What does it take to stay cancer-free? And what should you do once diagnosed? ESSENCE got nine smart tips from African-American M.D.'s on saving your life.
Imagine one day going to the drugstore to pick up a cancer test the same way you would a pregnancy test. Open the box and inside you'd find a tool that can detect markers in your blood associated with tumor growth. Surprisingly, this scenario is closer to fact than science fiction: "We're not too far away from something like that," says John Carpten, Ph.D., a senior investigator and director of integrated cancer genomics at the Translational Genomics Research Institute in Phoenix.
But you don't have to wait years for the tools you need to conquer cancer. From uncovering new signs for hard-to-spot diseases like ovarian cancer to using different machines such as MRIs and sonograms to detect breast cancer, there's an arsenal of weapons available to you right now to predict, prevent and prevail over this deadly disease. Here, seven top Black cancer experts reveal the hard-hitting defenses you can put up right now.
TIP #1: Figure out your risk
What factors into your chances of getting any type of cancer? Smoking (which makes you vulnerable to more than just lung cancer), not protecting yourself from sun exposure, having untreated HPV (critical when it comes to cervical cancer), your age, your diet and your family history (a biggie when it comes to breast cancer in particular). "If you have a family history of breast cancer or personal history of breast biopsies, these are red flags that your risks are increased," says Lisa A. Newman, M.D., M.P.H., associate professor and director at the University of Michigan Breast Care Center in Ann Arbor, Michigan.
Online tools can help you learn more about your risk, including the Women's Cancer Network risk assessment survey for six types of female cancers (wcn.org) and the National Cancer Institute (NCI) CARE Model risk assessment tool for breast cancer in African-American women (dceg.cancer.gov/tools/riskassessment/CARE). Whatever the results, discuss them with your M.D. Depending on your risk, he may have you supplement mammograms with MRIs or sonograms (which can better examine dense breast tissue) or devise a preventive game plan for you to follow.
TIP #2: Never be a passive patient
African-Americans have the highest death rate and shortest survival of any racial group in the United States for most cancers. "I tell women that if cancer is more aggressive in Black women, then you have to be more aggressive in taking care of yourself," says B. Lee Green, Jr., Ph.D., vice-president of the Office of Institutional Diversity at the H. Lee Moffitt Cancer Center & Research Institute in Tampa. Ask your doctor questions to try to prevent the illness, such as: "How can I avoid getting breast cancer like my mom did?" or "How accurate is the test you'd like me to take?" Take steps to prevail over cancer by asking: "Why is this treatment best for me?" and "What's a good time to call if I have questions?"
TIP #3: Know your first defense
Studies suggest one third of all cancer deaths are related to diet and obesity, which makes prevention the ultimate weapon in the war against the disease. Unfortunately, many inner-city Black women have a hard time maintaining a healthy diet rich in fresh fruits and vegetables, and low in fat, according to a report by researchers at the Johns Hopkins University in Baltimore and the University of Maryland. Whether it's an issue of access or education, we've got to try harder to turn things around.
Keep in mind that you don't have to give up all your favorite foods to eat smart. "To me, the whole idea of eating healthier means increasing fruits and vegetables," says Lucile L. Adams-Campbell, Ph.D., director of the Howard University Cancer Center in Washington, D.C. Exercise is another must-do when it comes to avoiding cancer. And smoking is a definite don't. It leads to one third of all cancer deaths. Even secondhand smoke at the club or a friend's house can harm you. Go to Smokefree.gov for help butting out.
TIP #4: Help find a cure
Even if you're not a cancer patient, now is the time to get involved with research. Participating in a clinical trial—which can be as simple as filling out a survey—helps doctors obtain accurate data on how diseases and drugs impact different groups of people. "We know that African-American women metabolize drugs in a different way than other racial or ethnic groups," says Doris Browne, M.D., M.P.H., program director in the Breast and Gynecologic Cancer Research Group in the Division of Cancer Prevention at the National Cancer Institute in Bethesda, Maryland. "Participation in clinical trials is important because it ultimately helps Black women get the care we need."
To find out if you qualify for a clinical trial, cancer-free or not, visit such Web sites as Cancer.gov/clinicaltrials (a resource for more than 6,000 cancer clinical trials) and wcn.org (Women's Cancer Network Web site). If you have cancer, you can also talk to your primary care provider about joining a trial.
