We’ve come a long way in the breast cancer fight

By Shirley Ruedy

November is always a bittersweet month for me, but this November is more sweet than bitter.

For I have beaten the odds, and proven the statistics. Yesterday, I celebrated a momentous milestone: 30 and 15 years of survivorship following two breast cancer diagnoses. Indeed, both arrived on Nov. 14, precisely 15 years apart.

I was stunned on both occasions in 1979 and 1994: The first, because I was just 43, and the second, because of the mind-numbing coincidence of the date. As I said in “Cancer Update,” the column I once wrote for The Gazette, “The gods of irony must have been rolling in the aisles.”

When I say I have beaten the odds and proven the statistics, I mean that most women who get breast cancer don't get it twice. I did. Most women who get it don't get the estrogen-negative form, where the cancer depends on estrogen for its nourishment. I did. And most women don't have male family members with breast cancer. I did, my brother finally succumbing to it.

Often there is a drop-off in survival between five and 10 years. I beat those odds both times. To my immense pleasure, and to the encouragement of women everywhere, I have proved the statistics: Breast cancer is one of the most survivable cancers there is, with a five-year relative survival rate of 89 percent in 2009. In 1979, it was 74.9 percent; 15 years later, in 1994, it was 86.6 percent.

What can you do to reduce your risk? Keep a healthy weight (fat stores estrogen) and limit the alcohol: one drink or fewer a day.

Early detection is high on the list of survival. We are so fortunate to have machines that look through flesh and see tiny tumors. President John Adams' only daughter, “Nabby,” died of breast cancer in 1813. She was 48. There were no mammography machines for Nabby. No ultrasounds or MRIs. Breast self-exam undoubtedly would have been frowned upon. Nutrition? No knowledge.

No one steers your health ship but you. Just think: If you don't avail yourself of mammograms, you are no better off than poor Nabby in 1813. “Busyness” is an excuse, not a reason. If you don't do it for yourself, do it for the people who care for you, some of them small dependent creatures.

The biggest deterrent to a woman surviving breast cancer? Late diagnosis, says Dr. James Ingle. He's co-director, along with Dr. Lynn Hartmann, of the Women's Cancer Program at Mayo Clinic, Rochester, Minn.: “Some early diagnoses behave badly,” he notes, “but still, the key to survival is early diagnosis.”

Another view: Hartmann thinks it is the intrinsic ability of some cancer cells to escape a chemotherapy or hormone barrage.

Hartmann says what excites her about the future is the identification of the “drivers of breast cancer ... identifying the genetic underpinnings of the different subtypes and designing specific therapies to zero in on them.”

As we approach 2010, Ingle reflects: “My optimism is more than it was in 2000 because I see the technology accomplished in mapping out the whole human genome, the foundation of human life ... . We've spent most of our time looking at characteristics of the tumor. In pharmacogenomics we are looking at the characteristics of the host, the patient. We are gaining a great deal of knowledge of both the cancer and how patients respond to treatment. There are a lot of promissory notes out there, but we are clearly heading in the right direction.”

Which means: We've come a long way, baby, since 1979.

Shirley Ruedy is a survivor of breast (twice) and endometrial uterine cancer, and for 16 years wrote The Gazette's former “Cancer Update” column. Shirley attributes her survival to vigilance, expert care from Mayo Clinic, and good luck. She says having a bilateral (double) mastectomy has its perks: Now she can be any chest size she wants.

Breast care help

l Eastern Iowa is a resource-rich area for women in need of financial assistance with breast care and mammography costs:

l Especially for You: For financially disadvantaged women who use health care facilities in the Cedar Rapids area. Women from Linn, Johnson, Benton, Cedar, Iowa, Jones and Tama counties are eligible for free screening, diagnostic mammograms, ultrasounds and other breast-related procedures at the site of their choice in Cedar Rapids, or Mercy's Mobile Unit. Information: Mercy Women's Center (319) 398-6821 or 1- (800) 626-6826.

l Care for Yourself: The Iowa Breast and Cervical Cancer Early Detection Program: No-cost cancer screening tests to uninsured, underinsured women with qualifying household incomes ($27,075/one person, add $9,350 for each additional person). Women must be older than 40, fit the above guidelines or be unable to pay deductibles/co-payments. Information: (319) 892-6081 or 1-(800) 369-2229.

l Susan G. Komen Fund: For qualified Eastern Iowa women needing mammograms, additional views and ultrasounds. Underwritten by the Des Moines affiliate. Information: (319) 892-6081.

l In Johnson County: For free screening and diagnostic mammogram information, call Donna Warner at the Visiting Nurse Association, (319) 337-9686, Ext. 155, or toll-free 1-(866) 862-6877, Ext. 155.