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Trying to Figure Out Why

Posted 11/27/2015

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  Here is the short answer: Unless you carry a known gene mutation that is associated with cancer risk (e.g. BRCA1 or BRCA2) or have been a smoker or worked with asbestos or have been a combination heavy smoker and heavy drinker (and in none of these cases is cancer a certainty), there is really no answer to the question: "Why did I get cancer?"

  The fact that there is no answer surely does not keep most of us from nights of pondering the unknowable and trying to come up with an explanation. If we knew why, some of the thinking usually goes, we might be a bit more in control of keeping it away in the future. Over and over I tell people that this train of thought and worry is a complete waste of time and energy, but that does not stop it, and many of us have a pet theory. One of my favorites was the woman who told me that her puppy stepped on her breast, and that caused breast cancer.

  All you have to do is glance at the popular press or listen to some of your less tactful friends to hear some suggested explanations: you didn't handle stress or anger well; you ate too many desserts; you grew up on Long Island where there is a known high rate of breast cancer. Nope, none of those things explain it. Nor do you ate not enough broccoli or used antiperspirants or heated your food in the microwave in the wrong kind of container. And certainly God is not punishing you for a past sin.

  The fact is that no one can explain what causes cancer (except in a few cases), and it is a highly complicated biological process at the cellular level in which a whole cascade of things need to go wrong--a perfect storm of mistakes, if you will. Nature has built in a number of checks and balances, and they all have to fail. Please believe this and stop blaming yourself for anything that you did or did not do. Believe the truth: shit happens.

  This article from Psycho-Oncology examines peoples' beliefs in cancer causality. I give you the abstract and the start. I can't link to the whole article, but, if you want it, email me, and I will send it along:

.The ‘cause’ of my cancer, beliefs about cause among breast cancer patients and survivors who do and do not seek IO care

M. Robyn Andersen1,2*, Kelsey Afdem1, Shelly Hager1, Marcia Gaul1, Erin Sweet3 and Leanna J. Standish3
1Molecular Diagnostics Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
2School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
3Bastyr University, Kenmore, WA, USA

Objective: We sought to describe survivors’ beliefs about the cause of their breast cancer and to test
the hypothesis that beliefs about cancer’s cause are associated with treatment preferences in accordance
with the common sense model of self-regulation of health and illness.
Methods: Breast cancer survivors (n = 552) participating in an observational study of cancer outcomes
responded to an open-ended question about the cause of their cancer. Of these, 245 women
had sought treatment from complementary and alternative integrative oncology (IO) clinics, and
307 women did not.
Results: Women frequently described theories for their cancer’s cause including genetics and family
history (31%), stress and coping (31%), toxins and chemicals (27%), a variety of lifestyle and epidemiological
risk factors, and randomness (17%). Self-reported beliefs about cancer’s cause differed
among women in association with their use of IO. IO users were somewhat more likely to describe
stress and poor coping as causes of their cancer and less likely to describe random chance as a cause
of cancer (p<0.05).
Conclusions: Beliefs about the cause of cancer change over time and may predict decisions to use
specific treatment including complementary and alternative medicine and IO.

And the beginning of the article:

There has been considerable interest in how patients attribute
the ‘cause’ of their cancer, their beliefs about ‘why’
they became ill. There is also continuing scientific discovery
around both established and newly discovered additional
risk factors for cancer. New findings around
genetics, stress, exposures (hormone replacement therapy
(HRT), pollution, plastics, etc.), diet, and exercise may
be providing women with many additional risk factors to
consider as potential ‘causes’ of their cancer [1–6]. Beyond
this, recent years have seen greatly increased interest
in complementary and alternative medicine (CAM) approaches
to cancer treatment including the development
of a national board certification for naturopathic doctors
(NDs) specializing in cancer care (Fellow of the American
Board of Naturopathic Oncology), and integrative oncology
(IO) clinics led by ND where CAM treatments for
cancer are offered. Between 50% and 80% of women with
breast cancer include CAM in their cancer care plans [7],
and perhaps 7% actually seek an ND as part of their treatment


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