Preventing Breast Cancer

Today is World Cancer Day. Thanks to the Union for International Cancer Control for organizing it and to all of the wonderful men and women out there who support this day. Per the World Cancer Day statistics, 17 people die every minute from cancer around the world.[1] The theme this year is “I can, we can,” which “acknowledges that everyone has the capacity to address the cancer burden.” So, let’s empower you with knowledge to address cancer.

Let me start with a couple of personal stories.

My grandmother died of cancer in her 50s. She never smoked. She never drank. She grew up living naturally on a farm, away from the city. She seemed to be the picture of health, but got it and it killed her slowly.

She was diagnosed with breast cancer. She had seen her doctor before and the traditional medical system failed to diagnose the problem. Had she seen a different doctor then or been alive today with advances in medical care, she may have lived. Then again, she may have still died. It may have still be missed.

I only have a few pictures of my grandmother holding me in her arms. I was far too young less than 2 years to even remember. She lived for years after the initial diagnosis, some years were ok and others not. The tragedy of her death lives on in the family now 4 decades later. Why? How did this happen? Will this happen to us?

My sister-in-law’s mother died of breast cancer…in her 40s. She was young and vibrant. She had young children, my sister-in-law who was left behind. The tragedy of her death impacts not just the immediate relatives, but will impact her grandson and her granddaughter’s lives, whom she will never have the chance to meet.

Mom and daughter hugging

Cancer is enemy #1 for many of us. We FIGHT cancer. We stage DEFENSE against cancer. We STAND with those that are fighting cancer. Every single one of us has lost someone we know to cancer. The toll is huge. The impact nearly immeasurable.

When I make a new diagnosis of cancer, people often ask, where’s the best place to go? What are my chances? In the initial moments, these questions can’t be answered. There will come a time to answer all of them, but the initial moments are usually completely helpless. We don’t know for sure that it is or isn’t. We don’t know what kind of cancer. We don’t know when, where and how to treat. What we do know is that in 2018, an estimated 1,735,350 million new cases of cancer will be diagnosed in the U.S. and 609,640 will die from the disease.[2] In 2012, there were 14.1 million new cases worldwide and 8.2 million cancer-related deaths worldwide.2

In 2016, there were an estimated 15.5 million cancer survivors in the United States.2 There were 323.4 million people in the U.S. In 2016, per U.S. Census Bureau. That means 4.7% of the population is LIVING with the potential that cancer might return. The number of cancer survivors is expected to increase to 20.3 million by 2026.2 One startlingly statistic is that 38.4% of men and women will be diagnosed with cancer of any site at some point in their lifetime.[3] Over 1 in 3 of us will experience the disease ourselves and 1 in 3 of all those we love as well.

If life itself and the threat of life wasn’t enough, the national expenditures for cancer care in the United States in 2017 were $147.3 billion. To put this in perspective, the budget for US Department of Education in 2017 was $69.4 billion.[4] The annual expense for cancer is 2 times what we spend as a country every year on our children’s education. This expense is passed on to all of us to bear and will continue to grow, as cancer diagnosis are increasing.

Treatments for cancer are improving. Early detection is of the utmost importance. The 5-year survivability for all cancers is now at 66.9% from the years 2018-2014. In 1992, survivability was 58%, so 66.9% survival is better. We are getting better at early detection, and treatment of the disease, but if you are the greater than 1 in 3 people who get the disease, you still have a 33% of dying. Let’s compare this to other ailments we have heard or read a lot about.

In 2014, there were 591,699 deaths from cancer or 186 per 100,000 people. In the same year, there were 6,721 deaths from HIV or 2 per 100,000 people and 10,945 deaths from firearms assault or 3 per 100,000 people. The purpose is comparing these items is not to lessen the impact of HIV and firearms, both of which are important causes of death.  My point is only that we talk about safe sex, firearm protection and personal safety items related to HIV and guns, but are we talking about how to prevent cancer?

Let’s get more specific. Given my family history, let’s talk about breast cancer. In 2018, there were 266,120 NEW cases of breast cancer.[3] In the same year, there were 40,920 deaths. [3]

The 5-year survival rate was 89.7% from 2008-2014.3 In comparison, the 5-year survival rate in 1992 was 75.7%, so we have had a 12% increase in survivability in 23 years. This is a testament to early detection, population health, radiation, chemotherapy, researchers, physicians, and community awareness campaigns.

Are we winning the battle? Maybe, we are showing success but here’s one big problem, it’s just as common as it was in 1992. In 1992, there were 130 new cases per 100,000 people. In 2015, there were 127.5 new cases per 100,000 people. Overall, looking at a graph, the new cases over that period are on a flat line, meaning we are diagnosing as many as we were then, so what’s the problem? Is it all just genetic?

There is a genetic component to most cancers, including breast cancer. You can’t change your genes, at least yet, so discussing family history is of little value in making a change and often leads only to worry and even despair. What you can change is your lifestyle.

The National Breast Cancer Foundation looked at Avoidable Risk Factors for breast cancer. TO make things clear, as risk factor does NOT absolutely lead to the disease, but it increases the likelihood of developing the disease. Here’s what they found, the following environmental and lifestyle risk factors[5]:

  • Lack of physical activity. A sedentary lifestyle with little physical activity can increase your risk for breast cancer.
  • Poor diet. A diet high in saturated fat and lacking fruits and vegetables can increase your risk for breast cancer.
  • Being overweight or obese. Risk is increased post-menopause.
  • Drinking Alcohol. Frequent Consumption of alcohol can increase your risk for breast cancer. The more alcohol you consume, the greater the risk.
  • Radiation to the chest. Having radiation therapy before 30 can increase risk.
  • Combined HRT or hormone replacement therapy, prescribed after menopause can increase the risk.