Studies suggest one third of all cancer deaths are related to diet and obesity, which makes prevention the ultimate weapon in the war against the disease. "Sometimes you only get one shot at this, so you want to be sure you make the best possible decision you can [by getting a second opinion]."
TIP #5: Go with your instincts
"We as doctors know that people know their own bodies best," says Carol Brown, M.D., a gynecologic oncologist and assistant attending surgeon at Memorial Sloan-Kettering Cancer Center in New York City. "Tell your doctor if something feels wrong and you want to rule out cancer." If you're seriously concerned, tell the doctor it's urgent so you don't wait three months for an appointment. Some illnesses, like breast cancer, are less likely to appear in young Black women, but symptoms can be more aggressive when they do, so timing is everything.
Make note of any unusual occurrence that could be significant: the persistent gas and abdominal pain associated with colon cancer, the abnormal menstrual bleeding tied to endometrial cancer or the urinary urgency that was recently shown to be a possible sign of ovarian cancer.
TIP #6: Seek out a specialist
While an oncologist—that's a doctor who specializes in cancer—is a critical part of your cancer-fighting team, a 2002 study published in the Journal of Clinical Oncology found that African-Americans with lung cancer are less likely than any other race to see one. If you or someone you know is diagnosed with cancer, insist a specialist be involved with care.
And know that even within the field of oncology, there are specialists. "If you've been told you might have ovarian cancer or uterine cancer, for example, it's very important that you see a gynecologic oncologist," says Brown. "We have special training in surgery and chemotherapy focused on cancers of the ovaries, uterus, cervix, vulva and vagina." She adds that some oncologists, whether their title implies it or not, do have specialties, so you should ask about their background. "At cancer centers, some medical oncologists only treat breast cancer or only treat lung cancer," says Brown. You can find a specialist through the Women's Cancer Network Web site (wcn.org), by contacting cancer centers you'll find on the National Cancer Institute Web site, or by calling local hospitals for recommendations.
TIP #7: Get a second opinion
"Sometimes you only get one shot at this, so you want to be sure you make the best possible decision you can. You want to be clear about what all your options are," suggests Green.
Initially, you need to do your homework. "The first second opinion should be yours," advises Green, who encourages patients diagnosed with cancer to research their condition for any options their doctor hasn't mentioned. Your current doctor, a major medical teaching hospital or even friends and family can offer recommendations for other doctors. Just be sure to call your insurance company and see what its policy is. "In most cases," says Green, "particularly with surgery and cancer, the company may require you to get a second opinion."
TIP #8: Never go it alone
If you're diagnosed with cancer, don't navigate the system by yourself. You may be too overwhelmed during doctor's appointments or confused about how your health insurance works to look out for yourself. With a friend or family member by your side though, you've got someone to help write down all of your appointment times so you don't miss one, or even arrange for friends and neighbors to rotate accompanying you to chemotherapy or radiation treatments.
You're also less likely to slip through the cracks of the health-care system. "Let's say your doctor says you need a breast biopsy, but he also tells you that you have diabetes and heart disease," says Harold P. Freeman, M.D., president and founder of the Ralph Lauren Center for Care and Prevention and senior adviser to the director of the National Cancer Institute. "Before your biopsy, you'll likely see a heart disease specialist to get medical clearance. That step back, however, is how people often get lost or stuck in the system." That's why it's crucial to have someone with a sense of urgency to help push you forward through the system. If you don't have someone to help you, ask your physician if her hospital has a patient navigation program and can offer an advocate to help.
TIP #9: Keep up with chemo
While no one relishes chemotherapy (the use of chemical substances, either orally or intravenously, to treat cancer), it's crucial for survival in some cases. "Part of the difficulty is that Black women don't want to get sick or they don't want to lose their hair. Because of this they don't want to get treated, even when doctors tell them to," says Olufunmilayo I. Olopade, M.D., director of the Center for Clinical Cancer Genetics at the University of Chicago. "Some have friends who didn't have chemo, and the word out there is that chemo is poison. Black women are opting for colonics or alternative therapies instead." Since none of these alternative remedies has been proven, always do the chemo course as directed. It could save your life.
This article was originally published in the April 2008 issue of ESSENCE magazine.