Like every other woman who's been diagnosed with breast cancer, I've tried to figure out why I got it. And after years of self-scrutiny and some regret, I thought I knew the answers:
- My stressful years on the aptly named "graveyard" shift
- My two-fisted drinking
- The unfiltered cigarettes I smoked for more than a decade
- Late-in-life childbearing
- My "fat baby," the little bulge around my midrift that appeared after my second child was born
- My "naughty dinners"—consisting of desserts, period
- My Ashkenazi Jewish ancestry
- Heating food in non-microwave-safe containers
- Proximity to the World Trade Centers and the noxious fumes from the fires that burned for three months after 9/11.
It seems pretty clear why I got breast cancer, no?
Well, actually, it isn't. Those may be risk factors for breast cancer, but they're not necessarily the reasons I personally got breast cancer.
There's a wonderful video on this site with Clifford Hudis, a breast cancer expert. And he makes the point that "it is nigh impossible for almost anybody … to know why they got breast cancer unless they have the gene for it or they were radiated for Hodgkin's disease. If you don't fall into those two groups, you basically don't get to know why it happened to you as an individual."
That's because risk factors are conditions or behaviors that are correlated with a disease, but they are not proven causes.
So if I'll never know what caused my particular breast cancer, should I ignore my risk factors? My 20-year-old daughter refuses to give up any of her guilty pleasures. She says, "I'm either going to get cancer or not, and if I gave up all the fun things in life and got cancer anyway, I'd be really mad." A part of me agrees with her. I feel like a fool forgoing dessert or being the only sober person at a party. But anxiety about cancer outweighs the pleasure I might get from sweets and cocktails. So I keep a grim grip on my diet and hope that will counteract the factors I can't control like age and a history of smoking.
How do you deal with risk factors and the uncertainty about whether they played a role in your cancer?
Megan is a volunteer on SHARE's Breast Cancer Helpline.