A look at the cancer statistics published by the American Cancer Society reveals good news and bad. First, the bad news: in the past 30 years, women have broken all previous records for deaths due to lung cancer, with a 440% increase since 1960! This disease is hard to detect until it has reached advanced, usually incurable stages and there's been little progress in lung cancer treatment, bad news indeed. Now, on the bright side: 90% of all cases (estimated 70,000 new lung cancers in women in 1993) are caused by cigarette smoking, a reversible cause. Even the accumulated damage to the linings of air passages due to years of smoking, will heal once the offensive fumes are avoided. The message to health-minded women is simple: quit smoking! We know it's not easy, but the rewards are great. Quitting smoking includes avoiding "second-hand smoke", since we have proof that it causes cancer and other lung disorders in non-smokers, who spend time in the presence of smokers.

For most other cancers afflicting women, good news prevails. Cancers of the stomach, liver and colon-rectum area are claiming 30-60% less lives now, compared to 30 years ago, probably due to our decreased consumption of the cancer-causing food preservatives sodium nitrate and sodium nitrite. Uterine and cervical cancers are also less lethal, due to the success of early detection programs. Breast and ovarian cancers give a mixed picture: no great decline in death rates, but much more knowledge about prevention and early detection, which will help those who are motivated to heed sound advice.

Breast Cancer: is totally curable when detected at the earliest stage. Warning signs include a persistent or growing lump, thickening, swelling, dimpling, skin irritation, distortion, indentation, pain, or nipple tenderness. Of course many of these changes are not due to cancer, but a physician should be consulted if any are noticed. Careful searching for breast cancer is the best approach, and a three-part approach is recommended: (1) breast self-examination every month by all women over age 20; (2) a professional/clinical physical examination of the breast every 3 years for women age 20 to 40, and annually for women over 40. This examination should also be requested whenever a woman is unsure of her self-examination technique or if she has noticed any abnormal conditions in her breast. The physicians at Rockwood Naturopathic Associates use a breast model to help women recognize the size and feel of various types of breast lumps. (3) An essential part of breast cancer screening is mammography, recommended for all women by age 40, repeated every 1 to 2 years until age 50, then yearly after 50. Mammography is a safe and inexpensive technology which can often detect tumors too small to be felt on physical examination. Ovary, Uterus and Cervix cancer: one of the outstanding success stories in the history of cancer is the 70% decline in deaths due to uterine cancer over the past 40 years. This dramatic decrease was brought about by women and their doctors using a simple, inexpensive diagnostic procedure: the periodical pelvic exam and PAP test. This examination usually includes the breast exam, an internal examination of the shape and position of the ovaries, uterus and uterine cervix, and a sample of the surface cells from the cervix. In a woman past menopause, a sampling of cells from the lining of the uterus is also recommended if a risk of uterine cancer is present, based on her history and examination. The American Cancer Society guidelines for cancer screening will be printed in the next newsletter but copies are available upon request. We encourage all our patients to follow this schedule, and we are happy to answer any of your questions about these procedures, types of cancer, cancer prevention and therapy.

Risk Factors: a woman's personal history and family medical history may include factors related to a higher cancer risk, and therefore a greater need for cancer detection and prevention. For cancers of the breast, a close relative with breast cancer is a "risk factor." For cancers of breast, uterus and cervix, and ovary, risk increases with the number of years of menstruation, so those who started earlier and reached menopause later have a greater need for checkups. Childbearing has a cancer- preventative effect on the breasts, ovaries, and uterus, especially if the mother first gave birth before her mid-30's. Women experiencing infertility or lack of ovulation tend to have a slightly greater chance of developing cancer of the uterine lining, and those who are sexually active in their early teens or who have had many sex partners show a higher rate of cervix cancer. A history of estrogen therapy which did not include progesterone therapy during part of each month is a cause of many cases of uterine cancer.

Dr. John Collins practices in Portland, Oregon and can be reached at (503) 667-1961