The article went on to say, however that 60-70% of people with breast cancer have no connection to these risk factors at all OR 60-70% of women have no risks for breast cancer.

The article also pointed out the breast cancer is not contagious, not caused by wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic in food serving items, microwaves, or cell phones and referred to all of this as MYTHS. [5]

Now you know what I knew, but this isn’t a complete picture and essentially tells us that for most women that get cancer, there’s nothing that she can or could have done.

The first question I have is, is that true? One important study looking at 8 recommendations from the World Cancer Research Fund and the American Institute for Cancer Research, found that breast cancer risk was reduced by 60% in women who met at least 5 recommendations compared with those who met none.[6] Further research found that the reduction is due to meeting recommendations related to body fatness, plant foods, and alcohol. Here are the specific recommendations within the general categories of body fatness, physical activity, energy density, plant-foods, red meat, alcohol, salt-preserved foods, and supplements:

  1. Body Fatness
    1. Be as lean as possible within normal BMI. This includes childhood through adulthood. Fluctuations in BMI are problematic, so maintaining steady weight is important. BMI between 18.5 kg/m2 and 25 kg/m2.
  2. Physical Activity
    1. Be moderately physically active.  >/= 30 minutes per day of moderate or fast walking and/or moderate or strenuous activity on at least 5 days per week in at least 7 of last 10 years. 60 minutes or more of moderate physical activity daily. Limit sedentary activities such as watching TV.
  3. Energy Dense Foods
    1. Consume energy-dense foods sparingly. < 1 sugary drink per week. No fast foods.
  4. Plant Foods
    1. Eat at least 5 servings (at least 400 g or 14 oz) of a variety of non-starchy vegetables and fruits every day.
    1. 1 serving of whole grains and/or legumes per day.
    1. Eat relatively unprocessed cereal (grains) and or pulses (legumes) with every meal.
    1. Can eat starchy roots or tubers, but most ensure intake of sufficient non-starchy vegetables.
  5. Meat
    1. Limit intake of red meat and processed meat.
  6. Alcohol
    1. Limit Alcoholic Drinks to less than 1 per day for woman and less than 2 per day for man.
  7. Salt-Preserved Foods
    1. Limit salt preserved foods.
    1. Limit consumption of processed foods with no more than 6 grams daily
    1. Do not eat moldy cereals, grains or legumes
  8. Supplements
    1. Aim to meet nutritional demands through diet. Supplements are NOT recommended for cancer prevention.

In this study, less than 40% of participants in the group of people who were supposed to do the above actually did all of the above.[6] This is significant, because when organizations claim that lifestyle has little impact on risk factors and development of cancer, part of the problem is that most people can’t maintain the RIGHT lifestyle. Moderation or mostly consuming a healthy lifestyle don’t cut it. It must be ALL the time.

Here’s where it’s exciting though. If you can meet 5 of the above, you will have a 60% risk reduction in breast cancer. It seems, based on the research that the 3 most important were body fatness, plant-foods, and alcohol. I want to be clear and not misleading, there is still a 40% chance, if you do 5 of the above, that you will go on to get breast cancer.

BUT, if you are a woman concerned about breast cancer, the above information should be empowering. Would it have helped my family members? Maybe…maybe not. We will never know, but one thing is for sure, we all would have given ANYTHING for them to have known this information and have had the opportunity to try it.

So…now you know. Will you give it a try? Will you tell someone you love to try the above? There are other things that may help, such as stress reduction techniques, working on spiritual connections with loved ones, avoiding air pollution, smoking cessation or avoidance of second-hand smoke and avoiding certain hormonal toxins. Getting smart with quality information is important. Make no mistake, you have more control than science can quantify YET.

You are now empowered to make your own choices. Will you be like the 40% of people in this study who followed the recommendations or the 60% who did not? Will you acknowledge your role in preventing cancer for you and your loved ones through knowledge? Through actions?

I believe in everyone’s potential to change. We all need to support each other.

For everyone out there going through cancer today in one way or another, you are not alone. Share your experience. It might just save someone else’s life.

That’s all for today, this is Doctor Jeremy signing off. If you haven’t already, follow us on Instagram @DoctorofLiving, on Twitter, Facebook. Thanks for joining me, let’s learn and grow.


[1] “Cancer.” https://www.who.int/cancer/world-cancer-day/en/. Accessed February 3rd, 2019.

[2] “Statistics at a Glance: The Burden of Cancer in the United States.” https://www.cancer.gov/about-cancer/understanding/statistics. Accessed February 3rd, 2019.

[3] :Cancer Stat Facts: Cancer of Any Site. https://seer.cancer.gov/statfacts/html/all.html. Accessed February 3rd, 2019.

[4] “FY 2017 Education Budget Fact Sheet – ED.gov.” https://www2.ed.gov/about/overview/budget/budget17/budget-factsheet.pdf. Accessed February 3rd, 2019.

[5] “Risk Factors.” National Breast Cancer Foundation, Inc. https://www.nationalbreastcancer.org/breast-cancer-risk-factors

[6] “Adherence to WCFR/AICR cancer prevention recommendations and risk of post-menopausal breast cancer.” Hastert, et al. Cancer Epidemiol Biomarkers Prev. Prev. 2013 Sep; 22 (9): 1498-1508. Published online 2013 Jun 18. doi: 10.1158/1055-9965.EPI-13-0210

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