We all know about the wicked stepmother in the story of Cinderella, and how she orders poor Cinderella to do the cleaning and household chores. The role of the wicked stepmother in the Broadway musical Cinderella has just been taken over by one of America's most iconic actors, Fran Drescher, who is best known as The Nanny.
But Fran Drescher's much more important legacy for all of us will probably be as the founder of Cancer Schmancer, a non-profit organization dedicated to early diagnosis and prevention of women's cancers. As a past board member of Cancer Schmancer at its inception and as a continuing member of its medical advisory board, I know the educational advice and lobbying activities of Fran, her staff and volunteers will have a beneficial effect on cancer prevention and control.
How did Fran come to this important role as patient advocate? Fran's story is told by her in her autobiographical book Cancer Schmancer and also retold by her in the foreword to my book Surviving American Medicine. After having abnormal vaginal bleeding, Fran promptly sought the advice of physicians. But having tests and therapy, the bleeding did not improve. So Fran looked for a second opinion... and then a third... and then more. Finally after her eighth opinion, Fran got the correct diagnosis of cancer of the uterus. She had her surgery just in time, before the cancer had become larger and spread, and has been cancer-free since then. Being very upset about the lack of a prompt diagnosis and the threat of needing additional treatments (chemotherapy and radiation) for larger tumors, and even premature death as a consequence of late cancer diagnosis in many patients, Fran started her advocacy organization Cancer Schmancer.
Here is where the intersection of her role as Cinderella's stepmother and cancer prevention is fortuitous. Many household cleaners as well as cosmetics and even foods contain chemicals that are carcinogenic, cancer-producing in animals and posing a threat to people who use them. Cinderella's (and possibly also your) use of such cleaners or cosmetics might raise the risk of cancer that can be avoided by being smarter when purchasing products. Looking for products that do not have carcinogenic chemicals can increase the likelihood of remaining cancer-free. On the stage, Fran as the wicked stepmother should tell Cinderella to get on with her household cleaning BUT only use carcinogen-free cleansers. And in real life, this is just what Fran tells all of us to do through her organization Cancer Schmancer. We had all better listen to this stepmother!
So here are my tips for prevention and early detection of women's cancers:
• Know the symptoms of women's cancers and promptly see your doctor for evaluation and testing. Remember, finding cancer early (Stage I) has very high cure rates. As Fran says, Stage I IS the cure!
• If you have symptoms of women's cancer, and the symptoms do not get better with treatment, get a second opinion. I discuss how and where to get second opinions in my book Surviving American Medicine, and I use Fran's personal story (discussed in the book) as an example of how important second opinions are in diagnosing and correctly treating disease. Again, listen to your favorite wicked stepmother Fran. Incidentally, Fran wrote the foreword to my book, and her story is very compelling.
• Discuss preventing women's cancers (and all cancers of course) with your physicians. With reforms in the Affordable Care Act, prevention and screening are now covered services paid for by insurance. Be sure to discuss mammography (see my piece on Shirley Temple and mammography), breast ultrasound or MRI, pap smears and HPV testing, HPV vaccinations, transvaginal ultrasound (TVUS) and annual CA125 testing, as well as preventive medications such as oral contraceptives for ovarian, uterine and colorectal cancers, tamoxifen or raloxifene or aromatase inhibitors for breast cancer, BRCA 1 and 2 testing or Lynch gene testing if there is a family history of cancer, and the possibility of risk-reducing surgery if you have a very high risk of cancer.
• Know about cancer-producing chemicals and products that contain them so you can make smart choices when you shop and avoid exposure at home and work.
• About one-third of cancers are linked to diet, so discuss with your doctor what diet you should be eating. Don't forget nuts, fruits and vegetables, and limiting red meat.
• Now, what if your doctor does not know the answers to your questions about screening, prevention and gene testing? Even if you have no symptoms, it's time for a second opinion about prevention from an oncologist who is familiar with and committed to prevention. Keeping you healthy should be your number one priority.
Let's be thankful for all the celebrity health advocates who have discussed their health challenges and reminded us of getting the best health care to prevent, diagnose and cure diseases. From Shirley Temple (the first) to Fran Drescher, they truly deserve to be called our stars.