Previving your disease risk
The women of 'Previvors' believe preemptive measures at a young age can liberate women with genetic risk for cancer.
Monday, December 20, 2010 - 23:03
BE PROACTIVE: Awareness of your hereditary risk can bring a life of empowerment rather than fear. (Photo: babka_babka/Flickr)
Healthcare anxiety is increasingly converting members of America's genetically doomed adults and 78 million aging baby boomers into advocates for preventative medicine. While controversy remains over how early and how radical preemptive measures should be, the women in a new book called "Previvors" believe it's never too soon or too drastic to turn cancer risk into empowerment.
"Previvors," written by Dina Roth Port, chronicles the life changing decisions of five women genetically predisposed to breast cancer and ovarian cancer. Lisa Marton, Mayde Wiener, Amy Rosenthal, Rori Clark and Suzanne Citere all had their breasts removed and reconstructed based on hereditary risk. Rori, who had both her breasts and ovaries removed, was determined to control her disease risk after the traumatic early loss of her mother to cancer. Lisa had been undergoing precautionary surgeries for suspicious lumps since she was a junior in high school, and by the time she was 29, she witnessed her mother die of cancer, as well. Mayde watched her mother go from thriving to withering.
Each of these women have similar stories of loss, and they also share subsequent empowerment by joining together in strategic prevention measures. The sacrifices and surgeries they chose were personal decisions that are not appropriate for everyone in every circumstance. Yet their call for awareness of hereditary risk and proactive measures should be taken to heart in an age of increasing predictive technologies.
Inside the book
These highly personal yet informative anecdotes give valuable advice on treatment strategies, emotional coping methods, and overcoming concerns over body image and sex, post-surgery. Port then gives detailed advice on when surgical and nonsurgical prevention methods are appropriate, as well as information on a diverse range of preemptive technologies and lifestyles.
As Port explains, experts believe five to ten percent of breast cancer cases may be hereditary, meaning a person inherited a mutated gene that increases risk of cancer. Most commonly such genes are identified as BRCA1 and BRCA2, but several other gene mutations exist. Scientists predict they will discover up to 100 other gene mutations in the next five years that link to breast cancer development. This would mean up to 50 percent of breast cancer cases would have a hereditary component.
Breast cancer treatment and prevention
Aside from reconstructive surgery options, Port outlines some popular drug choices intended to decrease risk. Chemoprevention, for example, is the use of drugs, vitamins or other agents to reduce the risk of, or development of, cancer. Some of these drugs do seem to reduce a woman's odds of breast cancer, but each has its own risks. Also, the drugs can reduce risk, but they can never fully eliminate it.
Estrogen receptor modulators (SERMs) are one such type of drugs. People have cell proteins in their bodies called estrogen receptors. Estrogen binds to those receptors and, in turn, may cause those cells to grow and multiply. SERMs bind to these receptors instead and seem to block estrogen from attaching to breast tissue. They also limit the effect the hormone has on certain organs. The FDA has approved two types of these drugs — tamoxifen and raloxifene — for women with high risk.
Basic lifestyle changes may reduce cancer risk, as well. Lisa, for example, stopped eating soy products when she heard they may stimulate estrogen production. Rori claimed she started taking more vitamins, exercising and meditating when she learned of her cancer risk.
America's expensive healthcare approach
Not only are the stories of "Previvors" encouraging, but they call into question America's overall curative healthcare approach. A reactionary healthcare system is thought by many to be risky and expensive. As the new year rolls in, the nation will be spending over $2.8 trillion on healthcare costs. It will rise to $4 trillion within ten years. According to Chris Fey, founder of U.S. Preventative Medicine, Inc., America is pouring this money into an outdated, symptom-based healthcare model, which precariously rests on late-stage disease detection. Dissidents of reactionary healthcare criticize medical providers for emphasizing expensive drugs and treatments before suggesting changes in lifestyle.
Hereditary risk is becoming increasingly explicit in certain families thanks to new technologies. People genetically predisposed toward diseases like cancer, heart disease and diabetes have many lifestyle changes to choose from, such as preemptive procedures, genetic testing, strategic diets, exercise regimens and other available tactics. So what keeps reactionary healthcare alive and well while drastic prevention measures, such as the surgeries in "Previvors," are considered rare?
Perhaps American culture considers such preemptive treatment to be just that: drastic. A culture built on reactionary and palliative care is not easily overturned — especially when that culture is fueled by dominant drug companies. What's more, a young, healthy person cannot easily enter the mindset that he needs major surgery. Patients are used to treating themselves when they are sick. Choosing key health foods and exercises are undoubtedly trendy, but intense sacrifices related to disease risk are not so common.
Yet as difficult as it is to admit, certain patients with predictive genes simply cannot wait to be preemptive at retirement age. As the women of "Previvors" show, this generation of young adults has the tools needed to turn risk into empowerment. Awareness at a young age of disease risk associated with genetics, as well as lifestyle, socioeconomic status, or even occupation, does not dictate a life of fear; women at risk can become proactive previvors and ultimately choose a life of liberation.
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