Mukilteo Musings

Being Married to a Toxicologist, Part 2

Four years ago my mother was diagnosed with breast cancer. My mother's cancer flipped me out; not only was I concerned about losing her, I believed this meant I too would automatically suffer the same fate. Having a calm, reassuring, and knowledgeable husband has been an incredible benefit.

My husband has a PhD in pharmacology (not pharmacy) with an emphasis in toxicology. He started out learning about and doing research into how drugs and medications are processed by the body which got him into the liver. The toxicology part got him into exposures such as natural toxins, pesticides, herbicides, arsenic, and industrial chemicals. The exposure issue led to cancer--liver cancer and then cancers of all types. The incredible mapping of the human genome has superimposed genetics over it all. (I remember more than 25 years ago my husband telling me how remarkable aspirin was and that he wouldn't be surprised if somehow someday, it would be the cure for cancer; history may yet prove him right.)

Two beliefs are mere myths and are not true:
1. My mother had breast cancer so I will get it.
2. Breast cancer is increasing because of all of these chemicals we are exposed to today.

I am at risk for breast cancer because....I am a woman. This is a fact. Because I am a woman, I have a one in eight lifetime chance of being diagnosed. The main cause of breast cancer is lifetime exposure to....estrogen. It boils down to estrogen with the complicating factor of some genes making certain women more susceptible. Also, the longer we live increases our risk of all cancers. This is why this cancer is rare in men.

Interrupting a woman's exposure to estrogen reduces the risk. Pregnancy and nursing interrupts exposure to estrogen and the earlier the better. In societies where women begin having babies early, where they nurse their babies, and where they have many babies, breast cancer is rare. In the United States, women are delaying pregnancy and they are having fewer children so breast cancer is not rare here. Reducing exposure to estrogen is also caused by late onset of menstruation, early menopause, or cycle interruptions by weight loss or extreme exercise. My risk goes above the baseline risk because I had only two children after age 30 BUT I reduced the risk by nursing (two babies) for 25 months total. I did not have periods when I nursed.

Lifestyle can increase a woman's estrogen. We now know that obesity and fat cells cause an increase in estrogen levels. Alcohol does, too. Hormone replacement therapy obviously does. Exercise probably reduces estrogen. My husband is suspicious of smoking; no scientific studies exist which connect smoking directly to breast cancer but smoking increases the risk of about every other type of cancer so it seems logical. My husband thinks it is possible that smoking somehow causes...yes, our good friend estrogen...to be increased in the same way alcohol or fat does. My mother smoked for over 40 years and she was taking hormone replacements. She had her children young, though only two babies. She nursed BUT her periods did not stop while she nursed--an interesting anecdote. And my Mom was old when she was diagnosed at age 72.

Sometimes we hear about neighborhoods where there is a "cluster" of breast cancers. The women are quick to blame the stuff in the barrels buried in the vacant lot or the spray used to control pests on their street. My husband, who knows a whole lot about the "stuff" in the barrels doesn't believe this is the culprit. More likely the women of the same socioeconomic level have had fewer children later in life--combine that with being overweight and increased alcohol consumption---throw in some hormone replacement and voila.

Of course, cancers, including breast cancer can be completely random with no apparent cause particularly in very young women or the familial gene for breast cancer can be a huge factor. I do not think we have the gene; my mother, the only smoker, is the first in my family. Furthermore, the causes of cancer are quite complicated, every individual is unique, and I do not mean to oversimplify; the scientific community realizes so much more needs to be learned and studied. But I needed my husband to explain some of the known "why's" to me. I desperately needed to differentiate myself from my mother.

The good news is that my Mom is doing well because her cancer was found at a very early stage--the key. After her treatments finished and she recovered strength, she resumed her normal life and took off to Israel and Turkey (after 9/11 so her life was probably more in danger there than from her cancer). She takes tamoxophen which according to hubby really really really works as a preventative.

As for me, I have my yearly check ups with a mammogram. I realize I am not my Mom but I need to be careful so I do not smoke, I exercise, keep my weight down, eat vegetables of all colors, eat fruit and berries, and try to drink no more than one glass of wine daily. I do not plan to take hormone replacements.

Finally, I think I am going to add low dose aspirin to my daily routine.