By Gwen Darien
Running the Risk
By Gwen Darien
One of the embarrassing stories my mom likes to tell from my toddler years is the time I ran out of the pediatrician’s office naked and was almost to the street before she could catch me. A few decades later, it would have required an extraordinary crisis for me to go outside without clothes on. Nonetheless, I was certainly considering dashing into the street in a hospital gown before the doctor could begin my first colonoscopy a few weeks ago.
Having turned 50 this year, I knew it was time to schedule a colonoscopy. I don’t think many people look forward to this test. Because I am a cancer survivor, any doctor’s visit—particularly for a cancer screening—makes my heart race. But the staff at Philadelphia’s Penn Presbyterian Medical Center, from the receptionists to the doctors, was warm and reassuring. The gastroenterologist was friendly and confident as he patiently told me what to expect. In the procedure room, when I told the nurse anesthetist how nervous I was, he began explaining what he was doing in a kind and soothing voice. Soon, I closed my eyes. When I opened them, the procedure was over. The report, which indicated a normal colonoscopy, was in my hands, and I felt fine. I won’t pretend that the prep the night before was fun. It wasn’t. But the procedure itself was easy.
There is much we can do to reduce our risk of primary and secondary cancers, even while there is still much we can’t do. This special issue of CR addresses some of the most pressing current issues in cancer prevention—from the difficult choice René Syler faced in deciding to have a prophylactic mastectomy to resources for smokers who want to quit. We also take a look at some of the promising medical prevention interventions on the horizon, as well as lifestyle choices that could reduce cancer risk.
Unfortunately, we frequently can’t prevent cancer, nor do we ever know precisely why we got it. Perhaps, as a survivor and a patient advocate, I am overly sensitive to the subtle blame-the-victim messages in many public health campaigns about disease prevention. As I’ve written in these pages before, too commonly people are asked, “What do you think you did to get your cancer?” Even if the question is a talisman the questioner is using to feel safe—to find a reason that he or she won’t develop cancer—it still stings.
Yet, I am committed to doing all that I can to prevent these diseases on a societal and individual level. Nationally and globally, research on the science of cancer prevention is critical. In "Finding Solutions for Screening," Nancy Roach and Electra Paskett illuminate the health disparities that persist in access to screening and vaccines for colorectal and cervical cancer. Access for all to proven risk reduction aids, such as screening, vaccines and healthy food, is the only moral approach society can take to reduce these disparities.
As individuals, we can reduce our risk of cancer by starting where we are. In "An Ounce of Prevention …," Tim Byers points out that people “shouldn’t get discouraged that the mountain is too high to climb.” Begin with modest lifestyle changes; these do have an effect on your risk. Moreover, we can get screened for cancer with tests that can reduce our risk. I’m happy I didn’t run out in my hospital gown, or put off my colonoscopy because I was scared. We should all take responsibility to reduce our risk of cancer when we can, without fear of blame if we are diagnosed. Achievable goals that challenge us to do better—collectively and individually—are the most effective and lasting cancer risk reduction we have.