There is risk in prevention messaging, not only for cancer but also for diabetes, cardiovascular disease, and other diseases. Individuals who lead healthy lifestyles risk being lulled into a false sense of immunity, with sometimes-deadly consequences. In addition, those diagnosed with so-called preventable disease risk being subject to victim blaming.
Surely, anyone diagnosed with cancer or another disease that we are told is preventable did something to cause this disease or condition, right?
Four years ago, as a 46-year old avid cyclist, jogger, vegetarian with no risk factors, it took me a good hour to believe that the chest pressure, light-headedness, mild nausea, and radiating pain in my arms and jaw might really be a heart attack. The emergency room physician could not believe it either, and it took another three hours to determine what to do with me. A positive troponin test indicating heart muscle damage from a heart attack finally convinced him to send me to a facility with full cardiac care unit, where an angiogram revealed that I had, indeed, suffered a heart attack. A spontaneous coronary artery dissection, or SCAD, a tear in the lining of a coronary artery that blocks the flow of blood to part of the heart, caused it.
SCAD is an uncommon, under-diagnosed, and 100% NON-preventable cause of heart attack. Nothing I did or did not do could have prevented my heart attack, yet in the months following, friends persisted in asking: Did you have a family history? High blood pressure? High cholesterol? They needed to hear that the heart attack was my fault, or somehow unique to me. They wanted to reassure themselves that their own healthy lifestyles, the same behaviors constantly promoted by public health and disease prevention advocates, would continue to guarantee immunity not only from heart attack but from the many other diseases, like colon cancer, which the public health community tells us are preventable.
Leading a healthy lifestyle offers tremendous benefits, but is never a guarantee. Nearly 50,000 Americans died from colorectal cancer last year. Over 130,000 will be diagnosed this year alone. I have faith that someday, ALL cancers truly will be preventable, treatable, and beatable. In the meantime, as disease advocates let’s be honest; we are not there yet. Please find a better message: one that balances fact and hope, and one that does not blame the victim.
