave me practical guidance in nutrition. Christiane Northrup, M.D., whose Woman to Woman medical practice in Yarmouth, Maine, inspired me with her revolutionary concepts of women's health care. My surgeon, Susan Love, M.D., opened the door to my recovery by working with me in true partnership.

My hope is by sharing what I learned, I will help you unlock your true nature as an intuitive being and to practice what Susun Weed, author and herbalist, calls "Wise Woman Ways." When you do, you may discover as I have that health is more than the absence of disease, it is a celebration of life.

According to the Atlanta-based federal Centers for Disease Control (CDC), there were a total of 184,300 new cases of breast cancer and 44,300 deaths from it in 1996. The probability of a woman developing breast cancer is age and ethnicity dependent; the rates are one in 62 2 for white women aged 3 5 and as high as one in 20 for white women 60 and over. Rates for black and Native American women are lower. Breast cancer is at epidemic levels. Yet contrary to popular belief, 70 percent of breast cancer patients have no known family history of the disease and only 5 percent of women who develop breast cancer do so because they have the breast cancer gene, which has received so much attention in the press.

As if the shadow of dreaded breast cancer wasn't bad enough, it has, unfortunately, irrevocably changed the way we view ourselves as women. Many of us think of our breasts as danger zones and live in mortal fear that we will become part of the grim statistics. Yet our breasts are so much more -- they are emblematic of our identity as women and the primal source of nourishment for our children. Part of our sexual allure, they are a pleasure center of the body. When we start seeing them as medical battlegrounds instead of erogenous zones, it undermines the way we feel about ourselves as women. is there anything we can do to defuse this anxiety about our breasts? Yes, plenty.

TAKING BACK CONTROL

Few experiences are as distressing as finding a suspicious lump in your breast. Even if you feel it's likely to be benign, there's an edge of worry that creeps into your mind. Most benign and cancerous lumps are found by a woman herself while rolling over in bed, bathing or making love, not in a doctor's office or during breast self-examination (BSE).

My surgeon, Susan Love, M.D., the author of Dr. Susan Love's Breast Book (Addison-Wesley, 1995) and a breast cancer specialist from Los Angeles, believes that breast self-examination's value is greatly exaggerated. "I am not opposed to breast self-examination as a concept. I am opposed to its overuse. I think it alienates women from their breasts instead of making them more comfortable with them. It becomes you against your breast; can you find the tiniest lump that may be cancer?" says Love.

Judy Dean, M.D., a board-certified radiologist from Santa Barbara, Calif., has a different view. She has seen women, who were familiar with examining their breasts, pick up lesions that were too small to be detected by mammography and says, "The downplaying of breast self-examination (BSE) bothers me. Breast self-examination can be lifesaving."

Experts do agree that familiarity with one's body is an important part of selfcare. We need to view BSE as a health-promoting rather than a fear-based procedure. In searching our breasts for signs of cancer, we have an expectation that is at odds with our purpose, which is to nurture our bodies and delight in our feminine nature.

Do women really understand how to examine their breasts and are they comfortable doing so? Dean referred to Swedish studies (where women were more comfortable touching their bodies), in which the average size of a self-discovered tumor was two and a half centimeters. This contrasts with similar studies in the United Kingdom, where Victorian attitudes still hold sway and the average size is four and a half centimeters.